Euromov, University of Montpellier, Montpellier, France.
Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.
J Am Med Dir Assoc. 2024 Oct;25(10):105175. doi: 10.1016/j.jamda.2024.105175. Epub 2024 Jul 27.
Mild cognitive impairment (MCI) is a critical stage preceding incident dementia, but not all individuals with MCI progress to dementia and some revert to normal cognition. This study examined whether personality is associated with the probability of transition from MCI to normal cognition or dementia.
Longitudinal observational study.
Older adults with MCI from the Health and Retirement Study (N = 1608, 56% female, mean age = 72.29, SD = 9.91). Personality traits; cognitive status; and demographic (age, sex, education, race, and ethnicity), clinical (diabetes, hypertension), behavioral (smoking, physical activity), psychological (depressive symptoms), and genetic (apolipoprotein E ε4) covariates were obtained in 2006/2008. Follow-up data on cognitive status were collected every 2 years up to the 2020 wave.
Cox regression analyses tested the association between personality and reversion from MCI to normal cognition and progression to dementia, controlling for demographic, clinical, behavioral, psychological, and genetic covariates.
Controlling for demographic factors, lower neuroticism and higher openness and conscientiousness were associated with a higher likelihood of reversion from MCI to normal cognition and a lower risk of progression to dementia over time. Higher agreeableness was related to a lower risk of progression to dementia. Clinical, behavioral, psychological, and genetic factors partially accounted for these associations. There was little evidence that demographic, genetic factors, or baseline cognition moderated these associations.
Personality traits can help identify individuals who are more likely to revert from MCI and not progress to dementia. These findings suggest that even during mild impairment, personality may modulate dementia risk and thus inform targeted interventions.
轻度认知障碍（MCI）是发生痴呆症的关键阶段，但并非所有 MCI 患者都会发展为痴呆症，有些患者会恢复正常认知。本研究旨在探讨人格特质是否与从 MCI 向正常认知或痴呆症转变的概率相关。
纵向观察性研究。
来自健康与退休研究（Health and Retirement Study，HRS）的 1608 名 MCI 老年人（56%为女性，平均年龄 72.29 岁，标准差 9.91 岁）。2006/2008 年获取了人格特质、认知状态以及人口统计学（年龄、性别、教育程度、种族和民族）、临床（糖尿病、高血压）、行为（吸烟、身体活动）、心理（抑郁症状）和遗传（载脂蛋白 E ε4）等协变量数据。在 2020 年之前，每两年对认知状态进行一次随访。
采用 Cox 回归分析，控制人口统计学、临床、行为、心理和遗传协变量后，检验人格特质与从 MCI 恢复正常认知以及向痴呆症进展之间的关联。
控制人口统计学因素后，较低的神经质和较高的开放性和尽责性与从 MCI 恢复正常认知的可能性更高以及随时间推移向痴呆症进展的风险更低相关。较高的宜人性与向痴呆症进展的风险降低相关。临床、行为、心理和遗传因素部分解释了这些关联。几乎没有证据表明人口统计学、遗传因素或基线认知会调节这些关联。
人格特质可以帮助识别更有可能从 MCI 恢复正常认知且不会发展为痴呆症的个体。这些发现表明，即使在轻度认知障碍期间，人格特质也可能调节痴呆症风险，从而为有针对性的干预措施提供信息。
