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Aschenbrenner AJ, Jackson JJ. High-frequency assessment of mood, personality, and cognition in healthy younger, healthy older and adults with cognitive impairment. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:914-931. [PMID: 39015997 PMCID: PMC11255411 DOI: 10.1080/13825585.2023.2284412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/12/2023] [Indexed: 07/18/2024]
Abstract
Increased variability in cognitive scores, mood or personality traits can be indicative of underlying neurological disorders. Whether variability in cognition is due to changes in mood or personality is unknown. A total of 66 younger adults, 51 healthy older adults and 38 participants with cognitive impairment completed 21 daily sessions of attention, working memory, mood, and personality assessment. Group differences in mean performance and variability were examined using Bayesian mixed effects location scale models. Variability in attention decreased from younger to older adults and then increased again in cognitive impairment. Younger adults were more variable in agreeableness, openness and conscientiousness compared to older adults. The clinically impaired group differed from the healthy older adults in terms of variability on attention, openness, and conscientiousness. Healthy aging results in greater stability in personality traits over short intervals yet this stability is not redundant with increased stability in cognitive scores.
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Affiliation(s)
| | - Joshua J. Jackson
- Department of Psychological and Brain Sciences, Washington University in St. Louis
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Troisi G, Marotta A, Lupiañez J, Casagrande M. Does personality affect the cognitive decline in aging? A systematic review. Ageing Res Rev 2024:102455. [PMID: 39153600 DOI: 10.1016/j.arr.2024.102455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 08/03/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024]
Abstract
Cognitive decline is a natural consequence of aging, but several genetic, environmental, and psychological factors can influence its trajectories. Among the most enduring factors, the Big Five personality traits - defined as relatively stable tendencies to think, behave, and react to the environment - can influence both directly (e.g., by physiological correlates) and indirectly (e.g., healthy or risky behaviors) the risk of developing dementia and mild cognitive impairment (MCI) - a preclinical form of cognitive decline. Despite the great amount of studies focusing on the relationship between personality and cognitive decline, an updated systematic synthesis of the results including a broader range of study designs is still lacking. This systematic review aims to summarize the findings of studies investigating: (i) differences in personality traits between groups of healthy individuals and those with MCI, (ii) the impact of personality traits on the risk for both MCI and dementia, and (iii) changes in personality traits among individuals progressing from normal cognition to MCI. Neuroticism emerged as a significant risk factor for MCI and dementia; Conscientiousness and Openness appear to offer protection against dementia and moderate cognitive decline. Overall, these findings suggest a pivotal role of personality structure in shaping cognitive outcomes on the long run.
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Affiliation(s)
- Giovanna Troisi
- Department of Psychology, University of Rome "Sapienza", 00185 Rome, Italy; Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.
| | - Andrea Marotta
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Juan Lupiañez
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health, University of Rome "Sapienza", 00185 Rome, Italy
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Stephan Y, Sutin AR, Luchetti M, Aschwanden D, Terracciano A. Personality and Transition From Mild Cognitive Impairment to Normal Cognition vs Dementia. J Am Med Dir Assoc 2024:105175. [PMID: 39074784 DOI: 10.1016/j.jamda.2024.105175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) is a critical stage preceding incident dementia, but not all individuals with MCI progress to dementia and some revert to normal cognition. This study examined whether personality is associated with the probability of transition from MCI to normal cognition or dementia. DESIGN Longitudinal observational study. SETTING AND PARTICIPANTS Older adults with MCI from the Health and Retirement Study (N = 1608, 56% female, mean age = 72.29, SD = 9.91). Personality traits; cognitive status; and demographic (age, sex, education, race, and ethnicity), clinical (diabetes, hypertension), behavioral (smoking, physical activity), psychological (depressive symptoms), and genetic (apolipoprotein E ε4) covariates were obtained in 2006/2008. Follow-up data on cognitive status were collected every 2 years up to the 2020 wave. METHODS Cox regression analyses tested the association between personality and reversion from MCI to normal cognition and progression to dementia, controlling for demographic, clinical, behavioral, psychological, and genetic covariates. RESULTS Controlling for demographic factors, lower neuroticism and higher openness and conscientiousness were associated with a higher likelihood of reversion from MCI to normal cognition and a lower risk of progression to dementia over time. Higher agreeableness was related to a lower risk of progression to dementia. Clinical, behavioral, psychological, and genetic factors partially accounted for these associations. There was little evidence that demographic, genetic factors, or baseline cognition moderated these associations. CONCLUSIONS AND IMPLICATIONS Personality traits can help identify individuals who are more likely to revert from MCI and not progress to dementia. These findings suggest that even during mild impairment, personality may modulate dementia risk and thus inform targeted interventions.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Damaris Aschwanden
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland; Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
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Hill PL, Pfund GN, Cruitt PJ, Spears I, Norton SA, Bogdan R, Oltmanns TF. Personality traits moderate associations between word recall and subjective memory. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:705-722. [PMID: 37665355 PMCID: PMC11139457 DOI: 10.1080/13825585.2023.2249195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023]
Abstract
Cognitive gerontology research requires consideration of performance as well as perceptions of performance. While subjective memory is positively associated with memory performance, these correlations typically are modest in magnitude, leading to the need to consider whether certain people may show weaker or stronger linkages between performance and perceptions. The current study leveraged personality (NEO Big Five), memory performance (i.e., word recall), and perceptions of memory ability (i.e., metamemory in adulthood and memory decline) data from the St. Louis Personality and Aging Network (SPAN) study (n = 774, mean age: 71.52 years). Extraversion and conscientiousness held the most consistent associations with the cognitive variables of interest, as both traits were positively associated with metamemory and word recall, but negatively associated with subjective decline. Moreover, extraversion moderated associations between word recall and both memory capacity and complaints, insofar that objective-subjective associations were weaker for those adults higher in extraversion. These findings highlight the need to understand how personality influences the sources of information employed for subjective cognitive beliefs.
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Affiliation(s)
- Patrick L Hill
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Gabrielle N Pfund
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | | | - Isaiah Spears
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Sara A Norton
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Thomas F Oltmanns
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
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Bethell J, Andrew MK, Hothi S, Mick P, Morgan D, O'Connell ME, Phillips NA, Stewart S, Walker JD, Wittich W, McGilton KS. Does social connection mediate the association between neuroticism and cognition? Cross-sectional analysis of the Canadian Longitudinal Study on Aging. Aging Ment Health 2024; 28:482-490. [PMID: 37667914 DOI: 10.1080/13607863.2023.2252369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES This study tested the association between neuroticism and six cognitive measures, and examined the potential mediating roles of social connection (social isolation and loneliness) among middle-aged and older adults. METHODS This cross-sectional study was a secondary analysis of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort, a sample of Canadians aged 45-85 years at baseline. Respondents with data collected at the first follow-up, between 2015 and 2018, were included (n = 27,765). Structural equation modelling was used to assess the association between neuroticism and six cognitive measures (Rey Auditory Verbal Learning Test immediate recall and delayed recall, Animal Fluency Test, Mental Alternation Test, Controlled Oral Word Association Test and Stroop Test interference ratio), with direct and indirect effects (through social isolation and loneliness). All analyses were stratified by sex, including females (n = 14,133) and males (n = 13,632). RESULTS In unadjusted models, there was evidence of associations between neuroticism and all cognitive measures, except the Stroop Test interference ratio, suggesting higher neuroticism was associated with lower scores on memory and executive function tests. In the models of these other five outcomes, there was consistent evidence of indirect effects (through social isolation and loneliness) and, in some cases, direct effects. The results are discussed in context with limitations, including the use of cross-sectional design and alternative hypotheses to explain the association between personality and cognition. CONCLUSION Among middle-aged and older adults, for both males and females, the findings suggest that the association between neuroticism and cognitive outcomes may be mediated by aspects of social connection.
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Affiliation(s)
- Jennifer Bethell
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Melissa K Andrew
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, Canada
| | - Sobhneek Hothi
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Health Studies, University College, University of Toronto, Toronto, Canada
| | - Paul Mick
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Debra Morgan
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Natalie A Phillips
- Department of Psychology, Centre for Research in Human Development, Concordia University, Montreal, Canada
| | - Steven Stewart
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Jennifer D Walker
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montreal, Canada
| | - Katherine S McGilton
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Marcolini S, Frentz I, Terracciano A, De Deyn PP. Association of personality facets and cognition in the Lifelines population-based cohort study. J Psychiatr Res 2023; 168:30-37. [PMID: 37875035 PMCID: PMC10956640 DOI: 10.1016/j.jpsychires.2023.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Personality traits have been associated with cognitive functioning and risk of cognitive decline. Fewer studies have investigated how personality facets are associated with cognition in large cohorts with a prospective design. METHODS The association between eight personality facets and cognition (speed measures reflecting psychomotor speed and visual attention; hit rate measures reflecting visual learning and working memory) was analyzed in middle-aged adults from the Lifelines cohort (N = 79911; age 43 ± 11 years). RESULTS High hostility, high vulnerability, low excitement seeking, and low competence were associated with worse cognitive performance on all tasks. Impulsivity-related facets had weak and differential associations, with self-discipline negatively associated with accuracy and deliberation negatively associated with speed. These associations remained largely unchanged when accounting for lifestyle factors (smoking, alcohol consumption, physical activity). The associations with cognition were stronger in older people for impulsiveness, deliberation, and hostility, while stronger in younger people for excitement seeking, self-discipline, and vulnerability. CONCLUSION In a large population-based sample with a broad age range, the associations of personality facets with cognitive functioning had small effect sizes, were independent of lifestyle factors, and varied with age and among facets within the same personality domain. These findings highlight the importance of developmental stages and facet-level research in personality-cognition associations.
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Affiliation(s)
- Sofia Marcolini
- Department of Neurology and Alzheimer Center, University Medical Center Groningen, Groningen, the Netherlands.
