Mild Behavioral Impairment as a Predictor of Cognitive Functioning in Older Adults

Abstract

Background: Mild behavioral impairment (MBI) is considered to be a late life transitional state between normal aging and dementia that describes individuals who have persistent behavioral changes and/or psychiatric symptoms. Individuals with MBI are found to be at greater risk of dementia compared to those without these symptoms. Identifying how MBI might relate to different domains of cognition is of key importance, as it could be an early indicator of a future dementia diagnoses. Method: Secondary data analysis of a sample (n=512) of older adults from the Florida Alzheimer’s Disease Research Center who were either cognitively healthy or presenting with mild cognitive impairment (MCI). Some individuals presented with MBI, as defined by decreased motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, or abnormal perception/thought content. Executive function, attention, short-term memory, and episodic memory, were compared using a battery of neuropsychological assessments. Results: Individuals with MCI performed worse on all tasks across all cognitive domains, where individuals with MBI performed worse on several tasks associated with executive function, attention, and episodic memory. Compared to individuals with only MCI, individuals with MCI and MBI performed significantly worse on tasks associated with executive function and episodic memory. Conclusion: The present study found evidence that individuals with MBI will perform worse on tasks of executive function, attention, and episodic memory. Further, those with MCI and MBI will perform significantly worse on executive function and episodic memory tasks. Future research should explore if these findings can help to predict specific dementia diagnoses.

Cognitive profile of mild behavioral impairment in Brain Health Registry participants

“…Longitudinal cohorts have demonstrated that an acceleration of decline in memory performance occurs 3-4 years before a diagnosis of MCI and 7 years before a diagnosis of AD, while for executive function an accelerated decline occurs 2-3 years before AD diagnosis 42,43 . The finding of small but significant associations between MBI and poorer memory and executive function performance is consistent with the evolving description of the cognitive profile of MBI [44][45][46] .…”

Prevalence of mild behavioural impairment: a systematic review and meta‐analysis

“… 22–32 Among these studies were seven that reported the prevalence of MBI among MCI patients, 22, 24–26, 28–30 five that reported the MBI prevalence among CN subjects, 26–28, 31, 32 and five that reported MBI prevalence among SCI or CN‐AR patients 22, 23, 25, 26, 32 . Two studies were performed in Japan, 25, 29 three studies in the USA, 28, 30, 32 two in Spain, 23, 24 two in Canada, 22, 31 and one each in Australia and the UK 26, 27 . More than half of the studies (6/11) were regarded as low quality mainly because of the lack of longitudinal follow‐up of subjects (Table 2).…”

“…With regard to the defining criteria for MBI, six studies used the Neuropsychiatric Inventory Questionnaire, three studies used the ISTAART criteria, and two studies used MBI‐C (Table 1). Thirteen studies were included in the systematic review to examine the effect of MBI in predicting cognitive deterioration, correlations to underling pathology or biomarkers, and genetic risks 20, 22–33 . No previous systematic review or meta‐analysis was identified.…”

“…A total of 1358 patients were reported in the seven studies that reported the prevalence of MBI among MCI patients 22, 24–26, 28–30 . Five of these studies were performed in non‐Asian countries, and two were performed in Asia 22, 24–26, 28–30 . The prevalence of MBI ranged from 14.2% to 67.9%.…”

“…The study by Rouse et al . was not included as the studied population may have overlapped with that examined by Ismail et al ., whose study was more recent and had a larger population 28, 32 . All four studies were performed in non‐Asian countries.…”