Vol.5, No.12A, 86-96 (2013) Health
Personality factors and self-perceived health in
Chilean elderly population
Pedro Olivares-Tirado*, Gonzalo Leyton, Eduardo Salazar
Studies and Development Department, Superintendence of Health, Santiago, Chile;
*Corresponding Author: polivares@superdesalud.gob.cl
Received 15 October 2013; revised 16 November 2013; accepted 25 November 2013
Copyright © 2013 Pedro Olivares-Tirado et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Empirical evidence suggests that the stability of
personality itself contributes to successful age-
ing and is associated with longer life. The aim of
this study was to investigate the association be-
tween personality traits and the self-perceived
health status, stratified by medical conditions in
a representative sample of non-institutionalized
elderly people in Chile. The data used for this
study come from the fourth waves (2009) of the
Chilean Social Protection Survey (SPS-2009). In-
cluded were a total of 2655 subjec ts aged 65 and
over. The results showed that higher scores of
all five personality factors were associated with
good health. Those with the perception of poor
health were more likely to be female, with lower
education level and older than those with good
health. With the exception of agreeablen ess, strong
and significant associations with self-perceived
health were demonstrated for extraversion, con-
scientiousness, emotional stability and open-
ness, among elderly with medical conditions.
Among elderly without medical problems, sig-
nificant associations with self-perceived health
were demonstrated only for extraversion, agree-
ableness and emotional stability. This study has
shown that there is a consistent association
between personality factors and self-perceived
health throughout the older population. Our re-
sults suggest that extraversion and openness
traits could be acting as “protector” factors and
agreeableness and conscientiousness traits as
“resilient” factors, facing to the health problems
among elderly people.
Keywords: Serous Personality; Self-Perceived
Health; Ageing; TIPI Questionnaire
Along with most other nations, Chile is undergoing an
accelerated growth of older populations with the in-
creased life expectancies. By 2025, the proportion of
people aged 65 and over is expected to reach 14% of the
total population and more than one million will be per-
sons aged 75 or more in Chile [1]. With the moderniza-
tion of the society and socioeconomic development in
the last 3 decades, the cultural values and the family
structure have been modified. Furthermore, values, be-
liefs and preferences of the elderly themselves have been
changing, and the current older generations tend to have
a stronger desire for autonomy and independence. Thus,
in this changing society, it is important to examine life
conditions of older people to better understand their ad-
aptation to the aging process and consequences on their
health and wellbeing.
Interest in the association between personality charac-
teristics and health has been renewed in recent years.
Studies have shown a strong association between per-
sonality characteristics and health suggesting that per-
sonality traits could contribute to self-perceived health,
health outcomes and longevity [2,3]. It has also been
shown that self-perception of health has shown its sig-
nificant ability to predict a variety of outcomes, includ-
ing service utilization, emotional distress, morbidity and
mortality [4-6].
Increased empirical evidence shows that personality in
terms of enduring dispositions remains stable after ap-
proximately age 30, exerting fairly generalized effects on
human behavior and constituting an important determi-
nant of psychological well-being in old age [7-9]. It is
suggested that the stability of personality itself contrib-
utes to successful ageing by allowing the individual to
plan the future [10], enhance their health-related quality
of life, prevent the disease progression [11] and even is
associated with longer life [3].
Personality constructs deserve special consideration
Copyright © 2013 SciRes. OPEN ACCESS
P. Olivares-Tirado et al. / Health 5 (2013) 86-96 87
when attempting to predict individual differences in be-
haviors. One of the current, predominant frameworks of
the personality is the five-factor model (FFM). The FFM
is a comprehensive, empirical, data-driven research find-
ing [12]. The five-factor model has emerged as an im-
portant taxonomy of global personality traits and appears
to hold a great promise for investigations of correlation
between the personality and various behaviors because of
its robustness and parsimony [13-15].
The five-factor model of personality is a hierarchical
organization of personality traits in terms of five broad
bipolar domains or dimensions that are defined by clus-
ters of interrelated specific traits: extraversion, agree-
ableness, conscientiousness, neuroticism, and openness
to experience. These five overarching domains have been
found to contain and subsume most known personality
traits and are assumed to represent the basic structure
behind all personality traits. Extraversion describes de-
grees of interpersonal interactions. Agreeableness esti-
mates the quality of interpersonal orientation. Conscien-
tiousness estimates motivation in goal-directed behavior.
