The frequency of psychotic symptoms in types of dementia: a systematic review

This study aimed to review the studies that analyze the frequency of the types of delusions, hallucinations, and misidentifications in dementia conditions of different etiologies.

Methods:

A systematic review was conducted on August 9, 2021, in the PubMed, PsycInfo, Embase, Web of Science, and Scopus databases with the following descriptors: (dementia OR alzheimer disease OR dementia with Lewy bodies OR frontotemporal dementia OR mixed dementia OR vascular dementia OR major neurocognitive disorder OR parkinson disease dementia) AND (psychotic symptoms OR psychosis OR hallucinations OR delusions OR psychopathology OR misidentification) AND (prevalence OR epidemiology).

Results:

A total of 5,077 articles were found, with a final inclusion of 35. The overall frequency of psychotic symptoms ranged from 34 to 63% in dementia conditions of the most varied etiologies. Alzheimer’s disease (AD) presents more delusions and hallucinations and has a higher frequency regarding the presence of misidentifications. On the contrary, Dementia with Lewy bodies (DLB) seems to present more hallucinations, even auditory, when compared to the other dementias, concomitantly with delusions. Vascular and frontotemporal dementia present fewer psychotic symptoms than DLB and AD.

Conclusions:

We identified a gap in the literature on the description of the psychotic symptoms of dementia, mainly in those of non-AD etiologies. Studies that assess the neuropsychiatric symptoms of dementias deeply might contribute in a more definite manner to the causal diagnosis of dementia.

Keywords:
Hallucinations; Delusions; Dementia; Prevalence; Geriatric Psychiatry; Systematic Review

Author	Etiology of dementia	Sample (n)	Frequency of psychosis (% of total sample)	Description of the symptoms (% of total sample)
Binetti et al.¹⁶16. Binetti G, Bianchetti A, Padovani A, Lenzi G, Leo DD, Trabucchi M. Delusions in Alzheimer’s disease and multi-infarct dementia. Acta Neurol Scand. 1993;88(1):5-9. https://doi.org/10.1111/j.1600-0404.1993.tb04177.x https://doi.org/10.1111/j.1600-0404.1993...	AD/VD	92 AD: 61 VD: 31	Delusions: AD: 46%; VD: 39% Misidentifications: AD: 37.7%; VD: 19%	Delusions: AD – Persecutory: 13%; Theft: 13%; Jealousy: 6% VD – Persecutory: 23%; Theft: 23%; Jealousy: 3%; Somatic: 3%
van de Beek et al.¹⁷17. van de Beek M, van Steenoven I, van der Zande JJ, Porcelijn I, Barkhof F, Stam CJ, et al. Characterization of symptoms and determinants of disease burden in dementia with Lewy bodies: DEvELOP design and baseline results. Alzheimers Res Ther. 2021;13(1):53. https://doi.org/10.1186/s13195-021-00792-w https://doi.org/10.1186/s13195-021-00792...	DLB	73	Delusion: 9.5 Hallucinations: 11%	Delusions: Paranoid: 2.7%; Capgras: 5.5%; Somatic: 1.4%; Guilt: 1.4% Hallucinations: Tactile: 4.1%; Olfactory: 7.3%; Auditory: 11%
