Personality and health-related quality of life (HRQoL) of Hong Kong Chinese older people: resilience as a mediator and financial status as a moderator

Personality and Health-Related Quality of Life of Older Chinese Adults: Cross-Sectional Study and Moderated Mediation Model Analysis

Background

Personality has an impact on the health-related quality of life (HRQoL) of older adults. However, the relationship and mechanisms of the 2 variables are controversial, and few studies have been conducted on older adults.

Objective

The aim of this study was to explore the relationship between personality and HRQoL and the mediating and moderating roles of sleep quality and place of residence in this relationship.

Methods

A total of 4123 adults 60 years and older were from the Psychology and Behavior Investigation of Chinese Residents survey. Participants were asked to complete the Big Five Inventory, the Brief version of the Pittsburgh Sleep Quality Index, and EQ-5D-5L. A backpropagation neural network was used to explore the order of factors contributing to HRQoL. Path analysis was performed to evaluate the mediation hypothesis.

Results

As of August 31, 2022, we enrolled 4123 older adults 60 years and older. Neuroticism and extraversion were strong influencing factors of HRQoL (normalized importance >50%). The results of the mediation analysis suggested that neuroticism and extraversion may enhance and diminish, respectively, HRQoL (index: β=-.262, P<.001; visual analog scale: β=-.193, P<.001) by increasing and decreasing brief version of the Pittsburgh Sleep Quality Index scores (neuroticism: β=.17, P<.001; extraversion: β=-.069, P<.001). The multigroup analysis suggested a significant moderating effect of the place of residence (EQ-5D-5L index: P<.001; EQ-5D-5L visual analog scale: P<.001). No significant direct effect was observed between extraversion and EQ-5D-5L index in urban older residents (β=.037, P=.73).

Conclusions

This study sheds light on the potential mechanisms of personality and HRQoL among older Chinese adults and can help health care providers and relevant departments take reasonable measures to promote healthy aging.

Mapping the terrain: a scoping review of empirical studies on the big five personality traits and QoL in China

The relationship between personality traits and Quality of Life (QoL) has garnered increasing scholarly attention, particularly within the context of China. This scoping review synthesizes existing literature on the connection between the Big Five personality traits (Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) and QoL among the Chinese population. The review explores correlations, measurement instruments, and theoretical frameworks employed in these studies. The study's significance lies in the profound implications for healthcare policies, organizational behavior, and social welfare programs in China, where rapid social and economic changes impact well-being. Investigating personality traits' impact on QoL can inform tailored interventions benefiting diverse Chinese subpopulations. This review addresses three primary research questions: (1) How do the Big Five personality traits correlate with QoL in different Chinese subpopulations, and what are the mediating or moderating factors? (2) What instruments assess these traits and QoL in the Chinese cultural context, and how are they validated? (3) What theoretical or disciplinary frameworks guide this research in China? Following a systematic PRISMA-ScR framework and a customized "C-BFQLC" protocol, the study identified 170 relevant documents. After rigorous screening, ten studies met the inclusion criteria, constituting 5.03% of the initial records. This scoping review critically examines the interplay between the Big Five personality traits and QoL in China, a context marked by rapid socioeconomic changes and cultural diversity. Employing a systematic approach guided by the PRISMA-ScR framework and our unique 'C-BFQLC' protocol, we meticulously analyzed 170 documents, selecting nine that met our rigorous inclusion criteria. Despite the emerging nature of this research area in the Chinese context, our study reveals significant insights into how individual personality traits influence various dimensions of well-being. The implications of these findings are profound, extending beyond academic discourse to inform healthcare policies, organizational behavior, and social welfare programs in China. Our review not only offers a comprehensive synthesis of the current research landscape but also identifies critical gaps in the literature. It emphasizes the urgent need for further culturally nuanced research to understand the complex dynamics of personality traits and QoL in China. This work lays a foundational framework for future investigations and the development of tailored interventions aimed at enhancing the well-being of diverse Chinese populations, including the elderly, people with disabilities, and specific occupational groups.

Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China

It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI  =  0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.

Loneliness, ageism, and mental health: The buffering role of resilience in seniors

Introduction

Ageism and loneliness are two relevant public health phenomena because of their negative impact on the senior's mental health. With the increase in average life expectancy, these tend to co-occur, which may increase the psychological distress (PD) of seniors. Resilience has been shown to be an important protective factor of seniors mental health, although its potential buffering role of public health risk factors with cumulative impact on mental health, such as loneliness and ageism, needs to be more studied.

Aim

To assess the potential mediator role of resilience between the effects of ageism and loneliness on PD in seniors.

Methods

A sample of 349 Portuguese seniors aged 60 years and over was collected through an online survey and during the COVID-19 pandemic period. Seniors completed the Kessler Psychological Distress Scale (K6), the Short-Form of UCLA Loneliness Scale (USL-6), the Ambivalent Ageism Scale (AAS) and the Connor-Davidson Resilience Scale (CD-RISC-10). A mediation analysis model was developed with resilience as a mediating variable.

Results

There were moderate to high levels of PD and moderate levels of ageism, loneliness and resilience. Resilience fully mediated the effect of ageism on PD and partially mediated the effect of loneliness on PD.

Conclusions

Resilience was an important protective factor of mental health against the effects of ageism, and partially protected mental health from the effects of loneliness among seniors. It is suggested that resilience be considered as a factor to be integrated in future intervention programs for mental health. The practical applicability of this study is discussed.