Neuropsychiatric and neuropsychological correlates of delusions in Alzheimer's disease

Abstract

SYNOPSISWe examined the prevalence, phenomenology, and clinical correlates of delusions in a consecutive series of 103 patients with probable Alzheimer's disease (AD). Patients were examined with the Present State Exam and the Dementia–Psychosis Scale. Twenty-one patients (20%) met DSM-III-R criteria for a delusional disorder. The most frequent delusion type was paranoid (71%), followed by hypochondriacal (67%), the Capgras syndrome (29%), house misidentification (29%), and grandiose delusions (29%). Out of the 21 AD patients with delusions, 76% had three or more different types of delusions simultaneously. The frequency of delusions was not significantly associated with age, education, or age at dementia onset, and the type and severity of cognitive impairments was similar for AD patients with and without delusions. However, AD patients with delusions had significantly higher mania and anosognosia scores.

Sintomas psiquiátricos entre pacientes com demência atendidos em um serviço ambulatorial

“…A limitação inerente a uma avaliação tão simplificada é evidente. No entanto, Migliorelli e col. 19 relataram a mesma frequência de ideação delirante entre os 103 pacientes com DA atendidos em um serviço ambulatorial especializado em Buenos Aires, Argentina. Taxas semelhantes foram descritas por outros pesquisadores 20 entre indivíduos portadores de DA vivendo na comunidade.…”

“…Além disso, não observamos diferença significativa entre pacientes com e sem ideação paranóide quanto à idade, sexo, ou escores no MMSE. Esses achados estão de acordo com os resultados observados em outros estudos 19,20 . Alguns estudos relataram que os cérebros de pacientes demenciados com delírios são mais bem preservados em medidas de tomografia computadorizada que daqueles pacientes sem esses sintomas 20,21 , o que está de acordo com os achados neuropatológicos mostrando que pacientes psicóticos têm preservação relativa no número de neurônios presentes no giro parahipocampal 22 .…”

Multidimensional Assessment of Awareness in Early-Stage Dementia: A Cluster Analytic Approach

“…The main methods of assessing awareness are general ratings of awareness based on interviews conducted by a clinician or researcher [16], calculation of discrepancies between patient and informant ratings on parallel questionnaires [17], and calculation of discrepancies between patient estimates of performance and actual task performance [18]. All have significant limitations [12,19,20].…”

Increased Neocortical Neurofibrillary Tangle Density in Subjects With Alzheimer Disease and Psychosis

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Longitudinal studies report psychosis occurring at rates of approximately 50%, 9,10,15 whereas those studies using crosssectional evaluations tend to find psychosis occurring at a lower rate. 11,13 Psychosis has a fluctuating course and recurs at a high rate with few long-term spontaneous remissions. 10,12 While several groups have examined the relationship of psychosis with other clinical variables (eg, course of illness and other behavioral and cognitive changes), few studies have examined the relationship of psychosis with the histological features of AD.…”