| | - Ingeborg Frentz
- Department of Neurology and Alzheimer Center, University Medical Center Groningen, Groningen, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Antonio Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Peter Paul De Deyn
- Department of Neurology and Alzheimer Center, University Medical Center Groningen, Groningen, the Netherlands; Laboratory of Neurochemistry and Behavior, Experimental Neurobiology Unit, University of Antwerp, Wilrijk, Antwerp, Belgium
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Lawson KM, Sutin AR, Atherton OE, Robins RW. Are trajectories of personality and socioeconomic factors prospectively associated with midlife cognitive function? Findings from a 12-year longitudinal study of Mexican-origin adults. Psychol Aging 2023; 38:749-762. [PMID: 37326565 PMCID: PMC10721735 DOI: 10.1037/pag0000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Problems with memory, executive function, and language are a significant public health concern, especially when they begin during midlife. However, there is relatively little work on risk and protective factors for cognitive function in middle adulthood. Using data from 883 Mexican-origin adults assessed up to 6 times across 12 years (Mage at Time 1 = 38.2 years; range = 27-63 years), the present study examined whether developmental trajectories (levels and slopes) of Big Five personality domains and socioeconomic factors (per capita income, economic stress) were prospectively associated with cognitive function (memory, mental status, verbal fluency) at the final assessment. We found that individuals with higher levels of, and smaller decreases in, Neuroticism had worse cognitive function 12 years later. Further, individuals with higher initial Conscientiousness had better subsequent memory, mental status, and verbal fluency, and individuals with higher Openness and Extraversion had better subsequent verbal fluency (but not memory or mental status). The trajectories of per capita income and economic stress were robustly associated with cognitive function, such that higher initial levels and greater increases in socioeconomic resources had protective associations, whereas higher levels and greater increases in economic stress had deleterious associations with cognitive function. Higher education level was associated with better cognitive function 12 years later. These findings suggest that changes in personality and socioeconomic factors across adulthood are associated with cognitive function, which may be informative for interventions to support healthier cognitive aging starting at least as early as midlife. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Sutin AR, Luchetti M, Stephan Y, Terracciano A. Informant-rated change in personality traits, psychological distress, well-being, and social connection with dementia. Arch Gerontol Geriatr 2023; 115:105218. [PMID: 37837789 PMCID: PMC10646812 DOI: 10.1016/j.archger.2023.105218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/26/2023] [Accepted: 09/30/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES Studies of retrospective personality change with dementia consistently find caregivers report large changes in personality (e.g., increases in neuroticism) of their care recipients compared to before dementia. This work seeks to replicate the established pattern of personality change, extend it to change in psychological distress, well-being, and social connection, and evaluate whether changes vary by stage of dementia. METHODS Caregivers of people with dementia (N = 188) reported on the psychological and social health of their care recipient currently and how they were before they developed dementia. Personality was measured as five factor model traits. Psychological distress was measured as symptoms of depression and anxiety, perceived stress, and pessimism. Psychological well-being was measured as purpose in life, life satisfaction, happiness, self-efficacy, and optimism. Social connection was measured as loneliness, belonging, social support, and social strain. RESULTS There were substantial increases in neuroticism (d = 1.14) and decreases in the other four personality traits (d range=-0.85 to -1.37). There were significant increases in psychological distress (e.g., d = 1.07 for depression) and substantial decreases in well-being (e.g., d=-1.18 for purpose in life) and social connection (e.g., d=-1.12 for belonging). Change was apparent across dementia stage and generally larger in more severe dementia. DISCUSSION In addition to personality, there are large retrospective changes in psychological distress, well-being, and social connection with dementia. These quantitative findings complement clinical observations of the natural history of psychosocial changes in people with dementia, and can inform families, clinicians, and researchers on commonly observed changes and improve interventions to mitigate dementia burden.
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Shoukat S, Zia MA, Uzair M, Attia KA, Abushady AM, Fiaz S, Ali S, Yang SH, Ali GM. Bacopa monnieri: A promising herbal approach for neurodegenerative disease treatment supported by in silico and in vitro research. Heliyon 2023; 9:e21161. [PMID: 37954293 PMCID: PMC10637926 DOI: 10.1016/j.heliyon.2023.e21161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
Neurodegenerative disorders, caused by progressive neuron loss, are a global health issue. Among the various factors implicated in their pathogenesis, dysregulation of acetylcholinesterase activity has been recognized as a key contributor. Acetylcholinesterase breaks down the neurotransmitter acetylcholine, important for neural transmission. Evaluating phyto-compounds from Bacopa monnieri Linn. through in vitro and in silico analysis may expand their role as alternative therapeutic agents by modulating the function of acetylcholinesterase and complementing existing treatments. To accomplish this objective, chemical structures of phyto-compounds were retrieved from PubChem database and subjected to in silico and in vitro approaches. Virtual screening was performed through molecular docking and molecular dynamic simulation resulting in four top hit compounds including quercetin, apigenin, wogonin, and bacopaside X (novel lead compound for acetylcholinesterase inhibitor) with least binding score. Further, dose dependent acetylcholinesterase inhibition biochemical assay depicted that bacopaside X, apigenin, quercetin, and wogonin exhibited strong potential against acetylcholinesterase with IC50 values of 12.78 μM, 13.83 μM, 12.73 μM and 15.48 μM respectively, in comparison with the donepezil (IC50: 0.0204 μM). The in silico and in vitro research suggests that B. monnieri phyto-compounds have the potential to modulate molecular targets associated with neurodegenerative diseases and have a role in neuroprotection.
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Affiliation(s)
- Shehla Shoukat
- Department of Plant Genomics and Biotechnology, PARC Institute of Advance Studies in Agriculture Research, Affiliated with Quaid-e-Azam University, National Agriculture Research Centre, Islamabad, Pakistan
- National Institute for Genomics and Advanced Biotechnology, National Agriculture Research Centre, Islamabad, Pakistan
| | - Muhammad Amir Zia
- National Institute for Genomics and Advanced Biotechnology, National Agriculture Research Centre, Islamabad, Pakistan
| | - Muhammad Uzair
- National Institute for Genomics and Advanced Biotechnology, National Agriculture Research Centre, Islamabad, Pakistan
| | - Kotb A. Attia
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 2455, 11451, Riyadh, Saudi Arabia
| | - Asmaa M. Abushady
- Biotechnology School, Nile University, 26th of July Corridor, Sheikh Zayed City, Giza, 12588, Egypt
- Department of Genetics, Agriculture College, Ain Shams University, Cairo, Egypt
| | - Sajid Fiaz
- Department of Plant Breeding and Genetics, University of Haripur, 22620 Haripur, Pakistan
| | - Shaukat Ali
- National Institute for Genomics and Advanced Biotechnology, National Agriculture Research Centre, Islamabad, Pakistan
| | - Seung Hwan Yang
- Department of Biotechnology, Chonnam National University, Yeosu, 59626, Republic of Korea
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Jo T, Kim J, Bice P, Huynh K, Wang T, Arnold M, Meikle PJ, Giles C, Kaddurah-Daouk R, Saykin AJ, Nho K. Circular-SWAT for deep learning based diagnostic classification of Alzheimer's disease: application to metabolome data. EBioMedicine 2023; 97:104820. [PMID: 37806288 PMCID: PMC10579282 DOI: 10.1016/j.ebiom.2023.104820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Deep learning has shown potential in various scientific domains but faces challenges when applied to complex, high-dimensional multi-omics data. Alzheimer's Disease (AD) is a neurodegenerative disorder that lacks targeted therapeutic options. This study introduces the Circular-Sliding Window Association Test (c-SWAT) to improve the classification accuracy in predicting AD using serum-based metabolomics data, specifically lipidomics. METHODS The c-SWAT methodology builds upon the existing Sliding Window Association Test (SWAT) and utilizes a three-step approach: feature correlation analysis, feature selection, and classification. Data from 997 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) served as the basis for model training and validation. Feature correlations were analyzed using Weighted Gene Co-expression Network Analysis (WGCNA), and Convolutional Neural Networks (CNN) were employed for feature selection. Random Forest was used for the final classification. FINDINGS The application of c-SWAT resulted in a classification accuracy of up to 80.8% and an AUC of 0.808 for distinguishing AD from cognitively normal older adults. This marks a 9.4% improvement in accuracy and a 0.169 increase in AUC compared to methods without c-SWAT. These results were statistically significant, with a p-value of 1.04 × 10ˆ-4. The approach also identified key lipids associated with AD, such as Cer(d16:1/22:0) and PI(37:6). INTERPRETATION Our results indicate that c-SWAT is effective in improving classification accuracy and in identifying potential lipid biomarkers for AD. These identified lipids offer new avenues for understanding AD and warrant further investigation. FUNDING The specific funding of this article is provided in the acknowledgements section.
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Affiliation(s)
- Taeho Jo
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Indiana Alzheimer Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Junpyo Kim
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Medical Research Institute, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Paula Bice
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Indiana Alzheimer Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, Melbourne, 3004, Victoria, Australia; Baker Department of Cardiometabolic Health, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Tingting Wang
- Baker Heart and Diabetes Institute, Melbourne, 3004, Victoria, Australia; Baker Department of Cardiometabolic Health, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Matthias Arnold
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27710, USA; Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, 3004, Victoria, Australia; Baker Department of Cardiometabolic Health, University of Melbourne, Parkville, 3010, Victoria, Australia; Monash University, Melbourne, VIC 3800, Australia
| | - Corey Giles
- Baker Heart and Diabetes Institute, Melbourne, 3004, Victoria, Australia; Baker Department of Cardiometabolic Health, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27710, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC, 27710, USA; Department of Medicine, Duke University, Durham, NC, 27710, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Indiana Alzheimer Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
| | - Kwangsik Nho
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Indiana Alzheimer Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
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Terracciano A, Luchetti M, Stephan Y, Löckenhoff CE, Ledermann T, Sutin AR. Changes in Personality Before and During Cognitive Impairment. J Am Med Dir Assoc 2023; 24:1465-1470.e1. [PMID: 37330217 PMCID: PMC10543616 DOI: 10.1016/j.jamda.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES Clinical observations and studies of retrospective observer ratings point to changes in personality in persons with cognitive impairment or dementia. The timing and magnitude of such changes, however, are unclear. This study used prospective self-reported data to examine the trajectories of personality traits before and during cognitive impairment. DESIGN Longitudinal observational cohort study. SETTING AND PARTICIPANTS Older adults from the United States in the Health and Retirement Study were assessed for cognitive impairment and completed a measure of the 5 major personality traits every 4 years from 2006 to 2020 (N = 22,611; n = 5507 with cognitive impairment; 50,786 personality and cognitive assessments). METHODS Multilevel modeling examined changes before and during cognitive impairment, accounting for demographic differences and normative age-related trajectories. RESULTS Before cognitive impairment was detected, extraversion (b = -0.10, SE = 0.02), agreeableness (b = -0.11, SE = 0.02), and conscientiousness (b = -0.12, SE = 0.02) decreased slightly; there was no significant change in neuroticism (b = 0.04, SE = 0.02) or openness (b = -0.06, SE = 0.02). During cognitive impairment, faster rates of change were found for all 5 personality traits: neuroticism (b = 0.10, SE = 0.03) increased, and extraversion (b = -0.14, SE = 0.03), openness (b = -0.15, SE = 0.03), agreeableness (b = -0.35, SE = 0.03), and conscientiousness (b = -0.34, SE = 0.03) declined. CONCLUSIONS AND IMPLICATIONS Cognitive impairment is associated with a pattern of detrimental personality changes across the preclinical and clinical stages. Compared with the steeper rate of change during cognitive impairment, the changes were small and inconsistent before impairment, making them unlikely to be useful predictors of incident dementia. The study findings further indicate that individuals can update their personality ratings during the early stages of cognitive impairment, providing valuable information in clinical settings. The results also suggest an acceleration of personality change with the progression to dementia, which may lead to behavioral, emotional, and other psychological symptoms commonly observed in people with cognitive impairment and dementia.
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Affiliation(s)
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| | | | | | - Thomas Ledermann
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
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Camargo Camargo L, Díaz Rodríguez MC, López Velásquez ND. Personality and Alzheimer's. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:270-272. [PMID: 38008669 DOI: 10.1016/j.rcpeng.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/28/2023]
Affiliation(s)
- Loida Camargo Camargo
- Neuróloga, Epidemióloga, Master en Neurociencias, PhD(c) Neurociencia Cognitiva, Universidad del Sinú, Cartagena, Bolívar, Colombia.
