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Neuropsychiatric aspects of cognitive impairment 

Neuropsychiatric aspects of cognitive impairment
Chapter:
Neuropsychiatric aspects of cognitive impairment
Author(s):

Dylan Wint

and Jeffrey L. Cummings

DOI:
10.1093/med/9780199655946.003.0019
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date: 24 May 2020

Neuropsychiatric symptoms are recognized as important considerations in cognitive impairment but they remain underdiagnosed, understudied, and undertreated. Although they affect most individuals who develop dementia, no medicines have yet been approved in the US for treatment of dementia-related behavioural and emotional problems. Agitation and aggression are the symptoms most likely to require medical intervention. Rates of major depression are markedly increased in dementia patients. Apathy is a common neuropsychiatric syndrome in dementia patients. Psychotic symptoms such as delusions and hallucinations are remarkably disruptive to the lives and relationships of people with dementia. Neuropsychiatric symptoms have been linked to abnormalities of acetylcholine, serotonin, noradrenaline, and dopamine systems. Antidepressant, antipsychotic, anti-epileptic, and anti-adrenergic medications have modest effects on some neuropsychiatric symptoms, but all are associated with significant risks. Further study of neuropsychiatric symptoms will contribute substantially to our understanding of the neurochemistry, anatomy, and treatment of cognitive disorders.

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