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Informant Reports of Changes in Personality Predict Dementia in a Population-Based Study of Elderly African Americans and Yoruba

Received June 14, 2001; revised September 27, 2001; accepted December 19, 2001. From the Departments of Psychiatry (VSG,KSH,HCH), Medicine (SLH,HCH), and The Regenstrief Institute Center on Aging Research (AJP,SLH,HCH), Indiana University School of Medicine, and the Departments of Psychiatry (OB,AJP,OG) and Neurology (AO), University of Ibadan (Nigeria). Address correspondence to Dr. Smith-Gamble, Department of Psychiatry, Indiana University School of Medicine, 541 Clinical Drive, Rm. 394, Indianapolis, IN 46202-5111. e-mail: Valerie.smith-gamble{at}med.va.gov

OBJECTIVE: The authors conducted a longitudinal, population-based survey of African Americans in Indianapolis, Indiana, and Yoruba in Ibadan, Nigeria, using the Community Screening Interview for Dementia to assess the predictive value of informant reports of changes in personality on incident dementia and Alzheimer disease. METHODS: In all, 3,021 subjects had informants' reports of changes in personality and dementia status (2,084 subjects residing in Ibadan and 937 subjects residing in Indianapolis). RESULTS: After adjusting for demographic, cognitive, and functional characteristics in two markedly different populations, socioeconomically and culturally, subjects with changes in personality had approximately twice the odds of having dementia as subjects with no change in personality. CONCLUSION: The finding that in two markedly different populations, personality change is a significant predictor of future dementia, independent of cognition and functional status, should make clinicians particularly sensitive to these reports when they occur in their elderly patients.

Key Words: Cross-Cultural Psychiatry • Alzheimer Disease • Diagnostic Tools

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