Journal
CURRENT PSYCHIATRY REPORTS
Volume 13, Issue 3, Pages 211-218Publisher
SPRINGER
DOI: 10.1007/s11920-011-0195-1
Keywords
Alzheimer's; Dementia; Psychosis; Delusions; Persecutory delusions; Misidentifications; BPSD; Neuropsychiatry; Neuropsychiatric symptoms; NPS; Neuropathology; Genetics; Cognition; Paranoia; Suspiciousness; Confabulation
Categories
Funding
- National Institutes of Health
- Canadian Institutes of Health Research
- National Institute of Mental Health
- Bristol-Myers Squibb
- Pfizer
- Wyeth
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Alzheimer's disease (AD) is associated with cognitive and functional impairment as well as neuropsychiatric sequelae, including psychotic symptoms such as delusions and hallucinations. Strong evidence supports the need to study delusions separate from hallucinations. Integrating the epidemiology, clinical correlates, and neuropathological and genetic literature for delusions in AD allows us to speculate on etiology and mechanisms. Plaque and tangle deposition in individuals with susceptible alleles of serotonergic, muscarinic, nicotinic, or Apo epsilon 4 genes appears to result in disruption of cortical circuitry, culminating in delusions. While delusions in AD correspond to a phenotype distinct from AD without delusions, subtypes of delusions may also define further distinct clinical entities. Persecutory delusions may occur earlier in the illness and have a more significant genetic component than misidentification delusions, which are associated with increased cognitive impairment and advanced dementia. Clearly distinguishing between these two syndromes is essential to making progress in the area of delusions in AD.
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