Key Takeaways
Extended Takeaways
- Among 79 patients who had any hallucinations within the previous month, 40 (32.3%) had both auditory and visual hallucinations, while only 4 patients had auditory hallucinations without visual hallucinations; in dementia with Lewy bodies, asking about sound accompanying a visual scene may improve detection.
- Auditory hallucinations were usually verbal and often distressing: 41 patients reported human voices, 29 (71%) described the voices as bad or unpleasant, and 4 patients reported command content such as "Get up early."
- Patients with auditory hallucinations had a greater overall neuropsychiatric burden, with higher total NPI scores, higher total NPI scores excluding the hallucinations domain, and higher total NPI scores excluding the hallucinations and delusions domain than patients without auditory hallucinations.
- Phantom boarder delusion appears particularly linked to multimodal hallucinations: 17.1% of patients with pure visual hallucinations had phantom boarder delusion versus 61.4% of patients with both visual and auditory hallucinations.
- Because hearing impairment was independently associated with auditory hallucinations, clinicians should assess potentially reversible sensory loss in dementia with Lewy bodies rather than viewing these experiences only as a primary psychotic phenomenon.
- The association between auditory hallucinations and antipsychotic use (P = .01) should be interpreted cautiously, because some patients had already started treatment at first visit and the cross-sectional design cannot determine whether medication exposure contributed to, or simply marked, more severe neuropsychiatric illness.
