Reliability and Validity of the Traditional Chinese Version of the Mild Behavioral Impairment – Checklist Among Persons With Mild Cognitive Impairment – A Validation Study
Restricted accessResearch articleFirst published online January, 2023
Reliability and Validity of the Traditional Chinese Version of the Mild Behavioral Impairment – Checklist Among Persons With Mild Cognitive Impairment – A Validation Study
To evaluate the reliability and validity of the traditional Chinese version of the Mild Behavioral Impairment Checklist (MBI-C) among Hong Kong Chinese with mild cognitive impairment (MCI).
Methods
A total of 172 participants were recruited from 2 community facilities. Cronbach’s alpha (α) was calculated to evaluate internal consistency. Intra-class correlation coefficient (ICC) was used to measure 2-week test–retest reliability. Construct validity was evaluated by conducting exploratory factor analysis to identify the internal structure of MBI-C, and assessing the correlation between theoretically related constructs, including objective and subjective cognitive impairment, neurotic personality, social supports, and maladaptive coping. Concurrent validity was assessed by its correlation with Neuropsychiatric Inventory Questionnaire (NPI-Q).
Results
The results revealed good internal consistency and test-retest reliability of the MBI-C. Item analysis identified 4 items with low item-to-total correlations. The EFA identified a seven-factor structure. Hypothesis testing identified its significant correlations with subjective cognitive impairment, neurotic personality, social supports, and maladaptive coping. Concurrent validity was supported by its significant correlation with the NPI-Q.
Conclusions
The traditional Chinese version of MBI-C is a valid and reliable outcome measure to assess the severity of neuropsychiatric symptoms of the MCI population.
GuerchetMPrinceMPrinaM. Numbers of People with Dementia Worldwide: An Update to the Estimates in the World Alzheimer Report 2015. London: Alzhimer’s Disease International; 2020.
2.
ZhuCWScarmeasNOrnsteinK, et al.Health-care use and cost in dementia caregivers: Longitudinal results from the predictors caregiver study. Alzheimers Dement. 2015;11(4):444-454.
3.
LivingstonGSommerladAOrgetaVCostafredaSGHuntleyJAmesD, et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673-2734.
4.
World Health Organization. Global Action Plan on the Public Health Response to Dementia 2017–2025. Genava, Switzerland: WHO; 2017:9241513489.
5.
PetersenRCLopezOArmstrongMJ, et al.Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126-135.
6.
OrgetaVQaziASpectorAOrrellM. Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: systematic review and meta-analysis. Br J Psychiatry. 2015;207(4):293-298.
7.
LinRSYYuDSFLiPWCMasikaGM. The effectiveness of non‐pharmacological interventions targeting neuropsychiatric symptoms among persons with preclinical and mild dementia: A systematic review and network meta‐analysis. Int J Geriatr Psychiatr. 2020.
8.
TibleOPRieseFSavaskanEvon GuntenA. Best practice in the management of behavioural and psychological symptoms of dementia. Ther Adv Neurol Disord. 2017;10(8):297-309.
9.
MartinEVelayudhanL. Neuropsychiatric symptoms in mild cognitive impairment: A literature review. Dement Geriatr Cogn Disord. 2020;49(2):146-155.
10.
BárriosHNarcisoSGuerreiroMMarocoJLogsdonRde MendonçaA. Quality of life in patients with mild cognitive impairment. Aging Ment Health. 2013;17(3):287-292.
11.
LindberghCADishmanRKMillerLS. Functional disability in mild cognitive impairment: A systematic review and meta-analysis. Neuropsychol Rev. 2016;26(2):129-159.
12.
RobertoNPortellaMJMarquiéM, et al.Neuropsychiatric profiles and conversion to dementia in mild cognitive impairment, a latent class analysis. Sci Rep. 2021;11(1):6448-6449.
13.
IsmailZAgüera-OrtizLBrodatyH, et al.The Mild Behavioral Impairment Checklist (MBI-C): a rating scale for neuropsychiatric symptoms in pre-dementia populations. J Alzheimers Dis. 2017;56(3):929-938.
14.
SiafarikasNSelbaekGFladbyTŠaltytė BenthJAuningEAarslandD. Frequency and subgroups of neuropsychiatric symptoms in mild cognitive impairment and different stages of dementia in Alzheimer's disease. Int Psychogeriatr. 2018;30(1):103-113.
15.
HallGRBuckwalterKC. Progressively lowered stress threshold: A conceptual model for care of adults with Alzheimer's disease. Arch Psychiatr Nurs. 1987;1(6):399-406.
16.
LinRSYYuDSFLiPWCChauPHLeeJJ. Lived experience of neuropsychiatric symptoms among females with mild cognitive impairment: A phenomenological study. J Adv Nurs2021.
17.
Mendez RubioMAntoniettiJPDonatiARossierJVon GuntenA. Personality traits and behavioural and psychological symptoms in patients with mild cognitive impairment. Dement Geriatr Cogn Disord. 2013;35(1-2):87-97.
18.
