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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Prevalence, Clinical Correlates, Cognitive Trajectories, and Dementia Risk Associated With Mild Behavioral Impairment
Cheuk Ni Kan1, Jemellee Cano2, Xuhao Zhao3
1Memory Aging & Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Abstract:
Mild behavioral impairment (MBI) is characterized as later-life-emergent and persistent neuropsychiatric symptoms (NPS). The symptom persistence criterion of MBI has shown to increase the signal-to-noise ratio of the syndrome, decreasing the likelihood of false-positive NPS. However, the long-term cognitive and prognostic impact of MBI remains to be evaluated against the traditional framework of NPS, especially in Asian cohorts. This study investigated the epidemiologic characteristics of MBI in a prospective clinical cohort of Singaporean elderly.
Abstract:
A total of 304 dementia-free individuals (mean [SD] age = 72.2 [8.0] years, 51.6% female) were recruited between August 2010 and October 2019. All participants underwent annual neuropsychological, neuropsychiatric, and clinical assessments for 4 consecutive years and were diagnosed as having no cognitive impairment (NCI) or cognitive impairment-no dementia (CIND). MBI was ascertained using both baseline and year-1 Neuropsychiatric Inventory assessments. Cognitive Z-scores and Clinical Dementia Rating Sum-of-Boxes (CDR-SoB) scores were calculated.
Abstract:
The prevalence of MBI was 14.5% (7.1% of NCI, 12.9% of CIND-mild, and 24.7% of CIND-moderate patients). MBI patients showed poorer cognitive function at baseline (F1,295 = 8.13 [SE = 0.47], P = .005), primarily in memory and executive function domains. MBI was associated with accelerated decline in global cognition (β = -0.15; 95% CI, -0.23 to -0.07) along with faster increase in CDR-SoB (β = 0.92; 95% CI, 0.62 to 1.21) as compared to individuals without symptoms or transient NPS. A total of 38.6% of MBI patients developed dementia as compared to 12.3% of non-MBI elderly (χ2 = 19.29, P < .001). MBI increased risk of incident dementia by 2.56-fold as compared to no symptoms or transient NPS, regardless of cognitive impairment.
Abstract:
MBI is a neurobehavioral risk factor for dementia, representing a potential target for dementia risk modeling, preventive intervention, and disease management.
Insights
Mild behavioral impairment (MBI) in older adults is linked to faster cognitive decline and a significantly higher risk of developing dementia. Early identification of MBI is crucial for dementia prevention strategies.
Area of Science:
- Neuroscience
- Gerontology
- Psychiatry
Background:
- Mild behavioral impairment (MBI) involves persistent neuropsychiatric symptoms in later life.
- The prognostic impact of MBI, particularly in Asian populations, requires further investigation.
- This study examines MBI's epidemiology in a Singaporean elderly cohort.
Purpose of the Study:
- To investigate the epidemiologic characteristics of MBI in a prospective Singaporean elderly cohort.
- To evaluate the long-term cognitive and prognostic impact of MBI.
- To assess MBI as a potential risk factor for dementia.
Main Methods:
- Recruited 304 dementia-free elderly individuals (mean age 72.2 years).
- Conducted annual neuropsychological, neuropsychiatric, and clinical assessments for 4 years.
- Assessed MBI using baseline and year-1 Neuropsychiatric Inventory, and diagnosed cognitive status (NCI, CIND).
Main Results:
- MBI prevalence was 14.5%, higher in those with cognitive impairment.
- MBI patients exhibited poorer baseline cognitive function, primarily in memory and executive domains.
- MBI was associated with accelerated global cognitive decline and faster increases in Clinical Dementia Rating Sum-of-Boxes scores.
- 38.6% of MBI patients developed dementia versus 12.3% of non-MBI individuals, a 2.56-fold increased risk.
Conclusions:
- MBI is a significant neurobehavioral risk factor for dementia.
- MBI serves as a potential target for dementia risk modeling and preventive interventions.
- Findings highlight the importance of addressing MBI in dementia risk assessment and management.
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