Auditory Hallucinations as the First Symptom of Alzheimer´s Disease - A Case Report

Neuropsychiatric symptoms frequently occur in patients with Alzheimer´s disease (AD); apathy, depression, delusions, optical hallucinations, anxiety, and agitation often appear as first symptoms of AD, while auditory hallucinations have never been described as the first symptom. In this case report, we describe a case of a woman who had auditory hallucinations as the first symptom of AD.

An 85-year-old woman was admitted to our hospital suffering from imperative auditory hallucinations without subjective and minimal objective memory complaints. Further diagnostics with an MRI scan, neuropsychological tests, and an analysis of cerebral spinal fluid were accomplished. AD was confirmed during the hospital stay, suggesting auditory hallucinations as the first symptom of AD. She was temporarily treated with risperidone, which improved the hallucinations.

Auditory hallucinations in older age could be the first symptom of AD and even occur before cognitive decline.