Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment
Abstract INTRODUCTION We compared three operational case definitions of mild behavioral impairment (MBI) in the context of MBI prevalence estimates and dementia risk modeling. METHODS Participants were dementia‐free older adults (n = 13701) from the National Alzheimer's Coordinating Center. Ope...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/dad2.12483 |
| _version_ | 1827397255658733568 |
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| author | Dylan X. Guan Eric E. Smith G. Bruce Pike Zahinoor Ismail |
| author_facet | Dylan X. Guan Eric E. Smith G. Bruce Pike Zahinoor Ismail |
| author_sort | Dylan X. Guan |
| collection | DOAJ |
| description | Abstract INTRODUCTION We compared three operational case definitions of mild behavioral impairment (MBI) in the context of MBI prevalence estimates and dementia risk modeling. METHODS Participants were dementia‐free older adults (n = 13701) from the National Alzheimer's Coordinating Center. Operational case definitions of MBI were generated based on neuropsychiatric symptoms at one (OV), two‐consecutive (TCV), or more than two‐thirds (TTV) of dementia‐free study visits. Definitions were compared in prevalence and in Cox regressions using MBI to predict incident dementia. RESULTS OV MBI was the most prevalent (54.4%), followed by TCV (32.3%) and TTV (26.7%) MBI. However, OV MBI had the lowest rate of incident dementia (hazard ratio [HR] = 2.54, 95% confidence interval [CI]: 2.33–2.78) and generated poorer model metrics than TCV MBI (HR = 4.06, 95% CI: 3.74–4.40) and TTV MBI (HR = 5.77, 95% CI: 5.32–6.26). DISCUSSION Case ascertainment with longer timeframe MBI operational case definitions may more accurately define groups at risk of dementia in datasets lacking tools designed to detect MBI. Highlights Mild behavioral impairment (MBI) can identify older adults at risk of dementia. Neuropsychiatric symptom (NPS) assessment tools can be proxy measures for MBI. Hazard for dementia was highest for MBI defined by NPS presence at more than two‐thirds of visits. |
| first_indexed | 2024-03-08T19:04:38Z |
| format | Article |
| id | doaj.art-4f9690b133ec42fe8143cf4a169748cf |
| institution | Directory Open Access Journal |
| issn | 2352-8729 |
| language | English |
| last_indexed | 2024-03-08T19:04:38Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring |
| spelling | doaj.art-4f9690b133ec42fe8143cf4a169748cf2023-12-28T01:18:31ZengWileyAlzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring2352-87292023-10-01154n/an/a10.1002/dad2.12483Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairmentDylan X. Guan0Eric E. Smith1G. Bruce Pike2Zahinoor Ismail3University of Calgary Calgary Alberta CanadaDepartments of Clinical Neurosciences and Community Health Sciences Hotchkiss Brain Institute University of Calgary Calgary Alberta CanadaDepartments of Radiology and Clinical Neurosciences Hotchkiss Brain Institute University of Calgary Calgary Alberta CanadaDepartments of Psychiatry Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary Calgary Alberta CanadaAbstract INTRODUCTION We compared three operational case definitions of mild behavioral impairment (MBI) in the context of MBI prevalence estimates and dementia risk modeling. METHODS Participants were dementia‐free older adults (n = 13701) from the National Alzheimer's Coordinating Center. Operational case definitions of MBI were generated based on neuropsychiatric symptoms at one (OV), two‐consecutive (TCV), or more than two‐thirds (TTV) of dementia‐free study visits. Definitions were compared in prevalence and in Cox regressions using MBI to predict incident dementia. RESULTS OV MBI was the most prevalent (54.4%), followed by TCV (32.3%) and TTV (26.7%) MBI. However, OV MBI had the lowest rate of incident dementia (hazard ratio [HR] = 2.54, 95% confidence interval [CI]: 2.33–2.78) and generated poorer model metrics than TCV MBI (HR = 4.06, 95% CI: 3.74–4.40) and TTV MBI (HR = 5.77, 95% CI: 5.32–6.26). DISCUSSION Case ascertainment with longer timeframe MBI operational case definitions may more accurately define groups at risk of dementia in datasets lacking tools designed to detect MBI. Highlights Mild behavioral impairment (MBI) can identify older adults at risk of dementia. Neuropsychiatric symptom (NPS) assessment tools can be proxy measures for MBI. Hazard for dementia was highest for MBI defined by NPS presence at more than two‐thirds of visits.https://doi.org/10.1002/dad2.12483Alzheimer diseasedementiamild behavioral impairmentneuropsychiatric symptoms |
| spellingShingle | Dylan X. Guan Eric E. Smith G. Bruce Pike Zahinoor Ismail Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring Alzheimer disease dementia mild behavioral impairment neuropsychiatric symptoms |
| title | Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment |
| title_full | Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment |
| title_fullStr | Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment |
| title_full_unstemmed | Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment |
| title_short | Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment |
| title_sort | persistence of neuropsychiatric symptoms and dementia prognostication a comparison of three operational case definitions of mild behavioral impairment |
| topic | Alzheimer disease dementia mild behavioral impairment neuropsychiatric symptoms |
| url | https://doi.org/10.1002/dad2.12483 |
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