Exploring modifiable factors that explain the adverse impact of neuroticism on physical health

objective:

Past research has shown that the personality trait of neuroticism is associated with health outcomes. To better understand this association, we sought to examine factors that may mediate the effect of neuroticism on physical function in a cohort of aging adults.

method:

Cross-sectional data from the LitCog cohort study was analyzed. Participants (n = 697) completed structured, face-to-face interviews. Health literacy (TOFHLA), patient activation (PAM), depression, and anxiety, which have been shown to independently predict health outcomes in this cohort, were examined. Neuroticism was measured using the NEO-FFM personality inventory. Physical function was assessed with the Patient Reported Outcomes Measurement Information Service (PROMIS) short-form subscales. 

results:

Neuroticism was significantly correlated with literacy (r=-0.23), patient activation (r=-0.27), anxiety (r=0.52), and depression (r=0.52; all p<0.001). In a linear regression model controlling for age and income, neuroticism was strongly associated with worse physical function (β -0.47, 95% CI (-0.66, -0.28) p<0.001). This relationship was fully attenuated with the addition of the other variables, to a point of non-significance (β -0.09, 95%CI (-0.32, 0.13) p=0.41). Activation and depression remained independent predictors of physical function (p<0.001 and p=0.01, respectively).

conclusion:

Neuroticism was no longer a significant predictor of physical health when controlling for health literacy, patient activation, anxiety, and depression. Interventions focusing on improving patient activation and addressing depressive symptoms, specifically, could mitigate the impact of neuroticism on health outcomes. Personality provides valuable insight into individual risk factors and should inform more targeted interventions.