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

Richard John Caselli, Blake T. Langlais, Amylou Dueck, Bruce R. Henslin, Travis A. Johnson, Bryan K Woodruff, Charlene Hoffman-Snyder, Dona E Locke

Research output: Contribution to journalArticle

9 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)671-678
Number of pages8
JournalJournal of the American Geriatrics Society
Volume66
Issue number4
DOIs
StatePublished - Apr 1 2018

Fingerprint

Health Transition
Personality
Confidence Intervals
Alzheimer Disease
Personality Tests
Apolipoprotein E4
Cognitive Dysfunction
Neuropsychological Tests
Neuroticism
Observational Studies
Dementia
Extraversion (Psychology)
Cohort Studies
Anxiety
Depression

Keywords

  • aging
  • behavioral disorder
  • mild cognitive impairment
  • NEO-Personality Inventory-Revised
  • personality change
  • preclinical Alzheimer's disease

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Personality Changes During the Transition from Cognitive Health to Mild Cognitive Impairment. / Caselli, Richard John; Langlais, Blake T.; Dueck, Amylou; Henslin, Bruce R.; Johnson, Travis A.; Woodruff, Bryan K; Hoffman-Snyder, Charlene; Locke, Dona E.

In: Journal of the American Geriatrics Society, Vol. 66, No. 4, 01.04.2018, p. 671-678.

Research output: Contribution to journalArticle

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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.",
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AU - Caselli, Richard John

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AU - Dueck, Amylou

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AU - Johnson, Travis A.

AU - Woodruff, Bryan K

AU - Hoffman-Snyder, Charlene

AU - Locke, Dona E

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N2 - 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.

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