Thursday, 21 August 2003
This presentation is part of : Approaches to Depression

S095-002 A Prospective Study into the Relationship Between Premorbid Neuroticism and Mood Disorders in Dementia

Pauline Aalten, Frans Verhey, Marjolein De Vugt, Richel Lousberg, Niek Jaspers, and Jelle Jolles. Psychiatry and Neuropsychology, Brain and Behaviour Institute, University of Maastricht, Maastricht, Netherlands

Objective: Mood disturbances are highly prevalent in patients with dementia. The pathogenesis is still unclear. In this respect, psychological risk factors have received relatively little attention. The aim of this study was to determine if premorbid neuroticism is a predictor of mood disturbances in dementia patients.

Design: The Maastricht Study of Behavior in Dementia (MAASBED) focuses on the course and risk factors of BPSD. The project is a 2-year follow-up study including 199 patients with dementia. Patients are seen at 6-month intervals.

Materials and Methods: A reliable informant to provide information about patient personality was present for 181 patients. Analyses were performed on the 1-year data, and complete follow-up data were available for 124 patients. The NEO-FFI was completed by the primary caregivers and provided information about the patient's premorbid neuroticism. Mood disturbances were assessed with a factor mood/apathy from the Neuropsychiatric Inventory (NPI) and with the Cornell Scale for Depression in Dementia (CSDD).

Results: Female patients with high premorbid neuroticism had more mood disturbances than females with low neuroticism at baseline (p=0.03) and after 6 months (p=0.001). These results were independent of caregiver neuroticism, caregiver depression, and duration of illness. When the CSDD was used, female patients with high premorbid neuroticism had more mood disturbances at baseline (p=0.001) and after 6 months (p<0.001), but also after 1 year (p=0.05). Premorbid neuroticism was also a significant predictor of hyperactive behavior.

Conclusion: Premorbid neuroticism is a risk factor for mood disturbances in female patients with dementia, independent of caregiver characteristics. This effect declines after 1 year and, therefore, probably does not hold for later stages of dementia. Identification of premorbid neuroticism must alert the clinician to the development of mood disturbances.

Maasbed was funded by the Dutch Research Counsil (NWO)

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