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Psychosis associated with dementia: evaluation and management.
Rajesh R Tampi1, Pallavi Joshi2, Dilip V Jeste3
1Department of Psychiatry, Creighton University School of Medicine, 7710 Mercy Road, Suite 601, Omaha, NE 68124, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA.
Schizophrenia Research
|May 4, 2025
Summary
Psychosis in dementia affects over half of patients, presenting diagnostic challenges. This review evaluates epidemiology, neurobiology, and treatment options, including psychosocial interventions and medications, to improve care.
Area of Science:
- Neuroscience
- Geriatrics
- Psychiatry
Background:
- Dementia is a prevalent neurodegenerative disorder.
- Psychotic symptoms occur in 34-63% of individuals with dementia.
- Neurobiological factors include increased plaque/tangle densities and D3 receptor density.
Purpose of the Study:
- To provide a comprehensive evaluation of psychosis in dementia.
- To cover epidemiology, neurobiology, diagnosis, and treatment strategies.
- To offer a framework for improving diagnosis and treatment.
Main Methods:
- Comprehensive literature review.
- Evaluation of psychosocial and pharmacological interventions.
- Synthesis of current evidence and clinical guidelines.
Main Results:
- Psychosocial interventions like communication and environmental simplification can reduce psychosis impact.
- Cholinesterase inhibitors, antidepressants, and antipsychotics show modest efficacy.
- Antipsychotics carry risks of adverse effects; emerging therapies show promise.
Conclusions:
- Diagnosis of psychosis in dementia is challenging due to symptom overlap and lack of specificity.
- A combination of psychosocial and pharmacological approaches is necessary.
- Further research and refined strategies are needed to improve patient care.
Keywords:
AntipsychoticsCholinesterase inhibitors (ChEIs)Electroconvulsive therapy (ECT)Neuropsychiatric symptomsRepetitive transcranial magnetic (rTMS)More Related Videos
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