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Effects of Longitudinal Changes in Neuroticism and Stress on Cognitive Decline

Published:October 21, 2022DOI:https://doi.org/10.1016/j.jagp.2022.10.005

      Highlights

      • What is the primary question addressed by this study?
      • What are the combined effects of changes in neuroticism and changes in stress on cognitive decline among older depressed adults?
      • What is the main finding of this study?
      • The interaction effect of 3-year change in Total Neuroticism score and 3-year change in Total Stressors on change in delayed story memory (Logical Memory-2, LM-II) was statistically significant. Specifically, we found that 1) when total stressors increased by 2 or more over 3 years, LMII change was inversely associated with neuroticism change, and 2) when neuroticism improved less, LMII change score was inversely associated with total stressor change.
      • What is the meaning of the finding?
      • In the course of treatment of late-life depression, it is clinically important to monitor changes in neuroticism and psychosocial stress, as these factors may impact long-term memory performance.

      Abstract

      Objective

      The relationships among depression, personality factors, stress, and cognitive decline in the elderly are complex. Depressed elders score higher in neuroticism than nondepressed older individuals. Independently, the presence of neuroticism and the number of stressful life events are each associated with worsening cognitive decline in depressed older adults. Yet little is known about combined effects of changes in neuroticism and changes in stress on cognitive decline among older depressed adults.

      Design

      Longitudinal observational study.

      Setting

      Academic Health Center.

      Participants

      The authors examined 62 participants in the Neurobiology of Late-life depression (NBOLD) study to test the hypothesis that, compared with older depressed subjects who experience improved neuroticism and lower psychosocial stressors over time, those with worsening neuroticism and greater psychosocial stressors will demonstrate more cognitive decline.

      Measurements

      The authors measured neuroticism using the NEO-Personality Inventory-Revised at baseline and 1 year. Study psychiatrists measured depression using the Montgomery-Ǻsberg Depression Rating Scale. At annual assessments, subjects reported the number of psychosocial stressors in the prior year and completed a neuropsychological evaluation. Participants completed a detailed neuropsychological battery at baseline and annually over 3 years. The battery included a test of delayed story memory (Logical Memory-2 or LMII). The outcome 3-year change in cognitive scores was regressed against 3-year change scores of neuroticism and number of psychosocial stressors, plus their interaction, while adjusting for sex, age, race, education, baseline cognitive score, and 3-year change in MADRS score as covariates.

      Results

      In multivariable linear regression analysis with the above covariates, the interaction effect of 3-year change in Total Neuroticism score and 3-year change in Total Stressors on change in LMII performance was statistically significant (B = −0.080[95%CL: −0.145 to −0.015], T = −2.48, df = 52, p = 0.017). Further exploration of this finding showed that 1) when total stressors increased by 2 or more over 3 years, LMII change was inversely associated with neuroticism change; and 2) when neuroticism improved less, LMII change score was inversely associated with total stressor change. There were no other significant interactions between stress and neuroticism on cognition.

      Conclusion

      Our findings document the importance of tracking change in neuroticism and monitoring psychosocial stress over the long-term course of treatment in geriatric depression. Both factors exert important combined effects on memory over time. Future studies in larger samples are needed to confirm our results and to extend them to examine both cognitive change and development of dementia.

