When most people think of psychosis -- hallucinations and delusions -- the image that comes to mind is of a person with schizophrenia.
In fact, modern research suggests that psychotic symptoms are prevalent in many disorders and even appear in non-clinical populations. Individuals with Alzheimer's disease have an unusually high rate of psychosis, with best estimates putting the figure at over 40%.
With a prevalence rate that high, you'd think that psychosis would get more attention in the literature on Alzheimer's. When these two conditions appear together they tend to cause particular difficulties in functioning and contribute to unusually high levels of caregiver burden, even by the standards of this already challenging disorder.
However, the phenomenon gets little attention when compared to other commonly co-occurring symptoms. A Google search for "Alzheimer's psychosis" currently yields 500k hits, whereas "Alzheimer's depression" gets nearly 100 times that number at 40 million. The academic literature shows a similarly extreme imbalance.
The neglect of Alzheimer's and psychosis in research and in the media has had consequences. The FDA has yet to recognize any approved drugs for the treatment of this condition, and unlike the copious amounts of lay information available to family members interested in helping their loved one's handle other complexities of alzheimer's such as agitation and depression, there are few resources available for public consumption that address psychosis.
I wish I could end this post with "a few simple tips" for family members and loved ones of people suffering from Alzheimer's and psychosis. There is some information out there, including limited scholarly work. But the truth is that the field simply has not gotten that far. Moving forward, we owe it to our patients -- and to our field -- to take a harder look at psychosis in Alzheimer's and how to help people more effectively.