NeupertSDMroczekDKSpiroAIII. Neuroticism Moderates the Daily Relation between Stressors and Memory Failures. Psychology and Aging2008;23(2):287-296.
19.
Agϋera‐OrtizLLyketsosCIsmailZ. Comment on “personality changes during the transition from cognitive health to mild cognitive impairment”. J Am Geriatr Soc. 2019;67(1):190-191.
20.
CummingsJLMegaMGrayKRosenberg-ThompsonSCarusiDAGornbeinJ. The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308-2314.
21.
CummingsJL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997;48(suppl 5-6):S10-S16.
22.
IsmailZSmithEEGedaY, et al.Neuropsychiatric symptoms as early manifestations of emergent dementia: provisional diagnostic criteria for mild behavioral impairment. Alzheimers Dement. 2016;12(2):195-202.
23.
GillSWangMMouchesP, et al.. Neural correlates of the impulse dyscontrol domain of mild behavioral impairment. Int J Geriatr Psychiatr. 2021.
24.
MiaoRChenH-YGillS, et al.. Plasma β-amyloid in mild behavioural impairment–neuropsychiatric symptoms on the Alzheimer’s continuum. J Geriatr Psychiatr Neurol. 2021:08919887211016068.
25.
NaudeJPGillSHuS, et al.Plasma neurofilament light: a marker of neurodegeneration in mild behavioral impairment. J Alzheimers Dis. 2020;76(3):1017-1027.
26.
CreeseBArathimosRBrookerH, et al.Genetic risk for Alzheimer's disease, cognition, and mild behavioral impairment in healthy older adults. Alzheimer's Dementia: Diagnosis, Assessment & Disease Monitoring. 2021;13(1):e12164.
27.
IsmailZMcGirrAGillSHuSForkertNDSmithEE. Mild behavioral impairment and subjective cognitive decline predict cognitive and functional decline. J Alzheimers Dis. 2021;80(1):459-469.
28.
CreeseBBrookerHIsmailZ, et al.Mild behavioral impairment as a marker of cognitive decline in cognitively normal older adults. Am J Geriatr Psychiatr. 2019;27(8):823-834.
29.
XuLLiTXiongL, et al.Reliability and Validity of the chinese version of mild behavioral impairment checklist in mild cognitive impairment and mild Alzheimer’s disease. J Alzheim Dis. 2021(Preprint):1-9.
30.
MalloSCIsmailZPereiroAX, et al.Assessing mild behavioral impairment with the mild behavioral impairment checklist in people with subjective cognitive decline. Int Psychogeriatr. 2019;31(2):231-239.
31.
KangYChinJHanN, et al.Mild behavioral impairment (MBI) in MCI, SCD, and normal elderly: A pilot study for validation of the mild behavioral impairment checkLIST (MBI-C). Alzheimer's Dementia. 2018;14(7):P793-P793.
32.
MalloSCIsmailZPereiroAX, et al.Assessing mild behavioral impairment with the mild behavioral impairment-checklist in people with mild cognitive impairment. J Alzheimers Dis. 2018;66(1):83-95.
33.
CuiYDaiSMiaoZ, et al.Reliability and validity of the chinese version of the mild behavioral impairment checklist for screening for Alzheimer's disease. J Alzheimers Dis. 2019;70(3):747-756.
34.
SuH-YChunC-C. Chineseness, Taiwaneseness, and the traditional and simplified Chinese scripts:Tourism, identity, and linguistic commodification. Lang Commun. 2021;77:35-45.
35.
LiuTHsiaoJ. The perception of simplified and traditional Chinese characters in the eye of simplified and traditional Chinese readers. In: Proceedings of the Annual Meeting of the Cognitive Science Society 2012.Sapporo, Japan, 1–4 Aug 2012.
36.
GuanYDengHBondMH. Examining stereotype content model in a Chinese context: Inter-group structural relations and Mainland Chinese's stereotypes towards Hong Kong Chinese. Int J Intercult Relat. 2010;34(4):393-399.
37.
PetersenRC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256(3):183-194.
38.
YeungPYWongLLChanCCLeungJLYungCY. A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong. Hong Kong Med J. 2014;20(6):504-510.
39.
PolitDF. Getting serious about test-retest reliability: a critique of retest research and some recommendations. Qual Life Res. 2014;23(6):1713-1720.
40.
MacCallumRCWidamanKFZhangSHongS. Sample size in factor analysis. Psychol Methods. 1999;4(1):84-99.
41.
BonettDG. Sample size requirements for testing and estimating coefficient alpha. J Educ Behav Stat. 2002;27(4):335-340.
42.
LuiVWLamLCChiuHF. Validation of a memory inventory for the assessment of awareness of memory deficits in Alzheimer's disease in Chinese elderly. Int J Geriatr Psychiatr. 2006;21(10):917-923.
43.
WongAChengSTLoES, et al.Validity and reliability of the neuropsychiatric inventory questionnaire version in patients with stroke or transient ischemic attack having cognitive impairment. J Geriatr Psychiatr Neurol. 2014;27(4):247-252.
