Longitudinal associations of emergent and persistent affective dysregulation symptoms with incident dementia in dementia‐free older adults

Background Neuropsychiatric symptoms (NPS) are risk factors for dementia. Mild behavioral impairment (MBI) is a neurobehavioral syndrome that refines NPS assessment to improve dementia prognostication by identifying later-life emergent and persistent specifically as the at-risk group. Affective dysregulation contributes an MBI domain characterized inability regulate emotions. Here, we investigate longitudinal association of MBI-affective with incident in dementia-free older adults from National Alzheimer Coordinating Centre (NACC). Method NACC participants no history psychiatric, neurological, or neurodevelopmental disorders were included. status was determined based on Inventory Questionnaire (NPI-Q) depression, anxiety, elation scores at two consecutive visits. The comparator group involved prior Participants baseline excluded study. Kaplan-Meier curves survival over ten years generated versus NPS. Cox proportional hazard models implemented assess dementia, adjusted age, sex, education, race, APOE e4 status, clinical cognitive diagnosis. Potential interactions further explored relevant model covariates. Result final sample consisted 3,446 (mean age 73.1; 63.0% female), 1,156 75.1; 53.9% female). associated lower chance (log rank, p<0.001) 1.67 times greater compared (CI:1.4-2, p<0.001). Moderation analysis revealed normal cognition (NC), those 2.56 than (CI:1.87-3.49, In mild (MCI), 1.4 (CI:1.14-1.72, p = 0.02). Conclusion emergence affective substantial When emerging individuals NC, these represent NPS, MCI. important factor should be considered assessments.