Personality, Alzheimer's disease and behavioural and cognitive symptoms of dementia: the PACO prospective cohort study protocol

International audienceBACKGROUND: Alzheimer's disease is characterised by a loss of cognitive function and behavioural problems as set out in the term "Behavioural and Psychological Symptoms of Dementia". These behavioural symptoms have heavy consequences for the patients and their families. A greater understanding of behavioural symptoms risk factors would allow better detection of those patients, a better understanding of crisis situations and better management of these patients. Some retrospective studies or simple observations suggested that personality could play a role in the occurrence of behavioural symptoms. Finally, performance in social cognition like facial recognition and perspective taking could be linked to certain personality traits and the subsequent risks of behavioural symptoms. We propose to clarify this through a prospective, multicentre, multidisciplinary study. Main Objective: -To assess the effect of personality and life events on the risk of developing behavioural symptoms. Secondary Objectives: -To evaluate, at the time of inclusion, the connection between personality and performance in social cognition tests; -To evaluate the correlation between performance in social cognition at inclusion and the risks of occurrence of behavioural symptoms; -To evaluate the correlation between regional cerebral atrophy, using brain Magnetic Resonance Imaging at baseline, and the risk of behavioural symptoms.METHODS/DESIGN: Study type and Population: Prospective multicentre cohort study with 252 patients with Alzheimer's disease at prodromal or mild dementia stage. The inclusion period will be of 18 months and the patients will be followed during 18 months. The initial evaluation will include: a clinical and neuropsychological examination, collection of behavioural symptoms data (Neuropsychiatric-Inventory scale) and their risk factors, a personality study using both a dimensional (personality traits) and categorical approach, an inventory of life events, social cognition tests and an Magnetic Resonance Imaging. Patients will be followed every 6 months (clinical examination and collection of behavioural symptoms data and risk factors) during 18 months.DISCUSSION: This study aims at better identifying the patients with Alzheimer's disease at high risk of developing behavioural symptoms, to anticipate, detect and quickly treat these disorders and so, prevent serious consequences for the patient and his caregivers.TRIAL REGISTRATION: ClincalTrials.gov: NCT01297140

Network analysis of the associations between personality traits, cognitive functioning, and inflammatory markers in elderly individuals without dementia

IntroductionLower cognitive functioning in old age has been associated with personality traits or systemic inflammatory markers. Associations have also been found between personality traits and inflammatory markers. However, no study has explored the inter-relationships between these three components simultaneously. The present study aims to better understand the inter-relationships among personality traits, inflammatory markers, and cognitive performance in elderly individuals without dementia.MethodsThis study utilizes a network analysis approach, a statistical method that allows visualization of the data’s unique pairwise associations. We performed a cross-sectional analysis on 720 elderly individuals without dementia, using data from Colaus|PsyColaus, a population-based study conducted in Lausanne, Switzerland. The Revised NEO Five-Factor Inventory (NEO-FFI-R) was used to assess personality traits, and interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were used as peripheral inflammatory markers. Cognitive domains were investigated using the Mini-Mental State Examination (MMSE), the Verbal Fluency Test, the Stroop Test, the DO40, and the Free and Cued Selective Reminding (FCSR) test.ResultsOpenness was associated with verbal fluency and Agreeableness with immediate free recall. In contrast, no association between inflammatory markers and personality traits or cognition was identified.DiscussionIn elderly individuals without dementia, a high level of Openness or Agreeableness was associated with executive functioning/semantic memory and episodic memory, respectively

