Martina Luchetti

Personality and Cognitive Decline in Older Adults: Data From a Longitudinal Sample and Meta-Analysis

OBJECTIVES Personality traits are associated with risk of dementia; less is known about their association with the trajectory of cognitive functioning. This research examines the association between the 5 major dimensions of personality and cognitive function and decline in older adulthood and includes a meta-analysis of published studies. METHOD Personality traits, objective and subjective memory, and cognitive status were collected in a large national sample (N = 13,987) with a 4-year follow-up period. For each trait, the meta-analysis pooled results from up to 5 prospective studies to examine personality and change in global cognition. RESULTS Higher Neuroticism was associated with worse performance on all cognitive measures and greater decline in memory, whereas higher Conscientiousness and Openness were associated with better memory performance concurrently and less decline over time. All traits were associated with subjective memory. Higher Conscientiousness and lower Extraversion were associated with better cognitive status and less decline. Although modest, these associations were generally larger than that of hypertension, diabetes, history of psychological treatment, obesity, smoking, and physical inactivity. The meta-analysis supported the association between Neuroticism and Conscientiousness and cognitive decline. DISCUSSION Personality is associated with cognitive decline in older adults, with effects comparable to established clinical and lifestyle risk factors.

Five-factor model personality traits and inflammatory markers: new data and a meta-analysis.

The purpose of this research is to examine the association between five major dimensions of personality and systemic inflammation through (a) new data on C-reactive protein (CRP) from three large national samples of adults that together cover most of the adult lifespan and (b) a meta-analysis of published studies on CRP and interleukin-6 (IL-6). New data (total N=26,305) were drawn from the National Longitudinal Study of Adolescent Health, the Midlife in the United States study, and the Health and Retirement Study. PRISMA guidelines were used for the meta-analysis to combine results of up to seven studies on CRP (N=34,067) and six on IL-6 (N=7538). Across the three new samples, higher conscientiousness was associated with lower CRP. The conscientiousness-CRP relation was virtually identical controlling for smoking; controlling for body mass index attenuated this association but did not eliminate it. Compared to participants in the highest quartile of conscientiousness, participants in the lowest quartile had an up to 50% increased risk of CRP levels that exceeded the clinical threshold (≥3 mg/l). The meta-analysis supported the association between conscientiousness and both CRP and IL-6 and also suggested a negative association between openness and CRP; no associations were found for neuroticism, extraversion and agreeableness. The present work indicates a modest, but consistent, association between conscientiousness and a more favorable inflammatory profile, which may contribute to the role of conscientiousness in better health across the lifespan.

The five-factor model of personality and physical inactivity: A meta-analysis of 16 samples

A sedentary lifestyle is harmful for health; personality traits may contribute to physical (in)activity. With participant-level data from 16 samples (N>125,000), we examined the personality correlates of physical inactivity, frequency of physical activity, and sedentary behavior (in a subset of samples). Lower Neuroticism and higher Conscientiousness were associated with more physical activity and less inactivity and sedentary behavior. Extraversion and Openness were also associated with more physical activity and less inactivity, but these traits were mostly unrelated to specific sedentary behaviors (e.g., TV watching). The results generally did not vary by age or sex. The findings support the notion that the interest, motivational, emotional, and interpersonal processes assessed by five-factor model traits partly shape the individuals engagement in physical activity.

Allostatic Load and Personality: A 4-Year Longitudinal Study.

