Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Mar;21(3):e70079.
doi: 10.1002/alz.70079.

Updates and future perspectives on neuropsychiatric symptoms in Alzheimer's disease

Myuri Ruthirakuhan  1 , Dylan X Guan  2 , Moyra Mortby  3 , Jennifer Gatchel  4 , Ganesh M Babulal  5   6
Affiliations
Review

Updates and future perspectives on neuropsychiatric symptoms in Alzheimer's disease

Myuri Ruthirakuhan et al. Alzheimers Dement. 2025 Mar.

Abstract

Neuropsychiatric symptoms (NPS) are common throughout the Alzheimer's disease (AD) continuum and profoundly affect patients, caregivers, and health-care systems. This review synthesizes key research presented in the 2022 and 2023 Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment Neuropsychiatric Syndromes-Professional Interest Area (NPS-PIA) Year-In-Reviews, emphasizing six critical areas: (1) diversity and disparities, (2) diagnostic frameworks, (3) neurobiology of NPS, (4) NPS as a disease marker, (5) the impact of COVID-19, and (6) interventions. NPS accelerates AD progression, increases functional decline, diminishes quality of life, and heightens caregiver burden and institutionalization rates. Current treatments primarily rely on psychotropics, which offer limited efficacy and raise safety concerns. This review aims to inform clinicians and researchers about recent NPS advancements while identifying gaps for future studies to improve outcomes for individuals with AD. HIGHLIGHTS: Research in Alzheimer's disease-related neuropsychiatric symptoms has rapidly increased, indicating heightened interest. Key areas include: diversity, diagnostics, markers, COVID-19 impact, and treatments. A road map for future studies, based on the key areas of research, is provided. This road map includes considerations to improve study applicability and validity.

Keywords: Alzheimer's disease; biomarkers; diagnosis; neuropsychiatric symptoms; treatments.

PubMed Disclaimer

Conflict of interest statement

The authors report no competing interests Author disclosures are available in the supporting information.

References

    1. Geda YE, Roberts RO, Knopman DS, et al. Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population‐based study. Arch Gen Psychiatry. 2008;65:1193‐1198. doi:10.1001/archpsyc.65.10.1193 - DOI - PMC - PubMed
    1. Pless A, Ware D, Saggu S, Rehman H, Morgan J, Wang Q. Understanding neuropsychiatric symptoms in Alzheimer's disease: challenges and advances in diagnosis and treatment. Front Neurosci. 2023;17:1263771. doi:10.3389/fnins.2023.1263771 - DOI - PMC - PubMed
    1. Lanctôt KL, Amatniek J, Ancoli‐Israel S, et al. Neuropsychiatric signs and symptoms of Alzheimer's disease: new treatment paradigms. Alzheimers Dement (N Y). 2017;3:440‐449. doi:10.1016/j.trci.2017.07.001 - DOI - PMC - PubMed
    1. Ruthirakuhan M, Ismail Z, Herrmann N, Gallagher D, Lanctôt KL. Mild behavioral impairment is associated with progression to Alzheimer's disease: a clinicopathological study. Alzheimers Dement. 2022;18:2199‐2208. doi:10.1002/alz.12519 - DOI - PMC - PubMed
    1. Karttunen K, Karppi P, Hiltunen A, et al. Neuropsychiatric symptoms and quality of life in patients with very mild and mild Alzheimer's disease. Int J Geriatr Psychiatry. 2011;26:473‐482. doi:10.1002/gps.2550 - DOI - PubMed