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Clinical and MRI Predictors of Conversion From Mild Behavioural Impairment to Dementia

B Orso1, C Mattei2, D Arnaldi3

  • 1Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa (Beatrice Orso, Dario Arnaldi, Federico Massa, Gianluca Serafini, Elisa Doglione, Flavio Nobili, Matteo Pardini), Italy.

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry
|January 14, 2020
PubMed
Abstract

Insights

Mild behavioral impairment (MBI) progression to dementia is linked to executive dysfunction, impaired Theory of Mind (ToM), and frontal atrophy. These factors predict conversion to neurodegenerative conditions like frontotemporal dementia (bv-FTD).

Area of Science:

  • Neuroscience
  • Geriatrics
  • Cognitive Neurology

Background:

  • Mild behavioral impairment (MBI) is a construct for late-onset behavioral symptoms, analogous to mild cognitive impairment (MCI).
  • Predictors of MBI conversion to dementia, including clinical, cognitive, and neuroimaging markers, remain poorly understood.
  • Early identification of individuals at high risk for dementia progression is crucial for timely intervention.

Purpose of the Study:

  • To identify clinical, cognitive, and neuroimaging predictors of conversion from MBI to dementia.
  • To investigate the association between baseline MBI characteristics and subsequent neurodegenerative disease diagnosis.
  • To validate predictive markers in an independent cohort.

Main Methods:

  • Retrospective analysis of 113 subjects with MBI and at least 4 years of clinical follow-up.
  • Assessment of cognitive performance (executive function, Theory of Mind) and structural brain MRI.
  • Comparison of baseline variables between converters and non-converters, with validation in a separate group.

Main Results:

  • In Group A, converters to behavioral-variant frontotemporal dementia (bv-FTD) or Alzheimer's Disease (AD) showed lower executive function and Theory of Mind (ToM) scores, and more frontal atrophy.
  • In Group B, converters to bv-FTD demonstrated similar patterns.
  • A combination of executive deficit, impaired ToM, and frontal atrophy significantly predicted conversion (91.22% accuracy).

Conclusions:

  • Executive dysfunction, impaired ToM, and frontal atrophy are key indicators of MBI progression.
  • These markers predict conversion to neurodegenerative conditions, primarily bv-FTD, within a 4-year period.
  • The findings support MBI as a potential prodromal stage for specific dementias.
Keywords:
Mild behavioral impairmentcognitiondementiasocial difficulties

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