Work

Psychosis in Neurocognitive Disorder Among Ethnoculturally Diverse Older Persons

Year: 2025

Type: article

Abstract: Background and Objectives: There is longstanding evidence that the presence of psychosis in neurocognitive disorders (NCDs) is associated with faster cognitive and functional decline. The goal of this study was to examine how clinician-diagnosed psychosis differs among ethnoracial groups with NCDs (including early onset) and to explore whether these differences exist even for those without advanced dementia. Method: This is an IRB-approved retrospective analysis. Data are from the National Alzheimer's Coordinating Center Uniform Dataset from 42 Alzheimer's Disease Research Centers. Participants aged 40-95 years as of June 2023 with mild cognitive impairment (MCI) or dementia on baseline evaluation were included. Psychosis was defined as clinician-diagnosed visual or auditory hallucinations or delusions manifesting at the time of baseline evaluation. Ethnoracial groups were self-reported. Associations between ethnoracial groups and psychosis in NCDs were estimated using adjusted multivariable logistic regression with dichotomous measures of outcomes. Covariates included age, sex, years of education, severity of cognitive impairment (Clinical Dementia Rating scale), and presence or absence of any self-reported preexisting psychiatric illness. An analysis by age younger than 65 years was also conducted. Exploratory multivariable logistic regression analyses were performed for participants with milder stages of dementia (Clinical Dementia Rating 0.5 or 1) and for the subset of participants diagnosed with MCI. Results: = 0.0002) participants had greater odds of psychosis in NCDs when compared with White-NL participants. For MCI alone, there were no significant differences. Discussion: Black-NL, Latino, and AI/AN individuals were more likely to be diagnosed with psychosis in NCDs when compared with White-NL participants. More research is needed to explore sociocultural, psychosocial, and neuropathologic factors involved.

Source: Neurology Clinical Practice

DOI: 10.1212/cpj.0000000000200467