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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Risk of Conversion to Dementia in a Mild Behavioral Impairment Group Compared to a Psychiatric Group and to a Mild
Fernando E Taragano1,2, Ricardo F Allegri1, Silvina L Heisecke1,2
1National Scientific Research Council - CONICET, Buenos Aires, Argentina.
Background:
There is insufficient available information on behavioral changes in the absence of cognitive impairment as factors increasing the risk of conversion to dementia.
Objective:
To observe and analyze patients with mild behavioral impairment (MBI), mild cognitive impairment (MCI), and a psychiatry group (PG) to compare the risk of progression to dementia.
Methods:
From 677 initially assessed ≥60-year-old patients, a series of 348 patients was studied for a five-year period until censoring or conversion to dementia: 96 with MBI, 87 with MCI, and 165 with general psychiatry disorders, including 4 subgroups: Anxiety, Depression, Psychosis and Others. All patients were assessed with clinical, psychiatric, neurological, neuropsychological, and neuroimaging studies.
Results:
From 348 patients, 126 evolved to dementia (36.2%). Conversion was significantly higher in MBI (71.5%), followed by the MCI-MBI overlap (59.6%) and MCI (37.8%) groups, compared to PG (13.9%) (Log-rank p < 0.001). MCI patients mostly converted to Alzheimer's dementia, while MBI converted to frontotemporal dementia and Lewy body dementia. Patients in PG converted to Lewy body dementia and frontotemporal dementia.
Conclusion:
Conversion to dementia is significantly higher in patients with neuropsychiatric symptoms. The MBI concept generates a new milestone in the refining of diagnosis of neurodegenerative diseases and the possibility of creating neuropsychiatric profiles. Its earlier identification will allow new possibilities for therapeutic intervention.
Insights
Mild behavioral impairment (MBI) significantly increases dementia risk, even without cognitive decline. Early MBI identification aids neurodegenerative disease diagnosis and treatment strategies.
Area of Science:
- Neuroscience
- Geriatrics
- Psychiatry
Background:
- Limited data exists on behavioral changes as dementia risk factors without cognitive impairment.
- Neuropsychiatric symptoms are increasingly recognized as potential early indicators of neurodegeneration.
Purpose of the Study:
- To compare dementia conversion risk in patients with mild behavioral impairment (MBI), mild cognitive impairment (MCI), and a general psychiatry group (PG).
- To analyze the diagnostic and therapeutic implications of identifying MBI in neurodegenerative disease progression.
Main Methods:
- A five-year longitudinal study of 348 patients (≥60 years) with MBI, MCI, or PG.
- Comprehensive assessments included clinical, psychiatric, neurological, neuropsychological, and neuroimaging evaluations.
Main Results:
- Dementia conversion occurred in 36.2% of patients.
- MBI patients showed the highest conversion rate (71.5%), followed by MCI (37.8%) and PG (13.9%).
- Specific dementia subtypes were associated with MBI (frontotemporal, Lewy body) and MCI (Alzheimer's).
Conclusions:
- Neuropsychiatric symptoms, particularly MBI, are significant predictors of dementia conversion.
- MBI represents a crucial advancement in diagnosing neurodegenerative diseases and developing targeted interventions.
- Early identification of MBI offers new therapeutic opportunities.
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