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August 11, 2016

Mild Behavioral Impairment Can Be the First Sign of Alzheimer's

When Mike Belleville found himself getting easily frustrated and angry, he assumed his stressful job was to blame. Soon, the usually patient 55-year-old found himself snapping at coworkers and even rolling down his car window to shout at passing drivers.

His wife became alarmed after the two not only had a heated argument, but Mike couldn’t remember what he had said to her during the fight. A trip to the doctor revealed Mike was dealing with early onset dementia.

We are all aware of the common “memory lapses” we associate with the beginning of Alzheimer’s disease—forgetting where we placed our keys, not recalling someone’s name or just being generally forgetful, but researchers have uncovered these changes in memory may not be the first sign of Alzheimer's. 

Dubbed mild behavioral impairment (MBI) by researchers at the Alzheimer's Association International Conference 2016, this syndrome may be a warning sign of the onset of Alzheimer’s disease and other forms of dementia. Seemingly unrelated psychiatric symptoms like losing interest in favorite activities, being more anxious or aggressive or frequently making crude comments in public can all be signals that dementia-like changes are taking place in the brain.

Checklist for Mild Behavioral Impairment Symptoms

In recent brain health news, researchers have designed a checklist physicians can use to evaluate five categories of behavioral symptoms to spot the beginnings for neurodegeneration in patients.

Though not finalized, researchers intend for the final document to also go to caregivers and older adults to help them document symptoms and changes in symptoms over time. The checklist will focus on these five areas:

  • Apathy/drive/motivation
  • Mood/affect/anxiety
  • Impulse control/agitation/reward
  • Social appropriateness
  • Thoughts/perception

Researchers propose that the MBI diagnosis be a clinical designation that would precede the more widely known diagnostic marker of mild cognitive impairment (MCI).

“Whatever is eroding memory and thinking skills in the dementia process may also affect the brain’s systems of emotional regulation and self-control,” says Dr. Zahinoor Ismail, a neuropsychiatrist at the University of Calgary.

Ismail explains that if two people had MCI and only one had mood changes associated with MBI, the person with MBI develops full-blown dementia faster.

It’s important to note, says Ismail, that behavioral changes don’t always denote impending Alzheimer’s or dementia. To be considered an MBI symptom, he says, the change has to have lasted for at least six months.

Any kind of cognitive change can be scary. If you or someone you know is experiencing behavioral or memory changes that concern you, talk with your doctor.

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