title: The meanings of delusions in dementia: a preliminary study.
abstract: One of the common symptoms of dementia is delusions. Due to a biological conceptualization of the behaviors represented as delusions, these are classified as psychotic symptoms. This is a qualitative and quantitative study aiming to describe the delusions experienced by older persons with dementia and the context of occurrence, and to elucidate their etiology. Participants were 74 nursing home residents aged 65 and over, diagnosed with dementia, from nine nursing homes in Israel. Participants with delusions were found to have significantly more difficulties in performing ADLs, and poorer vision and hearing. Based on assessment using the BEHAVE-AD, six categories of delusions were examined: 1. One's house is not one's home, 2. Theft, 3. Danger, 4. Abandonment, 5. Misidentification, and 6. Other non-paranoid. Common themes appeared across delusions including reality, disorientation, re-experience of past events, loneliness and insecurity, boredom, and trigger. Current results suggest that delusions may not represent psychotic symptoms for most participants, because they sometimes represented reality, or were neither firm nor incontrovertible. Thus, utilizing the term delusion relegates the person's behavior to the domain of severe psychiatric phenomena and precludes understanding its true meaning.
authors.affiliation: The Herczeg Institute on Aging, Tel-Aviv University and the Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. jiska@post.tau.ac.il
authors.forename: Jiska
authors.initials: J
authors.lastname: Cohen-Mansfield
authors.forename: Hava
authors.initials: H
authors.lastname: Golander
authors.forename: Joshua
authors.initials: J
authors.lastname: Ben-Israel
authors.forename: Doron
authors.initials: D
authors.lastname: Garfinkel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001887:Boredom; D003221:Confusion; D003702:Delusions / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007557:Israel; D008132:Loneliness / Q000523:psychology; D008297:Male; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D011936:Reality Testing; D011795:Surveys and Questionnaires