A Canadian researcher is proposing a different way of diagnosing dementia at the earliest stage yet: not from patients’ disappearing memory but from their change in behaviour.

Mild Behavioural Impairment, or MBI, is considered to be the transitional state between normal aging and developing dementia. MBI has been proven to show the presence of neuropsychiatric symptoms that research has proposed increases the risk of developing dementia.

Research has shown that behaviour variations such as anxiety and mood changes develop in the transitional state but are often perceived as normal aging behaviours. These warning signs are what Dr. Zahinoor Ismail, of the Hotchkiss Brain Institute at the University of Calgary, believes he can use to diagnose those at early risk for dementia.

“In fact, they may be the earliest symptoms of dementia that we didn’t pay attention to before,” said Ismail, who presented his findings Sunday to 5,000 scientists and researchers from around the world at the Alzheimer's Association International Conference in Toronto.

A 34-question checklist was developed by a Calgary clinic to look for sustained and unusual changes in an older person’s behaviour. These can include a loss of interest in family and friends, becoming more anxious or argumentative, saying crude or rude comments and talking to strangers as if they are familiar.

The checklist is already being used in Calgary, where Ismail is a practicing psychiatrist specializing in Alzheimer’s disease.

“Based off previous studies, even one symptom has been shown to increase the risk of cognitive decline,” Ismail told CTV News.  

The use of MBI to diagnose early dementia has also changed the way dementia is defined. It now encompasses the behavioural changes that often predate cognitive changes.

The checklist was designed to be given to the families of older people and has helped capture symptoms that families thought were unusual but had trouble defining or did not think were serious enough to go to the doctor for.

“The caregiver is often a better source of information than the person themselves,” said Larry Chambers of the Alzheimer Society of Canada. “They may deny or not recognize it as a change in their behaviour.”

Maria Carrillo, the chief science officer at the Alzheimer’s Association, said it’s time for the medical community at large to “weigh in” on the checklist and give feedback.

“It’s so exciting to discuss a different way to detect dementia much earlier than ever before,” she told CTV News

There is not yet a treatment for MBI but early diagnosis does raise the potential that some of the behaviours could be treated with dementia medications or Alzheimer’s therapies, as the behaviours then rise from the brain disease.

Some of the symptoms listed in the checklist, however, could mimic symptoms of other psychiatric problems or drug interactions, both of which can be treated on their own.

The checklist questions include:

  • Has the person lost interest in friends, family or home activities?
  • Has the person become less spontaneous and active -- for example, is he/she less likely to initiate or maintain conversation?
  • Has the person become more anxious or worried about things that are routine, like events, visits?
  • Does the person feel very tense, having developed an inability to relax, or shakiness, or symptoms of panic?
  • Has the person become agitated, aggressive, irritable or temperamental?
  • Does the person hoard objects when she/he did not do so before?

According to Ismail, MBI will require more research and routine testing on the brain while patients are in this state before it will be integrated into more clinics.

As of 2016, an estimated 564,000 people are living with dementia in Canada, with 25,000 new cases each year, according to the Alzheimer Society of Canada.

With a report by CTV medical specialist Avis Favaro and producer Elizabeth St. Phili and files from The Associated Press