Personality and incident disability in older persons

Correlates of subjective and objective everyday functioning in middle-aged and older adults with human immunodeficiency virus

People with human immunodeficiency virus (HIV) (PWH) are at an increased risk for impaired everyday functioning and they may also experience poor awareness of their functional status. This study identified factors associated with (1) subjective and objective instrumental activities of daily living (IADLs) and (2) awareness of functional capacity in PWH. In this cross-sectional study, 236 PWH completed a neurobehavioral assessment, including self-report and performance-based measures of IADLs. Multiple regressions were performed to identify demographic, personality, and cognitive factors contributing to subjective and objective evaluation of everyday functioning, as well as discrepancy between self-report and performance-based measures of IADLs. Results indicated that increased depression was associated with worsened self-report of everyday functioning but not performance of IADLs. Cognitive function and age were associated with IADL performance. Most participants (58.1%) demonstrated a discrepancy between self-report and actual performance of IADLs. Worse processing speed was correlated with greater discrepancy. Inaccurate self-reporters had worse overall cognitive functioning and lower levels of personality traits, including openness, conscientiousness, and agreeableness. In conclusion, self-report and actual performance of IADLs in PWH is influenced by different factors. Self-report may be more affected by psychological variables, such as mood and personality, while actual performance is more sensitive to age and cognitive function.

Health literacy across personality traits among older adults: cross-sectional evidence from Switzerland

This research aims to better understand the association of personality traits (PT)-Openness to Experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism-with health literacy (HL) skills of adults aged 58 years and older in a nationally representative sample from Switzerland. Analyses were conducted on a subsample (n = 1546) of respondents living in Switzerland from wave 8 (2019/2020) of the Survey of Health, Ageing, and Retirement in Europe (SHARE). PT were assessed with the Big-Five inventory ten (BFI-10). HL was measured using the short version of the European Health Literacy Survey questionnaire (HLS-EU-Q16). We used multivariable regressions to explore how respondents' PT are independently associated with (1) the HLS-EU-Q16 and (2) seven sub-indices derived from this HL scale. Results demonstrated that even when controlling for social, regional, and health characteristics, PT were significantly associated with HL among older adults in Switzerland. More open individuals showed better HL competencies. By contrast, individuals who scored higher on neuroticism expressed more difficulties regarding concrete health-relevant tasks or situations. These findings call for public health policies targeting older adults with lower levels of openness who are less likely to engage in self-examination, and individuals with higher levels of neuroticism who tend to experience more negative emotions. Moreover, health information and communication strategies content development that accounts for different personality types and addresses the needs of individuals with low levels of openness and high neuroticism may help improve HL among older adults whose personalities may otherwise put them at a disadvantage in handling health information.

Instrumental Activities of Daily Living by Subjective and Objective Measures: The Impact of Depression and Personality

Objective

Previous research shows that depression and personality are independently associated with self- and informant-reports of the ability to perform instrumental activities of daily living (IADLs). However, less is known about the association between depression and personality and performance-based measures of IADLs. We aimed to determine how depression and personality predict self-and informant-reports of IADL compared to performance-based measures of IADLs in a sample of older adults with normal cognition (NC) and Mild Cognitive Impairment (MCI).

Methods

Participants consisted of 385 older adults with NC (n = 235), or a diagnosis of MCI (n = 150), aged between 76 and 99-years from the Sydney Memory and Ageing Study. Participants underwent comprehensive neuropsychological and clinical assessments to determine global cognition and clinical diagnoses. Personality traits were measured by the NEO Five-Factor Inventory (NEO-FFI) and depression by the Geriatric Depression Scale (GDS). Subjective IADLs were self- and informant-reported Bayer Activities of Daily Living (B-ADL) scales and objective IADL was the Sydney Test of Activities of Daily Living in Memory Disorders (STAM). Linear regressions examined the relationship between depression and personality and the three types of IADL measures, controlling for all covariates and global cognition.

Results

Participant-reported IADL, although associated with global cognition, was more strongly associated with GDS and NEO-FFI scores (conscientiousness and neuroticism). Informant-reported IADL was strongly associated with both global cognition and participants' GDS scores. STAM scores were not associated with participants' GDS or NEO-FFI scores; instead, they were predicted by demographics and global cognition.

Conclusion

These results suggest that performance-based measures of IADL may provide more objective and reliable insight into an individual's underlying functional ability and are less impacted by the participants' mood and personality compared to subjectively reported IADL. We argue that performance-based IADL measures are preferable when trying to accurately assess everyday functional ability and its relationship to cognitive status. Where performance-based measures are not available (e.g., in some clinical settings), informant ratings should be sought as they are less influenced by the participant's personality and mood compared to self-reports.

Personality and limitations in instrumental activities of daily living in old age: Reciprocal associations across 12 years

Personality traits have been reported to predict difficulties in performing instrumental activities of daily living (IADL) in old age, such as preparing meals or shopping. However, little is known about the reciprocal effects on personality. In this study, we examined bidirectional relationships between personality traits and the capacity to perform IADL using four waves of longitudinal data from 3540 older adults (aged 65 years and older) from the Health and Retirement Study. We applied a random-intercept cross-lagged panel model to separate between- and within-person effects across time and compared it to a traditional cross-lagged panel model. At the between-person level, higher neuroticism and lower conscientiousness were associated with more IADL limitations. Within individuals across time, increases in neuroticism and decreases in conscientiousness and extraversion were associated with increases in IADL limitations 4 years later. In contrast, increases in IADL limitations only predicted increases in neuroticism and decreases in extraversion. These results indicate that some personality traits affect and are affected by limitations in functional capacities in old age. Results of the within-person model build a strong foundation for future personality interventions as a pathway to maintain high functioning in old age.

Financial fragility and scam susceptibility in community dwelling older adults

We tested the hypothesis that financial fragility is associated with higher scam susceptibility in older adults without dementia. Data came from nearly 900 community-dwelling participants from two ongoing cohort studies of aging. Financial fragility was determined by assessing an individual's ability to access $2,000 within a month for an unexpected expense. Scam susceptibility was assessed via a 5-item instrument that measures perceptions and behaviors that predispose older adults to financial fraud and scams. On average, participants were 82 years of age. Nearly 10% reported financial fragility. Financial fragility was higher in Blacks and among those with fewer years of education, lower income, lower global cognition, lower literacy, and poorer financial decision-making. Regression analysis revealed that financially fragile older adults were more susceptible to scams. These data suggest that targeted efforts to reduce financial fragility and improve literacy and cognitive health are needed to prevent elder exploitation among diverse populations.

