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Domain and Facet Personality Predictors of All-Cause Mortality Among Medicare Patients Aged 65 to 100
Abstract
OBJECTIVES: Our objectives were to test whether Conscientiousness, the other 4 domains of the Five-Factor Model, and their facets predicted mortality in older, frail individuals. METHODS: Controlling for demographic and health measures, we used Cox regression to test whether the NEO Five-Factor Inventory (NEO-FFI) Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness domains predicted all-cause mortality over 5 years in 1076 65- to 100-year-old participants who took part in a Medicare Demonstration study. Supplementary analyses on 597 participants aged 66 to 102 who were reassessed 2 years later were conducted to determine whether any of the Revised NEO Personality Inventory (NEO-PI-R) facets were related to mortality. RESULTS: When personality domains were treated as continuous variables, NEO-FFI Neuroticism and Agreeableness were significant protective factors. When personality domains were trichotomized, NEO-FFI Conscientiousness was a protective factor. In a third analysis, Agreeableness was not a significant predictor in a model that included the continuous Neuroticism and trichotomized Conscientiousness variables. Analysis of the NEO-PI-R Neuroticism, Agreeableness, and Conscientiousness factors showed that Agreeableness and Conscientiousness were protective and that there was a trend for a similar effect of Neuroticism. Facet-level analyses revealed that the Impulsiveness, Straightforwardness, and Self-Discipline facets of Neuroticism, Agreeableness, and Conscientiousness, respectively, were prospectively related to greater survival over a 3-year interval. CONCLUSION: The effects of Neuroticism and Agreeableness on mortality are inconsistent across previous studies. This study indicates that, in a sample of older, frail participants, high Neuroticism and Agreeableness scores are protective and that more specific effects are primarily the result of the Impulsiveness and Straightforwardness facet scales. The Conscientiousness findings are consistent with those in earlier studies and demonstrate the importance of the Self-Discipline facet.
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“The significant role of conscientiousness in health has been demonstrated in several longitudinal studies showing decreased all-life mortality rates while controlling for other key demographic variables such as gender, age, education level, smoking, and self-rated health (Costa et al., 2014;Taylor et al., 2009;Weiss & Costa, 2005).”
From Beyond yellow flags: The Big‐Five personality traits and psychologically informed musculoskeletal rehabilitation. (2023) · cites this paper as Weiss & Costa, 2005
In the citing paper
“Friedman (2019) is quick to point out that some studies demonstrate protective benefits to neuroticism (Weiss & Costa, 2005), and it is possible for worrying and vigilance to be healthy in the right context.”
From Beyond yellow flags: The Big‐Five personality traits and psychologically informed musculoskeletal rehabilitation. (2023) · cites this paper as Weiss & Costa, 2005
In the citing paper
“Agreeableness does impact mortality rates, but this effect has only been found in samples with adults aged 65 and older and in conjunction with high conscientiousness (Costa et al., 2014;Weiss & Costa, 2005).”
From Beyond yellow flags: The Big‐Five personality traits and psychologically informed musculoskeletal rehabilitation. (2023) · cites this paper as Weiss & Costa, 2005
In the citing paper
“However, in major longitudinal studies looking at all life mortality, extraversion did not have a significant effect (Costa et al., 2014;Taylor et al., 2009;Weiss & Costa, 2005).”
From Beyond yellow flags: The Big‐Five personality traits and psychologically informed musculoskeletal rehabilitation. (2023) · cites this paper as Weiss & Costa, 2005
In the citing paper
“Conscientiousness appears to a protective factor and neuroticism, a risk factor, although neuroticism is occasionally associated with reduced risk (13-15).”
From Socioeconomic Status Interacts with Conscientiousness and Neuroticism to Predict Circulating Concentrations of Inflammatory Markers (2017) · cites this paper as [13]
In the citing paper
“In individuals of high SES, however, high neuroticism may actually be protective, perhaps helping to explain sporadic associations of neuroticism with lower mortality appearing in the literature (13-15).”
