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Delusions in Alzheimer Disease Not Linked With Memory Errors
Delusions experienced by people with Alzheimer Disease (AD) are not a direct consequence of forgetting or misremembering, according to a cross-sectional study published in JAMA Psychiatry. These results lend more evidence to previous theories of a transdiagnostic mechanism for psychosis, authors say.
“Despite the superficial resemblances, delusions in AD are more than simply an extension of memory errors or confabulation,” lead author Emma McLachlan, PhD, University College London, United Kingdom, and co-authors said. “Furthermore, these findings suggest that psychosis in AD is a valid target for pharmacologic and nonpharmacologic treatment approaches and support the existence of a transdiagnostic mechanism for psychosis.”
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Study participant data was gathered from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and included 728 people diagnosed with AD. This group was made up of 43.5% women and had a mean (SD) age of 74.8 (7.4) years. Researchers measured false recognition using the 13-item Alzheimer Disease Assessment Scale–Cognitive Subscale (ADAS-Cog 13) and the Rey Auditory Verbal Learning Test (RAVLT). Mann-Whitney nonparametric tests were used to compare data between participants with delusions in AD and those without. Data was analyzed between June 24, 2020, and September 21, 2021.
Individuals with delusions at baseline had higher rates of false recognition on the ADAS-Cog 13 compared to the control participants. However, when confounding variables were accounted for using binary logistic regression models, false recognition was no longer associated with the presence of delusions. False recognition was found to be inversely associated with the volume of several brain regions, including the left and right hippocampal volumes, left entorhinal cortex volume, left parahippocampal gyrus volume, and left fusiform gyrus volume.
Authors noted that results could be limited by the small sample size and the retrospective nature of the study.
