Baseline neuroticism and subsequent reporting of doctor- treated glaucoma in the Health and Retirement Study

Abstract Background Personality has usually been measured after glaucoma diagnosis, limiting temporal interpretation. We examined whether baseline neuroticism was associated with subsequent survey reporting of doctor-treated glaucoma among older participants in the Health and Retirement Study (HRS). Methods This exploratory longitudinal analysis included HRS participants aged 65 years or older whose first psychosocial leave-behind assessment was in 2006 or 2008, who had no positive glaucoma report at or before baseline, and who had at least one later glaucoma assessment through 2020. Neuroticism was the standardized mean of four Midlife Development Inventory items, requiring at least three observed items in the primary analysis. The endpoint was the first subsequent respondent- or proxy-reported positive response to “Has a doctor ever treated you for glaucoma?” Observation intervals were split at fixed 2-year elapsed-time boundaries. Complementary log-log models included log segment duration as an offset, a fixed elapsed-time baseline hazard, age, sex, race/ethnicity, and education, with participant-clustered standard errors. Results The analysis included 7,217 participants, 1,067 first positive reports, and 61,833 person-years (median follow-up, 8.5 years). Of the events, 954 occurred at respondent interviews and 113 at proxy interviews. Each 1-SD higher neuroticism score was associated with a hazard ratio (HR) of 1.091 (95% CI, 1.025–1.161; P = .006). Reconstructing follow-up from respondent interviews only yielded HR 1.082 (95% CI, 1.013–1.156). Results were similar in the inverse-probability-of-censoring weighted attrition sensitivity (HR, 1.086; 95% CI, 1.018–1.159) and with the HRS guide-based two-of-four-item scoring rule (HR, 1.090; 95% CI, 1.024–1.160). In the healthcare-use complete-case sample, the HR was 1.076 before and 1.041 after adjustment for all measured general healthcare-use variables. Four- and 6-year landmark estimates were 1.072 (95% CI, 0.995–1.154) and 1.064 (95% CI, 0.972–1.166). Accounting for competing death, standardized 10-year probabilities at the 25th and 75th percentiles of neuroticism were 11.40% and 12.60%, a difference of 1.20 percentage points (95% CI, 0.25–2.13). Conclusions Higher baseline neuroticism was associated with a modestly higher rate of subsequent reporting of doctor-treated glaucoma in this selected HRS cohort. Attenuation after adjustment for general healthcare use, depressive symptoms, and baseline eye-health measures leaves disease occurrence, detection, and reporting as unresolved explanations.