Neuropsychiatric symptoms as a prodromal factor in Alzheimer’s type neurodegenerative disease: A scoping review

Abstract

Objective: Identifying neuropsychiatric symptoms (NPS) can aid in the early detection of Alzheimer’s disease (AD); however, there is still a need for a greater consensus. This review aims to delineate the predominant NPS, compile a comprehensive list of the most commonly employed NPS assessment tools, and corroborate the principal findings regarding the link between NPS and neuropsychological assessment and neurobiological substrates. Methods: To conduct this scoping review, we followed the Preferred Reporting Items for Systematic Reviews guidelines and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched for relevant articles published between 2017 and 2023 in MEDLINE, PsycINFO, PubMed, Web of Science, and Cochrane Library. Results: Of the 61 eligible articles, depression, anxiety, and apathy were the main NPSs. The Neuropsychiatric Inventory Questionnaire and Neuropsychiatric Inventory were the primary assessment tools used to evaluate NPS. Correlations between NPS severity and neurobiological markers were considered clinically significant. Furthermore, clinical procedures prioritized the use of global cognitive screening tools, assessments of executive functions, and functionality evaluations. Conclusion: Standardization of procedures is necessary because of the diversity of methods. The data show that NPS can predict the etiology, severity, form, and type of disease progression, serving as a precursor sign of AD. The results of the most common cognitive screening tools and NPS instruments provided an interesting overview of future clinical approaches.

Keywords:

• Dementia
• Alzheimer’s disease
• neuropsychiatric symptoms
• prodromal symptoms
• cognitive dysfunction

Acknowledgments

The authors are grateful for the support received during the development of this study by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and Centro Formador de Pessoal para a Saúde de São Paulo da Secretaria Estadual de Saúde (CEFOR/SES/SP).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Author 1: Receives research funding (master’s degree) from CAPES/PROEX scholarship, under grant n° 88887.701264/2022-00.Author 2: Receives research funding (Ph.D. level) from CNPq scholarship, under grant n° 141160/2019-5.