Chiu and Chung¹⁸18. Chiu PY, Chung CL. Delusions in patients with very mild, mild and moderate Alzheimer’s disease. Acta Neurol Taiwan. 2006;15(1):21-5. PMID: 16599280	AD	91	Delusions: 35.2%	Delusions: Theft: 27.5%; Persecutory: 15.4%; Not being home: 5.5%; Abandonment: 4.4%; Jealousy: 2.2%; Intruder: 2.2%; Media people in the house: 2.2%; Capgras: 1.1%
Cohen-Mansfield et al.¹⁹19. Cohen-Mansfield J, Golander H, Ben-Israel J, Garfinkel D. The meanings of delusions in dementia: a preliminary study. Psychiatry Res. 2011;189(1):97-104. https://doi.org/10.1016/j.psychres.2011.05.022 https://doi.org/10.1016/j.psychres.2011....	AD	74	Delusions: 46%	Delusions: Theft: 22%; Persecutory: 9%/Not being home: 7%; Abandonment: 5%; Non-paranoid: 5%
Cummings et al.²⁰20. Cummings JL, Miller B, Hill MA, Neshkes R. Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. Arch Neurol. 1987;44(4):389-93. https://doi.org/10.1001/archneur.1987.00520160031010 https://doi.org/10.1001/archneur.1987.00...	AD/VD	45 AD: 30 VD: 15	Psychosis: AD: 46%; VD: 46% Hallucinations: AD: 3.3%; VD: 27%	Hallucinations: AD – Olfactory: 3.33% VD – Auditory: 13%; Visual: 20% Misidentifications: AD – Capgras: 7%; Phantom Boarder: 3.33% VD – Phantom Boarder: 7%
Deutsch et al.⁷7. Deutsch LH, Bylsma FW, Rovner BW, Steele C, Folstein MF. Psychosis and physical aggression in probable Alzheimer’s disease. Am J Psychiatry. 1991;148(9):1159-63. https://doi.org/10.1176/ajp.148.9.1159 https://doi.org/10.1176/ajp.148.9.1159...	AD	170	Delusions: 43.5% Hallucinations: 23.5% Misidentifications: 30%	Delusions: Persecutory: 32%; Reference: 6%; Jealousy: 4%; Grandeur: 0.6; Somatic: 0.6% Hallucinations: Visual: 20%; Olfactory: 11%; Tactile: 0.6% Misidentifications: Not being home: 15%; Phantom Boarder: 9%; Mirror: 6%; Capgras (caregiver): 0.6%
Devenney et al.²¹21. Devenney EM, Landin-Romero R, Irish M, Hornberger M, Mioshi E, Halliday GM, et al. The neural correlates and clinical characteristics of psychosis in the frontotemporal dementia continuum and the C9orf72 expansion. Neuroimage Clin. 2016;13:439-45. https://doi.org/10.1016/j.nicl.2016.11.028 https://doi.org/10.1016/j.nicl.2016.11.0...	FTD-BV FTD-ALS	Total: 79 Dementia: 56 FTD-BV: 36 FTD-ALS: 20	Psychosis: 34% Delusions: 28.57% Hallucinations: 25%	Delusions: Persecutory: 18%; Somatic: 9%; Grandeur: 7%; Jealousy: 5% Hallucinations: Auditory: 9%; Visual: 9%; Tactile: 4%
Farber et al.²²22. Farber NB, Rubin EH, Newcomer JW, Kinscherf DA, Miller JP, Morris JC, et al. Increased neocortical neurofibrillary tangle density in subjects with Alzheimer disease and psychosis. Arch Gen Psychiatry. 2000;57(12):1165-73. https://doi.org/10.1001/archpsyc.57.12.1165 https://doi.org/10.1001/archpsyc.57.12.1...	AD	109	Psychosis: 63% Delusions: 60% Hallucinations: 32% (isolated: 4%) Misidentifications: 31% (84% with another psychosis)	Delusions: Persecutory: 37%; Jealousy: 3%; Others: 33% Hallucinations: Visual: 25%; Olfactory: 13%; Others: 6% Misidentifications: Other people: 23%; Person himself/herself: 5%; Television: 2%
