Summary: Despite popular belief, researchers have found no evidence that personality changes appear prior to the onset of dementia. The findings are published in JAMA Psychiatry.
Source: Florida State University.
For years, scientists and physicians have been debating whether personality and behavior changes might appear prior to the onset of Alzheimer’s disease and related dementias.
Now, the findings of a new and comprehensive study from FSU College of Medicine Associate Professor Antonio Terracciano and colleagues, published today in the journal JAMA Psychiatry, has found no evidence to support the idea that personality changes begin before the clinical onset of mild cognitive impairment (MCI) or dementia.
“We further found that personality remained stable even within the last few years before the onset of mild cognitive impairment,” Terracciano said.
Terracciano, College of Medicine Associate Professor Angelina Sutin and co-authors from the National Institute on Aging examined data from the Baltimore Longitudinal Study of Aging. The study looked at personality and clinical assessments obtained between 1980 and July 2016 from more than 2,000 individuals who initially showed no cognitive impairment.
About 18 percent of study participants later developed MCI or dementia.
“We compared whether personality change in people who later developed dementia differed from those who remained cognitively normal,” Terracciano said. “Unlike previous research, this study examined multiple waves of self-rated personality data collected up to 36 years before participants developed any sign of dementia.”
What the researchers found is that the trajectory of personality traits did not differ between those who would later develop dementia and those who did not.
While personality change was not an early sign of dementia, Terracciano’s study provides further support that personality traits (including high levels of neuroticism and low levels of conscientiousness) are risk factors for dementia.
For physicians and loved ones, personality changes remain an important consideration in the care of those who have already experienced the clinical onset of MCI or dementia. Increasing apathy, irritability, mood changes and other behavioral symptoms impact quality of life for both patients and their caregivers.
Source: Doug Carlson – Florida State University
Image Source: NeuroscienceNews.com image is credited to Aronowski lab, University of Texas Health Science Center, Houston.
Original Research: Abstract for “Personality Change in the Preclinical Phase of Alzheimer Disease” by Antonio Terracciano, PhD; Yang An, MS; Angelina R. Sutin, PhD; Madhav Thambisetty, MD; and Susan M. Resnick, PhD in JAMA Psychiatry. Published online September 20 2017 doi:10.1001/jamapsychiatry.2017.2816
Personality Change in the Preclinical Phase of Alzheimer Disease
Importance Changes in behavior and personality are 1 criterion for the diagnosis of dementia. It is unclear, however, whether such changes begin before the clinical onset of the disease.
Objective To determine whether increases in neuroticism, declines in conscientiousness, and changes in other personality traits occur before the onset of mild cognitive impairment or dementia.
Design, Setting, and Participants A cohort of 2046 community-dwelling older adults who volunteered to participate in the Baltimore Longitudinal Study of Aging were included. The study examined personality and clinical assessments obtained between 1980 and July 13, 2016, from participants with no cognitive impairment at first assessment who were followed up for as long as 36 years (mean [SD], 12.05 [9.54] years). The self-report personality scales were not considered during consensus diagnostic conferences.
Main Outcomes and Measures Change in self-rated personality traits assessed in the preclinical phase of Alzheimer disease and other dementias with the Revised NEO Personality Inventory, a 240-item questionnaire that assesses 30 facets, 6 for each of the 5 major dimensions: neuroticism, extraversion, openness, agreeableness, and conscientiousness.
Results Of the 2046 participants, 931 [45.5%] were women; mean (SD) age at first assessment was 62.56 (14.63) years. During 24 569 person-years, mild cognitive impairment was diagnosed in 104 (5.1%) individuals, and all-cause dementia was diagnosed in 255 (12.5%) participants, including 194 (9.5%) with Alzheimer disease. Multilevel modeling that accounted for age, sex, race, and educational level found significant differences on the intercept of several traits: individuals who developed dementia scored higher on neuroticism (β = 2.83; 95% CI, 1.44 to 4.22; P < .001) and lower on conscientiousness (β = −3.34; 95% CI, −4.93 to −1.75; P < .001) and extraversion (β = −1.74; 95% CI, −3.23 to −0.25; P = .02). Change in personality (ie, slope), however, was not significantly different between the nonimpaired and the Alzheimer disease groups (eg, neuroticism: β = 0.00; 95% CI, −0.08 to 0.08; P = .91; conscientiousness: β = −0.06; 95% CI, −0.16 to 0.04; P = .24). Slopes for individuals who developed mild cognitive impairment (eg, neuroticism: β = 0.00; 95% CI, −0.12 to 0.12; P = .98; conscientiousness: β = −0.09; 95% CI, −0.23 to 0.05; P = .18) and all-cause dementia (eg, neuroticism: β = 0.02; 95% CI, −0.06 to 0.10; P = .49; conscientiousness: β = −0.08; 95% CI, −0.16 to 0.00; P = .07) were also similar to those for nonimpaired participants.
Conclusions and Relevance No evidence for preclinical change in personality before the onset of mild cognitive impairment or dementia was identified. These findings provide evidence against the reverse causality hypothesis and strengthen evidence for personality traits as a risk factor for dementia.
“Personality Change in the Preclinical Phase of Alzheimer Disease” by Antonio Terracciano, PhD; Yang An, MS; Angelina R. Sutin, PhD; Madhav Thambisetty, MD; and Susan M. Resnick, PhD in JAMA Psychiatry. Published online September 20 2017 doi:10.1001/jamapsychiatry.2017.2816