PSYCHOTIC FEATURES AND THE COURSE OF ALZHEIMERS-DISEASE - RELATIONSHIP TO COGNITIVE, ELECTROENCEPHALOGRAPHIC AND COMPUTERIZED-TOMOGRAPHY FINDINGS

Thirty-one of 50 patients satisfying the NINCDS-ADRDA criteria of prob able or possible Alzheimer's disease showed psychotic features during a 2-year observation period. Paranoid delusions were reported in 23 pa tients, delusional misidentification in 17, visual hallucinations in 1 6 and auditory hallucinations in 8. All of the 7 patients who died wit hin the observation period had suffered from psychotic features even b efore the preterminal phase of illness. A faster progression of illnes s towards more severe stages of dementia was associated with paranoid delusions and hallucinations but not with delusional misidentification . We could not prove a significant influence of age, age of onset, cog nitive performance, ventricular enlargement or the severity of quantit ative electroencephalographic changes at initial examination on the co urse of illness. This may indicate that specific psychotic features an d their potential organic substrate exert an effect on the progression of illness and on survival in Alzheimer's disease, which is not relat ed to gross brain atrophy and generalized neurophysiological changes.