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Neuropsychiatric symptoms in the prodromal stages of dementia

Stella, Florindo, Radanovic, Márcia, Balthazar, Márcio L.F., Canineu, Paulo R., de Souza, Leonardo C., Forlenza, Orestes V.·2014·Current Opinion in Psychiatry
DOI 10.1097/yco.0000000000000050
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Abstract

Purpose of review To critically discuss the neuropsychiatric symptoms in the prodromal stages of dementia in order to improve the early clinical diagnosis of cognitive and functional deterioration. Recent findings Current criteria for cognitive syndrome, including Alzheimer's disease, comprise the neuropsychiatric symptoms in addition to cognitive and functional decline. Although there is growing evidence that neuropsychiatric symptoms may precede the prodromal stages of dementia, these manifestations have received less attention than traditional clinical hallmarks such as cognitive and functional deterioration. Depression, anxiety, apathy, irritability, agitation, sleep disorders, among other symptoms, have been hypothesized to represent a prodromal stage of dementia or, at least, they increase the risk for conversion from minor neurocognitive disorder to major neurocognitive disorder. Longitudinal investigations have provided increased evidence of progression to dementia in individuals with minor neurocognitive disorder when neuropsychiatric symptoms also were present. Summary Although neuropsychiatric symptoms are strongly associated with a higher risk of cognitive and functional deterioration, frequently the clinician does not acknowledge these conditions as increasing the risk of dementia. When the clinician accurately diagnoses neuropsychiatric symptoms in the prodromal stage of dementia, he could early establish appropriate treatment and, may be, delay the beginning of…

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  • Prior observational studies of anticholinergic medications and dementia did not take into account that certain anticholinergics are used to manage insomnia and depression, two prodromal conditions that can be seen in early but undiagnosed dementia, leading to protopathic bias.

    “Finally, these studies did not take into account that certain anticholinergics are used to manage insomnia and depression, two prodromal conditions that can be seen in early but undiagnosed dementia, leading to protopathic bias.17-19”

    From Cumulative Use of Strong Anticholinergics and Incident Dementia: A Prospective Cohort Study (2015) · cites this paper as [19]

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Metadata

Authors
Stella, F., Radanovic, M., Balthazar, M. L. F., Canineu, P. R., de Souza, L. C., & Forlenza, O. V.
Affiliations
  • Universidade Federal de Minas Gerais (BR)
  • Universidade de São Paulo (BR)
  • Universidade Estadual de Campinas (UNICAMP) (BR)
Corresponding author
Stella, Florindo
ORCID
Venue
Current Opinion in Psychiatry
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-05
Volume
27
Issue
3
Pages
230-235
ISSN
0951-7367 (ISSN-L)
DOI
10.1097/yco.0000000000000050
OpenAlex
W1969850569
Cited by
90
References
7
Citations by year
2026: 6 · 2025: 8 · 2024: 11 · 2023: 11 · 2022: 5 · 2021: 9 · 2020: 7 · 2019: 9 · 2018: 6 · 2017: 6 · 2016: 4 · 2015: 7
FWCI
0.63
Type
journal article
Language
en
Open access
closed
Locations
  • Current Opinion in Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Acervo Digital da Universidade Estadual Paulista (Universidade Estadual Paulista) (submittedVersion)
  • UNESP Institutional Repository (São Paulo State University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
  • Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
Keywords
neuropsychiatric symptoms, prodromal dementia, Alzheimer's disease, conversion to dementia, depression, anxiety, apathy, irritability, agitation, sleep disorders, early diagnosis, cognitive decline, functional decline
MeSH terms
Behavioral Symptoms, Cognition Disorders, Dementia, Humans, Neuropsychological Tests, Early Diagnosis, Cognitive Dysfunction, Prodromal Symptoms

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