From Socioeconomic Status Interacts with Conscientiousness and Neuroticism to Predict Circulating Concentrations of Inflammatory Markers (2017) · cites this paper as [13]
In the citing paper
“Other studies noted no substantial effects for the general Extraversion dimension on 3-year all-cause mortality in an older, ill US community sample [63], in substance and alcohol abusers [89], or in Japanese cancer patients (with a general case-mix of cancer types) [90].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [63]
In the citing paper
“However, links between Conscientiousness and longevity are only partly explained by commonly studied health behaviors [62–64].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [63]
In the citing paper
“In this vein, one study found that higher impulsivity in the elderly was actually associated with greater probability of 3-year survival [63].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [63]
In the citing paper
“To complicate the picture further, two studies have found that higher Neuroticism was associated with reduced all-cause mortality risk in mixed-gender older community samples in the US [63] and Australia [120].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [63]
In the citing paper
“One study to date has demonstrated a protective effect for Agreeableness against all-cause mortality over 3 years in an elderly sample; this was due primarily to specific aspects of the Agreeableness scale reflecting low levels of interpersonal antagonism [63].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [63]
In the citing paper
“Thus, researchers who decompose the Big 5 tend to examine each facet separately, or create linear combinations of facets [63, 192], in order to isolate personality effects on health.”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [63]
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“Such fine-grained facet-level analyses not only improve predictions, but they also help to explicate the mechanisms leading to specific health-risk behaviours (cf. Weiss & Costa, 2005).”
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BackgroundInfluentialEarly personality traits as predictors of mortality risk following conjugal bereavement.
Taga, K. A., Friedman, H., & Martin, L. (2009) · Journal of Personality · doi:10.1111/j.1467-6494.2009.00561.x · Cited by 69
Jonassaint, C. R., Why, Y. P., Bishop, G. D., Tong, E. M. W., Diong, S. M., Enkelmann, H. C., Khader, M., & Ang, J. C. H. (2009) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2009.09.012 · Cited by 84
Kato, K., Zweig, R., Schechter, C. B., Barzilai, N., & Atzmon, G. (2016) · Aging & Mental Health · doi:10.1080/13607863.2015.1056770 · Cited by 71
Stafford, L., Judd, F. K., Gibson, P., Komiti, A., Mann, G. B., & Quinn, M. A. (2015) · Supportive Care in Cancer · doi:10.1007/s00520-014-2571-y · Cited by 73
Santini, Z. I., Koyanagi, A., Tyrovolas, S., Haro, J. M., Fiori, K. L., Uwakwa, R., Thiyagarajan, J. A., Webber, M., Prince, M. J., & Prina, M. A. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.10.061 · Cited by 72
“Furthermore, there were some potential confounders such as personality type (Bogg and Roberts, 2004; Weiss and Costa, 2005) that we could not adjust for due to lack of data.”
BackgroundMaternal Exposure to the Holocaust and Health Complaints in Offspring
Flory, J. D., Bierer, L. M., & Yehuda, R. (2011) · Disease Markers · doi:10.1155/2011/250470 · Cited by 70
Bye, D., & Pushkar, D. (2009) · Motivation and Emotion · doi:10.1007/s11031-009-9135-3 · Cited by 72
“Conscientiousness also negatively predicts all-cause mortality over time in older adults, suggesting its motivational potential in promoting health behaviors ( Weiss and Costa 2005 ).”
BackgroundHagger-Johnson, G., Roberts, B., Boniface, D., Sabia, S., Batty, G. D., Elbaz, A., Singh-Manoux, A., & Deary, I. J. (2012) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31825c85ca · Cited by 63
“Limitations of the study include the lack of information about openness to experience, agreeableness and conscientiousness – other traits in the comprehensive ‘big five’ model of personality that may also influence mortality (7, 8, 10, 14-16, 21-23, 30).”
BackgroundLöckenhoff, C. E., Terracciano, A., Ferrucci, L., & Costa, P. T. (2011) · Journal of Personality · doi:10.1111/j.1467-6494.2011.00724.x · Cited by 70
“For example, some studies report beneficial effects of E on mortality (Iwasa et al., 2008) while others are not (Weiss & Costa, 2005; Wilson, et al., 2004).”
BackgroundSelf-citationEarly manifestations of personality and adult health: A life course perspective.
