Study Suggests Optimism Lowers, Cynical Hostility Increases, Fall Risk in Women

Fall Risk in Women

Try and list all the factors you can think of that can influence a woman’s fall risk. You likely thought of things such as age, bone health, and activity levels—not personality. Yet a study has been published recently which suggests that optimism and cynical hostility have correlations to how likely a woman is to suffer falls.

In Brief: Personality and Falls

The ability for personality to influence fall and fracture risk is not new, but it is relatively unexplored. One prior study found that athletes with “Type A” personalities were more likely to suffer fractures, and another Type A-fall pattern was found in a separate bit of research about elderly Chinese men and women. Since falls and fractures are particularly hazardous for older individuals, any research into potential falls risks for women or men are welcome.

The Study

The researchers looked at 87,342 women and assessed them for optimism scores, cynical hostility scores, and how many falls and/or fractures they reported in the past year. In order to avoid skewing of the results, falls or fractures related to sporting activities were not included. Certain other demographics (age, race, BMI, history, etc.) were collected as well. The results were controlled for age, region, ethnicity, height, diabetes, smoking, general health, calcium and vitamin D intake, and physical activity levels.

For clarity, “cynical hostility” refers to a specific personality dimension. Common features include suspicious or mistrustful attitudes and/or a cynical worldview.

Of the women who were surveyed, a total of 26,715 (30.6%) of participants experienced two-or-more falls during the study period. The same number of people reported at least one fracture as well. Several types of models were used to analyze the data, and the results changed slightly with each approach.

Depending on the analysis model used, above-average optimism scores were associated with anywhere from a 5% to 16% lower risk of having suffered more than two-or-more falls in the past year. Above-average cynical hostility scores showed a roughly 12% higher risk of having suffered two-or-more falls.

When fractures were examined, higher optimism scores were associated with a roughly 10% decrease in hip and total fracture risk, 14% lower vertebral fracture risk, and 7% lower arm fracture risk. However, these associations became much weaker depending on the type of analysis used. Higher cynical hostility scores were associated with a 5% increased risk of fracture, but the risk did not seem to change depending on the part of the body that was looked at.

What This Means

The study suggests that optimism and cynical hostility may be indicators of fall risk in women, but it is worth noting that these factors are not likely direct contributors to a fall. Personality influences, and is influenced by, many different lifestyle, environmental, and personal factors that may have more direct involvement in a woman’s fall risk. However, this study may also serve as a launching point for research into whether changing attitudes could influence fall risk. This would be an intriguing path to take and one that may be able to contribute to reducing the risk of falls and fractures as women age.

Cauley, J., et. al., “Optimism, Cynical Hostility, Falls and Fractures: The Women’s Health Initiative Observational Study (WHI-OS),” Journal of Bone and Mineral Research, 2016; 10.1002/jbmr.2984.
Everson-Rose, S., et al., “Hostility, Cynical,” Springer Link web site;, last accessed September 6, 2016.