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

Zahinoor Ismail; Luis Agüera-Ortiz; Henry Brodaty; Alicja Cieslak; Jeffrey Cummings; Corinne E. Fischer; Serge Gauthier; Yonas E. Geda; Nathan Herrmann; Jamila Kanji; Krista L. Lanctôt; David S. Miller; Moyra E. Mortby; Chiadi U. Onyike; Paul B. Rosenberg; Eric E. Smith; Gwenn S. Smith; David L. Sultzer; Constantine Lyketsos

doi:10.3233/JAD-160979

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

Zahinoor Ismail^*, Luis Agüera-Ortiz, Henry Brodaty, Alicja Cieslak, Jeffrey Cummings, Corinne E. Fischer, Serge Gauthier, Yonas E. Geda, Nathan Herrmann, Jamila Kanji, Krista L. Lanctôt, David S. Miller, Moyra E. Mortby, Chiadi U. Onyike, Paul B. Rosenberg, Eric E. Smith, Gwenn S. Smith, David L. Sultzer, Constantine Lyketsos

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

293 Citations (Scopus)

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.

Original language	English
Pages (from-to)	929-938
Number of pages	10
Journal	Journal of Alzheimer's Disease
Volume	56
Issue number	3
DOIs	https://doi.org/10.3233/JAD-160979
Publication status	Published - 2017

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10.3233/JAD-160979

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Ismail, Z., Agüera-Ortiz, L., Brodaty, H., Cieslak, A., Cummings, J., Fischer, C. E., Gauthier, S., Geda, Y. E., Herrmann, N., Kanji, J., Lanctôt, K. L., Miller, D. S., Mortby, M. E., Onyike, C. U., Rosenberg, P. B., Smith, E. E., Smith, G. S., Sultzer, D. L., & Lyketsos, C. (2017). The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations. Journal of Alzheimer's Disease, 56(3), 929-938. https://doi.org/10.3233/JAD-160979

@article{da2dbfef4635406a884a12a6f3cb8bac,

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

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.",

keywords = "Behavioral and psychological symptoms of dementia, dementia, mild behavioral impairment, mild cognitive impairment, neuropsychiatric symptoms, preclinical dementia, prodromal dementia",

author = "Zahinoor Ismail and Luis Ag{\"u}era-Ortiz and Henry Brodaty and Alicja Cieslak and Jeffrey Cummings and Fischer, {Corinne E.} and Serge Gauthier and Geda, {Yonas E.} and Nathan Herrmann and Jamila Kanji and Lanct{\^o}t, {Krista L.} and Miller, {David S.} and Mortby, {Moyra E.} and Onyike, {Chiadi U.} and Rosenberg, {Paul B.} and Smith, {Eric E.} and Smith, {Gwenn S.} and Sultzer, {David L.} and Constantine Lyketsos",

year = "2017",

doi = "10.3233/JAD-160979",

language = "English",

volume = "56",

pages = "929--938",

journal = "Journal of Alzheimer's Disease",

issn = "1387-2877",

publisher = "IOS Press BV",

number = "3",

}

Ismail, Z, Agüera-Ortiz, L, Brodaty, H, Cieslak, A, Cummings, J, Fischer, CE, Gauthier, S, Geda, YE, Herrmann, N, Kanji, J, Lanctôt, KL, Miller, DS, Mortby, ME, Onyike, CU, Rosenberg, PB, Smith, EE, Smith, GS, Sultzer, DL & Lyketsos, C 2017, 'The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations', Journal of Alzheimer's Disease, vol. 56, no. 3, pp. 929-938. https://doi.org/10.3233/JAD-160979

TY - JOUR

T1 - The Mild Behavioral Impairment Checklist (MBI-C)

T2 - A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations

AU - Ismail, Zahinoor

AU - Agüera-Ortiz, Luis

AU - Brodaty, Henry

AU - Cieslak, Alicja

AU - Cummings, Jeffrey

AU - Fischer, Corinne E.

AU - Gauthier, Serge

AU - Geda, Yonas E.

AU - Herrmann, Nathan

AU - Kanji, Jamila

AU - Lanctôt, Krista L.

AU - Miller, David S.

AU - Mortby, Moyra E.

AU - Onyike, Chiadi U.

AU - Rosenberg, Paul B.

AU - Smith, Eric E.

AU - Smith, Gwenn S.

AU - Sultzer, David L.

AU - Lyketsos, Constantine

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Behavioral and psychological symptoms of dementia

KW - dementia

KW - mild behavioral impairment

KW - mild cognitive impairment

KW - neuropsychiatric symptoms

KW - preclinical dementia

KW - prodromal dementia

UR - http://www.scopus.com/inward/record.url?scp=85011585251&partnerID=8YFLogxK

U2 - 10.3233/JAD-160979

DO - 10.3233/JAD-160979

M3 - Article

SN - 1387-2877

VL - 56

SP - 929

EP - 938

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

IS - 3

ER -

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

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