PT - JOURNAL ARTICLE AU - Johansson, Lena AU - Guo, Xinxin AU - Duberstein, Paul R. AU - Hällström, Tore AU - Waern, Margda AU - Östling, Svante AU - Skoog, Ingmar TI - Midlife personality and risk of Alzheimer disease and distress AID - 10.1212/WNL.0000000000000907 DP - 2014 Oct 21 TA - Neurology PG - 1538--1544 VI - 83 IP - 17 4099 - http://n.neurology.org/content/83/17/1538.short 4100 - http://n.neurology.org/content/83/17/1538.full SO - Neurology2014 Oct 21; 83 AB - 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.AD=Alzheimer disease; BMI=body mass index; CI=confidence interval; DSM-III-R=Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised; HR=hazard ratio