Neuroticism measures degrees of emotional stability.
And openness to experience estimates the willingness to
accept novel ideas [16].
These five factors provide a rich conceptual frame-
work for integrating all the research findings and theory
in the personality psychology [17]. All five factors were
shown to have convergent and discriminant validity acro-
ss instruments and observers, and to endure across dec-
ades in adults [13,14]. The most frequently used meas-
ures of the five factors comprise either items that are
self-descriptive sentences [18] or items that are single
adjectives in the case of lexical measures [19]. A research
using both self-descriptive sentences and lexical meas-
ures supports the comprehensiveness of the FFM model
and its applicability across observers and cultures [13].
The advantages and limitations of the five-factor mo-
del of personality as an integrating framework for studies
of personality and health had been widely discussed. Al-
though the FFM model has some potential limitations,
the application of this method—as well as other aspects
of current personality theory and research—is likely to
facilitate progress in the study of how personality influ-
ences health. Personality attributes have been shown to
mediate health-related behaviors and health outcomes
On the other hand, self-perceived health (SPH) is one
of the most commonly used psychometric indicators in
health surveys. SPH has often been thought of as meas-
uring only “subjective” health, the opposite to physi-
cian-rated health, which is considered as an “objective”
measurement. However, in several longitudinal studies,
SPH has been found to be a good predictor for survival
and for future health outcomes even better than a physi-
cian’s assessment [25-32]. SPH is a reliable and valid
measure for assessing the subjective and objective health
of individuals and in a large-scale survey [5,25,33,34].
Since elderly people are prone to several health prob-
lems which have physical, psychological and social com-
ponents, self-perceived health is an important factor in
old age. Self-perceived health has been extensively stud-
ied in older populations. A range of important factors
such as chronic diseases, mortality, health care utiliza-
tion, long-term care utilization and health-related quality
of life have been associated with self-perceived health in
the elderly population [26-32,35-38].
Some authors have reported that old people perceive
their health in positive terms and tend to over-estimate
their health compared with objective health measure-
ments [32,39-44]. Other data support the view that eld-
erly people are more pessimistic in their perceptions of
their own health than younger people, even after control-
ling for objective health conditions [45,46]. It is possible
that these differences are explained at least partly, by the
individual personality traits.
On the other hand, the association of some socio-
demographic variables or medical conditions with SPH
of the elderly people has varied in previous studies. Eld-
erly men tend to report poorer health than elderly women
for similar objective health conditions [40,42,47]. Poor
education and low socio-economical status are associated
with poor self-rated health [39,44,48]. The number of
symptoms and medical conditions, depression, heart dis-
ease, stroke decreased functional capacity and sensory
problems all correlate positively with low self-rated
health in elderly [26,39-44,47].
The purpose of this study was to investigate the asso-
ciation between personality traits and the perceived
health status in a representative sample of the older
Chilean population. The evaluation of personality traits
was based on the FFM model, and measured with the
Questionnaire of Personality TIPI (Ten-Item Personality
Inventory). The self-perceived health evaluation was
based on the question of the European Union Statistics
on Income and Living Room Conditions [49]: “How is
your health in general?” To the best of our knowledge,
this is the first study to investigate the role of personality
traits in explaining variations in self-perceived health in
the elderly Chilean population.
2.1. Data & Participants
The data used for this study comes from the fourth
(2009) waves of the Chilean Social Protection Survey
(SPS). The SPS is a nationally and regionally representa-
tive household survey that contains extensive individual
information about participation in the labor market and
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P. Olivares-Tirado et al. / Health 5 (2013) 86-96
in the social protection system, as well as socioeconomic
characteristics. It also contains a detailed set of health
and wealth questions, as well as questions that measure
the financial knowledge of respondents and their level of
risk aversion. The SPS contains longitudinal data for a
sample of 20,000 individuals firstly interviewed in 2002,
with follow-ups in 2004, 2006 and 2009 [50].
