Jeste D V, Wragg R E, Salmon D P, Harris M J, Thal L J
Department of Psychiatry, University of California, San Diego.
Am J Psychiatry. 1992 Feb;149(2):184-9. doi: 10.1176/ajp.149.2.184.
The goal of this investigation was to study the prevalence of delusions in Alzheimer's disease and to compare the performance of the delusional and nondelusional groups on a neuropsychological test battery.
The authors studied 107 patients with Alzheimer's disease and 51 age- and education-comparable normal subjects using a standardized psychiatric interview and a neuropsychological test battery.
Thirty-seven patients with Alzheimer's disease had delusions with or without hallucinations. Patients with delusions were significantly more impaired than those without delusions (and the normal comparison group) on the Mini-Mental State examination; Blessed Information-Memory-Concentration Test; Dementia Rating Scale, especially its conceptualization and memory subtests; and a test of verbal fluency. The delusional group also tended to be somewhat more impaired than the nondelusional group on the modified Wisconsin Card Sorting Test and the similarities subtest of the Wechsler Adult Intelligence Scale-revised.
Approximately one-third of patients with Alzheimer's disease had developed psychotic symptoms sometime after the onset of dementia. The presence of psychotic symptoms in Alzheimer's disease was associated with greater cognitive impairment, especially frontal/temporal dysfunction, and possibly with a more rapidly progressive dementia.
本研究旨在探讨阿尔茨海默病患者妄想症的患病率，并比较妄想症组与非妄想症组在一套神经心理测试中的表现。
作者使用标准化的精神科访谈和一套神经心理测试，对107例阿尔茨海默病患者及51名年龄和教育程度相匹配的正常受试者进行了研究。
37例阿尔茨海默病患者存在伴有或不伴有幻觉的妄想。在简易精神状态检查、Blessed信息-记忆-注意力测试、痴呆评定量表（尤其是其概念化和记忆子测试）以及语言流畅性测试中，有妄想的患者比无妄想的患者（以及正常对照组）受损更严重。在改良威斯康星卡片分类测试和修订版韦氏成人智力量表的相似性子测试中，妄想症组也往往比非妄想症组受损更严重一些。
约三分之一的阿尔茨海默病患者在痴呆症发作后的某个时间出现了精神病症状。阿尔茨海默病中精神病症状的出现与更严重的认知障碍相关，尤其是额叶/颞叶功能障碍，并且可能与进展更快的痴呆症有关。
