An Overview of Delusions in Dementia

How you can help your loved one

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A delusion is a false idea or belief, sometimes stemming from a misinterpretation of a situation. While having these unshakeable beliefs in things that are untrue can be classified as a health condition on its own, experiencing delusions can also be a sign of dementia.

About one-third of people with dementia experience delusions, with the likelihood increasing as the disease progresses.

Older mother with dementia and daughter hugging
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Symptoms

If your loved one is experiencing delusions, things that are untrue will seem very real to them, even when they have evidence to the contrary. For example, they may be convinced that they are living in the past or in a different place.

Your loved one may also seem paranoid or suspicious of others, even those that they normally trust. For example, they may be insistent that a loved one is having an affair or stealing their money. 

Causes

The underlying cause of delusion in dementia stems from a person's inability to put bits of information and memories together correctly. This leads them to draw false conclusions and believe in something untrue. Delusions tend to become more frequent as dementia progresses.

Delusions are most often associated with Lewy body dementia, but can also occur in people with:

Diagnosis

If your loved one is suffering from delusions due to dementia, make an appointment with their healthcare provider. You may be referred to a psychiatrist or neurologist to help diagnose their condition.

This may involve a memory or cognitive test to get a better idea of their ability to reason. Your practitioner may also order diagnostic tests such as a CT scan or MRI of the brain.

Seek help immediately if you think your loved one may cause self-harm or harm to anyone else. Your healthcare provider can work with you on the best course of treatment to help both you and your loved one to stay safe.

Treatment

Non-drug treatment approaches are typically the first choice for helping people experiencing delusions associated with dementia. These approaches often require high levels of patience and understanding on part of families and caregivers.

The strategies include not taking offense to accusations, working to switch the person's focus away from whatever is bothering them, and helping to change their environment. When delusions are mild, your loved one may just need a simple reassurance or a kind word.

If non-drug approaches do not work well enough, the healthcare provider may prescribe medications to help manage symptoms. These medications may come with increased risk for stroke or death for older adults, so you and your loved one's healthcare provider should work together to weigh the risks and benefits of using these medications.

Coping

If your loved one is having delusions, it can be difficult to know how to respond. It’s normal to feel frustrated, exhausted, or stressed. 

Remember that your loved one can’t control their behavior, so try not to take what they say personally. Don’t argue with them or explain why they’re wrong. The best method is often to listen to what they have to say. Offer simple answers when asked rather than long explanations. Try to redirect them to another topic or activity.

Remember to make time for yourself as well. Do activities you enjoy. Make sure you’re getting enough rest, nutrition, and exercise. Sharing your thoughts and feelings can be helpful as well, so try to connect with friends, family, a counselor, or a support group. 

A Word From Verywell

Delusions can be stressful for both you and your loved one. Talk with your healthcare provider about treatments for dementia and how they can help with delusions. They can also recommend resources for your well-being, including counselors, support groups, or other professionals in your area. 

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lai L, Lee PE, Chan P, et al. Prevalence of delusions in drug-naïve Alzheimer disease patients: A meta-analysis. Int J Geriatr Psychiatry. 2019 Sep;34(9):1287-1293. doi: 10.1002/gps.4812.

  2. Alzheimer's Society. Delusions and dementia. Page last reviewed February 26, 2021.

  3. National Health Service. How to get a dementia diagnosis.

  4. Alzheimer’s Association. Suspicions and delusions

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