Delusions in newly admitted residents of nursing homes

Article Abstract:

Dementia is a term used to describe a broad impairment of intellectual (cognitive) functioning that is usually progressive and interferes with normal activities. Delusions are described as false beliefs that are brought about without appropriate external stimuli. Residents of nursing homes commonly have diagnoses of dementia with attendant behavioral problems. Studies have demonstrated delusions to be part of senile dementia, and when treated, behavior problems often subside. This study was done to assess the prevalence of delusions among newly admitted nursing home residents, how patients with delusions differ from nondelusional patients in behavior and functioning, whether the nursing staff can recognize delusions and knows how to treat them, and what illnesses delusions are associated with. Psychiatrists examined 125 nursing home residents within four weeks of their admission. The patient's behavior before nursing home placement was determined by an interview with a family member. Behavior and function in the nursing home was assessed by an interview with a nursing assistant. Almost 85 percent of the subjects had a psychiatric disorder, and dementia was seen in 67.2 percent. Twenty-six of these residents had delusions, and the family had recognized this in 64 percent of the cases. Even so, only six of the delusional patients had seen a psychiatrist in the year before admission. The nursing staff identified delusions in only five of these patients. The delusional patients did not differ from the nondelusional residents in their need for assistance with daily activities. They did, however, have more behavior problems before and after admission to the nursing home, and were also more cognitively impaired. Most of these patients were not receiving proper treatment for their symptoms, and in fact were often given medications which could make their conditions worse. The authors suggest that the behavior problems associated with delusions and dementia could be diagnosed and treated before or after placement, if these elderly patients receive skilled geriatric psychiatric evaluations, along with interviews with family members regarding symptoms that are manifest prior to this evaluation. Also, nursing home staff members need to be taught to recognize delusions and understand their clinical importance so referrals occur in a timely manner. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Care and treatment, Research, Diagnosis, Nursing home care, Nursing home patients, Cognition disorders in old age, Geriatric cognitive disorders

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Psychosis and physical aggression in probable Alzheimer's disease

Article Abstract:

Alzheimer's disease, a type of dementia, is characterized in part by delusions, hallucinations, and behavioral changes. Psychotic symptoms in Alzheimer's patients have been associated with poorer cognitive performance and more rapid cognitive decline. Aggressive outbursts, in the forms of physical violence, are reported by caregivers of Alzheimer's patients as well; sometimes aggressive patients are also abused by their caregivers. In the present study, data were collected on 181 patients with probable Alzheimer's disease who had been assessed every six months for up to 4.5 years. Summary notes were reviewed for each clinic visit, and the symptoms of delusions, hallucinations, misidentifications, and physical aggression were noted. In 43.5 percent of the cases, delusions were present, and in 29.6 percent, physical aggression was observed. The most common delusions were of persecution, and delusions frequently preceded episodes of violent behavior. While delusions were significantly associated with violence, it accounted for only 3.5 percent of the variance under statistical analysis. This suggests that there are other variables related to physical aggression as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Alzheimer's disease, Aggressiveness (Psychology), Hallucinations and illusions, Hallucinations, Psychoses, Psychotic disorders

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