학술논문

Psychosis in Alzheimer’s Disease
Document Type
article
Source
Current Neurology and Neuroscience Reports. 20(12)
Subject
Biological Psychology
Psychology
Acquired Cognitive Impairment
Mental Health
Neurosciences
Dementia
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Aging
Neurodegenerative
Alzheimer's Disease
Clinical Research
Brain Disorders
Neurological
Good Health and Well Being
Alzheimer Disease
Antipsychotic Agents
Cholinesterase Inhibitors
Cognitive Dysfunction
Humans
Psychotic Disorders
Alzheimer's disease
Psychosis
Frequency
Impact
Mechanisms
Non-pharmacological
Pharmacological
Alzheimer’s disease
Clinical Sciences
Neurology & Neurosurgery
Biological psychology
Language
Abstract
Purpose of reviewTo review the incidence, treatment and genetics of psychosis in people with mild cognitive impairment (MCI) and Alzheimer's disease (AD).Recent findingsPsychosis in Alzheimer's disease (AD) has an incidence of ~ 10% per year. There is limited evidence regarding psychological interventions. Pharmacological management has focused on atypical antipsychotics, balancing modest benefits with evidence of long-term harms. The 5HT2A inverse agonist pimavanserin appears to confer benefit in PD psychosis with initial evidence of benefit in AD. Cholinesterase inhibitors give modest benefits in DLB psychosis. The utility of muscarinic agonists, lithium, glutamatergic and noradrenergic modulators needs further study. Recent work has confirmed the importance of psychosis in MCI as well as AD. The lack of evidence regarding psychological therapies is an urgent knowledge gap, but there is encouraging evidence for emerging pharmacological treatments. Genetics will provide an opportunity for precision medicine and new treatment targets.