title: Hallucinations and mortality in Alzheimer disease.
abstract: OBJECTIVE
  The authors tested the relationship of hallucinations and delusions to mortality in Alzheimer disease (AD).
  
  
  METHODS
  A group of 407 persons with clinically diagnosed AD completed a uniform clinical evaluation, after which vital status was monitored for a mean of 3.7 years. At the initial evaluation, a previously established, structured, informant interview was used to ascertain the presence of hallucinations and delusional thinking. The evaluation also included a structured medical history, inspection of all medications, and detailed assessment of cognitive functioning and parkinsonian signs.
  
  
  RESULTS
  At study onset, hallucinations were present in 41.0% of participants and delusions in 54.4%. During follow-up, 146 deaths occurred. In a proportional-hazards model adjusted for age, sex, race, and education, hallucinations were associated with a 78% increase in risk of death. The association was not substantially altered in subsequent analyses that controlled for level of cognitive impairment, severity of parkinsonism, use of antipsychotic medications, and the presence of chronic medical conditions. Risk of death was more than doubled in those with both auditory and visual hallucinations. By contrast, we did not find evidence of an association of delusions with mortality.
  
  
  CONCLUSIONS
  Hallucinations are associated with an increased risk of death in AD.
authors.affiliation: Rush Alzheimer's Disease Center, Dept. of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA. rwilson@rush.edu
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wilson
authors.forename: Kristin R
authors.initials: KR
authors.lastname: Krueger
authors.forename: Julia M
authors.initials: JM
authors.lastname: Kamenetsky
authors.forename: Yuxiao
authors.initials: Y
authors.lastname: Tang
authors.forename: David W
authors.initials: DW
authors.lastname: Gilley
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
authors.forename: Denis A
authors.initials: DA
authors.lastname: Evans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000401:mortality*; D002641:Chicago; D003072:Cognition Disorders / Q000175:diagnosis / Q000401:mortality; D003702:Delusions / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008297:Male; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000401:mortality; D012306:Risk; D013223:Statistics as Topic; D016019:Survival Analysis