NEW YORK (Reuters Health) - Hallucination, delusions and paranoia may be more common among very old people than previously believed, according to Swedish researchers.

``It has been suggested that this prevalence is underrated because the elderly persons may be reluctant to report psychotic symptoms,'' Drs. Svante Ostling and Ingmar Skoog of Goteborg University write in the January issue of the journal Archives of General Psychiatry.

To investigate the true prevalence of psychotic symptoms among older people, the researchers followed 347 people over the age of 85 for three years, assessing them for the development of psychotic symptoms and dementia. At the beginning of the study, the men and women had no signs of dementia or psychosis.

Over the study period, 10% of the group had one or more psychotic symptoms. Seven percent had hallucinations and 5.5% had delusions, while nearly 7% had paranoid thoughts.

``We found a higher prevalence of psychotic symptoms and paranoid (thoughts) in the elderly than previously reported, and these symptoms were associated with a poor prognosis,'' the authors report.

For example, hallucinations were associated with depression, disability and vision problems. People with paranoid thoughts were more likely to have visual impairments and heart attacks.

``The new findings make sense clinically,'' Dr. John C. S. Breitner of Johns Hopkins University in Baltimore, Maryland, writes in an editorial accompanying the study.

``Presumably, some affected individuals hide their symptoms out of fear of reprisal (while) others do so because they have learned that other people will not accept or understand their experience,'' Breitner adds.

SOURCE: Archives of General Psychiatry 2002;59:53-61.

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