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Peer-reviewedCC BY-NC-ND 4.0Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring

Neuropsychiatric symptoms across the revised Alzheimer's disease clinical staging framework: A review of current evidence and implications

  • Krushnaa Sankhe1,2
  • Daniella Vellone3,4
  • Dylan X. Guan3,4
  • Byron Creese5
  • Zahinoor Ismail4,6
  • Sanjeev Kumar7,8
  • Krista L. Lanctôt1,2,8
  • Moyra E. Mortby9,10,11,12
  • Fabricio Ferreira de Oliveira13
  • Lindsey Sinclair14
  • Jennifer Gatchel15,16
  • Catherine E. Munro15,17
17 affiliations
  1. 1Sunnybrook Research Institute Toronto Ontario Canada
  2. 2Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
  3. 3Faculty of Graduate Studies University of Calgary Calgary Alberta Canada
  4. 4Hotchkiss Brain Institute Cumming School of Medicine University of Calgary Calgary Alberta Canada
  5. 5Department of Psychology Brunel University of London Uxbridge, London UK
  6. 6Department of Psychiatry Cumming School of Medicine University of Calgary Calgary Alberta Canada
  7. 7Centre for Addiction and Mental Health Toronto Ontario Canada
  8. 8Department of Psychiatry University of Toronto Toronto Ontario Canada
  9. 9Mortby Consulting Canberra Australian Capital Territory Australia
  10. 10University of New South Wales Sydney New South Wales Australia
  11. 11UNSW Ageing Futures Institute Sydney New South Wales Australia
  12. 12Neuroscience Research Australia Sydney New South Wales Australia
  13. 13Escola Paulista de Medicina Federal University of São Paulo (UNIFESP) São Paulo São Paulo Brazil
  14. 14Department of Psychiatry Faculty of Medicine University of Southampton Southampton UK
  15. 15Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA
  16. 16McLean Hospital Belmont Massachusetts USA
  17. 17Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
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Abstract

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.

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Cite

BibTeXRIS
BibTeX
@article{sankhe2026neuropsychiatric,
  title = {{Neuropsychiatric symptoms across the revised Alzheimer's disease clinical staging framework: A review of current evidence and implications}},
  author = {Krushnaa Sankhe and Daniella Vellone and Dylan X. Guan and Byron Creese and Zahinoor Ismail and Sanjeev Kumar and Krista L. Lanctôt and Moyra E. Mortby and Fabricio Ferreira de Oliveira and Lindsey Sinclair and Jennifer Gatchel and Catherine E. Munro},
  journal = {Alzheimer's \& Dementia : Diagnosis, Assessment \& Disease Monitoring},
  year = {2026},
  month = nov,
  doi = {10.1002/dad2.70510},
  url = {https://doi.org/10.1002/dad2.70510},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Neuropsychiatric symptoms across the revised Alzheimer's disease clinical staging framework: A review of current evidence and implications
AU  - Krushnaa Sankhe
AU  - Daniella Vellone
AU  - Dylan X. Guan
AU  - Byron Creese
AU  - Zahinoor Ismail
AU  - Sanjeev Kumar
AU  - Krista L. Lanctôt
AU  - Moyra E. Mortby
AU  - Fabricio Ferreira de Oliveira
AU  - Lindsey Sinclair
AU  - Jennifer Gatchel
AU  - Catherine E. Munro
PY  - 2026
DA  - 2026/11/02
JO  - Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
DO  - 10.1002/dad2.70510
UR  - https://doi.org/10.1002/dad2.70510
AB  - 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.
SN  - 2352-8729
ER  -