Characteristics of Visual Hallucinations in Parkinson Disease Dementia and Dementia With Lewy Bodies

Parkinson disease dementia (PDD) and dementia with Lewy bodies (DLB) have overlapping clinical and pathologic features. Recurrent visual hallucinations (RVH) are common in both disorders. The authors have compared details of hallucination characteristics and associated neuropsychiatric features in D...

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Bibliographic Details
Published in:The American journal of geriatric psychiatry 2006-02, Vol.14 (2), p.153-160
Main Authors: Mosimann, Urs P., Rowan, Elise N., Partington, Cassie E., Collerton, Daniel, Littlewood, Elizabeth, O'Brien, John T., Burn, David J., McKeith, Ian G.
Format: Article
Language:English
Subjects:
Aged
Anxiety - epidemiology
Dementia
dementia with Lewy bodies
Female
Hallucinations - diagnosis
Hallucinations - epidemiology
Humans
Lewy Body Disease - epidemiology
Male
Parkinson Disease - epidemiology
Parkinson disease dementia
Severity of Illness Index
Sleep Wake Disorders - epidemiology
Surveys and Questionnaires
Visual hallucinations
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Summary:Parkinson disease dementia (PDD) and dementia with Lewy bodies (DLB) have overlapping clinical and pathologic features. Recurrent visual hallucinations (RVH) are common in both disorders. The authors have compared details of hallucination characteristics and associated neuropsychiatric features in DLB and PDD. This is a descriptive, cross-sectional study using the Institute of Psychiatry Visual Hallucinations Interview (IP-VHI) to explore self-reported frequency, duration, and phenomenology of RVH in PDD and DLB. The caregivers' ratings of hallucinations and other neuropsychiatric features were elicited with the Neuropsychiatric Inventory (NPI). Fifty-six patients (35 PDD; 21 DLB) with RVH were assessed. Hallucination characteristics were similar in both disorders. Simple hallucinations were rare. Most patients experienced complex hallucinations daily, normally lasting minutes. They commonly saw people or animals and the experiences were usually perceived as unpleasant. NPI anxiety scores were higher in PDD. Neuropsychiatric symptoms coexisting with hallucinations were apathy, sleep disturbance, and anxiety. Patients with mild to moderate dementia can provide detailed information about their hallucinations. Characteristics of RVH were similar in PDD and DLB, and phenomenology suggests the involvement of dorsal and ventral visual pathways in their generation. The coexistence of RVH with anxiety, apathy, and sleep disturbance is likely to impair patients' quality of life and may have treatment implications.
ISSN:1064-7481
1545-7214
DOI:10.1097/01.JGP.0000192480.89813.80