Relationship between Delusion of Theft and Cognitive Functions in Patients with Mild Alzheimer’s Disease

Abstract

Although delusion of theft (DT) is the most frequent type of delusion in Alzheimer’s disease (AD), its relationship to cognitive functions remains unclear. The aim of this study was to demonstrate the relationship between DT and cognitive functions in mild AD. Two hundred eighty-nine mild AD patients were enrolled in this study. These subjects were classified into three groups: patients with no delusions (ND, n=82), patients with paranoid delusions (PD, n=114) and patients with DT (n=93). Cognitive functions and their associations with the degree of delusion were compared among the three groups. The results showed that verbal Fluency scores were significantly lower in the PD group than in the DT and ND groups. Word List Recall scores were significantly lower in the DT group than in the PD and ND groups. Interestingly, delusion severity measured with the Neuropsychiatric Inventory delusion subscale correlated negatively with the Word List Recall scores in the DT group. In this study, we demonstrated that episodic memory functions in mild AD patients were associated with DT, but not with PD. Further studies might be needed to clarify the pathophysiology of delusions associated with AD.

Correlation between white matter hyperintensity and delusional symptoms in Alzheimer's disease

“…The mean rank of WMH in the non-delusional group was smaller than that in the delusional group. This suggests that WMH in the left occipital lobe may be related to the occurrence of delusional symptoms, which is partially consistent with the research results of Na HR et al [15] , it is suggest that occipital white matter changes may promotethe occurrence of delusional symptoms in AD patients.…”

“…Almost all patients with AD will develop neuropsychiatric symptoms (NPSs) [2] .Studies have found a prevalence of NPS in dementia between 50% and 80% [3] .They have been found to occur before cognitive decline [4] .Some studies have suggested that speci c NPS may be useful as early predictors of AD or dementia [5] .NPSs refers to non-cognitive mental and behavioral symptoms, which involve perception, emotion, behavior and other elds, mainly including hallucinations, delusions, depression, apathy and other symptoms [6] .Studies suggest that NPS may worsen cognitive symptoms and functional decline and have associated these symptoms with accelerated mortality [7] .Moreover, NPS can be di cult to treat [8] .While psychotropic drugs may temporarily alleviate certain NPS, some have severe and harmful effects [9,10] .Patients with dementia often report multiple NPS, and apathy, depression and anxiety are frequently found to be the most commonly reported symptoms in these patients [11,12] .Delusional symptoms are one of the highest burdens that cause pain to caregivers [13] .It is associated with greater functional impairment, malnutrition, increased risk of bedsores, and higher risk of death [11,14] .Previous studies have shown that AD patients with delusional symptoms have faster cognitive decline and more signi cant changes in language and executive function than patients without delusional symptoms [8] .Delusional symptoms in AD patients involves structural and functional changes in the brain. Studies have found that in addition to gray matter changes, white matter changes are also designed in these person, and parietal and occipital white matter changes have been shown to contribute to the development of delusional misjudgment in AD patients [15] .Several neurobiologically related factors may interact with the development of delusional disorders.For example, subcortical integrity is decreased, mainly manifested by chronic small vessel ischemia and lacunar infarction [16] .…”

“…[24] Previous studies have reported relationships between delusions and severity of white matter changes observed on MRI (Lee et al, 2006) [25] .At present the pathogenesis of cerebral white matter lesions are unclear, most of the research that deep brain white matter lesions is mainly composed of small blood vessels chronic lesions caused by chronic brain ischemia and blood-brain barrier damage to nerve bers demyelination, loss of axons, glial cell proliferationand parenchymal damage caused by [26] , and this is part of the consistency AD the source of the delusions. Parieto-occipital white matter changes have been shown to contribute to the development of delusional misidenti cation in patients with AD [15] .…”

Characteristics of very late-onset schizophrenia-like psychosis classified with the biomarkers for Alzheimer’s disease: a retrospective cross-sectional study

“…On the other hand, as shown in Table 4, all seven patients in both groups with delusion of theft scored lower than 10 on the WMS-R LM II, and all five patients in both groups with scores higher than 10 in the task did not show delusions related to theft. Although AD frequently accompanies delusions of theft (Ropacki and Jeste, 2005), patients with probable AD dementia and delusions of theft show more severe episodic memory impairment than those without similar delusions (Na et al ., 2018). Therefore, our results indicate that delusions of theft in VLOSLP may be associated with episodic memory impairment with or without AD pathology.…”

Correlation between white matter hyperintensity and delusional symptoms in Alzheimer’s disease

“…Previous studies have indicated that WMH observed on MRI of patients with AD is associated with delusions and depression [24]. WMH of the parietal and occipital lobes may impact delusional symptoms in AD patients [25,26].…”