La personalidad premórbida como factor de riesgo en la aparición de síntomas psicológicos y conductuales de la demencia: revisión sistemática / Premorbid personality as a risk factor in the appearance of psychological and behavioural symptoms of dementia: systematic review

La etiología de los síntomas psicológicos y conductuales de la demencia (SPCD) es multifactorial y existe una línea creciente de investigación de la personalidad premórbida como factor de riesgo para estos síntomas. El objetivo de la revisión es conocer la relación entre los SPCD y la personalidad premórbida. Los estudios se buscaron en PsycInfo, MedLine y PubMed a partir de la combinación de diversos términos relacionados con demencia, personalidad premórbida y SPCD. Diez estudios fueron incluidos en la revisión. Ocho de los diez estudios sugieren asociaciones entre la personalidad premórbida y los SPCD. Neuroticismo se relaciona positivamente con alteración de la conducta y ansiedad. Extraversión se relaciona positivamente con deambulación. Amabilidad se relaciona negativamente con alteraciones afectivas y síntomas de comportamiento agresivo y, positivamente con deambulación. Para apertura a la experiencia y responsabilidad no se muestran resultados congruentes. La personalidad premórbida puede incrementar el riesgo de manifestar SPCD durante el curso de la enfermedad. Aun así, la relación entre personalidad y SPCD es compleja debido a la etiología multifactorial de los síntomas

The aetiology of behavioural and psychological symptoms of dementia (BPSD) is defined by a diversity of factors, and recent studies suggest that premorbid personality could be a risk factor for BPSD. This study aimed to review studies on the relationship between premorbid personality and BPSD. Studies were identified using PsycInfo, MedLine, and PubMed. The searches combined terms for premorbid personality, dementia and BPSD. Ten studies have been included in this review. Eight out of ten studies show a relationship between premorbid personality and BPSD. Neuroticism is associated with behavioural disturbances and anxiety. Extraversion is associated with wandering. Low agreeableness is associated with affective disturbance and aggression-related behaviours and high agreeableness is associated with wandering. The studies found no congruent results for openness and conscientiousness. In conclusion, premorbid personality may increase the risk of developing BPSD during the course of the disease. Even so, the relationship between personality and BPSD is complex due to multifactorial aetiology

Disorder of the personality: a possible factor of risk for the dementia.

OBJECTIVES: The fact that more and more people suffer from dementia makes it very important to know the different risk factors to prevent their appearance. The objective of this article is to study personality disorder as a possible risk factor for the onset of an insane process, and to relate personality disorders of Cluster B and dementia. METHODOLOGY: A systematic review and meta-analysis was carried out with scientific literature published up to 2015. RESULTS: Twelve of the articles that we found met the specified criteria of selection and quality and study the relationship between a personality disorder and the emergence of a dementia. Although with the studies made so far it can't be concluded that the first one is a risk factor for the second one, it has been noted, thanks to neuroimaging techniques, that patients with Cluster B personality disorders develop alterations in brain structures (in the prefrontal, temporal and parietal cortex, as well as an alteration in the NAA levels and the grey matter levels) and which are also involved in a demented process. CONCLUSIONS: Definitely, the patients with medical record of the borderline or narcissistic personality disorder present more alterations in the brain structures mentioned, such that presenting these types of personality disorders could increase the risk of developing dementia in the future.

Trastorno de la personalidad: un posible factor de riesgo para la demencia / Disorder of the personality: a possible factor of risk for the dementia

Objetivos. El hecho de que cada vez haya más personas que padezcan demencia hace que sea muy importante conocer los diferentes factores de riesgo para prevenir su aparición. El objetivo de este artículo es estudiar el trastorno de la personalidad como posible factor de riesgo para la aparición de un proceso demencial, y relacionar trastornos de la personalidad del Clúster B y demencia. Metodología. Se realizó una revisión sistemática y metaanálisis con literatura científica publicada hasta el año 2015. Resultados. Doce de los artículos que se encontraron cumplían con los criterios de selección y calidad especificados y estudian la relación entre un trastorno de personalidad y la aparición de una demencia. Aunque con los estudios hechos hasta el momento no se puede concluir que el primero sea un factor de riesgo para el segundo, sí que se ha podido observar, mediante técnicas de neuroimagen, que los pacientes con trastornos de personalidad del Clúster B desarrollan alteraciones en estructuras cerebrales (en la corteza prefrontal, temporal y/o parietal, además de una alteración en los niveles de N-acetil Aspartato y de sustancia gris) que también están implicadas en un proceso demencial. Conclusiones. En definitiva, los pacientes con historia clínica de trastorno límite o trastorno narcisista de la personalidad presentan más alteraciones en las estructuras cerebrales mencionadas, de tal manera que presentar este tipo de trastornos de la personalidad podría aumentar el riesgo de padecer demencia en un futuro

