Mild Behavioral Impairment: A New Prodromal Syndrome for Dementia

Aslı AYTULUN, Şahinde Özlem ERDEN AKİ
2022 33(4): 280-289
DOI: 10.5080/u26980
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In this review, it is aimed to discuss neuropsychiatric symptoms as
prodromal symptoms of dementia syndromes, to define the concept of
‘Mild Behavioral Impairment’, and to introduce the ‘Mild Behavioral
Impairment Checklist’.
Neuropsychiatric symptoms (NPS) represent non-cognitive symptoms
and behaviors in dementia patients. The frequency of NPS accompanying
dementia increases as the disease progresses. Studies reveal that NPS
are seen in patients with dementia as well as in the elderly without
cognitive complaints, individuals with subjective cognitive complaints,
and individuals diagnosed with mild cognitive impairment. Based on
these findings, identifying and detecting these symptoms were thought
to be useful in predicting the development of dementia in cases where
cognitive symptoms have not yet appeared. ‘Mild Behavioral Impairment’
was first defined by Taragano and Allegri, and it was introduced as a
concept that includes neurobehavioral symptoms seen in elderly people
for at least 6 months and that do not meet the diagnostic criteria of
any other psychiatric syndrome. Mild Behavioral Impairment Checklist
(MBI-C) has been developed recently which consists of 34 questions
including apathy, mood, impulse dyscontrol, social inappropriateness,
abnormal thinking, and perception. Studies on the neurobiological basis
of these sub-domains and their relationship with biomarkers gained
momentum with the definition of the concept and the development
of MBI-C. However, the concept is still very new and it is possible
for people to be over-diagnosed and to face the risk of stigmatization
during the evaluation. Therefore, studies with large samples are needed.
Demonstrating the validity of this concept will also serve the purpose of
identifying the subjects with a neurodegenerative disease without any
cognitive complaints yet at a very early stage in clinical studies.
Keywords: Mild behavioral impairment, neuropsychiatric symptoms,
prodromal dementia