Relationship between Personality and Mortality among Japanese Older Adults: A 14-Year Longitudinal Study

Personality is one of the fundamental factors in determining longevity. We used a 14-year mortality surveillance to investigate the relationship between the Big Five personality traits and all-cause mortality among older adults dwelling in a Japanese community. Individuals over 65 years old (484 males and 743 females) were recruited for the study. We used the NEO Five-Factor Inventory to assess the Big Five personality traits: neuroticism, extraversion, openness, agreeableness, and conscientiousness. During the follow-up period, 502 persons (250 men and 252 women) had died. Cox proportional hazards regression controlling for covariates showed that extraversion (hazard ratio [HR] = 0.783, 95% confidence interval [CI] = 0.636 to 0.965 and HR = 0.757, 95% CI = 0.607 to 0.944 for the middle and highest tertiles, respectively), openness (HR = 0.768, 95% CI = 0.608 to 0.969 for the highest tertile), and conscientiousness (HR = 0.745, 95% CI = 0.607 to 0.913 and HR = 0.667, 95% CI = 0.530 to 0.840 for the middle and highest tertiles, respectively) were inversely associated with mortality when the five traits were analyzed separately. Our findings suggest that older adults who have a higher level of either extraversion, openness, or conscientiousness are more likely to live longer.

Relationship between personality and physical capacities in older adults: The mediating role of subjective age, aging attitudes and physical self-perceptions

Walking speed and muscular strength are two main markers of health in adulthood. Previous studies have shown that personality traits may predict these two outcomes. However, little is known about the mechanisms underlying these relationships. Thus, the present study examined whether personality traits are associated with walking speed and muscular strength through the mediating role of subjective age (how young or old individuals experience themselves to be), attitudes toward aging and physical self-perceptions. Community-dwelling older women (N = 243; M_age = 73.0; SD_age = 6.5) were recruited. For reasons of recruitment feasibility, participants were only older women. They were requested to complete a questionnaire measuring personality, subjective age, attitudes toward aging and physical self-perceptions. Following this, their walking speed and their muscular strength were investigated. Data were analyzed using structural equation modeling. In line with the literature, we extended the associations between extraversion, neuroticism, conscientiousness and walking speed and between conscientiousness, neuroticism, openness and muscular strength. Physical self-perceptions appear to be a robust mediator between personality traits and walking speed whereas attitudes toward aging and subjective age mediated the personality traits/muscular strength relationship. This study provides evidence, for the first time, that the associations between personality traits and physical capacities are different according to the physical capacities investigated. Based on these results, it could be interesting to adapt physical activity interventions to the psychological profile of older adults.

Neuroticism alters the transcriptome of the frontal cortex to contribute to the cognitive decline and onset of Alzheimer's disease

Accumulating evidence has suggested that the molecular transcriptional mechanism contributes to Alzheimer's disease (AD) and its endophenotypes of cognitive decline and neuropathological traits, β-amyloid (Aβ) and phosphorylated tangles (TAU). However, it is unknown what is the impact of the AD risk factors, personality characteristics assessed by the NEO Five-Factor Inventory, on the human brain's transcriptome. Using postmortem human brain samples from 466 subjects, we found that neuroticism has a significant overall impact on the brain transcriptome (omnibus P = 0.005) but not the other four personality characteristics. Focused on those cognitive decline related gene co-expressed modules, neuroticism has nominally significant associations (P < 0.05) with four neuronal modules, which are more related to PHFtau than Aβ across all eight brain regions. Furthermore, the effect of neuroticism on cognitive decline and AD might be mediated through the expression of module 7 and TAU pathology (P = 0.008). To conclude, neuroticism has a broad impact on the transcriptome of human brains, and its effect on cognitive decline and AD may be mediated through gene transcription programs related to TAU pathology.

Personality and health literacy among community-dwelling older adults living in Japan

BACKGROUND

Previous studies have demonstrated that health behaviours may be one of the major mechanisms underlying the relationship between personality and health outcomes. Such health behaviours may be established by consciousness toward one's health that include health literacy. Thus, this study aimed to explore the relationship between health literacy and its correlates, including personality, among community-dwelling older adults.

METHODS

This was a cross-sectional study with 683 older individuals (aged 60-84 years; 326 men and 357 women). A questionnaire was used to assess health literacy, personality, socioeconomic status, health status, and lifestyles. Health literacy was measured using the Communicative and Critical Health Literacy Scale, which is a self-report questionnaire comprising five items assessing degrees of health literacy. The Big Five personality traits were measured using the Japanese version of the Ten-Item Personality Inventory. Other variables were measured as factors associated with health literacy, including age, gender, education, subjective economic status, social isolation, chronic diseases, functional capacity, smoking and drinking.

RESULTS

Multiple regression analysis showed that education (β = 0.10), subjective economic status (β = -0.09), social isolation (β = -0.08), functional dependence (β = -0.22), neuroticism, (β = -0.08), extraversion (β = 0.10), openness (β = 0.17), and conscientiousness (β = 0.09) were independently and significantly associated with health literacy (coefficient of determination = 0.28).

CONCLUSIONS

This study found significant and independent associations of personality, socioeconomic status, and health status with health literacy. These results may help facilitate the development of efficient strategies to improve health status by promoting health literacy in community-dwelling older adults.

Association of big-5 personality traits with cognitive impairment and dementia: a longitudinal study

BACKGROUND

Personality traits have been liked to cognitive outcomes such as dementia, but whether these associations are robust to the effects of third variables remains the subject of debate. We examined the role of socioeconomic status, depression (history and depressive symptoms), health behaviours and chronic conditions in the association of the big-5 personality traits with cognitive performance, cognitive impairment and incidence of dementia.

METHODS

Data on 6135 persons (30% women), aged 60-83 years in 2012/13, are drawn from the Whitehall II Study. Participants responded to the 26-item Midlife Development Inventory to assess personality traits (openness, conscientiousness, extraversion, agreeableness and neuroticism), underwent cognitive testing in 2012/13 and 2015/16 and were followed for incidence of dementia (N=231) until 2019.

RESULTS

Logistic regression, adjusted for sociodemographic factors, suggested a cross-sectional association with cognitive impairment for four of the five traits but only neuroticism was associated with incident cognitive impairment. All associations were completely attenuated when the analyses were adjusted for depression. Cox regression (mean follow-up: 6.18 years) adjusted for sociodemographic variables showed higher conscientiousness (HR per SD increment=0.72; 95% CI 0.65 to 0.81) and extraversion (HR=0.85; 95% CI 0.75 to 0.97) to be associated with lower dementia risk; higher neuroticism (HR=1.32; 95% CI 1.17 to 1.49) was associated with increased risk. Further adjustment for depression led to only conscientiousness retaining an association with dementia (HR=0.81; 95% CI 0.69 to 0.96), which was robust to adjustment for all covariates (HR=0.84; 95% CI 0.71 to 0.91; P=0.001).

