This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

Original Research

Prevalence, Clinical Correlates, Cognitive Trajectories, and Dementia Risk Associated With Mild Behavioral Impairment in Asians

Cheuk Ni Kan, PDipPsycha; Jemellee Cano, MDb; Xuhao Zhao, MPHc; Zahinoor Ismail, MDd; Christopher Li-Hsian Chen, FRCPa,e; and Xin Xu, PhDa,c

Published: March 16, 2022

ABSTRACT

Objective: Mild behavioral impairment (MBI) is characterized as later-life–emergent and persistent neuropsychiatric symptoms (NPS). The symptom persistence criterion of MBI has shown to increase the signal-to-noise ratio of the syndrome, decreasing the likelihood of false-positive NPS. However, the long-term cognitive and prognostic impact of MBI remains to be evaluated against the traditional framework of NPS, especially in Asian cohorts. This study investigated the epidemiologic characteristics of MBI in a prospective clinical cohort of Singaporean elderly.

Methods: A total of 304 dementia-free individuals (mean [SD] age = 72.2 [8.0] years, 51.6% female) were recruited between August 2010 and October 2019. All participants underwent annual neuropsychological, neuropsychiatric, and clinical assessments for 4 consecutive years and were diagnosed as having no cognitive impairment (NCI) or cognitive impairment–no dementia (CIND). MBI was ascertained using both baseline and year-1 Neuropsychiatric Inventory assessments. Cognitive Z-scores and Clinical Dementia Rating Sum-of-Boxes (CDR-SoB) scores were calculated.

Results: The prevalence of MBI was 14.5% (7.1% of NCI, 12.9% of CIND-mild, and 24.7% of CIND-moderate patients). MBI patients showed poorer cognitive function at baseline (F1,295 = 8.13 [SE = 0.47], P = .005), primarily in memory and executive function domains. MBI was associated with accelerated decline in global cognition (β = –0.15; 95% CI, −0.23 to −0.07) along with faster increase in CDR-SoB (β = 0.92; 95% CI, 0.62 to 1.21) as compared to individuals without symptoms or transient NPS. A total of 38.6% of MBI patients developed dementia as compared to 12.3% of non-MBI elderly (χ2 = 19.29, P < .001). MBI increased risk of incident dementia by 2.56-fold as compared to no symptoms or transient NPS, regardless of cognitive impairment.

Conclusions: MBI is a neurobehavioral risk factor for dementia, representing a potential target for dementia risk modeling, preventive intervention, and disease management.

Volume: 83

Quick Links: Dementia

Continue Reading…

Subscribe to read the entire article

$40.00

Buy this Article as a PDF

References