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Personality Associations with Lung Function and Dyspnea: Evidence from Six Studies
Abstract
Objective:
The present study examined the association between Five Factor Model personality traits and lung function and dyspnea.
Methods:
Participants were middle aged and older adults aged 34-103 years old (N > 25,000) from the Midlife in the United States Study (MIDUS), the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), the National Health and Aging Trends Survey (NHATS), and the Wisconsin Longitudinal Study graduate (WLSG) and sibling (WLSS) samples. Data on peak expiratory flow (PEF), dyspnea, personality traits, smoking, physical activity, body mass index (BMI), emotional/psychiatric problems, and demographic factors were obtained in each sample.
Results:
A meta-analysis indicated that higher neuroticism was related to lower PEF, higher risk of PEF less than 80% of predicted value, and higher risk of dyspnea. In contrast, higher extraversion and conscientiousness were associated with higher PEF, lower likelihood of PEF lower than 80% of the predicted value, and lower risk of dyspnea. Higher openness was related to higher PEF and lower risk of PEF less than 80%, whereas agreeableness was related to higher PEF and lower risk of dyspnea. Smoking, physical activity, BMI and emotional/psychiatric problems partially accounted for these associations. There was little evidence that lung disease moderated the association between personality and PEF and dyspnea.
Conclusions:
Across cohorts, this study found replicable evidence that personality is associated with lung function and associated symptomatology.
... These traits include neuroticism (i.e., the propensity to experience distress and to feel negative emotions), extraversion (i.e., the tendency to experience positive emotions and to be sociable), openness to experiences (i.e., the tendency to be curious and unconventional), agreeableness (i.e., the propensity to be altruistic and accommodating), and conscientiousness (i.e., the tendency to self-discipline and responsibility). Research has shown that personality traits are closely linked to the overall health of individuals (Friedman & Kern, 2014;Strickhouser et al., 2017), including their pulmonary and functional capacities (Stephan et al., 2023;Stephan, Sutin, Bovier-Lapierre, et al., 2018;Terracciano et al., 2017). Theoretical models point to health-related behaviors, which are crucial action pathways for understanding the associations between personality traits and health (Turiano et al., 2015). ...
... For instance, neuroticism is the trait disposition to experience negative affects including anxiety and was positively associated with depression symptoms in CRD persons (Topp et al., 2016). Moreover, a high level of neuroticism and a low level of conscientiousness are related to a worse lung function and increased likelihood of reporting dyspnea (Stephan et al., 2023). ...
Objective: Pulmonary rehabilitation (PR) is the gold standard treatment for improving the health status of individuals with chronic respiratory diseases (CRD). However, to achieve lasting results, the adoption and maintenance of a physically active lifestyle are necessary. Unfortunately, the trajectories of change in physical activity (PA) and sedentary behavior (SB) following PR are marked by a high degree of heterogeneity between patients. This study aimed to better understand the factors underlying this variability by investigating the role played by the personality as defined by the five-factor model. Design: Eighty eight CRD patients were assessed on personality upon PR admission (Time 1). PA and SB were assessed at Time 1 and 6 months post-PR (Time 2) using questionnaires. Results: Multiple regression analyses revealed that “healthy neuroticism” is associated with an increase in PA 6 months after PR (β = .20, p < .05) independently of the PA at Time 1. A high level of neuroticism, when it is paired with a low level of conscientiousness, is related to an increase in SB 6 months after PR (β = −.20, p < .01), when the SB and exercise tolerance at Time 1 were controlled for. Conclusion: These findings highlight that investigating the interaction between personality traits is relevant to a better understanding of the interindividual differences in changes in PA and SB after PR in patients with CRD. The behavioral effects of PR could be improved if patients’ personality traits were taken into account in the design of behavior-change interventions.
... The most commonly reported risk factors include increasing age, female gender, elevated BMI, and respiratory or cardiac diseases [4]. Additionally, recent research suggests a correlation between personality traits and lung function, as well as dyspnea [5]. ...
Dyspnea is a subjective sensation often described as a feeling of respiratory effort, tightness, or air hunger. The underlying mechanisms of this symptom are multifaceted and involve factors such as respiratory centers, cardiovascular system, airways, neuromuscular components, and metabolic factors, although not fully elucidated. The classical theory of imbalance between inspiratory neural drive (IND) and the simultaneous dynamic responses of the respiratory system posits that the disruption of a normal and harmonious relationship fundamentally shapes the expression of respiratory discomfort. Assessment and comprehensive treatment of dyspnea are crucial for patient rehabilitation, including subjective self-reporting and objective clinical measurements. Non-pharmacological interventions, such as pulmonary rehabilitation, fan therapy, exercise, chest wall vibration, virtual reality technology, traditional Chinese medicine (acupuncture and acupressure), and yoga, have shown promise in alleviating dyspnea symptoms. Additionally, oxygen therapy, has demonstrated short-term benefits for patients with pre-hospital respiratory distress and hypoxemia. This review provides a comprehensive overview of dyspnea, emphasizing the importance of a multifaceted approach for its assessment and management, with a focus on non-pharmacological interventions that contribute to enhanced patient outcomes and quality of life.
The current study presented the first meta-analytic review on the associations between the Big Five personality traits and stress measured under different conceptualizations (stressor exposure, psychological and physiological stress responses) using a total of 1,575 effect sizes drawn from 298 samples. Overall, neuroticism was found to be positively related to stress, whereas extraversion, agreeableness, conscientiousness, and openness were negatively linked to stress. When stress assessed under different conceptualizations was tested, only neuroticism, agreeableness, and conscientiousness were related to stressor exposure. All of the Big Five personality traits were significantly associated with psychological stress perception, whereas the five personality traits showed weak to null associations with physiological stress response. Further moderation analyses suggested that the associations between personality traits and stress under different conceptualizations were also contingent upon different characteristics of stress, sample, study design, and measures. The results supported the important role of personality traits in individual differences in stress.
The present study examined the cross-sectional and longitudinal associations between the five major personality traits and fatigue. Participants were adults aged 16–104 years old (N > 40,000 at baseline) from the Health and Retirement Study, the National Social Life, Health, and Aging Project, the Wisconsin Longitudinal Study graduate and sibling samples, the National Health and Aging Trends Survey, the Longitudinal Internet Studies for the Social Sciences and the English Longitudinal Study of Ageing. Personality traits, fatigue, demographic factors, and other covariates were assessed at baseline, and fatigue was assessed again 5–20 years later. Across all samples, higher neuroticism was related to a higher risk of concurrent (meta-analytic OR = 1.73, 95% CI 1.62–1.86) and incident (OR = 1.38, 95% CI 1.29–1.48) fatigue. Higher extraversion, openness, agreeableness, and conscientiousness were associated with a lower likelihood of concurrent (meta-analytic OR range 0.67–0.86) and incident (meta-analytic OR range 0.80–0.92) fatigue. Self-rated health and physical inactivity partially accounted for these associations. There was little evidence that age or gender moderated these associations. This study provides consistent evidence that personality is related to fatigue. Higher neuroticism and lower extraversion, openness, agreeableness, and conscientiousness are risk factors for fatigue.
Background:
Impaired lung function is predictive of mortality and is a key component of chronic obstructive pulmonary disease. Lung function has a strong genetic component but is also affected by environmental factors such as increased exposure to air pollution, but the effect of their interactions is not well understood.
Objectives:
To identify interactions between genetic variants and air pollution measures which affect COPD risk and lung function. Additionally, to determine whether previously identified lung function genetic association signals showed evidence of interaction with air pollution, considering both individual effects and combined effects using a genetic risk score (GRS).
Methods:
We conducted a genome-wide gene-air pollution interaction analysis of spirometry measures with three measures of air pollution at home address: particulate matter (PM2.5 & PM10) and nitrogen dioxide (NO2), in approximately 300,000 unrelated European individuals from UK Biobank. We explored air pollution interactions with previously identified lung function signals and determined their combined interaction effect using a GRS.
