Table 1. Key Points.

1	Neuroticism is a multifaceted propensity toward negative affect. Dr. Manning's paper pinpoints one specific element of Neuroticism, vulnerability to stress, as a particularly potent risk factor for poor depression treatment response and for cognitive decline. Vulnerability to stress is operationalized by a common personality scale with items like “I often feel helpless and want someone else to solve my problems” and “When I'm under a great deal of stress, sometimes I feel like I'm going to pieces.”
2	Neuropathological mechanisms have been proposed to account for links between distress proneness and cognitive decline. However, mechanisms are likely complex and have yet to be definitively characterized.
3	Opinions vary about the feasibility of directly modifying personality traits in late life. An alternative approach would be to examine whether measures of personality phenotype can be leveraged in clinical prediction models of the course of disease, similar to the prediction models based on prognostic genotypes. Accurate and reliable predictions could inform treatment planning and decision-making.