Deterioro Conductual Leve (MBI), Deterioro Cognitivo Leve (MCI) y desarrollo de la demencia: implicancias diagnósticas y clínicas
Resumen
Tanto el Deterioro Conductual Leve (MBI) y el Deterioro Cognitivo Leve (MCI) han sido identificados como estados o fases predemenciales. Estas entidades constituyen factores de riesgo para el desarrollo de las demencias y en muchos casos, una manifestación temprana de las mismas. En este contexto, los síntomas neuropsiquiátricos que caracterizan al MBI no solo podrían presentarse concurrentemente con el MCI, sino también antes de su aparición o incluso sin que este se llegara a presentar. Esta aparición selectiva del MBI sigue representando un gran desafío en términos de la comprensión de su etiología y el sustrato neurobiológico que podría compartir con el MCI. En este artículo se presentan las características centrales del MBI, los criterios que se emplean para su diagnóstico, las relaciones que guarda con el MCI y sus posibles biomarcadores, para discutir algunos aspectos relacionados con su diagnóstico clínicoPalabras clave:
demencia, Deterioro Conductual Leve (MBI), Deterioro Cognitivo Leve (MCI), síntomas neuropsiquiátricos (NPS)Referencias
1. Mortby, M. E., Ismail, Z., & Anstey, K. J. “Prevalence estimates of mild behavioral impairment in a population-based sample of predementia states and cognitively healthy older adults”. Int Psychogeriatr. 2018 Feb.; 30(2): 221–232.
2. Lyketsos, C.G. “Neuropsychiatric Symptoms in Dementia: Overview and Measurement Challenges”. J Prev Alzheimers Dis. 2015 Sep.; 2(3): 155-156.
3. Creese, B., Griffiths, A., Brooker, H., Corbett, A., Aarsland, D., Ballard, C., & Ismail, Z. “Profile of mild behavioral impairment and factor structure of the Mild Behavioral Impairment Checklist in cognitively normal older adults”. Int Psychogeriatr. 2020 Jun.; 32(6): 705-717.
4. Lyketsos, C. G., Carrillo, M. C., Ryan, J. M., Khachaturian, A. S., Trzepacz, P., Amatniek, J., Cedarbaum, J., Brashear, R., & Miller, D. S. “Neuropsychiatric symptoms in Alzheimer’s disease.”Alzheimers Dement. 2011 Sep.; 7(5): 532–539.
5. Ismail, Z., Smith, E. E., Geda, Y., Sultzer, D., Brodaty, H., Smith, G., Agüera-Ortiz, L., Sweet, R., Miller, D., Lyketsos, C. G., & ISTAART Neuropsychiatric Symptoms Professional Interest Area. “Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment”. Alzheimers Dement. 2016 Feb.;12(2): 195–202.
6. Lanctôt, K. L., Amatniek, J., Ancoli-Israel, S., Arnold, S. E., Ballard, C., Cohen-Mansfield, J., Ismail, Z., Lyketsos, C., Miller, D. S., Musiek, E., Osorio, R. S., Rosenberg, P. B., Satlin, A., Steffens, D., Tariot, P., Bain, L. J., Carrillo, M. C., Hendrix, J. A., Jurgens, H., & Boot, B. “Neuropsychiatric signs and symptoms of Alzheimer’s disease: New treatment paradigms”. Alzheimers Dement (N Y). 2017 Aug.; 3(3):440-449.
7. Dillon, C., Serrano, C. M., Castro, D., Leguizamón, P. P., Heisecke, S. L., & Taragano, F. E.“Behavioral symptoms related to cognitive impairment”. Neuropsychiatr Dis Treat. 2013 Sep.;9:1443–1455.
8. Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J., & DeKosky, S.“Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study”. JAMA. 2002 Sep.;288(12): 1475–1483.
9. Gallagher, D., Fischer, C. E., & Iaboni, A.“Neuropsychiatric Symptoms in Mild Cognitive Impairment”. Can J Psychiatry.2017 Mar.; 62(3): 161–169.
10. Ismail, Z., Agüera-Ortiz, L., Brodaty, H., Cieslak, A., Cummings, J., Fischer, C. E., Gauthier, S., Geda, Y. E., Herrmann, N., Kanji, J., Lanctôt, K. L., Miller, D. S., Mortby, M. E., Onyike, C. U., Rosenberg, P. B., Smith, E. E., Smith, G. S., Sultzer, D. L., Lyketsos, C., & NPS Professional Interest Area of the International Society of to Advance Alzheimer’s Research and Treatment (NPS-PIA of ISTAART). “The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations”. J Alzheimers Dis. 2017;56(3): 929–938.
11. Elefante, C., Lattanzi, L., Ismail, Z., Medda, P., Bacciardi, S., Mainardi, C., & Perugi, G. “Mild Behavioral Impairment: presentation of the diagnostic criteria and the Italian version of the MBI-Checklist”. Riv Psichiatr. 2019 Mar.-Apr.; 54(2): 59-66.
