The Role of Neuropsychiatric Symptoms in Research Diagnostic Criteria for Neurodegenerative Diseases
Open accessAbstract
Neuropsychiatric syndromes and symptoms play increasingly important roles in research diagnostic criteria for neurodegenerative disorders. Diagnostic criteria were reviewed including those for dementia, Alzheimer's disease, mild cognitive impairment, mild behavioral impairment, prodromal Alzheimer's disease, dementia with Lewy bodies, prodromal dementia with Lewy bodies, Parkinson's disease, multiple system atrophy, frontotemporal dementia, primary progressive aphasia, progressive supranuclear palsy, corticobasal degeneration, traumatic encephalopathy syndrome, Huntington' disease, amyotrophic lateral sclerorsis. All contemporary research diagnostic criteria for neurodegenerative disorders expect those for Parkinson's disease, primary progressive aphasia, multisystem atrophy and amyotrophic lateral sclerosis include neuropsychiatric phenomena as core diagnostic criteria. There are no disease-specific neuropsychiatric symptoms; apathy and disinhibition are common in tauopathies, and rapid-eye-movement sleep behavioral disorder occurs almost exclusively in synucleinopathies. Neuropsychiatric symptoms and syndromes are increasingly integrated into research diagnostic criteria for neurodegenerative disorders; they require clinician skills for recognition; their biology is better understood as their relationships to cognitive, motor, and autonomic symptoms of neurodegenerative disorders are studied.
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A study using UK NHS electronic health records found both ChEIs and memantine temporarily stabilize cognitive decline for about 4 months post-initiation, particularly in moderate to severe cases.
“A study using UK NHS electronic health records found both ChEIs and memantine temporarily stabilize cognitive decline for about 4 months post-initiation, particularly in moderate to severe cases.32”
From A 2025 update on treatment strategies for the Alzheimer’s disease spectrum (2025) · cites this paper as [32]
The Introduction’s section on research diagnostic criteria discusses how cognitive and behavioral changes figure in dementia diagnosis, while the Discussion addresses diagnostic criteria and clinical trials. Searches for UK NHS electronic health records, ChEIs, memantine, and a four-month post-initiation effect found no passage addressing the claimed study or treatment outcome; page numbers were not available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredAntipsychotics were linked to worse cognitive outcomes and reduced effectiveness of ChEIs and memantine.
“Antipsychotics were linked to worse cognitive outcomes and reduced effectiveness of these medications.32”
From A 2025 update on treatment strategies for the Alzheimer’s disease spectrum (2025) · cites this paper as [32]
The Discussion addresses diagnostic criteria and trials for neuropsychiatric symptoms, but does not report cognitive outcomes associated with antipsychotics. Searches for antipsychotics, ChEIs, and memantine found no passage addressing whether antipsychotics reduce these medications’ effectiveness. (LLM, conf=0.76)
Experimental — accuracy not yet measuredResponse rates to ChEIs and memantine were higher in real-world settings (68%) compared to trials (40%), likely due to additional support and care provided particularly to patients who received medicines in the community.
“Response rates were higher in real-world settings (68%) compared to trials (40%), likely due to additional support and care provided particularly to patients who received medicines in the community.32”
From A 2025 update on treatment strategies for the Alzheimer’s disease spectrum (2025) · cites this paper as [32]
The Discussion addresses diagnostic criteria and their use in clinical trials, but does not report response rates for ChEIs or memantine. Searches for the 68% and 40% figures, community treatment, and additional support or care found no passage addressing the claimed comparison or explanation. (LLM, conf=0.76)
Experimental — accuracy not yet measuredAD is categorized into three stages: mild, moderate, and severe.
“AD is categorized into three stages: mild, moderate, and severe [24,25,26,27,28].”
From Recent Advances in Therapeutics for the Treatment of Alzheimer’s Disease (2024) · cites this paper as [25]
The most common symptoms of AD are short-term memory loss, followed by progressive impairment in implicit and explicit memory, and neuropsychiatric symptoms with eventual loss of ability to perform basic daily duties.
“The most common symptoms of AD are short-term memory loss, which is followed by a progressive impairment in both implicit and explicit memory. Those who have the condition also exhibit neuropsychiatric symptoms, and with time, they lose their ability to perform basic daily duties [24,25,26,27,28].”
From Recent Advances in Therapeutics for the Treatment of Alzheimer’s Disease (2024) · cites this paper as [25]
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- Authors
- Cummings, J.
- Affiliations
- Cleveland Clinic (US)
- Corresponding author
- Cummings, Jeffrey
- ORCID
- Cummings, Jeffrey
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 29
- Issue
- 4
- Pages
- 375-383
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC7855689
- OpenAlex
- W3044579069
- Cited by
- 96
- References
- 55
- Citations by year
- 2026: 11 · 2025: 21 · 2024: 28 · 2023: 16 · 2022: 9 · 2021: 10 · 2020: 1
- FWCI
- 1.49
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke
- National Institute on Aging
- National Institute of General Medical Sciences
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- neuropsychiatric symptoms, neuropsychiatric syndromes, Research Diagnostic Criteria, neurodegenerative diseases, dementia, Alzheimer's disease, mild cognitive impairment, prodromal Alzheimer's disease, dementia with Lewy bodies, prodromal dementia with Lewy bodies, Parkinson's disease, multiple system atrophy, frontotemporal dementia, primary progressive aphasia, progressive supranuclear palsy, corticobasal degeneration, traumatic encephalopathy syndrome, Huntington's disease, amyotrophic lateral sclerosis, apathy, disinhibition, REM sleep behavior disorder, tauopathy, synucleinopathies
- MeSH terms
- Dementia, Humans, Neuropsychological Tests, Parkinson Disease, Neurodegenerative Diseases, Tauopathies, Cognitive Dysfunction
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