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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.

Matin Soeizi1,2, Tovia Jacobs1, Zafarullah M Chaudhary1,2

  • 1NYU Grossman School of Medicine, New York, NY, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Neuropsychiatric symptoms (NPS) in dementia are often linked to Alzheimer's Disease Dementia (ADD) pathology. However, NPS can be misattributed in Lewy Body Dementia (LBD), Frontotemporal Dementia (FTD), and vascular dementia, impacting accurate diagnosis.

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Area of Science:

  • Neurology
  • Neuroscience
  • Geriatrics

Background:

  • Neuropsychiatric symptoms (NPS) significantly impair quality of life for dementia patients and caregivers.
  • High NPS burdens, assessed by the Neuropsychiatric Inventory Questionnaire (NPI-Q), are associated with Lewy Body Dementia (LBD) and Alzheimer Disease Dementia (ADD).
  • Accurate diagnosis of dementia subtypes is challenging, particularly when NPS complicate clinical presentation.

Purpose of the Study:

  • To compare clinical diagnoses of dementia with neuropathology findings.
  • To evaluate the diagnostic accuracy of dementia subtypes in the presence of NPS.
  • To investigate the association between NPS and specific dementia pathologies.

Main Methods:

  • Retrospective longitudinal cohort study using data from the National Alzheimer's Coordinating Center (NACC).
  • Inclusion criteria: participants with delusions, hallucinations, or agitation (NPI-Q) at Mild Cognitive Impairment or mild dementia stages.
  • Exclusion criteria: schizophrenia and unspecified psychiatric disorders. Analysis of clinical diagnosis versus neuropathology concordance using R software and ANOVA.

Main Results:

  • 1,089 participants included; average age with NPS was 77.96 years.
  • Agitation (NPI-Q) reported in 880, delusions in 296, and hallucinations in 184 participants.
  • High concordance for ADD (94%) but lower for Frontotemporal Dementia (FTD) (36%) and Lewy Body Dementia (LBD) (48.2%). Significant misattribution of NPS in FTD, LBD, and vascular dementia cases, often to ADD.

Conclusions:

  • NPS are predominantly associated with Alzheimer Disease Dementia (ADD) pathology.
  • Over 50% of cases with confirmed LBD, FTD, or vascular dementia pathology showed NPS misattributed to other diagnoses.
  • Further research is needed to improve diagnostic accuracy for dementias presenting with behavioral disturbances.