12. Behrens, M.I., Nervi, A., editores. Guías clínicas de diagnóstico y tratamiento de las demencias. Santiago: 2da. Ed. Sonepsyn., 2017.
13. Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Kokmen, E., & Tangelos, E.G.“Aging, memory, and mild cognitive impairment”. Int Psychogeriatr. 1997; 9 Suppl 1:65–69.
14. Eramudugolla, R., Mortby, M. E., Sachdev, P.,Meslin, C., Kumar, R., & Anstey, K. J. “Evaluation of a research diagnostic algorithm
for DSM-5 neurocognitive disorders in a population-based cohort of older adults”. Alzheimer’s research & therapy. 2017 Mar.; 9(1): 15.
15. Geda, Y. E., Roberts, R. O., Knopman, D. S., Petersen, R. C., Christianson, T. J., Pankratz, V. S., Smith, G. E., Boeve, B. F., Ivnik, R. J., Tangalos, E. G., & Rocca, W. A.“Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study”. Arch Gen Psychiatry. 2008 Oct.; 65(10): 1193–1198.
16. Taragano, F. E., Allegri, R. F., Krupitzki, H., Sarasola, D. R., Serrano, C. M., Loñ, L., & Lyketsos, C. G. “Mild behavioral impairment and risk of dementia: a prospective cohort study of 358 patients”. J Clin Psychiatry.2009 Apr.; 70(4): 584–592.
17. Julio, C., Síntomas neuropsiquiátricos en demencia. En:Behrens, M.I., Nervi, A., (Ed.) Guías clínicas de diagnóstico y tratamiento de las demencias. Santiago: 2da. Ed. Sonepsyn., 2017. pp. 181-188.
18. Andrews, S. J., Ismail, Z., Anstey, K. J., & Mortby, M.“Association of Alzheimer’s genetic loci with mild behavioral impairment”. Am J Med Genet B Neuropsychiatr Genet.2018 Dec.; 177(8):727-735.
19. Wang, X., Ren, P., Mapstone, M., Conwell, Y., Porsteinsson, A. P., Foxe, J. J., Raizada, R., Lin, F., & and the Alzheimer’s Disease Neuroimaging Initiative. “Identify a shared neural circuit linking multiple neuropsychiatric symptoms with Alzheimer’s pathology”. Brain Imaging Behav. 2019 Feb.; 13(1): 53-64.
20. Lussier, F. Z., Pascoal, T. A., Chamoun, M., Therriault, J., Tissot, C., Savard, M., Kang, M. S., Mathotaarachchi, S., Benedet, A. L., Parsons, M., Qureshi, M., Thomas, É. M., Shin, M., Dion, L. A., Massarweh, G., Soucy, J. P., Tsai, I. H., Vitali, P., Ismail, Z., Rosa-Neto, P., Gauthier, S. “Mild behavioral impairment is associated with β-amyloid but not tau or neurodegeneration in cognitively intact elderly individuals”.Alzheimer’s Dement. 2020 Jan.; 16(1): 192– 199.
21. Martin, E., & Velayudhan, L. “Neuropsychiatric Symptoms in Mild Cognitive Impairment: A Literature Review”. Dement Geriatr Cogn Disord. 2020 Apr.; 49(2): 146-155.
22. World Health Organization. “Risk reduction of cognitive decline and dementia”. WHO guidelines. 2019
2. Lyketsos, C.G. “Neuropsychiatric Symptoms in Dementia: Overview and Measurement Challenges”. J Prev Alzheimers Dis. 2015 Sep.; 2(3): 155-156.
3. Creese, B., Griffiths, A., Brooker, H., Corbett, A., Aarsland, D., Ballard, C., & Ismail, Z. “Profile of mild behavioral impairment and factor structure of the Mild Behavioral Impairment Checklist in cognitively normal older adults”. Int Psychogeriatr. 2020 Jun.; 32(6): 705-717.
4. Lyketsos, C. G., Carrillo, M. C., Ryan, J. M., Khachaturian, A. S., Trzepacz, P., Amatniek, J., Cedarbaum, J., Brashear, R., & Miller, D. S. “Neuropsychiatric symptoms in Alzheimer’s disease.”Alzheimers Dement. 2011 Sep.; 7(5): 532–539.
5. Ismail, Z., Smith, E. E., Geda, Y., Sultzer, D., Brodaty, H., Smith, G., Agüera-Ortiz, L., Sweet, R., Miller, D., Lyketsos, C. G., & ISTAART Neuropsychiatric Symptoms Professional Interest Area. “Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment”. Alzheimers Dement. 2016 Feb.;12(2): 195–202.
6. Lanctôt, K. L., Amatniek, J., Ancoli-Israel, S., Arnold, S. E., Ballard, C., Cohen-Mansfield, J., Ismail, Z., Lyketsos, C., Miller, D. S., Musiek, E., Osorio, R. S., Rosenberg, P. B., Satlin, A., Steffens, D., Tariot, P., Bain, L. J., Carrillo, M. C., Hendrix, J. A., Jurgens, H., & Boot, B. “Neuropsychiatric signs and symptoms of Alzheimer’s disease: New treatment paradigms”. Alzheimers Dement (N Y). 2017 Aug.; 3(3):440-449.
