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Observational Study
. 2023 Nov;35(11):643-652.
doi: 10.1017/S1041610221002878. Epub 2022 Feb 8.

Cognitive profile of people with mild behavioral impairment in Brain Health Registry participants

F Kassam  1 , H Chen  1 , R L Nosheny  2 , A McGirr  3 , T Williams  4 , Nicole Ng  5 , Monica Camacho  4 , R S Mackin  2 , M W Weiner  4 , Z Ismail  1   3
Affiliations
Observational Study

Cognitive profile of people with mild behavioral impairment in Brain Health Registry participants

F Kassam et al. Int Psychogeriatr. 2023 Nov.

Abstract

Objectives: Dementia assessment includes cognitive and behavioral testing with informant verification. Conventional testing is resource-intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. The aim of this study was to assess the relationship between informant-rated behavioral changes and participant-completed neuropsychological test performance in older adults, both measured remotely via an online unsupervised platform, the Brain Health Registry (BHR).

Design: Observational cohort study.

Setting: Community-dwelling older adults participating in the online BHR. Informant reports were obtained using the BHR Study Partner Portal.

Participants: The final sample included 499 participant-informant dyads.

Measurements: Participants completed online unsupervised neuropsychological assessment including Forward Memory Span, Reverse Memory Span, Trail Making B, and Go/No-Go tests. Informants completed the Mild Behavioral Impairment Checklist (MBI-C) via the BHR Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity.

Results: Mean age of the 499 participants was 67, of which 308/499 were females (61%). MBI + status was associated with significantly lower memory and executive function test scores, measured using Forward and Reverse Memory Span, Trail Making Errors and Trail Making Speed. Further, significant associations were found between poorer objectively measured cognitive performance, in the domains of memory and executive function, and MBI symptom severity.

Conclusion: These findings support the feasibility of remote, informant-reported behavioral assessment utilizing the MBI-C, supporting its validity by demonstrating a relationship to online unsupervised neuropsychological test performance, using a previously validated platform capable of assessing early dementia risk markers.

Keywords: Mild behavioral impairment (MBI); Mild cognitive impairment (MCI); Neuropsychiatric symptoms (NPS); neuropsychological testing; rating scales.

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Conflict of interest statement

Conflict of Interest Declaration

Data used in this study were collected using the BHR, which is funded by the NIH, Alzheimer’s Association, Alzheimer’s Drug Discovery Foundation, California Department of Public Health, Connie and Kevin Shanahan, The Drew Foundation, General Electric, Global Alzheimer’s Platform Foundation, Larry L. Hillbolm Foundation, The Ray and Dagmar Dolby Family Fund, The Rosenberg Alzheimer’s Project and Patient-Centered Outcomes Research Institute.

Z. Ismail is funded by the Canadian Institutes of Health Research, and has received consulting fees/honoraria from Otsuka/Lundbeck, outside the submitted work. His institution has received funds from Acadia, Biogen, Roche, and Sunovion, also outside the submitted work. R. Nosheny is a co-investigator for the BHR. S. Mackin has received grant funding from the National Institute of Mental Health and has received research support from Johnson & Johnson. M. Weiner receives support for his work from the following: National Institute of Health, Department of Defense, Patient-Centered Outcomes Research Institute, California Department of Public Health, University of Michigan, Siemens, Biogen, Larry L. Hillbolm Foundation, Alzheimer’s Association, The State of California, Johnson & Johnson, Kevin and Connie Shanahan, GE, Vrije Universiteit Medical Center Amsterdam, Australian Catholic University, The Stroke Foundation and the Veterans Administration. He has served on the Advisory Boards for Eli Lilly, Cerecin/Accera, Roche, Alzheon, Inc., and BHR.

Figures

Figure 1-
Figure 1-
Flowchart of participants from the BHR included for analysis
Figure 2
Figure 2
(a) Positive result (>7) on the MBI-C is associated with shorter Memory Span; (b) positive result (>7) on the MBI-C is associated with shorter Reverse Memory Span; (c) positive result (>7) on the MBI-C is associated with more errors in the Trail Making-B task; (d) positive result (>7) on the MBI-C is associated with longer response time in Trail Making-B task; (e) positive result (>7) on the MBI-C is not associated with the number of errors on a GoNoGo task; and (f) positive result (>7) on the MBI-C is not associated with the response time on a GoNoGo task.
Figure 2
Figure 2
(a) Positive result (>7) on the MBI-C is associated with shorter Memory Span; (b) positive result (>7) on the MBI-C is associated with shorter Reverse Memory Span; (c) positive result (>7) on the MBI-C is associated with more errors in the Trail Making-B task; (d) positive result (>7) on the MBI-C is associated with longer response time in Trail Making-B task; (e) positive result (>7) on the MBI-C is not associated with the number of errors on a GoNoGo task; and (f) positive result (>7) on the MBI-C is not associated with the response time on a GoNoGo task.
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