Basal ganglia calcification and psychotic symptoms in the very old

Background. Basal ganglia calcification (BGC) is associated with psychotic symptoms in young and middle-aged patient samples. Methods. We studied the cross-sectional relationship between psychotic symptoms and BGC in a population sample of non-demented 85-year-olds, of whom 86 were mentally healthy, 11 had hallucinations or delusions, 21 had mood disorders and 20 had anxiety disorders. BGC was measured using computerized tomography (CT). Mental disorders were diagnosed using DSM-III-R criteria and psychotic symptoms were evaluated using information from psychiatric examinations, key-informant interviews and review medical records. Results. BGC on CT was observed in 19% of mentally healthy and 64% of non-demented individuals with hallucinations or delusions [Odds Ratio (OR) 7.7,95% Confidence Intervals (CI) 2.9-29.7, p = 0.003]. There were no associations between BGC and mood or anxiety disorders. Conclusions. BGC is strongly associated with psychotic symptoms in very old age, possibly due to a disturbance in the basal ganglia dopaminergic system. Copyright (C) 2003 John Wiley Sons, Ltd.