Faisal Sheikh1, Zahinoor Ismail2,3,1,4,5, Moyra E. Mortby6,7, Philip A. Barber2, Alicja Cieślak2,5, Karyn Fischer5, Robert Granger1, David B. Hogan2,3,8, Aaron Mackie1, Colleen J. Maxwell3,9, Bijoy K. Menon2, Patricia W. Mueller5, David Patry2, Dawn Pearson2, Jeremy Quickfall2, Tolulope T. Sajobi2,3, Eric Tse2, Meng Wang1,4, Eric E. Smith2,4,5
1Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
2Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
3Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
4Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
5Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
6Australian National University, Canberra Australia
7NHMRC National Institute for Dementia Research, Canberra, Australia
8Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
9University of Waterloo, Waterloo, Ontario, Canada
Tóm tắt
ABSTRACTBackground: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.
