Elizabeth A.Coon, Neurology instructor, Mayo Clinic Rochestercoon.elizabeth@mayo.edu
Submitted March 13, 2015
Johansson et al. demonstrated an association between personality traits in women during midlife and an increased risk of Alzheimer dementia which was mediated by report of long standing distress. [1] Associations attributed to personality traits can be due to "third variables" such as socioeconomic status (SES), which account for patterns for which there is no adequate control. [2] We commend the authors’ prospective, longitudinal approach in evaluating personality factors, but this study did not account for SES by including variables of income, occupational status, and stratification of education levels other than "compulsory school or beyond." SES plays an important role in dementia. In a US sample of dementia showing disparity between black and white races, adjusting for SES negated the racial differences. [3] Additionally, SES is inversely related to chronic stress. [4]. The findings that stress mediated the personality findings in the Swedish study may be signifying that SES is an important confounder.
1. Johansson L, Guo X, Duberstein PR, et al. Midlife personality and
risk of Alzheimer disease and distress: A 38-year follow-up. Neurology 2014;83:1538-1544.
2. Roberts BW, Kuncel NR, Shiner R, et al. The power of personality: The
comparative validity of personality traits, socioeconomic status, and cognitive ability for predicting important life outcomes. Perspect Psychol Sci 2007;2:313-345.
3. Yaffe K, Falvey C, Harris TB, et al. Effect of socioeconomic
disparities on incidence of dementia among biracial older adults:
prospective study. Bmj 2013;347:f7051.
4. Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress.
Does stress account for SES effects on health? Ann N Y Acad Sci 1999;896:131-144.
For disclosures, contact the editorial office at journal@neurology.org.
Johansson et al. demonstrated an association between personality traits in women during midlife and an increased risk of Alzheimer dementia which was mediated by report of long standing distress. [1] Associations attributed to personality traits can be due to "third variables" such as socioeconomic status (SES), which account for patterns for which there is no adequate control. [2] We commend the authors’ prospective, longitudinal approach in evaluating personality factors, but this study did not account for SES by including variables of income, occupational status, and stratification of education levels other than "compulsory school or beyond." SES plays an important role in dementia. In a US sample of dementia showing disparity between black and white races, adjusting for SES negated the racial differences. [3] Additionally, SES is inversely related to chronic stress. [4]. The findings that stress mediated the personality findings in the Swedish study may be signifying that SES is an important confounder.
1. Johansson L, Guo X, Duberstein PR, et al. Midlife personality and risk of Alzheimer disease and distress: A 38-year follow-up. Neurology 2014;83:1538-1544.
2. Roberts BW, Kuncel NR, Shiner R, et al. The power of personality: The comparative validity of personality traits, socioeconomic status, and cognitive ability for predicting important life outcomes. Perspect Psychol Sci 2007;2:313-345.
3. Yaffe K, Falvey C, Harris TB, et al. Effect of socioeconomic disparities on incidence of dementia among biracial older adults: prospective study. Bmj 2013;347:f7051.
4. Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress. Does stress account for SES effects on health? Ann N Y Acad Sci 1999;896:131-144.
For disclosures, contact the editorial office at journal@neurology.org.