Marc E. Agronin

Personality disorders in late life. Understanding and overcoming the gap in research.

A review of the literature on personality disorders (PD) in late life reveals fewer research papers than those found for PD in younger adults and for other major late-life psychiatric diagnoses. The authors suggest that this gap is largely due to the difficult and inconsistent diagnostic process for late-life PDs. Diagnosis is complicated by the frequent unavailability and/or unreliability of longitudinal data, lack of age-adjusted diagnostic instruments, and failure of the current Axis II nosology to account for age-related issues, including changes in social functioning, and the effects of comorbid illness and cognitive impairment. They propose that the development of a geriatric subclassification for PD, along with improved clinical documentation of personality and data from dimensional instruments for both normal and pathologic personalities, would provide a more reliable, valid, and geriatric-friendly diagnostic process.