CONCLUSION

Our results show that only conscientiousness has an association with incidence of dementia that is not attributable to socioeconomic status or depression. The association of neuroticism with dementia was explained by depression.

Leveraging digital technology to intervene on personality processes to promote healthy aging

The scientific evidence is clear that personality processes (particularly conscientiousness and neuroticism) play an important role in healthy aging. Assuming it would be desirable to assist individuals to change their personality in directions that would promote healthy aging, the next step is designing interventions for the task. During the past decade, technological advances have made it possible to develop and evaluate interventions delivered via web and mobile digital technologies. The purpose of this article is to discuss the possibilities for leveraging technology to intervene on personality processes to promote healthy aging, with a specific emphasis on applications for older adults. We begin by reviewing interventions that target personality change to treat mental health problems and physical health, followed by the scant research leveraging digital technologies in targeting personality processes. We present a rationale for adopting a transdiagnostic model to guide intervention development and review the brief literature supporting transdiagnostic interventions when adapted for digital delivery (transdiagnostic Internet-based cognitive-behavioral therapy). We then summarize the literature on designing technology interventions to meet the specific needs of older adults and some of the impressive results from digital technology (Internet-based cognitive-behavioral therapy) intervention studies. We conclude with suggestions for addressing gaps in this important but understudied area of research, with a focus on research targeted to older adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Compensation Strategies in Older Adults: Association With Cognition and Everyday Function

BACKGROUND/RATIONALE

Compensation strategies may contribute to greater resilience among older adults, even in the face of cognitive decline. This study sought to better understand how compensation strategy use among older adults with varying degrees of cognitive impairment impacts everyday functioning.

METHODS

In all, 125 older adults (normal cognition, mild cognitive impairment, dementia) underwent neuropsychological testing, and their informants completed questionnaires regarding everyday compensation and cognitive and functional abilities.

RESULTS

Cognitively normal and mild cognitive impairment older adults had greater levels of compensation use than those with dementia. Higher levels of neuropsychological functioning were associated with more frequent compensation use. Most importantly, greater frequency of compensation strategy use was associated with higher levels of independence in everyday function, even after accounting for cognition.

CONCLUSION

Use of compensation strategies is associated with higher levels of functioning in daily life among older adults. Findings provide strong rational for development of interventions that directly target such strategies.

The role of gender in the association between personality and task priority in older adults' dual-tasking while walking

BACKGROUND

Falls are a major problem for older adults. Many falls occur when a person's attention is divided between two tasks, such as a dual task (DT) involving walking. Most recently, the role of personality in walking performance was addressed; however, its association with DT performance remains to be determined.

METHODS

This cross-sectional study of 73 older, community-dwelling adults explores the association between personality and DT walking and the role of gender in this relationship. Personality was evaluated using the five-factor model. Single-task (ST) and DT assessment of walking-cognitive DT performance comprised a 1-min walking task and an arithmetic task performed separately (ST) and concurrently (DT). Dual-task costs (DTCs), reflecting the proportional difference between ST and DT performance, were also calculated.

RESULTS

Gender plays a role in the relationship between personality and DT. Extraversion was negatively associated with DTC-motor for men (ΔR² = 0.06, p < 0.05). Conscientiousness was positively associated with DTC-cognition for women (ΔR² = 0.08, p < 0.01).

CONCLUSION

These findings may lead to effective personality-based early detection and intervention for fall prevention.

Religious Orders Study and Rush Memory and Aging Project

BACKGROUND

The Religious Orders Study and Rush Memory and Aging Project are both ongoing longitudinal clinical-pathologic cohort studies of aging and Alzheimer's disease (AD).

OBJECTIVES

To summarize progress over the past five years and its implications for understanding neurodegenerative diseases.

METHODS

Participants in both studies are older adults who enroll without dementia and agree to detailed longitudinal clinical evaluations and organ donation. The last review summarized findings through the end of 2011. Here we summarize progress and study findings over the past five years and discuss new directions for how these studies can inform on aging and AD in the future.

RESULTS

We summarize 1) findings on the relation of neurobiology to clinical AD; 2) neurobiologic pathways linking risk factors to clinical AD; 3) non-cognitive AD phenotypes including motor function and decision making; 4) the development of a novel drug discovery platform.

CONCLUSION

Complexity at multiple levels needs to be understood and overcome to develop effective treatments and preventions for cognitive decline and AD dementia.

Personality and Survival in Older Age: The Role of Lifestyle Behaviors and Health Status

OBJECTIVE

We intended to assess the relationship between personality and survival in an older population and to explore the role of lifestyle behaviors and health status as potential mediators.

DESIGN

Population-based cohort study.

SETTING

Swedish National Study of Aging and Care in Kungsholmen, Sweden.

PARTICIPANTS

2,298 adults aged 60 or more years, without dementia or depression, followed for 11 years.

MEASUREMENTS

Personality (extraversion, neuroticism, and openness) was assessed with a shortened version of the NEO-Five Factor Inventory. We tested whether personality affected mortality and examined the potential mediating effect of health status (body mass index, number of chronic diseases, impairment in instrumental activities of daily living, and C-reactive protein) and lifestyle behaviors (leisure activities, social network, smoking, and alcohol consumption).

RESULTS

Over 11 years of follow-up, higher levels of extraversion were associated with a 14% reduction in mortality. Examination of different combinations of personality traits showed that independent of levels of neuroticism and openness, high extraversion were associated with up to 65% lower mortality. Decomposing the effect of extraversion on mortality, we found that the majority (44%) of the beneficial effect was mediated by healthy lifestyle behaviors. Health status accounted for 5% of the association.

CONCLUSIONS

Extroverted people, who are characterized by higher optimism and high self-efficacy, are prone to healthier behaviors and better health, which may result in longer survival. These results highlight the importance of a healthy lifestyle in survival.

