From the time of Alzheimer’s first description of psychotic
symptoms in a patient with Alzheimer’s disease in 1907,
psychosis has been recognized as a major clinical syndrome in
this illness. The consequences of psychotic symptoms in
Alzheimer’s disease may be painful and costly for the affected
individuals, those who care for them, and society at large.
Psychotic symptoms have been linked to greater caregiver
distress (1–3) and have been found to be a significant predictor
of functional decline and institutionalization (4–7). Compared
to patients with Alzheimer’s disease without psychosis, those
with Alzheimer’s disease and psychotic symptoms are also more
likely to have worse general health (8) as well as a greater
incidence of other psychiatric and behavioral disturbances
(9–11). Psychotic patients tend to have more frequent and
problematic behaviors, including agitation (12–14), episodes of
verbal and physical aggression (10, 15–18), and anxiety (11).
Reviews completed before the early 1990s found that ps