Neuropsychiatric Symptoms in Cognitive Aging
Summary
Neuropsychiatric symptoms encompass a range of behavioural and emotional changes—such as depression, anxiety, apathy, irritability and psychosis—that frequently accompany cognitive decline in older adults. These symptoms may precede, occur alongside or follow measurable cognitive impairment and are increasingly recognised as early indicators of underlying neurodegenerative processes. The concept of mild behavioural impairment (MBI) provides a framework to identify later-life emergent neuropsychiatric changes that persist for at least six months and are not better explained by psychiatric illness. MBI domains include affective dysregulation, social inappropriateness, impulse dyscontrol, apathy and psychotic symptoms. Across diverse cohorts, the presence of neuropsychiatric symptoms has been linked to accelerated progression from subjective cognitive decline and mild cognitive impairment (MCI) to dementia, greater biomarker evidence of amyloid and tau pathology, and more rapid functional deterioration. Recognising and quantifying these symptoms within clinical and research settings is critical for early detection, prognosis and the design of interventions that integrate both cognitive and behavioural targets.
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Neuropsychiatric Symptoms in Cognitive Aging publication trend
The graph below shows the total number of articles in neuropsychiatric symptoms in cognitive aging across all publications each year (not limited to Nature Index journals).
Technical terms
Neuropsychiatric symptoms: alterations in mood, behaviour or perception observed in cognitive ageing.
Mild behavioural impairment (MBI): late-life onset of sustained neuropsychiatric changes that may herald neurodegenerative disease.
Mild cognitive impairment (MCI): measurable decline in cognitive function that does not yet compromise daily activities.
Cerebrospinal fluid biomarkers: proteins such as amyloid-β and phosphorylated tau measured in CSF to indicate neuropathology.
References
- Optimizing detection of Alzheimer’s disease in mild cognitive impairment: a 4-year biomarker study of mild behavioral impairment in ADNI and MEMENTO. Molecular Neurodegeneration (2023).
- Mild Behavioral Impairment and cognitive functions: A systematic review and meta-analysis. Ageing Research Reviews (2025).
- Mild behavioral impairment in early Alzheimer’s disease and its association with APOE and BDNF risk genetic polymorphisms. Alzheimer's Research & Therapy (2024).
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