International Psychogeriatrics


Psychotic Symptoms in Alzheimer's Disease Are Not Associated With More Severe Neuropathologic Features

Robert A. Sweet a1, Ronald L. Hamilton a3, Oscar L. Lopez a2, William E. Klunk a1, Stephen R. Wisniewski a4, Daniel I. Kaufer a2, Matthew T. Healy a1 and Steven T. DeKosky a1a2
a1 Division of Geriatrics and Neuropsychiatry, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
a2 Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
a3 Division of Neuropathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
a4 Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.

Article author query
sweet r   [PubMed][Google Scholar] 
hamilton r   [PubMed][Google Scholar] 
lopez o   [PubMed][Google Scholar] 
klunk w   [PubMed][Google Scholar] 
wisniewski s   [PubMed][Google Scholar] 
kaufer d   [PubMed][Google Scholar] 
healy m   [PubMed][Google Scholar] 
dekosky s   [PubMed][Google Scholar] 


Psychotic symptoms in Alzheimer's disease (AD) have been associated with increased rates of cognitive impairment and functional decline. Prior studies have been conflicting with regard to whether AD patients with psychosis (AD+P) have evidence of more severe neuropathologic findings at postmortem exam. We examined the severity of neuritic plaques and neurofibrillary tangles in six brain regions—middle frontal cortex, hippocampus, inferior parietal cortex, superior temporal cortex, occipital cortex, and transentorhinal cortex—in 24 AD+P subjects and 25 matched AD subjects without psychosis (AD-P). All analyses controlled for the presence of cortical Lewy bodies, and corrected for multiple comparisons. We found no significant associations between neuritic plaque and neurofibrillary tangle severity and AD+P, and no significant associations with any individual psychotic symptom. The association of AD+P with a more rapidly progressive course of AD appears to be mediated by a neuropathologic process other than increased severity of plaque and tangle formation.

(Received March 28 2000)
(Accepted May 5 2000)

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