Personality change in old age

Mediating role of coping styles on the relationship between personality types and mental disorders in cardiovascular patients: a cross-sectional study in Iran

BACKGROUND

Many mental problems lead to the occurrence of physical diseases, causing worse consequences of diseases. Despite many studies in the field of personality types and types of mental disorders, this relationship and the mediating role of coping styles in cardiovascular patients are still not well known. Therefore, the present study was conducted to investigate the mediating role of coping styles in the relationship between personality types and mental disorders in cardiovascular patients.

METHOD

The present study is a cross-sectional study that was conducted on 114 cardiovascular patients at the heart center in Bushehr, Iran. The sampling method is simple random sampling. Demographic information form, MCMI-III questionnaire, NEO-FFI questionnaire, and Lazarus and Folkman coping styles questionnaire were used to collect data. Data were analyzed using SPSS 22 and Amos 24 software. Descriptive statistics methods (mean, variance and percentage), Pearson correlation, and structural equation model (SEM) were applied to analyze the data.

RESULTS

The findings showed that the two variables of personality types and problem-oriented explain 15.2% of the variable of mental disorders, of which 10.7% is related to the variable of personality types and 4.5% is related to the intermediate variable of problem-oriented. Among the personality types, the neurotic personality type has the biggest role (0.632) and has a direct and significant effect on mental disorders. Also, the personality types of extroversion (-0.460), agreeableness (-0.312), and responsibility (-0.986) exert inverse and significant effects on mental disorders.

CONCLUSION

The results of the present study showed the frequency of personality disorders and other mental disorders among heart patients. Problem-oriented coping style plays a mediating role between personality types and mental disorders.

The power of personality in successful ageing: a comprehensive review of larger quantitative studies

In this paper, we highlighted links between personality traits and successful ageing through a systematic review of recent empirical studies. Particularly, we addressed the question of whether personality traits are related to successful ageing and, if so, why and how? Answers to this question provided, for example, arguments that supported personality's role in planning an individual's future based on self-knowledge, thereby contributing to a sense of identity throughout their life. Then, considering longitudinal studies, we examined whether personality is stable over one's life course, or does it change and, if so, why and under what conditions? Answers to this question gave substance to the idea that a stable personality allows for continuous and consistent development. In addition, certain personality changes are likely to allow an individual to develop the resilience to better adapt to life's challenges. Therefore, the arguments brought by these two questions can help clarify the modulating role of personality for successful ageing via health and well-being outcomes. These insights may contribute to the development of new prevention approaches, more focused on inter- and intraindividual differences, to promote successful ageing.

Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department. Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age <65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups. Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p < 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p < 0.001), male sex (B = -0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = -0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale. Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.

Differences regarding the five-factor personality model in patients with subjective cognitive decline and mild cognitive impairment

Personality and dementia are connected in different ways. A broad knowledge about personality and prodromal stages of dementia might be helpful to identify dementia as early as possible. Hence, personality differences between three cognitively impaired groups on the basis of patients’ self-assessments of personality traits and connections between personality and cognitive functioning were examined via a cross-sectional study. The sample consisted of cognitively impaired patients (N = 133), aged 50 and older, who came to a memory clinic due to cognitive complaints. The test procedure encompassed a cognitive screening, the Neuropsychological Test Battery Vienna (NTBV), and self-assessment questionnaires such as the Big Five Plus One Persönlichkeitsinventar (B5PO). While patients with subjective cognitive decline (SCD) did not differ from those with non-amnestic mild cognitive impairment (naMCI) concerning the different personality traits, patients with amnestic mild cognitive impairment (aMCI) showed significantly lower scores for extraversion (p < 0.05), openness (p < 0.001), and empathy (p < 0.001) than patients with SCD as well as patients with naMCI. Thus, cognitively impaired groups mainly differ concerning personality traits depending on whether they do show memory decline or not.

Big 5 personality changes in Greek bvFTD, AD, and MCI patients

Patients with neurodegenerative disease show distinct patterns of personality change, some of which may be traced to focal neurological damage, whereas others may be mediated by cultural reactions to functional impairment. Although such changes are early and pervasive in behavioral variant frontotemporal dementia (bvFTD), and milder changes are seen in Alzheimer disease (AD), no study has examined all Big 5 factors of personality in mild cognitive impairment (MCI) patients. In addition, the influence of culture and ethnicity on disease-related personality changes has seldom been examined. Premorbid and current personality were measured in 47 Greek patients with bvFTD, AD, and MCI on the basis of informant reports using the Traits Personality Questionnaire 5, a 5-factor inventory in the Greek language that accounts for Greek cultural factors. bvFTDs showed greater decreases in conscientiousness compared with ADs and MCIs. ADs and MCIs showed increased neuroticism, whereas the bvFTD patients were rated as having become much less neurotic in the course of their disease. The pattern of personality change in MCIs was very similar to that of ADs, supporting recent evidence that personality changes occur as early as the MCI disease stage. In all the groups, personality changes were similar to those previously described in non-Mediterranean cultures, supporting the hypothesis that they may result directly from disease-specific neurological processes.

