Psychotic Symptoms in Alzheimer's Disease Are Not Associated With More Severe Neuropathologic Features

• Published in: International psychogeriatrics Vol. 12; no. 4; pp. 547 - 558
• Main Authors: Sweet, Robert A., Hamilton, Ronald L., Lopez, Oscar L., Klunk, William E., Wisniewski, Stephen R., Kaufer, Daniel I., Healy, Matthew T., DeKosky, Steven T.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.12.2000
• Subjects: Aged; Alzheimer Disease - complications; Alzheimer Disease - pathology; Alzheimer Disease - psychology; Alzheimer's disease; Biological and medical sciences; Brain - pathology; Cognitive impairment; Cortex; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Functional impairment; Geriatrics; Hippocampus; Humans; In Vitro Techniques; Logistic Models; Male; Medical sciences; Neurofibrillary Tangles - pathology; Neurology; Neuropathology; Parietal cortex; Plaque, Amyloid - pathology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychosis; Psychotic Disorders - complications; Psychotic Disorders - pathology; Psychotic symptoms; Severity; Severity of Illness Index; Symptoms; Human; Psychosis; Symptomatology; Nervous system diseases; Senile plate; Alzheimer disease; Central nervous system disease; Degenerative disease; Neurofibrillary tangle; Elderly; Cerebral disorder; Lewy body
• ISSN: 1041-6102; 1741-203X
• DOI: 10.1017/S1041610200006657

Psychotic symptoms in Alzheimer's disease (AD) have been associated with increased rates of cognitive impairment and functional decline. Prior studies have been conflicting with regard to whether AD patients with psychosis (AD+P) have evidence of more severe neuropathologic findings at postmortem exam. We examined the severity of neuritic plaques and neurofibrillary tangles in six brain regions—middle frontal cortex, hippocampus, inferior parietal cortex, superior temporal cortex, occipital cortex, and transentorhinal cortex—in 24 AD+P subjects and 25 matched AD subjects without psychosis (AD-P). All analyses controlled for the presence of cortical Lewy bodies, and corrected for multiple comparisons. We found no significant associations between neuritic plaque and neurofibrillary tangle severity and AD+P, and no significant associations with any individual psychotic symptom. The association of AD+P with a more rapidly progressive course of AD appears to be mediated by a neuropathologic process other than increased severity of plaque and tangle formation.