The number of older adults living with schizophrenia is increasing and includes those who have had the illness since an early age and those who developed it later in life. Cognitive dysfunction is a core dimension of schizophrenia. Current literature suggests that older adults with schizophrenia who have been chronically institutionalized experience accelerated cognitive decline. In contrast, those living in the community seem to experience a relatively stable course of cognition. However, given that most of the community-based studies were short in duration or small in size, a more heterogeneous and fluctuating course of cognition consistent with a dynamic clinical course late in life cannot be ruled out. To date there is no evidence to support cognitive enhancement intervention, pharmacological or not. There is, however, evidence to support the use of psychosocial interventions to enhance functional abilities directly. Thus, larger and longer studies that could characterize the heterogeneity in cognitive trajectories are needed. They will also identify the factors that moderate these trajectories and could be targeted using cognitive enhancement interventions.