The concept of dementia: retain, reframe, rename or replace?

From antiquity the term "dementia" has denoted a state of severe acquired intellectual deterioration which significantly interferes with the fulfillment of personal, social or occupational roles, and makes the individual dependent on care and supervision by others. The medical concept of dementia refers to a pattern of cognitive and behavioral symptoms which typically arises from chronic and often progressive brain diseases. The quantitative expression of this pattern shows broad variability, and some patients fall within the boundaries of the concept whose intellectual and functional abilities are only mildly impaired. On the other hand, the concept currently has an unduly narrow qualitative bandwidth, because it is modeled after the subtype which occurs in Alzheimer's disease but does not represent a good fit for other important subtypes. In the authors' view, the concept of dementia should be retained despite its limitations, since it has an important role in directing the physician's attention to a certain group of underlying pathologies. This diagnostic role of the concept will remain important in primary care even if biological indicators for one or several etiologies will become part of the diagnostic routine in research units in the future. The medical construct has further value since it entitles patients to medical treatment, social assistance and legal protection. Although in our opinion the concept of dementia does not need to be replaced, upcoming revisions of the psychiatric classification systems will have to reframe it by emphasizing the heterogeneity of the psychopathological symptom pattern. In view of the increasing importance of early diagnosis and treatment, however, the term "dementia", which literally means "absence of mind", is no longer an appropriate and timely designation for the broad range of cognitive and behavioral limitations covered by the concept. It should be renamed, using a terminology which accommodates scientific advance and meets the requirements of medical communication while preserving the benefits for patients and their families.

[Personality in old age]

Modern developmental psychology tends to draw a positive, resource-based picture of human aging. We will however focus on more difficult aspects of personality in old age which are of psychiatric relevance: the persistence of cluster A and C personality disorders, antisocial personality in the elderly; the interaction of personality and a detection of mild cognitive impairment (MCI); personality features as risk or protective factors or early signs of Alzheimer's dementia; changes of personality in Parkinson's disease and frontotemporal dementia. We will briefly mention recent neuroimaging studies which appear to suggest a functional neuroanatomy of personality. A quote from Cicero's cato major, de senectute indicates that some of his perceptions regarding classic personality characteristics of the elderly can be recognized in our patients and can be prevented or treated with modern interventions.

Ludwig II, King of Bavaria: a royal medical history

OBJECTIVE

The case of Ludwig II, King of Bavaria, had soon become synonymous with paranoia, after he had drowned at the age of 40 together with the neuropsychiatrist Gudden.

METHOD

We were granted access to the Secret Archive of the House of Wittelsbach to study documents on Ludwig's medical history.

RESULTS

The documents underlying Gudden's expert opinion which led to Ludwig being deposed would be insufficient for a diagnosis of schizophrenia according to contemporary standards. The autopsy revealed prominent prefrontal brain atrophy.

CONCLUSION

The evidence is compatible with a diagnosis of schizotypal personality and suspected frontotemporal degeneration.

DSM-IV Personality Disorders and Coronary Heart Disease in Older Adults: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

We evaluated the relationship between seven personality disorders listed in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders and coronary heart disease (CHD) in a nationally representative sample of U.S. older adults. We analyzed data on 10,573 adults aged 60 or older from the National Epidemiologic Survey on Alcohol and Related Conditions. In our results, we found that 13.30% of older adults reported a diagnosis of CHD confirmed by a health professional. Age (odds ratio or OR = 1.04), morbid obesity (OR = 1.59), hypertension (OR = 2.30), nicotine dependence (OR = 1.39), any drug use disorder (OR = 2.13), and any mood disorder (OR = 1.87) increased the odds of having CHD. Female gender (OR = 0.72) and social drinking (OR = 0.71) decreased the odds of having CHD. Controlling for these variables, we found that avoidant (OR = 1.80), schizoid (OR = 1.63), and obsessive-compulsive (OR = 1.37) personality disorders increased the odds of having CHD. Personality disorders may increase the risk of CHD in older adults. Putative mechanisms and directions for future research are proposed.