"Capgras is a misidentification syndrome characterized by the transient, recurrent or permanent belief that someone known to a patient has been replaced by an impostor with a strong physical resemblance,” explains Erin Shvetzoff Hennessey, vice president of Health Dimensions Group. “These delusions are suggested to stem from impairment of the brain’s facial recognition system and are also associated with brain lesions.”

While it's unknown how prevalent this disorder is, it has been estimated that Capgras syndrome is found in 2 percent to 30 percent of people with Alzheimer's disease. It is a little-known condition that can gravely complicate an affected individual's quality of life.

This syndrome causes a different kind of loss of recognition, unlike the ongoing forgetfulness or the inability to remember close family and friends. For instance, the affected person may remember or know his or her caregiver or close family member, but believes these people are impostors. It can add another layer of frustration for the caregiver and make social experiences very confusing.

Caregivers tend to try to correct or challenge the individual regarding his/her delusions. But someone with Alzheimer's disease cannot reason or resolve situations, which is then compounded by Capgras, so it is a waste of time to challenge the individual. And, it is upsetting and frustrating for the affected person.

A research article in the Frontiers in Human Neuroscience journal states: “A defining characteristic of delusions also present in Capgras syndrome is that patients will firmly hold on to their delusional beliefs (even) in the presence of mounting contradictory evidence.”

Just as it is wise to validate those with Alzheimer's disease when they experience hallucinations, it's important to also support the a person with Alzheimer's delusions to reduce stress and anxiety for them and for their caregivers.

Communication is more difficult and interactions are overwhelmingly challenging between the caregiver (the believed impostor) and the affected individual with this condition. For example, the person with Alzheimer's may refuse to speak or be cooperative with the "impostor," so more creative methods to interact must be devised.

The caregiver "impostor" may need other people — ones that the affected person recognizes — to assist in caregiving and to continue interaction and socialization so important for a quality of life. Additionally, since connecting visually is so difficult, the caregiver might try connecting with sound. Conversations and dialogue can be held over the phone, for example, which can establish and emotional connection and trust.

Because Capgras syndrome can make caregiving extremely stressful and can cause great physical strain, the caregiver must practice good self-care to better care for his/her loved one. Getting enough rest, contracting for respite care, the caregiver's awareness of limitations and getting support from family and friends are all necessary in managing the disease and the syndrome.


Questions about Alzheimer's disease or a related disorder can be sent to Dana Territo, the Memory Whisperer, director of services at Alzheimer's Services of the Capital Area at advice@alzbr.org or visit the organization at 3772 North Blvd., Baton Rouge.