# Trajectories of Aging in Psychotic Disorders Over 27 Years

> **NIH NIH R01** · STATE UNIVERSITY NEW YORK STONY BROOK · 2020 · $901,410

## Abstract

Life expectancy is approximately 20 years shorter in schizophrenia and 10 years shorter in mood disorder with
psychosis than in the general population, which is almost entirely due to natural-cause mortality. One
proposed explanation is that psychotic disorders are associated with accelerated aging. Substantial evidence
indicates that this population experiences premature declines in three functional domains: internal (i.e., age-
related medical disorders), cognitive, and physical. However, it is unknown whether these declines are
explainable by exposure to risk factors highly elevated in psychotic disorders (obesity, poverty, smoking, low
physical activity, poor diet, inadequate medical care, etc) or are also due to pathophysiology of psychosis itself.
Indeed, biological processes associated with psychosis—genetic, neural (P3 and mismatch negativity), and
allostatic load (metabolic problems, increased inflammation, hypothalamic-pituitary-adrenal axis dysregulation,
and hypertension)—were found to predict accelerated aging in the general population, but this has not been
tested in psychotic disorders. Moreover, it remains uncertain when accelerated aging starts and how rapidly it
progresses, as prior studies typically began with older patients. Prevention of premature aging in psychotic
disorders would extend life and improve health of millions of people, but it is unclear how to target such efforts,
because fundamental information is lacking on trajectories of aging and their determinants in psychosis. The
Suffolk County Mental Health Project (SCMHP; MH094398) offers a unique opportunity to fill these crucial
gaps. It is the only US epidemiologic study designed to examine health, cognition, and physical performance in
psychotic disorders over 27 years following first admission (from mean age 30 to 57). In addition, the study has
gathered a wealth of information on premorbid risk factors. It also includes a geographically and
demographically matched never-psychotic comparison group. Thorough assessments of cases were done 6
times during the first two decades. At Year 20 (mean age 49), both case (N=385) and never-psychotic (N=261)
groups completed a comprehensive psychiatric evaluation, medical history, physical performance tests,
anthropometric exam, cognitive testing, event-related potentials battery, assays of blood samples, and
genotyping. The present proposal is to reassess cases and never-psychotic participants at ages 54 and 57 to
trace divergence of aging trajectories during a pivotal period (age 49 to 57, when medical morbidity is expected
to double and cognitive and physical functioning begin to decline) and identify risk factors and biological
vulnerabilities that help to determine what path aging takes. This innovative design will enable us to clarify
when and why aging is accelerated in psychotic disorders, and where interventions can be applied most
productively to extend life expectancy and health of this population.

## Key facts

- **NIH application ID:** 9994368
- **Project number:** 5R01MH110434-05
- **Recipient organization:** STATE UNIVERSITY NEW YORK STONY BROOK
- **Principal Investigator:** Roman I Kotov
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $901,410
- **Award type:** 5
- **Project period:** 2016-08-19 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994368

## Citation

> US National Institutes of Health, RePORTER application 9994368, Trajectories of Aging in Psychotic Disorders Over 27 Years (5R01MH110434-05). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9994368. Licensed CC0.

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