The fourth wave of the SPS was fielded between April
and December of 2009. The overall response rate was
76.5% on a sample of 19,512 peoples. Thus, the fourth
wave of the SPS-2009 contains longitudinal data for
14,463 individuals [50]. In the SPS elderly people were
oversampling to enhance the likelihood to build a sample
with sufficient representation of this age group. The
study sample corresponds to 2655 subjects aged 65 and
2.2. Measures
2.2.1. Personality Traits
The evaluation of personality traits was based on the
FFM model, and measured with the Questionnaire of
Personality TIPI (Ten-Item Personality Inventory) de-
veloped by Gosling, Renfro & Swann [51]. The TIPI
questionnaire is a validated short-form for use in applied
research settings where questionnaire space and respon-
dent time are limited [51]. TIPI is a standard 10-item
measure of the Big-Five personality dimensions. Each
item consists of two descriptors, separated by a comma,
using the common stem, ‘‘I see myself as:’’. Two sepa-
rate items together covered the breadth of each domain
including the high (+) and low() poles. The resulting
five dimension were: Extraversion [(+): extraverted, en-
thusiastic/(): reserved, quiet], Agreeableness [(+): sym-
pathetic, warm/(-): critical, quarrelsome], Conscien-
tiousness [(+): dependable, self-disciplined/(): disorgan-
ized, careless], Emotional stability [(+): calm, emotion-
ally stable/(): anxious, easily upset] and Openness to
experience [(+): open to new experience, complex/():
conventional, uncreative]. Each item is rated on a 7-point
scale that ranges from 1 (disagree strongly) to 7 (agree
strongly). To score TIPI scales, items 2, 4, 6, 8, and 10
are reversed-scored (i.e., recode a 7 with 1, a 6 with 2, a
5 with 3, etc) and then, take the average of the two items
(the standard item and the recoded reverse-scored item
(R)) that make up each scale. Extraversion: item 1, 6R;
Agreeableness: 2R, item 7; Conscientiousness: item 3,8R;
Emotional stability: 4R, item 9 and Openness to experi-
ence: item 5,10R (51). This variable was included as a
continuous variable with one decimal.
2.2.2. Self-Perception of Health
Self-perception of health status was assessed with a
Likert-scale item question based on EU-SILC question
on self-perceived health (“How is your health in gen-
eral?”), which contains six answering categories; 1) ex-
cellent; 2) very good; 3) good; 4) fair; 5) poor and 6) very
poor. The European Union Statistics on Income and Liv-
ing Conditions (EU-SILC, 2003) question on selfper-
ceived health is part of the Minimum European Health
Module (MEHM), which is also included in the Euro-
pean Health Interview Survey (EHIS). Self-perceived
general health (based on EU-SILC data) is one of the
indicators of the health and long term care developed
under the Open Method of Coordination (OMC) [49].
This variable was aggregated into two categories: good
health (i.e., excellent, very good and good) and poor
health (i.e., poor and very poor). Given that “fair” con-
cept, is generally evasive and ambiguous in Chilean
idiosyncrasy, fair category was excluded of the analysis.
2.2.3. Medical Conditions
It is clear that physical illness and mental disorders in-
fluence self-perception of health.
One of the health questions (f38) in the SPS-2009,
contribute to the evaluation of health problems and con-
sequently with the burden of diseases at the population
level. Individuals were asked to report whether they had
specific diseases diagnosed by a physician, in the list on
a yes/no format. The list of diseases includes eleven
chronic diseases and conditions commonly found among
older populations i.e.; respiratory problems, depression,
diabetes, high blood pressure, cardiac problems, cancer,
arthritis/arthrosis, kidney/urinary problems, stroke and
mental disorders. With the exception of HIV/AIDS, the
total number from the list was used for the analysis.
2.2.4. Socio-Demographics Features
With the purpose to adjust for potential confounders,
variables as; age, gender, educational level and marital
status were included in the analysis. Age (years) was
included as a continuous variable, gender as a dichoto-
mous variable (0 = male, 1 = female), educational level
as a categorical variable with 3 levels; primary (include-
ing illiterates), high school and university level (include
ing post-degree) and marital status as a categorical vari-
able with 4 levels: single, married, divorced and wid-
2.2.5. Statistical Analysis
One-way ANOVAs were used to compare each dimen-
sion of the personality between those with good and poor
self-perceived health. The Mantel-Haenszel chi-square
test was utilized to study the lineal associations between
prevalence of self-reported health problems and self-
perceived health status. A binary logistic regression was
used to examine the association between personality
traits and prevalence of self-reported health problems.