Flynn et al.²³23. Flynn FG, Cummings JL, Gornbein J. Delusions in dementia syndromes: investigation of behavioral and neuropsychological correlates. J Neuropsychiatry Clin Neurosci. 1991;3(4):364-70. https://doi.org/10.1176/jnp.3.4.364 https://doi.org/10.1176/jnp.3.4.364...	AD/VD	33 AD: 19 VD: 14	Delusions: Total: 60.6% AD: 68.4% VD: 50%	Delusions: AD – Theft: 58%; Not being home: 47%; Persecutory: 37%; Capgras: 37% Abandonment: 37%; Jealousy: 26%; Phantom Boarder: 21% VD – Theft: 21%; Not being home: 14%; Jealousy: 14%; Phantom Boarder: 14%; Capgras: 7%; Abandonment: 7%
Förstl et al.²⁴24. Förstl H, Burns A, Levy R, Cairns N. Neuropathological correlates of psychotic phenomena in confirmed Alzheimer’s disease. Br J Psychiatry. 1994;165(1):53-9. https://doi.org/10.1192/bjp.165.1.53 https://doi.org/10.1192/bjp.165.1.53...	AD	56	Delusions: 16% Misidentifications: 25%	Delusions: Persecutory: 7%; Jealousy: 4%; Theft: 2%; Poisoning: 2%; Nihilist: 2% Hallucinations: Auditory: 12.5%; Visual: 17.8% Misidentifications: Capgras: 16%; Phantom Boarder: 9%; Television: 4%; Mirror: 4%
Geroldi et al.²⁵25. Geroldi C, Akkawi NM, Galluzzi S, Ubezio M, Binetti G, Zanetti O, et al. Temporal lobe asymmetry in patients with Alzheimer’s disease with delusions. J Neurol Neurosurg Psychiatry. 2000;69(2):187-91. https://doi.org/10.1136/jnnp.69.2.187 https://doi.org/10.1136/jnnp.69.2.187...	AD	41	Delusions: 46%	Delusions: Theft: 46%; Persecutory or jealousy: 15%
Gormley and Rizwan²⁶26. Gormley N, Rizwan MR. Prevalence and clinical correlates of psychotic symptoms in Alzheimer’s disease. Int J Geriatr Psychiatry. 1998;13(6):410-4. https://doi.org/10.1002/(sici)1099-1166(199806)13:6<410::aid-gps787>3.0.co;2-s https://doi.org/10.1002/(sici)1099-1166(...	AD	70	Psychosis: 36% Delusions: 34% Hallucinations: 11%	Delusions: Persecutory: 21%; Theft: 14%; Jealousy: 11%; Abandonment: 7%; Capgras (caregiver): 4%; Not being home: 6%; Others: 6% Hallucinations: Visual: 7%; Auditory: 4%
Hamuro et al.²⁷27. Hamuro A, Isono H, Sugai Y, Torii S, Furuta N, Mimura M, et al. Behavioral and psychological symptoms of dementia in untreated Alzheimer’s disease patients. Psychogeriatrics. 2007;7(1):4-7. https://doi.org/10.1111/j.1479-8301.2006.00153.x https://doi.org/10.1111/j.1479-8301.2006...	AD	202	Delusions: 29.7% Hallucinations: 8.42% Misidentifications: 21.8%	Delusions: Insult: 26%; Theft: 21%; Jealousy: 2%; Poisoning: 1.4%; Persecutory: 0.5%; Observation: 0.5%; Others: 3% Hallucinations: Visual: 7.43%; Auditory: 2.97% Misidentifications: Phantom Boarder: 20%; Capgras: 1.4%; Mirror: 0.5%
Harciarek and Kertesz²⁸28. Harciarek M, Kertesz A. The prevalence of misidentification syndromes in neurodegenerative diseases. Alzheimer Dis Assoc Disord. 2008;22(2):163-9. https://doi.org/10.1097/WAD.0b013e3181641341 https://doi.org/10.1097/WAD.0b013e318164...	AD, FTD-BV, PPA, SD, CBD, PSP, PD, DLB	PPA: 60 SD: 17 PSP: 13 DLB: 36 PD: 9	Misidentifications: AD: 15.8% DLB: 16.3% SD: 8.3%	AD – Capgras: 5.9%; Capgras + Phantom Boarder or environment reduplication: 7.4%; Phantom Boarder or environment reduplication: 1.5% DLB – Capgras alone: 8.3%; Capgras + Phantom Boarder: 8.3% SD – Capgras: 2%; Capgras + Phantom Boarder/reduplication of place: 2% No relationship between MIs and FTD-BV, PPA, PSP, PD.
