Domain and Facet Personality Predictors of All-Cause Mortality Among Medicare Patients Aged 65 to 100

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. NEO-PI = NEO Personality Inventory, NEO-PI-R = Revised NEO Personality Inventory, NEO-FFI = NEO Five-Factor Inventory, MMPI = Minnesota Multiphasic Personality Inventory, ADL = activities of daily living, IADL = instrumental activities of daily living, HR = hazards ratio.