@article{e5f117ad0a7d496380e7af0a9b675318,
title = "Trajectories and personality correlates of change in perceptions of physical and mental health across adulthood and old age",
abstract = "Subjective health is known to predict later outcomes, including survival. However, less is known about subjective health changes across adulthood, how personality moderates those changes, and whether such associations differ with age. We applied growth models to 10 waves of data from the Household, Income and Labour Dynamics in Australia Survey (HILDA, N = 7,172; median ages 20-93) to examine age-related differences in trajectories of subjective physical and mental health. On average, perceptions of physical health declined with increasing steepness in old age, whereas self-rated mental health remained relatively stable across all ages. Higher neuroticism and lower extraversion and conscientiousness were each related to less successful aging. The health implications of personality did not differ by age for physical health, but were weaker for mental health in old age. We discuss implications of our results for accelerated longitudinal designs and consider avenues for future more mechanism-oriented research.",
keywords = "adulthood and old age, growth curve model, longitudinal, self-rated health, well-being",
author = "Jennifer Morack and Infurna, {Frank J.} and Nilam Ram and Denis Gerstorf",
note = "Funding Information: We note several limitations of our study. First, as with most large-sample studies the specific measures available have some shortcomings. For example, health is a multidimensional construct including objective indicators such as medical diagnoses and subjective indices such as self-ratings. With only moderate overlap among these indices ( Steinhagen-Thiessen & Borchelt, 1999 ), our findings based on changes in self-ratings may not generalize to more objective markers of health. Specifically, we note that the SF-36 may not be an ideal measure of mental and physical health because it is geared towards primarily assessing negative health aspects rather than positive ones such as well-being (e.g. emotional well-being, life satisfaction). In a similar vein, personality was measured only once in the HILDA, thereby not allowing us to examine how changes in personality and more broadly, psychological factors, are linked to changes in health ( Infurna, Ram, & Gerstorf, in press ; Mroczek & Spiro, 2007 ; Turiano et al., 2012 ). Following the same “trait” assumption underlying the single-occasion measurement of personality, we used a single-occasion measure of negative life events, a decision that precluded examining how fluctuations in experience of negative life events may affect health trajectories. In some cases, the response scale was also limited. For example, the measure of disability was dichotomous, and thus did not distinguish severity of disability or allow for examining how severity was related to health. Second, although our study describes how personality and age are related to adults{\textquoteright} health trajectories, we have not drilled into or explored the specific mechanisms through which these factors influence health. Further studies addressing such pathways are warranted, including examination of how health behaviours, physiological arousal, or social support mediate the effects noted here. Third, the relatively low number (only 10) and frequency (only yearly) of within-person assessments did not permit modeling of discrete shifts and change points in individual-level health trajectories. More closely spaced assessments would allow for a wider variety of change models (non-linear trajectories with many changes in direction), potential identification of individual-level timing of onset of health declines (e.g. second analysis in Gerstorf et al., 2008 ), and better opportunity to examine the interplay between physical and mental health, to identify time-varying predictors and to examine time-varying effects. Fourth, the data used here, obtained from a nationally representative sample of the population, certainly improves upon the predominantly cross-sectional studies on this topic, but an ideal study would follow individuals over a much longer time period and thoroughly track individual-level development across large parts of adult life. Finally, although the effects were small ( R 2 < .005), differences were found between participants providing more data (e.g. 6+ waves) compared to participants who provided less data (e.g. 5 or less waves). As a consequence, selective attrition of people in worse health needs to be taken into account when interpreting our findings. To conclude, our study represents an effort to better understand the vastly different long-term change trajectories of self-rated physical and mental health across adulthood and old age. Data from a national sample in a highly developed nation indicate that typical declines in perceived physical health are apparent throughout adulthood, whereas typical mental health remains relatively stable across adulthood. By more precisely understanding the health changes occurring in adulthood, we can better know when to intervene, and better inform public policy and programs as to when and how resources would be most needed to improve the health and well-being of individuals. We have also shown that personality factors may serve as protective factors against or risk factors for health declines. Of particular note is that some of these associations differ with age and this helps us to know which characteristics of individuals to target for health interventions (e.g. the ones that have greater health implications with age). Our study thus provides further impetus for research targeting the underlying pathways and processes involved in the emergence of health disparities during adulthood. Funding The first author was supported by a fellowship from the ISSBD (International Society for the Study of Behavioural Development-Jacobs Foundation Mentored Fellowship for Early Career Scholars). The authors are grateful for the support provided by the National Institute on Aging (Grants RC1 AG035645, R21-AG032379 and R21-AG033109). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. ",
year = "2013",
month = nov,
doi = "10.1177/0165025413492605",
language = "English (US)",
volume = "37",
pages = "475--484",
journal = "International Journal of Behavioral Development",
issn = "0165-0254",
publisher = "SAGE Publications Ltd",
number = "6",
}