Kubzansky, L. D., Martin, L. T., & Buka, S. L. (2009) · Health Psychology · doi:10.1037/a0014428 · Cited by 68
“Of the prospective studies, most have measured both personality and health in adulthood (e.g., Aldwin, Spiro, Levenson, & Cupertino, 2001; Shipley, Weiss, Der, Taylor, & Deary, 2007; Weiss & Costa, 2005).”
BackgroundChae, H., Lee, S., Park, S. H., Jang, E.-S., & Lee, S. J. (2012) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2012/657013 · Cited by 59
“The NEO-PI neuroticism is a sum of heterogeneous traits [39] and operationally defined as irritability, anger, sadness, impulsiveness, vulnerability, hostility, and worry [40–42].”
Five Factor Model Personality Traits and All-Cause Mortality in the Edinburgh Artery Study Cohort
Taylor, M. D., Whiteman, M. C., Fowkes, G. R., Lee, A. J., Allerhand, M., & Deary, I. J. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181a65298 · Cited by 82
Self-regulation and control in personality functioning
Carver, C. S., & Scheier, M. F. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9780511596544.027 · Cited by 59
Mueller, S., Wagner, J., Drewelies, J., Düzel, S., Eibich, P., Specht, J., Demuth, I., Steinhagen‐Thiessen, E., Wagner, G. G., & Gerstorf, D. (2016) · Journal of Research in Personality · doi:10.1016/j.jrp.2016.08.007 · Cited by 64
“For example, previous research has reported initial evidence for the utility of examining more differentiated facet-level associations of personality and health (Sutin et al., 2013; Weiss & Costa, 2005), which was not possible in this study.”
ResultFacets of Openness Predict Mortality in Patients With Cardiac Disease
Jonassaint, C. R., Boyle, S. H., Williams, R. B., Mark, D. B., Siegler, I. C., & Barefoot, J. C. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318052e27d · Cited by 72
Conscientiousness facets and health behaviors: A latent variable modeling approach
Hagger‐Johnson, G., & Whiteman, M. C. (2007) · Personality and Individual Differences · doi:10.1016/j.paid.2007.03.014 · Cited by 58
Ng, R., Allore, H. G., & Levy, B. R. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17165980 · Cited by 61
“A study of the oldest old found that neuroticism and agreeableness are protective against mortality [28].”
BackgroundBridging human and animal research: A comparative approach to studies of personality and health
Mehta, P. H., & Gosling, S. D. (2008) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2008.01.008 · Cited by 62
“…increased the risk of physical health problems (Goodwin et al., 2006) and mortality (Christensen et al., 2002; Shipley et al., 2007; Wilson et al., 2004), others found that neuroticism was a protective factor (Weiss and Costa, 2005), and yet others found null relationships (Martin et al., 2007).”
Openness to Experience and Mortality in Men: Analysis of Trait and Facets
Turiano, N. A., Spiro, A., & Mroczek, D. K. (2012) · Journal of Aging and Health · doi:10.1177/0898264311431303 · Cited by 72
“…openness to mortality via stress response is promising, most prior investigations into openness and mortality generally have not find any effect, protective or otherwise (Christensen et al., 2002; Maier & Smith, 1999; Weiss & Costa, 2005; Wilson, Mendes de Leon, Bienas, Evans, & Bennett, 2004).”
BackgroundImpact of Personality on Cognitive Aging: A Prospective Cohort Study
Caselli, R. J., Dueck, A. C., Locke, D. E. C., Henslin, B. R., Johnson, T. A., Woodruff, B. K., Hoffman‐Snyder, C., & Geda, Y. E. (2016) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617716000527 · Cited by 59
“…in frontostriatal regions (Blix, Perski, Berglund, & Savic, 2013; Kempton et al., 2011), generally increased morbidity and mortality (Goodwin & Friedman, 2006; Weiss & Costa, 2005), and a variety of functional and structural changes in prefrontal and hippocampal regions (Lucassen et al., 2014).”
