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This study identified NPS clusters and associated health factors in a geriatric clinical population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We analyzed 1234 participants from the Italian GERIatric COgnitive evaluation memory clinic cohort with Neuropsychiatric Inventory data. Clusters were derived using machine learning (K\u2010means, Elbow method) separately for dementia and dementia\u2010free groups. Associations were assessed via multinomial logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In the overall cohort, four NPS clusters emerged: minimal NPS, depression\u2010anxiety\u2010apathy, depression\u2010anxiety, and delusions\u2010agitation\u2010irritability. Cluster profiles differed between the dementia and dementia\u2010free groups. Specific clinical and metabolic factors \u2013 lipid abnormalities, glycemic control, thyroid dysfunction, and underweight status \u2013 were differentially associated with NPS clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Distinct NPS patterns exist across the dementia continuum. These clusters differ in demographic, cognitive, functional, and metabolic profiles, suggesting NPS may precede cognitive decline and represent syndromic entities with diagnostic relevance. Multidimensional, personalized approaches are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71255","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:08:33Z","timestamp":1772989713000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neuropsychiatric symptoms in preclinical and clinically manifest dementia: clusters and their health determinants"],"prefix":"10.1002","volume":"22","author":[{"given":"Anna Giulia","family":"Guazzarini","sequence":"first","affiliation":[{"name":"Division of Gerontology and Geriatrics Department of Medicine and Surgery University of Perugia  Perugia Italy"},{"name":"Division of Clinical Geriatrics Center for Alzheimer Research Department of Neurobiology Care Sciences and Society, Karolinska Institutet  Stockholm 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