Personality Changes in Alzheimer's Disease

Chatterjee, Anjan; Strauss, Milton E.; Smyth, Kathleen A.; Whitehouse, Peter J.

doi:10.1001/archneur.1992.00530290070014

Cited by 168 publications

(178 citation statements)

References 32 publications

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“…Informants indicate whether change is present or absent; however, there is no consideration of the degree of change. A structured and more sophisticated interview such as the Neuroticism Extroversion Openness-Personality Inventory (NEO-PI), [35][36][37] Neuropsychiatric Invento- ry, 38,39 or the BEHAVE-AD 40 might yield more detailed and comprehensive information regarding what facets of personality change first and what degree of change is indicative of dementia. The sample was not population-based, and thus we cannot directly compare our findings with epidemiologic data.…”

Section: Dlb Vs Ad Ever Present During Longitudinal Follow-upmentioning

confidence: 99%

Personality traits distinguishing dementia with Lewy bodies from Alzheimer disease

Galvin¹,

Malcom²,

Johnson³

et al. 2007

Neurology

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Objective: To identify personality traits that distinguish dementia with Lewy bodies (DLB) from Alzheimer disease (AD). Methods: We examined 290 participants enrolled in a longitudinal study (nondemented control ϭ 34, DLB ϭ 128, AD ϭ 128) followed to autopsy. As part of the annual interview with the collateral source, the clinician asked about specific changes in personality, interests, and drives based on items from the Blessed Dementia Scale (BDS). Statistical analysis was performed using 2 and Fisher exact tests. Factor analysis was performed to determine underlying structure and receiver operating characteristic curves assessed the ability for each of three derived factors to discriminate DLB from AD. Results: The sample was evaluated for a mean of 4.8 visits (range 1 to 14) with a mean age of 77.6 Ϯ 9.9 years. The participants' cognitive status ranged from nondemented (Clinical Dementia Rating [CDR] 0) through all stages of dementia (CDR Ն 0.5). Personality traits that distinguished DLB included diminished emotional responsiveness (p ϭ 0.004), relinquishing hobbies (p ϭ 0.01), growing apathy (p ϭ 0.03), and purposeless hyperactivity (p ϭ 0.003).Factor analyses of the BDS revealed a PASSIVE factor (diminished emotional responsiveness, relinquished hobbies, growing apathy, and purposeless hyperactivity) explaining 10.4% of variance and that DLB was more likely to manifest these personality traits than AD (p ϭ 0.001). The PASSIVE factor discriminated DLB from AD (area under the curve ϭ 0.61, 95% CI: 0.54 to 0.68, p ϭ 0.006).Any change in personality is associated with the presence of visual hallucinations. Conclusions: Our results suggest that incorporating a brief, simple inventory of personality traits may improve the identification of individuals with dementia with Lewy bodies. NEUROLOGY 2007;68: [1895][1896][1897][1898][1899][1900][1901] Identifying the earliest features of dementia enables clinicians to implement therapy as soon as possible and provides patients and families more time to plan for the accompanying progressive decline. Much effort has focused on the cognitive symptoms of dementia syndromes such as impairments in memory, visuospatial, attention, and executive function. An alternative approach to improve early detection is to study noncognitive symptoms such as behavioral and personality changes that may precede diagnosis or occur early in the course of the dementia.

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Section: Dlb Vs Ad Ever Present During Longitudinal Follow-upmentioning

confidence: 99%

Personality traits distinguishing dementia with Lewy bodies from Alzheimer disease

