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Alzheimers Dement (N Y). 2017 Aug 5;3(3):440-449. doi: 10.1016/j.trci.2017.07.001. eCollection 2017 Sep.

Neuropsychiatric signs and symptoms of Alzheimer's disease: New treatment paradigms.

Author information

1
Hurvitz Brain Sciences Program, Sunnybrook Research Institute and Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada.
2
Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA.
3
Department of Psychiatry, University of California, San Diego, CA, USA.
4
Department of Medicine, University of California, San Diego, CA, USA.
5
Interdisciplinary Brain Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
6
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
7
University of Exeter, Exeter, UK.
8
Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine and Minerva Center for the Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel.
9
Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
10
Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine Institutes, Baltimore, MD, USA.
11
Bracket Global, Wayne, PA, USA.
12
Department of Neurology, Hope Center for Neurological Disorders, and Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.
13
Center for Brain Health, NYU Langone Medical Center, New York, NY, USA.
14
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
15
Eisai, Inc., Woodcliff Lake, NJ, USA.
16
Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA.
17
Banner Alzheimer's Institute, Phoenix, AZ, USA.
18
Elverson, PA, USA.
19
Alzheimer's Association, Chicago, IL, USA.
20
Department of Neurology, Brigham and Women's Hospital, Harvard University School of Medicine, Boston, MA, USA.
21
Voyager Therapeutics, Cambridge, MA, USA.

Abstract

Neuropsychiatric symptoms (NPSs) are hallmarks of Alzheimer's disease (AD), causing substantial distress for both people with dementia and their caregivers, and contributing to early institutionalization. They are among the earliest signs and symptoms of neurocognitive disorders and incipient cognitive decline, yet are under-recognized and often challenging to treat. With this in mind, the Alzheimer's Association convened a Research Roundtable in May 2016, bringing together experts from academia, industry, and regulatory agencies to discuss the latest understanding of NPSs and review the development of therapeutics and biomarkers of NPSs in AD. This review will explore the neurobiology of NPSs in AD and specific symptoms common in AD such as psychosis, agitation, apathy, depression, and sleep disturbances. In addition, clinical trial designs for NPSs in AD and regulatory considerations will be discussed.

KEYWORDS:

Agitation; Alzheimer's disease; Apathy; Delusions; Depression; Hallucinations; Neuropsychiatric symptoms; Sleep disturbance; Trial design

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