Personality or behavioral changes could be signs of mental illness, like depression or bipolar disorder, but new research points out that differences in behavior could also be tied to cognitive decline.
A recent study specifically found behavioral changes in men – such as having false beliefs and a lack of enthusiasm later in life – were associated with a risk of faster cognitive decline compared to women.
According to Byron Creese, PhD, co-author of the study, behavioral changes were also defined as mild behavioral impairment (MBI) in the study. MBI describes a syndrome that can be made up of a combination of symptoms, including apathy or social withdrawal, changes in mood and anxiety, being more impulsive than usual, being socially inappropriate and having false beliefs or hallucinations.
Creese said while the rate of cognitive decline might not be something people notice day to day, observing some of these behavioral changes can help loved ones identify people with potential memory problems early on. The study also allows researchers and other health care professionals to identify people at a higher risk of developing dementia later in life.
“These early changes in cognition might go on to become more severe later, and these findings indicate that MBI might be a marker for this decline,” Creese added.
Understanding different behavioral changes in men and women
Creese and his colleagues studied changes in behavior in more than 8,000 cognitively healthy people 50 and older who were also enrolled in PROTECT, a British online cohort study. On average, participants were 63 years old, and more than half of them were women. The participants were asked to complete a series of online tests and questionnaires that assessed behavioral changes.
In people without dementia, the researchers found that people with MBI had more cognitive decline over a period of 3.5 years when compared to people without MBI. Creese said when they looked at apathy and impulse control, they identified the decline was higher in men than in women. Additionally, they also found that symptoms of psychosis were associated with cognitive decline in men only.
Creese said more biological studies are needed to explain why these findings might be; however, the broader point is “this research shows that it is critical to understand gender/sex differences in cognitive aging and dementia risk.”
Katrin Wolfova, PhD, first author of the study and PhD student at Charles University in Prague, told Neuroscience News that previous research suggests that structural differences in the hippocampal regions of the brain, functional differences in the serotonergic system, or unequal distribution of types of dementia in men and women could be possible explanations for the study’s findings.
Behavioral changes to look for
According to Creese, here are some examples of changes in behavior and MBI symptoms in daily life caregivers and loved ones can be on the lookout for:
- Interest, motivation and drive (also known as apathy—losing interest in usual hobbies, family and friends and being less spontaneous)
- Mood and anxiety (being depressed or believing you are a burden to your family)
- Impulse dyscontrol (acting more impulsively than usual, being agitated easily, being argumentative, becoming more reckless)
- Social inappropriateness (lacking social judgment, talking very openly about personal or private matters, being rude in a way not normal for them)
- Strongly held beliefs and sensory experiences (developing beliefs they’re in danger or others are planning to harm them, seeing things that are not there)
He noted that social inappropriateness and hallucinations are extremely rare in cognitively normal people. These behaviors should be new-onset, persistent and represent a change from usual, and not be attributed to some other mental health condition, like depression or schizophrenia. Symptoms should also be sustained for at least six months.
“I think many people may be better primed to look out for signs of memory and thinking changes in their loved ones as we age, but this research highlights the importance of recognizing changes in behaviors and personality as well,” Creese said.
Behavioral changes can occur suddenly or more gradually, but the key things to look for are whether a change in temperament or behaviors is not consistent with how they were before and if it’s affecting how they interact with you and the world around them, or having a negative impact in some other way.
If you notice your loved one is showing changes in their behavior, especially for six months or longer, consider talking with their doctor and scheduling an evaluation.