INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2002; 17: 779–783. Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/gps.697 A study of premorbid personality and behavioural and psychological symptoms of dementia in nursing home residents Lee-Fay Low 1 , Henry Brodaty 1,2 * and Brian Draper 1,2,3 1 Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, Australia 2 School of Psychiatry, University of New South Wales, Kensington, Australia 3 Schools of Public Health Community Medicine, University of New South Wales, Kensington, Australia SUMMARY Objective To investigate the relationship between pre-morbid personality and behavioural and psychological symptoms of dementia (BPSD). Methods We studied 58 subjects with dementia and depression and/or psychosis residing in 11 Sydney nursing homes cross-sectionally. Informal caregivers completed ratings of residents’ pre-morbid personality on the NEP Five-Factor Inventory (NEO-FFI). Information on BPSD was obtained using the BEHAVE-AD. Results Higher neuroticism was predictive of delusions; higher agreeableness of hallucinations, aggressiveness, affective disturbance and overall behavioural disturbance; and higher openness of affective disorder. Conclusion Our findings are inconsistent with previous research and clinical experience. Prospective studies are needed to clarify the association between personality and behavioural disturbance in dementia. Copyright # 2002 John Wiley & Sons, Ltd. key words — dementia; depression; psychosis; personality INTRODUCTION Behavioural and psychological symptoms of demen- tia (BPSD), including hallucinations, delusions, aggression, activity disturbance and depression, con- tribute significantly to caregiver burden (Coen et al., 1997; Teri, 1997; Clyburn et al., 2000) and are a major reason for institutionalization (Bianchetti et al., 1995; Lopez et al., 1999). The prevalence of BPSD in nursing homes has been reported to range from 43% to 93% in the United States (Beck and Shue, 1994) and 29% to 92% in Australia (Snowdon et al., 1996; Brodaty et al., 2001). It has been suggested that BPSD reflect an indivi- dual’s premorbid personality traits (Kolanowski and Whall, 1996). Previously reported associations between personality traits and BPSD in both commu- nity and nursing home samples include higher pre- morbid neuroticism with increased depression and dysphoria, severity of anxiety and troublesome beha- viour; lower premorbid extraversion and frustration tolerance with increased depression; higher premor- bid hostility with delusions; and higher openness with hallucinations (Chaterjee et al., 1992; Strauss et al., 1997; Meins et al., 1998). Other studies have failed to demonstrate links between premorbid personality and BPSD (Swearer et al., 1996; Brandt et al., 1998). We aimed to investigate the relationship between premorbid personality and BPSD in a nursing home in order to clarify the lack of replicated findings to date. Received 20 November 2001 Copyright # 2002 John Wiley & Sons, Ltd. Accepted 3 April 2002 *Correspondence to: Professor H. Brodaty, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, 2031, NSW, Australia. Tel: (61-2) 93823749. Fax: (61-2) 9382 3762. E-mail: h.brodaty@unsw.edu.au Contract/grant sponsor: National Action Plan for Dementia Care, Australian Commonwealth Department of Health and Family Services. Contract/grant sponsor: School of Psychiatry, University of New South Wales.