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Emerging Neuropsychiatric Symptoms May Represent an Early Manifestation of Preclinical Alzheimer’s Disease

      Neuropsychiatric symptoms (NPSs) of dementia are behavioral and psychiatric symptoms of dementia that include disturbances of mood, perception, and behavior (
      • Lyketsos C.G.
      • Carrillo M.C.
      • Ryan J.M.
      • Khachaturian A.S.
      • Trzepacz P.
      • Amatniek J.
      • et al.
      Neuropsychiatric symptoms in Alzheimer’s disease.
      ). NPSs are common in individuals with dementia and are associated with increased functional impairment and caregiver burden, a lower satisfaction with life, a higher burden of neuropathic markers of dementia, and an accelerated speed of disease progression (
      • Ismail Z.
      • Smith E.E.
      • Geda Y.
      • Sultzer D.
      • Brodaty H.
      • Smith G.
      • et al.
      Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment.
      ). NPSs can appear relatively early, even before a diagnosis of dementia, may progress in parallel with cognitive decline, and may be early behavioral markers of Alzheimer's disease (AD) pathology (
      • Donovan N.J.
      • Locascio J.J.
      • Marshall G.A.
      • Gatchel J.
      • Hanseeuw B.J.
      • Rentz D.M.
      • et al.
      Longitudinal association of amyloid beta and anxious-depressive symptoms in cognitively normal older adults.
      ,
      • Johansson M.
      • Stomrud E.
      • Lindberg O.
      • Westman E.
      • Johansson P.M.
      • van Westen D.
      • et al.
      Apathy and anxiety are early markers of Alzheimer’s disease.
      ).
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