Pain

Chronic pain (CP) is often accompanied by mental disorders (MDs). However, little is known concerning the long-term effect of MDs, personality traits, and early-life traumatic events (ETEs) on CP course. Accordingly, we aimed to prospectively assess the associations of major depressive disorders (MDDs), anxiety disorders, personality traits, and ETEs with the incidence and the persistence of CP in middle-aged and older community dwellers. Data stemmed from the 3 first follow-up evaluations of CoLaus|PsyCoLaus, a prospective cohort conducted in the general population of Lausanne (Switzerland). Diagnostic criteria for MDs and ETEs were elicited using semistructured interviews. CP and personality traits were assessed by self-rating questionnaires. Follow-up intervals were subdivided into 2 groups: those without (n = 2280) and those with (n = 1841) CP initially. The associations between the psychological variables and the occurrence or persistence of CP 5 years later were assessed using serially adjusted logistic regression models. Higher neuroticism (odds ratio [95% confidence interval] 1.21 [1.08; 1.36]) and extraversion (1.18 [1.06; 1.32]) were associated with higher 5-year CP incidence, whereas current (2.14 [1.34; 3.44]) and remitted MDD (1.29 [1.00; 1.66]) as well as lower extraversion (0.83 [0.74; 0.94]) were associated with persistence of CP. By contrast, ETEs and anxiety disorders were not associated with the incidence or persistence of CP. Our results suggest that personality traits are associated with both CP occurrence and persistence, whereas the MDDs may be more associated with CP persistence. Both personality and MDD are accessible to psychotherapy, and MDD is also accessible to pharmacotherapy. Hence, these therapeutic measures might decrease the risk of CP and its persistence

Cavitation Erosion Prediction on Francis Turbines Part 2 : Model Tests and Flow Analysis

Different measurement techniques have been used to detect cavitation on a Francis turbine model. The results are compared to those obtained on the prototype and presented in the first of this series of articles. The runner mode! used for that study is built on the basis of a geometrical recovery of one of most eroded blade of the prototype. The results of the different measurements are presented and commented by comparison with prototype measurements. This comparison leads to a proposal of the physics which should be involved in transposition laws for the prediction of prototype erosion from cavitation mode! tests. The consequences of such scaling laws, as well as their application to the prototype and mode! results, are part of the third facet of this work

Front Aging Neurosci

INTRODUCTION: Lower cognitive functioning in old age has been associated with personality traits or systemic inflammatory markers. Associations have also been found between personality traits and inflammatory markers. However, no study has explored the inter-relationships between these three components simultaneously. The present study aims to better understand the inter-relationships among personality traits, inflammatory markers, and cognitive performance in elderly individuals without dementia. METHODS: This study utilizes a network analysis approach, a statistical method that allows visualization of the data's unique pairwise associations. We performed a cross-sectional analysis on 720 elderly individuals without dementia, using data from Colaus|PsyColaus, a population-based study conducted in Lausanne, Switzerland. The Revised NEO Five-Factor Inventory (NEO-FFI-R) was used to assess personality traits, and interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were used as peripheral inflammatory markers. Cognitive domains were investigated using the Mini-Mental State Examination (MMSE), the Verbal Fluency Test, the Stroop Test, the DO40, and the Free and Cued Selective Reminding (FCSR) test. RESULTS: Openness was associated with verbal fluency and Agreeableness with immediate free recall. In contrast, no association between inflammatory markers and personality traits or cognition was identified. DISCUSSION: In elderly individuals without dementia, a high level of Openness or Agreeableness was associated with executive functioning/semantic memory and episodic memory, respectively

Front Psychiatry

OBJECTIVE: During the COVID-19 pandemic, older people and patients with psychiatric disorders had an increased risk of being isolated. The French National Authority for Health has recommended a reinforced follow-up of these patients. Cross-sectional studies reported an increased risk of developing anxiety and depression during pandemic. The aim of our study was to identify factors associated with higher anxiety during the pandemic in older patients with psychiatric disorders. METHODS: STERACOVID is a multicenter cohort study with 117 patients followed-up by phone in two French geriatric psychiatry units. In this work, we used cross-sectional data from a prospective follow-up conducted between January and May 2021. RESULTS: We found that coping strategies, personality, and living conditions were associated with general anxiety (GA) level during the pandemic period. Higher GA was associated with less positive thinking coping strategy, more avoidance strategies, a lower level of extraversion, a higher level of neuroticism, more time spent watching the news, a higher feeling of loneliness, and a lack of physical contact. FINDINGS: Our study identified factors associated with a poorer experience of pandemic crisis. Special attention should be paid to patients with a high level of neuroticism and a high feeling of loneliness. Support could aim to help patients use more functional strategies: reducing avoidance strategies and increasing positive thinking. Finally, reducing time watching news could also be an interesting prevention perspective. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov, identifier NCT04760795

