Abstract

Background:

Assessing neuropsychiatric symptoms (NPS) in older adults is important for determining dementia risk. Mild behavioral impairment (MBI) is an at-risk state for cognitive decline and dementia, characterized by emergent NPS in later life. MBI has significantly higher dementia incidence than late life psychiatric conditions. However, its utility as a proxy for neurodegeneration has not been demonstrated. Plasma neurofilament light (NfL) is a validated biomarker of axonal damage, and has been shown to associate with hallmarks of neurodegeneration.

Objective:

The purpose of this investigation was to identify associations between NfL rate of change and the presence of MBI symptomatology.

Methods:

We evaluated the association of MBI with changes in NfL in a cohort (n = 584; MBI + n = 190, MBI– n = 394) of non-demented participants from the Alzheimer’s Disease Neuroimaging Initiative. MBI was determined by transforming neuropsychiatric questionnaire items using a published algorithm. Change in NfL was calculated over 2 years.

Results:

Time*MBI status was the only significant interaction to predict change in NfL concentrations (F(1,574) = 4.59, p = 0.032), even after controlling for age, mild cognitive impairment, and demographics. Analyses reclassifying 64 participants with new onset MBI over 2 years similarly demonstrated greater increases in NfL (F(1,574) = 5.82, p = 0.016).

Conclusion:

These findings suggest MBI is a clinical proxy of early phase neurodegeneration with putative utility in identifying those at dementia risk. MBI can be used as a case ascertainment approach to capture those at high risk for cognitive decline and dementia, and is an important construct for clinicians dealing with cognitive and neuropsychiatric symptomatology in older adults.

中文翻译：

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血浆神经丝光：轻度行为障碍中神经退行性变的标志。

 抽象的

 背景：

评估老年人的神经精神症状（NPS）对于确定痴呆风险很重要。轻度行为障碍 (MBI) 是一种认知能力下降和痴呆的危险状态，其特征是晚年出现 NPS。 MBI 的痴呆症发病率明显高于晚年精神疾病。然而，其作为神经退行性变代理的效用尚未得到证实。血浆神经丝光 (NfL) 是一种经过验证的轴突损伤生物标志物，并已被证明与神经退行性疾病的标志相关。

 客观的：

本次调查的目的是确定 NfL 变化率与 MBI 症状之间的关联。

 方法：

我们在阿尔茨海默病神经影像计划的非痴呆参与者队列（ n = 584；MBI + n = 190，MBI– n = 394）中评估了 MBI 与 NfL 变化的关联。 MBI 是通过使用已发布的算法转换神经精神问卷项目来确定的。 NfL 的变化是在 2 年内计算的。

 结果：

时间*MBI 状态是预测 NfL 浓度变化的唯一显着交互作用（ F (1,574) = 4.59， p = 0.032），即使在控制了年龄、轻度认知障碍和人口统计学之后也是如此。对 2 年内新发 MBI 的 64 名参与者进行重新分类的分析同样表明 NfL 有更大的增加（ F (1,574) = 5.82， p = 0.016）。

 结论：

这些发现表明，MBI 是早期神经退行性变的临床指标，在识别痴呆风险人群方面具有推定的实用性。 MBI 可用作病例确定方法，以捕获认知能力下降和痴呆症高危人群，并且是临床医生处理老年人认知和神经精神症状的重要构建。