Results:
We identified seven new genome-wide interaction signals (P<5×10-8), and a further ten suggestive interaction signals (P<5×10-7). Additionally, we found statistical evidence of interaction for FEV1/FVC between PM2.5 and previously identified lung function signal, rs10841302, near AEBP2, suggesting increased susceptibility as copies of the G allele increased (but size of the impact was small - interaction beta: -0.363 percentage points, 95% CI: -0.523, -0.203 per 5 µg/m3). There was no observed interaction between air pollutants and the weighted GRS.
Discussion:
We carried out the largest genome-wide gene-air pollution interaction study of lung function and identified potential effects of clinically relevant size and significance. We observed up to 440 ml lower lung function for certain genotypes when exposed to mean levels of outdoor air pollution, which is approximately equivalent to nine years of average normal loss of lung function in adults.
Physical fatigability, or susceptibility to physical fatigue, is strongly associated with aging, disease, and disability. Over the lifecourse, personality traits are also connected to numerous age-related vulnerabilities and resistance-yet, their longitudinal association with fatigability remains unknown. Well-functioning community-dwelling volunteers aged ≥50 (N = 995) from the Baltimore Longitudinal Study of Aging (BLSA) were assessed over an average of 2 years on personality traits (NEO-PI-R; openness, conscientiousness, extraversion, agreeableness, and neuroticism) and perceived fatigability [Borg Rating of Perceived Exertion (RPE) after a 5-min slow treadmill walk; 6 (low) to 20 (high) exertion]. Linear and multinomial logistic regression models examined cross-sectional associations [treating fatigability continuously and by RPE category: low (6-7), intermediate (8-9), and high (10+)]. Generalized estimating equations (GEE) tested longitudinal associations. All models were adjusted for demographics and comorbid conditions. In cross-sectional models, openness, β = -.09 RPE (SE =.03); p < .01, conscientiousness, β = -.07 (.03); p < .05, and extraversion, β = -.10 (.03); p < .01, were negatively associated with fatigability. In parallel, lower openness, OR: .98, 95% CI [.96-1.00], conscientiousness, OR: .98, 95% CI [.96-1.00], and extraversion, OR: .97, 95% CI [.95-.99], corresponded with higher odds of having high versus low fatigability. In longitudinal models (mean follow-up time 2 ± 2 years), openness, conscientiousness, and extraversion associations remained significant and did not change over time (Trait × Year p values > .34). Together, findings suggest that personality plays a role in the perceived tolerance of fatigue in well-functioning older adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Objectives
To compare the obtained and predicted peak expiratory flow (PEF) values between frail, pre-frail, and non-frail older adults; verify the association between PEF and FS; and establish cut-off points for PEF as determinants of frailty syndrome (FS).DesignCross-sectional study.LocationMacapá, Amapá, Brazil.ParticipantsCommunity-based study community-dwelling older people.MethodsPEF was evaluated using a peak-flow meter and FS was evaluated using Fried’s frailty phenotype. The statistical analyses performed included a multinomial logistic regression model and Receiver Operating Characteristic (ROC) curves to establish cut-off points for discriminating FS.Results409 older adults with a mean age of 70.09±7.22 years were evaluated; of these, 58.7% were pre-frail, and 12.7% were frail. PEF was lower in frail than in pre-frail participants, and lower in pre-frail than in non-frail. Frail and pre-frail older adults obtained lower PEF values than predicted. PEF (% Predicted) was inversely associated with frailty and pre-frailty even after adjustment. Cut-off points were established to discriminate the presence of frailty in older men (PEF≤350L/min; AUC=0.669; sensitivity=76.92%; specificity=52%) and women (PEF≤220L/min; AUC=0.597; sensitivity=71.79%; specificity=46.98%).Conclusions
Frail and pre-frail older adults presented significantly lower PEF than non-frail participants, and these values were lower than predicted. PEF was inversely associated with frailty and pre-frailty. PEF cut-off points can be used as a complementary method to indicate frailty in community-dwelling older adults.
Objectivesto compare the obtained and predicted peak expiratory flow (PEF) values between frail, pre-frail, and non-frail older adults; verify the association between PEF and FS; and establish cut-off points for PEF as determinants of frailty syndrome (FS).DesignCross-sectional study.LocationMacapa, Amapa, Brazil.ParticipantsCommunity-based study community-dwelling older people.MethodsPEF was evaluated using a peak-flow meter and FS was evaluated using Fried’s frailty phenotype. The statistical analyses performed included a multinomial logistic regression model and Receiver Operating Characteristic (ROC) curves to establish cut-off points for discriminating FS.Results409 older adults with a mean age of 70.09±7.22 years were evaluated; of these, 58.7% were pre-frail, and 12.7% were frail. PEF was lower in frail than in pre-frail participants, and lower in pre-frail than in non-frail. Frail and pre-frail older adults obtained lower PEF values than predicted. PEF (% Predicted) was inversely associated with frailty and pre-frailty even after adjustment. Cut-off points were established to discriminate the presence of frailty in older men (PEF≤350L/min; AUC=0.669; sensitivity=76.92%; specificity=52%) and women (PEF≤220L/min; AUC=0.597; sensitivity=71.79%; specificity=46.98%).Conclusions
Frail and pre-frail older adults presented significantly lower PEF than non-frail participants, and these values were lower than predicted. PEF was inversely associated with frailty and pre-frailty. PEF cut-off points can be used as a complementary method to indicate frailty in community-dwelling older adults.
Background:
Spirometry is useful for evaluating respiratory health status and predicting health-related outcomes. As spirometry requires skilled technician and takes time, it is useful to find simple way for predicting lung function impairment. The aim of this study was to investigate which tests could predict lung function impairment among workers.
Methods:
This prospective study included workers of manufacturing industry who underwent health check-ups in 2017. Subjects underwent the chronic obstructive pulmonary disease (COPD) assessment test (CAT), spirometry, and physical fitness assessments, including handgrip strength (HGS). Lung function impairment was defined as a decline in any of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), or a FEV1/FVC ratio less than the lower limit of normal (LLN).
Results:
Complete data on 475 workers (366 men, 50.4% ever smokers) were available. Lung function impairment was observed in 99 subjects (64 men). Men with lung function impairment had significantly higher rate of ever-smoking, passive smoking at home in childhood, high CAT scores, and decreased HGS, compared with those without. On multivariate analyses, ever-smoking (odds ratio [OR], 2.50; 95% confidence intervals [CI], 1.25-4.97), passive smoking at home in childhood (OR, 2.71; 95% CI, 1.16-6.32), CAT scores (OR, 1.06; 95% CI, 1.01-1.12), and HGS (OR, 0.73; 95% CI, 0.57-0.92) were independently associated with lung function impairment in men.
Conclusions:
Ever-smoking, passive smoking at home in childhood, high CAT scores, and decreased HGS are significantly associated with lung function impairment in men.
Trial registration:
Registration number: UMIN000028011. Date of registration: July 1, 2017.
Background
Peak expiratory flow (PEF) and walking speed (WS) have been proposed as indicators of robustness and are independent predictors of health-related outcomes. We aimed to investigate how the co-occurrence of respiratory and physical impairments changes as a function of age, and to quantify the association of the combination of low PEF and slow WS on survival in older people.
Methods
This prospective study analyzes data from 2656 community-dwelling participants (age ≥ 60 years) from the SNAC-K study. At baseline, we assessed: (1) sociodemographic, lifestyle and medical data; (2) respiratory function, estimated through PEF and expressed as standardized residual (SR) percentile; and (3) WS at usual pace, categorized as no (>1.2 m/s), mild (0.8–1.2 m/s) and moderate-to-severe (<0.8 m/s) walking impairment. Participants' vital status over an 18-year follow-up was derived from registers. The association of different combinations of PEF and WS on median survival time was estimated through Laplace regression adjusted for potential confounders.
