The Treatment of Psychosis in Late Life

The authors emphasize the need for careful differential diagnosis when symptoms of psychosisarise in patients over the age of 65 years. Prevalence of psychotic disorders in the elderly ranges from0.2%-4.7% in community-based samples to 10% in a nursing home population and as high as 63% ina study of Alzheimer’s patients. Risk factors associated with the development of psychotic symptomsand common causes of delirium are reviewed. Because age-related changes affect the pharmacokineticsof neuroleptics, the authors’ treatment recommendations, which include the use of traditional andnovel antipsychotics, take into account the higher risk of side effects in the elderly.