Giltay Erik J, Kamphuis Marjolein H, Kalmijn Sandra, Zitman Frans G, Kromhout Daan
GGZ Delfland, Institute of Mental Health, Delft.
Arch Intern Med. 2006 Feb 27;166(4):431-6. doi: 10.1001/archinte.166.4.431.
Dispositional optimism, defined in terms of life engagement and generalized positive outcome expectancies for one's future, may be related to lower cardiovascular mortality. We aimed to determine whether dispositional optimism is a stable trait over time and whether it is independently related to lower cardiovascular mortality in elderly men.
In a cohort study with a follow-up of 15 years, we included 545 (61.4%) of 887 men, aged 64 to 84 years, who were free of preexisting cardiovascular disease and cancer and who had complete data on cardiovascular risk factors and sociodemographic characteristics. Dispositional optimism was assessed using a 4-item questionnaire in 1985, 1990, 1995, and 2000. In Cox proportional hazards models, the first 2 years of observation were excluded.
Optimism scores significantly decreased over 15 years, but showed temporal stability (reliability coefficients, 0.72 over 5 years and 0.78 over 15 years; P < .001). Optimists in 1985 had a hazard ratio for cardiovascular mortality of 0.45 (top tertile vs lowest tertile; 95% confidence interval, 0.29-0.68), adjusted for classic cardiovascular risk factors. The risk of cardiovascular death was inversely associated with increased tertiles of dispositional optimism (P < .001 for trend). Similar results were obtained using 1990 data after additional adjustment for depression (assessed by the Zung Self-rating Depression Scale).
Dispositional optimism is a relatively stable trait over 15 years and shows a graded and inverse association with the risk of cardiovascular death.
以生活参与度和对个人未来的普遍积极结果预期来定义的性格乐观，可能与较低的心血管疾病死亡率相关。我们旨在确定性格乐观是否随时间推移是一种稳定的特质，以及它是否与老年男性较低的心血管疾病死亡率独立相关。
在一项随访15年的队列研究中，我们纳入了887名年龄在64至84岁之间、无既往心血管疾病和癌症且拥有心血管危险因素及社会人口学特征完整数据的男性中的545名（61.4%）。在1985年、1990年、1995年和2000年使用一份包含4个条目的问卷对性格乐观进行评估。在Cox比例风险模型中，排除了观察的前2年。
乐观得分在15年中显著下降，但显示出时间稳定性（可靠性系数，5年期间为0.72，15年期间为0.78；P <.001）。1985年的乐观者在调整经典心血管危险因素后，心血管疾病死亡的风险比为0.45（最高三分位数与最低三分位数相比；95%置信区间，0.29 - 0.68）。心血管死亡风险与性格乐观程度的增加呈负相关（趋势P <.001）。在对抑郁（通过zung自评抑郁量表评估）进行额外调整后，使用1990年的数据也获得了类似结果。
性格乐观在15年中是一种相对稳定的特质，并且与心血管死亡风险呈分级负相关。
