The onset of degenerative dementia (especially Alzheimer’s dementia) usually begins several years before the first cognitive and behavioral symptoms appear. It is therefore important to develop criteria that enable dementia syndrome to be detected at an early stage, thereby allowing early intervention. The Alzheimer´s Association International Society to Advance Alzheimer´s Research and Treatment (ISTAART) aims to research Alzheimer’s disease so that the best possible treatment can be provided as early as possible.
The early signs of dementia manifest themselves in cognitive (Mild Cognitive Impairment, MCI) and behavioral impairments (Mild Behavioral Impairment, MBI). MBI is characterized by mild neuropsychiatric symptoms and manifests itself in mood and behavioral abnormalities. Such symptoms are associated with a higher caregiver burden (Fischer et al., 2012), a lower quality of life (Karttunen et al., 2011), and more pronounced dementia symptoms (Peters et al., 2015; Zubenko et al., 1991).
According to Ismail et al. (2016), the ISTAART criteria for MBI include:
The Mild Behavioral Impairment Scale (MBI-S) presented here is a short scale with eight items for assessing MBI. It was developed and validated by Hinkl et al. (2025).
The MBI-S does not aim to cover the diagnostic criteria for MBI (e.g., persistent symptoms within the last 6 months). It is therefore not a diagnostic tool for MBI.
Hinkl, P., Graessel, E., Rohleder, N., Landendoerfer, P., Kuehlein, T., Lauer, N., & Pendergrass, A. (2025). Validation of the Mild Behavioral Impairment Scale (MBI-S) for brief self-assessment of Mild Behavioral Impairment in people without dementia. Annals of General Psychiatry, 24(1), 1-13.
Ismail, Z., Smith, E. E., Geda, Y., Sultzer, D., Brodaty, H., Smith, G., … & Area, I. N. S. P. I. (2016). Neuropsychiatric symptoms as early manifestations of emergent dementia: provisional diagnostic criteria for mild behavioral impairment. Alzheimer’s & Dementia, 12(2), 195-202.
Karttunen, K., Karppi, P., Hiltunen, A., Vanhanen, M., Välimäki, T., Martikainen, J., … & ALSOVA Study Group. (2011). Neuropsychiatric symptoms and quality of life in patients with very mild and mild Alzheimer’s disease. International Journal of Geriatric Psychiatry, 26(5), 473-482.
Peters, M. E., Schwartz, S., Han, D., Rabins, P. V., Steinberg, M., Tschanz, J. T., & Lyketsos, C. G. (2015). Neuropsychiatric symptoms as predictors of progression to severe Alzheimer’s dementia and death: the Cache County Dementia Progression Study. American Journal of Psychiatry, 172(5), 460-465.
Zubenko, G. S., Moossy, J., Martinez, A. J., Rao, G., Claassen, D., Rosen, J., & Kopp, U. (1991). Neuropathologic and neurochemical correlates of psychosis in primary dementia. Archives of Neurology, 48(6), 619-624.
Mild Behavioral Impairment Scale (MBI-S); Mild Cognitive Impairment (MCI); Mild Behavioral Impairment (MBI)