Authors: Rouch, Isabelle | Padovan, Catherine | Pongan, Elodie | Boublay, Nawéle | Laurent, Bernard | Dorey, Jean-Michel | Krolak-Salmon, Pierre
Article Type: Research Article
Abstract: Background: A link between personality traits and cognitive performance has been shown in normal adults and elderly individuals. Very few studies have evaluated this link in Alzheimer’s disease (AD). Objective: To better understand cognitive performance as regards to personality traits, our study was aimed to evaluate the role of premorbid personality on cognitive functioning in a population of patients presenting prodromal or mild AD. Methods: 181 elderly with prodromal or mild AD participated in a cross-sectional, prospective cohort study. The participants completed a personality inventory and a neuropsychological battery exploring memory, attention, executive function, language, and praxis. Cognitive performance were …compared according to the level of each personality trait, using multivariate MANOVA models. Results: A higher level of neuroticism was associated with lower performance at similarities test (D = 9.49, p = 0.003), delayed Free and Cued Selective Reminding test (D = 5.22, p = 0.02), and digit span score (D = 7.99, p = 0.006). A higher level of openness was related to better performance at similarities (D = 4.33, p = 0.04), letter fluency (D = 11.45, p = 0.001), and category fluency test (D = 5.85, p = 0.02). Neuroticism interfered negatively with cognitive functioning at the prodromal stage; the association between openness and cognitive function was observed at both prodromal and mild AD stage. Conclusion: These results suggest that personality traits, in particular neuroticism and openness, modulate cognitive abilities in patients with early AD. These results encourage the development of stress management programs to prevent its negative effects on cognitive aging. Show more
Keywords: Alzheimer’s disease, cognitive function, neuroticism, openness, personality
DOI: 10.3233/JAD-190459
Citation: Journal of Alzheimer's Disease, vol. 71, no. 4, pp. 1153-1162, 2019
Authors: Dorey, Jean-Michel | Rouch, Isabelle | Padovan, Catherine | Boublay, Nawèle | Pongan, Elodie | Laurent, Bernard | PACO Group | von Gunten, Armin | Krolak-Salmon, Pierre
Article Type: Research Article
Abstract: Background: Neuroticism is recognized as the personality domain that is most strongly associated with behavioral and psychological symptoms (BPS) of Alzheimer’s disease (AD). Two sub-components of neuroticism have been recently isolated. Neuroticism-withdrawal (N-withdrawal) refers to the tendency to internalize negative emotion, whereas neuroticism-volatility (N-volatility) reflect the predisposition to externalize negative emotions. Objective: The objective of the current study was to investigate the specific influence of these two sub-components of neuroticism on BPS. Methods: One hundred eighty-seven patients with prodromal or mild AD were drawn from the PACO study (Personalité Alzheimer COmportement). Neuroticism and its facets were assessed at baseline using …the NEO-PI-R inventory. N-withdrawal and N-volatility were isolated using a principal component analysis led on the six facets composing neuroticism. BPS were measured with the short version of Neuropsychiatric Inventory (NPI-Q) and collected at baseline, then every 6 months over an 18-month follow-up. Linear mixed-effect analyses were conducted to investigate the association between N-withdrawal, N-volatility, and the severity of BPS over the follow-up. Results: Mean age of the participant was 79.2±6.5; 59% were female; mean MMSE was 24.5±2.5. Both N-volatility and N-withdrawal were related with the NPI-Q (p < 0.001; p = 0,004). N-withdrawal was positively associated with anxiety (p = 0.001) and depression (p = 0.002), while N-volatility was positively related to delusions (p = 0.004), agitation/aggression (p < 0.001), irritability/volatility (p = 0.037), and apathy (p = 0.021). Conclusion: The present study demonstrates that N-volatility and N-withdrawal influence the risk of developing BPS in a different way. These results highlight the relevance of considering sub-components of neuroticism when studying links between personality and BPS. Show more
Keywords: Alzheimer’s disease, behavior, dementia, neuroticism, personality
DOI: 10.3233/JAD-190884
Citation: Journal of Alzheimer's Disease, vol. 74, no. 1, pp. 79-89, 2020
