Delusions and behavioral disturbances in cognitively impaired elderly persons.
OBJECTIVE
To compare cognitive function and the prevalence of selected behavioral problems in delusional and non-delusional dementia patients.


METHODS
Retrospective medical record review.


METHODS
An outpatient geriatric assessment center.


METHODS
114 consecutive patients with dementia.


METHODS
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).


CONCLUSIONS
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.
Lachs
M S
MS
Department of Medicine, Yale University School of Medicine, New Haven, CT.
Becker
M
M
Siegal
A P
AP
Miller
R L
RL
Tinetti
M E
ME
D000368:Aged; D003072:Cognition Disorders / Q000150:complications* / Q000175:diagnosis; D003237:Connecticut / Q000453:epidemiology; D003702:Delusions / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006785:Hospitals, University; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D008609:Mental Status Schedule; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires