Personality in later life: personality disorder and the effects of illness on personality
This chapter covers disorders of personality in later life, including personality changes caused by dementia. There is little agreement on how best to measure personality in old age. Nevertheless, it is clear that specific changes in personality accompany dementia, particularly fronto-temporal dementia. Personality disorder (PD) in older people has been little studied and is beset by problems of definition. The current (DSM-IV) categories of PD need modification to take account of the biological and cultural contexts of old age before valid studies of the epidemiology and the life course of PDs can be made. An older person’s personality style will profoundly influence their adjustment to major life-stresses, and good care depends on clinicians’ understanding of this. Long-standing personality traits are probably important in the development of the Diogenes syndrome (extreme self-neglect) in later life.