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Henriques-Calado J. Personality traits and disorders in Alzheimer's disease. Brain Behav 2023; 13:e2938. [PMID: 36919197 PMCID: PMC10097140 DOI: 10.1002/brb3.2938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The relationships between axis II personality disorders and the normative personality traits were explored in the context of current and pre-morbid personality assessment in Alzheimer's disease (AD). METHODS The study was conducted with four groups who were administered the NEO-FFI and the PDQ-4+, in the form of individual interview sessions. Current personality measure: consisting of 44 female participants (AD group) and, the control group, consisting of 80 female participants from the population at large. Pre-morbid personality measure: AD group informants (n = 40); control group informants (n = 42). RESULTS The results are in line with the literature review and provide new research data. By factorial discriminant analysis, the current and pre-morbid personality variables that differentiate AD from control groups are identified. The personality traits variables are the best discriminators such as low agreeableness, low openness to experience, and high neuroticism, suggesting that the maladaptive personality functioning can be described extending the range of psychopathology to a dimensional approach. CONCLUSIONS The study of personality variables seems to suggest, in their inclusion, the possibility to increase sensitivity toward an assessment in AD.
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Affiliation(s)
- Joana Henriques-Calado
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal.,CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal
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Gabb L, Nicholas H, Abraham R, Prakash V, Boothby H. Do personality traits modify susceptibility to amyloid load in patients with mild cognitive impairment and dementia? A pilot study. Int J Geriatr Psychiatry 2021; 37. [PMID: 34632618 DOI: 10.1002/gps.5632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Rajesh Abraham
- Guildford and Waverley CMHTOP, Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, UK
| | - Vineet Prakash
- Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Harry Boothby
- Guildford and Waverley CMHTOP, Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, UK
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Henriques-Calado J, Duarte-Silva ME. The predictive power of personality through psychopathology in Alzheimer's disease: a control study of self-report and baseline retrospective assessment. PSYCHOL HEALTH MED 2020; 25:1144-1152. [PMID: 32101020 DOI: 10.1080/13548506.2020.1734218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although there is a growing body of literature on the Alzheimer's disease (AD) personality changes, its relationships with personality disorders are still largely understudied. The relationships between the Five-Factor Model and the Axis II personality disorders were explored in the context of current and baseline personality in AD. The study was conducted with four groups who were administered the NEO-FFI and the PDQ-4+, mainly in interview sessions. Self-report measurement: AD Group, 40 female participants (M = 81.48 years); Control Group, 47 female participants from the population at large (M = 76.81 years). Baseline retrospective measurement: AD Group Informants (n = 40); Control Group Informants (n = 47). Three logistic regressions were computed. The baseline Neuroticism moderates the Neuroticism in the current clinical state. High Neuroticism, low Openness, high Cluster B, and baseline high Neuroticism, predicted the presence of AD diagnosis, accounting for 85% of the variance. In order to increase sensitivity towards an earlier diagnosis in AD, future empirically-based research should take into account an assessment set of structural personality variables.
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Affiliation(s)
- Joana Henriques-Calado
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade , Lisboa, 1649-013, Portugal.,CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade , Lisboa, 1649-013, Portugal
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Henriques-Calado J, Duarte-Silva ME. Personality disorders characterized by anxiety predict Alzheimer's disease in women: A case-control studies. THE JOURNAL OF GENERAL PSYCHOLOGY 2019; 147:414-431. [PMID: 31833453 DOI: 10.1080/00221309.2019.1697637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This research is geared toward the evaluation of current and pre-morbid personality psychopathology in Alzheimer's disease (AD). The study was conducted with four groups who were administered the Personality Diagnostic Questionnaire-4+, mainly in the form of individual interviews. Current measurement: AD Group, 44 female participants (M = 81.36 years); Control Group, 80 female participants from the population at large (M = 75.84 years). Pre-morbid measurement: AD Group Informants (n = 40); Control Group Informants (n = 42). The incidence of all clusters in clinical state are significant, and Cluster B incidence in pre-morbidity is evidenced. Cluster C is highlighted throughout the life course as a predictor. Logistic regression analyses showed that schizotypical, narcissistic, avoidant, obsessive-compulsive, pre-morbid schizotypical, pre-morbid histrionic, and pre-morbid obsessive-compulsive personality disorders, predicted the presence of AD diagnosis, accounting for 49% of the variance. These findings are relevant to research relating personality and psychopathology in Alzheimer's disease.
