Personality change and associated factors in patients with mild cognitive impairment

Abstract

Background: Previous studies have shown that a history of personality change might guide to the diagnosis of
early mild cognitive impairment (MCI), which would lead to early treatment and better outcome of dementia.

Objectives: To investigate personality change and other factors associated with MCI.

Methods: This cross-sectional descriptive study was conducted by recruiting information from 83 patients with
MCI at King Chulalongkorn Memorial Hospital by using Thai version of questionnaires about demographic
data, Thai Mental State Examination (TMSE), Montreal Cognitive Assessment (MoCA), Thai Geriatric Depression
Scale, Neuropsychiatric Inventory Questionnaire (NPI-Q) and International Personality Item Pool (IPIP).
The patients’ caregivers were also asked to evaluate the patients’ personality during the prior 5 years before
the diagnosis and their current personality. The statistical analyses were frequency, percentage, mean and t - test.
Analysis of factors correlated with personality change was performed with logistic regression.

Results: Eighty-three patients were included, showing the mean age of 72.1 7.1 years old with 61.4% of
them were female. The mean TMSE was 27.6 1.9 and the mean MoCA was 21.6 3.1. Personality change
in patients with MCI showed a statistically significant increase in neuroticism and a decrease in openness to
experience, agreeableness and conscientiousness (P < 0.05). There was a negative correlation between
emotional stability, agreeableness, and NPI-Q (r = - 0.442 and - 0.227) (P < 0.001 and P = 0.039). A positive
correlation between extraversion and MoCA was found (r = 0.336) (P = 0.002). Neuroticism was detected to have
a correlation with the neuropsychiatric symptoms (NPS), including irritability, anxiety, depression, apathy, disinhibition, and agitation. There was a significant correlation between agreeableness and NPS (apathy) (P < 0.05).

Conclusions: Our findings suggested that there was personality change in MCI patients, featuring an increase
in neuroticism, openness to experience, agreeableness and a decrease in extraversion and conscientiousness.
Extraversion was found to be positively correlated with cognitive functions and there was a positive and negative
correlation with NPS among neuroticism and agreeableness, respectively.