The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations

Zahinoor Ismail, Luis Agüera-Ortiz, Henry Brodaty, Alicja Cieslak, Jeffrey Cummings, Corinne E. Fischer, Serge Gauthier, Yonas E. Geda, Nathan Herrmann, Jamila Kanji, Krista L. Lanctôt, David S. Miller, Moyra E. Mortby, Chiadi U. Onyike, Paul B. Rosenberg, Eric E. Smith, Gwenn S. Smith, David L. Sultzer, Constantine Lyketsos

Research output: Contribution to journalArticlepeer-review

117 Scopus citations


Background: Mild behavioral impairment (MBI) is a construct that describes the emergence at ≥50 years of age of sustained and impactful neuropsychiatric symptoms (NPS), as a precursor to cognitive decline and dementia. MBI describes NPS of any severity, which are not captured by traditional psychiatric nosology, persist for at least 6 months, and occur in advance of or in concert with mild cognitive impairment. While the detection and description of MBI has been operationalized in the International Society to Advance Alzheimer's Research and Treatment - Alzheimer's Association (ISTAART-AA) research diagnostic criteria, there is no instrument that accurately reflects MBI as described. Objective: To develop an instrument based on ISTAART-AA MBI criteria. Methods: Eighteen subject matter experts participated in development using a modified Delphi process. An iterative process ensured items reflected the five MBI domains of 1) decreased motivation; 2) emotional dysregulation; 3) impulse dyscontrol; 4) social inappropriateness; and 5) abnormal perception or thought content. Instrument language was developed a priori to pertain to non-demented functionally independent older adults. Results: We present the Mild Behavioral Impairment Checklist (MBI-C), a 34-item instrument, which can easily be completed by a patient, close informant, or clinician. Conclusion: The MBI-C provides the first measure specifically developed to assess the MBI construct as explicitly described in the criteria. Its utility lies in MBI case detection, and monitoring the emergence of MBI symptoms and domains over time. Studies are required to determine the prognostic value of MBI for dementia development, and for predicting different dementia subtypes.

Original languageEnglish (US)
Pages (from-to)929-938
Number of pages10
JournalJournal of Alzheimer's Disease
Issue number3
StatePublished - 2017


  • Behavioral and psychological symptoms of dementia
  • dementia
  • mild behavioral impairment
  • mild cognitive impairment
  • neuropsychiatric symptoms
  • preclinical dementia
  • prodromal dementia

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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