The effect of anticholinesterases on personality changes in Alzheimer's disease

Anticholinesterases are known to be effective against cognitive and non-cognitive symptoms of Alzheimer's disease (AD) but their effect on the personality changes in the disease is not known. This study examines the effect of anticholinesterase treatment on personality changes in AD. It involved the carers of patients with mild to moderate AD who were currently receiving anticholinesterases in south Manchester. The personality change was measured using the Brooks and McKinlay Personality Inventory. The carers were asked to complete the inventory for each of three periods in the patients' lives: before the onset of AD, after the diagnosis of AD but before starting anticholinesterases, and currently on anticholinesterases. Fifty-eight carers participated in the study. Personality became more negative (total score on the personality inventory became less) following the onset of AD (p <0.001). Following anticholinesterase treatment, the total score on the personality inventory remained the same or increased in 23 (39%) patients. Scores on individual personality traits remained the same or increased in the majority of patients. In approximately one fifth of the patients, the traits 'does things himself', 'happy', 'calm' and 'cautious' showed improvement on anticholinesterases. The study confirms that personality changes are almost universal and negative in AD and suggests that anticholinesterases may have a positive effect. Further double blind prospective studies are needed to understand natural progression of personality changes in AD and to validate the findings of this study.