Challenges in the management of visual and tactile hallucinations in elderly people

Core Tip

Core Tip: When elderly patients present with visual and tactile hallucinations, it is imperative to first exclude organic etiologies and substance use before considering primary psychotic disorders such as schizophrenia. For patients with evident cognitive decline, additional assessment is warranted to evaluate potential impairments in instrumental activities of daily living and executive functions. Psychotic symptoms that emerge in late life are predominantly observed in individuals with dementia, particularly Alzheimer’s disease. The occurrence of visual hallucinations and delusional infestations with associated scratching behaviors in elderly individuals may be linked to increased extracellular striatal dopamine levels in synapses, which is a consequence of striatal dopamine transporter dysfunction.