Horton Park Centre, Horton Park Avenue, Bradford District Care NHS Foundation Trust, Bradford, UK.
Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Int J Geriatr Psychiatry. 2018 Jan;33(1):39-46. doi: 10.1002/gps.4665. Epub 2017 Jan 24.
Charles Bonnet syndrome (CBS) is a common cause of visual hallucinations in older people. The relationship between CBS and cognitive impairment is unclear, but anecdotal reports exist of dementia emerging in patients diagnosed with CBS. This work set out to determine if there is an increased incidence of dementia, and increased severity of cognitive impairment, in people with CBS compared to controls from the same clinical setting.
People over 65 attending low-vision and glaucoma clinics, and a cohort of age-matched controls, underwent a psychiatric assessment. The cohorts were followed up after one year.
Mild cognitive impairment was present in 2/12 CBS participants and 2/10 controls. Partial insight was seen in nine CBS participants. Two participants with CBS, and no controls, developed dementia at follow-up. No significant differences in performance on the ACE-R were found between the groups. Both participants who developed dementia had partial insight and hallucinations of familiar figures at diagnosis of CBS, and one had mild cognitive impairment.
Reassurance that CBS is universally benign may be misplaced. Some people given this diagnosis go on to develop dementia. Cognitive testing at the point of diagnosis was unable to identify those at risk of this outcome. Partial insight, the presence of Mild Cognitive Impairment, and hallucinations of familiar figures at diagnosis of CBS may confer an increased risk of subsequent dementia diagnosis. Copyright © 2017 John Wiley & Sons, Ltd.
查尔斯·邦纳综合征（CBS）是老年人视觉幻觉的常见原因。CBS 与认知障碍之间的关系尚不清楚，但有传闻报道称，在被诊断为 CBS 的患者中出现了痴呆症。这项工作旨在确定与同一临床环境中的对照组相比，CBS 患者的痴呆症发病率是否更高，认知障碍的严重程度是否更高。
在低视力和青光眼诊所就诊的 65 岁以上人群以及一组年龄匹配的对照组接受了精神病学评估。在一年后对队列进行了随访。
2/12 的 CBS 参与者和 2/10 的对照组存在轻度认知障碍。在 9 名 CBS 参与者中观察到部分洞察力。在随访中，2 名 CBS 参与者和没有对照组参与者发展为痴呆症。两组在 ACE-R 上的表现无显着差异。在诊断为 CBS 时出现幻觉和熟悉人物的幻觉的两名痴呆症患者中，有一名患者有轻度认知障碍。
普遍认为 CBS 是良性的，这可能是错误的。一些被诊断出患有这种疾病的人会继续发展为痴呆症。在诊断时进行认知测试无法确定那些有这种结果风险的人。在诊断 CBS 时出现部分洞察力，轻度认知障碍和熟悉人物的幻觉可能会增加随后痴呆症诊断的风险。版权所有 © 2017 约翰威立父子有限公司
