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Published on: February 8, 2019
Delusions and behavioral disturbances in cognitively impaired elderly persons
M S Lachs1, M Becker, A P Siegal
1Department of Medicine, Yale University School of Medicine, New Haven, CT.
Objective:
To compare cognitive function and the prevalence of selected behavioral problems in delusional and non-delusional dementia patients.
Design:
Retrospective medical record review.
Setting:
An outpatient geriatric assessment center.
Participants:
114 consecutive patients with dementia.
Main Outcome Measures:
Delusions as recorded in a consultation report.
Results:
Delusions were described in 25.5% of patients. A variety of behavioral disturbances were more common in delusional than non-delusional patients, including agitation, angry or hostile outbursts, urinary incontinence, wandering or pacing, and insomnia. While cognitive function as measured by the MMSE was similar in delusional and non-delusional patients (18.9 +/- 3.8 and 19.2 +/- 5.9, respectively), there was a statistically borderline tendency for delusions to occur more often in patients in the mid-range of cognitive impairment (17 less than or equal to MMSE less than or equal to 23) compared with patients with greater or lesser degrees of cognitive impairment (32% vs 17% respectively).
Conclusion:
Delusions in dementia are associated with a variety of behavioral problems. Further studies are needed to clarify the role of delusions in the development of disruptive behaviors in dementing illness.
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