Multivariate Analysis of Variance (MANOVA), with the
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P. Olivares-Tirado et al. / Health 5 (2013) 86-96
Copyright © 2013 SciRes. OPEN ACCESS
Wilks-Lambda statistics, was used to study personality
factors between those with self-perceived health good
and poor health in both strata; with and without medical
conditions. All the 5 personality dimensions were ana-
lyzed simultaneously. Age, gender, education and marital
status were incorporated as covariates. The results were
presented as adjusted means and standard errors (S.E.)
evaluated at the mean for the covariates in the total sam-
ple. All analyses were conducted using the SAS software,
version 9.1 for Windows (SAS Institute Inc.).
3.1. Descriptive Statistics
Table 1 shows socio-demographic, health and person-
ality characteristics for the whole sample. From the 2655
participants, 36% (961 cases) had good health. About
43% (1147cases) and 21% (547 cases) of the sample had
either fair health or poor health, respectively.
Mean age for the whole sample was 74 years. Fifty-
one percent of the whole sample was females and 10.6%
illiterates. Among those with good health; 44% were
females, the mean age was 73 years, 8.7% had superior
education level and 54.3% were married. The corre-
sponding figures for those with poor health were; 60%,
75 years, 1.6% and 54.2%, respectively.
As shown in Table 1, the prevalence of medical prob-
lems increased with the decline in level of the selfper-
ceived health among all conditions queried. With the ex-
ception of high blood pressure, differences between good
and poor health groups were highly significant (p <
0.0001). Table 1, also depicts means and standard devia-
tions of all TIPI domain scores. For the whole sample,
people who reported a good health had better scores in
all TIPI personality dimensions than those reported a
poor health.
Table 1. Descriptive socio-demographic, medical condition and personality traits by self-perceived health (n: 2655).
self-perceived health
Poor/very poor (n: 547) Fair (n:1,147) Excellent/very good/good (n:961)
Age (mean, std) 75 (7.46) 74 (7.05) 73 (6.60)
Gender (% female) 60% 53% 44%
Educational level (%)
Primary 77.9% 75.0% 57.6%
High school 18.5% 22.0% 33.7%
Superior 1.6% 3.0% 8.7%
Marital status (%)
Single 10.5% 11.3% 11.6%
Married 54.2% 55.2% 54.3%
Divorced 5.5% 5.0% 7.6%
Widowed 29.8% 28.5% 26.5%
Medical conditions (% with condition)
Respiratory problems 17.4% 9.0% 2.9%
Depression 20.8% 10.5% 3.3%
Diabetes mellitus 30.0% 20.3% 10.1%
High blood pressure 68.2% 60.5% 39.9%
Cardiac problems 27.6% 17.6% 5.3%
Cancer 7.3% 2.7% 2.1%
Arthritis/arthrosis 36.2% 21.7% 10.4%
Kidney/urinary diseases 10.2% 3.6% 1.6%
Stroke 2.7% 0.4% 0.2%
Mental disorders 3.3% 0.9% 0.4%
Personality scale(TIPI) (mean, std)
Extraversion 3.7 (1.52) 3.8 (1.46) 4.2 (1.45)
Agreeableness 5.1 (1.37) 5.3 (1.31) 5.2 (1.34)
Conscientiousness 5.4 (1.33) 5.6 (1.32) 5.7 (1.31)
Emotional stability 4.8 (1.41) 5.1 (1.35) 5.1 (1.36)
Openness 3.9 (1.39) 4.1 (1.44) 4.3 (1.52)
P. Olivares-Tirado et al. / Health 5 (2013) 86-96
3.2. Personality Factors and So
Cio-Demographics Characteristics
For the whole sample, women had higher mean scores
of extraversion, agreeableness and openness than the
men. In turn, men had higher means scores of conscien
tiousness and emotional stability than women. With ex-
ception of openness (p = 0.05), there were no significant
differences in mean personality trait scores between
women and men (not shown).
For the whole sample, an increasing association level
was observed between the gradient of education levels -
lower to higher education- and extraversion (p = 0.02),
conscientiousness (p = 0.104) and openness (p = 0.002).
