The mild behavioral impairment checklist (MBI-C): A rating scale for neuropsychiatric symptoms in pre-dementia populations
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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. 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 five 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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The Mild Behavioral Impairment Checklist does not facilitate the differentiation of PPD from bvFTD.
“The Mild Behavioral Impairment Checklist is a more specific tool to measure later-life behavioural changes that can be the harbinger of dementia (Ismail et al. , 2017); however, it does not facilitate the differentiation of PPD from bvFTD.”
From Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders (2020) · cites this paper as Ismail et al., 2017
The MBI-C is different from traditional measures of neuropsychiatric symptoms as it is comprehensive and allows detecting behavioural changes that are also common in non-Alzheimer's dementias.
“The MBI-C is different from traditional measures of neuropsychiatric symptoms as the measure is comprehensive and allows detecting behavioural changes that are also common in non-Alzheimer's dementias (Ismail et al., 2017).”
From Exploring the impact of carer stressors and psychological inflexibility on depression and anxiety in family carers of people with dementia (2020) · cites this paper as Ismail et al., 2017
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- Authors
- Ismail, Z., for the NPS Professional Interest Area of the International Society of to Advance Alzheimer’s Research and Treatment (NPS-PIA of ISTAART), Agüera-Ortiz, L., Brodaty, H., Cieslak, A., Cummings, J., Fischer, C. E., Gauthier, S., Geda, Y. E., Herrmann, N., Kanji, J., Lanctôt, K. L., Miller, D. S., Mortby, M. E., Onyike, C. U., Rosenberg, P. B., Smith, E. E., Smith, G. S., Sultzer, D. L., & Lyketsos, C.
- Affiliations
- University of Calgary (CA)
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM,Department of Psychiatry & Research Institute i+12, Hospital, Universitario 12 de Octubre, Madrid, Spain
- UNSW Sydney (AU)
- 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
- Cleveland Clinic (US)
- St. Michael's Hospital (CA)
- Douglas Mental Health University Institute (CA)
- Mayo Clinic in Arizona (US)
- Sunnybrook Health Science Centre (CA)
- University of Toronto (CA)
- Bracket Global, Wayne, PA, USA
- Australian National University (AU)
- Johns Hopkins University (US)
- University of California, Los Angeles (US)
- Corresponding author
- Ismail, Zahinoor
- ORCID
- Venue
- Journal of Alzheimer's Disease
- Publisher
- SAGE Publications
- Published
- 2017-02-03
- Volume
- 56
- Issue
- 3
- Pages
- 929-938
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- PMC
- PMC5652315
- OpenAlex
- W2570315135
- Cited by
- 530
- References
- 50
- Citations by year
- 2026: 53 · 2025: 87 · 2024: 90 · 2023: 63 · 2022: 54 · 2021: 61 · 2020: 55 · 2019: 25 · 2018: 23 · 2017: 16
- FWCI
- 26.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- National Institute on Aging (R01AG041633, R01AG038893, P50AG005146)
- National Institute of General Medical Sciences (P20GM109025)
- 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
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- mild behavioral impairment, neuropsychiatric symptoms
- MeSH terms
- Delphi Technique, Emotions, Humans, Impulsive Behavior, Motivation, Neuropsychological Tests, Perception, Severity of Illness Index, Social Behavior, Thinking, Executive Function, Cognitive Dysfunction
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