Premorbid personality traits and neuropsychiatric symptoms in patients with mild cognitive impairment

Authors

  • Parin Tieosirisap Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Daruj Aniwattanapong Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Personality trait, mild cognitive impairment, mild neurocognitive disorder, neuropsychiatric symptoms, behavioral and psychological symptoms

Abstract

Background: Neuropsychiatric symptoms (NPS) are common in patients with mild cognitive impairment (MCI) and associated with greater functional impairment. NPS may precede the onset of cognitive decline. Thus, recognition of NPS will become increasingly important. Premorbid personality traits might be another potential risk factors of NPS in MCI patients. However, there are still restricted numbers of studies with conflicting data.

Objectives: To examine the association between premorbid personality traits and NPS in patients with MCI.

Methods: This is an observational study of adults aged gif.latex?\geq 50 years with MCI (n = 83). Data collection was performed using a personal information questionnaire, the Thai version of Mini-Mental State Examination (TMSE), Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory Questionnaire (NPI-Q) and International Personality Item (IPIP). Demographic data were analyzed by frequency and percentage. The associated factors of NPS were analyzed using Chi-square, t - test, univariate and multivariate logistic regression.

Results: Among 83 subjects with the mean age of 72.0 gif.latex?\pm7.1, 61.4% were female. The prevalence of NPS was 67.5%. The most common symptoms were irritability (34.9%), sleep problems (31.3%) and anxiety (26.5%), respectively. Premorbid emotionally stable and agreeableness personality trait were significantly lower in MCI with NPS compared to those without NPS (P < 0.05). The low emotionally stable trait was found to be significantly associated with anxiety and sleep problems in MCI patients (P < 0.05). After adjusting for age, gender, education, duration of symptoms, MoCA score, history of psychiatric disorder, psychiatric drugs and cognitive enhancing drugs in a multivariate model, low emotionally stable trait was independently associated with NPS in MCI (OR 0.62, 95% CI 0.38 to 1.00).

Conclusions: MCI subjects with NPS differ in their premorbid personality traits compared to those without NPS. The low premorbid emotionally stable could be considered as one risk factor for NPS in MCI patients.

Downloads

Download data is not yet available.

References

Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairment- beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240-6. https://doi.org/10.1111/j.1365-2796.2004.01380.x

Petersen RC, Lopez O, Armstrong MJ, Getchius TSD, Ganguli M, Gloss D, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90:126-35.

https://doi.org/10.1212/WNL.0000000000004826

Vicini Chilovi B, Conti M, Zanetti M, Mazzù I, Rozzini L, Padovani A. Differential impact of apathy and depression in the development of dementia in mild cognitive impairment patients. Dement Geriatr Cogn Disord 2009;27:390-8. https://doi.org/10.1159/000210045

Lyketsos CG, Lopez O, Jones B, Fitzpatrick AL, Breitner J, DeKosky S. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. Jama 2002;288:1475-83. https://doi.org/10.1001/jama.288.12.1475

Modrego PJ, Ferrández J. Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type: a prospective cohort study. Arch Neurol 2004;61:1290-3.

https://doi.org/10.1001/archneur.61.8.1290

Somme J, Fernandez-Martinez M, Molano A, Zarranz JJ. Neuropsychiatric symptoms in amnestic mild cognitive impairment: increased risk and faster progression to dementia. Curr Alzheimer Res 2013;10:86-94. https://doi.org/10.2174/1567205011310010012

Trivedi SC, Subramanyam AA, Pinto C, Gambhire DD. Neuropsychiatric symptoms in mild cognitive impairment: An analysis and its impact on caregiving. Indian J Psychiatry 2013;55:154-60.

https://doi.org/10.4103/0019-5545.111454

Apostolova LG, Cummings JL. Neuropsychiatric manifestations in mild cognitive impairment: a systematic review of the literature. Dement Geriatr Cogn Disord 2008;25:115-26.

https://doi.org/10.1159/000112509

Gallagher D, Fischer CE, Iaboni A. Neuropsychiatric symptoms in mild cognitive impairment. Can J Psychiatry 2017;62:161-9. https://doi.org/10.1177/0706743716648296

Apostolova LG, Di LJ, Duffy EL, Brook J, Elashoff D, Tseng CH, et al. Risk factors for behavioral abnormalities in mild cognitive impairment and mild Alzheimer's disease. Dement Geriatr Cogn Disord 2014;37:315-26. https://doi.org/10.1159/000351009

Aniwattanapong D, Tangwongchai S, Supasitthumrong T, Hemrunroj S, Tunvirachaisakul C, Tawankanjanachot I, et al. Validation of the Thai version of the short Boston Naming Test (T-BNT) in patients with Alzheimer's dementia and mild cognitive impairment: clinical and biomarker correlates. Aging Ment Health 2018:1-11. https://doi.org/10.1080/13607863.2018.1501668

Mirnics Z, Heincz O, Bagdy G, Suranyi Z, Gonda X, Benko A, et al. The relationship between the big five personality dimensions and acute psychopathology: mediating and moderating effects of coping strategies. Psychiatr Danub 2013;25:379-88.

