A 7-Year Study of Behavioral, Psychological and Personality Changes in Older Adults

INTRODUCTION: Behavioral changes may precede dementia and complement cognitive aging as indicators of brain health. Mild Behavioral Impairment (MBI) captures late-life behavioral, psychological and personality changes linked to dementia risk, yet trajectories remain unclear. This study examined behavioral change over time and its association with subjective cognitive impairment (SCI) and APOE status.METHODS: Data from dementia-free older adults in the PROTECT Study were analyzed longitudinally. MBI Checklist scores were modeled using zero-inflated negative binomial models to estimate symptom trajectories and probability of remaining symptom-free.RESULTS: Behavioral symptoms increased non-linearly with age, alongside reduced likelihood of remaining symptom-free. SCI and APOE were linked to higher symptom levels, with distinct patterns between self- and proxy-reports.DISCUSSION: Findings indicate behavioral changes evolve with aging and are shaped by dementia risk factors. Differences between reporting sources highlight complementary perspectives on decline. Integrating behavioral monitoring with cognitive assessment may enhance early risk identification and guide preventive strategies.