Results
Respiratory and walking impairments co-occurred more frequently with increasing age. Among individuals with PEF SR-percentiles<10th, the percentage of moderate-to-severe walking impairment was 12.1% in sexagenarians, 35.7% in septuagenarians, and 75–80% in the oldest old. The greatest reduction in median survival time (−5.4 [95%CI: −6.4; −4.4] years, p < .001) was observed among people with combined respiratory and moderate-to-severe walking impairments, compared with those with no dysfunctions, who had a median survival time of 17.4 (95%CI: 17.0; 17.8) years.
Conclusions
Impaired PEF and WS co-occur more frequently with advancing age, and their co-occurrence is associated with shorter survival.
Peak expiratory flow (PEF) has been linked to several health-related outcomes in older people, but its association with frailty is still unclear. This study investigates the association between PEF and prevalent and incident frailty in older adults. Data come from 2559 community-dwelling participants (age ≥ 60 years) of the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Baseline PEF was expressed as standardized residual (SR) percentiles. Frailty was assessed at baseline and over six years, according to the Fried criteria. Associations between PEF and frailty were estimated cross-sectionally through logistic regressions, and longitudinally by multinomial logistic regression, considering death as alternative outcome. Obstructive respiratory diseases and smoking habits were treated as potential effect modifiers. Our cross-sectional results showed that the 10th–49th and <10th PEF SR percentile categories were associated with three- and five-fold higher likelihood of being frail than the 80th–100th category. Similar estimates were confirmed longitudinally, i.e., adjusted OR = 3.11 (95% CI: 1.61–6.01) for PEF SR percentiles < 10th, compared with 80th–100th percentiles. Associations were enounced in participants without physical deficits, and tended to be stronger among those with baseline obstructive respiratory diseases, and, longitudinally, also among former/current smokers. These findings suggest that PEF is a marker of general robustness in older adults, and its reduction exceeding that expected by age is associated with frailty development.
The association between physical activity and lung function is thought to depend on smoking history but most previous research uses self-reported measures of physical activity. This cross-sectional study investigates whether the association between accelerometer-derived physical activity and lung function in older adults differs by smoking history. The sample comprised 3063 participants (age = 60–83 years) who wore an accelerometer during 9 days and undertook respiratory function tests. Forced vital capacity (FVC) was associated with moderate-to-vigorous physical activity (MVPA; acceleration ≥0.1 g (gravity)) in smokers but not in never smokers: FVC differences for 10 min increase in MVPA were 58.6 (95% Confidence interval: 21.1, 96.1), 27.8 (4.9, 50.7), 16.6 (7.9, 25.4), 2.8 (−5.2, 10.7) ml in current, recent ex-, long-term ex-, and never-smokers, respectively. A similar trend was observed for forced expiratory volume in 1 second. Functional data analysis, a threshold-free approach using the entire accelerometry distribution, showed an association between physical activity and lung function in all smoking groups, with stronger association in current and recent ex-smokers than in long-term ex- and never-smokers; the associations were evident in never smokers only at activity levels above the conventional 0.1 g MVPA threshold. These findings suggest that the association between lung function and physical activity in older adults is more pronounced in smokers than non-smokers.
Objectives
To investigate the relationship between handgrip strength and pulmonary function.
Design
Cross‐sectional study of a representative sample of older Korean women.
Setting
The Korean National Health and Nutrition Examination Survey.
Participants
Community‐dwelling women aged 65 and older without chronic diseases or pulmonary disease (N=605).
Measurements
Handgrip strength was measured using a digital hand dynamometer, and pulmonary function was tested according to guidelines of the American Thoracic Society/European Respiratory Society using a spirometry system. Impaired pulmonary function was defined as a lower limit of normal (LLN) or less of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Odds ratios (ORs) and 95% confidence intervals (CIs) for impaired pulmonary function according to handgrip strength quartile were calculated using multiple logistic regression analysis.
Results
Mean FVC and FEV1 gradually increased in accordance with handgrip strength quartiles (all P <.001). After adjusting for age, body mass index, smoking status, alcohol ingestion, aerobic physical activity, resistance exercise, household income, and education level the odds of impaired pulmonary function were greater for participants in the first quartile of handgrip strength (≤19.25 kg) than for those in the fourth quartile (25.31–37.30 kg) (FVC LLN: OR=3.46, 95 % CI=1.52–7.88; FEV1 LLN: OR=2.62, 95 % CI=1.12–6.15).
Conclusion
Handgrip strength was positively associated with pulmonary function in a dose‐dependent manner. Given the health implications of pulmonary function, timely detection of weaker handgrip strength in older people may be useful in assessing potential pulmonary function impairment.
Objective
Older people with reduced respiratory muscle strength may be misclassified as having COPD on the basis of spirometric results. We aimed to evaluate the relationship between lung function and grip strength in older hospitalized patients without known airways disease.
Methods
Patients in acute medical wards were recruited who were aged ≥70 years; no history, symptoms, or signs of respiratory disease; Mini Mental State Examination ≥24; willing and able to consent to participate; and able to perform hand grip and forced spirometry. Data including lung function (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC, peak expiratory flow rate [PEFR], and slow vital capacity [SVC]), grip strength, age, weight, and height were recorded. Data were analyzed using descriptive statistics and linear regression unadjusted and adjusted (for age, height, and weight).
Results
A total of 50 patients (20 men) were recruited. Stronger grip strength in men was significantly associated with greater FEV1, but this was attenuated by adjustment for age, height, and weight. Significant positive associations were found in women between grip strength and both PEFR and SVC, both of which remained robust to adjustment.
Conclusion
The association between grip strength and PEFR and SVC may reflect stronger patients generating higher intrathoracic pressure at the start of spirometry and pushing harder against thoracic cage recoil at end-expiration. Conversely, patients with weaker grip strength had lower PEFR and SVC. These patients may be misclassified as having COPD on the basis of spirometric results.
Objective:
To derive a robust and comprehensive estimate of the overall relation between Big Five personality traits and health variables using metasynthesis (i.e., second-order meta-analysis).
Method:
Thirty-six meta-analyses, which collectively provided 150 meta-analytic effects from over 500,000 participants, met criteria for inclusion in the metasynthesis. Information on methodological quality as well as the type of health outcome, unreliability adjustment, population sampled, health outcome source, personality source, and research design was extracted from each meta-analysis. An unweighted model was used to aggregate data across meta-analyses.
Results:
When entered simultaneously, the Big Five traits were moderately associated with overall health (multiple R = .35). Personality-health relations were larger when examining mental health outcomes than physical health outcomes or health-related behaviors and when researchers adjusted for measurement unreliability, used self-report as opposed to other-report Big Five scales, or focused on clinical as opposed to nonclinical samples. Further, effects were larger among agreeableness, conscientiousness, and neuroticism than extraversion or openness to experience.
Conclusions:
This metasynthesis provides among the most compelling evidence to date that personality predicts overall health and well-being. In addition, it may inform research on the mechanisms by which personality impacts health as well as research on the structure of personality. (PsycINFO Database Record
Greater increases in negative affect and greater decreases in positive affect on days stressors occur portend poorer mental and physical health years later. Although personality traits influence stressor-related affect, only neuroticism and extraversion among the Big Five personality traits have been examined in any detail. Moreover, personality traits may shape how people appraise daily stressors, yet few studies have examined how stressor-related appraisals may account for associations between personality and stressor-related affect. Two studies used participants (N = 2,022; age range: 30-84) from the National Study of Daily Experiences II to examine the associations between Big Five personality traits and stressor-related affect and how appraisals may account for these relationships. Results from Study 1 indicate that higher levels of extraversion, conscientiousness, and openness to experience and lower levels of neuroticism are related to less stressor-related negative affect. Only agreeableness was associated with stressor-related positive affect, such that higher levels were related to greater decreases in positive affect on days stressors occur. The second study found that stressor-related appraisals partially accounted for the significant associations between stressor-related negative affect and personality. Implications for these findings in relation to how personality may influence physical and emotional health are discussed. (PsycINFO Database Record
Background:
Common chronic conditions, such as heart disease and cancer, are associated with increased psychological distress, functional limitations and shortened life expectancy, but whether these diseases alter aspects of personality remains unclear.
