Personality, falls, and psychological concerns in aging: a multi-method study of risk, behavior, and coping among community-dwelling older adults

Abstract

This thesis investigated the relationship among personality traits, falls, and fall-related psychological concerns in community-dwelling older adults, using a multi-method approach across Canada (≥65 years) and Nigeria (≥60 years). Study 1, a scoping review of eight peer-reviewed studies, identified neuroticism (emotional instability) as a risk factor for both falls and fear of falling (FOF), and conscientiousness as protective. Evidence on balance confidence was absent and only one study addressed fall self-efficacy, revealing key gaps for future work. Study 2 used longitudinal data from the Canadian Longitudinal Study on Aging (CLSA) to test whether personality traits and health behaviors predicted fall outcomes over time. Stable traits and behavior change were associated with risk, with notable contributions from shifts in extraversion and openness alongside physical activity, alcohol use, and smoking patterns. Study 3 comprised two qualitative investigations conducted in Canada and Nigeria. Both used Interpretive Description with Reflexive Thematic Analysis, guided by the Transactional Model of Stress and Coping. The Canadian study showed that personality shaped cognitive appraisal of risk, emotion regulation, and engagement with formal and informal supports. The Nigerian study found that FOF clustered at specific environmental thresholds and was managed through brief, teachable procedures co-produced with peers and community actors. Taken together, the studies offer a coherent account of how personality and behavior interact with social and environmental contexts to influence falls and fall-related psychological responses. Findings support culturally sensitive, personality-informed approaches that emphasize threshold-specific coaching, meso-level delivery through community channels, and policies that integrate structural with individual determinants to enhance safe, dignified mobility in aging.