Behavioural and Psychological Symptoms in Alzheimer’s Disease

Abstract

Alzheimer's disease (AD) is not only characterised by cognitive decline, but the behavioural and psychological symptoms (BPSD) it induces are equally prevalent, with almost all patients experiencing one or two symptoms, including hallucinations, delusions, depression and anxiety. This has had a significant negative impact on patients' quality of life, carer burden, and clinical outcomes. This review synthesises clinical, neuropsychological and neurobiological findings to explore the main BPSD types and pathological features of AD from a neuroscientific perspective. It also summarises their common and symptom-specific mechanisms based on past studies. The results suggest that the mechanisms underlying the pathogenesis of these symptoms usually involve complex brain structural changes and alterations in neurotransmitter systems, at the same time, interact with each other. The nature and pathological features of BPSDs will, in turn, provide meaningful information about the underlying neurodegenerative pathological mechanisms, such as AD. Therefore, its importance as a potential diagnostic and therapeutic target should be given greater attention. In addition to this, based on several non-pharmacological therapies that are quite encouraging, this paper explores the clinical and nursing implications.