Method:
To examine whether the onset of heart disease, stroke, diabetes, cancer, hypertension, arthritis and respiratory disease is associated with subsequent changes in personality traits of the five-factor model, we pooled data from the Health and Retirement Study, the Midlife in the United States Survey, and the graduate and sibling samples of the Wisconsin Longitudinal Study for an individual-participant meta-analysis (total n=17,493; mean age at baseline 55.8 years).
Results:
After adjustment for age, we observed consistent decreases in extraversion [-0.25 T-scores per one disease; 95% confidence interval (CI) -0.40 to -0.10], emotional stability (-0.40, 95% CI -0.61 to -0.19), conscientiousness (-0.44, 95% CI -0.57 to -0.30) and openness to experience (-0.25, 95% CI -0.37 to -0.13) but not in agreeableness (-0.05, 95% CI -0.19 to 0.08) after the onset of chronic diseases. The onset of each additional chronic disease accelerated the average age-related personality change by 2.5 years in decreasing extraversion, 5.5 years in decreasing conscientiousness, and 1.6 years in decreasing openness to experience, and attenuated the increasing levels of emotional stability by 1.9 years. Co-morbid conditions were associated with larger changes than single diseases, suggesting a dose-response association between morbidity and personality change.
Conclusions:
These results support the hypothesis that chronic diseases influence personality development in adulthood.
A lifespan perspective on personality and health uncovers new causal pathways and provides a deeper, more nuanced approach to interventions. It is unproven that happiness is a direct cause of good health or that negative emotion, worry, and depression are significant direct causes of disease. Instead, depression-related characteristics are likely often reflective of an already-deteriorating trajectory. It is also unproven that challenging work in a demanding environment usually brings long-term health risks; on the contrary, individual strivings for accomplishment and persistent dedication to one's career or community often are associated with sizeable health benefits. Overall, a substantial body of recent research reveals that conscientiousness plays a very significant role in health, with implications across the lifespan. Much more caution is warranted before policy makers offer narrow health recommendations based on short-term or correlational findings. Attention should be shifted to individual trajectories and pathways to health and well-being.
Forced expiratory volume in one second (FEV1) is inversely associated with mortality in Western populations, but few studies have assessed the associations of peak expiratory flow (PEF) with subsequent cause-specific mortality, or have used populations in developing countries, including China, for such assessments.
A prospective cohort study followed ∼170 000 Chinese men ranging in age from 40-69 years at baseline (1990-1991) for 15 years. In the study, height-adjusted PEF (h-PEF), which was uncorrelated with height, was calculated by dividing PEF by height. Hazard ratios (HR) for cause-specific mortality and h-PEF, adjusted for age, area of residence, smoking, and education, were calculated through Cox regression analyses.
Of the original study population, 7068 men died from respiratory causes (non-neoplastic) and 22 490 died from other causes (including 1591 from lung cancer, 5469 from other cancers, and 10 460 from cardiovascular disease) before reaching the age of 85 years. Respiratory mortality was strongly and inversely associated with h-PEF. For h-PEF ≥ 250 L/min, the association was log-linear, with a hazard ratio (HR) of 1.29 (95% CI: 1.25-1.34) per 100 L/min reduction in h-PEF. The association was stronger but not log-linear for lower values of h-PEF. Mortality from combined other causes was also inversely associated with h-PEF, and the association was log-linear for all values of h-PEF, declining with follow-up, with HRs per 100 L/min reduction in h-PEF of 1.13 (1.10-1.15), 1.08 (1.06-1.11), and 1.06 (1.03-1.08) in three consecutive 5-year follow-up periods. Specifically, lower values of h-PEF were associated with higher mortality from cardiovascular disease and lung cancer, but not from other cancers.
A lower value of h-PEF was associated with increased mortality from respiratory and other causes, including lung cancer and cardiovascular disease, but its associations with the other causes of death declined across the follow-up period.
Personality traits and cardiorespiratory fitness in older adults are reliable predictors of health and longevity. We examined the association between personality traits and energy expenditure at rest (basal metabolic rate) and during normal and maximal sustained walking. Personality traits and oxygen (VO(2)) consumption were assessed in 642 participants from the Baltimore Longitudinal Study of Aging. Results indicate that personality traits were mostly unrelated to resting metabolic rate and energy expenditure at normal walking pace. However, those who scored lower on neuroticism (r = -0.12) and higher on extraversion (r = 0.11), openness (r = 0.13), and conscientiousness (r = 0.09) had significantly higher energy expenditure at peak walking pace. In addition to greater aerobic capacity, individuals with a more resilient personality profile walked faster and were more efficient in that they required less energy per meter walked. The associations between personality and energy expenditure were not moderated by age or sex, but were in part explained by the proportion of fat mass. In conclusion, differences in personality may matter the most during more challenging activities that require cardiorespiratory fitness. These findings suggest potential pathways that link personality to health outcomes, such as obesity and longevity.
The authors examined whether peak expiratory flow (PEF) is a valid measure of health status in older adults. Survey and test
data from the 2006 and 2008 cycles of the Health and Retirement Study, a longitudinal study of US adults over age 50 years
(with biennial surveys initiated in 1992), were used to develop predicted PEF regression models and to examine relations between
low PEF values and other clinical factors. Low PEF (<80% of predicted value) was prevalent among persons with chronic conditions,
including frequent pain, obstructive lung disease, heart disease, diabetes, and psychological distress. Persons with higher
physical disability scores had substantially higher adjusted odds of having low PEF, on par with those for conditions known
to be associated with poor health (cancer, heart disease, and stroke). In a multivariate regression model for difficulty with
mobility, PEF remained an independent factor (odds ratio (OR) = 1.69, 95% confidence interval (CI): 1.53, 1.86). Persons with
low PEF in 2006 were more likely to be hospitalized (OR = 1.26, 95% CI: 1.10, 1.43) within the subsequent 2 years and to estimate
their chances of surviving for 10 or more years at less than 50% (OR = 1.69, 95% CI: 1.24, 2.30). PEF is a valid measure of
health status in older persons, and low PEF is an independent predictor of hospitalization and poor subjective mortality assessment.
The present study addresses issues of measurement invariance and comparability of factor parameters of Big Five personality adjective items across age. Data from the Midlife in the United States (MIDUS) survey were used to investigate age-related developmental psychometrics of the MIDUS personality adjective items in 2 large cross-sectional samples (exploratory sample: N = 862; analysis sample: N = 3,000). After having established and replicated a comprehensive 5-factor structure of the measure, increasing levels of measurement invariance were tested across 10 age groups. Results indicate that the measure demonstrates strict measurement invariance in terms of number of factors and factor loadings. Also, we found that factor variances and covariances were equal across age groups. By contrast, a number of age-related factor mean differences emerged. The practical implications of these results are discussed, and future research is suggested.
The understanding of the influence of smoking and sex on lung function and symptoms is important for understanding diseases such as COPD. The influence of both genes and environment on lung function, smoking behaviour and the presence of respiratory symptoms has previously been demonstrated for each of these separately. Hence, smoking can influence lung function by co-varying not only as an environmental factor, but also by shared genetic pathways. Therefore, the objective was to evaluate heritability for different aspects of lung function, and to investigate how the estimates are affected by adjustments for smoking and respiratory symptoms.
The current study is based on a selected sample of adult twins from the Swedish Twin Registry. Pairs were selected based on background data on smoking and respiratory symptoms collected by telephone interview. Lung function was measured as FEV1, VC and DLco. Pack years were quantified, and quantitative genetic analysis was performed on lung function data adjusting stepwise for sex, pack years and respiratory symptoms.
Fully adjusted heritability for VC was 59% and did not differ by sex, with smoking and symptoms explaining only a small part of the total variance. Heritabilities for FEV1 and DLco were sex specific. Fully adjusted estimates were 10 and 15% in men and 46% and 39% in women, respectively. Adjustment for smoking and respiratory symptoms altered the estimates differently in men and women. For FEV1 and DLco, the variance explained by smoking and symptoms was larger in men. Further, smoking and symptoms explained genetic variance in women, but was primarily associated with shared environmental effects in men.
