Neurotic Symptoms In Midlife May Presage Alzheimer’s Dementia

Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg Interview with:
Lena Johansson, PhD, MSc, RN
Institute of Neuroscience and Physiology
Department of Psychiatry and Neurochemistry
Sahlgrenska Academy at Gothenburg University

Medical Research: What are the main findings of the study?

Dr. Johansson: We found that a higher degree of neuroticism in midlife was associated with increased risk of Alzheimer’s disease over 38 years. On the 24 point scale, the risk increased with 4% per each step. Women who score high on the neuroticism scale were more likely to experience feelings such as anxiety, nervousness, worry, and irritability, and they were more moodiness and stress-prone.

The association between neuroticism and Alzheimer’s disease diminished after adjusting for longstanding perceived distress symptoms, which suggest that the associations was at least partly depended on long-standing distress symptoms.

When the two personality dimensions were combined, women with high neuroticism/low extraversion had a double risk of Alzheimer’s disease compared to those with low neuroticism/high extraversion.

Medical Research: What was most surprising about the results?

Dr. Johansson: This study have a unique design, due to the long follow-up. No other study have shown that midlife personality, increased the risk of Alzheimer’s disease over a period of nearly 4 decades. So, from that view are the finding exceptional.

However, our hypothesis was that a stress-prone personality (neuroticism) might affect the risk of Alzheimer’s disease. However, over this 4 decades much happened in these women’s life, so to recognize a significant association between personality and dementia, over such a long period, was in some way surprising.

Medical Research: What should clinicians and patients take away from your report?

Dr. Johansson: Results have clinical implications, while a group of women at risk for Alzheimer’s disease dementia is identified.

It is important that clinicians pay attention to longstanding and/or severe symptoms of distress; such as sleeping problems, severe worries, psychosomatic symptoms etc, and consider to treat this symptoms.

Stress have been associated with a large number of bad outcomes, and here also with Alzheimer’s disease.

There are several possible explanations for the relationship between neuroticism and Alzheimer’s disease. Personality may influence the individual’s risk of dementia through its effect on behavior and lifestyle; e.g., individuals with low neuroticism more often have a lifestyle with healthier metabolic, cardiovascular, and inflammatory risk profiles.

Take this symptoms seriously and do what you can to try to lowering the stress level in life. Maybe through life-style changes, physical activities, cognitive therapy or autogenic exercise.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Johansson: Future studies should examine the etiologic pathways for this associations and test whether this group responds well to interventions. It remains to be seen whether neuroticism could be modified, e.g., by medical treatment or through lifestyle changes.


Midlife personality and risk of Alzheimer disease and distress: A 38-year follow-up

Lena Johansson, PhD, Xinxin Guo, MD, PhD, Paul R. Duberstein, PhD, Tore Hällström, MD, PhD, Margda Waern, MD, PhD, Svante Östling, MD, PhD and Ingmar Skoog, MD, PhD

Published online before print October 1, 2014, doi: 10.1212/WNL.0000000000000907 Neurology 10.1212/WNL.0000000000000907


Last Updated on October 7, 2014 by Marie Benz MD FAAD