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New symptom checklist may support earlier Alzheimer's diagnosis

Researchers presenting at the Alzheimer’s Association International Conference 2016 in Toronto, introduced a new condition known as Mild Behavioral Impairment, described as a potential forerunner of neurodegeneration and progression to mild cognitive impairment.

In addition, the researchers, led by Zahinoor Ismail, MD, of the University of Calgary Cumming School of Medicine, proposed a new checklist for Mild Behavioral Impairment (MBI)that would be administered by physicians and focus on five categories of behavioral symptoms. The checklist, called MBI-C, may help clinicians measure changes in behavior that could signal the beginnings of neurodegeneration.

According to the researchers, MBI is a syndrome of later-life acquired neuropsychiatric symptoms that are sustained for at least 6 months. Symptoms displayed as part of MBI, which are also included on the checklist, center on five domains: Apathy, drive and motivation; mood, affect and anxiety; impulse, control, agitation and reward; social appropriateness; and thoughts and perception.

“We propose that the utility of the MBI-C — once it is refined and vetted by the Alzheimer’s community — is significant not only clinically, but also in research,” Ismail said in a press release. “In addition, we may be able to create or derive a version that can be provided to family members of older adults to determine the nature and extent of neuropsychiatric symptoms and to measure changes over time. From a research perspective, the scale may prove to be usable in biomarker and neuroimaging studies in pre-dementia clinical states, in epidemiological studies of community samples, and in clinical sample observational studies to help assess the impact of [neuropsychiatric symptoms] in older adults.”

The researchers designed the checklist specifically to address a younger, pre-dementia population, emphasizing that the emergence of neuropsychiatric symptoms represented a significant change from prior behavior.

“This proposed new checklist describes and helps identify a new clinical stage in the disease and has the potential to represent a paradigm shift in formal neurodegeneration testing — away from a sole focus on the memory to also encompass behavior,” Maria C. Carrillo, PhD, chief science officer of the Alzheimer’s Association, said in a press release. “By looking beyond memory-related issues to closely evaluate the behavioral issues included in the checklist, physicians could reach a more efficient and accurate diagnosis sooner.” – by Jason Laday

Disclosure: Healio Family Medicine could not confirm researchers’ relevant financial disclosures.

Reference:

Ismail Z, et al. Abstract O1-13-03. Presented at AAIC 2016; July 22-28, 2016; Toronto.