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Clinical Manifestations.

Barbara L Fischer1, Carol A Van Hulle2, Derek L Norton3,4

  • 1Department of Neurology University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.

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

Mild Behavioral Impairment (MBI) impacts cognitive decline, especially in diverse populations. Centiloid concentration, a measure of amyloid-PET, may indicate early brain changes linked to MBI and cognitive decline.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Biomarker Research

Background:

  • The link between Mild Behavioral Impairment (MBI) and cognitive decline is recognized, but underlying mechanisms, especially in diverse populations, require further elucidation.
  • This study investigates the interplay between MBI, cognitive function, and various biomarkers in White and African American adults.
  • Data was drawn from the African Americans Fighting Alzheimer's in Midlife (AA-FAIM) study and the Wisconsin Registry for Alzheimer's Prevention (WRAP).

Purpose of the Study:

  • To explore the relationship between MBI, cognitive trajectories, and six biomarkers in a racially diverse cohort.
  • To determine if MBI influences the association between biomarkers and cognitive decline over time.
  • To assess MBI's association with the time to clinical dementia rating (CDR) >0.

Main Methods:

  • Participants without dementia underwent assessments including the Neuropsychiatric Inventory Questionnaire (NPI-Q) and biomarker analysis (hippocampal volume, amyloid-PET, plasma biomarkers: ptau217, Aβ42/40, GFAP, NfL).
  • Mixed-effects linear models examined MBI's impact on biomarker-cognition associations over time.
  • Cox proportional hazard models evaluated MBI's association with time to CDR >0.

Main Results:

  • No significant three-way interactions were found between MBI and most biomarkers (HPV, ptau217, Aβ42/40, NfL, GFAP) concerning cognitive decline.
  • Individuals with MBI showed accelerated declines across all cognitive measures.
  • Higher centiloid values (amyloid-PET) were significantly associated with faster memory decline, and baseline MBI correlated with time to CDR >0 in GFAP and centiloid models.

Conclusions:

  • Findings suggest MBI may modify the relationship between specific biomarkers and cognitive decline, particularly evident with centiloid concentration.
  • Centiloid concentration, a standardized amyloid-PET measure, shows promise as a sensitive indicator of early, stable brain changes associated with MBI in diverse populations.
  • Further research is needed to confirm these preliminary findings and understand the precise mechanisms involved.