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Low level of conscientiousness may be a risk
factor for Alzheimer's disease
Individuals who are more conscientious—in
other words, those with a tendency to be
self-disciplined, scrupulous and
purposeful—appear less likely to develop
Alzheimer’s disease, according to a report
in the October issue of Archives of General
Psychiatry, one of the JAMA/Archives
journals.
Conscientiousness refers to a person’s
tendency to control impulses and be
goal-directed, and is also known as will,
work and dependability, according to
background information in the article.
It has been associated with a wide range of
mental and physical disorders, disability
and death, suggesting it may be important
for maintaining overall health.
Robert S. Wilson, Ph.D., of Rush University
Medical Center, Chicago, and colleagues
studied 997 older Catholic nuns, priests and
brothers who did not have dementia when the
study began in 1994.
Participants underwent evaluations that
included medical history, neurologic
examinations and cognitive testing.
Conscientiousness was measured with a
12-item inventory, where participants rated
agreement with each item (for example, “I am
a productive person who always gets the job
done”) on a scale of one to five. Scores
ranged from zero to 48, with higher scores
indicating more conscientiousness. The
researchers conducted follow-up examinations
annually through 2006, with an average of
7.9 evaluations per person.
The participants had an average
conscientiousness score of 34 out of 48.
Through a maximum of 12 years of follow-up,
176 individuals developed Alzheimer’s
disease. Those who had conscientiousness
scores in the 90th percentile (40 points) or
higher had an 89 percent lower risk of
developing Alzheimer’s disease than those
whose scores ranked in the 10th percentile
(28 points) or lower. Controlling for known
Alzheimer’s disease risk factors did not
substantially change these results.
Conscientiousness also was associated with a
slower rate of cognitive decline and a lower
risk of mild cognitive impairment, a
condition that may precede Alzheimer’s
disease.
The researchers also analyzed results from
brain autopsies of 324 participants who died
during the study. In these patients,
conscientiousness was not linked to any of
the hallmark signs of Alzheimer’s disease,
including brain plaques and tangles.
However, conscientiousness did appear to
modify the association of these brain
changes with an individual’s cognitive
abilities before death.
There are several ways by which
conscientiousness might protect against
Alzheimer’s disease, the authors write.
First, conscientious individuals may be more
likely to experience educational or
occupational success, both of which have
been associated with a reduced risk of
Alzheimer’s disease. In addition,
conscientiousness has been linked to
resilience and to coping actively with
difficulties. “These factors might lessen
the adverse consequences of negative life
events and chronic psychological distress,
which have been associated with risk of
dementia in old age,” the authors note.
“In conclusion, level of conscientiousness
is associated with incidence of mild
cognitive impairment and Alzheimer’s disease
but not with the pathologic hallmarks of
these conditions,” they continue.
“Understanding the mechanisms linking
conscientiousness to maintenance of
cognition in old age may suggest novel
strategies for delaying the symptoms of
Alzheimer’s disease.”
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