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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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BackgroundResultTolea, M. I., Ferrucci, L., Costa, P. T., Faulkner, K. A., Rosano, C., Satterfield, S., Ayonayon, H. N., Simonsick, E. M., & for the Health, A. (2012) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbs001 · Cited by 17
“For ease of presentation and to be consistent with other reports ( Weiss & Costa, 2005 ) , the domain of openness was categorized as low ( 45), average (45 – 54) , or high ( ≥ 54).”
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“Inconsistent findings with respect to neuroticism have been found for a range of health outcomes, including type 2 diabetes, [37] and all-cause mortality [38].”
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“…one facet of the domain is related to a criterion, this may be overshadowed by the other facets that are not related to the criterion but still constitute the domain, causing the domain to show less predictive power than the individual facets (Ashton, 1998; Chapman, 2007; Weiss & Costa, 2005).”
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“This is an important difference because Big Five facet scores have been found to be related to mortality variables (e.g., Jonassaint et al., 2007; Weiss & Costa, 2005) and, according to Judge, Rodell, Klinger, Simon, and Crawford (2013), “broad traits assessed with omnibus measures obscure too many…”
BackgroundResultNo evidence of “healthy neuroticism” in the Hawaii Personality and Health Cohort
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The Five-Factor Model of Personality: Consensus and Controversy
McCrae, R. R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.013 · Cited by 20
Murray, C. L., Brett, C. E., Starr, J. M., & Deary, I. J. (2010) · Quality of Life Research · doi:10.1007/s11136-010-9718-1 · Cited by 16
“High neuroticism (low ES) has been found to be both protective against all-cause mortality [29] and an independent risk factor for mortality [30, 31].”
BackgroundLongevity candidate genes and their association with personality traits in the elderly
Luciano, M., Lopez, L. M., de Moor, M. H. M., Harris, S. E., Davies, G., Nutile, T., Krueger, R. F., Esko, T., Schlessinger, D., Toshiko, T., et al. (2011) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32013 · Cited by 15
“Agreeableness, particularly its straightforwardness facet, is predictive of survival in Americans older than 66 years [Weiss and Costa, 2005].”
BackgroundZhang, Y., Zhang, R., & Feng, T. (2021) · Neuroscience · doi:10.1016/j.neuroscience.2021.11.036 · Cited by 15
Savolainen, K., Eriksson, J. G., Kajantie, E., Pesonen, A., & Räikkönen, K. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.04.011 · Cited by 14
Krok‐Schoen, J. L., & Baker, T. A. (2014) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-014-0035-1 · Cited by 15
Burch, G. S. J., & Anderson, N. R. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9780511596544.046 · Cited by 13
Personality and physical health.
Smith, T. W., Williams, P., & Segerstrom, S. C. (2014) · American Psychological Association eBooks · doi:10.1037/14343-029 · Cited by 16
Moody and thin‐skinned? The interplay of neuroticism and momentary affect in older romantic couples
Mueller, S., Wagner, J., Hülür, G., Hoppmann, C. A., Ram, N., & Gerstorf, D. (2020) · British Journal of Psychology · doi:10.1111/bjop.12452 · Cited by 13
“…of facets and their differential associations with different life outcomes (M~ottus, 2016; Sutin, Zonderman, Ferrucci, & Terracciano, 2013; Weiss & Costa, 2005), more fine-grained facet-level 8 As an additional test of the robustness of our results, we reran our models with…”
Neuroticism facets and mortality risk in adulthood: A systematic review and narrative synthesis
Butler, M., Turiano, N. A., Buckley, L., McGeehan, M., & O’Súilleabháin, P. S. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111500 · Cited by 16
“For instance, some have reported specific facets linked to increased mortality risk [29] and others linked with protective effects [64].”
InfluentialCare Recipient Agreeableness Is Associated With Caregiver Subjective Physical Health Status
Riffin, C. A., Löckenhoff, C. E., Pillemer, K. A., Friedman, B., & Costa, P. T. (2012) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbs114 · Cited by 13
Self-citationEvolutionary Personality Psychology
Lewis, D. M. G., Al-Shawaf, L., & Buss, D. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.022 · Cited by 11
Larzelere, M., Campbell, J., & Adu-Sarkodie, N. Y. (2011) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2011.07.009 · Cited by 13
A NEO‐PI‐R short form for older adults
Mooi, B., Comijs, H., Fruyt, F. D., Ritter, D. D., Hoekstra, H., & Beekman, A. (2011) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.342 · Cited by 10
Bratt, A. S., Stenström, U., & Rennemark, M. (2015) · Aging & Mental Health · doi:10.1080/13607863.2015.1031638 · Cited by 10
“Some indications, however, show that high neuroticism also can be a protective mortality factor (Weiss & Costa, 2005).”
