Cognitive and behavioral determinants of psychotic symptoms in Alzheimer's disease

Davide Quaranta, Maria Gabriella Vita, Alessandra Bizzarro, Carlo Masullo, Chiara Piccininni, Guido Gainotti, Camillo Marra

Research output: Contribution to journalArticlepeer-review


Aims: To investigate the relationship between psychotic symptoms and cognitive impairment in Alzheimer's disease (AD). Methods: A total of 108 subjects affected by AD were subdivided into subjects without delusions (ND), subjects with paranoid delusions (PD), subjects with delusional misidentifications (DM), subjects with both DM and PD (DM+PD), subjects with visual hallucinations (v-HALL), and subjects without visual hallucinations (N-HALL). Results: PD and ND subjects performed similarly on neuropsychological tests, while DM patients performed significantly worse than PD and ND patients. v-HALL patients performed worse than N-HALL patients on memory, visuospatial, and executive functions. As for behavioral features, DM and v-HALL subjects reported higher scores on the abnormal motor behavior subscale of the neuropsychiatric inventory (NPI); PD subjects reported higher scores on the disinhibition subscale of the NPI. The severity of PD was predicted by the severity of disinhibition (B = 0.514; p = 0.016) but not by neuropsychological performances. The severity of DM was predicted by age (B = 0.099; p = 0.048) and MMSE (B = -0.233; p = 0.001). The severity of v-HALL was predicted by age (B = 0.052; p = 0.037) and scores on an immediate visual memory task (B = -0.135; p = 0.007). Conclusions: The occurrence of PD may require the relative sparing of cognitive functions and be favored by frontal lobe dysfunction, while DM is associated with the overall level of cognitive impairment. Finally, v-HALL are associated with the impairment of visuospatial abilities.

Original languageEnglish
Pages (from-to)194-206
Number of pages13
JournalDementia and Geriatric Cognitive Disorders
Issue number3-4
Publication statusPublished - Apr 18 2015


  • Alzheimer's disease
  • Delusional misidentifications
  • Delusions
  • Hallucinations
  • Neuropsychological assessment
  • Psychosis

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Cognitive Neuroscience
  • Medicine(all)


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