Acute Clinical Predictors of Symptom Recovery in Emergency Department Patients with Uncomplicated Mild Traumatic Brain Injury or Non-Traumatic Brain Injuries

There is a subset of patients with mild traumatic brain injury (mTBI) who report persistent symptoms that impair their functioning and quality of life. Being able to predict which patients will experience prolonged symptom recovery would help clinicians target resources for clinical follow-up to those most in need, and would facilitate research to develop precision medicine treatments for mTBI. The purpose of this study was to investigate the predictors of symptom recovery in a prospective sample of emergency department trauma patients with either mTBI or non-mTBI injuries. Subjects were examined at several time points from within 72 h to 45 days post-injury. We quantified and compared the value of a variety of demographic, injury, and clinical assessment (symptom, neurocognitive) variables for predicting self-reported symptom duration in both mTBI (n = 89) and trauma control (n = 73) patients. Several injury-related and neuropsychological variables assessed acutely (< 72 h) post-injury predicted symptom duration, particularly loss of consciousness (mTBI group), acute somatic symptom burden (both groups), and acute reaction time (both groups), with reasonably good model fit when including all of these variables (area under the receiver operating characteristic curve [AUC] = 0.76). Incorporating self-reported litigation involvement modestly increased prediction further (AUC = 0.80). The results highlight the multifactorial nature of mTBI recovery, and injury recovery more generally, and the need to incorporate a variety of variables to achieve adequate prediction. Further research to improve this model and validate it in new and more diverse trauma samples will be useful to build a neurobiopsychosocial model of recovery that informs treatment development.

Personality and Walking Speed Across Adulthood

Walking speed is one marker of health in adulthood. Although personality may contribute to gait speed, there is limited longitudinal data on this association. Thus, the present study examined whether personality traits are prospectively associated with walking speed among middle aged and older adults. Participants were adults aged from 25 to 100 years old ( N > 15,000) drawn from the Wisconsin Longitudinal Study Graduate and Sibling samples, the Midlife in the United States Survey, the Health and Retirement Study, and the National Health and Aging Trends Survey. Across most samples and in a meta-analysis, lower neuroticism and higher extraversion, conscientiousness, and openness at baseline were prospectively related to faster gait speed. In the HRS, lower neuroticism and higher extraversion, conscientiousness, and openness were related to slower gait speed decline. This study provides robust evidence that walking speed in adulthood reflects, in part, the individual’s personality.

Personality and Frailty: Evidence From Four Samples

Frailty is a prevalent geriatric syndrome. Little is known about the psychological factors associated with this syndrome. Based on four large samples of older adults aged from 65 to 104 years old, the present study examined whether personality traits are related to frailty. High neuroticism, low conscientiousness, low extraversion, low openness and low agreeableness were related to higher frailty across samples. Longitudinal analysis conducted in one sample revealed that high neuroticism was associated with worsening frailty over an 8-year period. Higher frailty at baseline and over time was related to maladaptive personality changes. This study extends existing knowledge on the link between personality and health in older adults, by identifying the personality traits associated with frailty, a complex geriatric syndrome.

A cross-sectional study of the association between mobility test performance and personality among older adults

Background

Falls among the elderly are a major public health challenge. The Timed-Up and Go (TUG) test is commonly used to identify older adults with mobility limitations. This study explored the association between TUG test results and personality among community-dwelling older adults.

Methods

This cross-sectional study included 85 older adults. Personality was evaluated with the Five Factor Model. Times to complete the TUG as a single task (TUGST) alone and also with an additional cognitive task i.e., dual-task (DT), were recorded. Ordinary least squares OLS regression models were used to examine the associations between personality factors and both single DT TUG.

Results

Extraversion was found to be inversely associated with time to complete the TUGST (β = -.26, p < .05). Conscientiousness was inversely associated with TUGDT (β = -.24, p < .01).

Conclusions

Findings from this study highlight the relationship between personality and the TUG test. Specifically, older adults with high Extraversion completed the TUGST test more quickly than those who had lower measures of this trait and, people with high Conscientiousness completed the TUGDT tests more quickly. These findings may contribute to early identification of older adults at higher risk from mobility limitations and falls, and to developing personality-tailored interventions for fall prevention.

The Association between High Neuroticism-Low Extraversion and Dual-Task Performance during Walking While Talking in Non-demented Older Adults

The Walking While Talking (WWT) dual-task paradigm is a mobility stress test that predicts major outcomes, including falls, frailty, disability, and mortality in aging. Certain personality traits, such as neuroticism, extraversion, and their combination, have been linked to both cognitive and motor outcomes. We examined whether individual differences in personality dimensions of neuroticism and extraversion predicted dual-task performance decrements (both motor and cognitive) on a WWT task in non-demented older adults. We hypothesized that the combined effect of high neuroticism-low extraversion would be related to greater dual-task costs in gait velocity and cognitive performance in non-demented older adults. Participants (N=295; age range,=65-95 years; female=164) completed the Big Five Inventory and WWT task involving concurrent gait and a serial 7's subtraction task. Gait velocity was obtained using an instrumented walkway. The high neuroticism-low extraversion group incurred greater dual-task costs (i.e., worse performance) in both gait velocity {95% confidence interval (CI) [-17.68 to -3.07]} and cognitive performance (95% CI [-19.34 to -2.44]) compared to the low neuroticism-high extraversion group, suggesting that high neuroticism-low extraversion interferes with the allocation of attentional resources to competing task demands during the WWT task. Older individuals with high neuroticism-low extraversion may be at higher risk for falls, mobility decline and other adverse outcomes in aging.

The influence of personality traits on perception of pain in older adults – Findings from the Swedish National Study on Aging and Care – Blekinge study

Background and aims

The experience of pain may vary in accordance with personality traits and individual characteristics. Neuroticism is demonstrated to constitute a vulnerability factor among younger and middle-aged pain patients. The combination of openness and neuroticism is associated with high anxiety/depression scores among adult individuals with chronic conditions. The aim of this study was to investigate possible associations between pain and the personality dimensions of neuroticism, extroversion, openness, agreeableness and conscientiousness among persons aged 60 years and older. An additional aim was to explore whether such associations are equally gender expressed.

Methods

The Swedish National Study on Aging and Care includes a randomly selected sample from the National Population Register. The data collection was conducted at four research centres and was approved by the Ethics Committees of Lund University and the Karolinska Institutet, Stockholm, Sweden. The Blekinge sample includes 1402 individuals, aged 60–96 years, of whom 769 (55%) reported pain. A total of 2312 individuals had been invited to participate. The reason for non-participation was registered. Participants underwent medical examination and testing by research personnel, conducted in two sessions, each of which lasted about 3 h. A questionnaire was completed between the two sessions. Pain was self-reported and based on the question: Have you had ache/pain during the last 4 weeks? Information on personality traits was obtained by means of the personality SGC1 questionnaire; a 60-item Swedish version of Costa & McCrae’s FFM questionnaire. Personality traits were then tested based on gender by means of multivariate forward logistic regression in models adjusted for age, insomnia, financial status and educational level.

