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. 2018 Apr 21:10:358-362.
doi: 10.1016/j.dadm.2018.03.005. eCollection 2018.

Understanding hallucinations in probable Alzheimer's disease: Very low prevalence rates in a tertiary memory clinic

Mascha M J Linszen  1   2   3 , Afina W Lemstra  2 , Meenakshi Dauwan  1   3   4 , Rachel M Brouwer  1 , Philip Scheltens  2 , Iris E C Sommer  1   3   5
Affiliations

Understanding hallucinations in probable Alzheimer's disease: Very low prevalence rates in a tertiary memory clinic

Mascha M J Linszen et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Averaging at 13.4%, current literature reports widely varying prevalence rates of hallucinations in patients with probable Alzheimer's disease (AD), and is still inconclusive on contributive factors to hallucinations in AD.

Methods: This study assessed prevalence, associated factors and clinical characteristics of hallucinations in 1227 patients with probable AD, derived from a tertiary memory clinic specialized in early diagnosis of dementia. Hallucinations were assessed with the Neuropsychiatric Inventory.

Results: Hallucination prevalence was very low, with only 4.5% (n = 55/1227) affected patients. Hallucinations were mostly visual (n = 40/55) or auditory (n = 12/55). Comorbid delusions were present in over one-third of cases (n = 23/55).Hallucinations were associated with increased dementia severity, neuropsychiatric symptoms, and a lifetime history of hallucination-evoking disease (such as depression and sensory impairment), but not with age or gender.

Discussion: In the largest sample thus far, we report a low prevalence of hallucinations in probable AD patients, comparable to rates in non-demented elderly. Our results suggest that hallucinations are uncommon in early stage AD. Clinicians that encounter hallucinations in patients with early AD should be sensitive to hallucination-evoking comorbidity.

Keywords: Alzheimer's disease; Comorbidity; Dementia severity; Hallucinations; Low prevalence.

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Figures

Fig. 1
Fig. 1
Prevalence of hallucinations, as stratified for dementia severity based on MMSE scores (total n = 1227). Error bars indicate lower and upper borders of 95% confidence intervals. MMSE data were missing in 15 subjects, 4 of which reported hallucinations. Distribution was statistically significant (χ2 12.3, P .006, df 3). Abbreviation: MMSE, Mini-Mental State Examination.
See this image and copyright information in PMC

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