The Impact of Mild Behavioral Impairment on Caregiver Burden: A Study of Cognitively Healthy Subjects and Those with Mild Cognitive Impairment

Introduction: Mild Behavioural Impairment (MBI) is a late-life neurobehavioral syndrome characterized by emergent changes in behaviour and personality in individuals aged ≥50 years. It has been associated with an increased risk of Mild Cognitive Impairment (MCI) and a higher likelihood of progression to dementia. However, its impact on caregivers’ burden has received little attention. Objective: The aim of this study was to investigate whether the presence of MBI in older adults, with or without MCI, is associated with increased caregiver burden. Method: Older adults (> 50 years) from the general population and their caregivers (i.e., partner, offspring) were recruited and classified into four groups cognitively healthy with (HC-MBI) and without MBI (HC-nMBI), individuals with MCI with (MCI-MBI) and without MBI (MCI-nMBI). MBI was evaluated through Mild Behavioural Impairment-Checklist (MBI-C). Cognitive status was assessed using a comprehensive neuropsychological battery, and MCI was defined following Petersen et al. (2004) criteria. Burden was assessed with the Italian version of the Zarit Burden Interview. Results: The final sample included of 122 participant-caregiver dyads. Caregivers of individuals with MBI showed higher burden compared to those of individuals without MBI, regardless of cognitive status (HC-MBI vs. HC-nMBI: p = 0.03; MCI-MBI vs. MCI-nMBI: p = .06). No significant differences emerged between caregivers of individuals without MBI (p = 0.37), , while caregivers of participants with MBI reported comparable distress levels (HC-MBI vs. MCI-MBI: p = 0.98). Conclusion: These findings indicate that behavioural changes, rather than a mild cognitive decline, have a substantial impact on caregiver’ distress, highlighting how these changes are clinically relevant not only for patients but also for those who take care of them. Integrating MBI evaluation into neuropsychological assessments may help identify early factors influencing both cognitive trajectories and caregiver burden, thereby supporting the development of targeted interventions for patients and proper support for caregiver.