Research offers alternative explanation for late-onset psychosis

Scientists from Neuroscience Research Australia have found that symptoms of psychosis in older people can actually be an early predictor of a type of frontotemporal dementia where patients also develop symptoms of Motor Neurone Disease.

“It is not easy for clinicians to diagnose frontotemporal dementia when psychotic symptoms appear in early stages of the disease,” says Dr Patricia Lillo, one of the authors of the study. “In some instances the diagnosis could be mistaken with late-onset schizophrenia.”

Frontotemporal dementia (FTD) is a type of dementia that affects a person’s personality, behaviour and language skills. About 15% of people with FTD will also develop symptoms of Motor Neurone Disease (MND), including difficulties in swallowing, breathing and walking.

Dr Lillo says it’s essential that these patients are diagnosed at an early stage. “These patients need a totally different approach to treatment. They need more care and medical services such as physio and occupational therapists,” she says.

Up until now, there has been no definitive way of predicting which people with FTD will also go on to develop MND.

In their study, Dr Lillo and colleagues analysed the clinical and pathological records of 61 people with FTD. They found that those people with FTD who also went on to develop MND experienced delusions and hallucinations.

“These types of symptoms are not usually found in people with FTD,” says Dr Lillo.

“What we now know is that if you have a patient with behavioural changes, as in FTD, and they also have psychotic symptoms, that fact should lead to an early search for MND features and a multidisciplinary management”.

The study was published in Archives of Neurology.