Grant: Project Grant

Early detection of dementia is essential to implement preventative interventions and optimize treatment. The current approach to detection is to identify overt impairment in memory and thinking as a marker of dementia. However, the vast majority of treatments at this stage have not been successful, with the explanation that disease course is too advanced by the time cognitive impairment is recognized. A new approach to detecting dementia risk earlier involves assessing the emergence of changes in behaviour or personality in later life as potential indicators of brain dysfunction leading to dementia. A neurobehavioural syndrome called Mild Behavioural Impairment (MBI) has been described by an Alzheimer's Association consensus group, which identifies later-life onset of neuropsychiatric symptoms (NPS- eg. changes in behaviour or personality, onset of apathy or social disinhibition) as a high-risk group for developing dementia. For some, NPS may be the earliest manifestation of dementia, first noticed by family members and caregivers. Often, these changes in behaviour and personality are attributed to a psychiatric illness, and the connection to dementia is not appreciated. Further, the neuroanatomy of these symptoms is poorly understood. We will recruit people with MBI and perform brain scans and cognitive testing, at baseline and at 2 year follow up. We will compare brain scans in these patients to those collected in other studies funded by Brain Canada and the Canadian Institutes of Health Research to determine the neural signatures of MBI. We will also compare the rates of cognitive decline in MBI to those without MBI, and progression to dementia. This study will help identify symptoms for early diagnosis of dementia and potential targets for early treatment. It will also help us understand the importance of monitoring for emerging changes in personality and behaviour in older adults, as a cost-effective method for identifying people with a high risk of dementia.