Neuroticism, negative life events, and dementia in older White and Black Brazilians

Abstract

Objective Exposure to negative life events (NLEs) and neuroticism are associated with dementia. It is unknown whether neuroticism explains or modifies the association of NLEs with dementia in older Black and White Brazilians. Methods A total of 1747 decedents 65 years and older White and Black (11% Black and 23% Mixed) Brazilians, 53% women, were included in the analyses. Data were obtained in a face‐to‐face interview with an informant (71% their children) who knew the decedents for 47 years on average. Dementia was classified using the Clinical Dementia Rating. NLEs were assessed with a 10‐item scale involving common problems (e.g., death, illness, alcoholism, and financial). Neuroticism was assessed with a 6‐item neuroticism scale adapted from the NEO Five‐Factor Inventory. Models adjusted for age, sex, and education. Black and mixed‐race were combined in the analyses. Results NLEs (median of 2) were more common in Blacks than Whites (2.04 vs. 1.82, p = 0.007). More NLEs increased the odds of dementia (OR = 1.112, β = 0.106, p = 0.002), similarly in Blacks and Whites (β interaction = 0.046, p = 0.526). More NLEs were also associated with higher neuroticism (β = 0.071, p < 0.0001), in Whites but not in Blacks (β interaction = −0.048, p = 0.006). Neuroticism was associated with higher odds of dementia (OR = 1.658, β = 0.506, p=<0.001), in Whites but not in Blacks (β interaction = −0.420, p = 0.040). Overall, 34% of the effect of NLEs on dementia was associated with the underlying neuroticism trait in Whites (65%, Indirect OR = 1.060, p < 0.001) but no association was evident in Blacks (6%, Indirect OR = 1.008, p = 0.326). Neuroticism did not moderate the association of NLEs with dementia (OR = 0.979, β = −0.021, p = 0.717). Conclusion The association of NLEs and dementia is partially explained by neuroticism in older White but not in Blacks Brazilians.

Neuropsychiatric symptoms in Brazilians with mild cognitive impairment and dementia

“…We used the informant portion of the Clinical Dementia Rating Scale 13 to classify dementia and MCI proximate to death, as described previously. 14 Function in each of six domains (memory, orientation, judgment and problem solving, community affairs, home and hobbies, personal care) was rated on a 5‐point scale. An algorithm converted the six domain scores to an overall rating of no cognitive impairment (score = 0), MCI (score = 0.5), or dementia (score >0.5).…”

“…We used the informant portion of the Clinical Dementia Rating Scale 13 to classify dementia and MCI proximate to death, as described previously 14 . Function in each of six domains (memory, orientation, judgment and problem solving, community affairs, home and hobbies, personal care) was rated on a 5‐point scale.…”

Quantifying longitudinal cognitive resilience to Alzheimer's disease and other neuropathologies

“…Participation in cognitive activities was calculated based on reported time spent reading books, magazines, newspapers, and playing games; these four items were queried in both ROS and MAP 32,33 . Neuroticism was measured using 12 items from the Revised NEO Personality Inventory (NEO‐PI‐R), and scores could range from 0 to 48, with higher scores indicating more neuroticism 34 . Depressive symptoms were assessed using a modified, 10‐item version of the Center for Epidemiologic Studies Depression scale (CES‐D), with one point assigned for each reported depressive symptom 35 .…”

“…32,33 Neuroticism was measured using 12 items from the Revised NEO Personality Inventory (NEO-PI-R), and scores could range from 0 to 48, with higher scores indicating more neuroticism. 34 Depressive symptoms were assessed using a modified, 10-item version of the Center for Epidemiologic Studies Depression scale (CES-D), with one point assigned for each reported depressive symptom. 35 Further, we examined the APOE ε4 genotype; this is an important risk factor for Alzheimer's dementia and AD pathology, but not for CR, as a way to examine the function of our CR measures for null relations as well.…”

Dementia and autopsy-verified causes of death in racially-diverse older Brazilians

“…Because the index cases were decedents, the study was determined to be of non-human subjects in the United States and IRB exempt in the USA. As previously described [ 20 ], enrollment for PARDoS takes place in the State of Sao Paulo and prioritizes Black/Mixed decedents who are 65 years or older at death, and White decedents with fewer than 9 years of education enriched with admixed ancestry. Many decedents, however, were born in different States.…”