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

Paranoid Symptoms Associated with the Affective Disorders

Depression is a common finding in the older adult population, with rates of minor and major depressions found in 13% of community dwellers, 24% of medical outpatients, 30% of acute care patients, and 43% of long-term care dwellers.[16] In one study of the prevalence of paranoid ideation and psychotic symptoms in individuals without dementia, 13% of the persons with psychotic symptoms and/or paranoid ideation were determined to have a major depressive disorder.[9] Delusions are also commonly associated with depression in Alzheimer's disease (AD).[17] Reviews of the patient's past history for marked mood fluctuations and of recent mood symptoms may help identify a mood disorder with psychotic features. The Short Form Geriatric Depression Scale, which consists of 15 questions, is used as a preliminary screening tool for the assessment of depression in late life. For clinical purposes, any score >5 warrants further assessment and intervention.

For new-onset, persistent, late-life psychotic disorders not secondary to a mood disorder or a general medical condition other than cognitive impairment, the differential should include dementia (e.g., dementia of the Alzheimer type), delusional disorder, and very-late-onset schizophrenia-like psychosis.


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