Centre for Research on Ageing,Health and Wellbeing,Research School of Population Health,The Australian National University,Canberra,Australia.
Departments of Psychiatry and Clinical Neurosciences,Mathison Centre for Mental Health Research & Education,Ron and Rene Centre for Healthy Brain Aging Research,Hotchkiss Brain Institute,University of Calgary,Calgary,Canada.
Int Psychogeriatr. 2018 Feb;30(2):221-232. doi: 10.1017/S1041610217001909. Epub 2017 Sep 21.
A dearth of population-based epidemiological research examines neuropsychiatric symptom (NPS) in sub-clinical populations across the spectrum from normal aging to mild cognitive impairment (MCI). The construct of mild behavioral impairment (MBI) describes the emergence of sustained and impactful NPS in advance of or in combination with MCI. This is the first epidemiological study to operationalize the recently published diagnostic criteria for MBI and determine prevalence estimates across the spectrum from cognitively normal to MCI.
MBI was assessed in 1,377 older (age range 72-79 years; 52% male; MCI ;= 133; cognitively normal, but-at-risk = 397; cognitively healthy = 847). MBI was assessed in accordance with the ISTAART-AA diagnostic criteria for MBI using the neuropsychiatric inventory.
34.1% of participants met the criteria for MBI. High prevalence of MBI across the cognitive spectrum was reported (48.9% vs. 43.1% vs. 27.6%). Irrespective of level of cognitive impairment, impulse dyscontrol (33.8% vs. 28.7% vs. 17.2%) and decreased motivation (32.3% vs. 26.2% vs. 16.3%) were the most frequently met MBI domains. MBI was more prevalent in men (χ2 = 4.98, p = 0.026), especially the domains of decreased motivation and impulse dyscontrol.
This study presents the first population-based prevalence estimates for MBI using the recently published ISTAART-AA diagnostic criteria. Findings indicate relatively high prevalence of MBI in pre-dementia clinical states and amongst cognitively healthy older adults. Findings were gender-specific, with MBI affecting more men than women. Knowing the estimates of these symptoms in the population is essential for understanding and differentiating the very early development of clinical disorders.
缺乏基于人群的流行病学研究来检查从正常衰老到轻度认知障碍（MCI）的亚临床人群中的神经精神症状（NPS）。轻度行为障碍（MBI）的构建描述了在 MCI 之前或与之同时出现的持续且有影响的 NPS。这是第一项对最近发表的 MBI 诊断标准进行操作化并确定从认知正常到 MCI 整个范围内的患病率估计的流行病学研究。
在 1377 名年龄在 72-79 岁的老年人（52%为男性；MCI=133；认知正常但处于高危状态=397；认知健康=847）中评估 MBI。根据 MBI 的 ISTAART-AA 诊断标准，使用神经精神病学调查评估 MBI。
34.1%的参与者符合 MBI 的标准。报告了认知谱中 MBI 的高患病率（48.9%比 43.1%比 27.6%）。无论认知障碍程度如何，冲动控制障碍（33.8%比 28.7%比 17.2%）和动机降低（32.3%比 26.2%比 16.3%）都是最常符合 MBI 标准的领域。男性中 MBI 的患病率更高（χ2=4.98，p=0.026），尤其是动机降低和冲动控制障碍领域。
本研究使用最近发表的 ISTAART-AA 诊断标准首次报告了 MBI 的基于人群的患病率估计。研究结果表明，在痴呆前临床状态和认知健康的老年人中，MBI 的患病率相对较高。研究结果具有性别特异性，MBI 影响的男性多于女性。了解这些症状在人群中的估计值对于理解和区分临床疾病的早期发展至关重要。
