Neuroticism predicts all-cause mortality over 19-years: The moderating effects on functional status, and the angiotensin-converting enzyme

Objective: To examine if the personality traits neuroticism, extraversion, and openness to experience are related to all-cause mortality in older adults over a follow-up period of 19 years. Methods: Participants were a locally representative sample of 417 older adults (M ± SD = 84.55 ± 8.62 years). Statistical significance levels for hazard ratios were estimated having adjusted for age, sex, education, income, depressive illness, and personality traits. Results: A significant effect was observed for neuroticism with each 1 SD increase in neuroticism associated with a 14% increased risk in all-cause mortality (p = 0.031: 95% CI, 1.01–1.28). Following the trichotomization of neuroticism, the hazard for those >1 SD above the mean was significantly greater than the average range (HR = 1.59; p = 0.001; 95% CI, 1.19–2.11). Examination of potential mechanisms revealed that neuroticism significantly moderated the effects of functional status (HR_interation = 1.09; p = 0.018; 95% CI = 1.02–1.17), and the angiotensin-converting enzyme (ACE; HR_interation = 0.88; p = 0.031; 95% CI = 0.79–0.99) on mortality. As such, for each 1 SD increase in neuroticism, the effect rate on all-cause mortality increased by 9% for functional status, and decreased by 12% for ACE. Conclusions: Findings suggest that neuroticism is associated with all-cause mortality in older age. Specifically, persons higher in neuroticism are at a distinctly greater risk of all-cause mortality. Both functional status, and the angiotensin-converting enzyme provide two potential mechanisms of effect in the association between neuroticism and mortality.