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The Epidemiology of Psychosis in Dementia

Received March 14, 2001; revised January 30, 2002; accepted January 30, 2002. From the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD (IL,JCSB,CGL), the Center for Mental Health and Department of Psychiatry, University of Athens, Athens, Greece (AV), and the Department of Mental Hygiene, Johns Hopkins University, School of Public Health, Baltimore, MD (JCSB,CGL). Address correspondence to Dr. Leroi, Osler 320, The Johns Hopkins Hospital, 600 North Wolfe St., Baltimore, MD 21287.

OBJECTIVE: Authors compared delusions, hallucinations, and misidentification delusions in Alzheimer disease (AD) and vascular dementia (VaD) patients. METHODS: The authors report data on the prevalence, severity, clinical, and demographic associations of these symptoms in a population sample of 260 persons with dementia, examined with the Neuropsychiatric Inventory. RESULTS: The primary finding was that there was no difference in psychosis as a whole, or in delusions and hallucinations, between AD and VaD. Also, in AD, female gender appeared to be a risk factor for delusions; subjects in an earlier stage of dementia showed fewer delusions. CONCLUSION: The profile of delusions and hallucinations seen is different from that seen in schizophrenia, further supporting the hypothesis that AD-associated psychosis is a distinct phenomenological syndrome.

Key Words: Dementias (general) • Psychosis • Epidemiological Studies

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