Galvin¹,

Malcom²,

Johnson³

et al. 2007

Neurology

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“…At that, only a few studies have systematically investigated personality changes in patients with Alzheimer disease. However, some studies [3][4][5] have examined changes in personality traits among patients with Alzheimer disease using ratings from close relatives asked to compare current with retrospective personality. These studies show that premorbid personality traits were the only significant predictor of change for neuroticism (particularly higher anxiety, depression, and vulnerability facets), extraversion (lower assertiveness and activity facets), and lower openness to new ideas, fantasy, esthetics, and values.…”

mentioning

confidence: 99%

Personality Changes in Patients with Beginning Alzheimer Disease

et al. 2011

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Objective: To investigate personality traits in patients with Alzheimer disease, compared with mentally healthy control subjects. We compared both current personality characteristics using structured interviews as well as current and previous personality traits as assessed by proxies. Method: Fifty-four patients with mild Alzheimer disease and 64 control subjects described their personality traits using the Structured Interview for the Five-Factor Model. Family members filled in the Revised NEO Personality Inventory, Form R, to evaluate their proxies' current personality traits, compared with 5 years before the estimated beginning of Alzheimer disease or 5 years before the control subjects. Results: After controlling for age, the Alzheimer disease group presented significantly higher scores than normal control subjects on current neuroticism, and significantly lower scores on current extraversion, openness, and conscientiousness, while no significant difference was observed on agreeableness. A similar profile, though less accentuated, was observed when considering personality traits as the patients' proxies remembered them. Diachronic personality assessment showed again significant differences between the 2 groups for the same 4 domains, with important personality changes only for the Alzheimer disease group. Conclusions: Group comparison and retrospective personality evaluation are convergent. Significant personality changes follow a specific trend in patients with Alzheimer disease and contrast with the stability generally observed in mentally healthy people in their personality profile throughout their lives. Whether or not the personality assessment 5 years before the current status corresponds to an early sign of Alzheimer disease or real premorbid personality differences in people who later develop Alzheimer disease requires longitudinal studies.

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“…Persons who rank high on this trait enjoy new activities and like to explore their environment, whereas persons who rank low on this trait prefer more conventional activities. Traits remain relatively stable in adulthood (Hooker & McAdams, 2003), and there is evidence that facets of extraversion and the trait of openness maintain both rank order and mean level stability in dementia (Chatterjee, Strauss, Smyth, & Whitehouse, 1992;Siegler et al, 1991;Strauss, Lee, & Di Filippo, 1997). These long-standing tendencies have been used to identify activity interests in persons with dementia, and improved prescriptive precision over current approaches (Kolanowski, Buettner, Costa, & Litaker, 2001).…”

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confidence: 99%

Efficacy of Theory-Based Activities for Behavioral Symptoms of Dementia

2005

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Abstract:Background: Agitation and passivity are behavioral symptoms exhibited by 90% of nursing home residents with dementia. They account for many poor health outcomes, caregiver burden, and increased costs of longterm care. Objectives: This study tested the efficacy of recreational activities derived from the Need-driven Dementiacompromised Behavior (NDB) model: activities matched to skill level only; activities matched to style of interest only; and a combination of both (NDB-derived) for responding to the behavioral symptoms of dementia. Methods: Thirty participants were randomly assigned to 1 of 6 possible order-of-condition presentations in this crossover experimental design with repeated measures of dependent variables. Trained research assistants, blind to condition match, implemented each condition for 12 consecutive days. Measures of engagement (time on task and participation), affect, and behavioral symptoms (agitation and passivity) were taken from videotape recordings of each session. Mood was measured with the Dementia Mood Picture Test. The primary analysis method was mixed-model analysis of variance. Results: Significantly more time on task, greater participation, more positive affect, and less passivity were found under NDB-derived and matched to interest only treatments compared with the matched to skill level only treatment or baseline. Agitation and negative affect improved under all treatments compared with baseline. There was no significant change in mood. Discussion: The NDB-derived activities are tailored to meet individual needs and improve behavioral symptoms associated with dementia. These findings help to explain factors that produce behavioral symptoms and the mechanisms that underlie their successful treatment.

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Personality Changes in Alzheimer's Disease

Cited by 168 publications

References 32 publications

Personality traits distinguishing dementia with Lewy bodies from Alzheimer disease

Personality traits distinguishing dementia with Lewy bodies from Alzheimer disease

Personality Changes in Patients with Beginning Alzheimer Disease

Efficacy of Theory-Based Activities for Behavioral Symptoms of Dementia

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