Functional outcome in delusional Alzheimer disease patients: A systematic review

Abstract

Background: In spite of the prevalence of delusions in Alzheimer's disease (AD) and their association with poor outcomes, there has been little study of the impact of delusions on real-world functioning. Method: A number of databases, including Psychlit and Medline, were searched using the keywords: delusions, functional outcomes, activities of daily living, dementia, and Alzheimer's disease. Studies were included in the review if they were in English, restricted to patients with AD, and addressed delusions and function. Results: The review yielded a total of 6 studies, 3 of which showed a correlation between delusions and real-world functioning and 3 of which did not. Conclusion: A critical analysis of the existing studies suggests that there may be an association between delusions and impaired real-world functioning. We believe that 2 of the 3 negative studies did not show an association due to issues relating to study design and the use of measures insensitive to executive impairment. This review highlights the future need for more scientifically rigorous studies to clarify this association, so as to ultimately improve treatment outcomes for patients. Copyright © 2009 S. Karger AG.