Psychosis in Dementia

Psychotic symptoms such as delusions and hallucinations are another common BPSD in dementia, and they are associated with various negative consequences that affect not only the individuals but also the caregivers. Nevertheless, differentiating psychotic symptoms from illusions or cognitive symptoms is sometimes difficult in people with dementia. Moreover, these individuals are not uncommonly mistaken as having schizophrenia or delirium. This has strong clinical implications, as the use of antipsychotics is associated with not only potential side effects but, more importantly, an increased risk of stroke and death in older adults with dementia. Here, we focus on describing the clinical aspects and management of psychosis in dementia rather than psychosis prior to dementia onset or due to delirium. The latest epidemiological data, the most recent diagnostic criteria, and the most up-to-date evidence of treatment for psychosis in dementia are discussed in this chapter.