There were no significant differences in mean scores of
agreeableness and emotional stability among education
levels (not shown).
For the whole sample, there were no significant asso-
ciation between personality trait scores and marital status.
However, single individuals shown higher mean scores
of conscientiousness (mean: 5.6), emotional stability
(mean: 4.9), and openness (mean: 4.5). Married subjects
shown higher mean scores of extraversion (mean: 4.2)
and good scores of conscientiousness (mean: 5.5), agree-
ableness (mean: 5.1), emotional stability (mean: 4.9) and
openness (mean: 4.9).Widowed individuals shown simi-
lar pattern than single individuals, excepting agreeable-
ness (mean: 5.2) where they were the best scored. Di-
vorced individuals showed the worse personality traits
scores (not shown).
3.3. Personality Factors and Medical
Conditions (Morbidity)
For the whole sample, there were no significant dif-
ferences in mean scores of extraversion, conscientious-
ness, emotional stability and openness between subjects
with and without medical conditions. However, those
with medical conditions showed agreeableness mean
score significantly better than individuals without medi-
cal conditions (5.16 vs 5.02, p = 0.02). After adjustment
for socio-demographic factors the association between
agreeableness and reported medical conditions remained
significant (OR: 1.081, 95% CI: 1.004-1.165) (not
Separate analysis for medical conditions and after ad-
justing for socio-demographic factors, there were no sig-
nificant associations between personality traits and respi-
ratory problems, high blood pressure, cardiac problems,
cancer, arthritis/arthrosis and kidney/urinary illness (Ta-
ble 2).
The level of extraversion and emotional stability
(neuroticism) among those with depression was signifi-
cantly lowers, compared to those without depression. On
the other hand, a lower score of agreeableness was sig-
nificant associated with diabetes compared with those
without this medical condition. The level of conscien-
tiousness among those with mental disorder was signifi-
cantly lower, compared to those without mental disorders.
Finally, the level of openness among those with stroke
was significantly lower, compared to those without
stroke (Table 2).
3.4. Personality Factors, Medical Conditions
and Self-Perceived Health
The results of the ANOVA shows relationships be-
tween each of the individual items of the personality in-
ventory and self-perceived health in both strata; with and
without medical conditions are presented in Table 3.
Without adjustment for socio-demographics factors, and
with the exception of agreeableness all of the other per-
sonality dimensions were significantly associated with
self-perceived health in those who reported medical con-
ditions. On the other hand, in those without medical con-
ditions just extraversion and emotional stability were
significantly associated with self-perceived health.
Among those with and without medical conditions,
comparing individual self-perception of health, those
with perception of poor health were more likely to be
female. Mean age of individuals with perception of poor
health was higher than among those with good health.
Higher education level was significantly associated with
good health.
The results of the MANOVAs are exhibited in Table 4.
The overall MANOVAs were highly significant both
among those with and without medical conditions. After
adjustments for socio-demographic factors, all personal-
ity traits except for agreeableness, were significantly
associated with self-perceived health among those with
medical conditions. Among those without medical condi-
tions, and after adjustments; extraversion, agreeableness
and emotional stability were significantly associated with
self-perceived health.
Of interest, three personality traits—conscientiousness,
emotional stability and openness—that were significant
among those with medical conditions and good self-
perceived health, showed higher mean scores than those
with perception of good self-perceived health among tho-
se without medical conditions.
The present study focused on the comprehensive five-
factor model of personality and self-perceived health
among subjects with and without medical conditions, in a
nationally representative sample of elderly people. To
our knowledge, this is the first study in Chile to observe
an association between personality traits and self-per-
ception of health in a community-based elderly popula-
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P. Olivares-Tirado et al. / Health 5 (2013) 86-96 91
Table 2. Adjusted OR (95% CI) for personality traits among elderly with and without medical conditions (n: 1914).
