Skip to main content

Advertisement

SpringerLink
Log in

Prevalence of mild behavioral impairment in patients with mild cognitive impairment

  • Original article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

Over the past years, increasing attention has been paid to the frequency of neuropsychiatric symptoms (NPS) in dementia, also known as the behavioral and psychological symptoms of dementia. This study’s main goal was to determine the prevalence of Mild Behavioral Impairment (MBI) and its subdomains in patients with Mild Cognitive Impairment (MCI) in Iran. Participants included 96 patients with MCI who attended the memory clinic between July and December 2020. Global cognitive function was evaluated using the Persian version of the Montreal Cognitive Assessment (MoCA). To assess MBI, the Persian version of the MBI checklist (MBI-C) was completed by the patient or a close caregiver. The mean age of patients was 71.4 ± 9.3 years, and 56 patients (58.3%) were female. Regarding the cutoff point of 6.5, 48 patients (50%) had MBI. In both groups of MBI and non-MBI, 28 (58%) were female. There was no significant difference in MBI subdomains scores and total MBI scores between the two genders. In addition, we found no significant difference in total MBI in patients with different risk factors. There was no significant difference in MoCA score between MBI and non-MBI patients (24.1 ± 3.9 versus 23.7 ± 4.0) (p = 0.59). NPS are highly prevalent in MCI patients, with the most common ones being impulse dyscontrol, emotional dysregulation, and decreased motivation. Psychotic symptoms and social inappropriateness are rare. New-onset psychiatric symptoms and behavioral changes in older adults, even in a mild form (MBI), should increase the suspicion of subsequent cognitive impairment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lussier FZ, Pascoal TA, Chamoun M et al (2020) Mild behavioral impairment is associated with β-amyloid but not tau or neurodegeneration in cognitively intact elderly individuals. Alzheimers Dement 16:192–199. https://doi.org/10.1002/alz.12007

    Article  PubMed  PubMed Central  Google Scholar 

  2. Mallo SC, Ismail Z, Pereiro AX et al (2018) Assessing mild behavioral impairment with the mild behavioral impairment-checklist in people with mild cognitive impairment. J Alzheimers Dis 66:83–95. https://doi.org/10.3233/JAD-180131

    Article  PubMed  Google Scholar 

  3. Feldman H, Scheltens P, Scarpini E et al (2004) Behavioral symptoms in mild cognitive impairment. Neurology 62:1199–1201. https://doi.org/10.1212/01.wnl.0000118301.92105.ee

    Article  CAS  PubMed  Google Scholar 

  4. Ismail Z, Elbayoumi H, Fischer CE et al (2017) Prevalence of depression in patients with mild cognitive impairment: a systematic review and meta-analysis. JAMA Psychiat 74:58–67. https://doi.org/10.1001/jamapsychiatry.2016.3162

    Article  Google Scholar 

  5. Rosenberg PB, Mielke MM, Appleby BS et al (2013) The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer disease. Am J Geriatr Psychiatry 21:685–695. https://doi.org/10.1016/j.jagp.2013.01.006

    Article  PubMed  Google Scholar 

  6. Petersen RC, Stevens JC, Ganguli M et al (2001) Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 56:1133–1142. https://doi.org/10.1212/wnl.56.9.1133

    Article  CAS  PubMed  Google Scholar 

  7. Cummings JL, Mega M, Gray K et al (1994) The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314. https://doi.org/10.1212/wnl.44.12.2308

    Article  CAS  PubMed  Google Scholar 

  8. Yokoi Y, Takano H, Sakata M et al (2019) Discrete effect of each mild behavioural impairment category on dementia conversion or cognitive decline in patients with mild cognitive impairment. Psychogeriatrics 19:591–600. https://doi.org/10.1111/psyg.12447

    Article  PubMed  Google Scholar 

  9. Lindau M, Almkvist O, Kushi J et al (2000) First symptoms–frontotemporal dementia versus Alzheimer’s disease. Dement Geriatr Cogn Disord 11:286–293. https://doi.org/10.1159/000017251

    Article  CAS  PubMed  Google Scholar 

  10. Ismail Z, Smith EE, Geda Y et al (2016) Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment. Alzheimers Dement 12:195–202. https://doi.org/10.1016/j.jalz.2015.05.017

    Article  PubMed  Google Scholar 

  11. Sheikh F, Ismail Z, Mortby ME et al (2018) Prevalence of mild behavioral impairment in mild cognitive impairment and subjective cognitive decline, and its association with caregiver burden. Int Psychogeriatr 30:233–244. https://doi.org/10.1017/S104161021700151X

    Article  PubMed  Google Scholar 

  12. Sclan SG, Reisberg B (1992) Functional assessment staging (FAST) in Alzheimer’s disease: reliability, validity, and ordinality. Int Psychogeriatr 4(Suppl 1):55–69. https://doi.org/10.1017/s1041610292001157

    Article  PubMed  Google Scholar 

  13. Badrkhahan SZ, Sikaroodi H, Sharifi F et al (2020) Validity and reliability of the Persian version of the Montreal Cognitive Assessment (MoCA-P) scale among subjects with Parkinson’s disease. Appl Neuropsychol Adult 27:431–439. https://doi.org/10.1080/23279095.2019.1565762

    Article  PubMed  Google Scholar 

  14. Ismail Z, Agüera-Ortiz L, Brodaty H et al (2017) The mild behavioral impairment checklist (MBI-C): a rating scale for neuropsychiatric symptoms in pre-dementia populations. J Alzheimers Dis 56:929–938. https://doi.org/10.3233/JAD-160979

