Affiliations: [a] Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| [b] Duke-NUS Medical School, Singapore, Singapore
| [c] Lee Kong Chian School of Medicine, Imperial College London, Nanyang Technological University, Singapore, Singapore
| [d] Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| [e] Hotchkiss Brain Institute and O’Brien Institute for Public Health, Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, University of Calgary, AB, Canada
Correspondence:
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Correspondence to: A/Prof Nagaendran Kandiah, FRCP, Senior Consultant Neurologist, Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433, Singapore. Tel.: +65 6357 7199; Fax: +65 6357 7137; E-mail: nagaendran.kandiah@singhealth.com.sg.
Note: [1] These authors contributed equally to this work.
Abstract: Background:Mild behavioral impairment (MBI) describes persistent behavioral changes in later life as an at-risk state for dementia. While cardiovascular risk factors (CVRFs) are linked to dementia, it is uncertain how CVRFs are associated with MBI. Objective:To determine the prevalence of MBI and its association with CVRFs among cognitively normal (CN) and mild cognitive impairment (MCI) individuals in Singapore. Methods:172 individuals (79 CN and 93 MCI) completed the MBI-checklist (MBI-C). The prevalence of MBI and MBI-C sub-domain characteristics among CN and MCI were examined. Regression models evaluated the relationships between MBI-C sub-domain scores with CVRFs. Results:The prevalence of MBI and mean MBI-C total score were significantly higher among MCI than CN (34.4%versus 20.3%, p = 0.022 and 7.01 versus 4.12, p = 0.04). The highest and lowest-rated sub-domains among CN and MCI were impulse dyscontrol and abnormal thoughts and perception respectively. Within the MCI cohort, a higher proportion of individuals with diabetes mellitus (DM) had MBI compared to individuals without DM (28.1%versus 10.4%, p = 0.025). The interaction of DM and MCI cohort resulted in significantly higher mean MBI-C total, decreased motivation, emotional dysregulation, impulse dyscontrol, and abnormal thoughts and perception sub-domain scores. Conclusion:The prevalence of MBI is higher among a Singapore cohort compared to Caucasian cohorts. The associations of DM with both the presence and severity of MBI among MCI suggest that DM may be a risk factor for MBI. The optimization of DM may be a potential therapeutic approach to improve clinical outcomes among MCI with MBI.