BackgroundDevelopment of Personality across the Life Span
Atherton, O. E., Donnellan, M. B., & Robins, R. W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.017 · Cited by 15
Schoormans, D., Verhoeven, J. E., Denollet, J., van de Poll-Franse, L. V., & Penninx, B. W. J. H. (2017) · Psychological Medicine · doi:10.1017/s0033291717002471 · Cited by 11
“…Type D personality and shorter LTL are associated with morbidity, such as the age-related diseases cancer and CVD, and mortality (Wilson et al. 2004; Denollet, 2005; Weiss & Costa, 2005; Chapman et al. 2010; Mols et al. 2012; Denollet, 2013; Denollet et al. 2013; Lyon et al. 2014; McCann, 2014).”
BackgroundResultPsychosocial resources as predictors of resilience and healthy longevity of older widows
Fry, P. S., & Debats, D. L. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511763151.009 · Cited by 10
Personality and Illness Behavior
Williams, P. (2006) · Wiley eBooks · doi:10.1002/9780470713860.ch7 · Cited by 10
Assessing personality traits, life balance domains, and work addiction among entrepreneurs
Therthani, S., Balkin, R. S., Perepiczka, M., Silva, S., Hunter, Q., & Juhnke, G. A. (2022) · The Career Development Quarterly · doi:10.1002/cdq.12296 · Cited by 9
Association between extraversion personality and abnormal glucose regulation in young Korean women
Shim, U., Oh, J. Y., Lee, H., Sung, Y., Kim, H., & Kim, H. (2013) · Acta Diabetologica · doi:10.1007/s00592-013-0529-z · Cited by 10
Personality and health in middle age as predictors for well-being and health in old age
Perrig-Chiello, P., Jaeggi, S., Buschkuehl, M., Stähelin, H., & Perrig, W. (2009) · European Journal of Ageing · doi:10.1007/s10433-008-0102-8 · Cited by 11
“…personality dimensions which have been related to well-being and health in old age, namely neuroticism and extraversion (Baltes and Mayer 1999; Friedman 2000; Gilhooly et al. 2007; Jerram and Coleman 1999; Samuelsson et al. 1997; Schwarzer 1996; WoodruffBorden et al. 2001; Weiss and Costa 2005).”
BackgroundAssociation of big-5 personality traits with cognitive impairment and dementia: a longitudinal study
Singh‐Manoux, A., Yerramalla, M. S., Sabia, S., Mika Kivimaki, B., Fayossé, A., Dugravot, A., & Dumurgier, J. (2020) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2019-213014 · Cited by 11
Why do some people thrive while others succumb to disease and stagnation?
Kern, M. L., & Friedman, H. S. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511763151.008 · Cited by 10
South, S. C., Reichborn‐Kjennerud, T., Eaton, N. R., & Krueger, R. F. (2012) · Wiley eBooks · doi:10.1002/9781118133880.hop205001 · Cited by 9
Approach–Avoidance Theories of Personality
Corr, P. J., & Krupıć, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.025 · Cited by 12
Karraker, A., Schoeni, R. F., & Cornman, J. C. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.09.011 · Cited by 8
“…non-representative samples (Campbell et al., 2014; Friedman et al., 1995; Terracianno et al., 2008), short observational windows (Hill et al., 2011; Weiss & Costa, 2005), or both, leaving unanswered questions regarding the generalizability of how these psychological and cognitive factors unfold…”
The Big Five personality traits and adherence to breast cancer early detection and prevention
Bahat, E. (2020) · Personality and Individual Differences · doi:10.1016/j.paid.2020.110574 · Cited by 8
Emotionale Ambivalenz, Körperbeschwerden, Depressivität und soziale Interaktion
Deighton, R. M., & Traue, H. C. (2006) · Zeitschrift für Gesundheitspsychologie · doi:10.1026/0943-8149.14.4.158 · Cited by 8
Weiss, A., & Costa, P. T. (2014) · American Journal of Epidemiology · doi:10.1093/aje/kwt300 · Cited by 8
Self-citationCaprara, G. V., & Vecchione, M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.038 · Cited by 9
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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