Mild Behavioral Impairment and Plasma Biomarkers of Neurodegeneration as Predictors of Cognitive Decline in Geriatric Patients With Psychiatric Disorders

Background: Mild Behavioral Impairment (MBI) has been increasingly recognized as a potential early clinical marker of neurodegenerative disease, while blood-based biomarkers such as phosphorylated tau 217 (p-tau217) and neurofilament light chain (NfL) are associated with Alzheimer’s disease and axonal damage, respectively. Objective: To investigate the role of MBI and blood-based biomarkers of neurodegeneration in the early detection of dementia. Methods: Fifty-one individuals without dementia aged 60 or older with mood or anxiety disorders underwent psychiatric, neuropsychiatric, and cognitive evaluations, as well as assessment of plasma p-tau217 and NfL at baseline and at one-year follow-up. Results: A higher proportion of males was observed in the MBI group compared to the non-MBI group (P = 0.076). MBI was significantly associated with a higher risk of conversion to dementia (P = 0.006). MBI patients showed a trend toward higher baseline p-tau217 (P = 0.096) and significantly higher NfL at follow-up (P = 0.025), suggesting active neurodegeneration. Individuals who converted to dementia had marginally higher baseline p-tau217 (P = 0.053) and NfL (P = 0.091). Conclusion: MBI and blood-based biomarkers of neurodegeneration appear to be promising clinical tools for identifying dementia risk in its early stages.