Florida State University College of Medicine, Tallahassee, FL.
Euromov, University of Montpellier, Montpellier, France.
J Am Med Dir Assoc. 2019 Feb;20(2):131-137. doi: 10.1016/j.jamda.2018.11.004. Epub 2019 Jan 7.
To examine changes in personality in individuals with mild cognitive impairment (MCI) or dementia as observed by family members using both new data and a meta-analysis with the published literature.
Current and retrospective personality assessments of individuals with dementia by family informants. PubMed was searched for studies with a similar design and a forward citation tracking was conducted using Google Scholar in June 2018. Results from a new sample and from published studies were combined in a random effect meta-analysis.
Family members of older adults with MCI or dementia.
The 5 major dimensions (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and facets of personality were assessed with NEO Personality Inventory questionnaires.
The new sample (n = 50) and meta-analysis (18 samples; n = 542) found consistent shifts in personality from the premorbid to current state in patients with cognitive impairment. The largest changes (>1 standard deviation) were declines in conscientiousness (particularly for the facets of self-discipline and competence) and extraversion (decreased energy and assertiveness), as well as increases in neuroticism (increased vulnerability to stress). The new sample suggested that personality changes were larger in individuals taking cognition-enhancing medications (cholinesterase inhibitors or memantine). More recent studies and those that examined individuals with MCI found smaller effects.
Consistent with the clinical criteria for the diagnosis of dementia, the new study and meta-analysis found replicable evidence for large changes in personality among individuals with dementia. Future research should examine whether there are different patterns of personality changes across etiologies of dementia to inform differential diagnosis and treatments. Prospective, repeated assessments of personality using both self- and informant-reports are essential to clarify the temporal evolution of personality change across the preclinical, prodromal, and clinical phases of dementia.
通过新数据和对已发表文献的荟萃分析，检查轻度认知障碍 (MCI) 或痴呆症患者的家庭成员观察到的人格变化。
痴呆症患者的家庭成员进行当前和回顾性人格评估。使用 PubMed 搜索具有相似设计的研究，并在 2018 年 6 月使用 Google Scholar 进行正向引文追踪。将新样本和已发表研究的结果结合起来进行随机效应荟萃分析。
MCI 或痴呆症老年患者的家庭成员。
使用 NEO 人格量表问卷评估人格的 5 个主要维度（神经质、外向性、开放性、宜人性和尽责性）和人格特质。
新样本（n=50）和荟萃分析（18 个样本；n=542）发现认知障碍患者的人格从发病前状态到当前状态发生了一致的转变。最大的变化（>1 个标准差）是尽责性下降（尤其是自律和能力方面）和外向性下降（精力和自信下降），以及神经质增加（对压力的脆弱性增加）。新样本表明，服用认知增强药物（胆碱酯酶抑制剂或美金刚）的个体人格变化更大。最近的研究和那些检查 MCI 患者的研究发现，影响较小。
与痴呆症的临床诊断标准一致，本研究和荟萃分析发现了可重复的证据，证明痴呆症患者的人格发生了较大变化。未来的研究应探讨不同痴呆症病因的人格变化模式是否不同，以提供鉴别诊断和治疗依据。使用自我报告和知情者报告对人格进行前瞻性、重复评估对于澄清痴呆症临床前、前驱和临床阶段人格变化的时间演变至关重要。
