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Mild Behavioral Impairment in Parkinson's Disease: Data from the Parkinson's Disease Cognitive Impairment Study
Roberta Baschi1, Vincenzo Restivo2, Alessandra Nicoletti3
1Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy.
Abstract:
Neuropsychiatric symptoms (NPS) have been frequently described in Parkinson's disease (PD), even in the earliest stages of the disease. Recently the construct of mild behavioral impairment (MBI) has been proposed as an at-risk state for incident cognitive decline and dementia. The aim of the present study is to evaluate the prevalence and associated factors of MBI in PD. Cross-sectional data from 429 consecutive PD patients enrolled in the PArkinson's disease COgnitive impairment Study (PACOS) were included in the study. All subjects underwent neuropsychological assessment, according to the MDS Level II criteria. NPS were evaluated with the Neuropsychiatric Inventory. Multivariate logistic regression models were used to evaluate clinical and behavioral characteristics, which are associated with PD-MBI. The latter was ascertained in 361 (84.1%) subjects of whom 155 (36.1%) were newly diagnosed patients (disease duration ≤1 year) and 206 (48.0%) had a disease duration >1 year. Furthermore, 68 (15.9%) out of 429 subjects were PDw (without MBI). Across the MBI domains, Impulse Dyscontrol was significantly more prevalent among PD-MBI with disease duration >1 year than newly diagnosed patients. The frequency of Social Inappropriateness and Abnormal Perception significantly increased throughout the entire PD-MBI sample with increasing Hoehn and Yahr (H&Y) stages. PD-MBI in newly diagnosed PD was significantly associated with H&Y stage (OR 2.35, 95% CI 1.05-5.24) and marginally with antidepressant drug use (OR 2.94, 95% CI 0.91-9.47), while in patients with a disease duration >1 year was associated with UPDRS-ME (OR 3.37, 95% CI 1.41-8.00). The overall MBI frequency in the PACOS sample was 84% and 36% among newly diagnosed patients. The presence of MBI mainly related to motor impairment and disability.
Insights
Mild behavioral impairment (MBI) affects 84% of Parkinson's disease (PD) patients, impacting motor function and disability. Early diagnosis and management of MBI are crucial for PD progression.
Area of Science:
- Neurology
- Neuroscience
- Psychiatry
Background:
- Neuropsychiatric symptoms (NPS) are common in Parkinson's disease (PD), even early on.
- Mild behavioral impairment (MBI) is a potential precursor to cognitive decline and dementia.
- Understanding MBI prevalence and factors in PD is crucial for early intervention.
Purpose of the Study:
- To determine the prevalence of Mild Behavioral Impairment (MBI) in Parkinson's disease (PD) patients.
- To identify clinical and behavioral factors associated with MBI in PD.
- To analyze MBI differences based on disease duration.
Main Methods:
- Cross-sectional study of 429 Parkinson's disease patients from the PArkinson's disease COgnitive impairment Study (PACOS).
- Neuropsychological assessment using MDS Level II criteria.
- Neuropsychiatric Inventory (NPI) for NPS evaluation.
- Multivariate logistic regression to identify associated factors.
Main Results:
- Mild Behavioral Impairment (MBI) was present in 84.1% of the Parkinson's disease (PD) sample.
- Impulse Dyscontrol was more frequent in patients with longer disease duration (>1 year).
- Social Inappropriateness and Abnormal Perception increased with Hoehn and Yahr (H&Y) stage.
- Newly diagnosed PD-MBI associated with H&Y stage; longer duration PD-MBI associated with UPDRS-ME.
Conclusions:
- Mild Behavioral Impairment (MBI) is highly prevalent in Parkinson's disease (PD), affecting over 80% of patients.
- MBI is significantly associated with motor impairment and disability in PD.
- Disease duration and motor severity are key factors influencing MBI presentation in PD.