Extraversion Agreeableness Conscientiousness Emotional stability Openness
Respiratory problems
without 1.00 1.00 1.00 1.00 1.00
with 0.93 (0.836-1.028) 1.10 (0.964-1.246) 0.91 (0.806-1.024) 1.00 (0.889-1.131) 1.01 (0.904- 1.122)
without 1.00 1.00 1.00 1.00 1.00
with 0.87 (0.787-0.952)** 1.03 (0.918-1.162) 1.04 (0.929-1.172) 0.87 (0.777-0.967)** 1.00 (0.901-1.098)
without 1.00 1.00 1.00 1.00 1.00
with 1.01 (0.935-1.086)
0.92 (0.841-1.008)* 1.01 (0.919-1.099) 0.99 (0.907-1.077) 1.03 (0.957-1.117)
High blood pressure
without 1.00 1.00 1.00 1.00 1.00
with 0.96 (0.892-1.039) 0.98 (0.888-1.072) 1.00 (0.916-1.102) 0.99 (0.907-1.083) 0.99 (0.914-1.071)
Cardiac problems
without 1.00 1.00 1.00 1.00 1.00
with 0.98 (0.903-1.063) 0.93 (0.839-1.023) 0.96 (0.875-1.061) 1.00 (0.913-1.103) 0.98 (0.901-1.070)
without 1.00 1.00 1.00 1.00 1.00
with 0.96 (0.826-1.117) 1.04 (0.865-1.252) 1.05 (0.871-1.260) 0.92 (0.776-1.093) 1.02 (0.870-1.185)
without 1.00 1.00 1.00 1.00 1.00
with 0.96 (0.890-1.032) 1.04 (0.946-1.140) 1.00 (0.915-1.098) 0.97 (0.892-1.059) 1.04 (0.958-1.119)
Kidney/Urinary Problems
without 1.00 1.00 1.00 1.00 1.00
with 0.91 (0.790-1.049) 0.89 (0.753-1.051) 0.99 (0.840-1.166) 1.01 (0.855-1.181) 1.05 (0.905-1.214)
without 1.00 1.00 1.00 1.00 1.00
with 1.10 (0.787-1.542) 0.85 (0.576-1.246) 1.02 (0.706-1.486) 0.77 (0.538-1.110) 0.66 (0.457-0.963)**
Mental Disorders
without 1.00 1.00 1.00 1.00 1.00
with 0.87 (0.644-1.163) 0.79 (0.573-1.100) 0.73 (0.541-0.976)** 0.79 (0.580-1.085) 0.89 (0.642-1.228)
Adjustment for age, gender and education level. **p < 0.05;*p < 0.1.
Table 3. Personality scores among elderly with and without medical conditions associated to self-perceived health.
With Medical conditions Without Medical conditions
Self-perceived health Self-perceived health
Good (n:496) Poor (n:503) p-value Good (n:465) Poor (n:44) p-value
Age (years, SD) 73 (6.38) 75 (7.29) 0.0001 72 (6.78) 78 (9.02) <0.0001
Gender(% female) 51.4% 61.2% 0.002 35.3% 54.6% 0.01
Education level (%) <0.0001 0.001
Primary 57.4% 78.8% 57.9% 87.5%
High school 32.7% 19.6% 34.9% 10.0%
Superior 9.9% 1.6% 7.2% 2.5%
Marital status (%) NS NS
Single 11.6% 9.6% 11.7% 20.5%
Married 52.4% 54.6% 56.1% 50.0%
Divorced 7.1% 5.8% 8.2% 2.3%
Widowed 28.9% 30.0% 24.0% 27.2%
TIPI Scales( una djusted mean, SD)
Extraversion 4.23 (1.446) 3.76 (1.515) <0.0001 4.17 (1.465) 3.49 (1.522) 0.008
Agreeableness 5.24 (1.319) 5.14 (1.360) NS 5.23 (1.359) 4.93 (1.531) NS
Conscientiousness 5.75 (1.260) 5.43 (1.341) 0.0001 5.59 (1.362) 5.21 (1.244) NS
Emotional stability 5.19 (1.376) 4.78 (1.418) <0.0001 5.10 (1.335) 4.51 (1.216) 0.01
Openness 4.34 (1.508) 3.84 (1.390) <0.0001 4.25 (1.528) 3.98 (1.462) NS
NS: no significant.
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P. Olivares-Tirado et al. / Health 5 (2013) 86-96
Table 4. Adjusted Personality scores among elderly with and without medical conditions associated to self-perceived health (MANO-
VA Analysis).
