Impulse dyscontrol is the leading mild behavioural impairment (MBI) domain among older adults of Chinese ethnicity across multiple regions cohorts including Singapore, according to a study.
Pooled data from 1,817 older Chinese adults showed impulse dyscontrol as the most prevalent MBI domain at 27 percent (95 percent confidence interval [CI], 8–52). This was followed by affective dysregulation at 22 percent (95 percent CI, 6–43) and decreased motivation at 18 percent (95 percent CI, 4–39). [J Prev Alzheimers Dis 2026;13:100589]
Social inappropriateness and abnormal perception or thought content were less common, with pooled prevalence estimates of 8 percent (95 percent CI, 1–18) and 6 percent (95 percent CI, 2–10), respectively.
“While MBI has been increasingly recognized as a critical marker for early identification and intervention, many studies have focused on examining MBI as a unitary construct. However, it is imperative to note the heterogeneous presentation of different MBI domains, especially across different cultures,” the investigators said.
“Our study showed that impulse dyscontrol was the most frequently observed domain… Symptoms of impulse dyscontrol including agitation and impulsivity are associated with a high risk of incident cognitive decline and dementia conversion,” they continued.
Indeed, in exploratory analyses involving 302 participants from the Singapore memory clinic cohort with available longitudinal data of up to 5 years, impulse dyscontrol had the highest population attributable fraction (PAF) for incident dementia at 40.3 percent, followed by decreased motivation at 38.3 percent and affective dysregulation at 20.6 percent.
These exploratory findings, according to the investigators, suggest “potential clinical relevance for early identification and dementia risk stratification.”
The study sample was obtained across three unpublished datasets (Hangzhou community cohort, China Longitudinal Aging Study, and Singapore memory clinic cohort) and three published studies. [BMC Geriatr 2020;20:510; J Alzheimers Dis 2022;90:1203-1213; J Alzheimers Dis 2022;90:1203-1213]
MBI domain prevalence was estimated using the Neuropsychiatric Inventory (NPI) and/or MBI-Checklist (MBI-C).
“Importantly, we showed that NPI and MBI-C had an adequate agreement between each other and the established NPI-to-MBI mapping algorithm could serve as a proxy measure for capturing MBI domains among Chinese participants,” the investigators noted.
“Future studies are encouraged to further examine the overlapping neuropsychiatric symptom profile across MBI domains, as well as investigate the caregiver profiles for early behavioural symptoms, which would aid the development of more tailored early identification and intervention for at-risk individuals,” they added.