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Clinical Manifestations.

Alyssa N De Vito1, Colin Stein2, Masood Manoochehri2

  • 1Brown University Medical School, Providence, RI, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Neuropsychiatric symptoms (NPS) like affective symptoms (AS) and psychosis/agitation (PA) affect Alzheimer's patients. Prevalence varies by race, with early-onset psychosis more common.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Psychiatry

Background:

  • Published rates of neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) exhibit wide variability.
  • Inconsistencies in NPS prevalence may stem from differences in demographics, clinical characteristics, and evaluation methods.
  • Harmonizing NPS data from the Alzheimer's Disease Sequencing Project (ADSP) is crucial for accurate prevalence estimation.

Purpose of the Study:

  • To investigate the prevalence of specific neuropsychiatric symptom phenotypes in a large cohort.
  • To explore the association between clinico-demographic factors, particularly race, and NPS prevalence.
  • To differentiate early-onset from late-onset psychosis/agitation symptoms.

Main Methods:

  • Utilized data from 36,194 participants across eight ADSP studies.
  • Defined three NPS phenotypes: early (EPA) and late psychosis/agitation (LPA), and affective symptoms (AS).
  • Employed descriptive statistics and chi-square analyses to assess prevalence and demographic differences.

Main Results:

  • Affective symptoms (AS+) were present in 18.8% and psychosis/agitation (PA+) in 5.2% of the cohort.
  • The majority of PA+ individuals (82.9%) exhibited early-onset symptoms (EPA).
  • Significant racial differences were observed in AS+ and PA+ prevalence, with distinct patterns for American Indian/Alaskan Native, multi-racial, and Asian/Pacific Islander groups.

Conclusions:

  • Affective symptoms are more prevalent than psychosis/agitation in the overall sample.
  • Psychosis/agitation symptoms in AD are more likely to manifest early in the disease course.
  • Observed racial disparities in NPS prevalence highlight the need for ancestry-specific research into genetic and molecular underpinnings for tailored treatments.