44.
XieY. Reliability and validity of the simplified coping style questionnaire. Chin J Clin Psychol. 1998.
45.
ChouK-L. Assessing Chinese adolescents' social support: The multidimensional scale of perceived social support. Pers Indiv Differ. 2000;28(2):299-307.
NunnallyJC. Psychometric Theory 3E. New York, NY: Tata McGraw-hill education; 1994.
48.
TerweeCBBotSDde BoerMR, et al.Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.
49.
FieldA. Discovering Statistics Using IBM SPSS Statistics. Thousand Oaks, CA: sage; 2013.
50.
HripcsakGHeitjanDF. Measuring agreement in medical informatics reliability studies. J Biomed Inf. 2002;35(2):99-110.
51.
KaiserHF. An index of factorial simplicity. Psychometrika. 1974;39(1):31-36.
52.
LedesmaRDValero-MoraPMacbethG. The scree test and the number of factors: a dynamic graphics approach. Spanish J Psychol. 2015;18:E11.
53.
StevensJP. Applied Multivariate Statistics for the Social Sciences. London, UK: Routledge; 2012.
MatsunagaM. How to factor-analyze your data right: do's, don'ts, and how-To's. Int J Psychol Res. 2010;3(1):97-110.
56.
DanceyCPReidyJ. Statistics without Maths for Psychology. London, UK: Pearson education; 2007.
57.
CuiYDaiSMiaoZ, et al.Reliability and validity of the chinese version of the mild behavioral impairment checklist for screening for Alzheimer's disease. J Alzheimers Dis. 2019;70(3):747-756.
58.
RaghupathiVRaghupathiW. The influence of education on health: An empirical assessment of OECD countries for the period 1995-2015. Arch Publ Health. 2020;78(1):20.
59.
MengXD'ArcyC. Education and dementia in the context of the cognitive reserve hypothesis: A systematic review with meta-analyses and qualitative analyses. PLoS One. 2012;7(6):e38268.
60.
KalesHCGitlinLNLyketsosCG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ. 2015;350:h369.
61.
GórskaSForsythKMaciverD. Living with dementia: A meta-synthesis of qualitative research on the lived experience. Gerontol. 2018;58(3):e180-e196.
62.
GaoEZuoXWangLLouCChengYZabinLS. How does traditional Confucian culture influence adolescents' sexual behavior in three Asian cities?J Adolesc Health. 2012;50(3):S12-S17.
63.
ChenX. Culture and shyness in childhood and adolescence. New Ideas Psychol. 2019;53:58-66.
64.
KovachCRNoonanPESchlidtAMWellsT. A model of consequences of need-driven, dementia-compromised behavior. J Nurs Scholarsh. 2005;37(2):134-140.
65.
Cohen-MansfieldJDakheel-AliMMarxMSTheinKRegierNG. Which unmet needs contribute to behavior problems in persons with advanced dementia?Psychiatr Res. 2015;228(1):59-64.
66.
PetersenRCCaraccioloBBrayneCGauthierSJelicVFratiglioniL. Mild cognitive impairment: A concept in evolution. J Intern Med. 2014;275(3):214-228.
67.
AubutVWagnerVCousineauMMBertrandK. Problematic substance use, help-seeking, and service utilization trajectories among seniors: An exploratory qualitative study. J Psychoact Drugs. 2021;53(1):18-26.
68.
NicoliniHSalin-PascualRCabreraBLanzagortaN. Influence of culture in obsessive-compulsive disorder and its treatment. Curr Psychiatr Rev. 2017;13(4):285-292.
69.
WilliamsMSteeverA. Cultural Manifestations of Obsessive-Compulsive Disorder. Obsessive-Compulsive Disorder: Etiology, Phenomenology, and Treatment United Kingdom. England, UK: Onus Books; 2015:63-84.
70.
JinyaoYXiongzhaoZAuerbachRP, et al.Insecure attachment as a predictor of depressive and anxious symptomology. Depress Anxiety. 2012;29(9):789-796.
71.
TorrisiMCacciolaAMarraADe LucaRBramantiPCalabròRS. Inappropriate behaviors and hypersexuality in individuals with dementia: An overview of a neglected issue. Geriatr Gerontol Int. 2017;17(6):865-874.
72.
GildengersAGButtersMAAlbertSM, et al.Design and implementation of an intervention development study: Retaining cognition while avoiding late-life depression (ReCALL). Am J Geriatr Psychiatr. 2016;24(6):444-454.
73.
O’ConnorSRConnaghanJMaguireR, et al.Healthcare professional perceived barriers and facilitators to discussing sexual wellbeing with patients after diagnosis of chronic illness: A mixed-methods evidence synthesis. Patient Education and Counseling. 2019;102(5):850-863.
74.
LiJQTanLWangHF, et al.Risk factors for predicting progression from mild cognitive impairment to Alzheimer's disease: A systematic review and meta-analysis of cohort studies. J Neurol Neurosurg Psychiatry. 2016;87(5):476-484.
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