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[Delirious states in elderly persons. Clinical characteristics]
1Département de médecine et de gérontologie, CH de Courbevoie-Neuilly, 30, av. Kilford, 92401 Courbevoie. mp.pancrazi@wanadoo.fr
Presse Medicale (Paris, France : 1983)
|July 15, 2003
Summary
Delusional disorders in the elderly exhibit significant heterogeneity, differing from younger adults due to onset age, causes, and behavioral outcomes. Diagnosis requires differentiating from confusion, considering age-related vulnerabilities and specific assessment tools.
Area of Science:
- Geriatric Psychiatry
- Neuropsychology
- Psychopathology
Context:
- Delusional disorders in the elderly present unique nosological challenges compared to younger populations.
- Heterogeneity arises from varying symptom onset, etiology, and behavioral consequences like agitation.
- Two distinct contexts are identified: long-term psychoses and late-onset delusions (after age 60).
Purpose:
- To explore the heterogeneity and distinct contexts of delusional disorders in the elderly.
- To identify enhancing factors and diagnostic considerations for late-onset delusions.
- To differentiate delusional disorders from mental confusion in geriatric populations.
Summary:
- Elderly delusional disorders are heterogeneous, influenced by age of onset, etiology, and behavioral impact.
- Late-onset delusions (post-60) have diverse causes, including dementia, vascular disorders, and sensory deficits, often indicating underlying deterioration.
- Vulnerability factors include somatic comorbidity, loneliness, sensory deficits, cognitive impairment, and polypharmacy.
Impact:
- Highlights the need for tailored diagnostic and treatment approaches for elderly patients with delusional disorders.
- Emphasizes the importance of identifying underlying causes for de novo delusions after age 65.
- Informs differential diagnosis by distinguishing from mental confusion using specific assessment scales (SANSS, PANSS, PDI, NPI).