Differences between men and women were found in how smoking and symptoms influence the variation in lung function. Pulmonary gas transfer variation related to the menstrual cycle has been shown before, and the findings regarding DLco in the present study indicates gender specific environmental susceptibility not shown before. As a consequence the results suggest that patients with lung diseases such as COPD could benefit from interventions that are sex specific.
The prevalence of metabolic syndrome has paralleled the sharp increase in obesity. Given its tremendous physical, emotional, and financial burden, it is of critical importance to identify who is most at risk and the potential points of intervention. Psychological traits, in addition to physiological and social risk factors, may contribute to metabolic syndrome. The objective of the present research is to test whether personality traits are associated with metabolic syndrome in a large community sample. Participants (N = 5,662) from Sardinia, Italy, completed a comprehensive personality questionnaire, the NEO-PI-R, and were assessed on all components of metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose). Logistic regressions were used to predict metabolic syndrome from personality traits, controlling for age, sex, education, and current smoking status. Among adults over age 45 (n = 2,419), Neuroticism and low Agreeableness were associated with metabolic syndrome, whereas high Conscientiousness was protective. Individuals who scored in the top 10% on Conscientiousness were approximately 40% less likely to have metabolic syndrome (OR = 0.61, 95% CI = 0.41-0.92), whereas those who scored in the lowest 10% on Agreeableness were 50% more likely to have it (OR = 1.53, 95% CI = 1.09-2.16). At the facet level, traits related to impulsivity and hostility were the most strongly associated with metabolic syndrome. The present research indicates that those with fewer psychological resources are more vulnerable to metabolic syndrome and suggests a psychological component to other established risk factors.
An earlier study of peak expiratory flow (PEF) in normal adults contained too few men aged over 55 and women aged over 65 for the regression equations to be used for prediction in older people. A subsequent study was therefore carried out on an additional 23 men and 29 women aged 55 or over who were lifelong non-smokers and satisfied the same strict criteria of normality that had been used in the original study. The data from both studies were combined and a new model used to calculate equations for the regression of PEF on age and height in the two sexes. With this model predicted values could be derived for men and women aged between 15 and 85. These new equations gave predicted values in men and women aged less than 55 and 65, respectively, which were almost identical with those reported previously. The new regression equations for PEF enable values to be predicted for people aged 15-85 and so enhance the accuracy of testing in the elderly.
The British Thoracic Society recommends spirometry, not peak expiratory flow, for diagnosing patients as having chronic obstructive pulmonary disease.1 Recording data from spirometry in patients' notes has been proposed as a marker of quality of care.2 But general practitioners are more familiar with peak expiratory flow rate, and have questioned using more complex spirometry tests to identify chronic obstructive pulmonary disease.3 We analysed data from the third national health and nutrition survey (NHANES III) to investigate how useful peak expiratory flow rate is for detecting people with chronic obstructive pulmonary disease in the community.
We included only white people aged 50-90 years because chronic obstructive pulmonary disease is uncommon in younger people, and we had insufficient statistical power to study other ethnic groups. We excluded people with self reported asthma.
For the remaining 3874 participants, we extracted information on lung function, history of smoking, …
Objective:
To examine the association between Five-Factor Model personality traits and grip strength.
Method:
Adults aged 16 to 104 years old (N > 40,000) were from the Health and Retirement Study, the Midlife in the United States Study, The English Longitudinal Study of Aging, the National Health and Aging Trends Survey, the United Kingdom Household Longitudinal Study, and the Wisconsin Longitudinal Study graduate and sibling samples. Participants had data on personality traits, demographic factors, grip strength, and mediators such as depressive symptoms, physical activity, body mass index (BMI), and c-reactive protein (CRP).
Results:
Across all samples and a meta-analysis, higher neuroticism was related to lower grip strength (meta-analytic estimate: -0.07, 95%CI: -0.075; -0.056). Higher extraversion (0.04, 95%CI: 0.022; 0.060), openness (0.05, 95%CI: 0.032; 0.062), and conscientiousness (0.05, 95%CI: 0.04; 0.065) were associated with higher grip strength across most samples and the meta-analysis. Depressive symptoms were the most consistent mediators between neuroticism and grip strength. Depressive symptoms and physical activity partly mediated the associations with extraversion, openness, and conscientiousness. Lower CRP partly mediated the association with conscientiousness. Sex moderated the associations for extraversion, openness, and conscientiousness, with stronger associations among males. Age moderated the neuroticism association, with stronger associations among younger individuals.
Conclusion:
This study provides replicable evidence that personality is related to grip strength and identifies potential moderators and mediators of these associations. Overall, higher neuroticism is a risk factor for low grip strength, whereas high extraversion, openness, and conscientiousness may be protective.
Researchers hypothesize that how people react to daily stressful events partly explains the relationship between personality and health, yet no study has examined longitudinal associations between these factors. The current study focused on the role of negative affect reactivity to daily stressful events as a mediating pathway between personality and physical health outcomes using three waves of data spanning 20 years from a nationwide probability sample of 1,176 adults. Results indicated that negative affect reactivity partially mediated personality and physical health. Wave 1 neuroticism was associated with greater negative affect reactivity at Wave 2, which predicted the development of chronic conditions and functional limitations at Wave 3. Higher conscientiousness at Wave 1 was associated with less negative affect reactivity at Wave 2, which predicted better physical health at Wave 3. These findings highlight the usefulness of using a daily-stress framework for understanding how personality impacts health over time, which has important implications for stress management and disease prevention.
Significance
Personality traits have consequences and are malleable throughout the lifespan. However, it is unclear if and how personality traits can be changed in desired directions. A 3-mo digital personality change intervention was deployed, and a large-scale randomized controlled trial ( n = 1,523) was conducted to examine the effects of intended personality change in a nonclinical sample. The intervention group showed greater changes than the control group, and changes aligned with intended goals for change. Observers also perceived personality changes, but reported changes were less pronounced. Moreover, self- and observer-reported changes persisted until 3 mo after the end of the intervention. These findings provide the strongest evidence to date that normal personality traits can be changed through intervention in nonclinical samples.
This study provides a quantitative synthesis of the prospective associations between personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) and the risk of incident Alzheimer’s disease and related dementias. We conducted five separate meta-analyses with 8-12 samples (N = 30,036 to 33,054) that were identified through a systematic literature search following the MOOSE guidelines. Higher neuroticism (HR = 1.24, 95% CI [1.17, 1.31]) and lower conscientiousness (HR = 0.77, 95% CI [0.73, 0.81]) were associated with increased dementia risk, even after accounting for covariates such as depressive symptoms. Lower extraversion (HR = 0.92, 95% CI [0.86, 0.97]), openness (HR = 0.91, 95% CI [0.86, 0.96]), and agreeableness (HR = 0.90, 95% CI [0.83, 0.98]) were also associated with increased risk, but these associations were less robust and not significant in fully adjusted models. No evidence of publication bias was found. The strength of associations was unrelated to publication year (i.e., no evidence of winner’s curse). Meta-regressions indicated consistent effects for neuroticism, openness, and conscientiousness across methods to assess dementia, dementia type, follow-up length, sample age, minority, country, and personality measures. The association of extraversion and agreeableness varied by country. Our findings indicate robust associations of neuroticism and conscientiousness with dementia risk.
Rationale
There is substantial evidence for the predictive value of single-item selfrated health measures for a range of health outcomes. Past research has found an association between personality traits and self-rated health. However, there has not been a multi-cohort large-scale study that has examined this link, and few studies have examined the association between personality and change in self-rated health.
Objective
To examine the concurrent and longitudinal association between personality and self-rated health.
Method
Participants were individuals aged from 16 to 107 years (N> 46,000) drawn from eight large longitudinal samples from the US, Europe, and Japan. Brief measures of the five-factor model of personality, a single item measure of self-rated health, and covariates (age, sex, and education, and race) were assessed at baseline and self-rated health was measured again 3 to 20 years later.
