Prevalence of mild behavioural impairment domains: a meta‐analysis

Abstract

Background Mild behavioural impairment (MBI) is a neurobehavioural syndrome characterised by later life emergence of persistent neuropsychiatric symptoms. Our previous meta‐analysis showed that MBI is prevalent among cognitively normal (CN), subjective cognitive impairment (SCI) and mild cognitive impairment (MCI) subjects. This study is to calculate the pooled prevalence of MBI domains among CN, SCI, and MCI subjects. Methods A search of relevant literature published between 1 January 2003 and 6 August 2021 was conducted. Meta‐analysis using a random effects model and meta‐regression was performed. Results Ten studies conducted among 12 067 subjects (9758 CN, 1057 SCI and 1252 MCI) with retrievable MBI domains data underwent meta‐analysis, revealing pooled prevalence of affective dysregulation (AFD), impulse dyscontrol (IDS), decreased motivation (DMT), social inappropriateness (SIP) and abnormal perception/thought (APT) of 32.84% (95% CI 24.44–42.5%), 26.67% (95% CI 18.24–37.23%), 12.58% (95% CI 6.93–21.75%), 6.05% (95% CI 3.44–10.42%), and 2.81% (95% CI 1.67–4.69%) respectively. AFD and APT domains demonstrated ordinal increase in pooled prevalence from CN, SCI and MCI subgroups, but meta‐regression demonstrated no significant difference in MBI domains prevalence among cognitive subgroups (in contrast to the significant increase in MBI prevalence from CN to SCI to MCI). The pooled prevalence of AFD and IDS are greater than that of DMT, SIP and APT among all cognitive subgroups. Several variables were found to explain the high heterogeneity. Conclusions AFD and IDS are the two most prevalent MBI domains and remain the same with cognitive deterioration. This finding is potentially relevant to clinical practice.

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

“…Indeed, variable MBI diagnostic approaches are a major contributor to heterogeneity in estimates of prevalence of global MBI and domains. 40 , 44 As the MBI-C is a novel instrument, not yet available in cohorts like the Alzheimer’s Disease Neuroimaging Initiative or National Alzheimer’s Coordinating Center, variable symptom durations and NPS measures have been used in many studies. More sensitive and specific prevalence estimates are expected as more MBI-C data become available.…”

“…Abbreviations: SCD, subjective cognitive decline; MCI, mild cognitive impairment; NPI-Q, neuropsychiatric inventory questionnaire associated with higher domain scores for apathy, mood/ anxiety, impulse dyscontrol, social inappropriateness, and psychosis, and lower MoCA score. 50%), while fewer had apathy (409/923;44.31%), social inappropriateness (214/923; 23.19%), or psychosis (94/923; 10.18%). Similar trends were observed for each participant group.…”

Neuroimaging of mild behavioral impairment: A systematic review

“…5 In a meta-analysis of the five MBI domains, the prevalence of affective dysregulation was highest (32.84%), followed by impulse dyscontrol (26.67%), decreased motivation (12.58%), social inappropriateness (6.05%), and abnormal perception or thought content (2.81%). 6 MBI increases the risk of dementia 7,8 and the annual rates of conversion are 14.7% from MBI to dementia and 2.5% from MBI to NC. 9 Since the rates in MCI without neuropsychiatric symptoms are 8.3% and 5.3%, MBI carries a greater risk of dementia than MCI without neuropsychiatric symptoms.…”

Late‐life onset psychotic symptoms and incident cognitive impairment in people without dementia: Modification by genetic risk for Alzheimer's disease

“…When considering self or proxy ratings only, the proportion of people in our sample with MBI‐psychosis (self: 3%; proxy: 6%) is broadly in line with the 2.8% (95% CI: 1.7–4.7%) prevalence in other cognitively normal studies reported in a recent meta‐analysis. 13 The combined proportion is 9% (i.e., either self‐ or proxy‐rated MBI‐psychosis) because there is very little overlap between self and proxy ratings. This estimate is higher than most (but not all 12 ) other studies in cognitively normal people, and further exploration of the significance of the lack of overlap will be an important avenue for future research.…”

“…In cognitively normal older individuals, psychosis prevalence when assessed in the MBI framework is ≈3% but has been reported as high as 10%–12% (henceforth MBI‐psychosis). 11 , 12 , 13 In people with normal cognition, most studies are focused on clinically defined groups of patients with psychotic disorders (e.g., delusional disorder, late‐onset schizophrenia, or very‐late‐onset schizophrenia‐like psychosis). Overall, these tend to show an increased risk of dementia; however, studies on individuals whose symptoms are not attributable to another clinical disorder are scarce.…”