Objective:

To examine the prevalence of cognitive impairment and factors associated with cognitive impairment among elderly patients with schizophrenia, and to explore potential clinical phenotypes using a clustering approach, highlighting the significance of these phenotypes in clinical practice.

Key Findings:

• The prevalence of cognitive impairment among elderly patients with schizophrenia was 47.7%.
• Higher MSPSS total score (OR = 0.609, 95% CI: 0.469-0.791) and higher ADL score (OR = 0.553, 95% CI: 0.379-0.806) were associated with lower odds of cognitive impairment.
• Diabetes mellitus was associated with increased odds of cognitive impairment (OR = 7.735, 95% CI: 1.129-52.979).
• K-means clustering identified three phenotypes: optimal functioning, mild-to-moderate impairment, and severe impairment.

Interpretation:

Cognitive impairment is prevalent among elderly patients with schizophrenia and is influenced by social support, functional independence, and diabetes, indicating a need for tailored nursing interventions that address these factors.

Limitations:

• The study is retrospective and may have inherent biases.
• The wide confidence interval for diabetes mellitus indicates limited precision in its association with cognitive impairment.
• The sample size may limit the generalizability of the findings to the broader population of elderly patients with schizophrenia.

Conclusion:

Cognitive impairment in elderly patients with schizophrenia is significant and heterogeneous, suggesting the potential for stratified nursing management. Further prospective studies are needed to validate these findings and explore the effectiveness of tailored interventions.