BackgroundA questionnaire-wide association study of personality and mortality: The Vietnam Experience Study
Weiß, A., Galé, C. R., Batty, G. D., & Deary, I. J. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.02.010 · Cited by 56
The role of vigilance in the relationship between neuroticism and health: A registered report
Weston, S. J., & Jackson, J. J. (2017) · Journal of Research in Personality · doi:10.1016/j.jrp.2017.10.005 · Cited by 53
“…2009; Iwasa et al., 2008; Jackson, Connolly, Garrison, Leveille, & Connolly, 2015; Maier & Smith, 1999) or has a protective effect (Brickman, Yount, Blaney, Rothberg, & De-Nour, 1996; Lang, Weiss, Gerstorf, & Wagner, 2012; Ragland & Brand, 1988; Taga, Friedman, & Martin, 2009; Weiss & Costa, 2005).”
BackgroundPersonality in cross-cultural perspective
Dragūns, J. G. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9780511596544.035 · Cited by 51
Luchetti, M., Sutin, A. R., Delitala, A., Stéphan, Y., Fiorillo, E., Marongiu, M., Masala, M., Schlessinger, D., & Terracciano, A. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.02.034 · Cited by 52
Personality and all cause mortality: Evidence for indirect links
Ploubidis, G. B., & Grundy, E. (2009) · Personality and Individual Differences · doi:10.1016/j.paid.2009.02.022 · Cited by 49
Schwartz, E. S., Chapman, B. P., Duberstein, P. R., Weinstock‐Guttman, B., & Benedict, R. H. B. (2010) · Assessment · doi:10.1177/1073191110368482 · Cited by 49
The trait approach to personality
Deary, I. J. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9780511596544.009 · Cited by 52
Hagger‐Johnson, G., Sabia, S., Nabi, H., Brunner, E. J., Mika Kivimaki, B., Shipley, M. J., & Singh‐Manoux, A. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.05.007 · Cited by 50
Mueller, S., Wagner, J., Smith, J., Voelkle, M. C., & Gerstorf, D. (2017) · Journal of Personality and Social Psychology · doi:10.1037/pspp0000173 · Cited by 53
Personality, Socio-Economic Status and Inflammation: Cross-Sectional, Population-Based Study
Millar, K., Lloyd, S. M., McLean, J. S., Batty, G. D., Burns, H., Cavanagh, J., Deans, K. A., Ford, I., McConnachie, A., McGinty, A., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0058256 · Cited by 47
Personality and gene expression: Do individual differences exist in the leukocyte transcriptome?
Vedhara, K., Gill, S., Eldesouky, L., Campbell, B. K., Arevalo, J. M. G., Ma, J., & Cole, S. W. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.10.028 · Cited by 49
“Some large epidemiological studies have found associations between personality characteristics and measures of disease or longevity (Weiss & Costa, 2005; Nakaya et al., 2010; Chapman et al., 2011), but the biological mechanisms of such relationships remain poorly understood.”
BackgroundPersonality and Survival in Older Age: The Role of Lifestyle Behaviors and Health Status
Rizzuto, D., Mossello, E., Fratiglioni, L., Santoni, G., & Wang, H. (2017) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2017.06.008 · Cited by 50
Do WTO rules preclude industrial policy? Evidence from the global economic crisis
Aggarwal, V. K., & Evenett, S. J. (2014) · Business and Politics · doi:10.1515/bap-2014-0040 · Cited by 46
Metadata
- Authors
- Weiss, A., & Costa, P. T.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Weiss, Alexander
- Venue
- Psychosomatic Medicine
- Published
- 2005-09
- Volume
- 67
- Issue
- 5
- Pages
- 724-733
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W1965023995
- Cited by
- 311
- References
- 37
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 10 · 2021: 10 · 2020: 57 · 2019: 9 · 2018: 10 · 2017: 13 · 2016: 13 · 2015: 13 · 2014: 17 · 2013: 22 · 2012: 29
- FWCI
- 13.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Developmental and Educational Psychology › Aging and Gerontology Research
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- personality, all-cause mortality, Big Five personality traits, conscientiousness, neuroticism, agreeableness, extraversion, openness to experience, personality facets, impulsivity, self-control, older adults, frail elderly, Medicare beneficiaries, protective factors
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Factor Analysis, Statistical, Medicare, Humans, Longitudinal Studies, MMPI, Models, Psychological, Mortality, Personality, Personality Inventory, Survival Analysis, Frail Elderly
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