Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden.
Am J Prev Med. 2010 Nov;39(5):440-8. doi: 10.1016/j.amepre.2010.07.015.
Psychological well-being is associated with mortality/survival. Although cardiorespiratory fitness (CRF) is one of the strongest predictors of mortality, studies examining the relationship between well-being and survival seldom account for the possible effects of CRF.
This study examined the independent associations of psychological well-being components (low level of negative emotion and high level of positive emotion) and CRF, as well as their combined effects, with survival.
Participants (N=4888) were examined in 1988-1997 and followed up for a median period of ∼15 years (212 deaths, 4.3%). CRF was assessed by a maximal exercise test on a treadmill. Low-level negative emotion was defined as the minimum score of the negative emotion subscale of the CES-D scale and high-level positive emotion as the maximum score of the positive emotion subscale. Results are presented as hazard ratios (95% CIs). Data were analyzed in 2009.
After adjustment for a set of established risk factors, men and women with low levels of negative emotion had lower risk of death than those with higher levels of negative emotion, 0.66 (95% CI=0.50, 0.87). The association persisted after additional adjustment for CRF and positive emotion. High level of positive emotion was not associated with survival. A high level of CRF independently predicted lower risk of death, 0.54 (95% CI=0.37, 0.79), compared to a low level of CRF. The risk of death in participants with both a low level of negative emotion and a high level of CRF was 0.37 (95% CI=0.22, 0.63), compared to their peers with higher levels of negative emotion/low levels of CRF.
Low levels of negative emotion and high levels of CRF are independent predictors of long-term survival in men and women. A strong combined effect was observed, as individuals with both a low level of negative emotion and a high level of CRF had a 63% lower risk of premature death than those with higher levels of negative emotion and a low level of CRF.
心理健康与死亡率/生存率相关。虽然心肺适能（CRF）是死亡率最强的预测因素之一，但很少有研究调查幸福感与生存率之间的关系，并考虑到 CRF 的可能影响。
本研究旨在检查心理健康的组成部分（低水平的负面情绪和高水平的积极情绪）和 CRF 与生存率的独立相关性，以及它们的综合影响。
参与者（N=4888）于 1988-1997 年接受检查，并进行了约 15 年的中位随访期（212 例死亡，4.3%）。CRF 通过跑步机上的最大运动试验进行评估。低水平的负面情绪定义为 CES-D 量表的负面情绪分量表的最低得分，高水平的积极情绪定义为积极情绪分量表的最高得分。结果以危险比（95%置信区间）表示。数据分析于 2009 年进行。
在调整了一系列既定风险因素后，与情绪负面程度更高的男性和女性相比，情绪负面程度较低的男性和女性的死亡风险较低，为 0.66（95%置信区间=0.50，0.87）。该关联在进一步调整 CRF 和积极情绪后仍然存在。高水平的积极情绪与生存率无关。与 CRF 水平较低的个体相比，CRF 水平较高的个体独立预测死亡风险降低，为 0.54（95%置信区间=0.37，0.79）。与情绪负面程度较高/CRF 水平较低的同龄人相比，情绪负面程度较低/CRF 水平较高的参与者的死亡风险为 0.37（95%置信区间=0.22，0.63）。
低水平的负面情绪和高水平的 CRF 是男性和女性长期生存的独立预测因素。观察到了很强的综合效应，因为情绪负面程度较低/CRF 水平较高的个体的过早死亡风险比情绪负面程度较高/CRF 水平较低的个体低 63%。
