{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:51:31Z","timestamp":1789829491515,"version":"4.0.1"},"reference-count":53,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG066511"],"award-info":[{"award-number":["P30AG066511"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["RF1AG088003 to AG"],"award-info":[{"award-number":["RF1AG088003 to AG"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG070953 to AG"],"award-info":[{"award-number":["R01AG070953 to AG"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG030153 to AG"],"award-info":[{"award-number":["R01AG030153 to AG"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Neuropsychiatric symptoms (NPS) are prevalent in dementia, but most studies focus on Western populations. This study examines the association between NPS and neurodegeneration\u2010related plasma biomarkers in older adults with and without dementia in the Democratic Republic of the Congo (DRC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Eighty\u2010five individuals (\u226565 years) underwent dementia adjudication using the Community Screening Instrument for Dementia (CSID) and Alzheimer's Questionnaire (AQ). Plasma biomarkers (amyloid \u03b2 [A\u03b2] 42\/40, phosphorylated\u2010tau181 [p\u2010tau181], neurofilament light [NfL], glial fibrillary acidic protein (GFAP), interleukin\u20101\u03b2 [IL\u20101\u03b2], tumor necrosis factor\u2010\u03b1 [TNF\u2010\u03b1]) were measured. NPS were assessed using the Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Neuropsychiatric Inventory Questionnaire (NPI) (for dementia cases). Logistic regressions examined associations between NPS and biomarkers, adjusting for age, sex, and education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      NPS were common in dementia cases, with irritability (57.8%) and depression (90.7%) most frequent. GFAP was linked to irritability (odds ratio [OR]\u00a0=\u00a03.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01), and NfL and GFAP were associated with depressive symptoms (OR\u00a0=\u00a00.76,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04; OR\u00a0=\u00a01.98,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>These findings highlight the burden of NPS in the DRC and suggest biomarker\u2010driven mechanisms, emphasizing the need for further research in diverse populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Identifies neuropsychiatric symptoms as early indicators of Alzheimer's disease (AD) progression.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Examines associations between depression and AD biomarkers in preclinical and prodromal stages.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Highlights the role of amyloid and tau pathology in depression\u2010related cognitive decline.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Discusses implications for early intervention and personalized treatment strategies.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70530","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T11:21:12Z","timestamp":1755084072000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between neuropsychiatric symptoms and neurodegeneration\u2010related plasma biomarkers in older adults with and without clinical dementia in the Democratic Republic of the Congo"],"prefix":"10.1002","volume":"21","author":[{"given":"Jean","family":"Ikanga","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Department of Psychiatry University of Kinshasa and Catholic University of Congo School of Medicine, Kinshasa  Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1070-6421","authenticated-orcid":false,"given":"Saranya Sundaram","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Emory University School of Medicine  Atlanta Georgia USA"},{"name":"OneRehab  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Schwinne","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Obenauf","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Department of Psychology University of Tennessee  Knoxville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Gikelekele","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Kinshasa and Catholic University of Congo School of Medicine, Kinshasa  Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Epenge","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Kinshasa  Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Tshengele","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Kinshasa and Catholic University of Congo School of Medicine, Kinshasa  Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immaculee","family":"Kavugho","sequence":"additional","affiliation":[{"name":"Memory Clinic of Kinshasa  Kinshasa Democratic 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Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.70530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T20:36:48Z","timestamp":1759955808000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/alz.70530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":53,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/alz.70530"],"URL":"https:\/\/doi.org\/10.1002\/alz.70530","archive":["Portico"],"relation":{},"ISSN":["1552-5260","1552-5279"],"issn-type":[{"value":"1552-5260","type":"print"},{"value":"1552-5279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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