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Aspects of dementia. A detailed phenomenological comparison of complex visual hallucinations in dementia with Lewy bodies and Alzheimer's disease

Lookup NU author(s): Dr Clive Ballard, Professor Ian McKeith, Rebecca Harrison, Professor John O'Brien, Paul Thompson, Kathleen Lowery, Emeritus Professor Robert Perry


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Visual hallucinations (VH) are a core feature of dementia with Lewy bodies (DLB), but little is known about their phenomenology. A total of 73 dementia patients (42 DLB, 30 Alzheimer's disease [AD], 1 undiagnosed) in contact with clinical services were assessed with a detailed standardized inventory. DLB was diagnosed according to the criteria of McKeith and colleagues, AD was diagnosed using the NINCDS-ADRDA criteria. Autopsy confirmation has been obtained when possible. VH were defined using the definition of Burns and colleagues. Detailed descriptions of hallucinatory experiences were recorded. Annual follow-up interviews were undertaken. The clinical diagnosis has been confirmed in 18 of the 19 cases that have come to autopsy. A total of 93% of DLB patients and 27% of AD patients experienced VH. DLB patients were significantly more likely to experience multiple VH that persisted over follow-up. They were significantly more likely to hear their VH speak but there were no significant differences in the other phenomenological characteristics including whether the hallucinations moved, the time of day that they were experienced, their size, the degree of insight, and whether they were complete. VH may be more likely to be multiple, to speak, and to be persistent in DLB patients. These characteristics could potentially aid accurate diagnosis.

Publication metadata

Author(s): Mckeith I; Thompson P; Perry R; Lowery K; O'Brien J; Ballard C; Harrison R; Ince P

Publication type: Article

Publication status: Published

Journal: International Psychogeriatrics

Year: 1997

Volume: 9

Issue: 4

Pages: 381-388

Print publication date: 01/12/1997

ISSN (print): 10416102

ISSN (electronic): 1741-203X

Publisher: Cambridge University Press


DOI: 10.1017/S1041610297004523

PubMed id: 9549588


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