      Keywords

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      References

        • Manning KJ
        • Chan G
        • Steffens DC
        Neuroticism traits selectively impact long-term illness course and cognitive decline in late-life depression.
        Am J Geriatr Psychiatry. 2017; 25: 220-229
        • Terracciano A
        • Aschwanden D
        • Passamonti L
        • et al.
        Is neuroticism differentially associated with risk of Alzheimer's disease, vascular dementia, and frontotemporal dementia?.
        J Psychiatr Res. 2021; 138: 34-40
        • Tschanz JT
        • Pfister R
        • Wanzek J
        • et al.
        Stressful life events and cognitive decline in late life: moderation by education and age. The Cache County Study.
        Int J Geriatr Psychiatry. 2013; 28: 821-830
        • Roberts BW
        • Walton KE
        • Viechtbauer W
        Patterns of mean-level change in personality traits across the life course: a meta-analysis of longitudinal studies.
        Psychol Bull. 2006; 132: 1-25
        • Caselli RJ
        • Langlais BT
        • Dueck AC
        • et al.
        Personality changes during the transition from cognitive health to mild cognitive impairment.
        J Am Geriatr Soc. 2018; 66: 671-678
        • Kondracki AJ
        • Riedel MC
        • Crooks K
        • et al.
        The link between neuroticism and everyday cognitive failures is mediated by self-reported mindfulness among college students.
        Psychol Rep. 2021; (332941211048467. in press)
        • Tang TZ
        • DeRubeis RJ
        • Hollon SD
        • et al.
        Personality change during depression treatment: a placebo-controlled trial.
        Arch Gen Psychiatry. 2009; 66: 1322-1330
        • Montoliu T
        • Pulopulos MM
        • Puig-Perez S
        • et al.
        Mediation of perceived stress and cortisol in the association between neuroticism and global cognition in older adults: a longitudinal study.
        Stress Health. 2022; 38: 290-303
        • Steffens DC
        • Manning KJ
        • Wu R
        • et al.
        Association of 1-year change in neuroticism and 3-year change in cognitive performance among older depressed adults.
        Int Psychogeriatr. 2022; 34: 645-650
        • Dickinson WJ
        • Potter GG
        • Hybels CF
        • et al.
        Change in stress and social support as predictors of cognitive decline in older adults with and without depression.
        Int J Geriatr Psychiatry. 2011; 26: 1267-1274
        • Steffens DC
        • Manning KJ
        • Wu R
        • et al.
        Methodology and preliminary results from the neurobiology of late-life depression study.
        Int Psychogeriatr. 2015; 27: 1987-1997
        • Hughes DC
        • George LK
        • Blazer DG
        Age differences in life event qualities: multivariate controlled analyses.
        J Community Psychol. 1988; 16: 161-174
        • Costa PT
        • McCrae RR
        Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) professional manual.
        Psychological Assessment Resources, Odessa, FL1992
        • Morris JC
        • Heyman A
        • Mohs RC
        • et al.
        The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease.
        Neurology. 1989; 39: 1159-1165
        • Reitan RM
        Validity of the Trail Making Test as an indicator of organic brain damage.
        Percept Mot Skills. 1958; 8: 271-276
        • Smith A
        Symbol Digit Modalities Test-Manual.
        Western Psychological Services, Los Angeles1982
        • Wechsler D
        Wechsler Memory Scale-Revised Manual.
        Psychological Corporation, San Antonio, TX1987
        • Sivan AB
        Benton Visual Retention Test.
        5th ed. The Psychological Corporation, San Antonio, TX1992
        • McCrae RR
        • Costa PT
        Brief Versions of the NEO-PI-3.
        J Indiv Differences. 2007; 28: 116-128
        • Steffens DC
        • Wu R
        • Grady JJ
        • et al.
        Presence of neuroticism and antidepressant remission rates in late-life depression: results from the Neurobiology of Late-Life Depression (NBOLD) study.
        Int Psychogeriatr. 2018; 30: 1069-1074
        • Steffens DC
        • Manning KJ
        • Wu R
        • et al.
        Association of 1-year change in neuroticism and 3-year change in cognitive performance among older depressed adults.
        Int Psychogeriatr. 2022; 34: 645-650
        • Sutin AR
        • Terracciano A
        • Deiana B
        • et al.
        High neuroticism and low conscientiousness are associated with interleukin-6.
        Psychol Med. 2010; 40: 1485-1493
        • Joseph C
        • Wang L
        • Wu R
        • et al.
        Structural brain changes and neuroticism in late-life depression: a neural basis for depression subtypes.
        Int Psychogeriatr. 2021; 33: 515-520
        • Steffens DC
        • Wang L
        • Manning KJ
        • et al.
        Negative affectivity, aging, and depression: results from the Neurobiology of Late-Life Depression (NBOLD) study.
        Am J Geriatr Psychiatry. 2017; 25: 1135-1149
        • Sorrells SF
        • Munhoz CD
        • Manley NC
        • et al.
        Glucocorticoids increase excitotoxic injury and inflammation in the hippocampus of adult male rats.
        Neuroendocrinology. 2014; 100: 129-140
        • Forlenza OV
        • Diniz BS
        • Talib LL
        • et al.
        Increased serum IL-1beta level in Alzheimer's disease and mild cognitive impairment.
        Dement Geriatr Cogn Disord. 2009; 28: 507-512
        • Zannas AS
        • McQuoid DR
        • Payne ME
        • et al.
        Negative life stress and longitudinal hippocampal volume changes in older adults with and without depression.
        J Psychiatr Res. 2013; 47: 829-834
        • Aschwanden D
        • Strickhouser JE
        • Luchetti M
        • et al.
        Is personality associated with dementia risk? A meta-analytic investigation.
        Ageing Res Rev. 2021; 67101269
        • Low LF
        • Harrison F
        • Lackersteen SM
        Does personality affect risk for dementia? A systematic review and meta-analysis.
        Am J Geriatr Psychiatry. 2013; 21: 713-728

      Linked Article

      • Reimagining Research on Personality, Stress and Cognition in Depressed Older Adults: Reflections on Steffens et al.
        The American Journal of Geriatric Psychiatry
        • Preview
          Steffens et al.1 add to the growing literature on the contributions of stressors and personality to cognitive impairment in older adults. For more than a decade, prospective studies have examined self-reported personality2and stress3 as predictors of cognitive decline, mild cognitive impairment, and dementia. For more than 3 decades, retrospective studies have repeatedly documented informant-reported personality change in cognitive decline. The article by Steffens et al. might be one of the first, if not the first, to explore the implications of both change in trait Neuroticism (the tendency to experience negative emotions) and change in self-reported stressors for cognitive outcomes.
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