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13
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Waschkies KF, Soch J, Darna M, Richter A, Altenstein S, Beyle A, Brosseron F, Buchholz F, Butryn M, Dobisch L, Ewers M, Fliessbach K, Gabelin T, Glanz W, Goerss D, Gref D, Janowitz D, Kilimann I, Lohse A, Munk MH, Rauchmann BS, Rostamzadeh A, Roy N, Spruth EJ, Dechent P, Heneka MT, Hetzer S, Ramirez A, Scheffler K, Buerger K, Laske C, Perneczky R, Peters O, Priller J, Schneider A, Spottke A, Teipel S, Düzel E, Jessen F, Wiltfang J, Schott BH, Kizilirmak JM. Machine learning-based classification of Alzheimer's disease and its at-risk states using personality traits, anxiety, and depression. Int J Geriatr Psychiatry 2023; 38:e6007. [PMID: 37800601 DOI: 10.1002/gps.6007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/07/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is often preceded by stages of cognitive impairment, namely subjective cognitive decline (SCD) and mild cognitive impairment (MCI). While cerebrospinal fluid (CSF) biomarkers are established predictors of AD, other non-invasive candidate predictors include personality traits, anxiety, and depression, among others. These predictors offer non-invasive assessment and exhibit changes during AD development and preclinical stages. METHODS In a cross-sectional design, we comparatively evaluated the predictive value of personality traits (Big Five), geriatric anxiety and depression scores, resting-state functional magnetic resonance imaging activity of the default mode network, apoliprotein E (ApoE) genotype, and CSF biomarkers (tTau, pTau181, Aβ42/40 ratio) in a multi-class support vector machine classification. Participants included 189 healthy controls (HC), 338 individuals with SCD, 132 with amnestic MCI, and 74 with mild AD from the multicenter DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE). RESULTS Mean predictive accuracy across all participant groups was highest when utilizing a combination of personality, depression, and anxiety scores. HC were best predicted by a feature set comprised of depression and anxiety scores and participants with AD were best predicted by a feature set containing CSF biomarkers. Classification of participants with SCD or aMCI was near chance level for all assessed feature sets. CONCLUSION Our results demonstrate predictive value of personality trait and state scores for AD. Importantly, CSF biomarkers, personality, depression, anxiety, and ApoE genotype show complementary value for classification of AD and its at-risk stages.
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Affiliation(s)
- Konrad F Waschkies
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Joram Soch
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Margarita Darna
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Anni Richter
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- German Center for Mental Health (DZPG), Munich, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Aline Beyle
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | | | - Friederike Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Tatjana Gabelin
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Doreen Goerss
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Daria Gref
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Andrea Lohse
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Department of Neuroradiology, University Hospital LMU, Munich, Germany
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Peter Dechent
- MR-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Goettingen, Göttingen, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Stefan Hetzer
- Berlin Center for Advanced Neuroimaging, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, Texas, USA
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
- School of Medicine, Technical University of Munich, Department of Psychiatry and Psychotherapy, Munich, Germany
- University of Edinburgh and UK DRI, Edinburgh, UK
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Björn H Schott
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Jasmin M Kizilirmak
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Neurodidactics and NeuroLab, Institute for Psychology, University of Hildesheim, Hildesheim, Germany
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Phongpreecha T, Cholerton B, Bhukari S, Chang AL, De Francesco D, Thuraiappah M, Godrich D, Perna A, Becker MG, Ravindra NG, Espinosa C, Kim Y, Berson E, Mataraso S, Sha SJ, Fox EJ, Montine KS, Baker LD, Craft S, White L, Poston KL, Beecham G, Aghaeepour N, Montine TJ. Prediction of neuropathologic lesions from clinical data. Alzheimers Dement 2023; 19:3005-3018. [PMID: 36681388 PMCID: PMC10359434 DOI: 10.1002/alz.12921] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/15/2022] [Accepted: 12/12/2022] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Post-mortem analysis provides definitive diagnoses of neurodegenerative diseases; however, only a few can be diagnosed during life. METHODS This study employed statistical tools and machine learning to predict 17 neuropathologic lesions from a cohort of 6518 individuals using 381 clinical features (Table S1). The multisite data allowed validation of the model's robustness by splitting train/test sets by clinical sites. A similar study was performed for predicting Alzheimer's disease (AD) neuropathologic change without specific comorbidities. RESULTS Prediction results show high performance for certain lesions that match or exceed that of research annotation. Neurodegenerative comorbidities in addition to AD neuropathologic change resulted in compounded, but disproportionate, effects across cognitive domains as the comorbidity number increased. DISCUSSION Certain clinical features could be strongly associated with multiple neurodegenerative diseases, others were lesion-specific, and some were divergent between lesions. Our approach could benefit clinical research, and genetic and biomarker research by enriching cohorts for desired lesions.
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Affiliation(s)
- Thanaphong Phongpreecha
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
| | - Brenna Cholerton
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
| | - Syed Bhukari
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
| | - Alan L. Chang
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Davide De Francesco
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Melan Thuraiappah
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Dana Godrich
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami 1501 NW 10 Ave, Miami, Florida 33136 USA
| | - Amalia Perna
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
| | - Martin G. Becker
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Neal G. Ravindra
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Camilo Espinosa
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Yeasul Kim
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Eloise Berson
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Samson Mataraso
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Sharon J. Sha
- Department of Neurology & Neurological Sciences, Stanford University 213 Quarry Road, MC 5979 Palo Alto, CA 94304 USA
| | - Edward J. Fox
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
| | - Kathleen S. Montine
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
| | - Laura D. Baker
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine 475 Vine Street, Winston-Salem, NC 27101 USA
| | - Suzanne Craft
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine 475 Vine Street, Winston-Salem, NC 27101 USA
| | - Lon White
- Pacific Health Research and Education Institute, Hawaii 3375 Koapaka Street, I-540, Honolulu, HI 96819 USA
| | - Kathleen L. Poston
- Department of Neurology & Neurological Sciences, Stanford University 213 Quarry Road, MC 5979 Palo Alto, CA 94304 USA
| | - Gary Beecham
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami 1501 NW 10 Ave, Miami, Florida 33136 USA
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University 300 Pasteur Drive, Room H3580 MC 5640 Stanford, CA 94305 USA
- Department of Biomedical Data Science, Stanford University 1265 Welch Road MC5464 MSOB West Wing, Third Floor Stanford, CA 94305 USA
- Department of Pediatrics, Stanford University 453 Quarry Road MC 5660 Palo Alto, CA 94304 USA
| | - Thomas J. Montine
- Department of Pathology, Stanford University 300 Pasteur Drive Medicine Lane Building L235 Stanford, CA 94305 USA
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Hunt A, Martyr A, Gamble LD, Morris RG, Thom JM, Pentecost C, Clare L. The associations between personality traits and quality of life, satisfaction with life, and well-being over time in people with dementia and their caregivers: findings from the IDEAL programme. BMC Geriatr 2023; 23:354. [PMID: 37280511 DOI: 10.1186/s12877-023-04075-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/27/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Cross-sectional evidence indicates that certain personality traits may influence how well people with dementia and their caregivers are able to live alongside the condition. However, no studies to date have explored these associations longitudinally. The present study aimed to explore whether each of the Five-Factor personality traits were associated with change over two years in perceptions of 'living well' for people with dementia and their caregivers. 'Living well' was conceptualized as a composite of quality of life, satisfaction with life, and subjective well-being. METHODS Data were analyzed from 1487 people with dementia and 1234 caregivers who took part in the IDEAL cohort. Participants were categorized into low, medium, and high groups for each trait using stanine scores. Latent growth curve models investigated associations between these groups and 'living well' scores for each trait at baseline and at 12 and 24 months. Covariates included cognition in people with dementia and stress in caregivers. A Reliable Change Index was calculated against which to evaluate changes in 'living well' scores over time. RESULTS At baseline, neuroticism was negatively associated with 'living well' scores for people with dementia, while conscientiousness, extraversion, openness, and agreeableness were positively associated. For caregivers, neuroticism was negatively associated with 'living well' scores at baseline while conscientiousness and extraversion were positively associated. 'Living well' scores were mostly stable over time with no influence of personality traits on observed changes. CONCLUSIONS Findings suggest that personality traits, particularly neuroticism, have a meaningful impact on how people with dementia and caregivers rate their capability to 'live well' at baseline. Over time 'living well' scores for each personality trait group were largely stable. Studies utilizing longer follow-up periods and more appropriate measures of personality are needed to corroborate and extend the findings of the present study.
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Affiliation(s)
- Anna Hunt
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Anthony Martyr
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK.
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Robin G Morris
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jeanette M Thom
- School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Claire Pentecost
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
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Sachs BC, Gaussoin SA, Brenes GA, Casanova R, Chlebowski RT, Chen JC, Luo J, Rapp SR, Shadyab AH, Shumaker S, Wactawski-Wende J, Wells GL, Hayden KM. The relationship between optimism, MCI, and dementia among postmenopausal women. Aging Ment Health 2023; 27:1208-1216. [PMID: 35694859 PMCID: PMC9741664 DOI: 10.1080/13607863.2022.2084710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The relationship between optimism and cognitive functioning is not fully understood. We examined the association of optimism with risk of mild cognitive impairment (MCI) and dementia in the Women's Health Initiative Memory Study (WHIMS). METHODS Optimism was measured by the Life Orientation Test-Revised (LOT-R) total score, and optimism and pessimism subscales. A panel of experts adjudicated cognitive endpoints based on annual cognitive assessments. We used cox proportional hazard regression models to examine the association of LOT-R total score and optimism and pessimism sub-scores with MCI/dementia. We also examined the relationship between vascular disease, LOT-R total score, optimism and pessimism, and cognition. RESULTS Mean age was 70.5 (SD = 3.9) years. The sample (N = 7249) was 87% white, and 29.8% of participants had < 12 years of education. Total LOT-R score (HR = 0.96, 95% CI: 0.94, 0.98, p < 0.001) was associated with lower risk of combined MCI or dementia. More pessimism (HR = 1.08, 95% CI: 1.05, 1.11, p < 0.0001) was associated with higher risk of MCI or dementia after adjustment for ethnicity, education, vascular disease, and depression. No significant relationships emerged from the optimism subscale. CONCLUSION These data suggest that less pessimism, but not more optimism, was associated with a lower risk of MCI and dementia.
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Affiliation(s)
- Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC USA
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem,NC USA
| | - Sarah A Gaussoin
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine Winston-Salem, NC USA
| | - Gretchen A Brenes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem,NC USA
| | - Ramon Casanova
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine Winston-Salem, NC USA
| | - Rowan T Chlebowski
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Jiu-Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, University of Southern California, Los Angeles, CA, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN USA
| | - Stephen R Rapp
- Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA
| | - Sally Shumaker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY USA
| | - Gretchen L Wells
- Gill Heart and Vascular Institute, University of Kentucky School of Medicine, Lexington, KY USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC USA
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17
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Fazeli PL, Cheatwood JD, Hopkins C, Vance DE, Shirey MR, Azuero A, Crowe M. Association between personality and cognitive performance in middle-aged and older adults with human immunodeficiency virus (HIV). APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:279-288. [PMID: 34167406 PMCID: PMC9045538 DOI: 10.1080/23279095.2021.1935954] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Nearly half of adults with human immunodeficiency virus (HIV) experience HIV-Associated Neurocognitive Disorder (HAND), characterized by cognitive impairments in two or more cognitive domains, which can interfere with everyday functioning. Many factors are thought to influence such cognitive impairments in adults with HIV; one factor seldom examined is personality. OBJECTIVE This study investigated the association between five major dimensions of personality (openness, conscientiousness, extraversion, agreeableness, and neuroticism) and cognitive function in older adults with HIV. METHODS In this cross-sectional study, a secondary data analysis was conducted on 261 HIV + participants. Participants completed a norm-based cognitive battery covering seven cognitive domains, which yielded the following indices: global cognitive impairment, and global and domain-specific T-scores. The Big Five Inventory was used to assess personality traits. RESULTS Higher openness, conscientiousness, and agreeableness were associated with better performance on individual cognitive domains while agreeableness and openness were also positively associated with global cognitive T-scores (p < .01). Only openness significantly predicted global cognition when adjusting for covariates (p < .01). DISCUSSION Openness was associated with better global cognitive function in persons with HIV. This study provides a basis for further investigation of potential mechanisms for the association between personality and cognition in people with HIV in order to ultimately inform intervention strategies.
