Neuropsychiatric symptoms in Alzheimer’s disease: Impact, risks and a comprehensive approach to treatment

Becker's Healthcare November 20, 2024
Lucille Carriere, PhD and Kasia Gustaw Rothenberg, MD, PhD, Cleveland Clinic Lou Ruvo Center for Brain Health

Neuropsychiatric symptoms are a pervasive and challenging aspect of Alzheimer’s disease (AD), affecting up to 90% of individuals over the course of the illness.

These symptoms include depression, anxiety, agitation, aggression, delusions, hallucinations and sleep disturbances, each profoundly impacting the quality of life for both patients and unpaid family caregivers. While cognitive decline is the most recognized aspect of AD, neuropsychiatric symptoms often lead to substantial distress, increasing caregiver burden and risk for premature institutionalization. Depression occurs in 30-50% of AD patients, while anxiety is seen in 30-40%; agitation and aggression impact 30-60% of patients, and psychotic symptoms (e.g., delusions and hallucinations) appear in 20-30% of cases. Variability in these symptoms is influenced by factors such as disease stage, patient...

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