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Abstract
The objective of this article is to review and integrate interrelated areas of research on personality and Alzheimer's disease (AD). Prospective studies indicate that individuals who score higher on conscientiousness (more responsible and self-disciplined) and lower on neuroticism (less anxious and vulnerable to stress) have a reduced risk of developing dementia, even in the presence of AD neuropathology. Personality is also related to measures of cognitive performance and cognitive decline, with effect sizes similar to those of other clinical, lifestyle, and behavioral risk factors. These associations are unlikely to be due to reverse causality: Long-term prospective data indicate that there are no changes in personality that are an early sign of the disease during the preclinical phase of AD. With the onset and progression of dementia, however, there are large changes in personality that are reported consistently by caregivers in retrospective studies and are consistent with the clinical criteria for the diagnosis of dementia. The review also discusses potential mechanisms of the observed associations and emphasizes the need for prospective studies to elucidate the interplay of personality traits with AD neuropathology (amyloid and tau biomarkers) in modulating the risk and timing of onset of clinical dementia. The article concludes with the implications of personality research for identifying those at greater risk of AD and the potential of personality-tailored interventions aimed at the prevention and treatment of AD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Science and Social Medicine, Florida State University College of Medicine
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Henriques-Calado J, Duarte-Silva ME, Sousa Ferreira A. Depressive vulnerability in women with Alzheimer's disease: Relationship with personality traits and abnormal personality dimensions. J Affect Disord 2018; 241:182-191. [PMID: 30125822 DOI: 10.1016/j.jad.2018.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/18/2018] [Accepted: 08/04/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND This study sought to determine the evaluation of current and pre-morbid depressive vulnerability dimensions in Alzheimer's disease. Sidney Blatt´s personality developmental perspective, the Five-Factor model and Axis II personality disorders were taken as references. METHODS The study was conducted with two groups which were assessed using the Depressive Experiences Questionnaire, the NEO-FFI and the Personality Diagnostic Questionnaire-4+, in the form of individual interview sessions. Current personality measure: Alzheimer's disease Group, consisting of 44 female participants (MAge = 81.36 years); Pre-morbid personality measure: Alzheimer's disease Group Informants (n = 40). RESULTS Self-Criticism personality vulnerability is a general indicator of psychopathology. In pre-morbidity, Neuroticism (β = 0.41), Agreeableness (β = -0.63) and Conscientiousness (β = -0.08) predicted Self-Criticism, explaining 64% of the variance; additionally, Self-Criticism (β = 0.72) and Neediness (β = 2.05) predicted the PDQ-4+ total, explaining 58% of the variance. In terms of current personality, the PDQ-4+ total was predicted by Self-Criticism (β = 0.55), explaining 30% of the variance. LIMITATIONS The small size of the samples, especially since it is difficult to access individuals diagnosed with AD at the onset or in its early stages; measuring personality changes by means of retrospective assessment by proxies may have introduced some memory bias. CONCLUSIONS These findings are relevant to research relating depressive vulnerability to personality traits and psychopathology in Alzheimer's disease.
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Affiliation(s)
- Joana Henriques-Calado
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal.
| | | | - Ana Sousa Ferreira
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; Instituto Universitário de Lisboa - Business Research Unit (BRU-IUL), Portugal.
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Yoneda T, Rush J, Berg AI, Johansson B, Piccinin AM. Trajectories of Personality Traits Preceding Dementia Diagnosis. J Gerontol B Psychol Sci Soc Sci 2017; 72:922-931. [PMID: 26945005 PMCID: PMC5927080 DOI: 10.1093/geronb/gbw006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/13/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Several retrospective studies using informant report have shown that individuals with dementia demonstrate considerable personality change. Two prospective studies, also using informant report, have shown that individuals who develop dementia show some personality changes prior to diagnosis. The current study is the first to assess personality trait change prior to dementia diagnosis using self-report measures from longitudinal data. METHOD This study used data from the Swedish OCTO-Twin Study, a longitudinal panel of 702 twins aged 80 and older. Analysis was restricted to 86 individuals who completed the Eysenck Personality Inventory and received a dementia diagnosis during follow-up occasions. Latent growth curve analyses were used to examine trajectories of extraversion and neuroticism preceding dementia diagnosis. RESULTS Controlling for sex, age, education, depressive symptoms, and the interaction between age and education, growth curve analyses revealed a linear increase in neuroticism and stability in extraversion. Individuals who were eventually diagnosed with dementia showed a significant increase in neuroticism preceding diagnosis of dementia. DISCUSSION Personality change, specifically an increase in neuroticism, may be an early indicator of dementia. Identification of early indicators of dementia may facilitate development of screening assessments and aid in early care strategies and planning.
