title: Midlife personality and risk of Alzheimer disease and distress: a 38-year follow-up.
abstract: OBJECTIVE
  To study the association between midlife neuroticism and extraversion and development of late-life dementia and long-standing distress in a sample of women followed for 38 years.
  
  
  METHODS
  A population-based sample of 800 women, aged 38 to 54 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, 2000, and 2005. Neuroticism and extraversion were assessed using the Eysenck Personality Inventory at baseline. Distress was measured according to a standardized question at each study wave. Dementia was diagnosed according to DSM-III-R criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data.
  
  
  RESULTS
  During the 38-year follow-up, 153 women developed dementia; Alzheimer disease (AD) dementia was diagnosed in 104 of these. A higher degree of neuroticism in midlife was associated with increased risk of AD dementia and long-standing distress over 38 years. The association between neuroticism and AD dementia diminished after adjusting for long-standing distress. Extraversion was associated with a lower degree of long-standing distress, but had no impact on AD dementia. When the 2 personality dimensions were combined, high neuroticism/low extraversion showed the highest risk of AD dementia.
  
  
  CONCLUSIONS
  Our study suggests that midlife neuroticism is associated with increased risk of AD dementia, and that distress mediates this association. The results have clinical implications because a group of women at risk of AD dementia is identified.
authors.affiliation: From the Neuropsychiatric Epidemiology Unit (L.J., X.G., T.H., M.W., S.Ö, I.S.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Department of Psychiatry (P.R.D.), University of Rochester Medical Center, NY. lena.johansson@neuro.gu.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Johansson
authors.affiliation: From the Neuropsychiatric Epidemiology Unit (L.J., X.G., T.H., M.W., S.Ö, I.S.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Department of Psychiatry (P.R.D.), University of Rochester Medical Center, NY.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Guo
authors.affiliation: From the Neuropsychiatric Epidemiology Unit (L.J., X.G., T.H., M.W., S.Ö, I.S.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Department of Psychiatry (P.R.D.), University of Rochester Medical Center, NY.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
authors.affiliation: From the Neuropsychiatric Epidemiology Unit (L.J., X.G., T.H., M.W., S.Ö, I.S.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Department of Psychiatry (P.R.D.), University of Rochester Medical Center, NY.
authors.forename: Tore
authors.initials: T
authors.lastname: Hällström
authors.affiliation: From the Neuropsychiatric Epidemiology Unit (L.J., X.G., T.H., M.W., S.Ö, I.S.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Department of Psychiatry (P.R.D.), University of Rochester Medical Center, NY.
authors.forename: Margda
authors.initials: M
authors.lastname: Waern
authors.affiliation: From the Neuropsychiatric Epidemiology Unit (L.J., X.G., T.H., M.W., S.Ö, I.S.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Department of Psychiatry (P.R.D.), University of Rochester Medical Center, NY.
authors.forename: Svante
authors.initials: S
authors.lastname: Ostling
authors.affiliation: From the Neuropsychiatric Epidemiology Unit (L.J., X.G., T.H., M.W., S.Ö, I.S.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; and Department of Psychiatry (P.R.D.), University of Rochester Medical Center, NY.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Skoog
mesh_terms: D000328:Adult; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D018672:Community Health Planning; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D000075384:Neuroticism; D010551:Personality; D010555:Personality Inventory; D012189:Retrospective Studies; D012307:Risk Factors