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Affiliation(s)
- Pariya L. Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, USA
| | - John D. Cheatwood
- School of Nursing, University of Alabama at Birmingham, Birmingham, USA
| | - Cierra Hopkins
- School of Nursing, University of Alabama at Birmingham, Birmingham, USA
| | - David E. Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, USA
| | - Maria R. Shirey
- School of Nursing, University of Alabama at Birmingham, Birmingham, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, USA
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18
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Dubey S, Ghosh R, Dubey MJ, Das S, Chakraborty AP, Santra A, Dutta A, Roy D, Pandit A, Roy BK, Das G, Benito-León J. Psychosocial Basis of Human Sufferings and Poverty in Patients with Neurological and Psychiatric Disorders. MEDICAL RESEARCH ARCHIVES 2023; 11:3919. [PMID: 37641666 PMCID: PMC10461571 DOI: 10.18103/mra.v11i5.3919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Neurological disorders and psychiatric ailments often lead to cognitive disabilities and low attainment of education, pivoting misconceptions, myths, and misbeliefs. Poverty and low educational attainment are intriguingly associated with poor awareness and perception of these diseases that add to the suffering. Poverty goes parallel with a low level of education and is intricately associated with neuropsychiatric ailments, which have the potential to spread transgenerationally. Robust education policies, proper government rules and regulations against the spread of disease-related myths and misconceptions, uplifting medical education in its true sense, voices against consanguinity, and programs to raise scientific perception about diseases can help to throw light at the end of this dark tunnel. In this article, the authors intend to 1) decipher the potential psychosocial basis of human suffering and poverty in patients with neurological and psychiatric disorders, and 2) discuss the apropos way-outs that would potentially mitigate suffering, and alleviate the economic burden and cognitive disabilities of families with neuropsychiatric diseases.
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Affiliation(s)
- Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College, and Hospital, Burdwan, West Bengal, India
| | - Mahua Jana Dubey
- Department of Psychiatry, Berhampur Mental Hospital, Berhampur, West Bengal, India
| | - Shambaditya Das
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Arka Prava Chakraborty
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Arindam Santra
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ajitava Dutta
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Dipayan Roy
- Indian Institute of Technology (IIT) Madras, Chennai, Tamil Nadu, India
- School of Humanities, Indira Gandhi National Open University (IGNOU), New Delhi, India
| | - Alak Pandit
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Biman Kanti Roy
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Gautam Das
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Julián Benito-León
- Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain
- Research Institute (i+12), University Hospital “12 de Octubre”, Madrid, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
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19
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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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20
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Dubey S, Dubey MJ, Ghosh R, Mukherjee D, Pandit A, Benito-León J. Behavioral and psychological symptoms in neurodegenerative dementias: harbinger, follower, or constant collateral? THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022; 58. [PMID: 36160603 PMCID: PMC9503106 DOI: 10.1186/s41983-022-00538-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neurodegenerative dementias such as the behavioral variant of frontotemporal dementia, Alzheimer’s disease, and Parkinson’s disease dementia are linked to various behavioral and psychological abnormalities. Whether these abnormalities precede, coincide or follow the onset of cognitive symptoms is still controversial in existing literature, with trajectories available so far dependent on types of dementia. The authors aim to review the different kinds of premorbid behavioral symptoms/personality traits associated with an increased risk of developing specific types of neurodegenerative dementia. Neuroticism has been associated with an increased risk of Alzheimer’s disease and late-onset behavioral abnormalities with the behavioral variant of frontotemporal dementia. The presence of obsessive–compulsive spectrum disorders in Parkinson’s disease dementia is also not rare. Analyzing this evidence, we propose “behavioral biomarkers” as neuroticism in Alzheimer’s disease, late-onset behavioral abnormalities in behavioral variant of frontotemporal dementia, and obsessive–compulsive traits in Parkinson’s disease dementia. These noninvasive behavioral biomarkers will be of immense help, particularly in developing countries, and will prevent the need for costlier investigations and aid in therapeutic strategies.
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21
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Relationship between Nutrition, Lifestyle, and Neurodegenerative Disease: Lessons from ADH1B, CYP1A2 and MTHFR. Genes (Basel) 2022; 13:genes13081498. [PMID: 36011409 PMCID: PMC9408177 DOI: 10.3390/genes13081498] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
In the present review, the main features involved in the susceptibility and progression of neurodegenerative disorders (NDDs) have been discussed, with the purpose of highlighting their potential application for promoting the management and treatment of patients with NDDs. In particular, the impact of genetic and epigenetic factors, nutrients, and lifestyle will be presented, with particular emphasis on Alzheimer’s disease (AD) and Parkinson’s disease (PD). Metabolism, dietary habits, physical exercise and microbiota are part of a complex network that is crucial for brain function and preservation. This complex equilibrium can be disrupted by genetic, epigenetic, and environmental factors causing perturbations in central nervous system homeostasis, contributing thereby to neuroinflammation and neurodegeneration. Diet and physical activity can directly act on epigenetic modifications, which, in turn, alter the expression of specific genes involved in NDDs onset and progression. On this subject, the introduction of nutrigenomics shed light on the main molecular players involved in the modulation of health and disease status. In particular, the review presents data concerning the impact of ADH1B, CYP1A2, and MTHFR on the susceptibility and progression of NDDs (especially AD and PD) and how they may be exploited for developing precision medicine strategies for the disease treatment and management.
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22
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Terracciano A, Piras MR, Sutin AR, Delitala A, Curreli NC, Balaci L, Marongiu M, Zhu X, Aschwanden D, Luchetti M, Oppong R, Schlessinger D, Cucca F, Launer LJ, Fiorillo E. Facets of Personality and Risk of Cognitive Impairment: Longitudinal Findings in a Rural Community from Sardinia. J Alzheimers Dis 2022; 88:1651-1661. [DOI: 10.3233/jad-220400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Few studies have examined the associations between personality facets and dementia risk and rarely included individuals from rural settings or with low education. Objective: To examine the association between personality and the risk of cognitive impairment. Methods: Participants (N = 1,668; age 50 to 94 at baseline; 56.4% women; 86.5% less than high school diploma) were from a rural region of Sardinia (Italy) who completed the Revised NEO Personality Inventory (NEO-PI-R) during the first wave (2001–2004) and the Mini-Mental State Examination (MMSE) at waves two to five (2005–2021). Cox regression was used to test personality and covariates as predictors of cognitive impairment based on MMSE education-adjusted cutoffs. Results: During the up to 18-year follow-up (M = 10.38; SD = 4.76), 187 individuals (11.2%) scored as cognitively impaired. Participants with higher neuroticism (particularly the depression facet [HR = 1.22, 95% CI = 1.06–1.40]), and lower agreeableness (particularly the modesty facet [HR = 0.83, 95% CI = 0.71–0.97]) and lower conscientiousness (particularly the dutifulness facet [HR = 0.78, 95% CI = 0.67–0.92]) were at higher risk of cognitive impairment. Lower warmth ([HR = 0.75, 95% CI = 0.65–0.87], facet of extraversion) and ideas ([HR = 0.76, 95% CI = 0.65–0.89], facet of openness) were also associated with increased risk of impairment. These associations were virtually unchanged in models that accounted for other risk factors, including smoking, depression, obesity, hypertension, diabetes, and apolipoprotein E (APOE) ɛ4 carrier status. Across the five domains, sex and the APOE variant did not moderate the associations. Conclusion: In a sample with demographic characteristics underrepresented in dementia research, this study identifies personality domains and facets most relevant to the risk of cognitive impairment.
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Affiliation(s)
| | - Maria Rita Piras
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | | | - Alessandro Delitala
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Nicolò Camillo Curreli
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Lenuta Balaci
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Michele Marongiu
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Xianghe Zhu
- Florida State University College of Medicine, Tallahassee, FL, USA
| | | | - Martina Luchetti
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Richard Oppong
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - David Schlessinger
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Francesco Cucca
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
| | - Lenore J. Launer
- National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Edoardo Fiorillo
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, c/o Cittadella Universitaria di Monserrato, Monserrato, Cagliari, Italy
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23
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Li Q, Lv X, Jin F, Liao K, Gao L, Xu J. Associations of Polygenic Risk Score for Late-Onset Alzheimer's Disease With Biomarkers. Front Aging Neurosci 2022; 14:849443. [PMID: 35493930 PMCID: PMC9047857 DOI: 10.3389/fnagi.2022.849443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
Late-onset Alzheimer's disease (LOAD) is a common irreversible neurodegenerative disease with heterogeneous genetic characteristics. Identifying the biological biomarkers with the potential to predict the conversion from normal controls to LOAD is clinically important for early interventions of LOAD and clinical treatment. The polygenic risk score for LOAD (AD-PRS) has been reported the potential possibility for reliably identifying individuals with risk of developing LOAD recently. To investigate the external phenotype changes resulting from LOAD and the underlying etiology, we summarize the comprehensive associations of AD-PRS with multiple biomarkers, including neuroimaging, cerebrospinal fluid and plasma biomarkers, cardiovascular risk factors, cognitive behavior, and mental health. This systematic review helps improve the understanding of the biomarkers with potential predictive value for LOAD and further optimizing the prediction and accurate treatment of LOAD.
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Affiliation(s)
- Qiaojun Li
- School of Information Engineering, Tianjin University of Commerce, Tianjin, China
- *Correspondence: Qiaojun Li
| | - Xingping Lv
- School of Sciences, Tianjin University of Commerce, Tianjin, China
| | - Fei Jin
- Department of Molecular Imaging, Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Kun Liao
- School of Sciences, Tianjin University of Commerce, Tianjin, China
| | - Liyuan Gao
- School of Sciences, Tianjin University of Commerce, Tianjin, China
| | - Jiayuan Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
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24
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Lopes KF, Bahia VS, Natividade JC, Bastos RVS, Shiguti WA, da Silva KER, de Souza WC. Changes in personality traits in patients with Alzheimer's Disease. Dement Neuropsychol 2022; 16:187-193. [PMID: 35720659 PMCID: PMC9173796 DOI: 10.1590/1980-5764-dn-2021-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/30/2021] [Indexed: 05/31/2023] Open
Abstract
Changes in personality traits in patients with Alzheimer's disease (AD) are extremely common throughout the course of the pathology, and these behavioral changes present themselves as challenges in clinical management and as a significant cause of caregivers’ burden.
