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Delusions and Hallucinations in Alzheimer's Disease: Review of the Brain Decade

Received March 15, 2002; revision received Dec. 3, 2002; accepted Dec. 13, 2002. From the Department of Psychiatry, Faculty of Medicine, Zagazig University, Sharkia, Zagazig, Egypt; and the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University. Address reprint requests to Dr. Lyketsos, Osler 320, Johns Hopkins Hospital, Baltimore, MD 21287; kostas{at}jhmi.edu (e-mail).

The authors reviewed studies published from 1990 to 2001 that address the epidemiology, phenomenology, course, etiology, assessment, and treatment of delusions and hallucinations in Alzheimer's disease. The prevalence of delusions in Alzheimer's disease patients ranged from 16% to 70% (median=36.5%) in the reviewed reports, and the prevalence of hallucinations ranged from 4% to 76% (median=23%). Delusions and hallucinations tended to persist over time, tended to recur often during the course of Alzheimer's disease, and were associated with sociodemographic and clinical correlates that differed from one study to another and with substantial consequences such as functional impairment and aggression. Psychosocial methods and both typical and atypical antipsychotics are effective in the treatment of delusions and hallucinations in Alzheimer's disease.

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