Summary: Researchers report personality changes that can result in behavioral changes may be an indicator of Alzheimer’s development in those with mild cognitive impairment.
A key feature of Alzheimer’s disease is memory loss and losing one’s ability to think and make decisions (also called “cognitive ability”). Those changes can begin slowly, during a phase called “mild cognitive impairment” (or MCI). A variety of diseases can cause MCI, but the most common is Alzheimer’s disease.
Not all people who have MCI develop Alzheimer’s disease–but if memory loss is a person’s key MCI symptom, and if that person’s genes (DNA) suggests they may be likely to develop Alzheimer’s disease, the risk for the condition can be as high as 90 percent.
Personality changes and behavior problems that come with Alzheimer’s disease are as troubling as memory loss and other mental difficulties for caregivers and those living with the condition. Mayo Clinic researchers wondered if personality changes that begin early, when MCI memory loss becomes noticeable, might help predict Alzheimer’s disease at its earliest stages. The researchers created a study to test their theory and published their findings in the Journal of the American Geriatrics Society.
Researchers recruited cognitively normal participants 21-years-old and older who were genetically more likely to develop Alzheimer’s disease. The recruitment period began in January 1994 and ended in December 2016. Researchers also recruited people without a genetic likelihood for developing Alzheimer’s disease to serve as a control group. All participants took several tests, including medical and neurological (or brain) exams. They were also screened for depression, as well as cognitive and physical function.
After analyzing results, the researchers concluded that personality changes, which can lead to changes in behavior, occur early on during the development of Alzheimer’s disease. The behavioral changes, however, may be barely noticeable, and can include mood swings, depression, and anxiety. They suggested that further research might be needed to learn whether diagnosing these early personality changes could help experts develop earlier, safer, and more effective treatments–or even prevention options–for the more severe types of behavior challenges that affect people with Alzheimer’s disease.
[cbtabs][cbtab title=”MLA”]AGS “Personality Changes During Transition to Developing MCI.” NeuroscienceNews. NeuroscienceNews, 23 January 2018. <https://neurosciencenews.com/mci-personality-changes-8359/>.[/cbtab][cbtab title=”APA”]AGS (2018, January 23). Personality Changes During Transition to Developing MCI. NeuroscienceNews. Retrieved January 23, 2018 from https://neurosciencenews.com/mci-personality-changes-8359/[/cbtab][cbtab title=”Chicago”]AGS “Personality Changes During Transition to Developing MCI.” https://neurosciencenews.com/mci-personality-changes-8359/ (accessed January 23, 2018).[/cbtab][/cbtabs]
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Background/Objectives Behavioral problems in individuals with Alzheimer’s disease (AD) impose major management challenges. Current prevention strategies are anchored to cognitive outcomes, but behavioral outcomes may provide another, clinically relevant opportunity for preemptive therapy. We sought to determine whether personality changes that predispose to behavioral disorders arise during the transition from preclinical AD to mild cognitive impairment (MCI).
Design Longitudinal observational cohort study.
Setting Academic medical center.
Participants Members of an apolipoprotein E (APOE) ɛ4 genetically enriched cohort of Maricopa County residents who were neuropsychiatrically healthy at entry (N = 277). Over a mean interval of 7 years, 25 who developed MCI and had the Neuroticism, Extraversion, and Openness Personality Inventory—Revised (NEO-PI-R) before and during the MCI transition epoch were compared with 252 nontransitioners also with serial NEO-PI-R administrations.
Intervention Longitudinal administration of the NEO-PI-R and neuropsychological test battery.
Measurements Change in NEO-PI-R factor scores (neuroticism, extraversion, openness, agreeableness, conscientiousness) from entry to the epoch of MCI diagnosis or an equivalent follow-up duration in nontransitioners.
Results NEO-PI-R neuroticism T-scores increased significantly more in MCI transitioners than in nontransitioners (mean 2.9, 95% confidence interval (CI) = 0.9–4.9 vs 0, 95% CI = −0.7–0.7, P = .02), and openness decreased more in MCI transitioners than in nontransitioners (−4.8, 95% CI = −7.3 to −2.4 vs −1.0, 95% CI = −1.6 to −0.4, P < .001). Concurrent subclinical but statistically significant changes in behavioral scores worsened more in MCI transitioners than nontransitioners for measures of depression, somatization, irritability, anxiety, and aggressive attitude.
Conclusion Personality and subclinical behavioral changes begin during the transition from preclinical AD to incident MCI and qualitatively resemble the clinically manifest behavioral disorders that subsequently arise in individuals with frank dementia.