School of Medicine, The University of Queensland, Brisbane, Australia.
Int J Geriatr Psychiatry. 2011 Oct;26(10):1019-29. doi: 10.1002/gps.2655. Epub 2010 Nov 9.
People with Alzheimer's disease (AD) commonly exhibit changes in personality that sometimes precede the other early clinical manifestations of the condition, such as cognitive impairment and mood changes. Although these personality changes reflect the impact of progressive brain damage, there are several possible patterns of personality change with dementia. Early identification of personality change might assist with the timely diagnosis of AD. The objective of this study was to review studies of personality change in AD.
Systematic searches of the PubMed, Ovid Medline, EBSCOhost, PsychINFO and CINAHL databases were undertaken from inception to November 2009. Published studies of informant-rated personality traits in AD patients were identified. Studies that mapped changes in traits from the five-factor model of personality which includes factors for Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness, were selected for analysis. The change in each of these five traits was calculated as the mean difference in score before and after the diagnosis of AD.
There was a mean increase in Neuroticism of 10-20 T scores (equivalent to 1-2 SD), a decrease of the same magnitude in Extraversion, consistently reduced Openness and Agreeableness, and a marked decrease in Conscientiousness of about 20-30 T scores (equivalent to 2-3 SD). These changes were systematic and consistent. Particularly striking was the similarity of both the magnitude and direction of change in all studies reviewed.
Conscientiousness and Neuroticism are the personality traits that exhibit the most change in dementia. These traits might be useful early markers of dementia.
阿尔茨海默病（AD）患者通常会出现人格改变，这些改变有时会先于该疾病的其他早期临床症状出现，如认知障碍和情绪变化。尽管这些人格改变反映了进行性脑损伤的影响，但痴呆症患者的人格改变可能有几种模式。早期识别人格改变可能有助于及时诊断 AD。本研究的目的是回顾 AD 患者人格改变的研究。
从建库到 2009 年 11 月，系统地检索了 PubMed、Ovid Medline、EBSCOhost、PsychINFO 和 CINAHL 数据库。确定了 AD 患者的知情者评定人格特质的已发表研究。选择分析符合五因素人格模型（包括神经质、外向性、开放性、宜人性和尽责性）的特质变化的研究。使用特质得分前后差值来计算每个特质的变化，差值用 T 分数表示（相当于 1-2 个标准差）。
神经质的 T 分数平均增加 10-20 分（相当于 1-2 个标准差），外向性的 T 分数平均降低相同幅度，开放性和宜人性持续降低，尽责性的 T 分数明显降低 20-30 分（相当于 2-3 个标准差）。这些变化是系统性和一致性的。特别是在所有回顾的研究中，变化的幅度和方向都非常相似。
尽责性和神经质是痴呆症中改变最大的人格特质。这些特质可能是痴呆症的早期有用标志物。