Objective Dysregulation across multiple physiological systems, referred to as allostatic load, has pervasive consequences for an individuals health. The present study examined whether allostatic load is associated with personality and personality changes during a 4-year follow-up. Methods A total of 5200 participants aged from 50 to 99 years (59.5% women, mean [standard deviation] age = 66.91 [8.88] years) from the Health and Retirement Study provided data on cardiovascular, metabolic, and immune markers at baseline and personality both at baseline and at 4 years later. Results Higher allostatic load was related to higher neuroticism (&bgr; = 0.03, p = .042), lower extraversion (&bgr; = −0.06, p < .001), and lower conscientiousness (&bgr; = −0.06, p < .001) at baseline, and to declines in extraversion (&bgr; = −0.03, p = .007), conscientiousness (&bgr; = −0.04, p < .001), and agreeableness (&bgr; = −0.02, p = .020) over the 4-year period, controlling for demographic covariates. A significant quadratic relation between allostatic load and changes in openness (&bgr; = −0.03, p = .002) suggested that openness declines when individuals exceed a high level of cumulative physiological dysregulation. No association was found with changes in neuroticism. Conclusions Allostatic load is associated with personality change across adulthood and old age. The findings indicate that physiological dysregulation across multiple systems challenges personality stability and is associated with accelerated personality traits change.

Measuring the phenomenology of autobiographical memory: A short form of the Memory Experiences Questionnaire

The Memory Experiences Questionnaire (MEQ) is a theoretically driven and empirically validated 63-item self-report scale designed to measure 10 phenomenological qualities of autobiographical memories: Vividness, Coherence, Accessibility, Time Perspective, Sensory Details, Visual Perspective, Emotional Intensity, Sharing, Distancing and Valence. To develop a short form of the MEQ to use when time is limited, participants from two samples (N = 719; N = 352) retrieved autobiographical memories, rated the phenomenological experience of each memory and completed several scales measuring psychological distress. For each MEQ dimension, the number of items was reduced by one-half based on item content and item-total correlations. Each short-form scale had acceptable internal consistency (median alpha = .79), and, similar to the long-form version of the scales, the new short scales correlated with psychological distress in theoretically meaningful ways. The new short form of the MEQ has similar psychometric proprieties as the original long form and can be used when time is limited.

Parental educational attainment and adult offspring personality: An intergenerational life span approach to the origin of adult personality traits.

Why do some individuals have more self-control or are more vulnerable to stress than others? Where do these basic personality traits come from? Although a fundamental question in personality, more is known about how traits are related to important life outcomes than their developmental origins. The present research took an intergenerational life span approach to address whether a significant aspect of the childhood environment—parental educational attainment—was associated with offspring personality traits in adulthood. We tested the association between parents’ educational levels and adult offspring personality traits in 7 samples (overall age range 14–95) and meta-analytically combined the results (total N > 60,000). Parents with more years of education had children who were more open, extraverted, and emotionally stable as adults. These associations were small but consistent, of similar modest magnitude to the association between life events and change in personality in adulthood, and were also supported by longitudinal analyses. Contrary to expectations, parental educational attainment was unrelated to offspring Conscientiousness, except for a surprisingly negative association in the younger cohorts. The results were similar in a subsample of participants who were adopted, which suggested that environmental mechanisms were as relevant as shared genetic variants. Participant levels of education were associated with greater conscientiousness, emotional stability, extraversion, and openness and partially mediated the relation between parent education and personality. Child IQ and family income were also partial mediators. The results of this research suggest that parental educational attainment is 1 intergenerational factor associated with offspring personality development in adulthood.

Age, memory type, and the phenomenology of autobiographical memory: findings from an Italian sample.

The present research explored differences in phenomenology between two types of memories, a general self-defining memory and an earliest childhood memory. A sample of 76 Italian participants were selected and categorised into two age groups: 20–30 years and 31–40 years. The Memory Experiences Questionnaire (MEQ) was administered, taking note of latency and duration times of the narratives. Consistent with the literature, the self-defining memory differed significantly from the earliest childhood memory in terms of phenomenology, with the recency of the memory associated with more intense phenomenological experience. The self-defining memory took longer to retrieve and narrate than the earliest childhood memory. Meaningful differences also emerged between the two age groups: Participants in their 30s rated their self-defining memory as more vivid, coherent, and accessible than participants in their 20s. According to latency findings, these differences suggest an expanded period of identity consolidation for younger adults. Further applications of the MEQ should be carried out to replicate these results with other samples of young adults.

