• apathy
• global functioning
• mild behavioral impairment
• neuropsychiatric symptoms
• old age

Background: Neuropsychiatric symptoms (NPS) are frequent in dementia and in pre-dementia states. They were included in the construct of Mild Behavioral Impairment (MBI), but literature on the pre-dementia stages is still limited. We investigated the relationship between MBI and both clinical presentation and functioning in an elderly population referred to outpatient psychiatric service. Methods: A prospective longitudinal study was performed in a sample of 144 patients aged ≥ 50 with either psychiatric disorders (PSY), MBI or dementia (DEM). Changes in symptoms severity and functioning were assessed at least after three-months of follow-up. We evaluated MBI symptoms, cognitive performances, severity of psychopathology, and overall functioning using MBI-C, MMSE, BPRS, CGI, GAF scales. Results: DEM patients reported the highest BPRS-Total, Psychosis, Activation, Negative Symptoms scores; MBI patients showed higher BPRS-Negative Symptoms than PSY ones. At follow-up, only PSY showed reduced BPRS and CGI-S, and increased GAF scores. No significant changes resulted at BPRS, CGI and GAF scores in MBI patients. Conclusions: The presence of MBI affects both clinical and functional short-term outcomes. The recognition of patients with MBI symptoms, including apathy, might be useful for the differential diagnosis with chronic psychiatric symptoms and for the early detection of individuals at risk of dementia.