Giltay Erik J, Geleijnse Johanna M, Zitman Frans G, Hoekstra Tiny, Schouten Evert G
Psychiatric Center GGZ Delfland, Delft; Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
Arch Gen Psychiatry. 2004 Nov;61(11):1126-35. doi: 10.1001/archpsyc.61.11.1126.
Major depression is known to be related to higher cardiovascular mortality. However, epidemiological data regarding dispositional optimism in relation to mortality are scanty.
To test whether subjects who are optimistic live longer than those who are pessimistic.
Our analysis formed part of a prospective population-based cohort study in the Netherlands (Arnhem Elderly Study).
General community.
Elderly subjects aged 65 to 85 years (999 men and women) completed the 30-item validated Dutch Scale of Subjective Well-being for Older Persons, with 5 subscales: health, self-respect, morale, optimism, and contacts. A total of 941 subjects (466 men and 475 women) had complete dispositional optimism data, and these subjects were divided into quartiles.
Number of deaths during the follow-up period.
During the follow-up period of 9.1 years (1991-2001), there were 397 deaths. Compared with subjects with a high level of pessimism, those reporting a high level of optimism had an age- and sex-adjusted hazard ratio of 0.55 (95% confidence interval, 0.42-0.74; upper vs lower quartile) for all-cause mortality. For cardiovascular mortality, the hazard ratio was 0.23 (95% confidence interval, 0.10-0.55) when adjusted for age, sex, chronic disease, education, smoking, alcohol consumption, history of cardiovascular disease or hypertension, body mass index, and total cholesterol level. Protective trend relationships were observed between the level of optimism and all-cause and cardiovascular mortality (P<.001 and P = .001 for trend, respectively). Interaction with sex (P = .04) supported a stronger protective effect of optimism in men than women for all-cause mortality but not for cardiovascular mortality.
Our results provide support for a graded and independent protective relationship between dispositional optimism and all-cause mortality in old age. Prevention of cardiovascular mortality accounted for much of the effect.
已知重度抑郁症与较高的心血管疾病死亡率相关。然而，关于性格乐观与死亡率关系的流行病学数据却很少。
检验乐观的受试者是否比悲观的受试者寿命更长。
我们的分析是荷兰一项基于人群的前瞻性队列研究（阿纳姆老年研究）的一部分。
普通社区。
65至85岁的老年受试者（999名男性和女性）完成了经过验证的30项荷兰老年人主观幸福感量表，该量表有5个分量表：健康、自尊、士气、乐观和社交。共有941名受试者（466名男性和475名女性）有完整的性格乐观数据，这些受试者被分为四分位数。
随访期间的死亡人数。
在9.1年（1991 - 2001年）的随访期内，有397人死亡。与高度悲观的受试者相比，报告高度乐观的受试者全因死亡率的年龄和性别调整风险比为0.55（95%置信区间，0.42 - 0.74；上四分位数与下四分位数）。对于心血管疾病死亡率，在调整年龄、性别、慢性病、教育程度、吸烟、饮酒、心血管疾病或高血压病史、体重指数和总胆固醇水平后，风险比为0.23（95%置信区间，0.10 - 0.55）。观察到乐观程度与全因死亡率和心血管疾病死亡率之间存在保护性趋势关系（趋势P值分别为<0.001和P = 0.001）。与性别的交互作用（P = 0.04）表明，对于全因死亡率，乐观对男性的保护作用强于女性，但对心血管疾病死亡率则不然。
我们的结果支持性格乐观与老年全因死亡率之间存在分级且独立的保护关系。预防心血管疾病死亡率在其中起了很大作用。