Stratified cost-utility analysis of C-Leg versus mechanical knees: Findings from an Italian sample of transfemoral amputees

Background: The fitting rate of the C-Leg electronic knee (Otto-Bock, D) has increased steadily over the last 15 years. Current cost-utility studies, however, have not considered the patients’ characteristics. Objectives: To complete a cost-utility analysis involving C-Leg and mechanical knee users; “age at the time of enrollment,” “age at the time of first prosthesis,” and “experience with the current type of prosthesis” are assumed as non-nested stratification parameters. Study design: Cohort retrospective. Methods: In all, 70 C-Leg and 57 mechanical knee users were selected. For each stratification criteria, we evaluated the cost-utility of C-Leg versus mechanical knees by computing the incremental cost-utility ratio, that is, the ratio of the “difference in cost” and the “difference in utility” of the two technologies. Cost consisted of acquisition, maintenance, transportation, and lodging expenses. Utility was measured in terms of quality-adjusted life years, computed on the basis of participants’ answers to the EQ-5D questionnaire. Results: Patients over 40 years at the time of first prosthesis were the only group featuring an incremental cost-utility ratio (88,779 €/quality-adjusted life year) above the National Institute for Health and Care Excellence practical cost-utility threshold (54,120 €/quality-adjusted live year): C-Leg users experience a significant improvement of “mobility,” but limited outcomes on “usual activities,” “self-care,” “depression/anxiety,” and reduction of “pain/discomfort.” Conclusion: The stratified cost-utility results have relevant clinical implications and provide useful information for practitioners in tailoring interventions. Clinical relevance A cost-utility analysis that considered patients characteristics provided insights on the “affordability” of C-Leg compared to mechanical knees. In particular, results suggest that C-Leg has a significant impact on “mobility” for first-time prosthetic users over 40 years, but implementation of specific low-cost physical/psychosocial interventions is required to retun within cost-utility thresholds.

Cognitive Impairment, Dementia, and Personality Stability Among Older Adults

There is contrasting evidence on personality stability in advanced age, and limited knowledge on the impact of cognitive impairment and dementia on trait stability. Group- and individual-level longitudinal analyses of the five major dimensions of personality assessed twice over 4 years (N = 9,935) suggest that rank-order stability was progressively lower with advancing age (from rtt = 0.68 for age 50 to 60 years to rtt = 0.58 for age >80 years). Stability was low in the dementia group (rtt = 0.43), and this was not simply due to lower reliability given that internal consistency remained adequate in the dementia group. Among individuals with no cognitive impairment or dementia, there was no association between stability and age (rtt = 0.70 even for age >80 years). These results suggest that the lower personality stability in older adults is not due to age but cognitive impairment and dementia.

Personality and Lung Function in Older Adults

Objectives Lung disease is a leading cause of disability and death among older adults. We examine whether personality traits are associated with lung function and shortness of breath (dyspnea) in a national cohort with and without chronic obstructive pulmonary disease (COPD). Method Participants (N = 12,670) from the Health and Retirement Study were tested for peak expiratory flow (PEF) and completed measures of personality, health behaviors, and a medical history. Results High neuroticism and low extraversion, openness, agreeableness, and conscientiousness were associated with lower PEF, and higher likelihood of COPD and dyspnea. Conscientiousness had the strongest and most consistent associations, including lower risk of PEF less than 80% of the predicted value (OR = 0.67; 0.62-0.73) and dyspnea (OR = 0.52; 0.47-0.57). Although attenuated, the associations remained significant when accounting for smoking, physical activity, and chronic diseases including cardiovascular and psychiatric disorders. The associations between personality and PEF or dyspnea were similar among those with or without COPD, suggesting that psychological links to lung function are not disease dependent. In longitudinal analyses, high neuroticism (β = -0.019) and low conscientiousness (β = 0.027) predicted steeper declines in PEF. Discussion A vulnerable personality profile is common among individuals with limited lung function and COPD, predicts shortness of breath and worsening lung function.