The etiology of geriatric schizophrenia is not singular, but rather multifactorial and complex. Many patients can have qualitative problems, somatic disease problems, personality problems, environmental problems, mental frustration problems, life problems, etc. It is difficult to determine which problem is the important or major factor and which factor is related to the onset of symptoms. It is now generally accepted that various factors act in combination with each other in terms of timing and dynamics, and are possible etiological factors of schizophrenia. I. Genetic factors Systematic family lineage investigations over more than half a century have shown that genetic factors play an important role in the development of schizophrenia. The prevalence rate among relatives of schizophrenia patients is much higher than that of the general population, and the closer the blood relationship, the higher the prevalence rate. However, this genetic predisposition is less pronounced in older schizophrenics than in younger patients.Funding (1961) found an expected incidence of schizophrenia in children of 148 patients who developed paranoia after age 50 to be 2.5%, higher than the expected incidence of 1% in the general population.Roth (1962) reported that in 99 immediate relatives of patients with late-onset schizophrenia Kay (1963) found that among 57 patients with late-onset paranoid symptoms, 19% of the presentees had at least one relative in the family with schizophrenia, with a risk rate of 4.9% for siblings and 7.3% for children, and most relatives had an age of onset before 40 years. rabins (1984) reported that in a same-sex, same-age Kay and Roth both concluded that schizophrenia is polygenic. Many scholars have found that schizophrenia patients have some specific personality traits before the disease, such as being withdrawn, introverted, shy, sensitive, illogical in thinking, and fanciful. Most late-onset schizophrenics have a relatively intact pre-morbid personality compared to younger schizophrenics. postt (1966) concluded that very few late-onset schizophrenics had neurotic-like qualities before the illness; Retterstoll (1966) concluded that the pre-morbid personality of older schizophrenics was characterized by self-centeredness, stubbornness, bossiness, sensitivity, jealousy, diminished interest, etc. Third, psychosocial factors Older people are often physically and mentally fragile, while many psychosocial problems exist prior to geriatric schizophrenia, such as retirement, changes in social and family status, widowhood, separation of children, sexual indifference, hypersexuality, phallic spasm, and neighborhood discord. Schizophrenia patients with psychiatric factors accounted for 56.3% of the cases. Older people’s tolerance for mental frustration is decreasing, and there are more and more opportunities to encounter various kinds of psychological stress, which has an obvious impact on the disease process. The incidence of somatic diseases in the elderly is two times more than that in young people, and the restriction of movement is six times more, indicating that chronic somatic diseases have a more important impact on psychological functioning in particular throughout life. knoll (1952) believed that ovarian insufficiency has a role in inducing late onset schizophrenia, and that most menopausal women have symptoms of suspicion. blazer (1984) in a community study of the elderly Post (1966) found that 30% of those suffering from persistent paranoid symptoms had deafness, and as deafness increased, hallucinations occurred, such as hearing musical sounds or verbal hallucinations, which may be an illusion related to tinnitus. As a result, the weakening or loss of hearing and vision causes isolation from society, causing loneliness, paranoia, and a tendency to misinterpret information from the outside world, prompting schizophrenia in people who otherwise have schizoid qualities. In the elderly, as they age, brain nerve cells begin to atrophy and decrease, while often suffering from physical diseases such as coronary heart disease, hypertension, myocardial infarction, cerebral infarction, metabolic diseases, brain degenerative diseases, infections, poisoning, etc., resulting in changes in brain function, which can cause impaired neurotransmitter metabolism in the brain, thus causing schizophrenia symptoms. V. Morphological and anatomical changes in the brain With the continuous application of new technologies, such as Cr, MRI, sPECT, ECT, etc., changes in the morphology and anatomy of the brain are receiving increasing attention. Many scholars have conducted systematic studies on brain morphology in schizophrenia and found that abnormal brain structures are more common in schizophrenic patients than in normal controls. The main alterations are cortical atrophy and ventricular enlargement. The relationship between structural brain abnormalities and disease duration and age is debated, but the vast majority of studies suggest that a longer disease duration and older age are associated with a higher incidence of brain atrophy. Thus, structural brain abnormalities are a reflection of certain pathological processes in the brain and do not indicate the cause of the disease. Histopathological studies have shown that sclerosis, fatty degeneration, and vacuole formation in brain cells are seen in schizophrenia, and that changes can occur in various parts of the cerebral cortex, subcortex, and basal ganglia, with more pronounced damage in the frontal, inferior parietal, and cervical lobes in particular.