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Psychosis in Neurodegenerative Dementias: A Systematic Comparative Review
Coralie Cressot1,2, Agathe Vrillon1,2, Matthieu Lilamand1,3
1Université Paris Cité, UMRS 1144, INSERM, Paris, France.
Journal of Alzheimer'S Disease : JAD
|April 26, 2024
Summary
Psychotic symptoms like delusions and hallucinations are common in Alzheimer's disease (AD) and other neurodegenerative dementias (ND). Different ND types exhibit distinct psychosis patterns, aiding differential diagnosis.
Area of Science:
- Neurology
- Psychiatry
- Gerontology
Background:
- Psychosis, including delusions and hallucinations, frequently complicates Alzheimer's disease (AD) and other neurodegenerative dementias (ND) such as dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD).
- These psychotic symptoms present significant diagnostic and management challenges for clinicians.
- Understanding the variations in psychosis across different ND is crucial for patient care.
Approach:
- A systematic review adhering to PRISMA guidelines was conducted.
- The review analyzed 98 original studies, encompassing 40 cohort studies and 57 case reports.
- The focus was on investigating psychosis phenotypes within neurodegenerative dementias.
Key Points:
- Prevalence of psychosis in ND varies: AD (22.5-54.1%), DLB (55.9-73.9%), FTD (18-42%).
- DLB commonly features misidentification delusions and visual hallucinations.
- AD and FTD show tendencies towards paranoid ideas and somatic preoccupations, respectively.
Conclusions:
- Neurodegenerative dementias are associated with distinct psychotic phenotypes, reflecting underlying disease-specific patterns.
- Further research into early-stage psychotic manifestations in ND is essential.
- Enhanced understanding of these early symptoms can improve differential diagnosis.
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