Neuropsychiatric symptoms relate to everyday functioning as reported by cognitively unimpaired older adults and their study partners.

INTRODUCTION: Neuropsychiatric symptoms and changes in everyday functioning emerge early in Alzheimer's disease, but the relationships among these signs are rarely considered. We aimed to examine associations between neuropsychiatric symptoms and daily functioning in cognitively unimpaired older adults. METHODS: 178 participants (70.4 ± 6.1 years; 62% female) and their study partners completed the Mild Behavioral Impairment Checklist (MBI-C) and Alzheimer's Disease Cooperative Study Activities of Daily Living Prevention Instrument (ADCS ADL-PI). We investigated associations between self- and study partner-reported MBI-C and ADCS ADL-PI. RESULTS: Higher study partner-reported MBI-C scores were associated with lower participant-reported (estimate [B] = -0.51, 95% confidence interval [CI] [-0.68, -0.34]) and study partner-reported (B = -0.50, 95% CI [-0.66, -0.34]) ADCS ADL-PI scores. Similar associations were apparent between participant-reported MBI-C and participant- and study partner-reported ADCS ADL-PI. DISCUSSION: Neuropsychiatric symptoms relate to daily functioning in cognitively unimpaired older adults. Early detection and management of these symptoms may improve the quality of life and sensitivity of clinical trial outcomes. HIGHLIGHTS: Neuropsychiatric symptoms relate to worse daily function in unimpaired older adults.Difficulties with motivation and emotional regulation were the strongest predictors.Associations were seen with both self-reported and study partner-reported measures.