title: Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment.
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.
authors.affiliation: 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.
authors.forename: Zahinoor
authors.initials: Z
authors.lastname: Ismail
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
authors.affiliation: Department of Psychiatry, Mayo Clinic, Scottsdale, AZ, USA; Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Yonas
authors.initials: Y
authors.lastname: Geda
authors.affiliation: 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.
authors.forename: David
authors.initials: D
authors.lastname: Sultzer
authors.affiliation: Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, University of New South Wales, New South Wales, Sydney, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Alzheimer's Disease Research Center, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Gwenn
authors.initials: G
authors.lastname: Smith
authors.affiliation: Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health and CIBERSAM, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Agüera-Ortiz
authors.affiliation: 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.
authors.forename: Rob
authors.initials: R
authors.lastname: Sweet
authors.affiliation: Bracket Global, Wayne, PA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
mesh_terms: D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis*; D003704:Dementia / Q000150:complications / Q000175:diagnosis*; D018450:Disease Progression; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology*; D009483:Neuropsychological Tests; D012307:Risk Factors; D063189:Symptom Assessment
keywords: Agitation; Alzheimer's disease; Apathy; BPSD; Behavior; Behaviour; Dementia; Depression; Disinhibition; FTD; MBI; MCI; NPS; Neuropsychiatric symptoms of dementia; Psychosis