Is there a difference between mild behavioural impairment (MBI) vs non-MBI
groups for APOE status and also for CSF amyloid status? 
   Lead Investigator:    Santhosh Nathan
   Institution      :    University of Calgary
   E-Mail           :    santhosh.nathan@ucalgary.ca
   Proposal ID      :    1315



   Proposal Description:
   Evidence in the literature shows that neuropsychiatric symptoms (NPS) are a  ubiquitous phenomenon in dementia. However, with the last FDA approved drug for dementia being over a decade ago, there is an increasing need to shift the focus to the pre-dementia population. Even subtle changes in NPS has been shown to be predictive of later cognitive decline. However, the current  neuropsychiatric inventory questionnaire (NPI-Q) to assess NPS only accounts  for a 1-month timepoint and is biased towards the dementia population. This is where the validated neurobehavioural syndrome known as mild behavioural  impairment (MBI) excels. MBI uses a sustained 6-month time point for meaningful NPS diagnosis in the pre-dementia population. NPS will be assessed and converted to MBI scores using a published algorithm (Sheikh et al. 2018). It is hypothesized that there exists a difference between MBI vs non-MBI groups for APOE genotype and CSF amyloid status. Our hypothesis will be tested by characterizing the baseline APOE and amyloid status and following the cohort to the 3-year time point and studying the trajectories of conversion. Clinical Dementia Rating (CDR) scores will also be used to track the progress from baseline. We will look at the florbetapir ligand binding/or lack of to beta-amyloid to work out the SUVR in our MBI regions of interest as outlined in our seminal paper (Ismail et al. 2016). Lastly, our core team consists of expert collaborators in the field of neuropsychiatry, vascular dementia and other investigators who are able to offer their expertise in PET, CSF and APOE data analysis during the course of this study. By undertaking this study, we are able to correlate the risk of MBI with APOE and CSF amyloid status, which will allow for future improved disease prognosis.