The present longitudinal study investigates continuity and change in the personality dimensions of extraversion and neuroticism among the oldest-old. Overall disease load, self-rated health, functional capacity, impaired vision and hearing, self-reported cognitive impairment, and measured cognitive status were tested for their role as potentially relevant late-life predictors of personality change. The sample consists of 408 individuals aged 80–98 in the Swedish OCTO-Twin Study who completed the Eysenck Personality Inventory at four measurement occasions during a 6-year period. Growth curve analyses revealed an age-related linear decrease in extraversion and stability in neuroticism. More extraverted individuals were more educated and perceived their health and cognition as better. Notably, only hearing impairment was found to be related to a steeper age-related decline in extraversion. A life span developmental model focusing on health-related changes can improve our understanding of personality change in late life.