Overlap and Mutual Distinctions between Clinical Recovery and Personal Recovery in People with Schizophrenia in a One-Year Study

Recovery is a multidimensional construct that can be defined either from a clinical perspective or from a consumer-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. We aimed to longitudinally examine the overlap and mutual distinctions between clinical and personal recovery. Of 1239 people with schizophrenia consecutively recruited from the FondaMental Advanced Centers of Expertise for SZ network, the 507 present at one-year did not differ from those lost to follow-up. Clinical recovery was defined as the combination of clinical remission and functional remission. Personal recovery was defined as being in the rebuilding or in the growth stage of the Stages of Recovery Instrument (STORI). Full recovery was defined as the combination of clinical recovery and personal recovery. First, we examined the factors at baseline associated with each aspect of recovery. Then, we conducted multivariable models on the correlates of stable clinical recovery, stable personal recovery, and stable full recovery after one year. At baseline, clinical recovery and personal recovery were characterized by distinct patterns of outcome (i.e. better objective outcomes but no difference in subjective outcomes for clinical recovery, the opposite pattern for personal recovery, and better overall outcomes for full recovery). We found that clinical recovery and personal recovery predicted each other over time (baseline personal recovery for stable clinical recovery at one year; P =. 026, OR = 4.94 [1.30-23.0]; baseline clinical recovery for stable personal recovery at one year; P =. 016, OR = 3.64 [1.31-11.2]). In short, given the interaction but also the degree of difference between clinical recovery and personal recovery, psychosocial treatment should target, beyond clinical recovery, subjective aspects such as personal recovery and depression to reach full recovery. © 2021 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.Sorbonne Universités à Paris pour l'Enseignement et la RechercheFondaMental-Cohorte

Does personality predict neuropsychiatric symptoms in mild Alzheimer's disease ?