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Affiliation(s)
- Kaoue Fonseca Lopes
- Universidade de Brasília, Instituto de Psicologia, Departamento de Processos Psicológicos Básicos, Brasília DF, Brazil.,Clínica de Neurologia Neurob, Brasília DF, Brazil
| | - Valéria Santoro Bahia
- Universidade Cidade de São Paulo, Departamento de Medicina Interna, São Paulo SP, Brazil
| | - Jean Carlos Natividade
- Pontifícia Universidade Católica do Rio de Janeiro, Instituto de Psicologia, Departamento de Psicologia Social, Rio de Janeiro RJ, Brazil
| | - Rafael Valdece Sousa Bastos
- Universidade São Francisco, Instituto de Psicologia, Departamento de Psicologia Social, São Paulo SP, Brazil
| | | | | | - Wânia Cristina de Souza
- Universidade de Brasília, Instituto de Psicologia, Departamento de Processos Psicológicos Básicos, Brasília DF, Brazil
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25
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Worthington RP, Tunnell R, Arora A. Decision-making tips for patients with dementia. CLINICAL TEACHER 2022; 19:162-165. [PMID: 35068063 DOI: 10.1111/tct.13461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 10/29/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND When patients with advanced dementia lose capacity to make medical decisions for themselves, a 'best interests' determination is usually made on their behalf by the responsible clinician. Where possible, this should be made in consultation with members of the multiprofessional team and the family, consistent with ethical and legal norms. This paper is about multidisciplinary approaches to education and practice in dementia care, using a framework. APPROACH At a UK multiprofessional workshop in 2020, delegates discussed ethical and legal issues that arise when making decisions for patients with advanced dementia. After an initial presentation, providing context and background, delegates broke into small groups. They were tasked with responding to questions arising from anonymised cases based on real-life scenarios. During plenary discussion afterwards, feedback was shared, and points of best practice were discussed. The authors took notes, and following positive evaluations after the event, they did further work on the framework with the intention of making it available for other health care professionals and clinical educators. EVALUATION Based on contemporaneous notes summarising the feedback, plus further reflections, the framework was developed into a 12-point plan to assist health care teams and educators address difficulties in making 'best interests' determinations. IMPLICATIONS Promoting understanding of ethics and law pertaining to 'best interests' should benefit patients and families, with the potential to reduce the need for cases to be decided in court. To help promote good clinical practice, educators may want to consider running case-based workshops at their institution, using the framework as a scaffold for learners.
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Affiliation(s)
- Roger P Worthington
- Department of Postgraduate Medical and Dental Education, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Richard Tunnell
- Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Amit Arora
- Department of Postgraduate Medical and Dental Education, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
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26
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Cruitt PJ, Hill PL, Oltmanns TF. Personality pathology predicts increased informant-reported, but not performance-based, cognitive decline: Findings from two samples. Personal Disord 2022; 13:30-40. [PMID: 33507791 PMCID: PMC8475501 DOI: 10.1037/per0000434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Research on the relationship between normal-range personality and cognitive aging has demonstrated consistent, modest effects. The current investigation increases our understanding of unhealthy cognitive aging by testing whether personality disorders (PDs), specifically borderline, avoidant, and obsessive-compulsive PDs, show prospective associations with the onset of cognitive problems. Interpersonal stressful life events and social support were expected to mediate these relationships. The current investigation used data from 2 longitudinal studies of older adulthood: the Alzheimer's disease Research Center cohort (ADRC, N = 434, Mage = 69.95, 56% women) and the St. Louis Personality and Aging Network study (SPAN, N = 1,058, Mage = 65.92, 54% women). The ADRC study administered a battery of neuropsychological tests to assess cognitive ability/memory. Borderline PD was measured with a composite from the NEO Five-Factor Inventory. The SPAN study administered self-, informant, and interview measures of the three PDs; a free-recall task; and an informant report measure of cognitive problems. Borderline PD features exhibited cross-sectional correlations with memory (ADRC: r = -.11; SPAN: all rs = -.08), general cognitive ability (ADRC: r = -.11), and informant-reported cognitive problems (rs ranged from .15 to .39). Most importantly, borderline PD features predicted an increase in informant-reported cognitive problems in SPAN participants (standardized bs = .13 and .15) over a 2-year period, but they did not predict a deterioration in the performance-based cognitive measures in either study. Avoidant and obsessive-compulsive PDs exhibited little association with cognitive aging. Neither interpersonal variable mediated any of these effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Patrick J. Cruitt
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO.,Psychology Doctoral Internship Program, Minneapolis VA Health Care System, Minneapolis, MN
| | - Patrick L. Hill
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO
| | - Thomas F. Oltmanns
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO
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27
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Bougea A, Anagnostouli M, Angelopoulou E, Spanou I, Chrousos G. Psychosocial and Trauma-Related Stress and Risk of Dementia: A Meta-Analytic Systematic Review of Longitudinal Studies. J Geriatr Psychiatry Neurol 2022; 35:24-37. [PMID: 33205677 DOI: 10.1177/0891988720973759] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Stress has deleterious effects on brain health and yet, the prognostic value of psychosocial stress regarding the most common types of dementias, including Alzheimer disease, is still unclear. The primary aim of this systematic review was to explore the association between psychosocial stress and late onset dementia. We classified 24articles from Medline, PsycINFO, CINAHL, and Web of Science, as pertaining toxic categories of psychosocial and trauma-related stress (low socio-economic status [SES] related inequalities, marital status, posttraumatic stress disorder, work stress, "vital exhaustion" [VE], and, combined stressors). Using the Quality of Prognosis Studies in Systematic Reviews tool, we judged the quality of evidence to be low. This systematic review provided some non-robust, yet suggestive evidence that the above psychosocial types of stress are associated with increased risk of dementia in later life. Future robust, longitudinal studies with repeated validated measures of psychosocial stress and dementiaare required to strengthen or refute these findings.
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Affiliation(s)
- Anastasia Bougea
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Demyelinating Diseases Clinic, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Efthalia Angelopoulou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Spanou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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28
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Oppong RF, Terracciano A, Picard M, Qian Y, Butler TJ, Tanaka T, Moore AZ, Simonsick EM, Opsahl-Ong K, Coletta C, Sutin AR, Gorospe M, Resnick SM, Cucca F, Scholz SW, Traynor BJ, Schlessinger D, Ferrucci L, Ding J. Personality traits are consistently associated with blood mitochondrial DNA copy number estimated from genome sequences in two genetic cohort studies. eLife 2022; 11:77806. [PMID: 36537669 PMCID: PMC9767459 DOI: 10.7554/elife.77806] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
Background Mitochondrial DNA copy number (mtDNAcn) in tissues and blood can be altered in conditions like diabetes and major depression and may play a role in aging and longevity. However, little is known about the association between mtDNAcn and personality traits linked to emotional states, metabolic health, and longevity. This study tests the hypothesis that blood mtDNAcn is related to personality traits and mediates the association between personality and mortality. Methods We assessed the big five personality domains and facets using the Revised NEO Personality Inventory (NEO-PI-R), assessed depressive symptoms with the Center for Epidemiologic Studies Depression Scale (CES-D), estimated mtDNAcn levels from whole-genome sequencing, and tracked mortality in participants from the Baltimore Longitudinal Study of Aging. Results were replicated in the SardiNIA Project. Results We found that mtDNAcn was negatively associated with the Neuroticism domain and its facets and positively associated with facets from the other four domains. The direction and size of the effects were replicated in the SardiNIA cohort and were robust to adjustment for potential confounders in both samples. Consistent with the Neuroticism finding, higher depressive symptoms were associated with lower mtDNAcn. Finally, mtDNAcn mediated the association between personality and mortality risk. Conclusions To our knowledge, this is the first study to show a replicable association between mtDNAcn and personality. Furthermore, the results support our hypothesis that mtDNAcn is a biomarker of the biological process that explains part of the association between personality and mortality. Funding Support for this work was provided by the Intramural Research Program of the National Institute on Aging (Z01-AG000693, Z01-AG000970, and Z01-AG000949) and the National Institute of Neurological Disorders and Stroke of the National Institutes of Health. AT was also supported by the National Institute on Aging of the National Institutes of Health Grant R01AG068093.
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Affiliation(s)
- Richard F Oppong
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Antonio Terracciano
- Department of Geriatrics, Florida State UniversityTallahasseeUnited States,Laboratory of Behavioral Neuroscience, National Institute on AgingBaltimoreUnited States
| | - Martin Picard
- Division of Behavioral Medicine, Department of Psychiatry; Merritt Center and Columbia Translational Neuroscience initiative, Department of Neurology, Columbia University Irving Medical Center; New York State Psychiatric InstituteNew YorkUnited States
| | - Yong Qian
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Thomas J Butler
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Ann Zenobia Moore
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Eleanor M Simonsick
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Krista Opsahl-Ong
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Christopher Coletta
- Laboratory of Genetics and Genomics, National Institute on AgingBaltimoreUnited States
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State UniversityTallahasseeUnited States
| | - Myriam Gorospe
- Laboratory of Genetics and Genomics, National Institute on AgingBaltimoreUnited States
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on AgingBaltimoreUnited States
| | - Francesco Cucca
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle RicercheMonserratoItaly
| | - Sonja W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and StrokeBethesdaUnited States,Department of Neurology, Johns Hopkins University Medical CenterBaltimoreUnited States
| | - Bryan J Traynor
- Department of Neurology, Johns Hopkins University Medical CenterBaltimoreUnited States,Laboratory of Neurogenetics, National Institute on AgingBethesdaUnited States
| | - David Schlessinger
- Laboratory of Genetics and Genomics, National Institute on AgingBaltimoreUnited States
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
| | - Jun Ding
- Translational Gerontology Branch, National Institute on AgingBaltimoreUnited States
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29
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Aschwanden D, Sutin AR, Ledermann T, Luchetti M, Stephan Y, Sesker AA, Zhu X, Terracciano A. Subjective Cognitive Decline: Is a Resilient Personality Protective Against Progression to Objective Cognitive Impairment? Findings from Two Community-Based Cohort Studies. J Alzheimers Dis 2022; 89:87-105. [PMID: 35848026 PMCID: PMC9843496 DOI: 10.3233/jad-220319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is related to personality functioning and risk of subsequent objective cognitive impairment. OBJECTIVE The aim of this study was to examine whether lower neuroticism and higher conscientiousness-resilient personality traits-protect against conversion from SCD to objective cognitive impairment in two longitudinal community-based cohorts. METHODS Data from the Health and Retirement Study (N = 1,741, Mean age = 68.64 years, Follow-up mean = 7.34 years) and the National Health and Aging Trends Survey (N = 258, Mean age = 79.34 years, Follow-up mean = 4.31 years) were analyzed using Cox regression analysis, controlling for sociodemographic covariates, symptoms of anxiety and depression, and apolipoprotein ɛ4. RESULTS The pooled results showed that lower neuroticism and higher conscientiousness were associated with decreased risk of conversion from SCD to objective cognitive impairment. CONCLUSION Among individuals with SCD, those with a resilient personality may have more cognitive and psychological reserve to maintain cognitive functioning and delay conversion to objective cognitive impairment. The findings further contribute to a better understanding of personality along the cognitive continuum: The observed effect sizes were smaller than those reported in cognitively normal individuals but larger than in individuals with mild cognitive impairment. Personality could provide useful information to identify individuals with SCD who may develop objective cognitive impairment-namely those who hold a vulnerable personality (higher neuroticism, lower conscientiousness).
