February 2, 2025, 4:13 pm | Read time: 6 minutes
Why do some people age mentally fit and healthy while others suffer early cognitive decline or even develop dementia? A new study shows that one’s personality could play a decisive role in this. Scientists identified three psychological profiles with different levels of risk for dementia.
The aging of society poses major challenges for the healthcare system, particularly with regard to the prevention of dementia. The German Alzheimer’s Society reports that around 1.84 million people in Germany suffer from dementia. According to forecasts, the number of people over the age of 65 with dementia will increase to between 2.3 and 2.7 million by 2050.1 Researchers are, therefore, looking for ways to identify the risk of cognitive decline at an early stage so that preventative measures can be taken. Last year, a British cohort study identified 15 risk factors for early-onset dementia – including depression and vitamin D deficiency. However, what has so far been ignored is a person’s personality. A recent international study has identified three personality types, each with a different risk of dementia.
Overview
Psychological Risk Factors Were the Focus of the Study on Dementia Risk
The aim of the study was to identify psychological profiles of middle-aged and older adults and to shed light on their relationship with mental health, cognitive performance, and brain structure2 The researchers wanted to find out whether certain combinations of psychological characteristics – i.e., not just individual factors such as depression or stress – are associated with cognitive decline in old age. Study leader David Bartrés-Faz from the University of Barcelona explained in a press release: “Until now, psychological risk and protective factors have been studied almost exclusively independently of each other. This approach is limiting because psychological traits do not exist in isolation.”3
The authors of the study begin by explaining that previous studies have already shown that psychological characteristics can influence mental health in old age. While factors such as a high level of life satisfaction, self-reflection, or seeing meaning in life are considered protective, emotional instability (neuroticism) and recurrent negative thinking are associated with an increased risk of dementia.
The study, therefore, focuses on the question: Are there certain personality types that have a favorable or unfavorable effect on the brain and, thus, on the risk of dementia?
How the Scientists Proceeded
To answer the question, data on 1,000 cognitively healthy adults from two independent study cohorts – the Barcelona Brain Health Initiative (BBHI) and the Medit-Ageing study – were analyzed. Data from 750 middle-aged participants (51.4 years on average) was taken from the first study. From the second, the researchers took data from 282 older adults (average age 71.1 years). A cross-sectional analysis was carried out in both, and a longitudinal analysis was performed in the BBHI. To this end, some of the BBHI participants took part in further examinations after 2.3 years so that the scientists could record any changes in cognition and brain structure.
Using latent profile analysis (LPA), a method for identifying hidden patterns of psychological characteristics in individuals, the psychological profiles were formed on the basis of nine factors. These included both risk factors (e.g., rumination, neuroticism) and protective factors (e.g., sense of purpose, self-reflection).
The scientists also carried out cognitive tests with the test subjects to measure their mental performance. They also used MRI scans to analyze the brain structure. Health and lifestyle factors such as sleep quality and social contacts were also recorded.
Study Identifies 3 Psychological Profiles Associated with Dementia Risk
So, is there a “dementia personality?” Bartrés-Faz and his team were able to identify three personality types and their respective dementia risk.
- Profile 1 (“low protective traits” ): Subjects in this profile showed little determination and openness to new things. In addition, their willingness to lead a healthy lifestyle was low. This group showed poorer cognitive performance, especially in old age. In middle age, the thinning of gray matter was accelerated. This profile has the highest risk of dementia.
- Profile 2 (“high-risk profile” ): Individuals in whom characteristics such as rumination, susceptibility to stress, and negative thoughts were pronounced. They suffered more frequently from depression, anxiety disorders, sleep problems, and social isolation. Their risk of dementia is increased but lower than in profile 1.
- Profile 3 (“Well-balanced profile” ): This group had both moderate protective and low-risk factors. For example, they were less susceptible to stress and open to new things. They achieved the best scores in all areas tested: mental health, cognition, and brain structure.
Surprisingly, profile 2 showed no severe cognitive impairment or brain changes. This suggests that emotional distress and cognitive decline may take different paths.
Significance of the Results
The study emphasizes that psychological factors not only influence mental health but also cognitive aging processes. It is particularly relevant that people with low protective factors – even without pronounced stress symptoms – could be at a higher risk of cognitive impairment and brain atrophy. Bartrés-Faz explains: “These associations were observed in all age groups studied, underlining the importance of a balanced spectrum of psychological aspects as a determinant of mental and cognitive health in adulthood and old age.”
If these results can be confirmed in studies with larger numbers of participants, they could have implications for the development of future prevention measures aimed at changing psychological factors and lifestyles. “For example, people with characteristics consistent with the psychological profile with low protective factors could benefit more from psychological therapies that involve identifying or re-identifying valued behaviors and life purposes, such as acceptance and commitment therapy,” says Bartrés-Faz. In other words, the prevention of dementia could be better adapted to the individual.
Classification of the Study
Although the study provides valuable insights into the role of psychological factors in the aging process, it also has limitations. Firstly, only limited long-term data was available, as only one of the two cohorts was re-examined after 2.3 years. As the cohorts studied were mainly from Europe, cultural differences in psychological disposition and lifestyle are not fully reflected. Accordingly, the results cannot be easily transferred to other population groups. Furthermore, the design of the study only allows correlations to be established. However, it cannot prove beyond doubt whether psychological profiles are the cause of cognitive and brain structural changes. Finally, it should be mentioned that no dementia-specific biomarkers were analyzed, so the direct effects on the risk of dementia still need to be investigated further.
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Conclusion
The study shows that personality types influence cognitive and mental health in old age. Particularly important is the finding that not only classic risk factors such as stress or depression are relevant, but also the lack of protective characteristics can increase the risk of cognitive decline. For prevention, this means that in addition to physical and behavioral factors, psychological aspects should also be given greater focus.