Behavior Changes Could Flag Alzheimer's Years Before Memory Loss
Researchers found that personality and behavior shifts in older adults—not just memory problems—reliably signal early Alzheimer's disease at the biological level. The discovery could let doctors and insurers identify at-risk patients sooner, opening a window for preventive treatments before cognitive decline becomes irreversible.
Originaltitel: Enhancing Alzheimer Disease Detection Using Neuropsychiatric Symptoms: The Role of Mild Behavioural Impairment in the Revised NIA-AA Research Framework
Background As the prevalence of Alzheimer disease (AD) rises, early identification of at-risk individuals is essential for effective intervention. Mild behavioral impairment (MBI), which captures emergent and persistent neuropsychiatric symptoms (NPS) in later life, may enhance early detection of AD; however, its associations with 2024 NIA-AA Core 1 biomarkers remain unexplored. We investigated associations between MBI and cerebrospinal fluid (CSF) amyloid beta-42 (A beta 42) and phosphorylated tau-181 (p-tau181).Method Baseline data from 1327 dementia-free Alzheimer's Disease Neuroimaging Initiative (ADNI) participants were analyzed. Participants were classified as MBI, non-MBI NPS, or no NPS. Gaussian mixture modeling defined biomarker positivity. Logistic and multinomial logistic regressions modeled associations between NPS status and biomarker positivity or biomarker profiles, adjusting for age, sex, education, and cognition.Results MBI was associated with A beta 42+ (aOR = 2.26; 95% CI = 1.71-2.99), p-tau181+ (aOR = 1.72; 95% CI = 1.30-2.28), and AD continuum profile (aOR = 2.33; 95% CI = 1.73-3.14), but not with non-AD pathology. Non-MBI NPS showed no associations.Conclusion MBI may serve as a behavioral marker of AD pathology.