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Affiliation(s)
- Damaris Aschwanden
- Department of Geriatrics, Florida State University College of Medicine, Florida, USA
| | - Angelina R. Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Florida, USA
| | - Thomas Ledermann
- Department of Human Development and Family Science, Florida State University College of Health and Human Sciences, Florida, USA
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Florida, USA
| | | | - Amanda A. Sesker
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Florida, USA
| | - Xianghe Zhu
- Department of Geriatrics, Florida State University College of Medicine, Florida, USA
| | - Antonio Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Florida, USA
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Bullying and Factors Contributing in Alzheimer’s Disease. PSYCHOLOGICAL STUDIES 2021. [DOI: 10.1007/s12646-021-00629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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31
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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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Herrmann FR, Montandon ML, Garibotto V, Rodriguez C, Haller S, Giannakopoulos P. Determinants of Cognitive Trajectories in Normal Aging: A Longitudinal PET-MRI Study in a Community-based Cohort. Curr Alzheimer Res 2021; 18:482-491. [PMID: 34602046 DOI: 10.2174/1567205018666210930111806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 04/01/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The determinants of the progressive decrement of cognition in normal aging are still a matter of debate. Alzheimer disease (AD)-signature markers and vascular lesions, but also psychological variables such as personality factors, are thought to have an impact on the longitudinal trajectories of neuropsychological performances in healthy elderly individuals. OBJECTIVE The current research aimed to identify the main determinants associated with cognitive trajectories in normal aging. METHODS We performed a 4.5-year longitudinal study in 90 older community-dwellers coupling two neuropsychological assessments, medial temporal atrophy (MTA), number of cerebral microbleeds (CMB), and white matter hyperintensities (WMH) at inclusion, visual rating of amyloid and FDG PET at follow-up, and APOE genotyping. Personality factors were assessed at baseline using the NEO-PIR. Univariate and backward stepwise regression models were built to explore the association between the continuous cognitive score (CCS) and both imaging and personality variables. RESULTS The number of strictly lobar CMB at baseline (4 or more) was related to a significant increase in the risk of cognitive decrement. In multivariable models, amyloid positivity was associated with a 1.73 unit decrease of the CCS at follow-up. MTA, WMH and abnormal FDG PET were not related to the cognitive outcome. Among personality factors, only higher agreeableness was related to better preservation of neuropsychological performances. CONCLUSION CMB and amyloid positivity are the only imaging determinants of cognitive trajectories in this highly selected series of healthy controls. Among personality factors, higher agreeableness confers a modest but significant protection against the decline of cognitive performances.
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Affiliation(s)
- François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Sven Haller
- CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland
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Camargo Camargo L, Díaz Rodríguez MC, López Velásquez ND. Personality and Alzheimer's. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00132-3. [PMID: 34518041 DOI: 10.1016/j.rcp.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Loida Camargo Camargo
- Neuróloga, Epidemióloga, Master en Neurociencias, PhD(c) Neurociencia Cognitiva, Universidad del Sinú, Cartagena, Bolívar, Colombia.
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Liang Z, Wu L, Gong S, Liu X. The cognitive dysfunction related to Alzheimer disease or cerebral small vessel disease: What's the differences. Medicine (Baltimore) 2021; 100:e26967. [PMID: 34449462 PMCID: PMC8389965 DOI: 10.1097/md.0000000000026967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 06/14/2021] [Accepted: 08/01/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT Alzheimer disease (AD) and sporadic cerebral small vessel disease (CSVD) are common cognitive disorders. Both AD and CSVD have mental symptoms including chronic progressive cognitive impairment, dysfunction, and behavioral abnormalities. However, the differences on the cognitive dysfunction of AD and CSVD remain unclear. It is necessary to elucidate the cognitive dysfunction differences of AD and CSVD, and to identify the potential risk factors.AD or sporadic CSVD patients treated in our hospital from December 1, 2018 to May 31, 2019 were included. And we selected healthy participants as controls. The mini-mental state examination and Montreal Cognitive Assessment Scale were used for neuropsychological assessment, and related medical information were collected and compared.A total of 190 patients were included. The total mini-mental state examination scores in AD, CSVD group were significantly less than that of control group, there were significant differences in the domains of directional ability, attention and computing ability, delayed recall, and visual perception (all P < .05); the total Montreal Cognitive Assessment Scale scores in AD, CSVD group were significantly less than that of control group. There were significant differences in the domains of visual space and execution, immediate remember, attention and computing ability, language, delayed recall, and directional ability (all P < .05); diabetes was a risk factor both for AD (hazard ratio = 1.63, 95% confidence interval: 1.35-1.97) and CSVD (hazard ratio = 1.15, 95% confidence interval: 1.08-1.27).The cognitive dysfunctions of AD are difference to that of CSVD patients, and diabetes is the risk factor both for AD and CSVD, future studies are needed to further identify the prevention and treatment of AD and CSVD.
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Affiliation(s)
- Zhenhong Liang
- School of Medicine, Taizhou University, Zhejiang Province, Taizhou 318000, China
| | - Lijuan Wu
- School of Medicine, Taizhou University, Zhejiang Province, Taizhou 318000, China
| | - Shumei Gong
- School of Nursing, The second Military Medical Universtiy, Shanghaihai 2000433, China
| | - Xiaohong Liu
- School of Nursing, The second Military Medical Universtiy, Shanghaihai 2000433, China
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Baena A, Bocanegra Y, Torres V, Vila-Castelar C, Guzmán-Vélez E, Fox-Fuller JT, Gatchel JR, Sánchez J, Pluim CF, Ramirez-Gómez L, Martínez J, Pineda D, Lopera F, Quiroz YT. Neuroticism Is Associated with Tau Pathology in Cognitively Unimpaired Individuals with Autosomal Dominant Alzheimer's Disease. J Alzheimers Dis 2021; 82:1809-1822. [PMID: 34219716 DOI: 10.3233/jad-210185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Greater neuroticism has been associated with higher risk for Alzheimer's disease (AD) dementia. However, the directionality of this association is unclear. We examined whether personality traits differ between cognitively-unimpaired carriers of autosomal-dominant AD (ADAD) and non-carriers, and are associated with in vivo AD pathology. OBJECTIVE To determine whether personality traits differ between cognitively unimpaired ADAD mutation carriers and non-carriers, and whether the traits are related to age and AD biomarkers. METHODS A total of 33 cognitively-unimpaired Presenilin-1 E280A mutation carriers and 41 non-carriers (ages 27-46) completed neuropsychological testing and the NEO Five-Factor Personality Inventory. A subsample (n = 46; 20 carriers) also underwent tau and amyloid PET imaging. RESULTS Carriers reported higher neuroticism relative to non-carriers, although this difference was not significant after controlling for sex. Neuroticism was positively correlated with entorhinal tau levels only in carriers, but not with amyloid levels. CONCLUSION The finding of higher neuroticism in carriers and the association of this trait with tau pathology in preclinical stages of AD highlights the importance of including personality measures in the evaluation of individuals at increased risk for cognitive impairment and dementia. Further research is needed to characterize the mechanisms of these relationships.
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Affiliation(s)
- Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Valeria Torres
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Clara Vila-Castelar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joshua T Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Jennifer R Gatchel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Justin Sánchez
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Celina F Pluim
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Liliana Ramirez-Gómez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jairo Martínez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - David Pineda
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Yakeel T Quiroz
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Terracciano A, Aschwanden D, Stephan Y, Cerasa A, Passamonti L, Toschi N, Sutin AR. Neuroticism and Risk of Parkinson's Disease: A Meta-Analysis. Mov Disord 2021; 36:1863-1870. [PMID: 33817817 PMCID: PMC8376751 DOI: 10.1002/mds.28575] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Neuroticism is linked to mood disorders and Alzheimer's disease, but fewer studies have tested the prospective association with Parkinson's disease (PD). OBJECTIVES To examine the association between neuroticism and risk of PD in a large cohort and a meta-analysis of prospective cohort studies. METHODS Participants from the UK Biobank (N = 490,755) completed a neuroticism scale in 2006-2010. Incident PD was ascertained using electronic health records or death records up to 2018. The systematic search and meta-analysis followed the MOOSE guidelines. RESULTS During 11.91 years of follow-up (mean = 8.88 years; 4,360,105 person-years) 1142 incident PD cases were identified. Neuroticism was associated with higher risk of incident PD, both as continuous (HR = 1.28; 95% CI: 1.21-1.36) and categorical variable (top vs. bottom quartiles: HR = 1.88; 95% CI: 1.60-2.22). The association remained significant after accounting for age, sex, smoking, physical activity, anxiety, and depressed mood, and after excluding cases that occurred within the first 5 years of follow-up. The associations were similar for women and men and across levels of socioeconomic status. Random-effect meta-analysis of four prospective studies (N = 548,284) found neuroticism associated with increased risk of incident PD (HR = 1.82; 95% CI: 1.59-2.08; P = 7.31-19 ). There was no evidence of heterogeneity across studies with follow-ups ranging from one to four decades. CONCLUSION The results from the large UK Biobank and meta-analysis of prospective studies indicate that neuroticism is consistently associated with a higher risk of incident PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Antonio Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Damaris Aschwanden
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, FL, USA
| | | | - Antonio Cerasa
- Institute for Biomedical Research and Innovation, National Research Council (IRIB-CNR), 87050 Mangone (CS), Italy
- S. Anna Institute, 88900 Crotone, Italy
| | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Consiglio Nazionale delle Ricerche (CNR), Milano, Italy
| | - Nicola Toschi
- Department of Biomedicine & Prevention, University "Tor Vergata", Rome, Italy
- A.A. Martinos Center for Biomedical Imaging - Harvard Medical School/MGH
| | - Angelina R. Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
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37
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Terracciano A, Aschwanden D, Passamonti L, Toschi N, Stephan Y, Luchetti M, Lee JH, Sesker A, O'Súilleabháin PS, Sutin AR. Is neuroticism differentially associated with risk of Alzheimer's disease, vascular dementia, and frontotemporal dementia? J Psychiatr Res 2021; 138:34-40. [PMID: 33819874 PMCID: PMC8192471 DOI: 10.1016/j.jpsychires.2021.03.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/10/2021] [Accepted: 03/19/2021] [Indexed: 02/04/2023]
Abstract
This study examines whether neuroticism is differentially associated with risk of incident Alzheimer's disease (AD), vascular dementia (VD), and frontotemporal dementia (FTD) using a prospective study design. Participants from the UK Biobank (N = 401,422) completed a self-report neuroticism scale in 2006-2010 and incident all-cause dementia, AD, VD, and FTD were ascertained using electronic health records or death records up to 2018. During an average follow-up of 8.8 years (3,566,123 person-years), there were 1798 incident of all-cause dementia, 675 AD, 376 VD, and 81 FTD. Accounting for age and sex, compared to individuals in the low quartile, individuals in the top quartile of neuroticism had higher risk of all-cause dementia (HR = 1.70; 95% CI: 1.49-1.93), AD (HR = 1.42; 1.15-1.75), VD (HR = 1.73; 1.30-2.29), but not FTD (HR = 0.89; 0.49-1.63). The associations with AD and VD were attenuated but remained significant after further accounting for education, household income, deprivation index, diabetes, hypertension, stroke, heart attack, ever smoker, physical activity, obesity, hemoglobin A1c, C-reactive protein, and low-density lipoprotein. The associations were not moderated by socioeconomic status. The findings were consistent in analyses that excluded cases that occurred within the first 5 years of follow-up. In conclusion, neuroticism is a robust predictor of incident AD and VD, but not FTD. This pattern suggests that the affective symptoms that distinguish dementia types may partly reflect premorbid differences in trait neuroticism.
