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Alzheimers Dement. 2016 Feb;12(2):195-202. doi: 10.1016/j.jalz.2015.05.017. Epub 2015 Jun 18.

Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment.

Author information

1
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. Electronic address: zahinoor@gmail.com.
2
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
3
Department of Psychiatry, Mayo Clinic, Scottsdale, AZ, USA; Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
4
Psychiatry Department, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
5
Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, University of New South Wales, New South Wales, Sydney, Australia.
6
Alzheimer's Disease Research Center, Johns Hopkins School of Medicine, Baltimore, MD, USA.
7
Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health and CIBERSAM, Madrid, Spain.
8
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
9
Bracket Global, Wayne, PA, USA.
10
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.

Abstract

Neuropsychiatric symptoms (NPS) are common in dementia and in predementia syndromes such as mild cognitive impairment (MCI). NPS in MCI confer a greater risk for conversion to dementia in comparison to MCI patients without NPS. NPS in older adults with normal cognition also confers a greater risk of cognitive decline in comparison to older adults without NPS. Mild behavioral impairment (MBI) has been proposed as a diagnostic construct aimed to identify patients with an increased risk of developing dementia, but who may or may not have cognitive symptoms. We propose criteria that include MCI in the MBI framework, in contrast to prior definitions of MBI. Although MBI and MCI can co-occur, we suggest that they are different and that both portend a higher risk of dementia. These MBI criteria extend the previous literature in this area and will serve as a template for validation of the MBI construct from epidemiologic, neurobiological, treatment, and prevention perspectives.

KEYWORDS:

Agitation; Alzheimer's disease; Apathy; BPSD; Behavior; Behaviour; Dementia; Depression; Disinhibition; FTD; MBI; MCI; NPS; Neuropsychiatric symptoms of dementia; Psychosis

PMID:
26096665
PMCID:
PMC4684483
DOI:
10.1016/j.jalz.2015.05.017
[Indexed for MEDLINE]
Free PMC Article

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