Results
In cross-sectional analyses, higher neuroticism was related to lower self-rated health whereas higher extraversion, openness, agreeableness and conscientiousness were associated with better self-rated health across most samples. A meta-analysis revealed that a one standard deviation higher neuroticism was related to more than 50% higher risk of fair to poor health, whereas a one standard deviation higher extraversion, openness, agreeableness and conscientiousness was associated with at least 15% lower risk of fair or poor health. A similar pattern was found in longitudinal analyses: personality was associated with risk of self-rated excellent/very good/good health at baseline becoming fair/poor at follow-up. In multilevel analyses, however, personality was weakly related to trajectories of self-rated health and in the opposite of the expected direction.
Conclusions
The present study shows replicable cross-sectional and small longitudinal associations between personality and self-rated health. This study suggests that lower neuroticism, higher extraversion, openness, agreeableness and conscientiousness are related to more favorable self-evaluations of health.
Personality traits are associated with risk of diabetes, but most research to date has relied on participants reported diagnosis rather than objective markers of glycaemia. The present study examined the association between the five major domains of personality (neuroticism, extraversion, openness, agreeableness and conscientiousness) and haemoglobin A1c (HbA1c). Participants (N> 26,000) were individuals aged from 16 to 104 years from six large community samples from the US, Europe, and Japan who had data on personality, demographic factors, body mass index (BMI), physical activity, and HbA1c. Of the five factors, only higher conscientiousness was related consistently to lower HbA1c level across most samples and in the meta-analysis. Conscientiousness was also related to lower risk of HbA1c ≥6.5% (OR = .85, 95%CI = 0.80-0.90). BMI and physical activity partially mediated the link between conscientiousness and HbA1c. There were not consistent associations for the other four traits across the six samples and no consistent associations between personality and likelihood of undiagnosed diabetes. The present study found replicable associations between conscientiousness and HbA1c in adulthood. Assessment of conscientiousness may improve the identification of individuals at risk of diabetes and guide personalized interventions for regulation of HbA1c level.
Background:
In addition to affecting the oxygen supply to the brain, pulmonary function is a marker of multiple insults throughout life (including smoking, illness, and socioeconomic deprivation). In this meta-analysis of existing longitudinal studies, we tested the hypothesis that lower pulmonary function and respiratory illness are linked to an elevated risk of dementia.
Method:
We conducted a systematic review of longitudinal studies using PubMed until April 1st, 2019 and, where possible, pooled results in random-effects meta-analyses.
Results:
We identified eleven studies relating pulmonary function to later dementia risk, and eleven studies of respiratory illness and dementia (including one which assessed both). The lowest quartile of Forced Expiratory Volume in one second (FEV1) compared with the highest was associated with a 1.4-fold (1.46, 95%CI 0.77-2.75) increased dementia risk (Ntotal=62,209, two studies). An decrease of one standard deviation in FEV1 was associated with a 28% increase in dementia risk (1.28, 95%CI 1.03-1.60; Ntotal=67,505; six studies). Respiratory illness was also associated with increased dementia risk to a similar degree (1.54, 1.30-1.81, Ntotal=288,641, 11 studies).
Conclusions:
Individuals with poor pulmonary function experience increased risk of dementia. The extent to which the association between poor pulmonary function and dementia is causal remains unclear and requires examination.
Background:
Former smokers now outnumber current smokers in many developed countries, and current smokers are smoking fewer cigarettes per day. Some data suggest that lung function decline normalises with smoking cessation; however, mechanistic studies suggest that lung function decline could continue. We hypothesised that former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers, including among those without prevalent lung disease.
Methods:
We used data on six US population-based cohorts included in the NHLBI Pooled Cohort Study. We restricted the sample to participants with valid spirometry at two or more exams. Two cohorts recruited younger adults (≥17 years), two recruited middle-aged and older adults (≥45 years), and two recruited only elderly adults (≥65 years) with examinations done between 1983 and 2014. FEV1 decline in sustained former smokers and current smokers was compared to that of never-smokers by use of mixed models adjusted for sociodemographic and anthropometric factors. Differential FEV1 decline was also evaluated according to duration of smoking cessation and cumulative (number of pack-years) and current (number of cigarettes per day) cigarette consumption.
Findings:
25 352 participants (ages 17-93 years) completed 70 228 valid spirometry exams. Over a median follow-up of 7 years (IQR 3-20), FEV1 decline at the median age (57 years) was 31·01 mL per year (95% CI 30·66-31·37) in sustained never-smokers, 34·97 mL per year (34·36-35·57) in former smokers, and 39·92 mL per year (38·92-40·92) in current smokers. With adjustment, former smokers showed an accelerated FEV1 decline of 1·82 mL per year (95% CI 1·24-2·40) compared to never-smokers, which was approximately 20% of the effect estimate for current smokers (9·21 mL per year; 95% CI 8·35-10·08). Compared to never-smokers, accelerated FEV1 decline was observed in former smokers for decades after smoking cessation and in current smokers with low cumulative cigarette consumption (<10 pack-years). With respect to current cigarette consumption, the effect estimate for FEV1 decline in current smokers consuming less than five cigarettes per day (7·65 mL per year; 95% CI 6·21-9·09) was 68% of that in current smokers consuming 30 or more cigarettes per day (11·24 mL per year; 9·86-12·62), and around five times greater than in former smokers (1·57 mL per year; 1·00-2·14). Among participants without prevalent lung disease, associations were attenuated but were consistent with the main results.
Interpretation:
Former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers. These results suggest that all levels of smoking exposure are likely to be associated with lasting and progressive lung damage.
Funding:
National Institutes of Health, National Heart Lung and Blood Institute, and US Environmental Protection Agency.
Objective:
Pain and prescription opioid medication use are prevalent and a major source of psychological and physical health burden. This research examines whether Five Factor Model personality traits prospectively predict who will experience persistent pain and use prescription opioid medication over a 10-year follow-up.
Methods:
Participants (N = 8491) were drawn from the Health and Retirement Study. At baseline, participants reported on their personality and whether they were in pain. Every two years, participants reported on their pain and, at the most recent assessment, their current use of prescription opioid medication. Logistic regression was used to test whether personality was associated with persistent pain over the up to 10-year follow-up and whether it predicted who would be taking prescription opioid medication.
Results:
Neuroticism was associated with higher risk of persistent pain (OR = 1.44, 95% CI = 1.38-1.51) and opioid medication use (OR = 1.21, 95% CI = 1.14-1.29) over the follow-up. Extraversion was associated with lower risk of persistent pain (OR = 0.83, 95% CI = 0.80-0.87) and opioid medication use (OR = 0.92, 95% CI = 0.86-0.97). Similarly, Conscientiousness was associated with lower risk of persistent pain (OR = 0.83, 95% CI = 0.79-0.87) and opioid medication use (OR = 0.91, 95% CI = 0.86-0.97).
Conclusions:
The findings suggest that personality traits are one psychological characteristic that modulates the likelihood of persistent pain and opioid medication use.
Depression, anxiety and high neuroticism (affective traits) are often comorbid with asthma. A causal direction between the affective traits and asthma is difficult to determine, however, there may be a common underlying pathway attributable to shared genetic factors. Our aim was to determine whether a common genetic susceptibility exists for asthma and each of the affective traits.
An adult cohort from the Swedish Twin Registry underwent questionnaire-based health assessments (n=23 693) and genotyping (n=15 908). Firstly, questionnaire-based associations between asthma and affective traits were explored. This was followed by genetic analyses: a) polygenic risk scores (PRS) for affective traits were used as predictors of asthma in the cohort, and b) genome-wide association results from UK Biobank were used in linkage-disequilibrium score regression (LDSC) to quantify genetic correlations between asthma and affective traits Analyses found associations between questionnaire-based asthma and affective traits (odds ratio (OR) 1.67 95%CI 1.50–1.86 major depression, OR 1.45 95%CI 1.30–1.61 anxiety, and OR 1.60 95%CI 1.40–1.82 high neuroticism). Genetic susceptibility for neuroticism explained the variance in asthma with a dose response effect; that is, study participants in the highest neuroticism PRS quartile were more likely to have asthma than those in the lowest quartile (OR 1.37, 95%CI 1.17–1.61). Genetic correlations were found between depression and asthma (r g =0.17), but not for anxiety or neuroticism.
