Assessing neuropsychiatric symptoms in context: Integrating standardized and ecological approaches for better care

Neuropsychiatric symptoms (NPS) are common, disabling, and burdensome core features of dementia that often dominate the disease presentation and trajectory. Despite their prevalence and clinical significance, the assessment of NPS remains challenging in clinical practice. Traditional standardized assessment instruments, while widely used, are limited by their reliance on caregivers' retrospective recall, single time-point measurements, lack of direct observation, and limited ability to capture the NPS dynamic, fluctuating and context-dependent nature. A critical caveat of standardized assessment instruments lies in the insufficient exploration of NPS underlying causes, underscoring the need to refine existing approaches to better assist clinicians in detection, diagnosis, and management.