Hallucinations and Aging

Aging in a society that values youth, beauty and thinness can be a difficult prospect. Added to that difficulty can be hallucinations of those who are going through their elder years.

Hallucinations are perceptions of an event that can be visual, auditory or olfactory (smell). They are powerful and convincing. But they do not exist in the real world. They can be a result of a problem deep in the neurological system or as a result of recreational drugs or prescribed medications.

Hallucinations and aging can be a result of several different factors, all of which can be demeaning and disturbing to both the sufferer and their family and friends. In some instances hallucinations can be an outcome of dementia, falling under the category of problems with the neurological system.

This type of dementia will sometimes occur alone or with Alzheimer’s or Parkinson’s disease. Dementia with Lewy-Body is the second most frequent cause in elderly adults. Unfortunately this type of dementia, associated with hallucinations, is also degenerative.

Elderly adults may also suffer from psychotic symptoms that include hallucinations or delusions. If an elderly person suffers from psychosis it is usually related to other disorders such as dementia, delirium or other mood disorders. Some of the psychotic disorders that lend themselves to hallucinations are schizophrenia and delusional disorders.

Hallucinations and aging can also be caused from severe visual loss. Approximately 10% of those adults with severe loss (greater than 20/60 in both eyes) will suffer from visual hallucinations. They usually take the form of shapes or are more complex with people seeing things such as children, animals or a scene from a movie.

Complex hallucinations in people with a vision loss is called Charles Bonnet syndrome. In this instance there is no evidence of brain disease, other psychiatric illness or medication interactions. People who suffer from this condition are usually aware that what they are seeing isn’t real but the hallucination is very real and vivid.

The elderly who suffer from Charles Bonnet syndrome need reassurance that their hallucinations are a result of eye disease and not a psychotic break or mental disease. If the sufferer becomes agitated from the hallucinations antipsychotic medications may be necessary if behavior becomes dangerous or leads to dangerous behavior.

Other older adults may suffer from hallucinations as a result of Parkinson’s disease, stroke or other brain disorders that are not a mental disorder or psychiatric problem. As with people who suffer from Charles Bonnet Syndrome; these sufferers also need support and reassurance that they aren’t losing their mind. They can benefit from education and support and potentially the occasional antipsychotic medication.

Some experience hallucinations because of other medications they may be taking to control another condition. In this case the physician or pharmacist will be able to help determine if one of the side effects of medications the sufferer is currently taking will affect visual, auditory or olfactory hallucinations. At this point the patient, doctor and family must weigh the benefit ratio of the medication vs. the risk of continuing the hallucinations.


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