We conclude that the observed comorbidity between asthma and the affective traits may in part be due to shared genetic influences between asthma and depression (LDSC) and neuroticism (PRS), but not anxiety.
This study examined the Big Five personality traits as predictors of mortality risk, and smoking as a mediator of that association. Replication was built into the fabric of our design: we used a Coordinated Analysis with 15 international datasets, representing 44,094 participants. We found that high neuroticism and low conscientiousness, extraversion, and agreeableness were consistent predictors of mortality across studies. Smoking had a small mediating effect for neuroticism. Country and baseline age explained variation in effects: studies with older baseline age showed a pattern of protective effects (HR<1.00) for openness, and U.S. studies showed a pattern of protective effects for extraversion. This study demonstrated coordinated analysis as a powerful approach to enhance replicability and reproducibility, especially for aging-related longitudinal research.
Walking speed is one marker of health in adulthood. Although personality may contribute to gait speed, there is limited longitudinal data on this association. Thus, the present study examined whether personality traits are prospectively associated with walking speed among middle aged and older adults. Participants were adults aged from 25 to 100 years old (N > 15,000) drawn from the Wisconsin Longitudinal Study Graduate (WLSG) and Sibling (WLSS) samples, the Midlife in the United States Survey (MIDUS), the Health and Retirement Study (HRS), and the National Health and Aging Trends Survey (NHATS). Across most samples and in a meta-analysis, lower neuroticism and higher extraversion, conscientiousness, and openness at baseline were prospectively related to faster gait speed. In the HRS, lower neuroticism and higher extraversion, conscientiousness and openness were related to slower gait speed decline. This study provides robust evidence that walking speed in adulthood reflects, in part, the individual’s personality.
Background
Psychological stress has long been suspected to have a deleterious effect on asthma, with acute psychological stress being associated with physiological responses in asthma patients.
Objectives
The purpose of this systematic review was to provide a narrative synthesis of the impact of acute laboratory psychological stress on physiological responses among asthma patients.
Methods
An extensive search was conducted by two independent authors using Pubmed, PsycINFO, PsyArticles and the Cochrane Library electronic databases (up to September 2016). English and French articles which assessed physiological responses during or post-stress and compare them to baseline or pre-stress values were included.
Results
Thirty-two studies met the inclusion criteria. Studies indicated that exposure to active stressors (e.g., arithmetic tasks) was associated with an increase in sympathetic nervous system (SNS) responses, cortisol, and inflammatory responses, but had little effect on the caliber of the bronchi. Exposure to passive stressors (e.g., watching stressful movies or pictures) was also associated with an increase in SNS responses and with mild bronchoconstriction. However, a paucity of data for passive stressors limited conclusions on other measures.
Conclusions
In patients with asthma, both active and passive stressors seem to be associated with an increased activation of the SNS. Passive stressors seem to have a more immediate, deleterious impact on the airways than active stressors, but the latter may be associated with delayed inflammatory driven an asthma exacerbation. Further studies are needed to understand the impact of acute stressors on the physiological mechanisms associated with asthma, particularly HPA and immune markers.
Systematic review registration number: CRD42015026431.
Introduction:
Obesity can cause hypoxemia by decreasing lung volumes to where there is closure of lung units during normal breathing. Studies describing this phenomenon are difficult to translate into clinical practice. We wanted to determine the lung volume measurements that are associated with hypoxemia in obese patients, and explore how we could use these measurements to identify them.
Methods:
We collected pulmonary function test results and arterial blood gas data on 118 patients without obstruction on pulmonary function testing. We included only patients with normal chest imaging and cardiac testing within one year of the pulmonary function test, to exclude other causes of hypoxemia.
Results:
We found that as BMI increases, the mean paO2, ERV % predicted, and ERV/TLC decrease (BMI 20-30 kg/m2: paO2=90±8 mmHg, ERV% predicted 112±50, ERV/TLC (%) 19.7±6.5; BMI 30-40 kg/m2: paO2=84±10 mmHg, ERV% predicted 84±40 ERV/TLC(%) 13.6±7.6; BMI>40 kg/m2: paO2 78 ±12 mmHg, ERV% predicted 64±27 ERV/TLC(%) 11.4±5.8, ANOVA p<0.001). The A-a gradient increases as BMI increases (r=0.42, p<0.001). This correlation was stronger in men (r=0.54) than in women (r=0.35). The paO2 is lower in patients with a low ERV than in those with a normal ERV (p<0.001). In a multivariate linear regression, only the ERV/TLC predicted (%), age, and BMI were associated with oxygenation (r2 for A-a gradient =0.28, p=0.036).
Conclusions:
In obese patients without cardiopulmonary disease, oxygen levels decrease as BMI increases. This effect is associated with the obesity-related reduction in ERV and is independent of hypoventilation.
Frailty is a prevalent geriatric syndrome. Little is known about the psychological factors associated with this syndrome. Based on four large samples of older adults aged from 65 to 104 years old, the present study examined whether personality traits are related to frailty. High neuroticism, low conscientiousness, low extraversion, low openness and low agreeableness were related to higher frailty across samples. Longitudinal analysis conducted in one sample revealed that high neuroticism was associated with worsening frailty over an 8-year period. Higher frailty at baseline and over time was related to maladaptive personality changes. This study extends existing knowledge on the link between personality and health in older adults, by identifying the personality traits associated with frailty, a complex geriatric syndrome.
Objectives:
To evaluate perceived fatigability as a predictor of meaningful functional decline in non-mobility-limited older adults.
Design:
Longitudinal analysis of data from the Baltimore Longitudinal Study of Aging (BLSA).
Setting:
National Institute on Aging, Clinical Research Unit, Baltimore, Maryland.
Participants:
Men and women aged 60 to 89 participating in the BLSA with concurrent perceived fatigability and functional assessments and follow-up functional assessment within 1 to 3 years (N = 540).
Measurements:
Perceived fatigability was ascertained using the Borg rating of perceived exertion (RPE) after 5 minutes of treadmill walking at 1.5 miles per hour. Functional assessments included usual and fast gait speed, the Health, Aging and Body Composition physical performance battery (HABC PPB) and reported walking ability. Reported tiredness and energy level were examined as complementary predictors. Covariates included age, age squared, race, follow-up time, and baseline function. Meaningful decline was defined as 0.05 m/s per year for usual gait speed, 0.07 m/s per year for fast gait speed, 0.12 points/year for HABC PPB, and 1 point for walking ability index.
Results:
Over a mean 2.1 years, 20-31% of participants declined across functional assessments. Fatigability was associated with a 13-19% greater likelihood of meaningful decline in all measures (P = .002- .02) per 1-unit RPE increase. After considering tiredness and energy level separately, findings were essentially unchanged, and neither was associated with gait speed or physical performance decline. In contrast, each separately predicted decline in reported walking ability independent of fatigability (P = .03 and P < .001, respectively).
Conclusion:
Routine assessment of fatigability may help identify older persons vulnerable to greater-than-expected functional decline.
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 individual’s engagement in physical activity.
