The Personality Domains and Styles of the Five-Factor Model are Related to Incident Depression in Medicare Recipients Aged 65 to 100

Objectives: Few prospective studies have examined personality and depression in older adults. The authors investigated whether the Five-Factor Model of personality traits Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness-and trait combinations ( styles) are related to incident major or minor depression. Participants/Setting: Prospective data were gathered on a community sample of 512 older adults with disability and a history of significant health care utilization who were enrolled in a Medicare Demonstration Project. Measurements: Depression and personality traits and styles were assessed at baseline; depression was assessed again at approximately 12 and 22 months. Design: Participants who developed incident major depression were compared with those free of depression at all three assessments. Similar analyses were done for minor depression. Results: High Neuroticism and low Conscientiousness were risk factors for both major and minor depression. Combinations of high Neuroticism with low or high Extraversion or high Openness conferred risk for major depression. Other novel findings for major depression revealed new trait combinations of low Conscientiousness with low or high Extraversion, high Openness, or low Agreeableness. Three trait combinations, all involving low Conscientiousness, predicted risk for minor depression: high Neuroticism, high Agreeableness, and low Openness. Conclusion: The present findings highlight the importance of examining combinations of personality traits or personality styles when identifying those who are most at-risk for geriatric depression. Since other personality domains may modify the risk related to high Neuroticism and low Conscientiousness, the prevention, diagnosis, and treatment of depression could be greatly improved by assessing older patients not only on all five domains of personality but in terms of their combinations. (Am J Geriatr Psychiatry 2009; 17:591-601)