title: Neuropsychiatric Symptoms in Mild Cognitive Impairment.
abstract: Neuropsychiatric symptoms (NPS) may be the first manifestation of an underlying neurocognitive disorder. We undertook a review to provide an update on the epidemiology and etiological mechanisms of NPS that occur in mild cognitive impairment (MCI) and just before the onset of MCI. We discuss common clinical presentations and the implications for diagnosis and care.
  
  
  
  The authors conducted a selective review of the literature regarding the emergence of NPS in late life, before and after the onset of MCI. We discuss recent publications that explore the epidemiology and etiological mechanisms of NPS in the earliest clinical stages of these disorders.
  
  
  
  NPS have been reported in 35% to 85% of adults with MCI and also occur in advance of cognitive decline. The occurrence of NPS for the first time in later life should increase suspicion for an underlying neurocognitive disorder. The presenting symptom may provide a clue regarding the etiology of the underlying disorder, and the co-occurrence of NPS may herald a more accelerated cognitive decline.
  
  
  
  NPS are prevalent in the early clinical stages of neurocognitive disorders and can serve as both useful diagnostic and prognostic indicators. Recognition of NPS as early manifestations of neurocognitive disorders will become increasingly important as we move towards preventative strategies and disease-modifying treatments that may be most effective when deployed in the earliest stages of disease.
authors.affiliation: 1 Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, Ontario.|2 Department of Psychiatry, University of Toronto, Toronto, Ontario.
authors.forename: Damien
authors.initials: D
authors.lastname: Gallagher
authors.affiliation: 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.|3 Keenan Research Centre for Biomedical Research, The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario.|4 Institute of Medical Sciences, University of Toronto, Toronto, Ontario.
authors.forename: Corinne E
authors.initials: CE
authors.lastname: Fischer
authors.affiliation: 2 Department of Psychiatry, University of Toronto, Toronto, Ontario.|5 Toronto Rehabilitation Institute and the Centre for Mental Health, University Health Network, Toronto, Ontario.
authors.forename: Andrea
authors.initials: A
authors.lastname: Iaboni
mesh_terms: D001007:Anxiety / Q000503:physiopathology*; D057565:Apathy / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D003702:Delusions / Q000503:physiopathology*; D003863:Depression / Q000503:physiopathology*; D006212:Hallucinations / Q000503:physiopathology*; D006801:Humans; D011595:Psychomotor Agitation / Q000503:physiopathology*; D012920:Social Behavior Disorders / Q000503:physiopathology*
keywords: behavioural and psychological symptoms of dementia; mild cognitive impairment; mild neurocognitive disorder; neuropsychiatric symptoms