DELUSIONS AND DEMENTIA - CLINICAL AND CT CORRELATES

Introduction - Delusions occur frequently during the course of Alzheim er's disease (AD) and multi-infarct dementia (MID). Their clinical sig nificance and their relationship with progression of disease and invol vement of selected cerebral areas are still unclear. The aim of the st udy was to determine the clinical and CT correlates of delusions in pa tients with dementia. Material and methods - A series of 67 probable A D and 32 MID patients, underwent computed tomographic scans, psychomet ric tests, neurologic and psychiatric examination, and blood and serum tests. Results - Twenty-four patients were found to have delusions du ring the clinical evaluation. Delusional patients showed a significant ly higher age when compared with non-delusional patients. The results of a multiple logistic regression (with stepwise deletion of the redun dant variables) of the CT lesions on the presence of delusions, showed that only the presence of isolated white matter lesions in the fronta l lobes were significantly related to the occurrence of delusions (Exp B = 3.42; Beta = 1.2; S.E. = 0.6; Sig T = 0.04). Frontal white matter changes were significantly related to delusions when a multiple regre ssion analysis, entering age and total number of lesions at CT scans, was carried out. Conclusions - We found that focal lesions in the fron tal areas were the only variable that appeared to be significantly and independently associated with delusional disorders.