Advances in research on association between mild behavioral impairment and Alzheimer′s disease

Abstract

Abstract:

Mild behavioral impairment (MBI) refers to a series of neuropsychiatric symptoms in adults aged ≥50 years, primarily characterized by affective dysregulation and impulse control deficits, including depression, mania, hallucinations, and delusions. As an early harbinger of cognitive decline, MBI is intrinsically linked to the pathological progression of Alzheimer's disease (AD) and may appear several years before the onset of dementia symptoms. Its prevalence is approximately 10% in cognitively normal populations, increasing to 14%-50% among individuals with mild cognitive impairment (MCI). However, in clinical practice, the potential associations between MBI and AD are often underestimated or overlooked due to the complexity and non-specificity of MBI symptoms. In recent years, with in-depth research on AD biomarkers, the intrinsic relationship between MBI and AD has been gradually revealed. Cross-sectional studies have confirmed that MBI is significantly associated with reduced cerebrospinal fluid (CSF) Aβ42 levels and elevated cerebral Aβ deposition burden. Longitudinal evidence further demonstrates positive associations between MBI severity, high Aβ deposition, and accelerated cognitive decline, though its links with tau pathology remain controversial. MBI shows spatial consistency with AD-characteristic brain atrophy, such as in the hippocampus, amygdala, and entorhinal cortex. Collectively, this evidence solidifies the important role of MBI as a neuropsychiatric biomarker in the preclinical stage of AD. To optimize early AD detection, this review aims to highlight the need to establish a multidimensional assessment framework integrating neuropsychiatric symptoms and cognitive decline in clinical practice and remind clinicians to heighten vigilance toward abnormal neuropsychiatric behaviors in the elderly, thereby improving the detection rate of the preclinical stage of AD.

Key words:Mild behavioral impairment,Alzheimer's disease,Neuropsychiatric symptoms,Biomarkers,Neuroima-ging,Cognitive decline

CLC Number:

R749.16
R446

LI Yuhang, XIAO Shifu, YUE Ling. Advances in research on association between mild behavioral impairment and Alzheimer′s disease[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(05): 548-554.

Figures/Tables2

Table 1

Epidemiological study of MBI

时间	研究者	使用工具	研究对象	MBI流行病学数据
2018	Sheikn等^{[ 13 ]}	NPI	MCI	MCI 49%~85%；非MCI 28%~75%
2019	Matsuoka等^{[ 12 ]}	NPI	精神科和记忆门诊	精神科门诊，SCD 19.6%，MCI 50.0% 记忆诊所，SCD 76.5%，MCI 85.3%
2020	Rao等^{[ 14 ]}	NPI	记忆门诊	遗忘型MCI 41.13%
2020	Kassam等^{[ 7 ]}	MBI-C	所有认知状态人群	认知正常10%；MCI 14%
2022	Xu等^{[ 15 ]}	MBI-C	临床患者	MCI超过50%
2021	肖辛怡等^{[ 16 ]}	NPI	记忆门诊	MCI 42.6%；痴呆78.3%
2023	曾黎等^{[ 17 ]}	MBI-C	农村老人	农村老人32.97%
2024	Leow等^{[ 18 ]}	MBI-C	新加坡社区	MBI-C平均得分（2.52±4.54）分
2024	Cherkasov等^{[ 19 ]}	MBI-C	50岁以上老人	50岁以上65%
2024	Richey等^{[ 20 ]}	NPI-Q	社区老人	有头部损伤史的31.3%；没有头部损伤史的 26.0%

Table 1

Figure 1

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