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Affiliation(s)
- Tomiko Yoneda
- Department of Psychology, University of Victoria, British Columbia, Canada
- Anne Ingeborg Berg and Boo Johansson, Department of Psychology, University of Gothenburg, Sweden
| | - Jonathan Rush
- Department of Psychology, University of Victoria, British Columbia, Canada
- Anne Ingeborg Berg and Boo Johansson, Department of Psychology, University of Gothenburg, Sweden
| | - Anne Ingeborg Berg
- Anne Ingeborg Berg and Boo Johansson, Department of Psychology, University of Gothenburg, Sweden
| | - Boo Johansson
- Anne Ingeborg Berg and Boo Johansson, Department of Psychology, University of Gothenburg, Sweden
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
- Anne Ingeborg Berg and Boo Johansson, Department of Psychology, University of Gothenburg, Sweden
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Henriques-Calado J, Duarte-Silva ME, Sousa Ferreira A. Anaclitic personality dimension in women with Alzheimer's disease: Comparison with control groups. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Personality traits in women with Alzheimer's disease: Comparisons with control groups with the NEO-FFI. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.06.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Prior J, Abraham R, Nicholas H, Chan T, Vanvlymen J, Lovestone S, Boothby H. Are premorbid abnormal personality traits associated with behavioural and psychological symptoms in dementia? Int J Geriatr Psychiatry 2016; 31:1050-5. [PMID: 26968137 DOI: 10.1002/gps.4418] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/03/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The study aims to investigate associations between behavioural and psychological symptoms of dementia (BPSD) and abnormal premorbid personality traits. METHODS Data were obtained from 217 patients with a diagnosis of probable Alzheimer's disease. Behavioural and psychological symptoms of late-onset dementia were assessed with the Neuropsychiatric Inventory. Premorbid personality traits were assessed using the Standardised Assessment of Personality. Abnormal premorbid personality traits were categorised with Diagnostic and Statistical Manual of Mental Disorders fourth edition and International Statistical Classification of Diseases and Related Health Problems-10 diagnostic criteria for personality disorders. RESULTS Abnormal premorbid personality traits were associated with increased behavioural and psychological symptoms in dementia. Cluster A (solitary/paranoid) premorbid personality traits were associated with anxiety, depression and hallucinations. Cluster C (anxious/dependent) traits were associated with a syndrome of depression. CONCLUSIONS The presence of Clusters A (solitary/paranoid) and C (anxious/dependent) abnormal premorbid personality traits seems to affect the expression of certain behavioural and psychological symptoms in dementia, depression in particular. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Jack Prior
- Department of Old Age Psychiatry, Godalming, Surrey, UK
| | | | - Helen Nicholas
- Department of Psychology, University of Worcester, Worcester, UK
| | - Tom Chan
- University of Surrey, Guildford, UK
| | | | | | - Harry Boothby
- Department of Old Age Psychiatry, Godalming, Surrey, UK
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Pilleron S, Clément JP, Ndamba-Bandzouzi B, Mbelesso P, Dartigues JF, Preux PM, Guerchet M. Is dependent personality disorder associated with mild cognitive impairment and dementia in Central Africa? A result from the EPIDEMCA programme. Int Psychogeriatr 2014; 27:1-10. [PMID: 25177857 DOI: 10.1017/s104161021400180x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACT Background: To date, no studies have examined the relationship between cognitive disorders and personality disorders. Our aim was to investigate the association between dependent personality disorder (DPD) and cognitive disorders in Central Africa. Methods: Between 2011 and 2012, a cross-sectional multicenter population-based study was carried out in rural and urban areas of the Central African Republic (CAR) and the Republic of Congo (ROC). Participants aged ≥65 years were interviewed using the Community Screening Interview for Dementia (CSI-D). Elderly people who performed poorly (CSI-D cognitive tests score or COGSCORE ≤ 24.5/30) were clinically assessed by neurologists and underwent further psychometric testing. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition and Petersen criteria were required for the diagnosis of dementia and mild cognitive impairment (MCI) respectively. DPD was assessed using the Personality Diagnostic Questionnaire-4+. Socio-demographic, vascular, and psychological factors were also documented. Multivariate multinomial logistic regression models were used to estimate the associations. Results: Of the 2,002 participants screened, 860 and 912 had data for cognitive status and DPD in CAR and ROC respectively. In fully adjusted models, DPD was significantly associated with MCI in ROC (Odds Ratio (OR) = 2.2, 95% CI: 1.0-4.7) and CAR (OR = 2.1, 95% CI: 1.1-4.0) and with dementia only in ROC (OR = 4.8, 95% CI: 2.0-11.7). Conclusions: DPD was associated with cognitive disorders among elderly people in Central Africa. This association should be confirmed in other contexts. This study paves the way for research on the association between personality and cognitive impairment in Africa.