A link between metabolic syndrome (MetS) and lung diseases has been observed in several cross sectional and longitudinal studies. This syndrome has been identified as an independent risk factor for worsening respiratory symptoms, greater lung function impairment, pulmonary hypertension and asthma. This review will discuss several potential mechanisms to explain these associations, including dietary factors and the effect of adiposity and fat-induced inflammation on the lungs, and the role of other co-morbidities that frequently co-exist with MetS, such as obstructive sleep apnea (OSA) and obesity. In contrast to the well-known association between asthma and obesity, the recognition that MetS affects the lung is relatively new. Although some controversy remains as to whether MetS is a unique disease entity, its individual components have independently been associated with changes in pulmonary function or lung disease; there is however, uncertainty as to the relative contribution that each metabolic factor has in adversely affecting the respiratory system; also, it is unclear how much of the MetS – lung effects occur independently of obesity. In spite of these epidemiological limitations, the proposed mechanistic pathways strongly suggest that this association is likely to be causal. Given the wide prevalence of MetS in the general population, it is imperative that we continue to further understand how this metabolic disorder impacts the lung and how to prevent its complications.
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.
Background:
Systemic inflammation is associated with impaired lung function in healthy adults as well as in patients with lung disease. The mechanism for this association is unknown and it is unclear if systemic inflammation leads to impaired lung function or if poor lung function leads to inflammation. We explored the temporal associations between blood C-reactive protein (CRP), fibrinogen, and white blood cells, and lung function in young adults.
Methods:
Spirometry, plethysmography, and diffusion capacity were measured in a population-based cohort at ages 32 and 38 years. High-sensitivity CRP, fibrinogen, and white blood cells were measured at the same ages.
Results:
Higher levels of CRP and, to a lesser extent, fibrinogen were associated with lower lung volumes in cross-sectional analyses at both ages 32 and 38 years. Higher CRP and fibrinogen at age 32 were associated with higher FEV1 and FEV1/FVC at age 38, but not other measures of lung function. Lower lung volumes (total lung capacity, functional residual capacity, and residual volume) but not airflow obstruction (FEV1/FVC) at age 32 were associated with higher CRP at age 38. Associations between age 32 lung function and fibrinogen at follow-up were weaker, but consistent. There were no longitudinal associations between white blood cells and lung function.
Conclusions:
We found no evidence that systemic inflammation causes a decline in lung function. However, lower lung volumes were associated with higher CRP and fibrinogen at follow-up indicating that pulmonary restriction may be a risk factor for systemic inflammation. The mechanism for this association remains unclear.
Objectives:
Mild cognitive impairment (MCI) is a high-risk condition for progression to Alzheimer's disease (AD). Vascular health is a key mechanism underlying age-related cognitive decline and neurodegeneration. AD-related genetic risk factors may be associated with preclinical cognitive status changes. We examine independent and cross-domain interactive effects of vascular and genetic markers for predicting MCI status and stability.
Method:
We used cross-sectional and 2-wave longitudinal data from the Victoria Longitudinal Study, including indicators of vascular health (e.g., reported vascular diseases, measured lung capacity and pulse rate) and genetic risk factors-that is, apolipoprotein E (APOE; rs429358 and rs7412; the presence vs absence of ε4) and catechol-O-methyltransferase (COMT; rs4680; met/met vs val/val). We examined associations with objectively classified (a) cognitive status at baseline (not impaired congnitive (NIC) controls vs MCI) and (b) stability or transition of cognitive status across a 4-year interval (stable NIC-NIC vs chronic MCI-MCI or transitional NIC-MCI).
Results:
Using logistic regression, indicators of vascular health, both independently and interactively with APOE ε4, were associated with risk of MCI at baseline and/or associated with MCI conversion or MCI stability over the retest interval.
Discussion:
Several vascular health markers of aging predict MCI risk. Interactively, APOE ε4 may intensify the vascular health risk for MCI.
To identify how demographic factors (sex, age, ethnicity) modify the association between personality traits and body mass index (BMI) and to test the extent that diet and physical activity account for the personality-BMI relations.
Cross-sectional study with a diverse sample (N=5,150, 50% female, 19% African American, 15% Hispanic). Participants completed a measure of the five major dimensions of personality and reported on their physical activity, diet and food intake behavior, and height and weight.
BMI and obesity (BMI≥30) Results: High Neuroticism was associated with higher BMI and risk for obesity, whereas Conscientiousness and, to a lesser extent, Extraversion and Openness were protective. These associations were generally stronger among women and older participants; there was less evidence for ethnicity as a moderator. Personality had similar relations with the behavioral factors, and physical activity, diet, and regular meal rhythms accounted for approximately 50% of the association between Neuroticism and Conscientiousness and BMI.
This study supports the links between personality traits and BMI and suggests that physical activity, more than diet, is a key factor in these associations.
To investigate cross-sectional and longitudinal associations between personality and smoking, and test whether sociodemographic factors modify these associations.
Cross-sectional and longitudinal individual-participant meta-analysis.
Nine cohort studies from Australia, Germany, UK and US.
A total of 79,757 men and women (mean age = 51 years).
Personality traits of the Five-Factor Model (extraversion, neuroticism, agreeableness, conscientiousness and openness to experience) were used as exposures. Outcomes were current smoking status (current smoker, ex-smoker, and never smoker), smoking initiation, smoking relapse, and smoking cessation. Associations between personality and smoking were modeled using logistic and multinomial logistic regression, and study-specific findings were combined using random-effect meta-analysis.
Current smoking was associated with higher extraversion (odds ratio per 1 standard deviation increase in the score: 1.16; 95% confidence interval: 1.08-1.24), higher neuroticism (1.19; 1.13-1.26), and lower conscientiousness (0.88; 0.83-0.94). Among nonsmokers, smoking initiation during the follow-up period was prospectively predicted by higher extraversion (1.22; 1.04-1.43) and lower conscientiousness (0.80; 0.68-0.93), whereas higher neuroticism (1.16; 1.04-1.30) predicted smoking relapse among ex-smokers. Among smokers, smoking cessation was negatively associated with neuroticism (0.91; 0.87-0.96). Sociodemographic variables did not appear to modify the associations between personality and smoking.
Adult smokers have higher extraversion, higher neuroticism and lower conscientiousness personality scores than non-smokers. Initiation into smoking is positively associated with higher extraversion and lower conscientiousness, while relapse to smoking among ex-smokers is association with higher neuroticism. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
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 (≥3mg/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.
Background:
An association between reduced lung function and increased cardiovascular risk has been reported, but the underlying mechanisms are unknown. The aim of this study was to assess the heritability of lung function and to estimate its genetic association with arterial stiffness.
Methods:
150 monozygotic and 42 dizygotic healthy Hungarian and American Caucasian twin pairs (age 43 ± 17 years) underwent spirometry (forced vital capacity/FVC/, forced expiratory volume in 1 s/FEV1/; MIR Minispir, USA); and their brachial and central augmentation indices (AIx), and aortic pulse wave velocity (PWV) were measured by oscillometric Arteriograph (TensioMed Ltd, Budapest, Hungary). Phenotypic correlations and bivariate Cholesky decomposition models were applied.
Results:
Age-, sex-, country- and smoking-adjusted heritability of FEV1, percent predicted FEV1, FVC and percent predicted FVC were 73% (95% confidence interval /CI/: 45-85%), 28% (95% CI: 0-67%), 68% (95% CI: 20-81%) and 45% (95% CI: 0-66%), respectively. Measured and percent predicted FVC and FEV1 values showed no significant phenotypic correlations with AIx or aortic PWV, except for phenotypic twin correlations between measured FEV1, FVC with brachial or aortic augmentation indices which ranged between -0.12 and -0.17. No genetic covariance between lung function and arterial stiffness was found.
Conclusions:
Lung function is heritable and the measured FVC and FEV are phenotypically, but not genetically, associated with augmentation index, a measure of wave reflection. This relationship may in turn reveal further associations leading to a better mechanistic understanding of vascular changes in various airway diseases.
The five-factor model of personality is a hierarchical organization of personality traits in terms of five basic dimensions: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience. Research using both natural language adjectives and theoretically based personality questionnaires supports the comprehensiveness of the model and its applicability across observers and cultures. This article summarizes the history of the model and its supporting evidence; discusses conceptions of the nature of the factors; and outlines an agenda for theorizing about the origins and operation of the factors. We argue that the model should prove useful both for individual assessment and for the elucidation of a number of topics of interest to personality psychologists.