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. 2018 Apr;66(4):671-678.
doi: 10.1111/jgs.15182. Epub 2018 Jan 17.

Personality Changes During the Transition from Cognitive Health to Mild Cognitive Impairment

Richard J Caselli  1 , Blake T Langlais  2 , Amylou C Dueck  2 , Bruce R Henslin  3 , Travis A Johnson  3 , Bryan K Woodruff  1 , Charlene Hoffman-Snyder  1 , Dona E C Locke  4
Affiliations

Personality Changes During the Transition from Cognitive Health to Mild Cognitive Impairment

Richard J Caselli et al. J Am Geriatr Soc. 2018 Apr.

Abstract

Background/objectives: Behavioral problems in individuals with Alzheimer's disease (AD) impose major management challenges. Current prevention strategies are anchored to cognitive outcomes, but behavioral outcomes may provide another, clinically relevant opportunity for preemptive therapy. We sought to determine whether personality changes that predispose to behavioral disorders arise during the transition from preclinical AD to mild cognitive impairment (MCI).

Design: Longitudinal observational cohort study.

Setting: Academic medical center.

Participants: Members of an apolipoprotein E (APOE) ɛ4 genetically enriched cohort of Maricopa County residents who were neuropsychiatrically healthy at entry (N = 277). Over a mean interval of 7 years, 25 who developed MCI and had the Neuroticism, Extraversion, and Openness Personality Inventory-Revised (NEO-PI-R) before and during the MCI transition epoch were compared with 252 nontransitioners also with serial NEO-PI-R administrations.

Intervention: Longitudinal administration of the NEO-PI-R and neuropsychological test battery.

Measurements: Change in NEO-PI-R factor scores (neuroticism, extraversion, openness, agreeableness, conscientiousness) from entry to the epoch of MCI diagnosis or an equivalent follow-up duration in nontransitioners.

Results: NEO-PI-R neuroticism T-scores increased significantly more in MCI transitioners than in nontransitioners (mean 2.9, 95% confidence interval (CI) = 0.9-4.9 vs 0, 95% CI = -0.7-0.7, P = .02), and openness decreased more in MCI transitioners than in nontransitioners (-4.8, 95% CI = -7.3 to -2.4 vs -1.0, 95% CI = -1.6 to -0.4, P < .001). Concurrent subclinical but statistically significant changes in behavioral scores worsened more in MCI transitioners than nontransitioners for measures of depression, somatization, irritability, anxiety, and aggressive attitude.

Conclusion: Personality and subclinical behavioral changes begin during the transition from preclinical AD to incident MCI and qualitatively resemble the clinically manifest behavioral disorders that subsequently arise in individuals with frank dementia.

Keywords: NEO-Personality Inventory-Revised; aging; behavioral disorder; mild cognitive impairment; personality change; preclinical Alzheimer's disease.

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Conflict of interest statement

Conflicts of Interest

Blake T. Langlais, BS reports no disclosures.

Amylou C. Dueck, PhD reports no disclosures.

Bruce R. Henslin, BA reports no disclosures.

Travis A. Johnson, BA reports no disclosures.

Charlene Hoffman-Snyder, DNP reports no disclosures.

Dona E. C. Locke, PhD reports no disclosures.

Figures

Figure 1
Figure 1. Mean Changes in NEO-PI-R Scores by MCI Transition Status
Fishbone plot of NEO-PI-R changes in MCI transitioners (left) and nontransitioners (right). a Unadjusted T-test P ≤ .05; b ANCOVA adjusted for first NEO-PI-R score and time interval P ≤ .05. Note that all significant differences indicate greater “worsening” in the MCI transitioners relative to the nontransitioners.
See this image and copyright information in PMC

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