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Throughout the trajectory of our lives, we meet thousands of people, each with their own set of personality traits and quirks.  Scientifically and psychologically speaking, there are about sixteen widely accepted personality types.  These unique and distinctive set of personality traits that define who we are as individuals are being closely examined in new research that seeks to define how personality traits may increase or decrease one’s risk for dementia.

In a study facilitated by the Journal of the American Geriatrics Society, five personality traits were studied: neuroticism, extraversion, conscientiousness, agreeableness and openness.  Overwhelmingly, individuals with high scores of neuroticism and low scores of conscientiousness appeared to have the highest risk for a later diagnosis of dementia.

The vast literature on dementia tells us that the strongest risk factor for Alzheimer’s disease is age, closely followed by genetics, cardiovascular health, and behavioral/psychosocial factors.  It is hypothesized that the five personality traits introduced in this study are correlated with various behaviors that may contribute to these risk factors.  For example, conscientiousness is loosely defined as the quality of being responsible, hard-working and goal-oriented.  A 2016 study found that individuals who have low amounts of conscientiousness were more likely to smoke cigarettes, have low levels of physical activity and to be clinically obese.

When investigating neuroticism more closely, researchers found that subjects who were defined as being more neurotic were also considered to be more moody, anxious and emotionally unstable.  All of these traits lead to psychosocial and behavioral factors that may increase one’s risk for Alzheimer’s disease.  One example may be an individual who is experiencing high levels of neuroticism. S/he is more likely to have anxiety related to social situations-lack of social connection is proven to be a risk factor for Alzheimer’s disease.

This distinction is important.  It tells us that personality traits like neuroticism or lack of conscientiousness are not directly the cause of dementias like Alzheimer’s disease, but they are directly correlated to leading to a dementia diagnosis.  Alternatively, study subjects who were considered to be more open-minded and agreeable were found to have a slightly reduced risk of Alzheimer’s disease.

Of course, the mechanisms through which this data was obtained is important.  The most commonly used tool for this research was the NEO Personality inventory, a screening that assesses an individual’s Big Five personality traits (openness to experience, conscientiousness, extraversion, agreeableness and neuroticism).  This assessment was given at various times to both the study subjects themselves and those closest to them-caregivers and immediate family.

Anyone who has ever cared for a person with dementia (PWD) can tell you that any individual with a dementia like Alzheimer’s disease will tell white lies, exaggerate or even confabulate (make up stories to fill gaps in their memory).  Naturally, researchers had to include this potential skew when receiving self-reported personality screenings from PWD.  Sure enough, informants who had dementia and who completed the personality screenings provided “overly-positive” judgements about themselves and their personalities-that’s to say, they inflated how positive and agreeable they were.  Reports from those individuals’ caregivers and immediate family consistently and accurately reflected the opposite; that the PWD did in fact have low levels of agreeableness and open-mindedness.  This denial of changes to self and personality is common for persons with dementia.

So, what does all this information mean?  First and foremost, it highlights the need for future clinical trials to include a person’s personality traits on screenings for trials.  In addition, the above mentioned research points to another milestone in dementia care.  Knowing what an individuals’ personality was like at baseline (pre-dementia) can help caregivers and physicians alike differentiate what type of dementia a person might have.  For example, in frontotemporal dementia patients, caregivers may often witness extremely sexual, racial or other inappropriate comments from the PWD.  if these behaviors were not common for the individual before their dementia diagnosis, this hallmark behavior could indicate which type of a dementia they are caring for, empowering them with specific techniques and approaches.

Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345278/#:~:text=High%20neuroticism%20and%20low%20conscientiousness,decline%20and%20risk%20of%20dementia.