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      The Mild Behavioral Impairment Checklist (MBI-C): A rating scale for neuropsychiatric symptoms in pre-dementia populations

      research-article
      , M.D. 1 , 2 , , M.D., PhD 3 , , M.D. 4 , , M.D. 2 , , M.D. 5 , , M.D. 6 , , M.D. 7 , , M.D. 8 , , M.D. 9 , 10 , , BSc 2 , , PhD 10 , , M.D. 11 , , PhD 12 , , M.D. 13 , , M.D. 13 , , M.D. 2 , , PhD 15 , , M.D. 16 , , M.D. 17
      Journal of Alzheimer's disease : JAD
      Dementia, Mild Cognitive Impairment (MCI), Mild Behavioral Impairment (MBI), Preclinical dementia, Prodromal dementia, Neuropsychiatric Symptoms (NPS), Behavioral and Psychological Symptoms of Dementia (BPSD)

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          Abstract

          Background

          Mild Behavioral Impairment (MBI) is a construct that describes the emergence at ≥ 50 years of age of sustained and impactful neuropsychiatric symptoms (NPS), as a precursor to cognitive decline and dementia. MBI describes NPS of any severity, which are not captured by traditional psychiatric nosology, persist for at least 6 months, and occur in advance of or in concert with Mild Cognitive Impairment (MCI). While the detection and description of MBI has been operationalized in the International Society to Advance Alzheimer’s Research and Treatment – Alzheimer’s Association (ISTAART-AA) research diagnostic criteria, there is no instrument that accurately reflects MBI as described.

          Objective

          To develop an instrument based on ISTAART-AA MBI criteria.

          Methods

          Eighteen subject matter experts participated in development using a modified Delphi process. An iterative process ensured items reflected the 5 MBI domains of 1) decreased motivation; 2) emotional dysregulation; 3) impulse dyscontrol; 4) social inappropriateness; and 5) abnormal perception or thought content. Instrument language was developed a priori to pertain to non-demented functionally independent older adults.

          Results

          We present the Mild Behavioral Impairment Checklist (MBI-C), a 34-item instrument, which can easily be completed by a patient, close informant, or clinician.

          Conclusion

          The MBI-C provides the first measure specifically developed to assess the MBI construct as explicitly described in the criteria. Its utility lies in MBI case detection, and monitoring the emergence of MBI symptoms and domains over time. Studies are required to determine the prognostic value of MBI for dementia development, and for predicting different dementia subtypes.

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          Author and article information

          Journal
          9814863
          21942
          J Alzheimers Dis
          J. Alzheimers Dis.
          Journal of Alzheimer's disease : JAD
          1387-2877
          1875-8908
          11 October 2017
          2017
          23 October 2017
          : 56
          : 3
          : 929-938
          Affiliations
          [1 ]Department of Psychiatry; and the Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, Calgary, Alberta, Canada
          [2 ]Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
          [3 ]Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Department of Psychiatry & Research Institute i+12. Hospital, Universitario 12 de Octubre. Madrid, Spain
          [4 ]Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, University of New South Wales, New South Wales, Sydney, Australia
          [5 ]Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
          [6 ]Keenan Research Centre for Biomedical Research, the Li Ka Shing Knowledge Institute, St. Michael’s Hospital; Faculty of Medicine, Department of Psychiatry, University of Toronto, Canada
          [7 ]McGill Centre for Studies in Aging; Douglas Mental Health Research Institute
          [8 ]Departments of Psychiatry and Neurology, Mayo Clinic, Scottsdale, AZ, USA
          [9 ]Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
          [10 ]Neuropsychopharmacology Research Program, Sunnybrook Research Institute and Departments of Psychiatry and Pharmacology/Toxicology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
          [11 ]Bracket Global, Wayne, PA, USA
          [12 ]Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University; NHMRC National Institute for Dementia Research, Canberra, Australia
          [13 ]Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD, USA
          [14 ]Division of Geriatric Psychiatry and Neuropsychiatry, John Hopkins University School of Medicine
          [15 ]Department of Psychiatry and Behavioral Sciences and Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
          [16 ]Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA; and the Brain, Behavior, and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
          [17 ]Memory and Alzheimer’s Treatment Center and Alzheimer’s Disease Research Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview and Johns Hopkins Medicine, Baltimore, Maryland, USA
          Author notes
          Correspondence Information: Zahinoor Ismail, TRW Building 1 st Floor, 3280 Hospital Dr. NW, Calgary, Alberta, Canada, T2N 4Z6, Telephone: 403.210.6900, Fax number: 403.210.9346, zahinoor@ 123456gmail.com
          Article
          PMC5652315 PMC5652315 5652315 nihpa911978
          10.3233/JAD-160979
          5652315
          28059789
          0971fd6c-df25-4840-83f9-fb4db6467dad
          History
          Categories
          Article

          Dementia,Mild Cognitive Impairment (MCI),Mild Behavioral Impairment (MBI),Preclinical dementia,Prodromal dementia,Behavioral and Psychological Symptoms of Dementia (BPSD),Neuropsychiatric Symptoms (NPS)

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