Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-25T08:29:46.477Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults

Published online by Cambridge University Press:  21 September 2017

Moyra E. Mortby Open the ORCID record for Moyra E. Mortby [Opens in a new window] ,
Zahinoor Ismail Open the ORCID record for Zahinoor Ismail [Opens in a new window]  and
Kaarin J. Anstey
Moyra E. Mortby*
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia NHMRC National Institute for Dementia Research, Canberra, Australia
Zahinoor Ismail
Affiliation:
Departments of Psychiatry and Clinical Neurosciences, Mathison Centre for Mental Health Research & Education, Ron and Rene Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
Kaarin J. Anstey
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
*
Correspondence should be addressed to: Moyra E. Mortby, Centre for Research on Ageing, Health and Wellbeing, Florey Building, 54 Mills Road, The Australian National University, Canberra, ACT 2601, Australia. Phone: +6126158413; Fax: +61261250733. Email: moyra.mortby@anu.edu.au.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

A dearth of population-based epidemiological research examines neuropsychiatric symptom (NPS) in sub-clinical populations across the spectrum from normal aging to mild cognitive impairment (MCI). The construct of mild behavioral impairment (MBI) describes the emergence of sustained and impactful NPS in advance of or in combination with MCI. This is the first epidemiological study to operationalize the recently published diagnostic criteria for MBI and determine prevalence estimates across the spectrum from cognitively normal to MCI.

Methods:

MBI was assessed in 1,377 older (age range 72–79 years; 52% male; MCI ;= 133; cognitively normal, but-at-risk = 397; cognitively healthy = 847). MBI was assessed in accordance with the ISTAART-AA diagnostic criteria for MBI using the neuropsychiatric inventory.

Results:

34.1% of participants met the criteria for MBI. High prevalence of MBI across the cognitive spectrum was reported (48.9% vs. 43.1% vs. 27.6%). Irrespective of level of cognitive impairment, impulse dyscontrol (33.8% vs. 28.7% vs. 17.2%) and decreased motivation (32.3% vs. 26.2% vs. 16.3%) were the most frequently met MBI domains. MBI was more prevalent in men (χ2 = 4.98, p = 0.026), especially the domains of decreased motivation and impulse dyscontrol.

Conclusions:

This study presents the first population-based prevalence estimates for MBI using the recently published ISTAART-AA diagnostic criteria. Findings indicate relatively high prevalence of MBI in pre-dementia clinical states and amongst cognitively healthy older adults. Findings were gender-specific, with MBI affecting more men than women. Knowing the estimates of these symptoms in the population is essential for understanding and differentiating the very early development of clinical disorders.

