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56/100

✓ Peer-reviewed alzhub usefulness score 56 out of 100. Prevention and risk

Topic: Risk, prevention and care in population studies

Objective Mild behavioral impairment (MBI) is a neurobehavioral syndrome characterized by later life emergent neuropsychiatric symptoms (NPS) that represent an at-risk state for incident cognitive decline and dementia in people with mild cognitive impairment (MCI). We undertook a study to determine whether MBI was associated with progressive changes in neuropsychological performance in people without significant cognitive impairment. Methods A total of 9,931 older adults enrolled in the PROTECT study who did not have MCI or dementia undertook a comprehensive neuropsychological battery measuring attention, reasoning, executive function, and working memory at baseline and 1 year. MBI was ascertained using self-administration of the Mild Behavioral Impairment Checklist at 1 year, and participants were grouped according to MBI status: No Symptoms, Intermediate NPS and MBI. All assessments were completed online, and data analyzed using mixed-effects model repeated measures analysis of covariance. Results A total of 949 (10%) people had MBI. These individuals had significantly worse cognitive performance at baseline and significantly greater decline over 1 year in the four composite cognitive scores measuring attentional intensity (F [2,8578] = 3.97; p = 0.019), sustained attention (F [2,8578] = 18.63; p Conclusion Our novel findings show that MBI is associated with faster decline in attention and working memory in this cognitively normal sample. MBI may be an earlier marker of neurodegenerative disease than MCI, captured at the stage of subjective cognitive decline or before, raising the possibility that MBI represents a novel target for dementia clinical trials or prevention strategies.

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APA 7th

Creese, B., Brooker, H., Ismail, Z., Wesnes, K. A., Hampshire, A., Khan, Z., et al. (2019). Mild Behavioral Impairment as a Marker of Cognitive Decline in Cognitively Normal Older Adults. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2019.01.215

Vancouver

Creese B, Brooker H, Ismail Z, Wesnes KA, Hampshire A, Khan Z, et al. Mild Behavioral Impairment as a Marker of Cognitive Decline in Cognitively Normal Older Adults. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2019. doi:10.1016/j.jagp.2019.01.215. PMID: 30902566.

BibTeX

@article{creese2019-30902566,
  author  = {Creese, B. and Brooker, H. and Ismail, Z. and Wesnes, K. A. and Hampshire, A. and Khan, Z. and Megalogeni, M. and Corbett, A. and others},
  title   = {{Mild Behavioral Impairment as a Marker of Cognitive Decline in Cognitively Normal Older Adults}},
  journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
  year    = {2019},
  doi     = {10.1016/j.jagp.2019.01.215},
  pmid    = {30902566},
  url     = {https://doi.org/10.1016/j.jagp.2019.01.215}
}

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Key findings

We undertook a study to determine whether MBI was associated with progressive changes in neuropsychological performance in people without significant cognitive impairment.
Results A total of 949 (10%) people had MBI.
These individuals had significantly worse cognitive performance at baseline and significantly greater decline over 1 year in the four composite cognitive scores measuring attentional intensity (F [2,8578] = 3.97; p = 0.019), sustained attention (F [2,8578] = 18.63; p <0.0001), attentional fluctuation (F [2,8578] = 10.13; p <0.0001) and working memory (F [2,9895] = 13.1; p <0.0001).

Why it matters

In 9,931 older adults without mild cognitive impairment or dementia, the 10% who reported mild behavioral impairment (new mood or behaviour symptoms appearing in later life) scored lower on online tests of attention and working memory and declined faster over one year. The authors suggest these behaviour changes "may be an earlier marker" of cognitive decline. However, symptoms were self-reported once, at the end of the year, follow-up was short, and the study shows an association, not that behaviour changes cause decline.

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Study details

Participants9,931
Evidence strengthLow

How this study scored 56/100

Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry)
Journal's citation record	2 / 4	American Journal of Geriatric Psychiatry: journal h-index 178 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2019 — within 10 year(s) of the newest study here
Sample size	3 / 4	9,931 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 199 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	22.1 citations a year over 9 year(s) since 2019
Impact for its field and year	4 / 6	Cited 17.0× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 7 other studies in this library
Still being cited	3 / 4	Cited 63 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author Clive G. Ballard: h-index 141 (OpenAlex, whole career)
Institution's track record	2 / 3	Imperial College London: institution h-index 1,744 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 9 institution(s) in 4 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 30902566)
Free to read	0 / 2	Behind a paywall — scores zero
Total	56 / 100	—

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