Examining the presence and nature of delusions in Alzheimer's disease and frontotemporal dementia syndromes.
Alzheimer's disease
C9orf72
cognitive impairment
frontotemporal dementia
primary progressive aphasia
psychosis
research domain criteria (RDoC)
structural imaging
Journal
International journal of geriatric psychiatry
ISSN: 1099-1166
Titre abrégé: Int J Geriatr Psychiatry
Pays: England
ID NLM: 8710629
Informations de publication
Date de publication:
08 Feb 2022
08 Feb 2022
Historique:
received:
30
08
2021
accepted:
03
02
2022
entrez:
18
2
2022
pubmed:
19
2
2022
medline:
19
2
2022
Statut:
aheadofprint
Résumé
Abnormal beliefs and delusions have been reported in some people with dementia, however, the prevalence of delusions, and their neurocognitive basis has been underexplored. This study aimed to examine the presence, severity, content and neural correlates of delusions in a large, well-characterised cohort of dementia patients using a transdiagnostic, cross-sectional approach. Four-hundred and eighty-seven people with dementia were recruited: 102 Alzheimer's disease, 136 behavioural-variant frontotemporal dementia, 154 primary progressive aphasia, 29 motor neurone disease, 46 corticobasal syndrome, 20 progressive supranuclear palsy. All patients underwent neuropsychological assessment and brain magnetic resonance imaging, and the Neuropsychiatric Inventory was conducted with an informant, by an experienced clinician. In our cohort, 48/487 patients (10.8%) had delusions. A diagnosis of behavioural-variant frontotemporal dementia (18.4%) and Alzheimer's disease (11.8%) were associated with increased risk of delusions. A positive gene mutation was observed in 11/27 people with delusions. Individuals with frequent delusions performed worse on the Addenbrooke's Cognitive Examination (p = 0.035), particularly on the orientation/attention (p = 0.022) and memory (p = 0.013) subtests. Voxel-based morphometry analyses found that increased delusional psychopathology was associated with reduced integrity of the right middle frontal gyrus, right planum temporale and left anterior temporal pole. Our results demonstrate that delusions are relatively common in dementia and uncover a unique cognitive and neural profile associated with the manifestation of delusions. Clinically, delusions may lead to delayed or misdiagnosis. Our results shed light on how to identify individuals at risk of neuropsychiatric features of dementia, a crucial first step to enable targeted symptom management.
Identifiants
pubmed: 35178786
doi: 10.1002/gps.5692
pmc: PMC9546395
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Australian Research Council Centre of Excellence in Cognition and its Disorders Memory Program
Organisme : Appenzeller Neuroscience Fellowship in Alzheimer's Disease
Organisme : National Health and Medical Research Council
Informations de copyright
© 2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.
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