Examining the presence and nature of delusions in Alzheimer's disease and frontotemporal dementia syndromes

International Journal of Geriatric PsychiatryKumfor F, Liang CT, Hazelton JL, et al. | February 10, 2022


Some people with dementia are reported to have abnormal beliefs and delusions. Researchers herein examined the prevalence of delusions, and their neurocognitive basis in a large, well-characterized cohort of dementia patients using a transdiagnostic, cross-sectional approach.

  • Among 487 people with dementia recruited in this study, there were 102 people with Alzheimer's disease, 136 with behavioral-variant frontotemporal dementia, 154 with primary progressive aphasia, 29 with motor neuron disease, 46 with corticobasal syndrome, 20 with progressive supranuclear palsy.

  • Delusions were reported in 48/487 patients (10.8%).

  • There appeared an increased risk of delusions in correlation with a diagnosis of behavioral-variant frontotemporal dementia (18.4%) and Alzheimer’s disease (11.8%).

  • There were 11/27 people with delusions exhibiting a positive gene mutation.

  • Performance on the Addenbrooke’s Cognitive Examination was relatively worse for individuals with frequent delusions, this was particularly evident on the orientation/attention and memory subtests.

  • In Voxel-based morphometry analyses, a correlation of increased delusional psychopathology was observed with decreased integrity of the right middle frontal gyrus, right planum temporal and left anterior temporal pole.

  • Clinically, delayed or misdiagnosis may occur because of delusions.

  • In light of these results, individuals at risk of neuropsychiatric features of dementia could be identified, a crucial first step to enable targeted symptom management.

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