Associations of neuroticism with falls in older adults: do psychological factors mediate the association?

Abstract

Objectives

Neuroticism predicts falls in older people. In addition, concern about falling and depressive symptoms are associated with fall risk. This study examined whether concern about falling and depressive symptoms mediate the association between neuroticism and falls.

Method

Cross-sectional data on 314 community-dwelling people aged 70–85 years were utilized. Neuroticism was assessed with a short modified form of the Eysenck Personality Inventory. Indoor and outdoor falls during the past year were self-reported. Concern about falling was assessed with the Falls Efficacy Scale-International and depressive symptoms with the Geriatric Depression Scale-15. Path modeling was used to examine the associations between variables.

Results

Mediating pathways linking neuroticism and falls were found: neuroticism was positively associated with concern about falling, which was subsequently linked to indoor falls (indirect effect β = 0.34, p = 0.002) and recurrent outdoor falls (β = 0.19, p = 0.045). Moreover, a pathway from neuroticism to indoor falls through depressive symptoms was also found (β = 0.21, p = 0.054). In other words, higher neuroticism was associated with higher concern about falling and depressive symptoms, both of which were linked to falls. The associations were independent of age, sex, use of psychotropic, chronic diseases, persistent pain, physical performance, physical activity, and executive functioning that are known risk factors for falls.

Discussion

The results indicate that concern about falling and depressive symptoms mediate the association between neuroticism and falling. Longitudinal studies are needed to confirm the causality of the findings and to examine the potential to reduce falls by targeting concern about falling and depressive symptoms among older adults higher in neuroticism.

KEYWORDS:

• Aged
• cross-sectional studies
• accidental falls
• risk factors
• fear
• personality

Acknowledgements

We are grateful to all the PASSWORD participants who contributed their time and information. We also thank the staff members who helped with the PASSWORD data collection.

Additional information

Funding

This work was supported by the Academy of Finland (296843), and the Ministry of Education and Culture of Finland (OKM/49/626/2017, OKM/72/626/2018 OKM/92/626/2019).