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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Clinical Manifestations.

Fareshte Erani1, Caitlin M Terao2, Shanna Cooper3

  • 1University of California, San Diego, La Jolla, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Neuropsychiatric symptom (NPS) patterns in cognitively unimpaired older adults predict cognitive decline and dementia risk. High NPS, especially agitation and anxiety, indicate greater progression risk than depression alone.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Psychiatry

Background:

  • Subtle cognitive decline phenotypes are linked to Alzheimer's disease.
  • Neuropsychiatric symptoms (NPS) are emerging predictors of cognitive decline and dementia.
  • Early detection of cognitive decline can be improved by understanding NPS phenotypes.

Purpose of the Study:

  • To examine associations between distinct NPS phenotypes and progression to mild cognitive impairment (MCI)/dementia.
  • To investigate the relationship between NPS phenotypes and cognitive decline trajectories over six years.

Main Methods:

  • Latent class analysis of NPS data from 20,599 cognitively unimpaired older adults.
  • Logistic regressions to assess odds of MCI/dementia progression by NPS phenotype.
  • Linear mixed-effects models to examine 6-year cognitive changes across domains (memory, attention, executive function, language).

Main Results:

  • Four NPS phenotypes were identified: Low-All, High-Depression, High-Agitation/Anxiety/Irritability, and High-All.
  • The High-All phenotype exhibited the highest risk for MCI/dementia progression (3x odds vs. Low-All).
  • High Agitation/Anxiety/Irritability phenotypes showed greater progression risk than High-Depression alone; cognitive decline varied by phenotype.

Conclusions:

  • Distinct NPS phenotypes are associated with differential risks of MCI/dementia progression and cognitive trajectories.
  • Phenotypes characterized by agitation, anxiety, and irritability predict higher progression odds than depression alone.
  • Early identification of NPS patterns offers potential for predicting cognitive decline and enabling early risk detection.