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Published on: March 2, 2019
Mild Behavioral Impairment as a Predictor of Functional Status
Natascia De Lucia1, Laura Petraglia2, Klara Komici3
1Department of Neurosciences, Reproductive and Odontostomatological Sciences (NDL, NMM), "Federico II" University, Naples 80131, Italy.
Objectives:
Mild behavioral impairment (MBI) occurs in absence of dementia, but no studies explored whether MBI may limit the individuals' ability to complete everyday tasks necessary to live independently. In this study we elucidated on the relevance of specific behavioral markers on functional decline in both cognitively normal (CN) older adults and with mild cognitive impairment (MCI), and evaluated whether individuals with MBI present worse cognition and neurodegenerative dysfunctions compared to subjects without MBI.
Design:
Observational cross-sectional study.
Setting:
Alzheimer's Disease Neuroimaging Initiative (ADNI) database.
Participants:
Amnesic MCI (aMCI; n = 232) participants and CN (n = 418) individuals.
Measurements:
Neuropsychological assessment, volumetric MR brain scan, Flortaucipir PET for in vivo assessment of regional tau deposition, functional assessment questionnaire (FAQ), and neuropsychiatric inventory.
Results:
MBI occurred in 53.5% aMCI and 19.6% CN. In aMCI, the most prevalent behaviors were affective dysregulation (34.4%), impulse dyscontrol (30.6%), and decreased drive/motivation (15.9%), whereas affective dysregulation (13.1%) and impulse dyscontrol (10.2%) were most prevalent in CN. In aMCI, affective dysregulation, decreased drive, social inappropriateness and abnormal perception MBI domains significantly predicted the FAQ score, whereas only decreased drive/motivation MBI domain showed a predicted role on FAQ in CN. No effects of MBI were detected on regional tau deposition or brain volumes in aMCI.
Conclusions:
Our findings suggest that the occurrence of MBI might predict a high risk of dysfunction in daily life in both aMCI and CN. An early detection of functional impairment may improve the success of disease-modifying interventions.
Insights
Mild behavioral impairment (MBI) is linked to difficulties in daily living for older adults, even without dementia. Early detection of these behavioral changes can improve interventions for cognitive decline.
Area of Science:
- Neurology
- Gerontology
- Neuropsychiatry
Background:
- Mild behavioral impairment (MBI) is recognized in older adults but its impact on daily functioning, independent of dementia, remains understudied.
- Specific behavioral markers within MBI may predict functional decline in cognitively normal (CN) and mild cognitive impairment (MCI) individuals.
Purpose of the Study:
- To investigate the relationship between specific MBI behavioral markers and functional decline in CN and MCI.
- To assess if individuals with MBI exhibit worse cognition and neurodegenerative changes compared to those without MBI.
Main Methods:
- Cross-sectional observational study using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database.
- Included 232 amnesic MCI (aMCI) and 418 cognitively normal (CN) participants.
- Utilized neuropsychological assessments, MRI, Flortaucipir PET scans, Functional Assessment Questionnaire (FAQ), and neuropsychiatric inventory.
Main Results:
- MBI was present in 53.5% of aMCI and 19.6% of CN participants.
- In aMCI, affective dysregulation, impulse dyscontrol, and decreased drive were most common; in CN, affective dysregulation and impulse dyscontrol predominated.
- MBI domains (affective dysregulation, decreased drive, social inappropriateness, abnormal perception) predicted FAQ scores in aMCI, while only decreased drive predicted FAQ in CN. MBI did not affect tau deposition or brain volumes.
Conclusions:
- MBI occurrence predicts a high risk of daily life dysfunction in both MCI and CN individuals.
- Early identification of functional impairment associated with MBI may enhance the effectiveness of disease-modifying interventions.
