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INTRODUCTIONGlobal efforts to prevent or reduce the burden of Alzheimer's disease (AD) dementia have not been successful, partially due to challenges in detecting disease early enough for therapeutic interventions. Mild cognitive impairment (MCI) is an at‐risk state for AD,1 representing prodromal disease when associated with AD neurobiological changes.1,2 However, many with MCI do not have dementia‐related neurobiological changes and do not progress to dementia.3 In the absence of overt cognitive symptoms, early detection is even more difficult. Thus, more accurate approaches are required to identify a high‐risk group for dementia.Increasingly, data support improved sensitivity and specificity of dementia prognostication and early detection by incorporating neuropsychiatric symptoms (NPS) into modeling. Developed and validated explicitly for dementia prognostication, mild behavioral impairment (MBI) selects later‐life emergent and persistent NPS, to identify the high‐risk group.4 Incorporating MBI assessment (i.e., behavioral risk) into models using cognitive assessments (i.e., cognitive risk) could provide greater specificity in identifying this high‐risk group, improving estimates from those based on cognitive status alone. MCI participants with concurrent MBI have a higher progression rate to dementia and a lower reversion rate to normal cognition (NC) than MCI without MBI.3 Similarly, in subjective cognitive decline (SCD) and NC, concurrent MBI confers
Alzheimer s & Dementia Translational Research & Clinical Interventions – Wiley
Published: Jan 1, 2023
Keywords: Alzheimer's disease; mild behavioral impairment; mild cognitive impairment; neuropsychiatric symptoms; resting‐state functional magnetic resonance imaging
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