Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
CHU de Lille, Unité de Psychogériatrie, Pôle de gérontologie, 59037 Lille, France.
Neurosci Biobehav Rev. 2017 Dec;83:713-720. doi: 10.1016/j.neubiorev.2017.02.021. Epub 2017 Feb 21.
Due to their prevalence, hallucinations are considered as one of the most frequent psychotic symptoms in Alzheimer's disease (AD). These psychotic manifestations reduce patients' well-being, increase the burden of caregivers, contribute to early institutionalization, and are related with the course of cognitive decline in AD. Considering their consequences, we provide a comprehensive account of the current state of knowledge about the prevalence and characteristics of hallucinations in AD. We propose a comprehensive and testable theoretical model about hallucinations in AD: the ALZHA (ALZheimer and HAllucinations) model. In this model, neurological, genetic, cognitive, affective, and iatrogenic factors associated with hallucinations in AD are highlighted. According to the ALZHA model, hallucinations in AD first involve trait markers (i.e., cognitive deficits, neurological deficits, genetic predisposition and/or sensory deficits) to which state markers that may trigger these experiences are added (e.g., psychological distress and/or iatrogenic factors). Finally, we provide recommendations for assessment and management of these psychotic manifestations in AD, with the aim to benefit patients, caregivers, and health professionals.
由于其普遍性，幻觉被认为是阿尔茨海默病（AD）中最常见的精神病症状之一。这些精神病表现降低了患者的幸福感，增加了照顾者的负担，导致患者更早地住进疗养院，并与 AD 患者认知能力下降的过程有关。鉴于其后果，我们全面介绍了 AD 中幻觉的患病率和特征的现有知识。我们提出了一个关于 AD 中幻觉的综合和可测试的理论模型：ALZHA（ALZheimer 和 HAllucinations）模型。在该模型中，强调了与 AD 中幻觉相关的神经、遗传、认知、情感和医源性因素。根据 ALZHA 模型，AD 中的幻觉首先涉及特质标志物（即认知缺陷、神经缺陷、遗传易感性和/或感觉缺陷），然后再加上可能引发这些体验的状态标志物（例如，心理困扰和/或医源性因素）。最后，我们为 AD 中这些精神病表现的评估和管理提供了建议，旨在使患者、照顾者和卫生专业人员受益。
