Emerging Neuropsychiatric Symptoms May Represent an Early Manifestation of Preclinical Alzheimer’s Disease

Neuropsychiatric symptoms (NPSs) of dementia are behavioral and psychiatric symptoms of dementia that include disturbances of mood, perception, and behavior ( 1 Lyketsos C.G. Carrillo M.C. Ryan J.M. Khachaturian A.S. Trzepacz P. Amatniek J. et al. Neuropsychiatric symptoms in Alzheimer’s disease. Alzheimers Dement. 2011; 7: 532-539 Abstract Full Text Full Text PDF PubMed Scopus (496) Google Scholar ). NPSs are common in individuals with dementia and are associated with increased functional impairment and caregiver burden, a lower satisfaction with life, a higher burden of neuropathic markers of dementia, and an accelerated speed of disease progression ( 2 Ismail Z. Smith E.E. Geda Y. Sultzer D. Brodaty H. Smith G. et al. Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment. Alzheimers Dement. 2016; 12: 195-202 Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar ). NPSs can appear relatively early, even before a diagnosis of dementia, may progress in parallel with cognitive decline, and may be early behavioral markers of Alzheimer's disease (AD) pathology ( 3 Donovan N.J. Locascio J.J. Marshall G.A. Gatchel J. Hanseeuw B.J. Rentz D.M. et al. Longitudinal association of amyloid beta and anxious-depressive symptoms in cognitively normal older adults. Am J Psychiatry. 2018; 175: 530-537 Crossref PubMed Scopus (106) Google Scholar , 4 Johansson M. Stomrud E. Lindberg O. Westman E. Johansson P.M. van Westen D. et al. Apathy and anxiety are early markers of Alzheimer’s disease. Neurobiol Aging. 2020; 85: 74-82 Crossref PubMed Scopus (60) Google Scholar ). SEE CORRESPONDING ARTICLE ON PAGE 34 SEE CORRESPONDING ARTICLE ON PAGE 34 Development of Apathy, Anxiety, and Depression in Cognitively Unimpaired Older Adults: Effects of Alzheimer’s Disease Pathology and Cognitive DeclineBiological PsychiatryVol. 92Issue 1PreviewThe impact of Alzheimer’s disease (AD) pathology and cognitive deficits on longitudinal neuropsychiatric symptoms is unclear, especially in early disease stages. Full-Text PDF Open Access