Ikeda et al.²⁹29. Ikeda M, Shigenobu K, Fukuhara R, Hokoishi K, Nebu A, Maki N, et al. Delusions of Japanese patients with Alzheimer’s disease. Int J Geriatr Psychiatry. 2003;18(6):527-32. https://doi.org/10.1002/gps.864 https://doi.org/10.1002/gps.864...	AD	112	Delusions: 47.3% Misidentifications: 23%	Delusions: Theft: 75.5%; Persecutory: 9%; Abandonment: 2%; Jealousy: 5%; Others: 9% Misidentifications: Phantom Boarder: 14%; Not being home: 4%; Television: 4%/Capgras: 1%
Korhonen et al.³⁰30. Korhonen T, Katisko K, Cajanus A, Hartikainen P, Koivisto AM, Haapasalo A, et al. Comparison of prodromal symptoms of patients with behavioral variant frontotemporal dementia and Alzheimer disease. Dement Geriatr Cogn Disord. 2020;49(1):98-106. https://doi.org/10.1159/000507544 https://doi.org/10.1159/000507544...	AD/FTD-BV	83 AD 75 FTD-BV	Delusions: AD: 4.8% FTD-BV: 34.67% Hallucinations: AD: 4.8% FTD-BV: 16%	AD – Auditory: 1.2%; Visual: 3.6% FTD – Auditory: 8%; Visual: 13.3%
Kwak et al.³¹31. Kwak YT, Yang YS, Kwak SG, Koo MS. Delusions of Korean patients with Alzheimer’s disease: study of drug-naïve patients. Geriatr Gerontol Int. 2013;13(2):307-13. https://doi.org/10.1111/j.1447-0594.2012.00897.x https://doi.org/10.1111/j.1447-0594.2012...	AD	230	Delusions: 27.4% Misidentifications: 5.2%	Delusions: Theft: 15%; Jealousy: 5%; Persecutory: 4%; Abandonment: 4%; Erotic: 0.4%; Grandeur: 0.4%; Mixed: 5% Misidentifications: Capgras: 4%; Phantom Boarder: 3%; Reduplication of place: 3%; Television: 2%; Mirror: 1%
Leroi et al.³²32. Leroi I, Voulgari A, Breitner JCS, Lyketsos CG. The epidemiology of psychosis in dementia. Am J Geriatr Psychiatry. 2003;11(1):83-91. https://doi.org/10.1097/00019442-200301000-00011 https://doi.org/10.1097/00019442-2003010...	AD/VD	260	Psychosis: AD: 26.9%/VD: 15.3% Delusions: AD: 21.8%/VD: 12.5% Hallucinations: AD: 12.8%/VD: 15.5% Misidentifications: AD: 8%/VD: 6.8%	Delusions: AD – Persecutory: 6.6%; Theft: 12.7%; Jealousy: 2.2%; Abandonment: 4.1%; Phantom Boarder: 4.6%; Capgras: 1.6%; Not being home: 3.1%; Media people in the house: 2% VD – Theft: 6.8%; Abandonment: 3.4%; Phantom Boarder: 5.1%; Capgras: 5.1%; Not being home: 3.4%; Media people in the house: 1.7% Hallucinations: AD – Auditory: 3.6%; Visual: 9.1%; Tactile: 1%; Gustatory: 0.5% VD – Auditory: 6.9%; Visual: 8.5%
Linszen et al.³³33. Linszen MM, Lemstra AW, Dauwan M, Brouwer RM, Scheltens P, Sommer IEC. Understanding hallucinations in probable Alzheimer’s disease: very low prevalence rates in a tertiary memory clinic. Alzheimers Dement (Amst). 2018;10:358-62. https://doi.org/10.1016/j.dadm.2018.03.005 https://doi.org/10.1016/j.dadm.2018.03.0...	AD	1,227	Delusions: 2% Hallucinations: 4.5%	Delusions: Theft: 22%; Capgras: 0.8%; Persecutory: 0.7% Hallucinations: Visual: 3%; Auditory: 1%; Olfactory: 0.4%; Tactile: 0.2%; Not specified: 1%
Liu et al.³⁴34. Liu CY, Wang PN, Lin KN, Liu HC. Behavioral and psychological symptoms in Taiwanese patients with Alzheimer’s disease. Int Psychogeriatr. 2007;19(3):605-13. https://doi.org/10.1017/S1041610207005121 https://doi.org/10.1017/S104161020700512...	AD	142	Delusions: 50.7% Hallucinations: 24.6%	Delusions: Theft: 30.3%; Persecutory: 29.6%; Not being home: 14.7%; Capgras (caregiver): 3.5%; Abandonment: 4.2%; Jealousy: 4.2%; Others: 1.4% Hallucinations: Visual: 21.1%; Auditory: 12%; Olfactory: 0.7%; Tactile: 0.7%