Results

When adjusting for covariates among women, neuroticism had a small but significant odds ratio of experiencing pain (OR 1.05, CI 1.02–1.08). Insomnia had the highest odds ratio (OR 2.19, CI 1.52–3.15) followed by low education (OR 1.59, CI 1.07–2.36), while belonging to the younger part of the older adult cohort was also associated with pain (OR 1.02, CI 1.005–1.04). In men, neuroticism (OR 1.03, CI 1.002–1.06) followed by openness (OR 1.03 CI 1.001–1.07) had a small but significant odds ratio of experiencing pain. Insomnia had the highest odds ratio (OR 1.98, CI 1.24–3.15).

Conclusions

Personality traits and pain were related among the older adults but there were gender differences. The relationship between pain and neuroticism in women was about the same in strength as the relation between pain and neuroticism/openness in men. Both sexes suffer from insomnia. The relationship between personality traits and pain was only affected to a minor extent by insomnia.

Implications

There is a need to increase awareness of the impact of personality as well as to provide improved treatment for pain and insomnia in older people.

Personality traits as predictors of decline in higher-level functional capacity over a 7-year follow-up in older adults: the Ohasama study

Numerous factors that affect functional decline have been identified, and personality traits are considered to be an important factor in functional decline risk. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG) was developed to measure three higher-level functional capacities, instrumental activities of daily living, intellectual activity, and social roles, in Japanese elderly, which were previously not assessed adequately with existing scales of functional decline. The objective of this study was to explore the effect of personality traits as predictors of higher-level functional decline over a 7-year follow-up in a rural Japanese community. Data on 676 participants (mean 67.1 years) who were free of functional decline and had completed questionnaires at baseline and 7 years later, were analyzed. Demographic characteristics, lifestyle and personality characteristics were obtained from a self-administered questionnaire at baseline. Higher-level functional decline was examined using the subscales of the TMIG at baseline and at a 7-year follow-up examination. Over the 7-year study period, 21.7% of eligible participants reported decline in higher-level functional capacity. After adjustment for putative confounding factors, the traits that were significant predictors of decline in higher-level functional capacity at the 7-year follow-up had higher psychoticism scores [odds ratio (95% confidence interval) 2.12 (1.23-3.66)] and lower extraversion scores [1.89 (1.01-3.56)]. The personality traits of higher psychoticism and lower extraversion were significantly associated with a risk of future functional decline. A better understanding of these personality traits may help identify of at-risk individuals and could help reduce functional decline in older adults.

Harm avoidance is associated with progression of parkinsonism in community-dwelling older adults: a prospective cohort study

Background

We tested the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the rate of change in parkinsonism in older adults.

Methods

At baseline harm avoidance was assessed with a standard self-report instrument in 969 older people without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Parkinsonism was assessed annually with a modified version of the motor section of the Unified Parkinson’s Disease Rating Scale (mUPDRS).

Results

Average follow-up was 5 years. A linear mixed-effects model controlling for age, sex and education showed that for an average participant (female, 80 years old at baseline, with 14 years of education and a harm avoidance score of 10), the overall severity of parkinsonism increased by about 0.05 unit/ year (Estimate, 0.054, S.E., 0.007, p <0.001) and that the level of harm avoidance was associated with the progression of parkinsonism (Estimate, 0.004, S.E., 0.001, p <0.001). Thus, for an average participant, every 6 point (~1 SD) increase in harm avoidance score at baseline, the rate of progression of parkinsonism increased about 50% compared to an individual with an average harm avoidance score. This amount of change in parkinsonism over the course of the study was associated with about a 5% increased risk of death. The association between harm avoidance and progression of parkinsonism persisted when controlling for cognitive function, depressive symptoms, loneliness, neuroticism, late-life cognitive, social and physical activities and chronic health conditions.

Conclusion

A higher level of the harm avoidance trait is associated with a more rapid progression of parkinsonism in older adults.

Association of personality with physical, social, and mental activities across the lifespan: Findings from US and French samples

Despite evidence for its health-related benefits, little is known on the psychological predictors of the participation in leisure activities across the lifespan. Therefore, this study aimed to identify whether personality is associated with a variety of different types of activities, involving physical, cognitive, and social components. The samples included individuals from the second wave of the National Study of Midlife in the United States (N = 3,396) and community-dwelling French individuals (N = 2,917) aged between 30 and 84. Both samples completed measures of the five-factor model of personality. To create an activity index, we combined the physical, social, and cognitive (games and developmental) activities performed at least once a month. In both samples, individuals who scored higher on extraversion and openness were more likely to engage in a variety of activity types. The findings were consistent across two samples from different western societies and suggest that extraversion and openness contribute to social, cognitive, and physical functioning across the lifespan.

Neuroticism, extraversion, and motor function in community-dwelling older persons

OBJECTIVE

Personality traits are associated with adverse health outcomes in old age, but their association with motor function is unclear. We tested the hypothesis that neuroticism and extraversion are associated with motor decline in older persons.

DESIGN

Prospective, observational cohort study.

SETTING

Retirement communities across metropolitan Chicago.

PARTICIPANTS

Nine hundred eighty-three older persons without dementia.

MEASUREMENTS

At baseline, neuroticism and extraversion were assessed and annual assessment of 18 motor measures were summarized in a composite measure.

RESULTS

Average follow-up was 5 years. Separate linear mixed-effects models controlling for age, sex, and education showed that baseline levels of neuroticism and extraversion were associated with the rate of motor decline. For each 7-point (∼1 SD) higher neuroticism score at baseline, the average annual rate of motor decline was more than 20% faster. This amount of motor decline was associated with a 10% increased risk of death compared to a participant with an average neuroticism score. Each 6-point (∼1 SD) lower extraversion score at baseline was associated with an 8% faster rate of motor decline. This amount of motor decline was associated with about a 9% increased risk of death compared to a participant with an average extraversion score. Neuroticism and extraversion were relatively independently associated with motor decline. These associations were unchanged when controlling for depressive symptoms and current health status but were partially attenuated when controlling for late-life cognitive and social activities.

CONCLUSIONS

Higher levels of neuroticism and lower levels of extraversion are associated with more rapid motor decline in old age.

Worship attendance and the disability process in community-dwelling older adults

OBJECTIVES

We examined the contribution of religious involvement to age-related declines in health by examining the association of worship attendance with measures of different stages in the disability continuum.

