Risk of Conversion to Dementia in a Mild Behavioral Impairment Group Compared to a Psychiatric Group and to a Mild Cognitive Impairment Group

Article type: Research Article

Authors: Taragano, Fernando E.^{a; b; *} | Allegri, Ricardo F.^a | Heisecke, Silvina L.^{a; b} | Martelli, María I.^b | Feldman, Mónica L.^b | Sánchez, Viviana^b | García, Virginia A.^b | Tufro, Graciela^{b; †} | Castro, Diego M.^b | Leguizamón, Patricio Perez^b | Guelar, Verónica^b | Ruotolo, Eva^b | Zegarra, Cecilia^b | Dillon, Carol^{a; b}

Affiliations: [a] National Scientific Research Council – CONICET, Buenos Aires, Argentina | [b] Neuropsychiatry Research Unit, CEMIC University Hospital, Galvan, Buenos Aires, Argentina

Correspondence: [*] Correspondence to: Fernando E. Taragano, National Scientific Research Council – CONICET, Buenos Aires, Argentina. Tel.: +54 11 5299 0372 #6; Fax: +54 11 4541 3790; E-mail: [email protected].

Note: [†] Deceased.

Abstract: Background:There is insufficient available information on behavioral changes in the absence of cognitive impairment as factors increasing the risk of conversion to dementia. Objective:To observe and analyze patients with mild behavioral impairment (MBI), mild cognitive impairment (MCI), and a psychiatry group (PG) to compare the risk of progression to dementia. Methods:From 677 initially assessed ≥60-year-old patients, a series of 348 patients was studied for a five-year period until censoring or conversion to dementia: 96 with MBI, 87 with MCI, and 165 with general psychiatry disorders, including 4 subgroups: Anxiety, Depression, Psychosis and Others. All patients were assessed with clinical, psychiatric, neurological, neuropsychological, and neuroimaging studies. Results:From 348 patients, 126 evolved to dementia (36.2%). Conversion was significantly higher in MBI (71.5%), followed by the MCI-MBI overlap (59.6%) and MCI (37.8%) groups, compared to PG (13.9%) (Log-rank p < 0.001). MCI patients mostly converted to Alzheimer’s dementia, while MBI converted to frontotemporal dementia and Lewy body dementia. Patients in PG converted to Lewy body dementia and frontotemporal dementia. Conclusion:Conversion to dementia is significantly higher in patients with neuropsychiatric symptoms. The MBI concept generates a new milestone in the refining of diagnosis of neurodegenerative diseases and the possibility of creating neuropsychiatric profiles. Its earlier identification will allow new possibilities for therapeutic intervention.

Keywords: Alzheimer’s disease, conversion to dementia, follow-up, frontotemporal disease, Lewy body disease, mild behavioral impairment, mild cognitive impairment, pre-dementia

DOI: 10.3233/JAD-170632

Journal: Journal of Alzheimer's Disease, vol. 62, no. 1, pp. 227-238, 2018