Examining the Content, Frequency of Auditory Hallucinations in Dementia

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The presence of auditory and visual hallucinations and other neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory.
The presence of auditory and visual hallucinations and other neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory.

According to data published in the Journal of Clinical Psychiatry, auditory hallucinations in patients with dementia with Lewy bodies (DLB) are more likely to occur in women and in those with visual hallucinations, impaired hearing, depression, and delusions. 

Researchers recruited 124 consecutive patients with probable DLB from Kumamoto University Hospital in Japan. The presence of auditory and visual hallucinations and other neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory. Researchers captured additional clinical features of participants with auditory hallucinations from available clinical records. Multiple logistic regression analyses were used to identify predictors of auditory hallucinations. 

Of the total cohort, 44 (35.5%) patients had auditory hallucinations and 75 (60.5%) had visual hallucinations. The majority of patients (90.9%) with auditory hallucinations also experienced visual hallucinations. Auditory hallucinations were most often described as "human voices" and as "a soundtrack of the scene." Demographic and regression analyses indicated that auditory hallucinations were more likely in women (P =.04), patients with hearing impairment (P =.004), and patients receiving antipsychotic medications (P =.01). Patients with auditory hallucinations were also significantly older than those without (P =.02). The presence of visual hallucinations (P <.001), phantom boarder delusions (P =.001), and depression (P =.038) were each independently correlated with the presence of auditory hallucinations. 

These results highlight the risk for auditory hallucinations in certain subsets of patients with DLB and may be useful for clinicians in developing targeted treatment options. Future studies on the likelihood and content of hallucinations in patients with dementia may be helpful in pinpointing the most effective therapeutic approaches. 

Reference

Tsunoda N, Hashimoto M, Ishikawa T, et al. Clinical features of auditory hallucinations in patients with dementia with Lewy bodies: a soundtrack of visual hallucinations. J Clin Psychiatry. 2018;79(3):17m11623. 

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