METHOD

Participants included 5,863 Black and White older adults from the Chicago Health and Aging Project. Worship attendance was coded in 3 levels: very frequent (several times a week or more), frequent (several times a month), and infrequent (several times a year or less). Measures of disability included self-reported instrumental activities of daily living (IADL) and activities of daily living (ADL) disability as well as observed physical function.

RESULTS

In multiple regression models adjusted for demographic factors, compared with those with infrequent worship attendance, those with frequent or very frequent attendance had lower levels of IADL and ADL disability and higher levels of physical performance at baseline. These associations remained significant in models that adjusted for health and cognitive status. There was no association between frequency of worship attendance and change in disability or physical function over time.

DISCUSSION

These results suggest that more frequent worship attendance does not contribute to slowing the progress of disability in late life. Future research is needed to better understand the development of the differences in disability associated with worship attendance observed at baseline.

Personality typology in relation to muscle strength

BACKGROUND

Physical inactivity plays a central role in the age-related decline in muscle strength, an important component in the process leading to disability. Personality, a significant determinant of health behaviors including physical activity, could therefore impact muscle strength throughout adulthood and affect the rate of muscle strength decline with aging. Personality typologies combining "high neuroticism" (N ≥ 55), "low extraversion" (E < 45), and "low conscientiousness" (C < 45) have been associated with multiple risky health behaviors but have not been investigated with regards to muscle strength.

PURPOSE

The purpose of this study is to investigate associations between individual and combined typologies consisting of high N, low E, and low C and muscle strength, and whether physical activity and body mass index act as mediators.

METHOD

This cross-sectional study includes 1,220 participants from the Baltimore Longitudinal Study of Aging.

RESULTS

High N was found among 18%, low E among 31%, and low C among 26% of the sample. High levels of N, particularly when combined with either low E or low C, were associated with lower muscle strength compared with having only one or none of these personality types. Facet analyses suggest an important role for the N components of depression and hostility. Physical activity level appears to partly explain some of these associations.

CONCLUSION

Findings provide support for the notion that the typological approach to personality may be useful in identifying specific personality types at risk of low muscle strength and offer the possibility for more targeted prevention and intervention programs.

Overview and findings from the religious orders study

The Religious Orders Study is a longitudinal clinical-pathologic cohort study of aging and Alzheimer's disease (AD). In this manuscript, we summarize the study methods including the study design and describe the clinical evaluation, assessment of risk factors, collection of ante-mortem biological specimens, brain autopsy and collection of selected postmortem data.

THE RESULTS

(1) review the relation of neuropathologic indices to clinical diagnoses and cognition proximate to death; (2) examine the relation of risk factors to clinical outcomes; (3) examine the relation of risk factors to measures of neuropathology; and (4) summarize additional study findings. We then discuss and contextualize the study findings.

Associations between personality traits, physical activity level, and muscle strength

Associations among personality as measured by the Five Factor Model, physical activity, and muscle strength were assessed using data from the Baltimore Longitudinal Study of Aging (N = 1220, age: mean = 58, SD = 16). General linear modeling with adjustment for age, sex, race, and body mass index, and bootstrapping for mediation were used. We found neuroticism and most of its facets to negatively correlate with strength. The extraversion domain and its facets of warmth, activity, and positive-emotions were positively correlated with strength, independent of covariates. Mediation analysis results suggest that these associations are partly explained by physical activity level. Findings extend the evidence of an association between personality and physical function to its strength component and indicate health behavior as an important pathway.

Associations of openness and conscientiousness with walking speed decline: findings from the Health, Aging, and Body Composition Study

OBJECTIVES

The objective of this study was to explore the associations between openness to experience and conscientiousness, two dimensions of the five-factor model of personality, and usual gait speed and gait speed decline.

METHOD

Baseline analyses were conducted on 907 men and women aged 71-82 years participating in the Cognitive Vitality substudy of the Health, Aging, and Body Composition study. The longitudinal analytic sample consisted of 740 participants who had walking speed assessed 3 years later.

RESULTS

At baseline, gait speed averaged 1.2 m/s, and an average decline of 5% over the 3-year follow-up period was observed. Higher conscientiousness was associated with faster initial walking speed and less decline in walking speed over the study period, independent of sociodemographic characteristics. Lifestyle factors and disease status appear to play a role in the baseline but not the longitudinal association between conscientiousness and gait speed. Openness was not associated with either initial or decline in gait speed.

DISCUSSION

These findings extend the body of evidence suggesting a protective association between conscientiousness and physical function to performance-based assessment of gait speed. Future studies are needed to confirm these associations and to explore mechanisms that underlie the conscientiousness mobility connection in aging adults.

Personality and reduced incidence of walking limitation in late life: findings from the Health, Aging, and Body Composition Study

OBJECTIVES

To examine the association between openness to experience and conscientiousness and incident reported walking limitation.

METHOD

The study population consisted of 786 men and women aged 71-81 years (M = 75 years, SD = 2.7) participating in the Health, Aging, and Body Composition-Cognitive Vitality Substudy.

RESULTS

Nearly 20% of participants (155/786) developed walking limitation during 6 years of follow-up. High openness was associated with a reduced risk of walking limitation (hazard ratio [HR] = 0.83, 95% confidence interval [CI] = 0.69-0.98), independent of sociodemographic factors, health conditions, and conscientiousness. This association was not mediated by lifestyle factors and was not substantially modified by other risk factors for functional disability. Conscientiousness was not associated with risk of walking limitation (HR = 0.91, 95% CI = 0.77-1.07).

DISCUSSION

Findings suggest that personality dimensions, specifically higher openness to experience, may contribute to functional resilience in late life.

Genetic influences on life span and its relationship to personality: a 16-year follow-up study of a sample of aging twins

OBJECTIVE

The relationship between personality and life span is not well understood, and no study to date has examined genetic influences underlying this relationship. The present study aimed to explore the phenotypic and genetic relationship between personality and life span, as well as genetic influences on all-cause mortality.

METHODS

Prospective community-based study including 3752 twin individuals older than 50 years. Neuroticism, psychoticism, extraversion, and social desirability and pessimism/optimism were measured at baseline using the Revised Eysenck Personality Questionnaire and the Revised Life Orientation Test, respectively. Information on age at death was obtained 16 years after the initial assessment of personality.

RESULTS

Extraversion was inversely related to mortality with the risk of death decreasing 3% per unit increase of the extraversion score. Psychoticism and pessimism were positively related to mortality with a 36% and 39% increase in risk of death per unit increase in the respective personality score. Heritability of life span was 7%. Cross-twin cross-trait hazard ratios (HRs) were only significant for optimism/pessimism in monozygotic (MZ) twins with no significant differences in HRs between MZ and dizygotic twins in all traits; however, there was a trend for slightly higher HRs in MZ compared with dizygotic twins in psychoticism and optimism/pessimism.

