Department of Psychology, University of Michigan, Ann Arbor 48109-1043, USA.
J Psychosom Res. 2013 May;74(5):427-32. doi: 10.1016/j.jpsychores.2013.01.013. Epub 2013 Feb 28.
To determine whether purpose in life is associated with reduced stroke incidence among older adults after adjusting for relevant sociodemographic, behavioral, biological, and psychosocial factors.
We used prospective data from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. 6739 adults who were stroke-free at baseline were examined. A multiple imputation technique was used to account for missing data. Purpose in life was measured using a validated adaptation of Ryff and Keyes' Scales of Psychological Well-Being. After controlling for a comprehensive list of covariates, we assessed the odds of stroke incidence over a four-year period. We used psychological and covariate data collected in 2006, along with occurrences of stroke reported in 2008, 2010, and during exit interviews. Covariates included sociodemographic factors (age, gender, race/ethnicity, marital status, education level, total wealth, functional status), health behaviors (smoking, exercise, alcohol use), biological factors (hypertension, diabetes, systolic blood pressure, diastolic blood pressure, BMI, heart disease), negative psychological factors (depression, anxiety, cynical hostility, negative affect), and positive psychological factors (optimism, positive affect, and social participation).
Greater baseline purpose in life was associated with a reduced likelihood of stroke during the four-year follow-up. In a model that adjusted for age, gender, race/ethnicity, marital status, education level, total wealth, and functional status, each standard deviation increase in purpose was associated with a multivariate-adjusted odds ratio of 0.78 for stroke (95% CI, 0.67-0.91, p=.002). Purpose remained significantly associated with a reduced likelihood of stroke after adjusting for several additional covariates including: health behaviors, biological factors, and psychological factors.
Among older American adults, greater purpose in life is linked with a lower risk of stroke.
确定在调整相关社会人口学、行为、生物和心理社会因素后，生活目标是否与老年人中风发病率降低有关。
我们使用了健康与退休研究（Health and Retirement Study）的前瞻性数据，这是一项针对 50 岁以上美国成年人的全国代表性小组研究。在基线时无中风的 6739 名成年人接受了检查。采用多重插补技术来处理缺失数据。生活目标使用 Ryff 和 Keyes 的心理幸福感量表的经过验证的改编版来衡量。在控制了一整套协变量后，我们评估了在四年内中风发病率的可能性。我们使用了 2006 年收集的心理和协变量数据，以及 2008 年、2010 年和退出访谈中报告的中风事件。协变量包括社会人口学因素（年龄、性别、种族/族裔、婚姻状况、教育程度、总财富、功能状态）、健康行为（吸烟、锻炼、饮酒）、生物因素（高血压、糖尿病、收缩压、舒张压、BMI、心脏病）、消极心理因素（抑郁、焦虑、愤世嫉俗的敌意、消极情绪）和积极心理因素（乐观、积极情绪和社会参与）。
在四年的随访中，较高的基线生活目标与中风发生的可能性降低相关。在一个调整了年龄、性别、种族/族裔、婚姻状况、教育程度、总财富和功能状态的模型中，生活目标每增加一个标准差，与多变量调整后的中风比值比（OR）为 0.78（95%CI，0.67-0.91，p=.002）。在调整了更多的协变量后，如健康行为、生物因素和心理因素，生活目标与中风发生的可能性降低仍有显著关联。
在美国老年成年人中，较高的生活目标与较低的中风风险相关。
