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Cited by 131Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsParkinson's Disease Mechanisms and Treatments

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Understanding neuropsychiatric symptoms in Alzheimer’s disease: challenges and advances in diagnosis and treatment

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Pless, Andrew, Ware, Destany, Saggu, Shalini, Rehman, Hasibur, Morgan, John, Wang, Qin·2023·Frontiers in Neuroscience
DOI 10.3389/fnins.2023.1263771PMC PMC10508352
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Abstract

Neuropsychiatric symptoms (NPS) in Alzheimer’s disease (AD) affect up to 97% of AD patients, with an estimated 80% of current AD patients experiencing these symptoms. Common AD-associated NPS include depression, anxiety, agitation, aggression, and apathy. The severity of NPS in AD is typically linked to the disease’s progression and the extent of cognitive decline. Additionally, these symptoms are responsible for a significant increase in morbidity, mortality, caregiver burden, earlier nursing home placement, and greater healthcare expenditure. Despite their high prevalence and significant impact, there is a notable lack of clinical research on NPS in AD. In this article, we explore and analyze the prevalence, symptom manifestations, challenges in diagnosis, and treatment options of NPS associated with AD. Our literature review reveals that distinguishing and accurately diagnosing the NPS associated with AD remains a challenging task in clinical settings. It is often difficult to discern whether NPS are secondary to pathophysiological changes from AD or are comorbid psychiatric conditions. Furthermore, the availability of effective pharmaceutical interventions, as well as non-pharmacotherapies for NPS in AD, remains limited. By highlighting the advance and challenges in diagnosis and treatment of AD-associated NPS, we aspire to offer new insights into the complexity of identifying and treating these symptoms within the context of AD, and contribute to a deeper understanding of the multifaceted nature of NPS in AD.

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  • Depression may represent an early symptom or prodrome of dementia in some individuals.

    “Depression may also even represent an early symptom or prodrome of dementia in some individuals, making it challenging to disentangle causality in the antidepressant-dementia relationship [27-29].”

    From Long-Term Antidepressant Use and Dementia Risk: A Propensity Score-Matched Study of Swiss Older Adults, with an Anticholinergic-Specific Analysis (2026) · cites this paper as [28]

    The Diagnosis and challenges section (page unavailable) says neuropsychiatric symptoms, including depression, can emerge quickly after an Alzheimer’s diagnosis. The Depression section discusses depression in diagnosed patients and its association with increased AD risk, but does not establish that depression is a prodrome preceding dementia. (LLM, conf=0.78)

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Cited by

Sorted by citations

Metadata

Authors
Pless, A., Ware, D., Saggu, S., Rehman, H., Morgan, J., & Wang, Q.
Affiliations
Augusta University (US)
Corresponding author
Wang, Qin
ORCID
Venue
Frontiers in Neuroscience
Publisher
Frontiers Media SA
Published
2023-09-05
Volume
17
Pages
1263771-1263771
ISSN
1662-453X (ISSN-L)
DOI
10.3389/fnins.2023.1263771
PMC
PMC10508352
OpenAlex
W4386440853
Cited by
131
References
21
Citations by year
2026: 46 · 2025: 53 · 2024: 31 · 2023: 1
FWCI
4.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Neuroscience (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institutes of Health (AG067729)
  • National Institute on Aging (RF1AG056815, RF1AG067729, R01AG064664)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
Keywords
neuropsychiatric symptoms, Alzheimer's disease, depression, anxiety, agitation, aggression, apathy, diagnosis, treatment, comorbidities, caregiver burden, non-pharmacological treatment

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