The Overlap of Neurocognitive Impairment and Psychosis: A Cross-Sectional Study on Dementia Patients with Schizophrenic Features in Bangladesh
Main Article Content
Abstract
Background: Dementia is frequently accompanied by neuropsychiatric symptoms, including psychosis, which can significantly complicate diagnosis and care. In low-resource settings like Bangladesh, this overlap remains understudied. Objective: This study explores the relationship between cognitive impairment and psychotic symptoms in dementia patients, with emphasis on schizophrenic features. Methods: A descriptive cross-sectional study was conducted from January to December 2024 at the Department of Psychiatry, President Abdul Hamid Medical College, Kishoreganj, Bangladesh. Results: The majority of patients had Alzheimer’s disease (47.4%) and severe cognitive impairment (MMSE <18 in 49.5%). Psychotic symptoms were prevalent: hallucinations (54.7%), delusions (50.5%), and suspiciousness (40.0%). BPSD symptoms included agitation/aggression (47.4%) and apathy (42.1%). A significant inverse correlation was found between MMSE and BPRS scores (r = -0.62, p < 0.001), indicating that greater cognitive decline was associated with more severe psychotic features. Chi-square analysis revealed significant associations between dementia severity and hallucinations (p = 0.002), delusions (p = 0.003), and suspiciousness (p = 0.007). No significant differences in psychotic symptom severity were found across dementia subtypes (p = 0.08). Conclusion: Psychotic symptoms are common and strongly associated with the severity of cognitive impairment in dementia patients.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
References
1. Nichols E, Szoeke CE, Vollset SE, et al. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(1):88–106.
2. WHO. Global action plan on the public health response to dementia 2017–2025. 2017.
3. McGrattan AM, Zhu Y, Richardson CD, et al. Prevalence and risk of mild cognitive impairment in low and middle-income countries. A Systematic Rev. 2021;79(Preprint):1–20.
4. Prince M, Acosta D, Ferri CP, et al. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study. Lancet. 2012;380(9836):50–58.
5. Avan A, Hachinski V. Global, regional, and national trends of dementia incidence and risk factors, 1990–2019: a Global Burden of Disease study. J Alzheimers Dementia. 2022;19(4):1281–1291.
6. Stephan B, Birdi R, Tang EYH, et al. Secular trends in dementia prevalence and incidence worldwide: a systematic review. J Alzheimers Dis. 2018;66(2):653–680.
7. Wolters FJ, Chibnik LB, Waziry R, et al. Twenty-seven-year time trends in dementia incidence in Europe and the United States: the Alzheimer cohorts consortium. Neurology. 2020;95(5):e519–e531.
8. Prina AM, Mayston R, Wu Y-T, Prince M. A review of the 10/66 dementia research group. Soc Psychiatry Psychiatr Epidemiol. 2019; 54:1–10.
9. Catindig J-AS, Venketasubramanian N, Ikram MK, Chen CC. Epidemiology of dementia in Asia: insights on prevalence, trends and novel risk factors. J Neurol Sci. 2012;321(1-2):11–16.
10. Raicher I, Shimizu MM, Takahashi DY, et al. Alzheimer's disease diagnosis disclosure in Brazil: a survey of specialized physicians' current practice and attitudes. Int Psychogeriatr. 2008; 20:471–81.
11. Wimo A, Jonsson L, Winblad B. An estimate of the worldwide prevalence and direct costs of dementia in 2003. Dement Geriatr Cogn Disord. 2006; 21:175–81.
12. Zhang ZX, Zahner GE, Roman GC, et al. Socio-demographic variation of dementia subtypes in China: methodology and results of a prevalence study in Beijing, Chengdu, Shanghai, and Xian. Neuroepidemiology. 2006; 27:177–87.
13. Waldemar G, Phung KT, Burns A, et al. Access to diagnostic evaluation and treatment for dementia in Europe. Int J Geriatr Psychiatry. 2007; 22:47–54
14. Skoog I, Lernfelt B, Landahl S, et al. 15-year longitudinal study of blood pressure and dementia. Lancet. 1996; 347:1141–45.
15. Luchsinger J, Mayeux R. Cardiovascular risk factors and Alzheimer's disease. Curr Atheroscler Rep. 2004; 6:261-66.