    Article  PubMed  PubMed Central  Google Scholar 

  15. Peters ME, Rosenberg PB, Steinberg M et al (2013) Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the Cache County Study. Am J Geriatr Psychiatry 21:1116–1124. https://doi.org/10.1016/j.jagp.2013.01.049

    Article  CAS  PubMed  Google Scholar 

  16. Geda YE, Roberts RO, Knopman DS et al (2008) Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study. Arch Gen Psychiatry 65:1193–1198. https://doi.org/10.1001/archpsyc.65.10.1193

    Article  PubMed  PubMed Central  Google Scholar 

  17. Fernández-Martínez M, Molano A, Castro J, Zarranz JJ (2010) Prevalence of neuropsychiatric symptoms in mild cognitive impairment and Alzheimer’s disease, and its relationship with cognitive impairment. Curr Alzheimer Res 7:517–526. https://doi.org/10.2174/156720510792231748

    Article  Google Scholar 

  18. Peters KR, Rockwood K, Black SE et al (2006) Characterizing neuropsychiatric symptoms in subjects referred to dementia clinics. Neurology 66:523–528. https://doi.org/10.1212/01.wnl.0000198255.84842.06

    Article  CAS  PubMed  Google Scholar 

  19. Geda YE, Smith GE, Knopman DS et al (2004) De novo genesis of neuropsychiatric symptoms in mild cognitive impairment (MCI). Int Psychogeriatr 16:51–60. https://doi.org/10.1017/s1041610204000067

    Article  PubMed  Google Scholar 

  20. Lo TWB, Karameh WK, Barfett JJ et al (2020) Association between neuropsychiatric symptom trajectory and conversion to Alzheimer disease. Alzheimer Dis Assoc Disord 34:141–147. https://doi.org/10.1097/WAD.0000000000000356

    Article  PubMed  Google Scholar 

  21. Mortby ME, Ismail Z, Anstey KJ (2018) Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults. Int Psychogeriatr 30:221–232. https://doi.org/10.1017/S1041610217001909

    Article  PubMed  Google Scholar 

  22. Monastero R, Mangialasche F, Camarda C et al (2009) A systematic review of neuropsychiatric symptoms in mild cognitive impairment. J Alzheimers Dis 18:11–30. https://doi.org/10.3233/JAD-2009-1120

    Article  PubMed  Google Scholar 

  23. Matsuoka T, Ismail Z, Narumoto J (2019) Prevalence of mild behavioral impairment and risk of dementia in a psychiatric outpatient clinic. J Alzheimers Dis 70:505–513. https://doi.org/10.3233/JAD-190278

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lyketsos CG, Lopez O, Jones B et al (2002) Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA 288:1475–1483. https://doi.org/10.1001/jama.288.12.1475

    Article  PubMed  Google Scholar 

  25. Lyketsos CG, Steinberg M, Tschanz JT et al (2000) Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry 157:708–714. https://doi.org/10.1176/appi.ajp.157.5.708

    Article  CAS  PubMed  Google Scholar 

  26. Geda YE, Roberts RO, Mielke MM et al (2014) Baseline neuropsychiatric symptoms and the risk of incident mild cognitive impairment: a population-based study. Am J Psychiatry 171:572–581. https://doi.org/10.1176/appi.ajp.2014.13060821

    Article  PubMed  PubMed Central  Google Scholar 

  27. Demey I, Zimerman M, Allegri RF et al (2007) Neuropsychiatric symptoms in mild cognitive impairment. Vertex 18:252–257

    PubMed  Google Scholar 

  28. Binetti G, Mega MS, Magni E et al (1998) Behavioral disorders in Alzheimer disease: a transcultural perspective. Arch Neurol 55:539–544. https://doi.org/10.1001/archneur.55.4.539

    Article  CAS  PubMed  Google Scholar 

  29. Treiber KA, Lyketsos CG, Corcoran C et al (2008) Vascular factors and risk for neuropsychiatric symptoms in Alzheimer’s disease: the Cache County study. Int Psychogeriatr 20:538–553. https://doi.org/10.1017/S1041610208006704

    Article  PubMed  PubMed Central  Google Scholar 

  30. Steinberg M, Corcoran C, Tschanz JT et al (2006) Risk factors for neuropsychiatric symptoms in dementia: the Cache County study. Int J Geriatr Psychiatry 21:824–830. https://doi.org/10.1002/gps.1567

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Gilda Kianimehr and Farzad Fatehi contributed equally in this work.

Authors and Affiliations

  1. Department of Neuropsychiatry and Cognitive Neurology, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran, Iran

    Gilda Kianimehr & Maryam Noroozian

  2. Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Farzad Fatehi

Authors
  1. Gilda Kianimehr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Farzad Fatehi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maryam Noroozian
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

G.K. wrote the manuscript and gathered the data. F.F. wrote the manuscript and analyzed the data. M.N. wrote the manuscript, performed the final edit and supervised the project.

Corresponding author

Correspondence to Maryam Noroozian.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical standards

The protocol of the present study was in accordance with the latest versions of the Declaration of Helsinki and was approved by the ethics committee of Tehran University of Medical Sciences (ID: IR.TUMS.MEDICINE.REC.1400.296).

Informed consent

Informed consent was obtained from patients or their legal representatives.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kianimehr, G., Fatehi, F. & Noroozian, M. Prevalence of mild behavioral impairment in patients with mild cognitive impairment. Acta Neurol Belg 122, 1493–1497 (2022). https://doi.org/10.1007/s13760-021-01724-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-021-01724-z

Keywords

Search

Navigation