Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
Psychogeriatrics. 2024 May;24(3):555-564. doi: 10.1111/psyg.13092. Epub 2024 Feb 25.
Mild behavioural impairment (MBI) is an emergent and persistent neuropsychiatric symptom (NPS) in subjects aged 50 and older who are at risk for cognitive decline. We examined the prevalence of MBI across the spectrum from cognitively normal (CN), mild cognitive impairment (MCI), to dementia, and further investigated the association between the MBI domain and cognitive and functional impairment.
MBI was assessed in 2337 elderly patients in the Alzheimer's Disease Neuroimaging Initiative database (mean age, 73.04 years; 52.8% male). Among the subjects, 868 (37.1%) had normal cognition, 1066 (45.6%) had MCI, and 403 (17.2%) had mild Alzheimer's dementia (AD). MBI was evaluated in accordance with the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment diagnostic criteria for MBI, utilising the Neuropsychiatric Inventory. We compared the prevalence of the MBI domain with CN using multinominal logistic regression analysis and further quantified the magnitude of the association between MCI/AD and the MBI domains by calculating the population attributable risk (PAR). We assessed the association between the MBI domains and cognitive and functional impairment using simultaneous linear regression analysis.
The most common MBI domains in each diagnostic group were affective dysregulation followed by impulse dyscontrol, decreased motivation, social inappropriateness, and abnormal perception or thought content. The PARs for MBI domains in subjects with MCI or AD were respectively: 16.60% and 24.34% for affective dysregulation; 3.72% and 18.06% for impulse dyscontrol; 4.78% and 14.13% for decreased motivation, 1.91% and 2.29% for social inappropriateness; and 0.68% and 3.85% for abnormal perception or thought content. All MBI domains except for social inappropriateness were significantly associated with a higher 11-item Alzheimer's Disease Assessment Scale-Cognitive Subscale total score. All MBI domains were significantly associated with a higher Functional Activities Questionnaire total score.
Our findings show that MBI is highly prevalent across subjects with CN, MCI, and AD and is associated with cognitive and functional decline. MBI could be a crucial clinical phenotype relevant to the risk of cognitive and functional impairment, and provides a useful dimension pertinent to diagnostic approaches.
轻度行为障碍（MBI）是一种在 50 岁及以上有认知能力下降风险的人群中出现的持续性神经精神症状（NPS）。我们研究了 MBI 在认知正常（CN）、轻度认知障碍（MCI）到痴呆的范围内的患病率，并进一步探讨了 MBI 与认知和功能障碍之间的关联。
我们在阿尔茨海默病神经影像学倡议数据库中的 2337 名老年患者中评估了 MBI（平均年龄 73.04 岁；52.8%为男性）。在这些受试者中，868 人（37.1%）认知正常，1066 人（45.6%）有 MCI，403 人（17.2%）有轻度阿尔茨海默病痴呆。我们根据阿尔茨海默病协会国际协会推进阿尔茨海默病研究和治疗的 MBI 诊断标准，利用神经精神病学调查评估 MBI。我们使用多项逻辑回归分析比较了 MBI 域与 CN 的患病率，并通过计算人群归因风险（PAR）进一步量化了 MCI/AD 与 MBI 域之间的关联程度。我们使用同时线性回归分析评估了 MBI 域与认知和功能障碍之间的关联。
在每个诊断组中，最常见的 MBI 域分别是情绪失调，其次是冲动控制障碍、动机减退、社交不当和异常感知或思维内容。在 MCI 或 AD 患者中，MBI 域的 PAR 分别为：情绪失调 16.60%和 24.34%；冲动控制障碍 3.72%和 18.06%；动机减退 4.78%和 14.13%；社交不当 1.91%和 2.29%；异常感知或思维内容 0.68%和 3.85%。除社交不当外，所有 MBI 域均与较高的 11 项阿尔茨海默病评估量表认知子量表总分显著相关。所有 MBI 域均与较高的功能活动问卷总分显著相关。
我们的研究结果表明，MBI 在 CN、MCI 和 AD 患者中均高度流行，并与认知和功能下降相关。MBI 可能是与认知和功能损伤风险相关的重要临床表型，为诊断方法提供了有用的维度。
