학술논문

Persistence of neuropsychiatric symptoms and dementia prognostication: A comparison of three operational case definitions of mild behavioral impairment
Document Type
article
Source
Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, Vol 15, Iss 4, Pp n/a-n/a (2023)
Subject
Alzheimer disease
dementia
mild behavioral impairment
neuropsychiatric symptoms
Neurology. Diseases of the nervous system
RC346-429
Geriatrics
RC952-954.6
Language
English
ISSN
2352-8729
Abstract
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.