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The incidence of first-onset psychotic symptoms and paranoid ideation in a representative population sample followed from age 70-90 years. Relation to mortality and later development of dementia.

Journal article
Authors Svante Östling
Sigurdur Palsson
Ingmar Skoog
Published in International journal of geriatric psychiatry
Volume 22
Issue 6
Pages 520-8
ISSN 0885-6230
Publication year 2007
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 520-8
Language en
Keywords Aged, Aged, 80 and over, Alzheimer Disease, diagnosis, mortality, psychology, Cross-Sectional Studies, Delusions, diagnosis, mortality, therapy, Female, Follow-Up Studies, Hallucinations, diagnosis, mortality, psychology, Humans, Incidence, Male, Paranoid Disorders, diagnosis, mortality, psychology, Psychotic Disorders, diagnosis, mortality, psychology, Retrospective Studies, Survival Rate, Sweden
Subject categories Psychiatry


BACKGROUND: Limited data are available on the incidence of psychotic symptoms in the elderly. OBJECTIVE: To elucidate the incidence of first-onset psychotic symptoms in the elderly and their relation to mortality and later development of dementia. METHOD: A population-sample (n = 392) born 1901-1902 was assessed from age 70-90 with psychiatric examinations, medical record reviews and from age 85, also with key-informant interviews. Individuals developing dementia were excluded. RESULT: The cumulative incidence of first-onset psychotic symptoms was 4.8% (8.0% including key-informant reports in the total sample) and 19.8 % in those who survived to age 85. Sixty-four percent of those with first-onset hallucinations later developed dementia, compared to 30% of those with delusions and 25% of those without psychotic symptoms. CONCLUSIONS: One fifth of non-demented elderly who survives up to age 85 develops first-onset psychotic symptoms. Hallucinations predict dementia, but most elderly individuals with first-onset psychotic symptoms do not develop dementia.

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