La maladie d’Alzheimer (MA) est une affection neurodégénérative se manifestant par une détérioration cognitive d’aggravation progressive. Elle s’accompagne systématiquement de modifications comportementales désignées sous le terme de symptômes neuropsychiatriques (SNP). Ces SNP regroupent un ensemble de manifestations diverses : symptômes affectifs, symptômes psychotiques, symptômes comportementaux, troubles des fonctions instinctuelles. L’origine des SNP est multifactorielle. La localisation et le degré d’extension des lésions neurodégénérative joue un rôle essentiel dans leur survenue mais d’autres facteurs ont été identifiés. Ainsi, certains profils de personnalité pourraient moduler leur typologie et leur sévérité, notamment aux stades débutants de la MA quand les lésions neurodégénératives sont encore circonscrites. L’objectif de ce travail de thèse est d’évaluer l’impact de la personnalité sur la survenue des SNP aux stades de MA prodromale et débutante. Les données analysées sont issues du protocole PACO (Personnalité Alzheimer COmportement). Deux cent trente-sept patients ont été inclus et suivis longitudinalement pendant 18 mois. Le diagnostic de MA reposait sur des critères neuropsychologiques et d’imagerie. Les domaines de personnalité (Névrosisme, Consciensciosité, Extraversion, Ouverture, Agréabilité) ont été évaluées à l’aide du questionnaire NEO-PI-R issu du modèle à 5 facteurs. Les SNP ont été recueillis à l’inclusion puis tous les 6 mois sur une période de 18 mois. La première partie de la thèse propose une revue de la littérature abordant les liens entre personnalité et expression clinique de la MA. Trois publications sont présentées dans la partie expérimentale. La première introduit la méthodologie et les objectifs du protocole PACO. La deuxième intitulée « Does personality predict behavioral and psychological symptoms of dementia ?» démontre l’effet spécifique de la personnalité sur la typologie des SNP, en particulier l’impact protecteur des hauts niveaux de conscienciosité et délétère des hauts niveaux de névrosisme. Suite à ces premières conclusions, nous nous sommes intéressés spécifiquement au névrosisme, domaine de personnalité fortement corrélé à la psychopathologie en population générale. Ainsi, dans une troisième publication nous explorons l’effet de deux sous-dimensions du névrosisme appelées Névrosisme-Volatilité et Névrosisme-Retrait reflétant respectivement la tendance à internaliser ou externaliser les émotions négatives. Le Névrosisme-Volatilité était corrélé positivement au risque d’agitation, d’irritabilité, et de délire tandis que le Névrosisme-Retrait était associé à l’anxiété et à la dépression. L’effet de la personnalité sur les SNP au stade débutant de la MA est discuté comme la résultante d’un possible effet combiné des lésions neurodégénératives et d’une vulnérabilité neurologique prémorbide associée à certains domaines de comme le névrosismeAlzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive impairment, and often accompanied by behavioural changes known as neuropsychiatric symptoms (NPS). These SNPs include a variety of manifestations: affective symptoms, psychotic symptoms, behavioural symptoms, and perturbations of instinctual functions. The origin of SNPs is multifactorial. The location and the extension of neurodegenerative lesions plays a key role in their occurrence, but other factors have been identified. Thus, certain personality profiles could modulate their typology and severity, particularly in the early stages of AD when neurodegenerative lesions are still circumscribed. The objective of this thesis is to evaluate the impact of personality on the occurrence of SNPs in prodromal and early stages of AD. The data analysed are drawn from the PACO (Personality Alzheimer Behaviour) protocol. Two hundred and thirty-seven patients were included and followed longitudinally for 18 months. The diagnosis of AD was based on neuropsychological and imaging criteria. Personality domains (Neuroticism, Conscientiousness, Extraversion, Openness, Agreeableness) were assessed using the NEO-PI-R questionnaire based on the 5-factor model. SNPs were collected at baseline and then every 6 months for 18 months. The first part of the thesis consists of a review of the literature examining the links between personality and clinical expression of AD. Three publications are presented in the experimental part. The first introduces the methodology and objectives of the PACO protocol. The second entitled "Does personality predict behavioral and psychological symptoms of dementia?" demonstrates the specific effect of personality on the typology of SNPs, and more specifically the protective impact of high levels of conscientiousness and the deleterious impact of high levels of neuroticism. Following these initial conclusions, we focused on neuroticism, a personality domain strongly correlated with psychopathology in the general population. Thus, in a third publication we explore the effect of two sub-dimensions of neuroticism called Neuroticism-Volatility and Neuroticism-Withdrawal, reflecting respectively the tendency to internalize or externalize negative emotions. Neuroticism-Volatility was positively correlated with the risk of agitation and delusion, while Neuroticism-Withdrawal was related to anxiety and depression. The impact of personality on SNPs in mild AD is discussed as the result of a possible combined effect of neurodegenerative lesions and premorbid neurological vulnerability associated with certain dimensions such as neuroticis

Impact de la personnalité sur les symptômes neuropsychiatriques de la maladie d'Alzheimer débutante

