Vascular contribution to mild behavioral impairment
1
Department of Public Health, Second Faculty of Medicine, Charles University, Prague, Czech Republic
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Mild Behavioral Impairment (MBI) is recognized as a prodromal stage of dementia, characterized by the later-life onset of neuropsychiatric symptoms. Although MBI is believed to arise primarily from neurodegenerative processes, it remains unclear whether vascular pathology also contributes to its development. We examined whether white matter hyperintensities (WMH)—a well-established marker of small vessel disease and cumulative cardiovascular risk factor burden—are associated with MBI. We analyzed data from 1,273 participants enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI), all of whom had either normal cognition or mild cognitive impairment at baseline. MBI symptoms and status were derived from the Neuropsychiatric Inventory. WMH burden was measured volumetrically, and both global and regional associations with MBI were assessed. We employed general linear models to evaluate the relationship between total WMH volume and both MBI total score and MBI status. To investigate spatial specificity, we also conducted voxel-wise analyses across the white matter. Our results showed that greater total WMH volume was significantly associated with higher MBI total scores as well as with increased odds of meeting criteria for MBI. These associations were observed across individuals with normal cognition and those with mild cognitive impairment, suggesting that WMH may influence behavioral changes even before overt dementia develops. The voxel-wise analyses revealed a significant cluster within the left inferior longitudinal fasciculus, where higher WMH burden was related to elevated MBI total scores. This tract, which plays a key role in emotional regulation and social cognition, may represent a pathway through which vascular pathology contributes to behavioral alterations. Our findings indicate that both the overall burden and the spatial distribution of WMH are linked to MBI. These results support the hypothesis that MBI may, in part, reflect neurovascular mechanisms, highlighting the importance of considering vascular health in early behavioral changes associated with dementia risk.
Mild Behavioral Impairment (MBI) is recognized as a prodromal stage of dementia, characterized by the later-life onset of neuropsychiatric symptoms. Although MBI is believed to arise primarily from neurodegenerative processes, it remains unclear whether vascular pathology also contributes to its development. We examined whether white matter hyperintensities (WMH)—a well-established marker of small vessel disease and cumulative cardiovascular risk factor burden—are associated with MBI. We analyzed data from 1,273 participants enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI), all of whom had either normal cognition or mild cognitive impairment at baseline. MBI symptoms and status were derived from the Neuropsychiatric Inventory. WMH burden was measured volumetrically, and both global and regional associations with MBI were assessed. We employed general linear models to evaluate the relationship between total WMH volume and both MBI total score and MBI status. To investigate spatial specificity, we also conducted voxel-wise analyses across the white matter. Our results showed that greater total WMH volume was significantly associated with higher MBI total scores as well as with increased odds of meeting criteria for MBI. These associations were observed across individuals with normal cognition and those with mild cognitive impairment, suggesting that WMH may influence behavioral changes even before overt dementia develops. The voxel-wise analyses revealed a significant cluster within the left inferior longitudinal fasciculus, where higher WMH burden was related to elevated MBI total scores. This tract, which plays a key role in emotional regulation and social cognition, may represent a pathway through which vascular pathology contributes to behavioral alterations. Our findings indicate that both the overall burden and the spatial distribution of WMH are linked to MBI. These results support the hypothesis that MBI may, in part, reflect neurovascular mechanisms, highlighting the importance of considering vascular health in early behavioral changes associated with dementia risk.
| eISSN: | 2654-1459 |
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