Validation of the Mild Behavioral Impairment-Checklist in Subjective Cognitive Decline, Mild Cognitive Impairment and Dementia

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dc.contributor.advisorIsmail, Zahinoor
dc.contributor.advisorPatten, Scott B.
dc.contributor.authorHu, Sophie
dc.contributor.committeememberFick, Gordon Hilton
dc.contributor.committeememberSmith, Eric Edward
dc.date2019-11
dc.date.accessioned2019-06-21T14:28:21Z
dc.date.available2019-06-21T14:28:21Z
dc.date.issued2019-06-17
dc.description.abstractIntroduction: Neuropsychiatric symptoms (NPS) are early markers of dementia preceding cognitive impairment. The Mild Behavioral Impairment Checklist (MBI-C) was developed to characterize NPS for pre-dementia patients. This thesis examines the validity and utility of the MBI-C for detecting neuropsychiatric symptoms in relation to cognition. Objectives: This study was conducted in three parts: 1) To compare factors of the MBI-C and Neuropsychiatric Inventory-Questionnaire (NPI-Q) using factor analysis. 2) To determine the association between baseline MBI-C and NPI-Q severity scores with cognition. 3) To determine the predictive utility of MBI-C and NPI-Q severity scores for change in cognition. Methods: Patients diagnosed with subjective cognitive decline, mild cognitive impairment and dementia were sampled from a cognitive neurology clinic. 1) Exploratory factor analysis was conducted to determine MBI-C and NPI-Q domains. 2) The association between baseline MBI-C and NPI-Q severity and cognition, as measured by the Montreal Cognitive Assessment (MoCA), was modelled using linear regression analysis. 3) The association between MBI-C and NPI-Q severity at baseline and change in cognition per six months was modelled using generalized linear mixed models. Results: 1) The MBI-C is a valid five-factor questionnaire with the following domains: apathy, mood/anxiety, impulse dyscontrol, social inappropriateness, and psychosis. Anhedonia and appetite disturbances are features that load onto apathy. The NPI-Q is a one-factor questionnaire in our sample. (2) Higher MBI-C and NPI-Q severity is associated with decreased cognition. MBI prevalence increases with increasing severity of cognitive diagnosis. All MBI-C domains are significantly associated with lower MoCA. Psychosis is most strongly associated and total score is most weakly associated. The MBI-C identifies age, sex and diagnosis-specific estimates. 3) Baseline MBI-C and NPI-Q scores predict cognitive decline over time. Impulse dyscontrol, mood/anxiety and social inappropriateness are most predictive of cognitive decline. Conclusions: Neuropsychiatric symptoms are associated with cognitive decline in pre-dementia and dementia patients. The MBI-C is a valid five-factor questionnaire for detecting NPS and is especially robust in pre-dementia patients. MBI domains are indicative and predictive of cognitive decline and can be targeted for management of NPS. The NPI-Q is not as applicable to pre-dementia and does not fully capture NPS groupings. The MBI-C and NPI-Q act as complements and both should be administered with consideration of patient status.en_US
dc.identifier.citationHu, S. (2019). Validation of the Mild Behavioral Impairment-Checklist in Subjective Cognitive Decline, Mild Cognitive Impairment and Dementia (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/36651
dc.identifier.urihttp://hdl.handle.net/1880/110515
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectNeuropsychiatry; aging; dementia; validationen_US
dc.subject.classificationEpidemiologyen_US
dc.subject.classificationPsychology--Behavioralen_US
dc.subject.classificationPsychology--Clinicalen_US
dc.subject.classificationPsychology--Cognitiveen_US
dc.titleValidation of the Mild Behavioral Impairment-Checklist in Subjective Cognitive Decline, Mild Cognitive Impairment and Dementiaen_US
dc.typemaster thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrue
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