CONCLUSIONS

Extraversion, psychoticism, and optimism/pessimism are significant predictors of longevity; extraversion is associated with a reduction, and pessimism and psychoticism are associated with an increase in mortality risk. Genetic influences on longevity in Australian twins are very low (7%). Our data also suggest a small, albeit nonsignificant, genetic influence on the relationship of pessimism and psychoticism with life span.

Correlates of Functional Capacity Among Centenarians

This study investigated correlates of functional capacity among participants of the Georgia Centenarian Study. Six domains (demographics and health, positive and negative affect, personality, social and economic support, life events and coping, distal influences) were related to functional capacity for 234 centenarians and near centenarians (i.e., 98 years and older). Data were provided by proxy informants. Domain-specific multiple regression analyses suggested that younger centenarians, those living in the community and rated to be in better health were more likely to have higher functional capacity scores. Higher scores in positive affect, conscientiousness, social provisions, religious coping, and engaged lifestyle were also associated with higher levels of functional capacity. The results suggest that functional capacity levels continue to be associated with age after 100 years of life and that positive affect levels and past lifestyle activities as reported by proxies are salient factors of adaptation in very late life.

Detection of depression in older adults by family and friends: distinguishing mood disorder signals from the noise of personality and everyday life

BACKGROUND

The capacity of friends and family member informants to make judgments about the presence of a mood disorder history in an older primary care patient has theoretical, clinical, and public health significance. This study examined the accuracy of informant-reported mood disorder diagnoses in a sample of primary care patients aged 65 years or older. We hypothesized that the accuracy (sensitivity and specificity) of informant reports would vary with the patient's personality.

METHODS

Hypotheses were tested in 191 dyads consisting of patients and their friends or relatives (informants) recruited from primary care settings. Gold-standard mood disorder diagnoses were established at consensus conferences based on a review of medical charts and data collected in a structured interview with the patient. Patients completed an assessment battery that included the NEO-Five Factor Inventory.

RESULTS

Sensitivity and specificity of informant-derived mood disorder diagnoses were related to patient personality. Sensitivity of informant-derived lifetime mood disorder diagnoses was compromised by higher Extraversion and higher Agreeableness. Specificity of informant-derived lifetime mood disorder diagnoses was compromised by lower Agreeableness and higher Conscientiousness.

CONCLUSION

Patient personality has implications for the accuracy of mood disorder histories provided by friends and family members. Given that false negatives can have grave consequences, we recommend that practitioners be particularly vigilant when interpreting collateral information about their extraverted, agreeable patients.

Relation of late-life social activity with incident disability among community-dwelling older adults

BACKGROUND

We tested the hypothesis that a higher level of social activity was associated with decreased risk of incident disability in older adults.

METHODS

Data came from older adults in the Rush Memory and Aging Project, an ongoing longitudinal cohort study of aging. Analyses were restricted to persons without clinical dementia and reporting no need for help performing any task in the particular functional domain assessed. Participants were followed for an average of 5.1 years (SD = 2.5). Social activity, based on 6 items (visiting friends or relatives; going to restaurants, sporting events, or playing games; group meetings; church/religious services; day or overnight trips; unpaid community/volunteer work), was assessed at baseline. Disability in basic activities of daily living, mobility disability, and instrumental activities of daily living was assessed annually. Proportional hazard models adjusted for age, sex, and education were used to examine the association between social activity and incident disability. Fully adjusted models included terms for depression, vascular diseases and risk factors, body mass index, social networks, and self-reported physical activity.

RESULTS

In fully adjusted models, among 954 persons without baseline disability, the risk of developing disability in activities of daily living decreased by 43% (hazard ratio = 0.57, 95% confidence interval = 0.46, 0.71) for each additional unit of social activity. Social activity was also associated with decreased risk of developing mobility disability (hazard ratio = 0.69, 95% confidence interval = 0.54, 0.88) and disability in instrumental activities of daily living (hazard ratio = 0.71, 95% confidence interval = 0.55, 0.93).

CONCLUSIONS

Social activity is associated with a decreased risk of incident disability in activities of daily living, mobility, and instrumental activities of daily living, among community-dwelling older adults.

Purpose in life is associated with a reduced risk of incident disability among community-dwelling older persons

BACKGROUND

Purpose in life is thought to be associated with positive health outcomes in old age, but its association with disability is unknown.

OBJECTIVE

Test the hypothesis that greater purpose in life is associated with a reduced risk of incident disability, including impairment in basic and instrumental activities of daily living and mobility disability, among community-based older persons free of dementia.

DESIGN

Participants were from the Rush Memory and Aging Project, a large longitudinal clinical-pathologic study of aging.

SETTING

Retirement communities, senior housing facilities, and homes across the greater Chicago metropolitan area.

MEASUREMENTS

All participants underwent baseline assessment of purpose in life and detailed annual clinical evaluations to document incident disability.

RESULTS

The mean score on the purpose in life measure at baseline was 3.6 (standard deviation = 0.5, range: 2-5). In a series of proportional hazards models adjusted for age, sex, and education, greater purpose in life was associated with a reduced risk of disability in basic activities of daily living (hazard ratio [HR] = 0.60, 95% confidence interval [C1] = 0.45-0.81), instrumental activities of daily living (HR = 0.56, 95% CI = 0.40-0.78), and mobility disability (HR = 0.61, 95% CI = 0.44-0.84). These associations did not vary along demographic lines and persisted after the addition of terms to control for global cognition, depressive symptoms, social networks, neuroticism, income, physical frailty, vascular risk factors, and vascular diseases.

CONCLUSIONS

Among community-based older persons without dementia, greater purpose in life is associated with maintenance of functional status, including a reduced risk of developing impairment in basic and instrumental activities of daily living and mobility disability.

Dimensions and correlates of quality of life according to frailty status: a cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy

Background

There is a lack of knowledge concerning the relationship between two closely-linked multidimensional variables: frailty and quality of life (QOL). The aim of this study was to investigate dimensions and correlates of QOL associated with frailty status among community-dwelling older outpatients.

Methods

We conducted a cross-sectional survey of 239 community-dwelling outpatients aged 65+ (mean age 81.5 years) consecutively referred to a geriatric medicine clinic in Italy between June and November 2009. Participants underwent a comprehensive geriatric assessment, including assessment of their frailty status according to the Study of Osteoporotic Fractures (SOF) criteria, and QOL, which was evaluated by using the Older People's QOL (OPQOL) questionnaire. One-way ANOVA and chi-squared tests were used to find correlates of frailty, including QOL dimensions, after stratification of participants in the "robust" (n = 72), "pre-frail" (n = 89) and "frail" (n = 78) groups. Multiple linear regression analyses were performed to find correlates of QOL in the overall sample and among "frail" and "robust" participants.