Objectives. The fact that more and more people suffer from dementia makes it very important to know the different risk factors to prevent their appearance. The objective of this article is to study personality disorder as a possible risk factor for the onset of an insane process, and to relate personality disorders of Cluster B and dementia. Methodology. A systematic review and meta-analysis was carried out with scientific literature published up to 2015. Results. Twelve of the articles that we found met the specified criteria of selection and quality and study the relationship between a personality disorder and the emergence of a dementia. Although with the studies made so far it can’t be concluded that the first one is a risk factor for the second one, it has been noted, thanks to neuroimaging techniques, that patients with Cluster B personality disorders develop alterations in brain structures (in the prefrontal, temporal and parietal cortex, as well as an alteration in the NAA levels and the grey matter levels) and which are also involved in a demented process. Conclusions. Definitely, the patients with medical record of the borderline or narcissistic personality disorder present more alterations in the brain structures mentioned, such that presenting these types of personality disorders could increase the risk of developing dementia in the future

[Premorbid personality as a risk factor in the appearance of psychological and behavioural symptoms of dementia: Systematic review]. / La personalidad premórbida como factor de riesgo en la aparición de síntomas psicológicos y conductuales de la demencia: revisión sistemática.

The aetiology of behavioural and psychological symptoms of dementia (BPSD) is defined by a diversity of factors, and recent studies suggest that premorbid personality could be a risk factor for BPSD. This study aimed to review studies on the relationship between premorbid personality and BPSD. Studies were identified using PsycInfo, MedLine, and PubMed. The searches combined terms for premorbid personality, dementia and BPSD. Ten studies have been included in this review. Eight out of ten studies show a relationship between premorbid personality and BPSD. Neuroticism is associated with behavioural disturbances and anxiety. Extraversion is associated with wandering. Low agreeableness is associated with affective disturbance and aggression-related behaviours and high agreeableness is associated with wandering. The studies found no congruent results for openness and conscientiousness. In conclusion, premorbid personality may increase the risk of developing BPSD during the course of the disease. Even so, the relationship between personality and BPSD is complex due to multifactorial aetiology.

¿Supone la presencia de episodios de delírium en el anciano un factor de riesgo para la aparición posterior de un síndrome demencial? / Is the presence of episodes of delirium in the elderly a risk factor for the subsequent appearance of a demential syndrome?

Objetivos: El aumento durante los últimos años de la población anciana y, consecuentemente, de las personas con deterioro cognitivo grave hace que sea necesario buscar soluciones, tanto preventivas como de actuación sobre la enfermedad para controlar los síntomas. El objetivo de este metaanálisis es estudiar la relación que existe entre la ocurrencia de delírium en el anciano y la aparición posterior de demencia. Metodología: Los estudios fueron identificados a través de las bases de datos de PsychInfo, PubMed y Psicodoc. La búsqueda combinó términos de deterioro cognitivo, así como delírium y demencia, con términos como factor de riesgo, entre otros. Los datos de los artículos fueron extraídos, analizados, revisados sistemáticamente y metaanalizados apropiadamente. Resultados: Se incluyeron 8 estudios, con variedad de pacientes provenientes de cirugía de cadera, de fractura del femoral, de población general, accidente vascular cerebral y pacientes de la UCI. Todos los estudios analizados concluyeron que el hecho de haber sufrido uno o varios episodios de delírium es un factor de riesgo importante a tener en cuenta en el posterior desarrollo de demencia. Conclusiones: Este hallazgo puede ser de utilidad en un futuro de cara a establecer programas de prevención secundaria de demencia en personas mayores, aumentar su calidad de vida y a reducir los gastos que ocasionan estos pacientes en el sistema sanitario

Aims: The increase of elderly people during the last years, and consequently of the people with severe cognitive impairment, makes necessary to seek preventive and actuation solutions of the disease to control the symptoms. The aim of the present meta-analysis is to study the relation between the occurrence of delirium in the elderly and the further development of dementia. Methodology: Studies were identified through Psychinfo, PubMed and Psicodoc databases. The search combined words like cognitive impairment, delirium and dementia with other terms like risk factors among others. Data were extracted and checked, systematically reviewed and meta-analyzed appropriately. Results: Eight studies were included, with a variety of patients from hip surgery, femoral fracture, general population, stroke and ICU patients. All the studies analyzed concluded that having one or more episodes of delirium is an important risk factor for the subsequent development of dementia. Conclusions: This finding may be for an important help in the future in order to establish secondary prevention programs for dementia in the elderly, to increase quality of life of this people and to reduce the costs that those patients cause in the healthcare system