Delusions and Hallucinations Are Associated With Worse Outcome in Alzheimer Disease

Scarmeas, Nikolaos; Brandt, Jason; Albert, Marilyn; Hadjigeorgiou, Georgios M.; Papadimitriou, Alexandros; Dubois, Bruno; Sarazin, M.; Devanand, Devangere P.; Honig, Lawrence S.; Marder, Karen; Bell, Karen L.; Wegesin, Domonick J.; Blacker, Deborah; Stern, Yaakov

doi:10.1001/archneur.62.10.1601

Cited by 297 publications

(259 citation statements)

References 53 publications

Supporting

Mentioning

244

Contrasting

Unclassified

Order By: Relevance

“…In contrast, underestimation of the years of life lost might have occurred, as life tables included AD cases in the population. Comorbid medical [13,44] and psychiatric conditions [45] might increase mortality in dementia; these variables were not specifically addressed in this study. However, not all previous studies have observed this association [10].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors That Affect Life Expectancy in Alzheimer's Disease: A 15-Year Follow-Up

Wattmo

Londos

Minthon³

2014

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Backgrounds/Aims: Future disease-modifying therapies might affect the expected life span in Alzheimer's disease (AD). Our aim was to identify factors that influence life expectancy in cholinesterase inhibitor (ChEI)-treated patients. Methods: This study included 791 deceased individuals with a clinical diagnosis of AD and a Mini-Mental State Examination score of 10-26 at baseline who were recruited from a 3-year, prospective, multicenter study of ChEI therapy in clinical practice. The participants' date of death was recorded and their survival was compared with the gender- and age-matched general population. Results: The mean survival time after the start of ChEI therapy (time of AD diagnosis) was 5.10 years for men and 6.12 years for women. Better cognitive ability, less impaired basic functional capacity, and fewer medications, but not education level or apolipoprotein E (APOE) genotype, were independent prognostic factors of longer survival after diagnosis, after controlling for gender and age. Conclusion: AD shortens life expectancy in ChEI-treated patients diagnosed before the age of 85 years, similar to that reported previously for untreated individuals. A longer life span was observed in the eldest patients (≥85 years) compared with untreated cohorts, which did not differ from that observed in the general population. Higher education or carrying two APOE ε4 alleles were risk factors for earlier death.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors That Affect Life Expectancy in Alzheimer's Disease: A 15-Year Follow-Up

Wattmo

Londos

Minthon³

2014

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

show abstract

“…In an earlier study, Drevets and Rubin (1989) suggest that, in addition to the different underlying neuropathology, patients with psychotic disturbances appear to have a lower mortality level than non-psychotic patients, and they attribute this to patients with Alzheimer's disease and psychosis receiving a different quality of care, which may have a positive psychological impact and contribute to their longevity. In a longitudinal study spanning 14 years, Scarmeas et al (2005) provide corroborating evidence for the association between delusions and mortality. In their longitudinal comparative study, results show that the presence of delusions was a time-dependent predictor of cognitive and functional decline but not mortality.…”

Section: Delusions and Symptom Co-morbiditymentioning

confidence: 58%

“…Hallucinations correlated negatively with education levels and positively with severity of dementia and duration of illness, whereas delusions correlated positively with age, depression, and aggression, and negatively with general health. The presence of hallucinations has also been negatively associated with functional outcomes (Mok et al, 2004), institutionalisation, and mortality (Scarmeas et al, 2005). The authors conclude that the phenomenon of psychosis in Alzheimer's disease is a composite of distinct subtypes that may have different underlying clinical, demographic, and neuropathological substrates.…”

Section: Hallucinations and Clinical Characteristicsmentioning

confidence: 93%

Psychosis in Alzheimer's Disease: Prevalence, Clinical Characteristics, Symptom Co-Morbidity, and Aetiology

Cassimjee

2008

South African Journal of Psychology

View full text Add to dashboard Cite

Alzheimer's disease was identified almost a century ago. Cognitive morbidity (deterioration in memory, attention, language, and executive functioning) was regarded as a sufficient index for the description and diagnosis of Alzheimer's disease. Within the cognitive discourse, the importance of neuropsychiatric and neurobehavioural referents was often eschewed. Recent research studies attest to the profound impact of the non-cognitive symptoms on the quality of life of both patient and caregiver. The purpose of this article is to review studies on psychosis in Alzheimer's disease, examine its prevalence, and discuss its manifestation with reference to the association between neuropathology and psychotic disturbances. The importance of clarifying the validity of the construct 'psychosis in Alzheimer's disease', the specificity of symptoms, and the phenomenology of subtypes with their distinct clinical and biological associations is addressed.

show abstract

“…[2][3][4][5][6][7][8] AD+P is further associated with additional psychiatric and behavioral disturbances, the most frequent and troublesome of which are agitation 9 and aggression 10;11 . AD+P leads to greater distress for family and caregivers 12 , greater functional impairment, 13 higher institutionalization rates, [14][15][16][17] worse health 18 and increased mortality 19 compared to AD-P patients.…”

Section: Introductionmentioning

confidence: 99%

[P3–102]: Genetic Risk for Schizophrenia and Psychosis in Alzheimer Disease

DeMichele-Sweet

Weamer

Klei

et al. 2017

Alzheimer's & Dementia

View full text Add to dashboard Cite

Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms Psychotic symptoms, defined as the occurrence of delusions or hallucinations, are frequent in Alzheimer Disease, affecting ~ 40% to 60% of individuals with AD (AD with psychosis, AD+P). In comparison to AD subjects without psychosis, AD+P subjects have more rapid cognitive decline and poor outcomes. Prior studies have estimated the heritability of psychosis in AD at 61%, but the underlying genetic sources of this risk are not known. We evaluated a Discovery Cohort of 2876 AD subjects with (N=1761) or without psychosis (N=1115). All subjects were genotyped using a custom genotyping array designed to evaluate SNPs with evidence of genetic association with AD+P and include SNPs affecting or putatively affecting risk for schizophrenia and Alzheimer disease. Results were replicated in an independent cohort of 2194 AD subjects with (N=734) or without psychosis (N=1460). We found that AD+P is associated with polygenic risk for a set of novel loci and inversely associated with polygenic risk for schizophrenia. Among the biologic pathways identified by the associations of schizophrenia SNPs with AD+P are endosomal trafficking, autophagy, and calcium channel signaling. These findings provide the first clear demonstration that AD+P is associated with common genetic variation. In addition, they provide an unbiased link between polygenic risk for schizophrenia and a lower risk of psychosis in AD. This provides an opportunity to leverage progress made in identifying the biologic effects of schizophrenia alleles to identify novel mechanisms protecting against more rapid cognitive decline and psychosis risk in AD. HHS Public Access

show abstract

Delusions and Hallucinations Are Associated With Worse Outcome in Alzheimer Disease

Cited by 297 publications

References 53 publications

Risk Factors That Affect Life Expectancy in Alzheimer's Disease: A 15-Year Follow-Up

Risk Factors That Affect Life Expectancy in Alzheimer's Disease: A 15-Year Follow-Up

Psychosis in Alzheimer's Disease: Prevalence, Clinical Characteristics, Symptom Co-Morbidity, and Aetiology

[P3–102]: Genetic Risk for Schizophrenia and Psychosis in Alzheimer Disease

Contact Info

Product

Resources

About