Mendez et al.³⁵35. Mendez MF, Martin RJ, Smyth KA, Whitehouse PJ. Disturbances of person identification in Alzheimer’s disease. A retrospective study. J Nerv Ment Dis. 1992;180(2):94-6. https://doi.org/10.1097/00005053-199202000-00005 https://doi.org/10.1097/00005053-1992020... ,³⁶36. Mendez MF, Martin RJ, Smyth KA, Whitehouse PJ. Psychiatric symptoms associated with Alzheimer’s disease. J Neuropsychiatry Clin Neurosci. 1990;2(1):28-33. https://doi.org/10.1176/jnp.2.1.28 https://doi.org/10.1176/jnp.2.1.28...	AD	217	Delusions: 30% Hallucinations: 25.4% Misidentifications: 25.4%	Delusions: Theft: 11%; The other is dead: 5.5%; Persecutory: 5.5%; Jealousy: 2.5%; Somatic: 2%; Intrusion: 1.3%; Duplicate residence: 0.5%; Abandonment: 0.5% Hallucinations: Visual: 19%; Auditory: 3%; Tactile: 1%; Auditory+Visual: 3% Misidentifications: Capgras: 5%; Phantom Boarder: 5%; Mirror: 2.3%; Prosopagnosia: 1.4%; Television: 0.5%; Double subjective autoscopy: 0.5%
Mendez et al.⁶6. Mendez MF, Shapira JS, Woods RJ, Licht EA, Saul RE. Psychotic symptoms in frontotemporal dementia: prevalence and review. Dement Geriatr Cogn Disord. 2008;25(3):206-11. https://doi.org/10.1159/000113418 https://doi.org/10.1159/000113418...	AD/FTD	AD: 23 FTD: 86	Delusions AD: 17.4%/FTD: 2.3% Hallucinations AD: 21.7%/FTD: 3.48%	Delusions: AD – Delusions of jealousy: 17.4% FTD – Delusions of having been married to famous people and that her husband treated her badly; 1% with paranoid delusion
Migliorelli et al.³⁷37. Migliorelli R, Petracca G, Tesón A, Sabe L, Leiguarda R, Starkstein SE. Neuropsychiatric and neuropsychological correlates of delusions in Alzheimer’s disease. Psychol Med. 1995;25(3):505-13. https://doi.org/10.1017/s0033291700033420 https://doi.org/10.1017/s003329170003342...	AD	103	Delusional disorder: 20% Hallucinations: 3%	Delusions: Theft: 14%; Hypochondriac: 14%; Abandonment: 7%; Not being home: 6%; Capgras: 6%; Grandeur: 6%; Jealousy: 4%; Erotomania: 2%
Mizrahi et al.³⁸38. Mizrahi R, Starkstein SE, Jorge R, Robinson RG. Phenomenology and clinical correlates of delusions in Alzheimer disease. Am J Geriatr Psychiatry. 2006;14(7):573-81. https://doi.org/10.1097/01.JGP.0000214559.61700.1c https://doi.org/10.1097/01.JGP.000021455...	AD	771	Delusions: 32% Hallucinations: 7%	Delusions: Theft: 22%; Grandeur: 11%; Not being home: 9%; Abandonment: 6%; Jealousy: 6%; Capgras: 4%; Erotomania: 3%; Phantom Boarder: 1% Hallucinations: Visual: 4.2%; Auditory+Visual: 2%; Auditory: 1%; Tactile: 0.4%; Olfactory: 0.1%
Nagahama et al.¹¹11. Nagahama Y, Okina T, Suzuki N, Matsuda M, Fukao K, Murai T. Classification of psychotic symptoms in dementia with Lewy bodies. Am J Geriatr Psychiatry. 2007;15(11):961-7. https://doi.org/10.1097/JGP.0b013e3180cc1fdf https://doi.org/10.1097/JGP.0b013e3180cc...	DLB	100	Delusions: 25% Hallucinations: 78% Misidentifications: 56%	Delusions: Theft: 14%; Persecutory: 11%; Hypochondriac: 3%; Jealousy: 1%; Pregnancy: 1% Hallucinations: Auditory: 8%; Tactile: 2% Misidentifications: People: 17%; Objects: 14%; Places: 28%; Phantom Boarder: 11%; Reduplication of people: 10%; Reduplication of places: 6%; Capgras: 6%; Television: 3%