With Medical conditions Without Medical conditions
Self-perceived health self-perceived health
Good (n:496) Poor (n:503)p-value Good (n:465) Poor (n:44) p-value
Extraversion 4.29 (0.094) 3.87 (0.110) <0.0001 4.31 (0.116) 3.72 (0.296) 0.0380
Agreeableness 5.15 (0.085) 5.02 (0.100) NS 5.21 (0.109) 4.67 (0.277) 0.0459
Conscientiousness 5.81 (0.081) 5.56 (0.096) 0.0049 5.73 (0.108) 5.43 (0.275) NS
Emotional stability 5.08 (0.089) 4.64 (0.105) <0.0001 4.95 (0.106) 4.33 (0.270) 0.0191
Openness 4.50 (0.091) 4.13 (0.108) 0.0002 4.50 (0.116) 4.51 (0.296) NS
Overall MANOVA: Wilks Lambda = 0.947, df = 5,
den df = 896, F = 10.03 p = < 0.0001
Wilks Lambda = 0.975, df = 5, den df = 450,
F = 2.30 p = 0.044
Adjusted for age, gender, educational level & marital status.
tion. The major contribution of this study is its support
for the notion that personality is associated with subjec-
tive health in older people, independent of potential con-
founding effects of the socio-demographic and medical
As proposed by Contrada et al. (1999), the link be-
ween personality and health may reflect three different
though overlapping processes. First, personality traits are
associated with factors that cause disease. Second, per-
sonality may lead to behaviors that protect or diminish
health. Last, personality traits are related to the success-
ful implementation of health-related coping behaviors and
adherence to treatment regimens [52]. Data from several
studies indeed suggest that high scores in the extraver-
sion and conscientiousness and low scores in neuroticism
are among the best predictors of well-being, health and
longer life in old age [3,24,53-55]. While the extraver-
sion has been found to be linked to the positive health
behavior, to good perceived health to longer life [3,56],
neuroticism has been associated with more reports of
psychological symptoms, poorer perceived health and a
lower level of psychological well-being [57-59]. A large
body of evidence suggest that conscientiousness was
associated with positive health behaviors, health-pro-
moting activities, adherence to medical regimens and the
resilience face to adversity [21,25,60-66].
For the whole sample, after adjustment for socio-
demographic factors, our results indicate that mean
scores of agreeableness, conscientiousness and emotional
stability among those with medical problems were higher
than among those without medical conditions. However,
the mean difference was significant for agreeableness
and marginally significant (p = 0.08) for conscientious-
ness. On the other hand, mean scores of extraversion and
openness were higher among elderly without medical
conditions. These differences were significant. Thus, our
results suggest that extraversion and openness traits
could be acting as “protector” factors and agreeableness
and conscientiousness traits as “resilient” factors, face to
the health problems among elderly people.
After stratifying for medical conditions and control-
ling for socio-demographic variables, our results indicate
that personality traits show relevant associations with
self-perception of health. In both strata with and without
medical conditions, higher levels of all five personality
factors were associated with good health. Strong and
significant associations with self-perception of health
were demonstrated for extraversion, conscientiousness,
emotional stability and openness, among elderly people
with medical conditions. No association was found be-
tween agreeableness and perception of health among
those with medical problems. On the other hand, among
elderly people without medical problems, significant
associations with self-perception of health were demon-
strated for extraversion, agreeableness and emotional
stability. No association was found between conscien-
tiousness, openness and perception of health among
those without medical problems. Our results are consis-
tent with findings by Godwyn & Engstrom (2002) that
personality factors show strong and significant associa-
tions with self-perception of health, independent of
physical and mental health problems.
In the present study, independent of individual medical
conditions there was a significant positive association
between extraversion and self-perceived health in both
bivariate and multivariate analysis. In other words, indi-
viduals with higher scores of extraversion were likely to
perceive their own health better. This finding is consis-
tent with prior studies on older people that suggest that
high scores in extraversion are among the best predictors
of well-being and health in old age [24,54-56]. Moreover,
individuals who score high on extraversion are prone to
the physical active lifestyle [67]. Extraversion factor is
considered as a protector factor of mortality [6] and as-
sociated with decreased level of impairment among eld-
erly people with the physical illness [21].
