A Look at Dementia-Related Psychosis

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PATRICIA ANDREWS
Psychosis is a condition in which a person loses touch with reality. And dementia is one of the behavioral symptoms that we see. It manifests through paranoia, delusions, agitation, hallucinations.

And so seeing or hearing things that are not there or sometimes feeling things that are not there-- so like feeling bugs in your skin, or hearing things hearing voices, hearing the mom talking on the other bedroom. When they're 90 years old and their mother has passed 50 years ago, you know that there is actually not a person there talking to them. Or seeing things-- this are more common in Lewy Body dementia that they see little kids running around the room or small animals, things like that.

Or we talk about delusions or paranoia. So delusion is a firm belief that something's real when it's not. We talk about paranoid delusions. So for example, a firm belief that they didn't pay their taxes this year-- and they called their account multiple times a day. And that kind of reaffirms then that they did pay the taxes. But now, they have this term belief, the delusion that this didn't happen when it did happen.

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It's coming in all forms of dementia and at any stage of the disease. But it's a little bit more frequent with disease progression. So people who have in the moderate or late stages of the disease have psychosis more often.

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We don't know exactly how it happens. It's not pinned down. We think it's multi-factorial. In dementia, there's a lot of changes in damages through different areas of the brain. So it's likely, depends on what areas are affected that can trigger some of the symptoms.

The personality of the person might either more prone or affect how they respond to the symptoms that they're having. So for example, a grandmother that's in their 80s that always managed her household, always made all the meals, raised 12 kids, helped raise 30 grandkids, and always manages all the holidays, cooks for everybody, and starts having dementia, or starts having this memory problems. They might become very anxious or distressed about not being able to control all the things that they were able to do, or multitask with all the things that they were able to manage.

So her personality might be prone to having a little bit more behavioral symptoms or anxiety. And this could also trigger some symptoms of psychosis. We always want to provide a good quality of life, like for the person who has dementia to have good quality of life. So this is a conversation to have with a health care provider, of what can be done to help with the symptoms.