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Prevalence of mild behavioral impairment in mild cognitive impairment and subjective cognitive decline, and its association with caregiver burden

Published online by Cambridge University Press:  07 September 2017

Faisal Sheikh ,
Zahinoor Ismail Open the ORCID record for Zahinoor Ismail [Opens in a new window] ,
Moyra E. Mortby Open the ORCID record for Moyra E. Mortby [Opens in a new window] ,
Philip Barber ,
Alicja Cieslak ,
Karyn Fischer ,
Robert Granger ,
David B. Hogan ,
Aaron Mackie  and
Colleen J Maxwell
...Show all authors
Faisal Sheikh
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Zahinoor Ismail*
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Moyra E. Mortby
Affiliation:
Australian National University, Canberra, Australia NHMRC National Institute for Dementia Research, Canberra, Australia
Philip Barber
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Alicja Cieslak
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Karyn Fischer
Affiliation:
Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Robert Granger
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
David B. Hogan
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
Aaron Mackie
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Colleen J Maxwell
Affiliation:
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada University of Waterloo, Waterloo, Ontario, Canada
Bijoy Menon
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Patricia Mueller
Affiliation:
Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
David Patry
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Dawn Pearson
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Jeremy Quickfall
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Tolulope Sajobi
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Eric Tse
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Meng Wang
Affiliation:
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
Eric E. Smith
Affiliation:
Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
*
Correspondence should be addressed to: Zahinoor Ismail, 3280 Hospital Dr NW, TRW Building 1st Floor, Calgary T2N 4Z6, Alberta, Canada. Phone: +1 (403) 210-6900. Email: zahinoor@gmail.com
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Abstract

Background:

Mild behavioral impairment (MBI) describes later life acquired, sustained neuropsychiatric symptoms (NPS) in cognitively normal individuals or those with mild cognitive impairment (MCI), as an at-risk state for incident cognitive decline and dementia. We developed an operational definition of MBI and tested whether the presence of MBI was related to caregiver burden in patients with subjective cognitive decline (SCD) or MCI assessed at a memory clinic.

Methods:

MBI was assessed in 282 consecutive memory clinic patients with SCD (n = 119) or MCI (n = 163) in accordance with the International Society to Advance Alzheimer's Research and Treatment – Alzheimer's Association (ISTAART–AA) research diagnostic criteria. We operationalized a definition of MBI using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Caregiver burden was assessed using the Zarit caregiver burden scale. Generalized linear regression was used to model the effect of MBI domains on caregiver burden.

Results:

While MBI was more prevalent in MCI (85.3%) than in SCD (76.5%), this difference was not statistically significant (p = 0.06). Prevalence estimates across MBI domains were affective dysregulation (77.8%); impulse control (64.4%); decreased motivation (51.7%); social inappropriateness (27.8%); and abnormal perception or thought content (8.7%). Affective dysregulation (p = 0.03) and decreased motivation (p=0.01) were more prevalent in MCI than SCD patients. Caregiver burden was 3.35 times higher when MBI was present after controlling for age, education, sex, and MCI (p < 0.0001).

Conclusions:

MBI was common in memory clinic patients without dementia and was associated with greater caregiver burden. These data show that MBI is a common and clinically relevant syndrome.

Keywords

mild behavioral impairment (MBI)mild cognitive impairment (MCI)caregiver burdensubjective cognitive declinememory clinicprodromal dementia
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 2: Mild Behavioral Impairment , February 2018 , pp. 233 - 244
Copyright
Copyright © International Psychogeriatric Association 2017 

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