A positive association between conscientiousness and
good perceived health was demonstrated among elderly
people with medical problems. Our findings are in line
with recent research from Goodwin et al. (2006), sug-
Copyright © 2013 SciRes. OPEN ACCESS
P. Olivares-Tirado et al. / Health 5 (2013) 86-96 93
gesting consistent linkages between conscientiousness
and improved health outcomes and functional health
status among adults with physical illnesses, compared
with those lower on conscientiousness. Conscientious-
ness is often considered to have exclusive beneficial ef-
fects on health outcomes [68]. A possible explanation for
this association is that conscientious people may also be
more able to cope with stressful life events, be more
likely to monitor their health, high adherence to the pre-
scribed medication [66] or more likely to maintain stable
marriages and other social support networks which relate
to their health [69].
The association between neuroticism and self-percep-
tion of health was highly significant among those with
medical problems and slightly attenuated among those
elderly without medical problems. In other words, indi-
viduals with lower scores of emotional stability were
likely to perceive their self-perceived health worse.
These findings are not surprising, given the well docu-
mented association between neuroticism/negative affec-
tivity and self-perception of poor health in clinical sam-
ples [20,70] and as a strong predictor of psychological
well-being in old age [52,71-73]. Our findings also pro-
vide support for the suggestion from Goodwyn & Eng-
strom (2002) that neuroticism increases the likelihood of
perceived poor health even in the absence of medical
Openness has been related to the cognitive ability [74]
which is well known as a predictor of longevity inde-
pendent of a person’s social position [75] and a protector
factor of premature mortality in adults over 55-year-old
[69]. However, some studies question the over-rated role
of openness and extraversion (emotional reactivity) as
long-term predictors for adaptation and health in old age
[9,55]. Our results show that the association between
openness and self-perception of health among those eld-
erly with medical problems was highly significant. It is
likely that this relationship may be explained by the cog-
nitive ability which may be acting as a relevant factor in
the adaptation process at illness-resilience—in elderly
people. This finding confirms results from Goodwyn
(2002) that there is a striking association between open-
ness and perception of health.
The association observed between agreeableness and
self-perception of health among those elderly without
medical problems, was significant in the multivariate
analysis. No association was found among those with
medical problems. These data are inconsistent with find-
ings by Goodwyn & Engstrom (2002) that there is no
association between agreeableness and perception of
health among adults without health problems. Also,
Goodwyn & Friedman (2006) didn’t find the association
between the agreeableness and the level of impairment
among adults with physical illness. A possible explana-
tion to this finding may be psychometrics difficulties to
evaluate agreeableness dimension with only few de-
scriptors [76]. Another explanation may be, given that
agreeableness traits involve the quality of interpersonal
orientation more than personal endurance. Those indi-
viduals who are altruist, caring, sympathetic, warm or
emotional supporter have a higher level of psychological
well-being. Consequently, their perceived health is better
when they are healthy than they are facing medical
This study has several limitations, which should be
considered when interpreting results. First, the informa-
tion on medical conditions was self-report. However, the
majority of community-based studies that examine the
relationship between self-perceived health and other out-
comes use self-reported health problems [5]. Therefore,
we believe this measure would provide a reasonable es-
timate of medical disorders for the current study. Sec-
ondly, self-perceived health construct (SPH item struc-
ture) could be biased to an optimist pole, given that only
two over 6 options have negative meanings. Thirdly, the
number of medical and mental disorders queried is lim-
ited and included as dichotomy responses. Then it is pos-
sible that other disorders or severity of queried disorders
may affect these relationships. However, the disorders
that were asked about are consistent, in number and type,
with those used in previous studies [5]. Lastly, a small
sample of individuals with poor health in the strata with-
out medical conditions is likely affecting some results in
the statistical analysis of personality traits in this strata.
In conclusion, the association between personality
factors and self-perceived health is a consistent relation-
ship throughout the older population. The analysis of
personality traits could be used to guide the effort to raise
the quality of public health interventions promoting the
engagement of elderly people in behaviors that promote
or protect health or functioning, to improve health out-
comes and quality of life in old age. Future studies that
investigate whether personality factors explain the rela-
tionship between health problems and/or disability with
self-perception of health or other health or well-being
outcomes in elderly people are needed to improve our
understanding of these associations. Further, other stud-
ies that investigate gender differences and the overlap
effects (interactions) of personality traits on
self-perceived health must be necessary.
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