Alzheimer's & Dementia · Jul 13, 2026

Associations among mild behavioral impairment, cognition, and brain pathology in preclinical autosomal dominant Alzheimer's disease

By Tristão-Pereira C, Vasquez D, Alcina J et al.

INTRODUCTION: The Mild Behavioral Impairment Checklist (MBI-C) captures neuropsychiatric symptoms in individuals at risk of dementia. In this study, we examined MBI-C scores in autosomal dominant Alzheimer's disease (ADAD). METHODS: We included 83 cognitively unimpaired presenilin-1 E280A mutation carriers and 114 non-carriers with MBI-C, obfjective cognition, and subjective cognitive decline (SCD) assessments. Study sub-samples underwent neuroimaging to assess Alzheimer's disease (AD) pathology and neurodegeneration. RESULTS: MBI-C total scores were greater in carriers than non-carriers (r rb = 0.19 [95% confidence interval (CI) 0.05, 0.31], P = 0.009), driven by impulse dyscontrol symptoms. Elevated MBI-C scores were associated with higher study partner-reported SCD scores (β = 0.28 [95% CI 0.07, 0.050], P = 0.008) and with greater neocortical amyloid beta (β = 0.46 [95% CI 0.17, 0.075], P = 0.003) among carriers. DISCUSSION: Our study reveals that mild behavioral impairment symptoms may emerge before cognitive decline in ADAD and supports the MBI-C as a tool for detecting early behavioral changes linked to AD pathology and identifying at-risk individuals for clinical trials and early intervention.

doi.org/10.1002/dad2.70424Open accessPubMed 42444728Biomarkers