Addressing the Alzheimer's disease crisis through better understanding, treatment, and eventual prevention of associated neuropsychiatric syndromes

Abstract

This Perspectives article offers a series of recommendations to the implementers of the National Alzheimer’s Project Act (NAPA) under the premise that better treatment and preventive strategies targeting neuropsychiatric syndromes (NPS) will improve patient outcomes, lessen caregiver burden, and potentially lead to prevention of Alzheimer’s disease (AD) and related primary dementias. These recommendations arise from the activities of the Neuropsychiatric Syndromes Professional Interest Area (NPSPIA) of the Alzheimer’s Association International Society to Advance Alzheimer’s Research and Treatment. The NPS-PIA was constituted after an Alzheimer’s Association Research Roundtable meeting devoted to this topic in April 2010. The Roundtable concluded that, despite several decades of efforts, few effective treatments are currently available for NPS and that redoubled efforts are needed in this area because of their great public health impact. We seek to ensure that the NAPA-created Advisory Council on Alzheimer’s Research, Care, and Services gives serious and careful consideration to the challenges created by NPS. We further seek inclusion of NPS-focused recommendations in the National Alzheimer’s Strategic Plan. As the AD crisis is a worldwide challenge, and the NPS-PIA is an international group, we anticipate that these recommendations will serve as an example for other nations facing the challenge of AD 1 NPS. In the interest of time and space, these recommendations are high level and abbreviated. They will be followed by morespecificrecommendationsaswellasdetailedsupporting documentationinthenextfewmonths.Althoughweprimarily discussNPSinthecontextofAD,theserecommendationsalso applytorelateddementias,suchasthoseassociatedwithfrontotemporaldegeneration,Lewybodydisease,dementiadueto brain vascular disease, and others. Although AD is considered by many people as simply a memory or cognitive disorder, almost all individuals with AD develop one or more NPS at some point in their disease [1]. It is now well accepted that, in the vast majority of