Dementia: What is dementia-related psychosis?


More than 2 million Americans suffer from dementia-related psychosis. If you have a relative who suffers from dementia, then you know that it is a terrible condition for the person experiencing this condition and their caregivers. This can be even more disturbing when they also have to deal with psychotic episodes.

“But I don’t want to let psychiatry be a taboo, evil topic, but to make people understand that this is a normal manifestation of these diseases. An expected manifestation. One is talking about diseases,” said Banner Alzheimer’s director Pierre N. Tariot. Phoenix Research Institute, Arizona.

“The people you love are not’crazy.’ They are sick. Their brains are not functioning properly. We can evaluate this and we can help you understand this. And we can help relieve you and your loved ones Troubles.”

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To understand the psychosis associated with dementia, it helps to break the terminology:

Some experts now refer to dementia as “neurocognitive disorder.” But doctors still use the term dementia. This is a broad term that covers various conditions caused by changes in the brain.

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Alzheimer’s disease is perhaps the most famous form of dementia. But there are others, including:

  • Lewy body dementia
  • Frontotemporal dementia
  • Vascular Dementia

These conditions include decreased thinking and problem-solving skills, which often make daily life and independent living difficult.

Common symptoms of dementia include:

  • Memory loss (for example, forgetting the name of a loved one)
  • Attention is gradually diminished
  • Difficult to communicate (for example, using unusual words to refer to familiar objects)

Broadly speaking, mental illness refers to a person having trouble figuring out what is real and what is not. People with mental illness may have delusions, such as firm, false beliefs that someone is trying to kill them. They may also have hallucinations-seeing or hearing something or something that others cannot see.

Gary Small (MD), director of the UCLA President’s Life Center, said: “People have extremely poor understanding and knowledge of these terms.” “These terms are frightening. Dementia sounds a bit derogatory. And, like mental illness. The term psychiatric or mental illness is also frightening.

“What I’m trying to do is explain what those things are, what those phenomena are, and try to help them understand them.”


As the term might imply, people with dementia-related psychosis have decreased thinking and problem-solving skills, as well as delusions or hallucinations of psychosis. (Illusions are more common.)

All of these can cause other problems, such as:

  • indifferent
  • anxiety
  • aggression
  • insomnia
  • agitation
  • Lack of inhibition


To determine whether a loved one has dementia-related psychosis, the first step is to ensure that hallucinations or delusions are not the result of other things. For example, uterine infections can cause hallucinations.

Diagnosing psychosis related to dementia is mainly about collecting information. Rule out other causes; then observe, listen and ask questions.

“What I have to do is, I have never seen [people] George Grossberg, MD, director of geriatric psychiatry at St. Louis University School of Medicine, said: “I always see them with at least one or more, but at least one, personal care worker or care partner. Usually a spouse or adult child.

“I asked them some questions, and they are paying attention to their relatives with dementia.”

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What could these problems be?

“I might say, ‘3 to 4 months have passed since we met you and mom. How’s it going?

“‘Have you noticed any anomalies or differences?

“‘Mum may have heard or seen what you imagined or imagined because of something you can’t see or hear or imagine?”

“This gives them an entire area to discuss.”

This is not always easy. Those with dementia may hide their symptoms because they worry that mental health problems often cause stigma. Other people-nurses, doctors, professional nursing staff-may not see the signs for various reasons. This makes observation, conversation and asking the right questions-for everyone involved-all the more important.

Principal Investigator Zaino Ismail, MD, of the Ron Reed Ward Center for Healthy Brain Aging Research at the University of Calgary, said: “I told all my interns, medical students and residents that this is detective work. “

“You have to look at it, in fact you have to ask for information from all sources.”


There is no cure for Alzheimer’s and other dementias. Therefore, the first-line treatment for psychosis associated with dementia is not drugs or drugs.

In fact, sometimes people with mild mental illness may not need treatment. If hallucinations or delusions do not bother people with dementia, treatment is usually not required. If it does bother them, then some simple methods (such as ensuring that the environment around the person with dementia does not trigger the attack) can help.

Tariot recalled a woman with dementia, and she believed someone was in the room with her. In fact, the woman caught a glimpse of her reflection. Covering the mirror eased her anxiety. When another person thought someone was watching them, Small said that lowering the curtains would ease the trouble.

It’s also effective for some people with dementia: just take their minds out of the plot that might depress them.

Small said: “The best way to deal with it is to calmly distract people.” “I often remind them of what it’s like when their children are petty. You redirect them by playing games, etc. they.”

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If these methods do not work, the doctor may choose to prescribe drugs. The FDA has not approved any drugs specifically for dementia-related psychosis. Instead, doctors often prescribe “off-label” antipsychotic drugs that are not specifically used for dementia-related psychosis.

“where is it [methods that involve drugs] Without working, we can only resort to drugs. The problem is that our existing drugs…they just don’t work well,” Tariot said. “They have a one-fifth chance at best to help get people’s attention, and about an 80 or 80% chance to help. they. 90% chance of causing damage. “

Mental illness with dementia can be difficult to diagnose and treat. But understanding it, recognizing that it affects people with dementia and those around them, and using care and compassion to treat it will make things better for everyone involved.

Grossberg said: “I have been asked all the time,’Guise, Dr. Grossberg, I know you specialize in Alzheimer’s disease. What do you do? Will you not be depressed? Will you not be depressed ?'”

“I said,’No. Just the opposite.’ There are many things we can do to really improve people’s quality of life. [person] With care partners, make the rest of their days more enjoyable and more comfortable. This makes me very satisfied. “


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