Neuropsychiatric symptoms across the revised Alzheimer's disease clinical staging framework: A review of current evidence and implications
Krushnaa Sankhe, Daniella Vellone, Dylan X. Guan, Byron Creese, Zahinoor Ismail, Sanjeev Kumar, Krista L. Lanctôt, Moyra E. Mortby, Fabricio Ferreira de Oliveira, Lindsey Sinclair, Jennifer Gatchel, Catherine E. MunroAbstract
The field of Alzheimer's disease (AD) research has seen major advances in understanding manifestations of AD‐related neuropsychiatric symptoms (NPS), including recent addition of NPS to the 2024 National Institute of Aging–Alzheimer's Association (NIA‐AA) clinical staging framework. This focused review highlights key publications (49 in 2024; 28 in 2025) indexed in MEDLINE examining AD‐related NPS, in alignment with the Scale for the Assessment of Narrative Review Articles guidelines. Data were thematically organized across NIA‐AA clinical stages, with emphasis on measurement, diagnosis, and biomarker‐cognition correlates of AD‐related NPS. Together, these findings can inform future research and clinical practice through enhanced understanding of AD‐related NPS and their relationships with pathology and clinical outcomes. Finally, three key priorities were identified for future research: (1) incorporating sex/gender and ethnocultural diversity; (2) integrating NPS assessment with cognitive, fluid, and neuroimaging biomarkers; and (3) including perspectives of individuals with lived experience to support personalized NPS management.