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Personality Traits, Education, and Health-Related Quality of Life Among Older Adult Primary Care Patients

Department of Psychiatry, University of Rochester Medical Center, New York.

Both lower education and the personality trait of neuroticism have been associated with lower health-related quality of life (HRQOL) among older adults, but little is known about the role of other personality traits in HRQOL. We examined the associations of all Five-Factor Model personality traits and education, above and beyond physician-rated medical burden, with different aspects of HRQOL in a sample of 442 primary care patients 65 years of age or older who completed the NEO Five-Factor Inventory. We used the Medical Outcomes Survey Short Form-36 (SF-36), instrumental activities of daily living (IADLs), and the physical self-maintenance scale to assess different aspects of HRQOL. Even after statistically adjusting for age, gender, the presence of major depressive disorder, and physician-rated medical morbidity, we found that a higher neuroticism level was associated with lower functioning on the IADLs and the physical self-maintenance scale and worse HRQOL on the Social Functioning and Role Emotional subscales of the SF-36. Higher conscientiousness level was associated with better HRQOL on the SF-36 Role Physical scale and better IADL function. Higher education level was associated with better HRQOL on all measures except emotional role impairment. In exploratory moderation analyses, a higher openness level diminished the effect of medical burden on IADL impairment. Preliminary population-attributable risk comparisons suggest that—on a strictly population basis—the impairment conferred by a neuroticism level that is 1 SD above the mean may be equivalent to or greater than that of major depressive disorder. Future research aimed at understanding how personality traits are linked with HRQOL and functioning in later life may enhance the identification of at-risk older adults and inform the development of interventions.