Schizophrenia typically has age of onset during late adolescence or early adulthood; yet, several patients manifest symptoms for the first time in middle or old age. These patients with late (older than 40 years) or very-late-onset schizophrenia (older than 60 years) have similar characteristics to those with early-onset schizophrenia regarding psychopathology, family history, cognitive deficits, non-specific brain imaging abnormalities, course of illness and treatment response. During the 20’th century, schizophrenic symptoms that onset after 40's are defined as “late onset schizophrenia”, “late parafreni”, “very late onset schizophrenia” or late psychoses. In those days neither ICD-10 nor DSM-IV had no separate codeable diagnoses for late-onset schizophrenia and there is no age restriction. Our patient was 70 years old woman, who was living with her sister came to psychiatric outpatient clinic with the symptoms of paranoid persecutory delusion and delusion of reference, diagnosed as a “paranoid schizophrenia” according to DSM- IV criterias. She administered paliperidone and neuroimaging and laboratory tests, neuropsychological assessments were done in the inpatient unit. A new classification would be more appropriate for such late onset schizophrenia cases which differentiate by the clinical features etiology, treatment and prognosis in DSM-V.