Objective: Better methods for detecting preclinical neuropathological change are required for prevention of dementia. Mild behavioral impairment (MBI) and subjective cognitive decline (SCD) can represent neurobehavioral and neurocognitive axes of early stage neurodegenerative processes, which are represented in Stage 2 of the NIA-AA Alzheimers disease research framework. Both MBI and SCD may offer an opportunity for premorbid detection. We test the hypothesis that MBI and SCD confer additive risk for incident cognitive decline. Methods: Participants were cognitively normal older adults followed up approximately annually at Alzheimers Disease Centers. Logistic regression was used to determine the relationship between baseline classification (MBI+, SCD+, neither (MBI-SCD-), or both (MBI+SCD+)) and cognitive decline, defined by Clinical Dementia Rating (CDR) total score, at 3 years. Results: Of 2769 participants (mean age=76; 63% females), 1536 were MBI-SCD-, 254 MBI-SCD+, 743 MBI+SCD-, and 236 MBI+SCD+. At 3-years, 349 individuals (12.6%) developed cognitive decline to CDR>0. Compared to SCD-MBI-, we observed an ordinal progression in risk, with ORs [95% CI] as follows: 3.61 [2.42-5.38] for MBI-SCD+ (16.5% progression), 4.76 [3.57-6.34] for MBI+SCD-, (20.7% progression) and 8.15 [5.71-11.64] for MBI+SCD+ (30.9% progression). Conclusion: MBI in older adults alone or in combination with SCD is associated with a higher risk of incident cognitive decline at 3 years. The highest rate of progression to MCI is observed in those with both MBI and SCD. Used in conjunction, MBI and SCD could be simple and scalable methods to identify patients at high risk for cognitive decline for prevention studies.

中文翻译：

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轻度的行为障碍和主观认知下降预测轻度的认知障碍

目的：需要更好的方法来检测临床前神经病理学改变，以预防痴呆。轻度的行为障碍（MBI）和主观认知下降（SCD）可以代表早期神经变性过程的神经行为和神经认知轴，这在NIA-AA阿尔茨海默氏病研究框架的第2阶段中得到了体现。MBI和SCD均可为病前检测提供机会。我们检验了MBI和SCD赋予事件认知下降的加成风险的假设。方法：参与者是认知正常的成年人，大约每年在阿尔茨海默氏病中心进行一次随访。使用Logistic回归确定基线分类（MBI +，SCD +，既不（MBI-SCD-），又不都（MBI + SCD +））与认知能力下降之间的关系，由3年时的临床痴呆评分（CDR）总分定义。结果：在2769名参与者（平均年龄= 76； 63％的女性）中，有1536名MBI-SCD-，254名MBI-SCD +，743名MBI + SCD-和236名MBI + SCD +。在3年的时间里，有349个人（12.6％）的认知能力下降至CDR> 0。与SCD-MBI-相比，我们观察到风险有序进展，OR值为[95％CI]如下：MBI-SCD +为3.61 [2.42-5.38]（进展为16.5％），MBI +为4.76 [3.57-6.34] MBI + SCD +的SCD-（进展为20.7％）和8.15 [5.71-11.64]（进展为30.9％）。结论：单独或与SCD联合使用的老年人MBI与3岁时发生认知功能下降的较高风险相关。在患有MBI和SCD的患者中观察到向MCI的最高进展率。结合使用