Optimism, Cynical Hostility, Falls, and Fractures

The Women's Health Initiative Observational Study (WHI-OS)

Jane A. Cauley, Stephen F. Smagula, Kathleen M. Hovey, Jean Wactawski-Wende, Christopher A. Andrews, Carolyn J. Crandall, Meryl S. Leboff, Wenjun Li, Mace Coday, Maryam Sattari, Hilary A. Tindle

Research output: Contribution to journalArticle

Abstract

Traits of optimism and cynical hostility are features of personality that could influence the risk of falls and fractures by influencing risk-taking behaviors, health behaviors, or inflammation. To test the hypothesis that personality influences falls and fracture risk, we studied 87,342 women enrolled in WHI-OS. Optimism was assessed by the Life Orientation Test-Revised and cynical hostility, the cynicism subscale of the Cook-Medley questionnaire. Higher scores indicate greater optimism and hostility. Optimism and hostility were correlated at r=-0. 31, p<0.001. Annual self-report of falling ≥2 times in the past year was modeled using repeated measures logistic regression. Cox proportional hazards models were used for the fracture outcomes. We examined the risk of falls and fractures across the quartiles (Q) of optimism and hostility with tests for trends; Q1 formed the referent group. The average follow-up for fractures was 11.4 years and for falls was 7.6 years. In multivariable (MV)-adjusted models, women with the highest optimism scores (Q4) were 11% less likely to report ≥2 falls in the past year (odds ratio [OR]=0.89; 95% confidence intervals [CI] 0.85-0.90). Women in Q4 for hostility had a 12% higher risk of ≥2 falls (OR=1.12; 95% CI 1.07-1.17). Higher optimism scores were also associated with a 10% lower risk of fractures, but this association was attenuated in MV models. Women with the greatest hostility (Q4) had a modest increased risk of any fracture (MV-adjusted hazard ratio=1. 05; 95% CI 1.01-1.09), but there was no association with specific fracture sites. In conclusion, optimism was independently associated with a decreased risk of ≥2 falls, and hostility with an increased risk of ≥2 falls, independent of traditional risk factors. The magnitude of the association was similar to aging 5 years. Whether interventions aimed at attitudes could reduce fall risks remains to be determined.

Original languageEnglish (US)
JournalJournal of Bone and Mineral Research
DOIs
StateAccepted/In press - 2016
Externally publishedYes

Fingerprint

Hostility
Women's Health
Observational Studies
Confidence Intervals
Accidental Falls
Odds Ratio
Personality Tests
Optimism
Annual Reports
Health Behavior
Risk-Taking
Proportional Hazards Models
Self Report
Personality
Logistic Models
Inflammation

Keywords

  • FALLS
  • FRACTURES
  • HOSTILITY
  • OPTIMISM
  • PERSONALITY
  • PROSPECTIVE STUDY
  • WOMEN'S HEALTH INITIATIVE

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

Cite this

Cauley, J. A., Smagula, S. F., Hovey, K. M., Wactawski-Wende, J., Andrews, C. A., Crandall, C. J., ... Tindle, H. A. (Accepted/In press). Optimism, Cynical Hostility, Falls, and Fractures: The Women's Health Initiative Observational Study (WHI-OS). Journal of Bone and Mineral Research. https://doi.org/10.1002/jbmr.2984

Optimism, Cynical Hostility, Falls, and Fractures : The Women's Health Initiative Observational Study (WHI-OS). / Cauley, Jane A.; Smagula, Stephen F.; Hovey, Kathleen M.; Wactawski-Wende, Jean; Andrews, Christopher A.; Crandall, Carolyn J.; Leboff, Meryl S.; Li, Wenjun; Coday, Mace; Sattari, Maryam; Tindle, Hilary A.

In: Journal of Bone and Mineral Research, 2016.

Research output: Contribution to journalArticle

Cauley, JA, Smagula, SF, Hovey, KM, Wactawski-Wende, J, Andrews, CA, Crandall, CJ, Leboff, MS, Li, W, Coday, M, Sattari, M & Tindle, HA 2016, 'Optimism, Cynical Hostility, Falls, and Fractures: The Women's Health Initiative Observational Study (WHI-OS)', Journal of Bone and Mineral Research. https://doi.org/10.1002/jbmr.2984
Cauley, Jane A. ; Smagula, Stephen F. ; Hovey, Kathleen M. ; Wactawski-Wende, Jean ; Andrews, Christopher A. ; Crandall, Carolyn J. ; Leboff, Meryl S. ; Li, Wenjun ; Coday, Mace ; Sattari, Maryam ; Tindle, Hilary A. / Optimism, Cynical Hostility, Falls, and Fractures : The Women's Health Initiative Observational Study (WHI-OS). In: Journal of Bone and Mineral Research. 2016.
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abstract = "Traits of optimism and cynical hostility are features of personality that could influence the risk of falls and fractures by influencing risk-taking behaviors, health behaviors, or inflammation. To test the hypothesis that personality influences falls and fracture risk, we studied 87,342 women enrolled in WHI-OS. Optimism was assessed by the Life Orientation Test-Revised and cynical hostility, the cynicism subscale of the Cook-Medley questionnaire. Higher scores indicate greater optimism and hostility. Optimism and hostility were correlated at r=-0. 31, p<0.001. Annual self-report of falling ≥2 times in the past year was modeled using repeated measures logistic regression. Cox proportional hazards models were used for the fracture outcomes. We examined the risk of falls and fractures across the quartiles (Q) of optimism and hostility with tests for trends; Q1 formed the referent group. The average follow-up for fractures was 11.4 years and for falls was 7.6 years. In multivariable (MV)-adjusted models, women with the highest optimism scores (Q4) were 11{\%} less likely to report ≥2 falls in the past year (odds ratio [OR]=0.89; 95{\%} confidence intervals [CI] 0.85-0.90). Women in Q4 for hostility had a 12{\%} higher risk of ≥2 falls (OR=1.12; 95{\%} CI 1.07-1.17). Higher optimism scores were also associated with a 10{\%} lower risk of fractures, but this association was attenuated in MV models. Women with the greatest hostility (Q4) had a modest increased risk of any fracture (MV-adjusted hazard ratio=1. 05; 95{\%} CI 1.01-1.09), but there was no association with specific fracture sites. In conclusion, optimism was independently associated with a decreased risk of ≥2 falls, and hostility with an increased risk of ≥2 falls, independent of traditional risk factors. The magnitude of the association was similar to aging 5 years. Whether interventions aimed at attitudes could reduce fall risks remains to be determined.",
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AU - Andrews, Christopher A.

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