Results

A negative trend of QOL with frailty status was found for almost all dimensions of QOL (health, independence, home and neighbourhood, psychological and emotional well-being, and leisure, activities and religion) except for social relationships and participation and financial circumstances. Independent correlates of a poor QOL in the total sample were "reduced energy level" (SOF criterion for frailty), depressive status, dependence in transferring and bathing abilities and money management (adjusted R squared 0.39); among "frail" participants the associations were with depressive status and younger age, and among "robust" participants the association was with lower body mass index.

Conclusions

Five out of seven dimensions of QOL were negatively affected by frailty, but only one SOF criterion for frailty was independently related to QOL, after correction for age, functional status and depression. A more advanced age as well as a better affective status were correlates of a better QOL among frail elders. Interventions targeting the QOL in frail community-dwelling older outpatients should consider as outcomes, not only health-related QOL, but also other domains of the QOL.

Sex-specific correlates of walking speed in a wide age-ranged population

The goals of this cross-sectional study were to explore correlates of walking speed in a large wide age-ranged population and to identify factors affecting lower walking speed at older ages. Participants were 3,872 community-dwelling adults in the first follow-up of the SardiNIA study who completed a 4-m walking test. Sex-specific correlates of walking speed included marital status, height, waist circumference, pulse wave velocity, comorbidity, subjective health, strength, and personality. Effect modifiers of the age-walking speed association included extraversion (<55 years, p = .019) and education (<55 years, p = .021; > or =55 years, p = .012) in women, and openness (<55 years, p = .005), waist circumference (<55 years, p = .010), and subjective health (<55 years, p = .014) in men. The strong impact of personality suggests that certain personality traits may be associated with behaviors that affect physical performance and condition the reduced mobility mostly at younger ages. If these patterns are confirmed in longitudinal studies, personality may be an important target for prevention.

Personality traits affect individual interests in day service activities

AIM

To assess the association of user interest in various activities with personality traits for the provision of activity programs at adult day centers.

METHODS

A self-reported questionnaire survey of service users was conducted at 25 day centers in Tokyo; 133 men and 344 women, with a mean age of 81.6 +/- 7.9 years, responded. The questionnaire examined their demographics, lifestyles, requested activities, purpose of activity participation, attitudes toward participation, and personality traits by using the BASIC-3 Personality Inventory (PI)-short version.

RESULTS

The participants with higher sociability and novelty-seeking scores on the BASIC-3 PI-short version requested significantly more activities than those with lower scores. Music appreciation and singing were significantly associated with both sociability and novelty-seeking facets. The sociability facets were significantly associated with activities, such as walking and interaction with children, while the novelty-seeking facets were significantly associated with contact with animals and the Internet. There was no significant relationship between the neuroticism facets and any specific activity. Flower arrangement, handicrafts, fashion or make up, cooking, and singing were significantly more frequently requested by the women than by the men, while shogi or mahjong was requested significantly more frequently by the men than by the women.

CONCLUSIONS

Sociability and novelty-seeking facets, sex, and age were significantly associated with an interest in particular activities. We recommend that adult day centers create a system under which nurses and formal caregivers fully assess the elderly in order to provide activity programs based on user needs.

Health worry, physical activity participation, and walking difficulty among older adults: a mediation analysis

This study examined the effect of health worry (i.e., cognitive aspect of anxiety resulting from concern for health) on walking difficulty in a nationally representative sample (N = 7,527) of older adults (M age = 76.83 years). The study further tested whether physical activity mediates the effect of health worry on walking difficulty in a 6-year follow-up design. Results of a mediation analysis using structural equation modeling showed that people with a high degree of health worry engaged in less physical activity (beta = -.24, p < .001), and people who participated in less physical activity were more likely to report walking difficulty at the 6-year follow-up (beta = -.22, p < .001). There was a significant indirect effect from health worry to walking difficulty through physical activity (beta = .05, p < .001), controlling for demographic, psychosocial, and health related factors. Results suggested that inducing threat and worry may not be effective for physical activity promotion in the older population. More promising coping and regulation strategies are discussed.

Personality and all-cause mortality among older adults dwelling in a Japanese community: a five-year population-based prospective cohort study

OBJECTIVE

Personality is an important factor in determining longevity. It has been reported that some personality traits can affect mortality via health-related behaviors, engaging in social interactions, and a tendency to experience negative emotions. The authors examined the relationships between five major domains of personality traits and all-cause mortality among Japanese community-dwelling elderly.

DESIGN

A 5-year prospective cohort study design with mortality surveillance.

SETTING

Community based.

PARTICIPANTS

A total sample of 486 men and 742 women aged 65 years and over at the baseline.

MEASUREMENTS

The NEO five-factor inventory was administered to assess the "big five" personality traits: neuroticism, extraversion, openness, agreeableness, and conscientiousness.

RESULTS

During the 5-year follow-up period, 127 persons (73 men and 54 women) died. In Cox multivariate proportional hazards models adjusted for gender, age, number of years of education, living alone, presence of psychiatric problems, and presence of chronic diseases, conscientiousness (risk ratio [RR] = 0.50, 95% confidence interval [CI] = 0.33-0.76 and RR = 0.46, 95% CI = 0.29 to 0.71, for the middle and highest tertiles, respectively), extraversion (RR = 0.58, 95% CI = 0.37 to 0.92, for the highest tertile), and openness (RR = 0.62, 95% CI = 0.41 to 0.96, for the middle tertile) were independently and inversely associated with all-cause mortality. Neither neuroticism nor agreeableness was related to mortality.

CONCLUSIONS

Our results suggest that out of the five domains of personality traits, conscientiousness, extraversion, and openness are reliable predictors of all-cause mortality among community-dwelling elderly.

Personality change in old age

PURPOSE OF REVIEW

The present short review summarizes some of the most important personality changes in older adults.

RECENT FINDINGS

Personality changes in old age are usually minimal. Cluster B personality disorders appear to become less prevalent. Significant changes in personality are typically associated with frontotemporal lobar degeneration (e.g., slowly progressive sociopathy), Alzheimer's disease, mild cognitive impairment due to incipient dementia or underlying medical illness.

SUMMARY

Therefore, we suggest that a significant change in personality in old age always warrants careful neuropsychiatric examination.