Nagahama et al.³⁹39. Nagahama Y, Fukui T, Akutagawa H, Ohtaki H, Okabe M, Ito T, et al. Prevalence and clinical implications of the mirror and TV signs in advanced Alzheimer’s disease and dementia with Lewy bodies. Dement Geriatr Cogn Dis Extra. 2020;10(1):56-62. https://doi.org/10.1159/000506510 https://doi.org/10.1159/000506510...	AD/DLB	AD: 200 DLB: 200	–	Persecutory delusions: AD: 55%; DLB: 65.5% Visual hallucinations: AD: 0%; DLB: 86.5% Auditory hallucinations: AD: 8%; DLB: 87.5% MI of people AD: 11.5%; DLB: 25% Television sign: AD: 1.5%; DLB: 4% Mirror sign: AD: 3%; DLB: 4.5%
Nedelec-Ciceri et al.⁹9. Nedelec-Ciceri C, Chaumier JA, Lussier MD, Merlet-Chicoine I, Bouche G, Paccalin M, et al. Troubles de l’identification et délires d’identité dans la maladie d’Alzheimer: une enquête régionale. Revue Neurologique. 2006;162(5):628-36. https://doi.org/10.1016/S0035-3787(06)75057-3 https://doi.org/10.1016/S0035-3787(06)75...	AD	98	Misidentifications: 81.6%	Misidentifications: MI of people: 62% (Capgras: 1%) MI of places: 81% MI of self-identification: 14% (mirror 10%)
Naasan et al.⁴⁰40. Naasan G, Shdo SM, Rodriguez EM, Spina S, Grinberg L, Lopez L, et al. Psychosis in neurodegenerative disease: differential patterns of hallucination and delusion symptoms. Brain. 2021;144(3):999-1012. https://doi.org/10.1093/brain/awaa413 https://doi.org/10.1093/brain/awaa413...	AD DLB FTD	AD: 111 DLB: 59 FTD: 201	Delusions: AD: 16.2% DLB: 25.4% FTD: 18.4% Hallucinations: AD: 12.6% DLB: 47.5% FTD: 18.1% Psychosis: AD: 22.5% DLB: 56.0% FTD: 20.1%	Delusions: AD – Paranoid: 9.0%; Persecutory: 1.8%; Intrusion: 0.9%; Hurting: 0.9%; Jealousy: 11.1%; Place: 3.0%; Other person: 11.1%; Grandeur: 1.8% DLB – Paranoid: 18.6%; Persecutory: 13.6%; Intrusion: 5.1%; Theft: 3.4%; Hurting: 5.0%; Jealousy: 8.5%; Place: 10.2%; Other person: 14.1%; Grandeur: 8.5% FTD – Paranoid: 11.9%; Persecutory: 7.5%; Intrusion: 2.5%; Theft: 3.1%; Hurting: 3.0%; Jealousy: 7.5%; Place: 1.5%; Other person: 2.5%; Grandeur: 7.5%; Erotomania: 2.5% Hallucinations: AD – Visual: 3.6%; Other hallucinations: 13.5% DLB – Tactile: 3.4%; Olfactory: 1.7%; Visual: 13.5%; Other hallucinations: 47.5% FTD – Tactile: 0.5; Olfactory: 0.5%; Visual: 1.5%; Other hallucinations: 18.1%
Perini et al.⁴¹41. Perini G, Carlini A, Pomati S, Alberoni M, Mariani C, Nemni R, et al. Misidentification delusions: Prevalence in Different Types of Dementia and Validation of a Structured Questionnaire. Alzheimer Dis Assoc Disord. 2016;30(4):331-7. https://doi.org/10.1097/WAD.0000000000000141 https://doi.org/10.1097/WAD.000000000000...	AD/VD/FTD/DLB	186 AD: 146 VD: 13 FTD: 6 DLB: 21	Misidentifications: 33.3-36% AD: 30.1% VD: 46.1% DLB: 57.1% FTD: 0	AD/DLB/VD MI of the house: 28.1/47.6/38.5% Capgras (people): 3.4/33.3/30.8% Capgras (objects/animals): 4.1/9.5/15.4% Fregoli: 0.7/9.5/7.7% Reduplicative Paramnesia: 7.5/23.8/15.4% Intermetamorphosis: 1.4/14.3/15.4% Syndrome of double subjects: 0/4.8%/0 MI of mirror: 4.8%/0/0 Division of people: 8.9/19/15.4% Television: 6.2/19/7.7% Cotard: 0.7%/0/0
