Cognitive profile of people with mild behavioral impairment in Brain Health Registry participants

Abstract

Objectives: Dementia assessment includes cognitive and behavioral testing with informant verification. Conventional testing is resource-intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. The aim of this study was to assess the relationship between informant-rated behavioral changes and participant-completed neuropsychological test performance in older adults, both measured remotely via an online unsupervised platform, the Brain Health Registry (BHR). Design: Observational cohort study. Setting: Community-dwelling older adults participating in the online BHR. Informant reports were obtained using the BHR Study Partner Portal. Participants: The final sample included 499 participant–informant dyads. Measurements: Participants completed online unsupervised neuropsychological assessment including Forward Memory Span, Reverse Memory Span, Trail Making B, and Go/No-Go tests. Informants completed the Mild Behavioral Impairment Checklist (MBI-C) via the BHR Study Partner portal. Cognitive performance was evaluated in MBI+/− individuals, as was the association between cognitive scores and MBI symptom severity. Results: Mean age of the 499 participants was 67, of which 308/499 were females (61%). MBI + status was associated with significantly lower memory and executive function test scores, measured using Forward and Reverse Memory Span, Trail Making Errors and Trail Making Speed. Further, significant associations were found between poorer objectively measured cognitive performance, in the domains of memory and executive function, and MBI symptom severity. Conclusion: These findings support the feasibility of remote, informant-reported behavioral assessment utilizing the MBI-C, supporting its validity by demonstrating a relationship to online unsupervised neuropsychological test performance, using a previously validated platform capable of assessing early dementia risk markers.

Plasma Phosphorylated Tau at Threonine 181 and Neuropsychiatric Symptoms in Preclinical and Prodromal Alzheimer Disease

“…These findings are consistent with the previous literature on the cognitive profile of MBI. 5,9 Memory and executive deficits have been observed in early AD, 44,45 and earlier detection of these deficits could help identify an at-risk population for AD. Our findings demonstrate that capturing later-life persistent NPS as per the MBI criteria provides an accessible means for identifying memory and executive deficits earlier in the disease course and identifying those at risk for greater decline in memory and executive function over time.…”

Validating the Mild Behavioral Impairment Checklist in a Cognitive Clinic: Comparisons With the Neuropsychiatric Inventory Questionnaire

“… 6 In a similar cohort from the Brain Health Registry of 499 largely cognitively unimpaired participants who were able to complete online neuropsychological testing, MBI prevalence was 6.2% at an MBI-C cutoff >7. 47 These lower prevalences likely better reflect the baseline rate in primary care and community samples, given the MBI-C was used for case ascertainment. Additionally, community samples likely have fewer cognitively impaired individuals than the specialty care cognitive neurology population represented here.…”

Functional connectivity and mild behavioral impairment in dementia‐free elderly

“…Participants with an MBI‐C score ≥6 were defined as MBI+. 27 Applying the inclusion criteria resulted in a sample of 60 participants from FAVR, with 30 of them cross‐enrolled in COMPASS‐ND, and 35 participants from COMPASS‐ND only. Pooling harmonized data over both cohorts resulted in a final sample of 95 dementia‐free participants (mean age = 71.7; 54.7 females; mean MoCA = 25.0).…”