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Affiliation(s)
- Sophie Pilleron
- INSERM UMR1094,Tropical Neuroepidemiology,University of Limoges,Limoges,France
| | - Jean-Pierre Clément
- INSERM UMR1094,Tropical Neuroepidemiology,University of Limoges,Limoges,France
| | | | - Pascal Mbelesso
- INSERM UMR1094,Tropical Neuroepidemiology,University of Limoges,Limoges,France
| | | | - Pierre-Marie Preux
- INSERM UMR1094,Tropical Neuroepidemiology,University of Limoges,Limoges,France
| | - Maëlenn Guerchet
- INSERM UMR1094,Tropical Neuroepidemiology,University of Limoges,Limoges,France
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Low LF, Harrison F, Lackersteen SM. Does personality affect risk for dementia? A systematic review and meta-analysis. Am J Geriatr Psychiatry 2013; 21:713-28. [PMID: 23567438 DOI: 10.1016/j.jagp.2012.08.004] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 07/01/2012] [Accepted: 08/01/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE A life course epidemiologic approach suggests that personality may have lifelong pathways of influence on risk of dementia and mild cognitive impairment (MCI). This article aimed to systematically review case-control and prospective studies on the association between personality and risk of these cognitive disorders. METHODS Studies were identified through Scopus, Medline, PubMed, and PsycINFO. Searches combined terms for personality with those for dementia and MCI. Data were extracted and checked by a second reviewer, systematically reviewed, and meta-analyzed where appropriate. RESULTS Twelve longitudinal and three case-control studies were included. Five of nine studies found that higher neuroticism was associated with greater dementia risk (pooled hazard ratio [HR] per unit increase on neuroticism score, HR = 1.13, 95% confidence interval [CI] = 1.08-1.18, z = 5.11, p <0.001, N = 3,285), and two studies showed it increased risk of MCI. Three of four studies showed that higher conscientiousness was protective against dementia (pooled HR = 0.88, 95% CI = 0.81-0.97, z = 3.34, p = 0.001, N = 1,687), and one of two studies suggested it reduced risk of MCI. Three of four studies found no association between openness and dementia; however, pooled data suggested openness was protective (HR = 0.88, 95% CI = 0.81-0.97, z = 2.34, p = 0.008, N = 1,687). Seven studies indicated that extraversion was not linked with dementia, and four found no association between agreeableness and dementia. CONCLUSIONS Neuroticism increased risk for dementia, and conscientiousness reduced risk. The protective effect of openness was tentative. Extraversion and agreeableness were not associated with dementia. Personality should be incorporated in conceptual models of dementia risk. Clinicians and public health professionals should consider personality when planning dementia risk reduction strategies.
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Affiliation(s)
- Lee-Fay Low
- Dementia Collaborative Research Centre, School of Psychiatry, Faculty of Medicine, University of New South Wales, NSW, Australia.
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Förstl H, Perneczky R, Karenberg A, Diehl-Schmid J, Lautenschlager NT. [Personality in old age]. DER NERVENARZT 2009; 80:1275-1282. [PMID: 19859685 DOI: 10.1007/s00115-009-2806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Modern developmental psychology tends to draw a positive, resource-based picture of human aging. We will however focus on more difficult aspects of personality in old age which are of psychiatric relevance: the persistence of cluster A and C personality disorders, antisocial personality in the elderly; the interaction of personality and a detection of mild cognitive impairment (MCI); personality features as risk or protective factors or early signs of Alzheimer's dementia; changes of personality in Parkinson's disease and frontotemporal dementia. We will briefly mention recent neuroimaging studies which appear to suggest a functional neuroanatomy of personality. A quote from Cicero's cato major, de senectute indicates that some of his perceptions regarding classic personality characteristics of the elderly can be recognized in our patients and can be prevented or treated with modern interventions.
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Affiliation(s)
- H Förstl
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, 81675 München.
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