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Delusions not linked to psychotic symptoms in elderly
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A cohort of nursing home residents in Israel demonstrated a variety of delusional themes that were not linked to psychotic symptoms, according to study results.
Researchers conducted a qualitative and quantitative analysis to describe the delusions experienced by 74 residents, aged 65 years and older and diagnosed with dementia, from nine nursing homes.
Six categories of delusions were examined using the Behavioral pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD). Those included:
- One’s house is not one’s home,
- Theft,
- Danger,
- Abandonment,
- Misidentification,
- Other non-paranoid.
The delusional themes most commonly observed included reality, disorientation, re-experience of past events, loneliness and insecurity, boredom, and trigger.
The reality delusion frequently manifested itself in participants realizing that the nursing home was not their own home, which caused them to desire to return home. This was linked to past transfer trauma, disorientation and trigger in the five participants (7%) who experienced this delusion.
Other findings indicated that the delusion of theft was experienced by 22% of the study population, while 9% experienced delusions of danger, and 5% of participants experienced delusions of abandonment and non-paranoid delusions.
Researchers reported that performing Activities of Daily Living was significantly more difficult for individuals with delusions. These individuals also were significantly more likely to have poorer vision and hearing than other participants.
Delusions may not be linked to psychotic symptoms for most of the individuals in the study population, according to the researchers. They said delusions 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,” researchers wrote. “An attention to stimuli that trigger ‘delusions’ can help staff in limiting their occurrence.” -by Rob Volansky