7. Dillon, C., Serrano, C. M., Castro, D., Leguizamón, P. P., Heisecke, S. L., & Taragano, F. E.“Behavioral symptoms related to cognitive impairment”. Neuropsychiatr Dis Treat. 2013 Sep.;9:1443–1455.
8. Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J., & DeKosky, S.“Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study”. JAMA. 2002 Sep.;288(12): 1475–1483.
9. Gallagher, D., Fischer, C. E., & Iaboni, A.“Neuropsychiatric Symptoms in Mild Cognitive Impairment”. Can J Psychiatry.2017 Mar.; 62(3): 161–169.
10. Ismail, Z., Agüera-Ortiz, L., Brodaty, H., Cieslak, A., Cummings, J., Fischer, C. E., Gauthier, S., Geda, Y. E., Herrmann, N., Kanji, J., Lanctôt, K. L., Miller, D. S., Mortby, M. E., Onyike, C. U., Rosenberg, P. B., Smith, E. E., Smith, G. S., Sultzer, D. L., Lyketsos, C., & NPS Professional Interest Area of the International Society of to Advance Alzheimer’s Research and Treatment (NPS-PIA of ISTAART). “The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations”. J Alzheimers Dis. 2017;56(3): 929–938.
11. Elefante, C., Lattanzi, L., Ismail, Z., Medda, P., Bacciardi, S., Mainardi, C., & Perugi, G. “Mild Behavioral Impairment: presentation of the diagnostic criteria and the Italian version of the MBI-Checklist”. Riv Psichiatr. 2019 Mar.-Apr.; 54(2): 59-66.
12. Behrens, M.I., Nervi, A., editores. Guías clínicas de diagnóstico y tratamiento de las demencias. Santiago: 2da. Ed. Sonepsyn., 2017.
13. Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Kokmen, E., & Tangelos, E.G.“Aging, memory, and mild cognitive impairment”. Int Psychogeriatr. 1997; 9 Suppl 1:65–69.
14. Eramudugolla, R., Mortby, M. E., Sachdev, P.,Meslin, C., Kumar, R., & Anstey, K. J. “Evaluation of a research diagnostic algorithm
for DSM-5 neurocognitive disorders in a population-based cohort of older adults”. Alzheimer’s research & therapy. 2017 Mar.; 9(1): 15.
15. Geda, Y. E., Roberts, R. O., Knopman, D. S., Petersen, R. C., Christianson, T. J., Pankratz, V. S., Smith, G. E., Boeve, B. F., Ivnik, R. J., Tangalos, E. G., & Rocca, W. A.“Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study”. Arch Gen Psychiatry. 2008 Oct.; 65(10): 1193–1198.
16. Taragano, F. E., Allegri, R. F., Krupitzki, H., Sarasola, D. R., Serrano, C. M., Loñ, L., & Lyketsos, C. G. “Mild behavioral impairment and risk of dementia: a prospective cohort study of 358 patients”. J Clin Psychiatry.2009 Apr.; 70(4): 584–592.
17. Julio, C., Síntomas neuropsiquiátricos en demencia. En:Behrens, M.I., Nervi, A., (Ed.) Guías clínicas de diagnóstico y tratamiento de las demencias. Santiago: 2da. Ed. Sonepsyn., 2017. pp. 181-188.
18. Andrews, S. J., Ismail, Z., Anstey, K. J., & Mortby, M.“Association of Alzheimer’s genetic loci with mild behavioral impairment”. Am J Med Genet B Neuropsychiatr Genet.2018 Dec.; 177(8):727-735.
19. Wang, X., Ren, P., Mapstone, M., Conwell, Y., Porsteinsson, A. P., Foxe, J. J., Raizada, R., Lin, F., & and the Alzheimer’s Disease Neuroimaging Initiative. “Identify a shared neural circuit linking multiple neuropsychiatric symptoms with Alzheimer’s pathology”. Brain Imaging Behav. 2019 Feb.; 13(1): 53-64.
20. Lussier, F. Z., Pascoal, T. A., Chamoun, M., Therriault, J., Tissot, C., Savard, M., Kang, M. S., Mathotaarachchi, S., Benedet, A. L., Parsons, M., Qureshi, M., Thomas, É. M., Shin, M., Dion, L. A., Massarweh, G., Soucy, J. P., Tsai, I. H., Vitali, P., Ismail, Z., Rosa-Neto, P., Gauthier, S. “Mild behavioral impairment is associated with β-amyloid but not tau or neurodegeneration in cognitively intact elderly individuals”.Alzheimer’s Dement. 2020 Jan.; 16(1): 192– 199.
21. Martin, E., & Velayudhan, L. “Neuropsychiatric Symptoms in Mild Cognitive Impairment: A Literature Review”. Dement Geriatr Cogn Disord. 2020 Apr.; 49(2): 146-155.
22. World Health Organization. “Risk reduction of cognitive decline and dementia”. WHO guidelines. 2019