Osborne H, Simpson J, Stokes G. The relationship between pre-morbid personality and challenging behaviour in people with dementia: A systematic review. Aging Ment Health 2010;14:503-15.

https://doi.org/10.1080/13607861003713208

Mendez Rubio M, Antonietti JP, Donati A, Rossier J, von Gunten A. Personality traits and behavioural and psychological symptoms in patients with mild cognitive impairment. Dement Geriatr Cogn Disord 2013;35: 87-97. https://doi.org/10.1159/000346129

Brandt J, Campodonico JR, Rich JB, Baker L, Steele C, Ruff T, et al. Adjustment to residential placement in Alzheimer disease patients: does premorbid personality matter? Int J Geriatr Psychiatry 1998;13:509-15. https://doi.org/10.1002/(SICI)1099-1166(199808)13:8<509::AID-GPS809>3.0.CO;2-R

Muangpaisan W, Assantachai P, Sitthichai K, Richardson K, Brayne C. The Distribution of Thai Mental State Examination Scores among NonDemented Elderly in Suburban Bangkok Metropolitan and Associated Factors. J Med Assoc Thai 2015;98: 916-24.

Tangwongchai S, Charernboon T, Phanasuthit M, Akkayagorn L, Hemrungrojn S, Phanthumchinda K, et al. The validity of thai version of the montreal cognitive assessment (MoCA-T). Dement Neuropsychol 2009;3:172. [abstract]

Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53:695-9. https://doi.org/10.1111/j.1532-5415.2005.53221.x

Jatupornphan J, Nimnuan C. Reliability and validity of International Personality Item Pool Thai Version (IPIP-Thai). Chula Med J 2013;57:107-19.

Gow AJ, Whiteman MC, Pattie A, Deary IJ. Goldberg's 'IPIP' Big-Five factor markers: Internal consistency and concurrent validation in Scotland. Pers Individ Dif 2005;39:317-29.

https://doi.org/10.1016/j.paid.2005.01.011

Archer N, Brown R, Boothby H, Foy C, Nicholas H, Lovestone S. The NEO FFI is a reliable measure of premorbid personality in patients with probable Alzheimer's disease. Int J Geriatr Psychiatry 2006;21:477-84. https://doi.org/10.1002/gps.1499

Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, et al. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci 2000;12:233-9.

https://doi.org/10.1176/jnp.12.2.233

Monastero R, Mangialasche F, Camarda C, Ercolani S, Camarda R. A systematic review of neuropsychiatric symptoms in mild cognitive impairment. J Alzheimers Dis 2009;18:11-30.

https://doi.org/10.3233/JAD-2009-1120

Edwards ER, Spira AP, Barnes DE, Yaffe K. Neuropsychiatric symptoms in mild cognitive impairment: differences by subtype and progression to dementia. Int J Geriatr Psychiatry 2009;24:716-22.

https://doi.org/10.1002/gps.2187

Sutin AR, Stephan Y, Luchetti M, Terracciano A. Self-reported personality traits are prospectively associated with proxy-reported behavioral and psychological symptoms of dementia at the end of life. Int J Geriatr Psychiatry 2018;33:489-94. https://doi.org/10.1002/gps.4782

Low L-F HF, Lackersteen SM. Does personality affect risk for dementia? A systematic review and metaanalysis. Am J Geriatr Psychiatry 2013;21:713-28. https://doi.org/10.1016/j.jagp.2012.08.004

Archer N, Brown RG, Reeves SJ, Boothby H, Nicholas H, Foy C, et al. Premorbid personality and behavioral and psychological symptoms in probable Alzheimer disease. Am J Geriatr Psychiatry 2007;15:202-13. https://doi.org/10.1097/01.JGP.0000232510.77213.10

Farnam A, Farhang S, Bakhshipour A, Niknam E. The five factor model of personality in mixed anxietydepressive disorder and effect on therapeutic response. Asian J Psychiatr 2011;4:255-7.

https://doi.org/10.1016/j.ajp.2011.10.001

Löckenhoff CE, Terracciano A, Ferrucci L, Costa PT, Jr. Five-factor personality traits and age trajectories of self-rated health: the role of question framing. J Pers 2012; 80: 375-401.

https://doi.org/10.1111/j.1467-6494.2011.00724.x

Kotov R, Gamez W, Schmidt F, Watson D. Linking "big" personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychol Bull 2010;136:768-821.

https://doi.org/10.1037/a0020327

Pocnet C, Rossier J, Antonietti JP, von Gunten A. Personality traits and behavioral and psychological symptoms in patients at an early stage of Alzheimer's disease. Int J Geriatr Psychiatry 2013;28:276-83.

https://doi.org/10.1002/gps.3822

Downloads

Published

2023-07-26

How to Cite

1.
Tieosirisap P, Aniwattanapong D. Premorbid personality traits and neuropsychiatric symptoms in patients with mild cognitive impairment. Chula Med J [Internet]. 2023 Jul. 26 [cited 2024 Oct. 12];64(2). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/192