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Examining the presence and nature of delusions in Alzheimer's disease and frontotemporal dementia syndromes

International Journal of Geriatric Psychiatry Feb 11, 2022

Some people with dementia are reported to have abnormal beliefs and delusions. Researchers herein examined the prevalence of delusions, and their neurocognitive basis in a large, well-characterized cohort of dementia patients using a transdiagnostic, cross-sectional approach.

  • Among 487 people with dementia recruited in this study, there were 102 people with Alzheimer's disease, 136 with behavioral-variant frontotemporal dementia, 154 with primary progressive aphasia, 29 with motor neuron disease, 46 with corticobasal syndrome, 20 with progressive supranuclear palsy.

  • Delusions were reported in 48/487 patients (10.8%).

  • There appeared an increased risk of delusions in correlation with a diagnosis of behavioral-variant frontotemporal dementia (18.4%) and Alzheimer’s disease (11.8%).

  • There were 11/27 people with delusions exhibiting a positive gene mutation.

  • Performance on the Addenbrooke’s Cognitive Examination was relatively worse for individuals with frequent delusions, this was particularly evident on the orientation/attention and memory subtests.

  • In Voxel-based morphometry analyses, a correlation of increased delusional psychopathology was observed with decreased integrity of the right middle frontal gyrus, right planum temporal and left anterior temporal pole.

  • Clinically, delayed or misdiagnosis may occur because of delusions.

  • In light of these results, individuals at risk of neuropsychiatric features of dementia could be identified, a crucial first step to enable targeted symptom management.

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