PAPER

Premorbid proneness to distress and episodic memory impairment in Alzheimer’s disease

R S Wilson¹, D A Fleischman¹, R A Myers², D A Bennett¹, J L Bienias³, D W Gilley³, D A Evans³

¹ Rush Alzheimer’s Disease Center and Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
² Rush Alzheimer’s Disease Center, Rush University Medical Center
³ Rush Institute for Healthy Aging, and Department of Internal Medicine, Rush University Medical Center

Correspondence to:
Correspondence to:
Dr Robert S Wilson
Rush Alzheimer’s Disease Center, 600 S Paulina, Suite 1038, Chicago, IL 60612, USA; rwilson{at}rush.edu

Background: Chronic stress has been associated with impaired episodic memory, but the association of premorbidly experienced distress with memory function in Alzheimer’s disease is unknown.

Objective: To investigate the link between proneness to distress and Alzheimer’s disease.

Methods: Participants were 363 persons with clinically diagnosed Alzheimer’s disease. At baseline, a knowledgeable informant rated each person’s premorbid personality (that is, before dementia onset) along five dimensions, one of which was the tendency to experience psychological distress. Participants underwent structured clinical evaluations at baseline and then annually for up to four years. Each evaluation included 17 cognitive tests from which previously established measures of episodic memory, visuoconstruction, repetition, and naming were derived.

Results: In a series of random effects models adjusted for age, sex, and education, premorbid distress proneness was associated with baseline impairment in episodic memory but not with impairment in other cognitive domains, or with change in any cognitive domain. No other trait was related to baseline function or rate of decline in any cognitive domain.

Conclusions: The results suggest that premorbid proneness to experience psychological distress is related to level of impairment in episodic memory in persons with Alzheimer’s disease, but neither distress proneness nor other personality traits are related to disease progression.

Keywords: Alzheimer’s disease; cognitive function; memory; stress

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