Factors associated with psychotic symptoms in Alzheimer’s disease
- Nobutsugu Hironoa,
- Etsuro Moria,
- Minoru Yasudab,
- Yoshitaka Ikejiria,
- Toru Imamuraa,
- Tatsuo Shimomuraa,
- Manabu Ikedaa,
- Mamoru Hashimotoa,
- Hikari Yamashitaa
- aDivision of Clinical Neurosciences, bDivision of Basic Neurosciences, Hyogo Institute for Aging Brain and Cognitive Disorders, Himeji, Japan
- Dr Nobutsugu Hirono, Division of Clinical Neurosciences, Hyogo Institute for Aging Brain and Cognitive Disorders, 520 Saisho-ko, Himeji, 670 Japan. Telephone 0081 792 95 5511; fax 0081 792 95 8199; emailhirono{at}hiabcd.go.jp
- Received 2 April 1997
- Revised 14 October 1997
- Accepted 16 October 1997
Abstract
OBJECTIVES Many clinical and biological factors have been reported to be associated with the presence of psychosis in patients with Alzheimer’s disease, although the associations were variable. The aim of this study was to clarify factors associated with the presence of psychosis in patients with Alzheimer’s disease.
METHODS Psychiatric functioning was studied in 228 patients with Alzheimer’s disease based on the results of the behavioural pathology in Alzheimer’s disease rating scale or the neuropsychiatric inventory. The effects of sex, education level, age, duration of illness, cognitive function, and apolipoprotein E genotype were investigated for dichotomous psychotic status with a multiple logistic regression analysis.
RESULTS Of the 228 patients with Alzheimer’s disease, 118 (51.8%) showed evidence of delusions or hallucinations. Of these, 94 had delusions only, three had hallucinations only, and 21 had both. Older age, female sex, longer duration of illness, and more severe cognitive impairment were the factors independently associated with the presence of psychosis. The presence of psychosis was not significantly related to either educational level or apolipoprotein E genotype.
CONCLUSIONS Age, sex, and severity of illness were independent factors associated with the presence of psychosis in patients with Alzheimer’s disease. The reason why some patients with Alzheimer’s disease develop psychosis remains unclear. There may be distinctive subtypes of Alzheimer’s disease or the presence of individual factors which affect the development of psychosis.
