Personality traits, cognition and volumetric MRI changes in elderly patients with early-onset depression: A 2-year follow-up study Kerstin Weber a, ⁎, Panteleimon Giannakopoulos a, b , Christophe Delaloye a, c , Fabienne de Bilbao a , Guenaël Moy a , Karsten Ebbing b , Abba Moussa a , François R. Herrmann d , Gabriel Gold d , Alessandra Canuto a a Division of Geriatric Psychiatry, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, 1225 Geneva, Switzerland b Division of Old Age Psychiatry, University Hospitals of Lausanne, Hospices-CHUV, 1015 Lausanne, Switzerland c Faculty of Psychology and Science of Education, University of Geneva, 1204 Geneva, Switzerland d Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, 1226 Thônex, Switzerland abstract article info Article history: Received 16 February 2011 Received in revised form 30 August 2011 Accepted 20 November 2011 Keywords: Aging Cognition Imaging Temperament Affective disorder Follow-up study Previous studies revealed personality changes in elderly patients with early-onset depression (EOD) that persist in euthymic stages. However, depression in older patients is a complex disorder that may affect not only person- ality, but also cognition and brain structure. To address this issue, a cross-sectional comparison and 2-year follow-up of 28 EOD elderly patients and 48 healthy controls included detailed neurocognitive assessment, esti- mates of brain volumes in limbic areas and white matter hyperintensities, as well as evaluation of the Five Factor Model of personality, in a remitted mood state. Results revealed that cognitive performances as well as brain vol- umes were preserved in EOD patients both at baseline and at follow-up. The increased Neuroticism factor and Anxiety facet scores as well as the decreased Warmth and Positive Emotions facet scores found at baseline reached the level of healthy controls after 2 years. Only the Depression facet scores remained significantly higher in EOD patients compared to controls upon follow-up. Results were independent of depressive relapse since baseline (25% of patients). These findings suggest that both cognitive performances and brain volumes show long-term preservation in older EOD patients. In contrast, the depression-related personality facet might be a trait like marker that persists in the long-term evolution of this disorder. © 2012 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Whether or not personality traits represent determinants of early psychological vulnerability in depressed patients is a long-standing debate (for review see Akiskal et al. 1983; Clark et al., 1994). Support- ing this idea, recent studies showed a major impact of high Neuroti- cism and low Extraversion both on the development of depressive symptoms and clinical prognosis (Jylhä and Isometsä, 2006; Jylhä et al., 2009; Kotov et al., 2010). In younger cohorts, Neuroticism has been shown to mediate treatment response (Quilty et al., 2008) and predict depressive relapse (Enns and Cox, 1997). When persisting in euthymic stages, these personality changes may represent trait markers of at least some types of depression (Tang et al., 2009). Alter- natively, they may be simple by-products of remitted or residual de- pression symptoms (Jylhä et al., 2009). In contrast to the focus on younger adults, studies of personality traits and depression in late life are quite rare (Boyd et al., 2000; Brodaty et al., 2001; Grace and O'Brien, 2003). In this age group, greater Extraversion is associated with positive affect, whereas Neu- roticism has been repeatedly related to poorer outcomes such as anx- iety and negative affect (Lyness et al., 1998; Oldehinkel et al., 2001). The robust relationship between Neuroticism and depression ob- served in younger populations apparently holds in older samples (Ormel et al., 2001). Interestingly, Neuroticism has been shown to re- main at high levels even in elderly patients who recovered from de- pression (Abrams et al., 1991), raising the idea that personality traits may be relatively resistant to current mood in this age group. When addressing the complex relationship between personality and depression in old age, one should take into account the marked heterogeneity of late-life depression that concerns cases with early- onset (EOD) and late-onset symptoms. The impact of personality on elderly subjects with depression in the absence of acute symptoms may be critically influenced by the etiopathogenetic differences be- tween late- and early-onset depression. Whereas the first is thought to be predominantly determined by neurocognitive and vascular pa- rameters, several studies have revealed that positive family history and personality abnormalities are more common in patients with EOD (usually defined by age of onset of the first major depressive ep- isode before 60 years) (Brodaty et al., 2001; Grace and O'Brien, 2003; Psychiatry Research 198 (2012) 47–52 ⁎ Corresponding author at: Outpatient Center for Old Age Psychiatry and Psycho- therapy, University Hospitals of Geneva, 10 rue des Epinettes, CH-1227 Carouge, Switzerland. Tel.: +41 22 304 49 00; fax +41 22 304 49 49. E-mail address: kerstin.weber@hcuge.ch (K. Weber). 0165-1781/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.psychres.2011.11.017 Contents lists available at SciVerse ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres