Personality has long been recognized as important in Alzheimer disease (AD), although primarily in terms of exaggeration or diminishment of preexisting traits around the clinical onset. The findings reported by Johansson et al. in this issue further suggest that there may be traits, neuroticism in this case, that are associated with increased risk of AD. The long interval (nearly 40 years) between onset of neuroticism and outcome (AD) rules out any effect of early AD pathology, which has been a perennial limitation of shorter-term studies of depressive symptoms as a risk factor. Selective survival is also an unlikely explanation because stress and early cognitive decline are both likely to predict mortality and thus obscure the association of interest—indeed, it is surprising how many risk factors for mortality are also found to be risk factors for AD despite this bias.
Original Article: http://www.neurology.org/cgi/content/short/83/17/1542?rss=1
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