Mild Behavioral Impairment and Subjective Cognitive Decline predict Mild Cognitive Impairment

Ismail, Zahinoor; McGirr, Alexander; Gill, Sascha; Hu, Sophie; Forkert, Nils D.; Smith, Eric E.

doi:10.1101/2020.05.24.20112284

Cited by 17 publications

(32 citation statements)

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“…Neuropsychiatric symptoms are associated with an increased risk of cognitive de cits across the lifespan, and MBI is associated with poorer cognition cross-sectionally (76), as well as longitudinally in comparison to those without MBI (23,24). In agreement with this previous evidence, we also found subtle but signi cant differences in global cognition re ected by lower scores on both the MMSE and MoCA in patients with MBI.…”

Section: Discussionsupporting

confidence: 89%

“…Although MBI and MCI can co-occur, MBI can also precede MCI, manifesting in older adults with subjective cognitive decline or even normal cognition, in whom MBI has demonstrated an increased risk of cognitive decline and dementia (22)(23)(24)(25)(26). MBI may be the initial manifestation of neurodegeneration for some, and has been connected with known biomarkers for dementia including amyloid beta (27), tau (28,29), neuro lament light (30), cortical atrophy (31,32), white matter atrophy (33), and AD risk genes (34,35).…”

Section: Introductionmentioning

confidence: 99%

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Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

Fan

Liang

Yun

et al. 2020

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Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a dementia risk syndrome characterized by later-life emergence of persistent neuropsychiatric symptoms, has yet to be elucidated. We aimed to evaluate the associations between MBI and frailty in older adults without dementia.Methods: In this cross-sectional study, a consecutive series of 137 older adults without dementia in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist (MBI-C) at a cut-off point of >8. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariable logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariable logistic regression analysis demonstrated that compared to those without MBI (MBI- status), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49-37.21, p = 0.02). Frailty and MBI were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status were associated with higher odds of cognitive impairment. MBI was significantly associated with an increased risk of having frailty in the absence of dementia. This association merits further study to identify potential strategies for the early detection, prevention and therapeutic intervention of frailty.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

Fan

Liang

Yun

et al. 2020

Preprint

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“…This analysis was conducted in the subset of participants with normal cognition at year 1 and year 2 (the timeline of this analysis is further depicted in Additional file 2)-those who reported anxiety or SCD at both years were deemed as having "consistent" symptoms, while those who reported anxiety or SCD at either year only were deemed as having "inconsistent" symptoms. The use of two consecutive annual visits (year 1 and year 2) to determine symptom consistency is not inconsistent with what has been done in the literature [35][36][37]. In particular, "consistent" SCD has also been shown to be more predictive of neurocognitive disorders in recent literature [35,38,39].…”

Section: Statistical Analysesmentioning

confidence: 88%

Subjective cognitive decline, anxiety symptoms, and the risk of mild cognitive impairment and dementia

Liew

2020

Alz Res Therapy

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Background Subjective cognitive decline (SCD) and anxiety symptoms both predict neurocognitive disorders, but the two correlate strongly with each other. It is unclear whether they reflect two independent disease processes in the development of neurocognitive disorders and hence deserve separate attention. This cohort study examined whether SCD and anxiety symptoms demonstrate independent risks of mild cognitive disorder and dementia (MCI/dementia). Methods The study included 14,066 participants aged ≥ 50 years and diagnosed with normal cognition at baseline, recruited from Alzheimer’s Disease Centers across the USA. The participants were evaluated for SCD and anxiety symptoms at baseline and followed up almost annually for incident MCI/dementia (median follow-up 4.5 years; interquartile range 2.2–7.7 years). SCD and anxiety symptoms were included in Cox regression to investigate their independent risks of MCI/dementia. Results SCD and anxiety symptoms demonstrated independent risks of MCI/dementia, with HR 1.9 (95% CI 1.7–2.1) and 1.3 (95% CI 1.2–1.5), respectively. Co-occurring SCD and anxiety symptoms demonstrated the highest risk (HR 2.4, 95% CI 1.9–2.9)—participants in this group had a 25% probability of developing MCI/dementia by 3.1 years (95% 2.4–3.7), compared to 8.2 years among those without SCD or anxiety (95% CI 7.9–8.6). The results remained robust even in the sensitivity analyses that took into account symptom severity and consistency of symptoms in the first 2 annual visits. Conclusions The findings suggest that clinicians should not dismiss one over the other when patients present with both SCD and anxiety and that both constructs may potentially be useful to identify high-risk populations for preventive interventions and trials. The findings also point to the need for further research to clarify on the neurobiological distinctions between SCD and anxiety symptoms, which may potentially enrich our understanding on the pathogenesis of neurocognitive disorders.

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“…Mild behavioral impairment (MBI) is a validated neurobehavioral syndrome that describes the later life emergence of persistent NPS as an atrisk state for incident cognitive decline and dementia (11). These NPS have been suggested to be an index manifestation of dementia for some (12)(13)(14)(15)(16)(17)(18)(19)(20). MBI captures preclinical and prodromal disease symptoms and is associated with known dementia biomarkers including amyloid- (21), tau (22,23), neuro lament light (24), brain atrophy (25,26), and AD risk genes (27,28).…”

Section: Introductionmentioning

confidence: 99%

Neural Correlates of the Impulse Dyscontrol Domain of Mild Behavioral Impairment

Gill

Wang

Mouchès

et al. 2020

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Background: Agitation and aggression are common in dementia and pre-dementia. The dementia risk syndrome mild behavioral impairment (MBI) includes these symptoms in the impulse dyscontrol domain. However, the neural circuitry associated with impulse dyscontrol in neurodegenerative disease is not well understood. The aim of this work is to investigate if regional micro- and macro-structural brain properties are associated with impulse dyscontrol symptoms in older adults with normal cognition, mild cognitive impairment, and Alzheimer’s disease. Methods: Clinical, neuropsychiatric, and T1-weighted and diffusion-tensor MRI (DTI) data from 80 individuals with and 123 individuals without impulse dyscontrol, were obtained from the Alzheimer’s Disease Neuroimaging Initiative. Linear mixed effect (LME) models were used to assess if impulse dyscontrol was related to regional DTI and volumetric parameters. Results: Impulse dyscontrol was present in 17% of participants with NC, 43% with MCI, and 66% with AD. Impulse dyscontrol was associated with: 1) lower fractional anisotropy, and greater mean, axial, and radial diffusivity in the fornix; 2) lesser fractional anisotropy, and greater radial diffusivity in the superior fronto-occipital fasciculus; 3) greater axial diffusivity in the cingulum; 4) grey matter atrophy, specifically, lower cortical thickness and greater surface area in the parahippocampal gyrus. Conclusion: Our findings provide evidence that well-established atrophy patterns of AD are prominent in the presence of impulse dyscontrol, even when disease status is controlled for, and possibly in advance of dementia. Our findings support the growing evidence base for impulse dyscontrol symptoms as an early manifestation of Alzheimer’s disease.

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Mild Behavioral Impairment and Subjective Cognitive Decline predict Mild Cognitive Impairment

Cited by 17 publications

References 50 publications

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

Subjective cognitive decline, anxiety symptoms, and the risk of mild cognitive impairment and dementia

Neural Correlates of the Impulse Dyscontrol Domain of Mild Behavioral Impairment

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