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. 2017;56(3):929-938.
doi: 10.3233/JAD-160979.

The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations

Affiliations

The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations

Zahinoor Ismail et al. J Alzheimers Dis. 2017.

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. 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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Conflict of interest statement

No authors declare any conflicts of interest

Figures

Figure 1
Figure 1
Modified Delphi-process flow diagram for MBI-C development
Figure 2
Figure 2
MBI Checklist
Figure 2
Figure 2
MBI Checklist

References

    1. Ballard C, Day S, Sharp S, Wing G, Sorensen S. Neuropsychiatric symptoms in dementia: importance and treatment considerations. Int Rev Psychiatry. 2008;20:396–404. - PubMed
    1. Geda YE, Schneider LS, Gitlin LN, Miller DS, Smith GS, Bell J, Evans J, Lee M, Porsteinsson A, Lanctôt KL. Neuropsychiatric symptoms in Alzheimer’s disease: Past progress and anticipation of the future. Alzheimers Dement. 2013;9:602–608. - PMC - PubMed
    1. Steinberg M, Shao H, Zandi P, Lyketsos CG, Welsh-Bohmer KA, Norton MC, Breitner J, Steffens DC, Tschanz JT. Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study. Int J Geriatr Psychiatry. 2008;23:170–177. - PMC - PubMed
    1. Stern Y, Albert M, Brandt J, Jacobs D, Tang M, Marder K, Bell K, Sano M, Devanand D, Bylsma F. Utility of extrapyramidal signs and psychosis as predictors of cognitive and functional decline, nursing home admission, and death in Alzheimer’s disease Prospective analyses from the Predictors Study. Neurology. 1994;44:2300–2300. - PubMed
    1. Peters ME, Schwartz S, Han D, Rabins PV, Steinberg M, Tschanz J, Lyketsos C. Neuropsychiatric symptoms as predictors of progression to severe alzheimer’s dementia and death: the Cache Country dementia progression study. Am J Psychiatry. 2015;172:460–465. - PMC - PubMed

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