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Am J Psychiatry 1992; 149:184-189
Copyright © 1992 by American Psychiatric Association
Cognitive deficits of patients with Alzheimer's disease with and without delusions
DV Jeste, RE Wragg, DP Salmon, MJ Harris and LJ Thal
Department of Psychiatry, University of California, San Diego.
OBJECTIVE: The goal of this investigation was to study the prevalence of
delusions in Alzheimer's disease and to compare the performance of the
delusional and nondelusional groups on a neuropsychological test battery.
METHOD: The authors studied 107 patients with Alzheimer's disease and 51
age- and education-comparable normal subjects using a standardized
psychiatric interview and a neuropsychological test battery. RESULTS:
Thirty-seven patients with Alzheimer's disease had delusions with or
without hallucinations. Patients with delusions were significantly more
impaired than those without delusions (and the normal comparison group) on
the Mini-Mental State examination; Blessed Information-Memory-Concentration
Test; Dementia Rating Scale, especially its conceptualization and memory
subtests; and a test of verbal fluency. The delusional group also tended to
be somewhat more impaired than the nondelusional group on the modified
Wisconsin Card Sorting Test and the similarities subtest of the Wechsler
Adult Intelligence Scale-revised. CONCLUSIONS: Approximately one-third of
patients with Alzheimer's disease had developed psychotic symptoms sometime
after the onset of dementia. The presence of psychotic symptoms in
Alzheimer's disease was associated with greater cognitive impairment,
especially frontal/temporal dysfunction, and possibly with a more rapidly
progressive dementia.
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