Closing the Recognition Gap: Underdiagnosis, Patient Education, and Treatment Goals in Alzheimer's Disease Agitation

In this episode, 'Closing the Recognition Gap: Underdiagnosis, Patient Education, and Treatment Goals in Alzheimer's Disease Agitation,' the expert neurologists explored the following questions:

Do you believe that Alzheimer's disease agitation is currently underdiagnosed?

How are you educating patients and families?

What are the treatment goals for patients with Alzheimer's disease agitation?

Anton Porsteinsson and Alireza Atri agreed that Alzheimer's disease agitation is not overdiagnosed but rather frequently unrecognized and misattributed, often going unaddressed until symptoms reach a crisis point, underscoring the critical importance of early detection, structured clinical querying, and proactive family education. Dr. Atri described a 7-year Institute of Medicine guideline development process that produced 19 structured recommendations and clinical workflows for approaching patients with behavioral concerns, emphasizing that detection, accurate diagnosis, and compassionate disclosure are the essential first steps before any treatment can occur. Dr. Porsteinsson outlined the treatment goals for Alzheimer's disease agitation across multiple stakeholder groups, noting that for patients the goals include preserved cognition, safety, dignity, and the ability to age in place, for caregivers the focus is on improving the quality of interactions and reducing crisis cascades, and for providers and society the aim is to reduce emergency department visits, hospitalizations, and premature institutionalization that unmanaged agitation and aggression tend to accelerate.

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, 'Non-Pharmacologic Approaches to Alzheimer's Disease Agitation: Interventions, Best Practices, and Case Examples,' panelists continue their discussion on Alzheimer's disease agitation and highlight the non-pharmacologic treatment options available before initiating medications, best practices for educating patients and caregivers, and real-world case examples illustrating how environmental and behavioral interventions can meaningfully reduce agitation.