Conscientiousness and the incidence of Alzheimer disease and mild cognitive impairment
Conscientiousness and the incidence of Alzheimer disease and mild cognitive impairment
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DOI：
10.1001/archpsyc.64.10.1204
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发表时间：
2007-10-01
影响因子：
--
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
--
作者：
Wilson, Robert S.;Schneider, Julie A.;Bennett, David A.
内容：性格特征的肥胖与老年的发病率和死亡率有关，但其与阿尔茨海默病的发展还不清楚。目的：为了检验假设，即较高水平的肥胖与阿尔茨海默病的风险降低有关。设计：纵向临床病理队列研究，每年随访长达12年。设置：宗教秩序研究。参与者：共有997名老年天主教修女，牧师和兄弟在登记时没有痴呆症，从美国各地的40多个团体招募。在基线时，他们完成了一项标准的12项测量。死亡者接受统一的神经病理学评估，从先前建立的淀粉样蛋白负荷、缠结密度、路易体和慢性脑梗死的测量中得出主要结果测量：阿尔茨海默病的临床诊断和先前建立的整体认知和特定认知功能测量的变化。（平均值34.0;标准差5.0）。在随访期间，有176人患上了老年痴呆症.在调整年龄，性别和教育的比例风险回归模型中，与低评分（第10百分位数）相比，高评分（第90百分位数）与阿尔茨海默病风险降低89%相关。通过控制其他人格特征、活动模式、血管状况或其他危险因素，结果没有实质性改变。在那些死亡并进行脑尸检的人中，死亡与神经病理学指标无关，但它改变了神经病理学变化和脑梗死与死亡认知的相关性。结论：肥胖程度是阿尔茨海默病的危险因素。
Context: The personality trait of conscientiousness has been related to morbidity and mortality in old age, but its association with the development of Alzheimer disease is not known.Objective: To test the hypothesis that a higher level of conscientiousness is associated with decreased risk of Alzheimer disease.Design: Longitudinal clinicopathologic cohort study with up to 12 years of annual follow- up.Setting: The Religious Orders Study.Participants: A total of 997 older Catholic nuns, priests, and brothers without dementia at enrollment, recruited from more than 40 groups across the United States. At baseline, they completed a standard 12- item measure of conscientiousness. Those who died underwent a uniform neuropathologic evaluation from which previously established measures of amyloid burden, tangle density, Lewy bodies, and chronic cerebral infarction were derived.Main Outcome Measures: Clinical diagnosis of Alzheimer disease and change in previously established measures of global cognition and specific cognitive functions.Results: Conscientiousness scores ranged from 11 to 47 ( mean, 34.0; SD, 5.0). During follow- up, 176 people developed Alzheimer disease. In a proportional hazards regression model adjusted for age, sex, and education, a high conscientiousness score ( 90th percentile) was associated with an 89% reduction in risk of Alzheimer disease compared with a low score ( 10th percentile). Results were not substantially changed by controlling for other personality traits, activity patterns, vascular conditions, or other risk factors.Conscientiousness was also associated with decreased incidence of mild cognitive impairment and reduced cognitive decline. In those who died and underwent brain autopsy, conscientiousness was unrelated to neuropathologic measures, but it modified the association of neurofibrillary pathologic changes and cerebral infarction with cognition proximate to death. Conclusion: Level of conscientiousness is a risk factor for Alzheimer disease.