Neuropsychiatric symptoms in Alzheimer's disease: Past progress and anticipation of the future

Yonas E. Geda, Lon S. Schneider, Laura N. Gitlin, David S. Miller, Gwenn S. Smith, Joanne Bell, Jovier Evans, Michael Lee, Anton Porsteinsson, Krista L. Lanctôt, Paul B. Rosenberg, David L. Sultzer, Paul T. Francis, Henry Brodaty, Prasad P. Padala, Chiadikaobi U. Onyike, Luis Agüera Ortiz, Sonia Ancoli-Israel, Donald L. Bliwise, Jennifer L. MartinMichael V. Vitiello, Kristine Yaffe, Phyllis C. Zee, Nathan Herrmann, Robert A. Sweet, Clive Ballard, Ni A. Khin, Cara Alfaro, Patrick S. Murray, Susan Schultz, Constantine G. Lyketsos

Research output: Contribution to journalArticlepeer-review

261 Scopus citations


Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are widespread and disabling. This has been known since Dr. Alois Alzheimer's first case, Frau Auguste D., presented with emotional distress and delusions of infidelity/excessive jealousy, followed by cognitive symptoms. Being cognizant of this, in 2010 the Alzheimer's Association convened a research roundtable on the topic of NPS in AD. A major outcome of the roundtable was the founding of a Professional Interest Area (PIA) within the International Society to Advance Alzheimer's Research and Treatment (ISTAART). The NPS-PIA has prepared a series of documents that are intended to summarize the literature and provide more detailed specific recommendations for NPS research. This overview paper is the first of these living documents that will be updated periodically as the science advances. The overview is followed by syndrome-specific synthetic reviews and recommendations prepared by NPS-PIA workgroups on depression, apathy, sleep, agitation, and psychosis.

Original languageEnglish (US)
Pages (from-to)602-608
Number of pages7
JournalAlzheimer's and Dementia
Issue number5
StatePublished - Sep 2013

Bibliographical note

Funding Information:
The authors thank Dr. Michelle M. Mielke for her helpful comments and feedback on early drafts of this manuscript. Dr. Geda was supported by NIMH grant K01-MH68351 , NIA grant U01-AG006786 (the Mayo Clinic Study of Aging), National Center for Research Resources grant RR024150 (Mayo Clinic CTSA [Career Transition Award]), the Robert Wood Johnson Foundation (Harold Amos Scholar), and the European Union Regional Development Fund (Project FNUSA-ICRC: CZ.1.05/1.1.00/02.0123). Dr. Schneider reports being an editor on the Cochrane Collaboration Dementia and Cognitive Improvement Group, which oversees systematic reviews of drugs for cognitive impairment and dementia. He received a grant from the Alzheimer's Association for a registry for dementia and cognitive impairment trials; he is also in receipt of grant or research support from Baxter , Elan Pharmaceuticals , Johnson & Johnson , Eli Lilly , Myriad , Novartis , and Pfizer . He has served as a consultant for or received consulting fees from Abbott Laboratories, AC Immune, Allergan, Allon, the Alzheimer Drug Discovery Foundation, AstraZeneca, Bristol-Myers Squibb, Elan, Eli Lilly, Exonhit, Forest, GlaxoSmithKline, Ipsen Pharmaceuticals, Johnson & Johnson, Lundbeck, Myriad, Medavante, Medivation, Merck, Merz, Novartis, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, Schwabe, Toyama, and Transition Therapeutics. Dr. Gitlin was supported by NIMH grants R24-MH074779 , R01-MH079814 , and RC1-MH090770-01 and Alzheimer's Association grant IIRG-07-28686 and served on the Phillips Life Line Falls Advisory Board. Dr. Miller is a full-time employee of Bracket. Dr. Lyketsos was supported by the Johns Hopkins Alzheimer's Disease Research Center ( P50-AG005146 ). He has received grant support (research or CME) from NIMH , NIA , the Associated Jewish Federation of Baltimore , the Weinberg Foundation , Forest , GlaxoSmithKline , Eisai , Pfizer , AstraZeneca , Lilly , Ortho-McNeil , Bristol-Myers , Novartis , the National Football League , Elan , and Functional Neuromodulation Inc . He has served as consultant/advisor for AstraZeneca, GlaxoSmithKline, Eisai, Novartis, Forest, Supernus, Adlyfe, Takeda, Wyeth, Lundbeck, Merz, Lilly, Pfizer, Genentech, Elan, the NFL Players Association, the NFL Benefits Office, Avanir, and Zinfandel. He has also received honorarium or travel support from Pfizer, Forest, GlaxoSmithKline, and Health Monitor. Supplementary data Appendix A Appendix B Appendix C Appendix D Appendix E


  • Agitation/aggression
  • Alzheimer's disease
  • Apathy
  • Behavioral and psychological symptoms of dementia
  • Delusions
  • Dementia
  • Depression
  • Hallucinations
  • Mild behavioral impairment
  • Mild cognitive impairment
  • Neuropsychiatric symptoms
  • Psychosis
  • Sleep disorders


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