Personality and Physician-Assessed Illness Burden in Older Primary Care Patients Over 4 Years

Abstract

Background Personality traits have been associated with physician-rated illness burden cross-sectionally, but longitudinal associations between personality and objective medical morbidity remain unclear. Purpose To examine associations between personality and physician-rated illness burden 4 years prospectively in older primary care patients. Method At baseline, patients (average age = 75, SD = 6.6, 62% female) completed the NEO-Five Factor Inventory. At baseline and 4 yearly follow-ups, a physician completed the Cumulative Illness Rating Scale based on medical records. Results Linear mixed effects models revealed that higher neuroticism and lower conscientiousness predicted worse average illness burden longitudinally. Relatively disagreeable persons (25th percentile) accumulated morbidity at a 33% faster rate than agreeable (75th percentile) peers. At the final follow-up, a person at the 75th percentile of neuroticism and the 25th percentile of conscientiousness and agreeableness showed morbidity comparable to a peer of average personality but 10 years older. An individual at the 25th percentile of neuroticism and 75th percentile of conscientiousness and agreeableness showed end-point illness burden comparable to a peer of average personality but 10 years younger. 21% of the morbidity associated with neuroticism was explained by total cholesterol. History of hypertension, smoking, alcohol/drug abuse, and affective symptoms of depression each explained 10% or less of the other observed personality effects. Conclusion Personality plays a non-trivial role in healthy aging among older persons. Brief personality assessment may identify at-risk older persons for closer monitoring, enhance the accuracy of medical prognosis, and provide clues for clinical interventions to promote better health.

Are personality traits associated with white-coat and masked hypertension?

“…More broadly, this finding is consistent with other evidence that low conscientiousness is associated with risk factors for hypertension such as obesity [30], physical inactivity [31, 32], and tobacco smoking [33]. In this and many other samples, conscientiousness has been related to cardiovascular [34], metabolic [35], and inflammatory [36] markers, as well as medical conditions [37, 38], treatment adherence [28, 29], and premature mortality [39–42]. …”

Personality Traits and Circadian Blood Pressure Patterns

“…In addition to a non-dipping pattern, individuals with low levels of conscientiousness are likely to have other risk factors for cardiovascular health, including cigarette smoking and other substance use (23, 46), sedentary behavior (43), obesity (22, 49), inflammation (48, 50), dyslipidemia (51), and metabolic syndrome (24). In long-term prospective studies, low conscientiousness is also associated with a number of health outcomes (52, 53), such as Alzheimer's disease (25), and mortality (26, 54-56). Less is known about whether conscientiousness predicts cardiovascular events, such as stroke.…”

Longitudinal Correlated Changes in Conscientiousness, Preventative Health‐Related Behaviors, and Self‐Perceived Physical Health

“…In addition, higher levels of conscientiousness are associated with a healthier blood lipid profile (Sutin et al, 2010), and healthier body composition (Terracciano et al, 2009). Similarly, higher levels of conscientiousness predict lower levels of physician-rated illness burden (Chapman, Lyness, & Duberstein, 2007; Chapman, Duberstein, & Roberts, in press). In addition, among patients with chronic medical illness, higher conscientiousness is associated with longer survival (Christensen et al, 2002).…”