ABSTRACT Auditory hallucinations can occur in normal senior adults or indicate serious medical illness. No algorithm exists for approaching auditory hallucinations in the medical literature, which can confuse the practicing physician. We developed an algorithm to implement a systematic, step-by-step approach that may aid in diagnosing and managing emerging auditory hallucinations in geriatric patients by considering potential differential diagnoses and etiologies. Our work was prompted by a case of auditory hallucinations in an eighty-five-year-old white female with severe hearing impairment and frontotemporal dementia who was referred to the geriatric medicine outpatient clinic by treating primary care provider for management of auditory hallucinations. Prompt recognition and referral to a Geriatrician/Geriatric Psychiatrist, especially when clinical suspicion of certain dementias is high, could lead to better management of the disease course in scenarios where psychosocial factors play a significant role in alleviating the burden on the patient’s family. Refractory auditory hallucinations impose significant morbidity on both the patient and the family. A straightforward algorithmic approach could shed light on the potential etiology and facilitate timely management.
Shalak et al. (Thu,) studied this question.