Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment
Open accessAbstract
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.
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In some individuals, the initial presentation of AD may be neurobehavioral (e.g., depression, anxiety, and apathy) rather than cognitive.
“While cognitive symptoms represent the core clinical feature of AD, in some individuals, the initial presentation may be neurobehavioral (e.g., depression, anxiety, and apathy) rather than cognitive [189].”
From NIA‐AA Research Framework: Toward a biological definition of Alzheimer's disease (2018) · cites this paper as [189]
Neuropsychiatric symptoms may accelerate the course of neurodegenerative diseases and are potential modifying risk factors for cognitive decline.
“NPS may accelerate the course of neurodegenerative diseases and are potential modifying risk factors for cognitive decline [21–25].”
From Psychotherapeutic interventions in individuals at risk for Alzheimer’s dementia: a systematic review (2022) · cites this paper as [24]
Neuropsychiatric symptoms may occur early in the course of dementia, at the stage of mild cognitive impairment or even before.
“Recent work has shown that neuropsychiatric symptoms may occur early in the course of dementia, at the stage of mild cognitive impairment or even before that.”
From Mental health care for older adults: recent advances and new directions in clinical practice and research (2022) · cites this paper as [117]
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- Authors
- Ismail, Z., Smith, E. E., Geda, Y., Sultzer, D., Brodaty, H., Smith, G., Agüera‐Ortiz, L., Sweet, R., Miller, D., Lyketsos, C. G., & Area, I. N. S. P. I.
- Affiliations
- University of Calgary (CA)
- Mayo Clinic (US)
- University of California, Los Angeles (US)
- UNSW Sydney (AU)
- Johns Hopkins University (US)
- Research Unit, Alzheimer Center Reina Sofia Foundation Carlos III Institute of Health and CIBERSAM Madrid Spain
- University of Pittsburgh (US)
- Bracket global Wayne PA USA
- Corresponding author
- Ismail, Zahinoor
- ORCID
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2015-06-18
- Volume
- 12
- Issue
- 2
- Pages
- 195-202
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC4684483
- OpenAlex
- W577743257
- Cited by
- 818
- References
- 57
- Citations by year
- 2026: 84 · 2025: 110 · 2024: 110 · 2023: 83 · 2022: 98 · 2021: 85 · 2020: 82 · 2019: 41 · 2018: 51 · 2017: 45 · 2016: 23 · 2015: 4
- FWCI
- 33.24
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- neuropsychiatric symptoms, mild behavioral impairment
- MeSH terms
- Mental Disorders, Dementia, Humans, Neuropsychological Tests, Risk Factors, Disease Progression, Cognitive Dysfunction, Symptom Assessment
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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