Table 1.

Manic-like symptoms in patients with Alzheimer’s disease (AD).

References	Study Design	N	Sample and Setting	Age	MMSE	NPI Factors	Prevalence of Manic Symptoms	Additional Information
Frisoni et al. (1999) [19]	Cross-sectional	162	Outpatients without a history of psychiatric disorders prior to the onset of dementia	76.4	13.3	Mood, Psychotic, Frontal (euphoria and disinhibition)	Euphoria: 26%; disinhibition: 20.4%	Frontal syndrome prevalence has been shown to be associated to higher education, longer disease duration, and a slower rate of progression
Fuh et al. (2001) [20]	Cross-sectional	95	AD outpatient clinic	73.9	12.7	Mood, Psychosis, Psychomotor regulation (agitation, euphoria, irritability), Social engagement	Euphoria: 5%; disinhibition: 34%	Euphoria had an inverse relationship with age. Disinhibition, loaded on Social engagement and had a positive relationship with the severity of dementia
Benoit et al. (2003) [21]	Longitudinal (one-year follow-up)	244	AD outpatients	77.2	23.4	MMSE 21-30: Productive, Mood, Sensorial	Euphoria: 4.5%; disinhibition: 10.2%	Frontal syndrome prevalence increased with increasing severity of dementia
		255		77.6	16.7	MMSE 11-20: Mood, Frontal (euphoria and disinhibition), Motor/sensorial	Euphoria: 9.8%; disinhibition: 13.3%
Aalten et al. (2003) [22]	Cross-sectional	199	AD outpatients (excluded if living in a nursing home)	76.4	18.2	Mood/apathy, Psychosis, Hyperactivity (agitation, euphoria, irritability, disinhibition, aberrant motor behavior)	Euphoria: 7%; disinhibition: 12.6%	-
Mirakhur et al. (2004) [16]	Retrospective (caregiver interview)	435	Outpatient memory-clinic	78	13	Affective, Physical behaviour, Psychosis, Hypomania (euphoria and disinhibition)	Euphoria: 16.6%; disinhibition: 29.5%	Agitation/aggression/irritability clustered with depressive symptoms
Hollingworth et al. (2006) [23]	Cross-sectional	1120	AD late-onset volunteers	81.2	12.8	Behavioral dyscontrol (euphoria, disinhibition, aberrant motor behavior, sleep/appetite disturbances), Psychosis, Mood, Agitation	Euphoria: 10.5%; disinhibition: 31.4%	A higher score in behavioral dyscontrol was associated to female sex, younger age at the onset, and more severe cognitive impairment.
Spalletta et al. (2010) [18]	Cross-sectional, multicenter	1015	Untreated AD outpatients	73.3	18.3	Apathy, Affective, Psychomotor, Manic (disinhibition and euphoria), Psychotic	Euphoria and/or disinhibition: 7.7%	Increased occurrence/severity of manic syndrome with cognitive decline
Palmer et al. (2011) [17]	Longitudinal (one-year median follow-up)	177	Memory-clinic AD outpatients	73.1	19.4	Apathy, Affective, Psychomotor, Manic (disinhibition and euphoria), Psychotic	Euphoria and/or disinhibition: 7.9%	The manic syndrome was associated with an increased risk of cognitive decline.

Abbreviations: AD = Alzheimer’s disease, MMSE = Mini-mental state examination, NPI = Neuropsychiatric inventory.