The symptoms of AD can be generally divided into three categories – cognitive, functional, and neuropsychiatric. Cognitive symptoms in AD include memory, language, attention and executive functions, visuospatial skills and praxis (processing).2 These impairments can manifest as memory loss (repeating oneself, losing items), aphasia (language impairment), poor organization, impaired spatial and temporal orientation, apraxia (inability to perform purposeful actions), and agnosia (inability to recognize objects or persons).2,5,6 Initial impact of functional symptoms may be observed in work or social situations, progressing to problems with finances and self-care, eventually resulting in a complete loss of independent function for some individuals.3 Cognitive decline and neuropsychiatric symptoms (NPS) are key clinical manifestations of AD, with evidence that the prevalence of NPS increases with the severity of cognitive impairment.7 Particularly, symptoms of agitation, delusion, and irritability have been associated with worse cognitive performance.7
References:
1.Chen Y, Dang M, Zhang Z. Brain mechanisms underlying neuropsychiatric symptoms in Alzheimer’s disease: a systematic review of symptom-general and -specific lesion patterns. Mol Neurodegener 2021; 16 (1): 38.
2.Joubert S, Joncas S, Barbeau E, et al. Cognition. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
3.Gélinas I. Functional autonomy. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
4.Teng E, Cummings JL. Behaviour. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
5.Rainville C, Caza N, Belleville S, Gilbert B. Neuropsychological assessment. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.
6.Alzheimer’s Association. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12 (4): 459–509.
7.Lü W, Duan J, Zhang W, et al. Relationship between neuropsychiatric symptoms and cognitive functions in patients with cognitive impairment. Psychogeriatrics 2021; 21 (5): 773–782.