Keywords

mild behavioral impairmentneuropsychiatric symptomscognitively healthypre-clinical statesprodromal dementiamild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 2: Mild Behavioral Impairment , February 2018 , pp. 221 - 232
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anstey, K. J. et al. (2011). Cohort profile: the PATH through life project. International Journal of Epidemiology, 41, 951–960.CrossRefGoogle ScholarPubMed
Brodaty, H., Altendorf, A., Withall, A. and Sachdev, P. (2010). Do people become more apathetic as they grow older? A longitudinal study in healthy individuals. International Psychogeriatrics, 22, 426–436.CrossRefGoogle Scholar
Buchanan, R. J., Wang, S., Ju, H. and Graber, D. (2004). Analyses of gender differences in profiles of nursing home residents with Alzheimer's disease. Gender Medicine, 1, 48–59.CrossRefGoogle ScholarPubMed
Cerejeira, J., Lagarto, L. and Mukaetova-Ladinska, E. B. (2012). Behavioral and psychological symptoms of dementia. Frontiers in Neurology, 3, 73.CrossRefGoogle ScholarPubMed
Crook, T. H., Feher, E. P. and Larrabee, G. J. (1992). Assessment of memory complaint in age-associated memory impairment: the MAC-Q. International Psychogeriatrics, 4, 165–176.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Dillon, C., Serrano, C. M., Castro, D., Leguizamón, P. P., Heisecke, S. L. and Taragano, F. E. (2013). Behavioral symptoms related to cognitive impairment. Neuropsychiatric Disease and Treatment, 9, 1443–1455.CrossRefGoogle ScholarPubMed
Eramudugolla, R., Mortby, M. E., Sachdev, P., Meslin, C., Kumar, R. and Anstey, K. J. (2017). Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a cohort of adults aged 72–76 years, and comparison with DSM-IV dementia and MCI diagnoses. Alzheimer's Research & Therapy 9, 15.CrossRefGoogle Scholar
Forrester, S. N., Gallo, J. J., Smith, G. S. and Leoutsakos, J. M. (2016). Patterns of neuropsychiatric symptoms in mild cognitive impairment and risk of dementia. The American Journal of Geriatric Psychiatry, 24, 117–125.CrossRefGoogle ScholarPubMed
Geda, Y. E. et al. (2008). Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study. Archives of General Psychiatry, 65, 1193–1198.CrossRefGoogle ScholarPubMed
Geda, Y. E. et al. (2014). Baseline neuropsychiatric symptoms and the risk of incident mild cognitive impairment: a population-based study. The American Journal of Psychiatry, 171, 572–581.CrossRefGoogle ScholarPubMed
Gotovac, K., Nikolac Perkovic, M., Pivac, N. and Borovecki, F. (2016). Biomarkers of aggression in dementia. Progress in Neuropsychopharmacology and Biological Psychiatry, 69, 125–130.CrossRefGoogle ScholarPubMed
Guercio, B. J. et al. (2015). The apathy evaluation scale: a comparison of subject, informant, and clinician report in cognitively normal elderly and mild cognitive impairment. Journal of Alzheimer's Disease, 47, 421–432.CrossRefGoogle Scholar
Holtta, E. H., Laakkonen, M. L., Laurila, J. V., Strandberg, T. E., Tilvis, R. S. and Pitkala, K. H. (2012). Apathy: prevalence, associated factors, and prognostic value among frail, older inpatients. Journal of the American Medical Directors Association, 13, 541–545.CrossRefGoogle ScholarPubMed
Ismail, Z. et al. (2016). Neuropsychiatric symptoms as early manifestations of emergent dementia: provisional diagnostic criteria for mild behavioral impairment. Alzheimer's & Dementia, 12, 195–202.CrossRefGoogle ScholarPubMed
Ismail, Z. et al. (2017). The mild behavioral impairment checklist (MBI-C): a rating scale for neuropsychiatric symptoms in pre-dementia populations. Journal of Alzheimer's Disease, 56, 929–938.CrossRefGoogle ScholarPubMed
Kaufer, D., Cummings, J., Ketchel, P., Smith, V., MacMillan, A. and Shelley, T. (2000). Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. Journal of Neuropsychiatry and Clinical Neurosciences, 12, 233–239.CrossRefGoogle ScholarPubMed
Kitamura, T., Kitamura, M., Hino, S., Tanaka, N. and Kurata, K. (2012). Gender differences in clinical manifestations and outcomes among hospitalized patients with behavioral and psychological symptoms of dementia. Journal of Clinical Psychiatry, 73, 1548–1554.CrossRefGoogle ScholarPubMed
Lovheim, H., Sandman, P. O., Karlsson, S. and Gustafson, Y. (2009). Sex differences in the prevalence of behavioral and psychological symptoms of dementia. International Psychogeriatrics, 21, 469–475.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. Jama, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Minett, T. S., Da Silva, R. V., Ortiz, K. Z. and Bertolucci, P. H. (2008). Subjective memory complaints in an elderly sample: a cross-sectional study. International Journal of Geriatric Psychiatry, 23, 49–54.CrossRefGoogle Scholar
Mortby, M. E. and Anstey, K. J. (2015). Mental health and aging. In Pachana, A. N. (ed.), Encyclopedia of Geropsychology (pp. 1–6). Singapore: Springer.Google Scholar
Mortby, M. E., Burns, R., Eramudugolla, R., Isamil, Z. and Anstey, K. J. (2017). Neuropsychiatric symptoms and cognitive impariment: understanding the importance of co-morbid symptoms. Journal of Alzheimer's Disease, 59, 141–153.CrossRefGoogle Scholar
Okura, T., Plassman, B. L., Steffens, D. C., Llewellyn, D. J., Potter, G. G. and Langa, K. M. (2010). Prevalence of neuropsychiatric symptoms and their association with functional limitations in older adults in the United States: the aging, demographics, and memory study. Journal of the American Geriatrics Society, 58, 330–337.CrossRefGoogle ScholarPubMed
Palmer, K. et al. (2010). Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer's disease: the role of depression and apathy. Journal of Alzheimer's Disease, 20, 175–183.CrossRefGoogle ScholarPubMed
Peters, M. E. et al. (2012). Prevalence of neuropsychiatric symptoms in CIND and its subtypes: the cache county study. The American Journal of Geriatric Psychiatry, 20, 416–424.CrossRefGoogle ScholarPubMed
Peters, M. E. et al. (2013). Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the cache county study. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 21, 10.1016/j.jagp.2013.1001.1049.CrossRefGoogle ScholarPubMed
Petersen, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L. and DeKosky, S. T. (2001). Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the quality standards subcommittee of the American academy of neurology. Neurology, 56, 1133–1142.CrossRefGoogle Scholar
Pink, A. et al. (2015). Neuropsychiatric symptoms, APOE epsilon4, and the risk of incident dementia: a population-based study. Neurology, 84, 935–943.CrossRefGoogle ScholarPubMed
Roberts, J. L., Clare, L. and Woods, R. T. (2009). Subjective memory complaints and awareness of memory functioning in mild cognitive impairment: a systematic review. Dementia and Geriatric Cognitive Disorders, 28, 95–109.CrossRefGoogle ScholarPubMed
Rosenberg, P. B., Mielke, M. M., Appleby, B. S., Oh, E. S., Geda, Y. E. and Lyketsos, C. G. (2013). The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer disease. American Journal of Geriatric Psychiatry, 21, 685–695.CrossRefGoogle ScholarPubMed
Steinberg, M., Shao, H., Zandi, P., Lyketsos, C., Welsh-Bohmer, K. and Norton, M. (2008). Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the cache county study. International Journal of Geriatric Psychiatry, 23, 170–177.CrossRefGoogle ScholarPubMed
Taragano, F., Allegri, R., Krupitzki, H., Sarasola, D., Serrano, C. and Lon, L. (2009). Mild behavioral impairment and risk of dementia: a prospective cohort study of 358 patients. Journal of Clinical Psychiatry, 70, 584–592.CrossRefGoogle ScholarPubMed
Winblad, B. et al. (2004). Mild cognitive impairment–beyond controversies, towards a consensus: report of the international working group on mild cognitive impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar
Zuidema, S. U., de Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2009). Predictors of neuropsychiatric symptoms in nursing home patients: influence of gender and dementia severity. International Journal of Geriatric Psychiatry, 24, 1079–1086.CrossRefGoogle ScholarPubMed
Supplementary material: File

Mortby et al supplementary material

Table S1

Download Mortby et al supplementary material(File)
File 13.5 KB