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive impairment, and often accompanied by behavioural changes known as neuropsychiatric symptoms (NPS). These SNPs include a variety of manifestations: affective symptoms, psychotic symptoms, behavioural symptoms, and perturbations of instinctual functions. The origin of SNPs is multifactorial. The location and the extension of neurodegenerative lesions plays a key role in their occurrence, but other factors have been identified. Thus, certain personality profiles could modulate their typology and severity, particularly in the early stages of AD when neurodegenerative lesions are still circumscribed. The objective of this thesis is to evaluate the impact of personality on the occurrence of SNPs in prodromal and early stages of AD. The data analysed are drawn from the PACO (Personality Alzheimer Behaviour) protocol. Two hundred and thirty-seven patients were included and followed longitudinally for 18 months. The diagnosis of AD was based on neuropsychological and imaging criteria. Personality domains (Neuroticism, Conscientiousness, Extraversion, Openness, Agreeableness) were assessed using the NEO-PI-R questionnaire based on the 5-factor model. SNPs were collected at baseline and then every 6 months for 18 months. The first part of the thesis consists of a review of the literature examining the links between personality and clinical expression of AD. Three publications are presented in the experimental part. The first introduces the methodology and objectives of the PACO protocol. The second entitled "Does personality predict behavioral and psychological symptoms of dementia?" demonstrates the specific effect of personality on the typology of SNPs, and more specifically the protective impact of high levels of conscientiousness and the deleterious impact of high levels of neuroticism. Following these initial conclusions, we focused on neuroticism, a personality domain strongly correlated with psychopathology in the general population. Thus, in a third publication we explore the effect of two sub-dimensions of neuroticism called Neuroticism-Volatility and Neuroticism-Withdrawal, reflecting respectively the tendency to internalize or externalize negative emotions. Neuroticism-Volatility was positively correlated with the risk of agitation and delusion, while Neuroticism-Withdrawal was related to anxiety and depression. The impact of personality on SNPs in mild AD is discussed as the result of a possible combined effect of neurodegenerative lesions and premorbid neurological vulnerability associated with certain dimensions such as neuroticismLa maladie d’Alzheimer (MA) est une affection neurodégénérative se manifestant par une détérioration cognitive d’aggravation progressive. Elle s’accompagne systématiquement de modifications comportementales désignées sous le terme de symptômes neuropsychiatriques (SNP). Ces SNP regroupent un ensemble de manifestations diverses : symptômes affectifs, symptômes psychotiques, symptômes comportementaux, troubles des fonctions instinctuelles. L’origine des SNP est multifactorielle. La localisation et le degré d’extension des lésions neurodégénérative joue un rôle essentiel dans leur survenue mais d’autres facteurs ont été identifiés. Ainsi, certains profils de personnalité pourraient moduler leur typologie et leur sévérité, notamment aux stades débutants de la MA quand les lésions neurodégénératives sont encore circonscrites. L’objectif de ce travail de thèse est d’évaluer l’impact de la personnalité sur la survenue des SNP aux stades de MA prodromale et débutante. Les données analysées sont issues du protocole PACO (Personnalité Alzheimer COmportement). Deux cent trente-sept patients ont été inclus et suivis longitudinalement pendant 18 mois. Le diagnostic de MA reposait sur des critères neuropsychologiques et d’imagerie. Les domaines de personnalité (Névrosisme, Consciensciosité, Extraversion, Ouverture, Agréabilité) ont été évaluées à l’aide du questionnaire NEO-PI-R issu du modèle à 5 facteurs. Les SNP ont été recueillis à l’inclusion puis tous les 6 mois sur une période de 18 mois. La première partie de la thèse propose une revue de la littérature abordant les liens entre personnalité et expression clinique de la MA. Trois publications sont présentées dans la partie expérimentale. La première introduit la méthodologie et les objectifs du protocole PACO. La deuxième intitulée « Does personality predict behavioral and psychological symptoms of dementia ?» démontre l’effet spécifique de la personnalité sur la typologie des SNP, en particulier l’impact protecteur des hauts niveaux de conscienciosité et délétère des hauts niveaux de névrosisme. Suite à ces premières conclusions, nous nous sommes intéressés spécifiquement au névrosisme, domaine de personnalité fortement corrélé à la psychopathologie en population générale. Ainsi, dans une troisième publication nous explorons l’effet de deux sous-dimensions du névrosisme appelées Névrosisme-Volatilité et Névrosisme-Retrait reflétant respectivement la tendance à internaliser ou externaliser les émotions négatives. Le Névrosisme-Volatilité était corrélé positivement au risque d’agitation, d’irritabilité, et de délire tandis que le Névrosisme-Retrait était associé à l’anxiété et à la dépression. L’effet de la personnalité sur les SNP au stade débutant de la MA est discuté comme la résultante d’un possible effet combiné des lésions neurodégénératives et d’une vulnérabilité neurologique prémorbide associée à certains domaines de comme le névrosism