Associations of mild behavioral impairment, subjective cognitive decline, activities of daily living, and mood with objective cognition in community-dwelling Chinese older adults

Abstract

Mild behavioral impairment (MBI) is a late-life syndrome marked by new, sustained changes in behavior orpersonality linked to a heightened risk of cognitive decline. This study addresses critical gaps in understanding MBI among Chinese communitydwelling older adults, focusing on four key questions: MBI prevalence, its associations with demographic factors, relationships with subjective cognitive decline (SCD), mood, activities of daily living (ADL), and objective cognition, and whether MBI and SCD jointly predict global and sub-domain cognition stronger than either alone. The aim was to investigate MBI's associations with SCD, ADL, mood, and objective cognition in this population, with specific objectives to determine MBI prevalence, analyze demographic correlates, explore inter-variable relationships, and evaluate combined predictive value ofMBI and SCD. Conducted in Nanyang City, Henan Province, China, this cross-sectional study used convenience sampling to enroll 316 communityd welling older adults (~60 years). Data were collected via validated tools and analyzed using Spearman correlations, linear regression, and hierarchical regression. Key findings indicated that MBI prevalence was 23.73%, associated with lower education, unstable income, and specific marital/living statuses, with higher rates in 60-64-yearolds. MBI correlated significantly with SCD, depressive symptoms, ADL impairment, and lower cognitive scores. Hierarchical regression revealed MBixSCD interaction negatively predicted global cognition, memory, and executive function, notably within the visuospatial and language domains. This study contributes to the field by systematically examining MBI in Chinese communities, confirming its utility as an early marker of cognitive risk and highlighting MBI-SCD co-occurrence as a robust predictor. Policy implications include integrating MBI and SCD screening into community geriatric care, targeting low-education and economically unstable groups with tailored interventions to enhance early detection and management of cognitive decline.