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Affiliation(s)
| | | | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Consiglio Nazionale delle Ricerche (CNR), Milano, Italy
| | - Nicola Toschi
- Department of Biomedicine & Prevention, University "Tor Vergata", Rome, Italy; A.A. Martinos Center for Biomedical Imaging - Harvard Medical School/MGH, USA
| | | | - Martina Luchetti
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Ji Hyun Lee
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Amanda Sesker
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Páraic S O'Súilleabháin
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - Angelina R Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
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Aschwanden D, Aichele S, Ghisletta P, Terracciano A, Kliegel M, Sutin AR, Brown J, Allemand M. Predicting Cognitive Impairment and Dementia: A Machine Learning Approach. J Alzheimers Dis 2021; 75:717-728. [PMID: 32333585 DOI: 10.3233/jad-190967] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Efforts to identify important risk factors for cognitive impairment and dementia have to date mostly relied on meta-analytic strategies. A comprehensive empirical evaluation of these risk factors within a single study is currently lacking. OBJECTIVE We used a combined methodology of machine learning and semi-parametric survival analysis to estimate the relative importance of 52 predictors in forecasting cognitive impairment and dementia in a large, population-representative sample of older adults. METHODS Participants from the Health and Retirement Study (N = 9,979; aged 50-98 years) were followed for up to 10 years (M = 6.85 for cognitive impairment; M = 7.67 for dementia). Using a split-sample methodology, we first estimated the relative importance of predictors using machine learning (random forest survival analysis), and we then used semi-parametric survival analysis (Cox proportional hazards) to estimate effect sizes for the most important variables. RESULTS African Americans and individuals who scored high on emotional distress were at relatively highest risk for developing cognitive impairment and dementia. Sociodemographic (lower education, Hispanic ethnicity) and health variables (worse subjective health, increasing BMI) were comparatively strong predictors for cognitive impairment. Cardiovascular factors (e.g., smoking, physical inactivity) and polygenic scores (with and without APOEɛ4) appeared less important than expected. Post-hoc sensitivity analyses underscored the robustness of these results. CONCLUSIONS Higher-order factors (e.g., emotional distress, subjective health), which reflect complex interactions between various aspects of an individual, were more important than narrowly defined factors (e.g., clinical and behavioral indicators) when evaluated concurrently to predict cognitive impairment and dementia.
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Affiliation(s)
| | - Stephen Aichele
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Colorado State University, Fort Collins, CO, USA
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss Distance University Institute, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Universities of Lausanne and of Geneva, Switzerland
| | | | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Universities of Lausanne and of Geneva, Switzerland
| | | | | | - Mathias Allemand
- University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Switzerland
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Ma YH, Yang YX, Shen XN, Chen SD, Tan L, Dong Q, Yu JT. Evaluation relationships between subjective wellbeing, personality traits, and Alzheimer's disease: A two-sample Mendelian randomization study. J Psychiatr Res 2021; 137:498-505. [PMID: 33798978 DOI: 10.1016/j.jpsychires.2021.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/19/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Observational studies have suggested that subjective wellbeing and personality traits link to risk of Alzheimer's disease (AD), but it is unclear if these associations are causal. METHODS We performed two-sample Mendelian randomization to assess potential causality. Genetic associations were obtained from the largest genome-wide association studies in Social Science Genetic Association Consortium (N = 298,420), Genetics of Personality Consortium (N = 81,036), and four independent consortia of AD (N = 455,258). We run the inverse variance weighted (IVW) approach as one primary analysis. A Bonferroni-corrected threshold of p < 8.33 × 10-3 was considered significant, and p values between 8.33 × 10-3 and 0.05 were considered to be suggestive of an association. RESULTS The suggestive association with decreased risk of AD was noted for a genetically predicted 1-SD increase in subjective wellbeing (odds ratio = 0.963, 95% confidence interval = 0.930-0.997; p = 0.032). Genetically predicted greater neuroticism was significantly associated with lower subjective wellbeing (β = -0.077; p = 0.004). No putative personality traits were significantly associated with AD risk after correction for multiple tests, including agreeableness (β = -0.0010; p = 0.477), conscientiousness (β = 0.0018; p = 0.270), openness (β = 0.0004; p = 0.738), neuroticism (β = -0.0098; p = 0.262), or extraversion (β = 0.0120; p = 0.262). CONCLUSIONS Subjective wellbeing may independently reduce the risk of AD. Residual confounding is likely to be responsible for the previous observational relationships between personality traits and AD.
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Affiliation(s)
- Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, China
| | - Yu-Xiang Yang
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xue-Ning Shen
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shi-Dong Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, China.
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
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Personality and behavioral changes after brain tumor resection: a lesion mapping study. Acta Neurochir (Wien) 2021; 163:1257-1267. [PMID: 33576912 DOI: 10.1007/s00701-021-04756-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/01/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cognitive functioning is generally well preserved in patients with diffuse low-grade glioma (DLGG), even in the case of extended tumor and resection. To date, the question of personality changes in these patients has received little attention. Our aim was to investigate to what extent certain aspects of personality and behaviors could be affected by DLGG resection. METHODS We used self-reported personality questionnaires (NOEPI-R and TCI-R) and hetero-evaluation of executive behavioral changes in a large sample of 98 patients operated on for DLGG. To compare the patients' scores from the personality questionnaires, we recruited 47 healthy controls participants. To identify the putative neural networks associated with behavioral changes, a combination of voxel-wise and tract-wise lesion-symptom mapping was performed. RESULTS First, results revealed no difference between patients and controls for each subdimension of the NOEPI-R. Regarding the TCI-R, the character dimensions and three out of four temperament dimensions did not differ. Second, behavioral changes (Irritability, Hypoactivity, Anticipative disorders, and disinterest) were reported between 40 and 50% of cases. Third, some personality dimensions (as neuroticism) were strongly predictive of postoperative behavioral disorders (as hypoactivity). Lastly, specific behavioral changes were associated with selective damage to cortical (left inferior frontal gyrus, supplementary motor area, and right fusiform gyrus) and white matter (left inferior fronto-occipital and uncinate fasciculi, right cingulum) structures. CONCLUSION This study demonstrates that extensive lesions caused by DLGGs and their surgical resection have no or minor impact on patients' personality. However, specific personality dimensions are strongly predictive of behavioral disorders suggesting that the observed surgically related behavioral changes are modulated by the personality profile. Finally, the lesion mapping analyses indicate that damage to differential cortical or white matter structures leads to distinct patterns of behavioral abnormalities.
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Pichet Binette A, Vachon-Presseau É, Morris J, Bateman R, Benzinger T, Collins DL, Poirier J, Breitner JCS, Villeneuve S. Amyloid and Tau Pathology Associations With Personality Traits, Neuropsychiatric Symptoms, and Cognitive Lifestyle in the Preclinical Phases of Sporadic and Autosomal Dominant Alzheimer's Disease. Biol Psychiatry 2021; 89:776-785. [PMID: 32228870 PMCID: PMC7415608 DOI: 10.1016/j.biopsych.2020.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Major prevention trials for Alzheimer's disease (AD) are now focusing on multidomain lifestyle interventions. However, the exact combination of behavioral factors related to AD pathology remains unclear. In 2 cohorts of cognitively unimpaired individuals at risk of AD, we examined which combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle (years of education or lifetime cognitive activity) related to the pathological hallmarks of AD, amyloid-β, and tau deposits. METHODS A total of 115 older adults with a parental or multiple-sibling family history of sporadic AD (PREVENT-AD [PRe-symptomatic EValuation of Experimental or Novel Treatments for AD] cohort) underwent amyloid and tau positron emission tomography and answered several questionnaires related to behavioral attributes. Separately, we studied 117 mutation carriers from the DIAN (Dominant Inherited Alzheimer Network) study group cohort with amyloid positron emission tomography and behavioral data. Using partial least squares analysis, we identified latent variables relating amyloid or tau pathology with combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle. RESULTS In PREVENT-AD, lower neuroticism, neuropsychiatric burden, and higher education were associated with less amyloid deposition (p = .014). Lower neuroticism and neuropsychiatric features, along with higher measures of openness and extraversion, were related to less tau deposition (p = .006). In DIAN, lower neuropsychiatric burden and higher education were also associated with less amyloid (p = .005). The combination of these factors accounted for up to 14% of AD pathology. CONCLUSIONS In the preclinical phase of both sporadic and autosomal dominant AD, multiple behavioral features were associated with AD pathology. These results may suggest potential pathways by which multidomain interventions might help delay AD onset or progression.
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Affiliation(s)
- Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Étienne Vachon-Presseau
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
| | - John Morris
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Randall Bateman
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Tammie Benzinger
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John C S Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
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42
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Simon SS. Good News for Dementia Prevention: Multiple Behavioral Features Are Associated With Markers of Brain Pathology in the Preclinical Phase of Sporadic and Autosomal Dominant Alzheimer's Disease. Biol Psychiatry 2021; 89:739-741. [PMID: 33766237 DOI: 10.1016/j.biopsych.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Sharon Sanz Simon
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, New York; Old Age Research Group, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
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Singleton E, Hansson O, Pijnenburg YAL, La Joie R, Mantyh WG, Tideman P, Stomrud E, Leuzy A, Johansson M, Strandberg O, Smith R, Berendrecht E, Miller BL, Iaccarino L, Edwards L, Strom A, Wolters EE, Coomans E, Visser D, Golla SSV, Tuncel H, Bouwman F, Van Swieten JC, Papma JM, van Berckel B, Scheltens P, Dijkstra AA, Rabinovici GD, Ossenkoppele R. Heterogeneous distribution of tau pathology in the behavioural variant of Alzheimer's disease. J Neurol Neurosurg Psychiatry 2021; 92:jnnp-2020-325497. [PMID: 33850001 PMCID: PMC8292599 DOI: 10.1136/jnnp-2020-325497] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/16/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The clinical phenotype of the rare behavioural variant of Alzheimer's disease (bvAD) is insufficiently understood. Given the strong clinico-anatomical correlations of tau pathology in AD, we investigated the distribution of tau deposits in bvAD, in-vivo and ex-vivo, using positron emission tomography (PET) and postmortem examination. METHODS For the tau PET study, seven amyloid-β positive bvAD patients underwent [18F]flortaucipir or [18F]RO948 PET. We converted tau PET uptake values into standardised (W-)scores, adjusting for age, sex and mini mental state examination in a 'typical' memory-predominant AD (n=205) group. W-scores were computed within entorhinal, temporoparietal, medial and lateral prefrontal, insular and whole-brain regions-of-interest, frontal-to-entorhinal and frontal-to-parietal ratios and within intrinsic functional connectivity network templates. For the postmortem study, the percentage of AT8 (tau)-positive area in hippocampus CA1, temporal, parietal, frontal and insular cortices were compared between autopsy-confirmed patients with bvAD (n=8) and typical AD (tAD;n=7). RESULTS Individual regional W-scores ≥1.96 (corresponding to p<0.05) were observed in three cases, that is, case #5: medial prefrontal cortex (W=2.13) and anterior default mode network (W=3.79), case #2: lateral prefrontal cortex (W=2.79) and salience network (W=2.77), and case #7: frontal-to-entorhinal ratio (W=2.04). The remaining four cases fell within the normal distributions of the tAD group. Postmortem AT8 staining indicated no group-level regional differences in phosphorylated tau levels between bvAD and tAD (all p>0.05). CONCLUSIONS Both in-vivo and ex-vivo, patients with bvAD showed heterogeneous distributions of tau pathology. Since key regions involved in behavioural regulation were not consistently disproportionally affected by tau pathology, other factors are more likely driving the clinical phenotype in bvAD.
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Affiliation(s)
- Ellen Singleton
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - William G Mantyh
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Pontus Tideman
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital Lund, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital Lund, Lund, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Maurits Johansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Evi Berendrecht
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Emma E Wolters
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Emma Coomans
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Denise Visser
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Sandeep S V Golla
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Hayel Tuncel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Janne M Papma
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bart van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
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Trait anxiety, a personality risk factor associated with Alzheimer's Disease. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110124. [PMID: 33035604 DOI: 10.1016/j.pnpbp.2020.110124] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 12/25/2022]
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease in elderly population and the leading cause of dementia worldwide. While senile plaques and neurofibrillary tangles have been proposed as the principal histopathologic hallmarks of AD, the exact etiology of this disease is still far from being clearly understood. AD has been recognized as pathological consequences of complex interactions among genetic, aging, medical, life style and psychosocial factors. Recently, the roles of neuroticism personality traits in AD incidence and progression have come into focus. More specifically, increasing evidence has further shown that the trait anxiety, one major component of neuroticism predicting the individual vulnerability in response to stress, is a risk factor for AD and may correlated with various AD pathologies. In this review, we summarized recent literature on the association of trait anxiety with AD. We also discussed the possible neuroendocrinological and neurochemical mechanisms of this association, which may provide clinical implications for AD diagnosis and therapy.
