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When it comes to Alzheimer's disease, it is likely that a patient will experience a magnitude of personality and mood changes. This can be difficult to deal with but there are numerous therapies that can be beneficial to help cope with these new changes.

When it comes to the later stages of Alzheimer's Disease, one of the more noticeable changes in this disease will be alterations in the patient's personality and mood. This is due to damage in the frontal cortex of the brain and can present as a challenge to both family and friends who may feel like they are dealing with a completely different individual.

Here, we'll look at how these types of personality changes may manifest and what types of treatment options could be available for patients in this condition. 

The root cause of personality changes in Alzheimer's disease

A person's personality stems from the frontal cortex of the brain. This is the region that is mostly responsible for motor function, problem-solving, impulse control, memory, language, judgment and behavior. As you can see, this is quite a significant portion of the brain and its functions can greatly influence every aspect of your daily living. The changes occur due to the plaque accumulation in this portion of your brain. These plaques can cause the lobe to deteriorate and as it shrinks, the functions of the brain start to degrade as well. 

Although these changes may become more apparent in the later stages of the disease, in a subset of patients ultimately diagnosed with Alzheimer's disease, personality changes can actually be observed before more obvious symptoms of Alzheimer's. This can be quite frustrating and confusing because it may be diagnosed only as a form of depression. It can come as quite a shock for these patients when they learn that their disease is more extensive. 

In one study done to analyze what portion of a personality seems to be affected the most, it was determined that patients with Alzheimer's disease will typically have the most noticeable changes in:

  • Agreeability
  • Openness
  • Conscientiousness
  • Neuroticism

Agreeability will manifest as patients being more likely to challenge or disagree with simple decisions. Openness is affected by patients becoming more socially withdrawn. They may not actively engage in conversations and can easily become frustrated with their deficits in language and communication so their sentences may become quite choppy and short. Conscientiousness is their drive to do work and tasks to a high standard. Simple chores may start to be ignored and those that are completed can be done in such a way that it seems that a teenager was performing them. Neuroticism is the last category most likely affected and this means that a patient will be moodier than previously observed. Their attitude can be more volatile and patients can easily become argumentative. 

Other noticeable changes that will likely follow will be impaired judgment, a greater tendency to use profanity and potentially even lewd behavior that was not previously seen. The frontal lobe of the brain is largely responsible for inhibition control. You may notice yourself making poorer decisions after drinking alcohol and this is due to the fact that this inhibition pathway is downregulated. This means that you are more likely to make poorer decisions because you do not have the self-control to stop yourself. In AD, this inhibition pathway is progressively damaged to the point where patients can begin to undress in public unexpectedly, defecate in inappropriate places or utter lewd remarks. 

Personality changes and Alzheimer's: Treatment options that may be worth a try 

Although the brain becomes increasingly damaged as this disease progresses, there are some treatment options that are remarkable at helping patients cope with the changes and function as they did previously before the disease. One of the first things that would help would be using some type of antidepressant medication. Patients at this stage are likely to suffer from depression and the moodiness associated with frontal cortex destruction. When taking medications like antidepressants, hormones in the brain are better regulated in order to help stabilize these episodes of depression. 

Another treatment option that patients with Alzheimer's can likely benefit from would be group therapy with their family and friends. What this can entail would be sitting down and meeting with a psychiatrist in order to discuss what types of personality changes are possible and how to best to cope with them. During this interaction, you will learn about what types of symptoms are possible with this disease and techniques and factors that you can try in order to help reduce the anxiety.

Even if the prognosis may not be altered, the magnitude of knowing what to expect can make a world of difference for everyone and you will be able to approach this disease with a team effort. This is also considered to be the best approach to help adjust to a new personality a patient may have. Medications will not bring back a previous personality but learning to help the family and the patient adjust to it will help with acceptance of the situation. 

A more specialized form of this type of therapy is known as cognitive behavioral therapy. This is a practice where patients target their negative viewpoints of depression to help them learn thinking strategies to not have such a negative perspective. A person who is depressed will usually have a perspective of very low self-worth and believe they are in a hopeless situation. In this situation, patients will typically already believe that medications will not be effective and will not be compliant with their treatment. These medications are effective in around 95 percent of cases and will work in patients are willing to complete their therapy. Not taking the medications due to a belief that they will not work is typically one of the only reasons that the drugs will not at least make a slight difference in their moods. 

In the event there is no improvement after the introduction of medications, the next best step to follow would be the use of electroconvulsive therapy or ECT. This is a type of therapy that is considered to be the last resort in patients who do not respond effectively to medication. Patients will be given a small electrical shock to stimulate certain areas in the brain. It is an effective therapy for depression and patients may only have a slight side effect of temporary amnesia.