I would make sure it was not neurological in origin as well because psychosis and dementia can occur in elderly people from conditions that are not psychiatric. "Impaired executive functioning" sounds more neurological in origin to me. I would have her see a neurologist to rule out any neurological disability (its common for elderly people to have transient ischemic attacks and be unaware of it and it cause some long term residual damage) Also it is important to understand that there is concern about the use of anti-psychotics in the elderly due to long term side effects. If any aspect of her condition was dementia Namenda could be used. If it were psychotic, which it sounds like it, generally an antipsychotic would help but there the concern as regarding age. Zofran is helpful on psychosis from Parkinson's and has been of some use for schizophrenia and although both usages are experimental the medication is approved (I take it for what is being studied as the criteria tardive psychosis) and could potentially be of help.
I would say it is obsessive but I'm not sure if its ocd as it is a psychotic delusion as well. The truth is it could be both if its not neurological. I myself have recovered from schizoaffective disorder with the experimental antipsychotic glycine in Phase II FDA study a new form of antipsychotic called a glutamate antagonist that will promote a fuller recovery and not cause tardive dyskinesia (which I have in advanced forms) and diabetes. My case study will be published in a psychiatric journal. For the official study google "Dr. Javitt, glycine". Schizoaffective disorder is schizophrenia which a co-existing mood disorder which in my case is bipolar disorder. However, the American Psychiatric Association is considering a new criteria which is "schizo-obsessive disorder" and regardless obessive behavior can occur in schizophrenia so it has aspects of both.
IL,
Thanks for the post and the tips. Very informative. I took my mother to a neurologist, but her diagnosis was somewhat lacking. She said she was "crazy" so we didn't return there. In subsequent medical reviews with a geriatric psych and clinicians, they felt there was no dementia, but did feel there was deep depression and the executive dysfunction. My mother hates going to doctors and she now lives 2800 miles away from me, closer to my sister. My sister is equally anti doctor, so it makes further diagnosis difficult.
However, in the last visit, they found no signs of dementia and didn't recommend use of anti-psychotics for the hallucinations, which seem to have subsided..
I'll look into the articles you mention. I'm glad to hear some of the newer treatments are coming available and that they are of help to you. Hopefully we can find something there that will help my mother as well.
Best of luck,
J90