Sala et al.⁴²42. Sala SD, Francescani A, Muggia S, Spinnler H. Variables linked to psychotic symptoms in Alzheimer’s disease. Eur J Neurol. 1998;5(6):553-60. https://doi.org/10.1046/j.1468-1331.1998.560553.x https://doi.org/10.1046/j.1468-1331.1998...	AD	180	Psychosis: 35.5% Delusions: 18.3% Hallucinations: 24% Misidentifications: 11.1%	Delusions: Theft: 11%; Persecution: 6%; Jealousy: 2% Hallucinations: Visual: 21%; Auditory+Visual: 2%; Auditory: 2% Misidentifications: Television: 8%; Phantom Boarder: 2%; Mirror: 1%
Suárez-González et al.⁴³43. Suárez-González A, Serrano-Pozo A, Arroyo-Anlló EM, Franco-Macías E, Polo J, García-Solís D, et al. Utility of neuropsychiatric tools in the differential diagnosis of dementia with Lewy bodies and Alzheimer’s disease: quantitative and qualitative findings. Int Psychogeriatr. 2014;26(3):453-61. https://doi.org/10.1017/S1041610213002068 https://doi.org/10.1017/S104161021300206...	AD/DLB	165 AD: 85 DLB: 80	Delusions AD: 32.9%/DLB: 47.5% Hallucinations AD: 12.9%/DLB: 51.2% Misidentifications: AD: 17.6%/DLB: 42.5%	Delusions (AD/DLB): Paranoid: 20/23.7% Abandonment: 2.3/6.2% Somatic: 0/5% Hallucinations (AD/DLB): Visual: 12.9/50%; Auditory: 1.2/17.5%; Tactile: 0/3.7%; Olfactory: 0/3.7% Misidentifications (AD/DLB): Capgras: 9.4/22.5%; Phantom Boarder: 4.7/22.5%; Not being home: 7.1/31.2%; Television: 3.5/13.7%; Mirror: 1.2/2.5%
Tsunomoda et al.⁴⁴44. Tsunoda N, Hashimoto M, Ishikawa T, Fukuhara R, Yuki S, Tanaka H, et al. Clinical features of auditory hallucinations in patients with dementia with Lewy bodies: a soundtrack of visual hallucinations. J Clin Psychiatry. 2018;79(3):17m11623. https://doi.org/10.4088/JCP.17m11623 https://doi.org/10.4088/JCP.17m11623...	DLB	124	Delusions: 54.8% Hallucinations: 63.7% Misidentifications: 13.7%	Delusions: Theft: 25.8%; Persecutory: 14.5%; Jealousy: 6.5%; Abandonment: 4% Hallucinations: Visual: 60.5%; Auditory: 35.5%; Auditory+Visual: 32.3% Misidentifications: Phantom Boarder: 31.4%; Not being home: 13.7%; Television: 12.1%; Capgras: 8.9%
Tzeng et al.⁴⁵45. Tzeng RC, Tsai CF, Wang CT, Wang TY, Chiu PY. Delusions in patients with dementia with Lewy bodies and the associated factors. Behav Neurol. 2018:6707291. https://doi.org/10.1155/2018/6707291 https://doi.org/10.1155/2018/6707291...	DLB	207	Delusions: 51.2%	Delusions: Theft: 35.3%; Persecutory: 21.3%; Not being home: 10.8%; Jealousy: 7.2%; Abandonment: 4.8% Misidentifications: Phantom Boarder: 2.9%; Media people in the house: 2.9%; Capgras: 1%
Wilson et al.⁵5. Wilson RS, Tang Y, Aggarwal NT, Gilley DW, McCann JJ, Bienias JL, et al. Hallucinations, cognitive decline, and death in Alzheimer’s disease. Neuroepidemiology. 2006;26(2):68-75. https://doi.org/10.1159/000090251 https://doi.org/10.1159/000090251...	AD	478	Delusions: 27.3% Hallucinations: 29.6% Misidentifications: 25.5%	Hallucinations: Auditory+Visual: 14%; Visual: 11%; Auditory: 5%

Type of dementia	Psychotic symptoms (%)	Delusions (%)	Hallucinations (%)	Misidentifications (%)
Alzheimer’s disease	82	2–68.4	3–32	5.2–81.6
Dementia with Lewy bodies	71	9.5–54.8	11–79.5	13.7–57.1
Vascular dementia	60	12.5–50	15.5–27	6.8–46
Frontotemporal dementia	66	3–25	3–25	0

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Correspondence: Madson A. Maximiano-Barreto; Email: mmaximianopsi@gmail.com.