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O'Súilleabháin PS, Turiano NA, Gerstorf D, Luchetti M, Gallagher S, Sesker AA, Terracciano A, Sutin AR. Personality pathways to mortality: Interleukin-6 links conscientiousness to mortality risk. Brain Behav Immun 2021; 93:238-244. [PMID: 33571630 PMCID: PMC7979517 DOI: 10.1016/j.bbi.2021.01.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/21/2020] [Accepted: 01/28/2021] [Indexed: 01/29/2023] Open
Abstract
Personality is associated consistently with mortality hazards, but the physiological pathways are not yet clear. Immune system dysregulation may be one such pathway due to its role in age-related morbidity and mortality. In this preregistered study, we tested whether interleukin-6 (IL-6) and C-reactive protein (CRP) mediated the associations between personality traits and mortality hazards. The sample included 957 participants (M ± SD = 58.65 ± 11.51 years; range = 35-86 years) from the Midlife in the United States Survey that had 14 years of follow-up. Higher conscientiousness was associated with lower mortality hazards, with each one standard deviation higher conscientiousness associated with a 35% lower mortality risk. IL-6, but not CRP, partially mediated this association, with IL-6 accounting for 18% of this association in the fully adjusted model. While there was initial evidence that the biomarkers mediated both neuroticism and agreeableness and mortality risk, the indirect effects were not significant when controlling for the sociodemographic variables. Taken together, higher conscientiousness may lead to a longer life partially as a result of lower IL-6. This work highlights the importance of biological pathways that link personality to future mortality risk.
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Affiliation(s)
- Páraic S O'Súilleabháin
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | | | - Denis Gerstorf
- Department of Psychology, Humboldt University Berlin, Germany
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, United States
| | - Stephen Gallagher
- Department of Psychology, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - Amanda A Sesker
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, United States
| | - Antonio Terracciano
- Department of Geriatrics, Florida State University, Tallahassee, United States
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, United States
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46
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Strickhouser JE, Sutin AR. Personality, Retirement, and Cognitive Impairment: Moderating and Mediating Associations. J Aging Health 2021; 33:187-196. [PMID: 33100104 PMCID: PMC7906949 DOI: 10.1177/0898264320969080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Five-factor model (FFM) personality traits, including higher conscientiousness and lower neuroticism, are associated with lower risk of dementia and cognitive impairment. In this research, we test whether retirement status moderates and/or mediates the relation between personality and cognitive impairment. Method: We used data from the Health and Retirement Study (N = 9899), a longitudinal study of Americans over the age of 50 years, to examine moderating and mediating associations between personality traits and retirement status on risk of dementia and cognitive impairment not dementia (CIND) over an 8-10 year follow-up. Results: Personality and retirement each had strong, independent associations with risk of dementia and CIND. There were not, however, strong or consistent, moderating or mediating associations between personality and retirement predicting impairment risk. Discussion: Overall, these results indicate that personality and retirement are independent risk factors for incident cognitive impairment. Mechanisms other than retirement are likely to explain this association.
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47
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Leggett AN, Bugajski BC, Gitlin LN, Kales HC. Characterizing dementia caregiver style in managing care challenges: Cognitive and behavioral components. DEMENTIA 2021; 20:2188-2204. [PMID: 33517792 DOI: 10.1177/1471301220988233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Caring for a person living with dementia can take a physical and emotional toll, but understudied is the process by which family caregivers actually provide care. Caregiver management styles may vary and affect care decision-making, experiences, receptivity to and participation in interventions, and outcomes for the caregiver and person living with dementia. METHODS Participants included 100 primary family caregivers for persons with dementia who were on average 64 years old and had been providing care for 55 months, 74% women, and 18% nonwhite. Participants were interviewed in Michigan and Ohio regarding their cognitive and behavioral management of a recent care challenge and values guiding their decision-making. The rigorous and accelerated data reduction technique was used to analyze qualitative data leading to the identification of caregiving styles. Styles were compared across sample characteristics using chi-square and ANOVA tests. FINDINGS Five distinct styles emerged: "Externalizers" (superficial understanding, self-focused, and frequent expressions of anger or frustration), "Individualists" (provide care by going alone, emotionally removed, and lack management strategies), "Learners" (recognize need to change their approach but are stuck and emotionally turbulent), "Nurturers" (positive affect and empathy toward care and reflect natural mastery), and "Adapters" (arsenal of acquired management strategies and adapt to challenges). Style groups differed significantly in terms of age and use of formal care supports. DISCUSSION We identified five distinct styles by which caregivers addressed care challenges using a robust qualitative methodology. Styles may be important to identify in order to better tailor interventions to needs and abilities.
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Affiliation(s)
| | - Benjamin C Bugajski
- Ambulatory and Chronic Disease Clinical Trial Support Unit, University of Michigan, USA
| | - Laura N Gitlin
- 15775Drexel University College of Nursing and Health Professions, USA
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, 8789University of California Davis, USA; Department of Psychiatry, 1259University of Michigan, USA
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48
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Zufferey V, Gunten AV, Kherif F. Interactions between Personality, Depression, Anxiety and Cognition to Understand Early Stage of Alzheimer's Disease. Curr Top Med Chem 2021; 20:782-791. [PMID: 32066361 DOI: 10.2174/1568026620666200211110545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 11/25/2019] [Accepted: 12/06/2019] [Indexed: 01/18/2023]
Abstract
The multifaceted nature of Alzheimer's disease (AD) and Mild cognitive impairment (MCI) can lead to wide inter-individual differences in disease manifestation in terms of brain pathology and cognition. The lack of understanding of phenotypic diversity in AD arises from a difficulty in understanding the integration of different levels of network organization (i.e. genes, neurons, synapses, anatomical regions, functions) and in inclusion of other information such as neuropsychiatric characteristics, personal history, information regarding general health or subjective cognitive complaints in a coherent model. Non-cognitive factors, such as personality traits and behavioral and psychiatric symptoms, can be informative markers of early disease stage. It is known that personality can affect cognition and behavioral symptoms. The aim of the paper is to review the different types of interactions existing between personality, depression/anxiety, and cognition and cognitive disorders at behavioral and brain/genetic levels.
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Affiliation(s)
- Valérie Zufferey
- Laboratoire de Recherche en Neuroimagerie (LREN), Departement des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois, Universite de Lausanne, 1011 Lausanne, Switzerland.,Service Universitaire de Psychiatrie de l'Age Avance (SUPAA), Centre Hospitalier Universitaire Vaudois, 1008 Prilly-Lausanne, Switzerland.,Ecole Polytechnique Fédérale de Lausanne (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Armin von Gunten
- Service Universitaire de Psychiatrie de l'Age Avance (SUPAA), Centre Hospitalier Universitaire Vaudois, 1008 Prilly-Lausanne, Switzerland
| | - Ferath Kherif
- Laboratoire de Recherche en Neuroimagerie (LREN), Departement des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois, Universite de Lausanne, 1011 Lausanne, Switzerland
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49
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Graham EK, James BD, Jackson KL, Willroth EC, Boyle P, Wilson R, Bennett DA, Mroczek DK. Associations Between Personality Traits and Cognitive Resilience in Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 76:6-19. [PMID: 32969474 PMCID: PMC8574296 DOI: 10.1093/geronb/gbaa135] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES The goal of this paper was to examine associations between personality traits and resilience to neuropathologic burden. METHOD Using data from the Religious Orders Study and the Rush Memory and Aging Project, we identified a total of 1,375 participants with personality, cognitive, and post-mortem neuropathology data. We regressed cognition onto pathology and extracted the residuals as an indicator of cognitive resilience. We then modeled the effect of Big Five personality traits on cognitive resilience, adjusting for demographics, APOE status, medical comorbidities, and cognitive activity. The analytic plan was preregistered prior to data access or analysis, and all scripts and outputs are available online. RESULTS Higher neuroticism was associated with greater vulnerability to pathology. Results from exploratory analyses suggest that higher conscientiousness was associated with less cognitive decline relative to the amount of pathology, or greater resilience. Education and cognitive activity did not moderate these associations. DISCUSSION Personality may have a pathoplastic effect on neuropathology, as low neuroticism and high conscientiousness are associated with better function despite neuropathologic burden.
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Affiliation(s)
- Eileen K Graham
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Bryan D James
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Kathryn L Jackson
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Emily C Willroth
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Patricia Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Robert Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
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50
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Wiels WA, Wittens MMJ, Zeeuws D, Baeken C, Engelborghs S. Neuropsychiatric Symptoms in Mild Cognitive Impairment and Dementia Due to AD: Relation With Disease Stage and Cognitive Deficits. Front Psychiatry 2021; 12:707580. [PMID: 34483998 PMCID: PMC8415837 DOI: 10.3389/fpsyt.2021.707580] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The interaction between neuropsychiatric symptoms, mild cognitive impairment (MCI), and dementia is complex and remains to be elucidated. An additive or multiplicative effect of neuropsychiatric symptoms such as apathy or depression on cognitive decline has been suggested. Unraveling these interactions may allow the development of better prevention and treatment strategies. In the absence of available treatments for neurodegeneration, a timely and adequate identification of neuropsychiatric symptom changes in cognitive decline is highly relevant and can help identify treatment targets. Methods: An existing memory clinic-based research database of 476 individuals with MCI and 978 individuals with dementia due to Alzheimer's disease (AD) was reanalyzed. Neuropsychiatric symptoms were assessed in a prospective fashion using a battery of neuropsychiatric assessment scales: Middelheim Frontality Score, Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD), Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia (CSDD), and Geriatric Depression Scale (30 items). We subtyped subjects suffering from dementia as mild, moderate, or severe according to their Mini-Mental State Examination (MMSE) score and compared neuropsychiatric scores across these groups. A group of 126 subjects suffering from AD with a significant cerebrovascular component was examined separately as well. We compared the prevalence, nature, and severity of neuropsychiatric symptoms between subgroups of patients with MCI and dementia due to AD in a cross-sectional analysis. Results: Affective and sleep-related symptoms are common in MCI and remain constant in prevalence and severity across dementia groups. Depressive symptoms as assessed by the CSDD further increase in severe dementia. Most other neuropsychiatric symptoms (such as agitation and activity disturbances) progress in parallel with severity of cognitive decline. There are no significant differences in neuropsychiatric symptoms when comparing "pure" AD to AD with a significant vascular component. Conclusion: Neuropsychiatric symptoms such as frontal lobe symptoms, psychosis, agitation, aggression, and activity disturbances increase as dementia progresses. Affective symptoms such as anxiety and depressive symptoms, however, are more frequent in MCI than mild dementia but otherwise remain stable throughout the cognitive spectrum, except for an increase in CSDD score in severe dementia. There is no difference in neuropsychiatric symptoms when comparing mixed dementia (defined here as AD + significant cerebrovascular disease) to pure AD.
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Affiliation(s)
- Wietse A Wiels
- Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Mandy M J Wittens
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Dieter Zeeuws
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Psychiatry, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Chris Baeken
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Psychiatry, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Sebastiaan Engelborghs
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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