Hallucinations, delusions, and cognitive decline in Alzheimer's disease

被引:110
作者
Wilson, RS
Gilley, DW
Bennett, DA
Beckett, LA
Evans, DA
机构
[1] Rush Alzheimers Dis Ctr, Dept Neurol Sci, Chicago, IL 60612 USA
[2] Rush Inst Healthy Aging, Chicago, IL 60612 USA
[3] Rush Univ, Dept Med, Chicago, IL 60612 USA
[4] Rush Univ, Dept Psychol, Chicago, IL 60612 USA
[5] Rush Presbyterian St Lukes Med Ctr, Chicago, IL 60612 USA
关键词
Alzheimer's disease; hallucinations; cognitive decline;
D O I
10.1136/jnnp.69.2.172
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives-To examine the occurrence of hallucinations and delusions in Alzheimer's disease over a 4 year period and their association with rate of cognitive decline. Methods-A cohort of 410 persons with clinically diagnosed Alzheimer's disease underwent annual clinical evaluations over a 4 year period. Participation in follow up exceeded 90% in survivors. Evaluations included structured informant interview, from which the presence or absence of hallucinations and delusions was ascertained, and detailed testing of cognitive function. The primary cognitive outcome measure was a composite cognitive score based on 17 individual performance tests. The mini mental state examination (MMSE) and summary measures of memory, visuoconstruction, repetition, and naming were used in secondary analyses. Results-At baseline, hallucinations (present in 41%) and delusions (present in 55%) were common and associated with lower cognitive function. In analyses that controlled for baseline level of cognitive function, demographic variables, parkinsonism, and use of antipsychotic medications, hallucinations, but not delusions, were associated with more rapid cognitive decline on each cognitive measure. In the primary model, there was a 47% increase in the average annual rate of decline on a composite cognitive measure in those with baseline hallucinations compared with those without them. This effect was mainly due to a subgroup with both auditory and visual hallucinations. Conclusion-These findings suggest that the presence of hallucinations is selectively associated with more rapid cognitive decline in Alzheimer's disease.
引用
收藏
页码:172 / 177
页数:6
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