Psychosis in Alzheimer disease — mechanisms, genetics and therapeutic opportunities

Neuropsychiatric symptoms (NPS) are almost ubiquitous in people with dementia, with prevalence estimates as high as 97% 1 . These non-cognitive symptoms are distressing not only for people with Alzheimer disease (AD) or other dementias but also for their caregivers, and are associated with poor outcomes in terms of function, quality of life, disease course, mortality and economic cost 2,3 . Also known as behavioural and psychological symptoms of dementia (BPSD), these NPS include impairments in motivation, interest, social behaviour and awareness, mood disorders, anxiety, agitation, impulsivity, and hallucinations and delusions, all of which often require clinical intervention. However, reliable and safe treatments for NPS have remained elusive