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Diagnostic Approaches to Assessment of Mild Behavioral Impairment in Patients with Mild Cognitive Impairment
Objectives. To assess the prevalence of mild behavioral impairment (MBI) syndrome in older people with mild cognitive impairment (MCI), to clarify the diagnostic criteria, and to characterize the neuropsychiatric symptoms identified.
Materials and methods. The study included 63 patients over 50 years of age (median 72 [68; 77] years) with MCI syndrome who underwent psychopathological and psychometric examination using clinical, psychopathological, and psychometric methods. Statistical analysis was run to assess between-group differences; ROC curves were constructed and areas under the curve (AUC) were calculated, and the sensitivity, specificity, and accuracy of diagnoses of MBI were determined.
Results. The prevalence of MBI syndrome using the study criteria alone was 65%. The optimal diagnostic threshold for the MBI rating scale with the greatest AUC (0.793) was found to be 10 points. Comprehensive assessment of MBI syndrome using the criteria and the optimum cutoff for the MBI grading scale yielded a prevalence of 33% (median 16 [14, 20]). The MBI + MCI and MCI-only groups showed no significant differences on other tests. Significant between-group differences were noted in the severity of the symptoms of apathy (p < 0.001), depression and anxiety (p < 0.001), agitation and disinhibition (p < 0.001), social behavior disorders (p = 0.009), and subpsychotic symptoms (p < 0.001). The most common symptoms were those associated with deficits in impulse control, irritability, agitation, depression and anxiety, and apathy. Social behavior disorders and subpsychotic symptoms were less common.
Conclusions. New data are presented here on the characteristics of the diagnosis of MBI syndrome in elderly patients with MCI in the Russianspeaking population. The optimal diagnostic threshold was determined by applying the MBI assessment scale to a sample of patients attending specialized clinics for use in combination with generally accepted criteria. Further research is required to adapt and validate the MBI assessment scales and predictive assessment of MBI syndrome in the context of the progression of MCI to dementia.