Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA 19104, USA.
Alzheimer's Disease Research Center, University of Pennsylvania, Philadelphia, PA 19104, USA.
Arch Clin Neuropsychol. 2024 May 21;39(4):399-408. doi: 10.1093/arclin/acad079.
Personality change in Alzheimer's disease and related dementias (ADRD) is complicated by the patient and informant factors that confound accurate reporting of personality traits. We assessed the impact of caregiver burden on informant report of Big Five personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness) and investigated the regional cortical volumes associated with larger discrepancies in the patient and informant report of the Big Five personality traits.
Sixty-four ADRD participants with heterogeneous neurodegenerative clinical phenotypes and their informants completed the Big Five Inventory (BFI). Caregiver burden was measured using the Zarit Burden Interview. Discrepancy scores were computed as the difference between patient and informant ratings for the BFI. Regional gray matter volumes from T1-weighted 3T MRI were normalized to intracranial volume and related to global Big Five discrepancy scores using linear regression.
Higher levels of caregiver burden were associated with higher informant ratings of patient neuroticism (ß = 0.08, p = .012) and with lower informant ratings of patient agreeableness (ß = 0.11, p = .021) and conscientiousness (ß = 0.04, p = .034) independent of disease severity. Patients with greater Big Five discrepancy scores showed smaller cortical volumes in the right medial prefrontal cortex (β = -5.24, p = .045) and right superior temporal gyrus (β = -7.91, p = .028).
Informant ratings of personality traits in ADRD can be confounded by the caregiver burden, highlighting the need for more objective measures of personality and behavior in dementia samples. Discrepancies between informant and patient ratings of personality may additionally reflect loss of insight secondary to cortical atrophy in the frontal and temporal structures.
阿尔茨海默病和相关痴呆症（ADRD）中的人格变化很复杂，因为患者和信息提供者的因素会混淆人格特征的准确报告。我们评估了照顾者负担对信息提供者报告五大人格特质（外向性、宜人性、尽责性、神经质和开放性）的影响，并调查了与患者和信息提供者报告的五大人格特质差异较大相关的皮质区域体积。
64 名具有异质神经退行性临床表型的 ADRD 参与者及其信息提供者完成了五大人格量表（BFI）。使用 Zarit 负担访谈来衡量照顾者负担。差异评分是通过患者和信息提供者对 BFI 的评分计算得出的。从 T1 加权 3T MRI 获得的区域灰质体积被标准化为颅内体积，并使用线性回归与全局五大差异评分相关。
较高的照顾者负担水平与信息提供者对患者神经质的评分较高（β=0.08，p=0.012）以及对患者宜人性和尽责性的评分较低相关（β=0.11，p=0.021；β=0.04，p=0.034），与疾病严重程度无关。具有较大五大差异评分的患者在右侧内侧前额叶皮质（β=-5.24，p=0.045）和右侧颞上回（β=-7.91，p=0.028）的皮质体积较小。
ADRD 中人格特质的信息提供者评分可能会受到照顾者负担的混淆，这突出表明在痴呆症样本中需要更客观的人格和行为测量方法。信息提供者和患者对人格的评分差异可能还反映了额叶和颞叶结构皮质萎缩引起的洞察力丧失。
