New Research on Psychosis in Older Adults

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Mental Health and Psychosocial Well-being".

Deadline for manuscript submissions: 15 July 2026 | Viewed by 2159

Special Issue Editors


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Guest Editor
Mazovia Branch, Polish Society of Gerontology, 01-826 Warsaw, Poland
Interests: internal medicine; geriatrics; psychogeriatrics; medical rehabilitation
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Guest Editor
Wolski Mental Health Center, 01-211 Warsaw, Poland
Interests: psychiatry; psychogeriatrics; education in psychiatry

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute your valuable knowledge to the Special Issue of Healthcare dedicated to new research on psychosis in older adults. Psychotic symptoms may accompany various clinical entities, including delirium, dementia, depression, bipolar disorder, and late-onset schizophrenia. Interrelationships between somatic and psychological determinants of mental health in older age make psychosis in older adults a multidimensional and multidisciplinary area of research and clinical practice. Aging of the population and increasing use of healthcare services by older adults worldwide justify the urgent need to develop guidelines for the diagnosis and treatment of psychosis for emergency services, family medicine, and long-term care.

This Special Issue aims to address the issue of psychosis in older adults in a wide spectrum of scientific and practice-oriented approaches applicable to various levels of healthcare. Understanding the bases and trajectories of psychotic symptoms as well as including cultural, social, and linguistic aspects of psychosis may support the development of personalized therapies. Including the perspective of older individuals affected with psychotic disorders might be a valuable but often overlooked clue to the optimal treatment.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: risk factors for psychotic disorders in older adults, diagnostic tools, symptomatology and differential diagnosis of psychotic symptoms in older adults, guidelines for diagnosis and treatment of psychosis in emergency services, therapeutic options in old age psychosis, non-pharmacological approaches to psychotic disorders, patient’s perspective, and education of medical staff to prevent, diagnose, and treat psychosis.

We look forward to receiving your contributions.

Dr. Katarzyna Broczek
Dr. Tomasz Krzysztof Szafrański
Guest Editors

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Keywords

  • psychotic disorder
  • delirium
  • agitation
  • neurocognitive decline
  • psychological and behavioral symptoms of dementia
  • late-onset schizophrenia
  • mania
  • geriatric psychiatry

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Published Papers (2 papers)

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Review

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24 pages, 679 KB  
Review
The Utility of Addenbrooke’s Cognitive Examination III (ACE-III) in Differentiating Neurodegenerative Disorders with Psychotic Symptoms: A Narrative Review
by Anna Barczak
Healthcare 2026, 14(10), 1313; https://doi.org/10.3390/healthcare14101313 - 12 May 2026
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Abstract
Psychotic symptoms, including delusions and hallucinations, frequently complicate the course of Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), Parkinson’s disease dementia (PDD), and frontotemporal dementia (FTD). Their presence accelerates decline, worsens outcomes, and complicates management. Cognitive screening in such patients is essential [...] Read more.
Psychotic symptoms, including delusions and hallucinations, frequently complicate the course of Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), Parkinson’s disease dementia (PDD), and frontotemporal dementia (FTD). Their presence accelerates decline, worsens outcomes, and complicates management. Cognitive screening in such patients is essential yet challenging due to attentional fluctuation, impaired insight, and diagnostic overlap. Addenbrooke’s Cognitive Examination III (ACE-III) is a multidomain tool with higher sensitivity than the MMSE. Evidence indicates that ACE-III captures disorder-specific cognitive-psychotic profiles: memory impairment in AD with delusions of theft, visuospatial and attentional deficits in DLB with hallucinations, or executive dysfunction in FTD with paranoid ideation. Mini-ACE (M-ACE), a shorter derivative, is useful in acute psychiatric or advanced dementia settings. This review synthesizes evidence on ACE-III and M-ACE in psychosis-related neurodegeneration, highlights their role in differentiating from primary psychiatric psychoses, and identifies knowledge gaps, particularly in atypical AD variants, mixed dementia, and autosomal dominant AD. ACE-III emerges as a practical and informative tool, but psychosis-specific normative data and longitudinal studies are needed. Full article
(This article belongs to the Special Issue New Research on Psychosis in Older Adults)
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22 pages, 2148 KB  
Systematic Review
Antipsychotic Medications in Parkinson’s Disease Psychosis; A Systematic Review of Double-Blind, Randomised, Placebo-Controlled Trials
by Christopher John McKeown and Alberto Salmoiraghi
Healthcare 2026, 14(5), 698; https://doi.org/10.3390/healthcare14050698 - 9 Mar 2026
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Abstract
Background: Psychosis is a common neuropsychiatric symptom associated with Parkinson’s disease (PD), with prevalence rates of up to 75% over the course of the disease. Parkinson’s disease psychosis (PDP) is associated with increased morbidity, caregiver burden, depression, poorer quality of life and progression [...] Read more.
Background: Psychosis is a common neuropsychiatric symptom associated with Parkinson’s disease (PD), with prevalence rates of up to 75% over the course of the disease. Parkinson’s disease psychosis (PDP) is associated with increased morbidity, caregiver burden, depression, poorer quality of life and progression of dementia. It has also been shown to be a strong predictive factor for long-term care placement, and results in up to 71% increase in risk of mortality compared with PD patients free from psychotic symptoms. Use of APs for PDP is common, with up to 35% of PD patients prescribed at least one AP within 7 years of PD diagnosis. Methods: Four electronic databases (Ovid MEDLINE, Embase, PsycINFO, PubMed) were systematically searched for double-blind, randomised, placebo-controlled clinical trials for the use of APs in the treatment of PDP and their effects on PD motor symptoms, according to PRISMA guidelines. Results: Eleven studies from ten publications were identified and included in this review. Four studies investigated quetiapine, three investigated olanzapine, two investigated clozapine and a further two investigated pimavanserin. Quetiapine showed no significant improvement for PDP over placebo in three of the four studies, with both olanzapine studies also showing no improvement. Olanzapine studies also showed significant motor worsening compared to placebo. Clozapine significantly improved psychosis compared with placebo in both studies, with large effect sizes in primary outcome measures; (−0.82, 95% CI −1.37 to −0.26), −0.89 (95% CI −1.42 to −0.36). Pimavanserin also showed significant improvement (−0.48, 95% CI −0.77 to −0.18). Quetiapine, clozapine and pimavanserin showed no significant worsening in motor scores compared with placebo groups. Conclusions: Data from the studies included in this review suggest that the use of quetiapine for the management of PDP may not be evidence based. Clozapine may improve PDP symptoms with low doses however significant side-effects may limit usability. The findings from this review support the use of clozapine as an alternative AP for the management of PDP when clinically appropriate. Full article
(This article belongs to the Special Issue New Research on Psychosis in Older Adults)
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