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

Prevalence and Risk Factors

Paranoid symptoms are common in community samples of older individuals. Among the older adult population with cognitive impairment, one study found that paranoid symptoms are present in 12.1% of aging patients.6 While cognitive dysfunction has been identified as a clear risk factor for paranoid symptoms,[6,7,8] even in the absence of cognitive impairment, prevalence rates among older individuals have been shown to be as high as 14.1% for suspiciousness, 6.9% for paranoid ideation, and 5.5% for delusions.[2]

Racial differences in paranoid ideation have also been well documented, with its prevalence being significantly greater in blacks than in whites.[9,10,11] One study reported that nearly one-fourth of the older blacks studied expressed paranoid ideation or psychotic symptoms, in contrast with roughly one-tenth of the older whites.[9]

Medical illness, impaired vision and hearing, social isolation, and the aging process itself are thought to place older adults at greater risk for persecutory thoughts. Other risk factors include depressive symptoms, difficulties in activities of daily functioning, the presence of negative life events, financial strain, gender, immigrant status, and lower education level.[3,6,9,12] A relationship also clearly exists between trauma exposure with a diagnosis of post-traumatic stress disorder and paranoid symptoms.[13] The vulnerability of these individuals to the development of delusions and paranoid ideation may become more marked when complicated by cognitive impairment.[14]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.