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Clinical Manifestations.

Yingqi Liao1, Yaping Zhang2, Eric Tan1

  • 1Memory, Ageing, and Cognition Centre (MACC), Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Mild behavioral impairment (MBI) in Chinese older adults is most commonly impulse dyscontrol, unlike Western populations. This finding highlights the need for targeted research and interventions for this demographic.

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Area of Science:

  • Gerontology
  • Neuroscience
  • Psychiatry

Background:

  • Mild behavioral impairment (MBI) is an early indicator of cognitive decline and dementia.
  • The clinical presentation of MBI in Chinese older adults remains understudied.
  • This study investigates MBI domains in Chinese elders and the utility of the Neuropsychiatric Inventory (NPI) for assessment.

Purpose of the Study:

  • To identify the most prevalent MBI domain in Chinese individuals free of dementia.
  • To assess how well the Neuropsychiatric Inventory (NPI) captures MBI subdomains defined by the Mild Behavioral Impairment-Checklist (MBI-C).
  • To explore the underlying factors of neuropsychiatric symptoms within the leading MBI domain.

Main Methods:

  • Meta-analysis of informant-based NPI data from three cohorts (two community, one memory clinic) involving 1,396 participants aged ≥50.
  • Analysis of NPI item frequencies within MBI subdomains using the Hangzhou cohort.
  • Principal factor analysis (PCA) with Promax rotation to identify symptom clusters in the NPI.

Main Results:

  • Impulse dyscontrol was the most frequent MBI domain (11%) among Chinese older adults, contrasting with affective dysregulation in Western populations.
  • In the Hangzhou cohort, 28% showed impulse dyscontrol, with irritability (45%) and agitation (37%) being the most common NPI items.
  • PCA identified three factors: Factor 1 included agitation, disinhibition, irritability, delusion, and hallucination; Factor 2 included depression and anxiety; Factor 3 included elation.

Conclusions:

  • Impulse dyscontrol is the primary MBI subdomain in Chinese older adults, differing from Western findings.
  • Further research is needed to understand the presentation and mechanisms of impulse dyscontrol in this population.
  • Identifying specific patterns of impulse dyscontrol can aid in developing targeted treatments for cognitive decline.