Paranoia In Older Adults – Symptoms, Causes & Clinical Treatment 

Paranoia is a thought process characterized by irrational and persistent feelings of suspicion and distrust toward others, making it difficult to function socially and maintain relationships. Paranoia has been identified as a mental health disorder belonging to the psychosis family.

Unfortunately, it is a widespread problem among the elderly, with experts estimating that up to 23% of the elderly have experienced psychosis. However, this can be managed with care and support.

Symptoms Of Having Paranoia

It is essential to consider the degree and frequency of paranoia exhibited by an elderly person before making any assumptions. We should also investigate their claims, as there are people who take advantage of their age. Some of the most common examples of paranoid behavior in the elderly to look out for include:

Symptoms of Paranoia

  • Having delusions, that is, believing things that are not real.
  • Constant feelings of stress or agitation with no proper explanation.
  • Frequent hallucinations, which mean seeing animals or people who aren’t there and hearing strange noises that can’t be explained.
  • Believing they are being mistreated and that people are talking about them behind their backs.
  • Being suspicious of others, resulting in rude behavior or remarks.

Some of these could be because of side effects of medications or hearing and vision problems associated with age.

Causes Of Psychosis In Elderly

Older individuals may be more susceptible to delusions or paranoid thinking due to age-related alterations in the functioning of the brain or sensory organs. While there may be a variety of contributing factors to psychosis in the elderly, it is generally associated with one or more of the following:

  • Side effects from medications: Some medications can cause irritability and sometimes delusions, hallucinations, and other forms of psychosis.
  • Alcohol and other toxins: Alcohol abuse can cause kidney dysfunction, which can lead to physical and psychological changes in an individual, such as paranoia and dementia. Alcohol psychosis is one of the disorders that is most commonly diagnosed in alcoholic men. Another alcohol-induced paranoia includes alcohol hallucinosis, which shows symptoms of hallucination.
  • Cognitive impairment: This can be caused by delirium, dementia, or Alzheimer’s and affects an individual’s ability to remember, concentrate, or make decisions.
  • Delirium: This involves a sudden change in cognition, where they may either be quiet and withdrawn or become extremely agitated and confused. This may be brought on by the stress of a severe illness, the side effects of medications, or surgery.
  • Dementia: It is a medical condition characterized by impairment of at least two brain functions, affecting how people think, feel, or perceive things.
  • Alzheimer’s disease: Alzheimer’s disease is a long-term, degenerative brain disease that gradually destroys memory and cognitive function, eventually leading to the inability to perform everyday tasks.
  • Mood disorders: Mood disorders like severe depression, bipolar disorder, or schizophrenia may cause delusions of guilt. If left untreated, extreme aggression will develop in patients.
  • Diseases: Diseases like brain tumors and urinary tract infections can cause paranoia if left untreated.
  • Urinary tract infections: A urinary tract infection (UTI) is a bacterial infection that occurs when bacteria enter the urinary system. If the infection is not treated promptly, the bacteria can travel up the urinary tract and infect the kidneys and bladder. In the elderly, this can lead to paranoia and may worsen symptoms.
  • Brain tumors: A brain tumor is a growth of cells in the brain that is capable of causing changes in the mood or behavior of a person.


While there is no definitive treatment for paranoia, treatment can help the individual manage their symptoms and lead a meaningful life.

The type of treatment varies depending on the severity of the condition. Medication, psychotherapy, or a combination of the two are typically recommended by medical professionals.

  • Medications: Antipsychotics or antidepressants are medications that are usually prescribed to treat some of these symptoms. Antipsychotics can be prescribed for paranoia in a person with paranoid schizophrenia. Antidepressants and mild tranquilizers are prescribed for anxiety or depression. While antipsychotic medications can help reduce a person’s attention to the delusions, eliminating them can take some time.
  • Psychotherapy: Psychotherapy can also help people manage their symptoms and improve their communication abilities. However, people with paranoia are less likely to communicate with a therapist openly and candidly, which means that progress can be very slow. Through therapy, patients may be able to build trust with others and find new ways to voice their worries.

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Final Thoughts

Paranoia is common among the elderly. Taking care of them is no easy task, and it can be even more difficult depending on the extent of cognitive decline. Talk to your doctor if you notice significant changes in their health or behavior, if the symptoms affect their ability to do everyday tasks, or if they are becoming a threat to themselves or others.

Depending on the severity and how often they exhibit these symptoms, doctors may consider several treatment options, which are mainly composed of medications and psychotherapy. Early medical intervention can reduce the symptoms and improve the quality of their lives.

About the Author

Nicole Carter is a dedicated and passionate nutritionist, committed to helping individuals achieve their health and wellness goals through the power of proper nutrition. With a Bachelor's degree in Nutritional Science and years of practical experience.

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