Authors: Rouch, Isabelle | Dorey, Jean-Michel | Padovan, Catherine | Trombert-Paviot, Béatrice | Benoit, Michel | Laurent, Bernard | PACO group (appendix) | Boublay, Nawèle | Krolak-Salmon, Pierre
Article Type: Research Article
Abstract: Background: Premorbid personality could play a role in the onset of behavioral and psychological symptoms (BPS) in Alzheimer’s disease (AD) but prospective studies are lacking. Objective: The present study aimed at prospectively assessing the influence of premorbid personality traits on BPS evolution in a population of patients with prodromal or mild AD. Methods: We used a multicenter prospective cohort study of 237 patients followed-up for 18 months. The influence of personality traits on BPS evolution, measured with Neuropsychiatric Inventory (NPI), was assessed using linear mixed-effect models. Results: A principal components analysis of the 12 NPI behavioral domains yielded five factors …labelled as psychotic symptoms, affective symptoms, behavioral dyscontrol, apathy/appetite symptoms, and sleep disorders. During the follow-up, higher neuroticism was significantly associated with a higher progression of affective symptoms (p < 0.0001), apathy/appetite symptoms (p = 0.002), sleep disorders (p = 0.001) as well as global NPI scores (p < 0.0001). Greater conscientiousness was related to a lower evolution of psychotic (p = 0.002), affective (p = 0.02) and apathy/appetite symptoms (p = 0.02), and global NPI score (p < 0.0001). Higher openness was associated with lower affective symptoms evolution (p = 0.01). A significant relationship was found between higher extraversion, lower affective symptoms (p = 0.02), and higher behavioral dyscontrol (p = 0.04). Conclusion: The present analysis suggests that premorbid personality may influence the evolution of BPS in prodromal or mild AD. Given these results, it seems important to give more importance to personality assessment in early AD, in order to better identify and manage patients at risk of adverse behavioral changes. Show more
Keywords: Alzheimer’s disease, behavior, dementia, neuropsychiatry
DOI: 10.3233/JAD-190183
Citation: Journal of Alzheimer's Disease, vol. 69, no. 4, pp. 1099-1108, 2019
Authors: Boublay, Nawele | Bouet, Romain | Dorey, Jean-Michel | Padovan, Catherine | Makaroff, Zaza | Fédérico, Denis | Gallice, Isabelle | Barrellon, Marie-Odile | Robert, Philippe | Moreaud, Olivier | Rouch, Isabelle | Krolak-Salmon, Pierre | Alzheimer’s Disease Neuroimaging Initiative
Article Type: Research Article
Abstract: Background: Behavioral and psychological symptoms of dementia (BPSD) are frequent and troublesome for patients and caregivers. Considering possible preventive approaches, a better understanding of underlying neural correlates of BPSD is crucial. Objective: The aim is to assess whether brain regional volume predicts behavioral changes in mild AD. Methods: This work took part from the PACO study, a multicenter and prospective study that included 252 patients with mild AD from 2009 to 2014. Fifty-three patients were retained. Forty healthy matched control subjects from the ADNI cohort were included as controls. Voxel-based morphometry analysis was conducted to assess regional brain volume using …baseline MRI scans as a predictor of future behavioral changes over a period of 18 months. Behavior was assessed at baseline and longitudinally at 6-month intervals using the shortened form of the Neuropsychiatric Inventory (NPI). Results: The volume of 23 brain structures in frontal, temporal, parietal, occipital, subcortical regions and cerebellum predicted the evolution of NPI scores. Frontal volume was the most powerful predictor with frontal gyri, anterior cingulate cortex, and orbital gyri being particularly involved. Conclusion: To our knowledge, this is the first study assessing regional brain volumes as predictors of behavioral changes considered at earlier stages of AD. Up to 23 brain structures were associated with an increased risk of developing BPSD. Frontal lobe volume was the strongest predictor of future evolution of NPI. The involvement of multiple structures in the prediction of behavior suggests a role of the main large-scale networks involved in cognition. Show more
Keywords: Alzheimer’s disease, behavioral and psychological symptoms of dementia, Neuropsychiatric Inventory, magnetic resonance imaging, neuroimaging
DOI: 10.3233/JAD-190612
Citation: Journal of Alzheimer's Disease, vol. 73, no. 4, pp. 1343-1353, 2020