Background: There is insufficient available information on behavioral changes in the absence of cognitive impairment as factors increasing the risk of conversion to dementia. Objective: To observe and analyze patients with mild behavioral impairment (MBI), mild cognitive impairment (MCI), and a psychiatry group (PG) to compare the risk of progression to dementia. Methods: From 677 initially assessed ≥60-year-old patients, a series of 348 patients was studied for a five-year period until censoring or conversion to dementia: 96 with MBI, 87 with MCI, and 165 with general psychiatry disorders, including 4 subgroups: Anxiety, Depression, Psychosis and Others. All patients were assessed with clinical, psychiatric, neurological, neuropsychological, and neuroimaging studies. Results: From 348 patients, 126 evolved to dementia (36.2%). Conversion was significantly higher in MBI (71.5%), followed by the MCI-MBI overlap (59.6%) and MCI (37.8%) groups, compared to PG (13.9%) (Log-rank p < 0.001). MCI patients mostly converted to Alzheimer’s dementia, while MBI converted to frontotemporal dementia and Lewy body dementia. Patients in PG converted to Lewy body dementia and frontotemporal dementia. Conclusion: Conversion to dementia is significantly higher in patients with neuropsychiatric symptoms. The MBI concept generates a new milestone in the refining of diagnosis of neurodegenerative diseases and the possibility of creating neuropsychiatric profiles. Its earlier identification will allow new possibilities for therapeutic intervention.

Neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI) can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI) in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct ‘MBI’ and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI) and dementia stages of Alzheimer’s disease and frontotemporal lobar degeneration.

La asociación entre la condición “madre adolescente” y los resultados adversos del embarazo ha sido bien documentada; de este modo, la literatura describe el mayor riesgo de bajo peso al nacimiento, la prematuridad y el retardo del crecimiento intrauterino (RCI) como las principales complicaciones ^{2,3,4,5,6,7,8,9}. Estos resultados adversos se han atribuido tradicionalmente a la inmadurez biológica de la madre joven ¹⁰. Sin embargo, gran cantidad de evidencia sugiere que ellos podrían ser el resultado de causas socioeconómicas ^2,3,5,6,11.

Birth defects are prenatal morphological or functional anomalies. Associations among them are studied to identify their etiopathogenesis. The graph theory methods allow analyzing relationships among a complete set of anomalies. A graph consists of nodes which represent the entities (birth defects in the present work), and edges that join nodes indicating the relationships among them. The aim of the present study was to validate the graph theory methods to study birth defect associations. All birth defects monitoring records from the Estudio Colaborativo Latino Americano de Malformaciones Congénitas gathered between 1967 and 2017 were used. From around 5 million live and stillborn infants, 170,430 had one or more birth defects. Volume-adjusted Chi-Square was used to determine the association strength between two birth defects and to weight the graph edges. The complete birth defect graph showed a Log-Normal degree distribution and its characteristics differed from random, scale-free and small-world graphs. The graph comprised 118 nodes and 550 edges. Birth defects with the highest centrality values were nonspecific codes such as Other upper limb anomalies. After partition, the graph yielded 12 groups; most of them were recognizable and included conditions such as VATER and OEIS associations, and Patau syndrome. Our findings validate the graph theory methods to study birth defect associations. This method may contribute to identify underlying etiopathogeneses as well as to improve coding systems.

Frontotemporal dementia (FTD) is the main differential diagnosis with early stages of Alzheimer’s disease (AD). Usually, differential diagnosis between a first depressive episode and the beginning of an early degenerative dementia with mood disorders, either AD or FTD, can be difficult. Objective: To evaluate the clinical characteristics of patients with senile and presenile onset dementia, to compare their neuropsychiatric and neuropsychological profiles according to onset age and to provide clinical approach. Methods: A two year prospective-retrospective study was conducted. All patients were evaluated with a complete neuropsychiatric and neuropsychological battery, laboratory tests and neuroimaging. Healthy control subjects were also studied. Results: Included 366 subjects were divided into over or under 65 years old, and then matched for educational level. AD was the most common cause of dementia in subjects over 65 years of age, followed by depression and FTD. Subjects younger than 65 years old, showed higher prevalence of depression followed by FTD, AD, and finally primary progressive aphasia (PPA). At younger ages, the highest severity of cognitive impairment, behavioral disorder and major depression were observed. Conclusion: Onset age of cognitive and/or behavioral impairment may be one of the variables influencing the clinical heterogeneity of dementias. Many of the young-onset dementias may be potentially reversible so, its early identification and pathophysiology understand, increase pharmacological intervention opportunities of halting the cascade of events that lead inexorably to dementia. In the new era of biomarkers, their help in identifying each clinical phenotype could encourage their best use in clinical practice and help selecting more accurate pharmacological treatment.