In a small minority of people who have schizophrenia, it starts not at the usual age of between 25 and 35 but, instead, around the 40s. There's also a very late-onset schizophrenia that tends to start around the 60s. This is more frequently occurring in women, and around the post-menopausal period, so after they've had their menopause. So, there are some theories that involve the effects of estrogen withdrawal on leading to the onset of schizophrenia at that time.
People who develop late-onset schizophrenia more often have a hearing or visual deficits, which we think maybe leads to a higher likelihood of paranoia, and that's why it sort of comes on at that time. They also may have had, before becoming ill, a tendency to have some paranoid ideas about people or to be more withdrawn than the average person. So, those are some of the risk factors for late-onset schizophrenia.
People who have late-onset schizophrenia, compared with people of earlier-onset schizophrenia, tend to be a little bit more paranoid. It's primarily that they develop paranoid delusions about other people wanting to hurt them or plotting against them.
The good news about late-onset schizophrenia is that usually it responds to lower doses of medications, and so it's more regularly treated with support and medications.