Paranoid Symptoms Among Older Adults

Muzumel A. Chaudhary, MD; Kiran Rabheru, MD, CCFP, FRCP, ABPN


Geriatrics and Aging. 2008;11(3):143-149. 

In This Article

Diagnostic Challenges

Psychological disorders among older adults often present many clinical challenges in the face of differing signs and symptoms, origins, and functional changes from presentations among the younger adults. Individuals with late-onset paranoia often have symptom complexes that do not dominate the individual's mental life, and are frequently concealed. Even with semistructured interviews, it can often be difficult to reveal important psychopathology.[2] For example, studies of cognitively impaired individuals report that information derived from caregivers yields up to fourfold higher rates of psychopathology than the results of clinical examinations alone.[3]

Because older adults may be reluctant to report paranoid symptoms, or may lack insight into their experiences due to cognitive impairment, it is necessary to collect collateral information from a reliable third party. Particular attention should be paid to gathering information concerning symptom onset and any associated precipitants (e.g., medication changes, physical health concerns, or new life stressors). Additionally, the symptom form, progression, behavioural manifestations, and any resultant functional impairment should be ascertained.


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