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NEUROLOGY 2003;61:954-958
© 2003 American Academy of Neurology

Neuromotor abnormalities and risk for psychosis in Alzheimer’s disease

M. P. Caligiuri, PhD, G. Peavy, PhD, D. P. Salmon, PhD, D. R. Galasko, MD and L. J. Thal, MD

From the Departments of Psychiatry (Dr. Caligiuri) and Neuroscience (Drs. Peavy, Salmon, Galasko, and Thal), University of California, San Diego, and the UCSD Alzheimer’s Disease Research Center.

Address correspondence and reprint requests to Dr. Michael P. Caligiuri, Movement Disorders Laboratory, Department of Psychiatry (0603), University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093; e-mail: mcaligiuri{at}ucsd.edu

Background: Cross-sectional studies in Alzheimer’s disease (AD) show a strong relationship between extrapyramidal motor signs and presence of psychosis, yet it remains unclear whether neuromotor abnormalities precede and therefore can predict development of psychosis in AD.

Objective: To identify cognitive and motor risk factors for the development of psychosis in patients with AD.

Methods: Baseline clinical motor ratings and instrumental measures of neuromuscular function were obtained from 54 nonpsychotic patients with AD who were evaluated annually for 2 years for the development of psychosis. Survival analyses were performed to identify incidence and risks associated with psychosis.

Results: The incidence of new onset psychosis in our sample was 32.5% in 2 years. Patients with abnormal agonist muscle burst amplitudes during rapid alternating movements of the hand were more likely to develop psychosis than those without (OR = 4.31; p = 0.007). Women with AD also had a higher risk of developing psychosis within 2 years than men (OR = 1.33; p = 0.01).

Conclusions: Using simple noninvasive instrumental procedures for assessing neuromotor function, it may be possible to identify an individual’s level of risk for developing psychosis during the course of AD.

Received September 26, 2002. Accepted in final form June 26, 2003.

Presented in part at the American Association of Geriatric Psychiatry; Orlando; February 2002.




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[Abstract] [Full Text] [PDF]


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