The incidence of first-onset psychotic symptoms and paranoid ideation in a representative population sample followed from age 70-90 years. Relation to mortality and later development of dementia.
BACKGROUND
Limited data are available on the incidence of psychotic symptoms in the elderly.


OBJECTIVE
To elucidate the incidence of first-onset psychotic symptoms in the elderly and their relation to mortality and later development of dementia.


METHODS
A population-sample (n = 392) born 1901-1902 was assessed from age 70-90 with psychiatric examinations, medical record reviews and from age 85, also with key-informant interviews. Individuals developing dementia were excluded.


RESULTS
The cumulative incidence of first-onset psychotic symptoms was 4.8% (8.0% including key-informant reports in the total sample) and 19.8 % in those who survived to age 85. Sixty-four percent of those with first-onset hallucinations later developed dementia, compared to 30% of those with delusions and 25% of those without psychotic symptoms.


CONCLUSIONS
One fifth of non-demented elderly who survives up to age 85 develops first-onset psychotic symptoms. Hallucinations predict dementia, but most elderly individuals with first-onset psychotic symptoms do not develop dementia.
Ostling
S
S
The Sahlgrenska Academy at Göteborg University, Institute of Clinical Neuroscience and Physiology, Psychiatry Section, Unit of Epidemiology, Sahlgrenska University Hospital, Göteborg, Sweden. svante.ostling@neuro.gu.se
Pálsson
S P
SP
Skoog
I
I
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D003430:Cross-Sectional Studies; D003702:Delusions / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D006801:Humans; D015994:Incidence; D008297:Male; D010259:Paranoid Disorders / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D012189:Retrospective Studies; D015996:Survival Rate; D013548:Sweden