Department of Epidemiology and Public Health, University College London, London, UK.
Woodrow Wilson School and Department of Economics, Princeton University, Princeton, NJ, USA.
Lancet. 2015 Feb 14;385(9968):640-648. doi: 10.1016/S0140-6736(13)61489-0. Epub 2014 Nov 6.
Subjective wellbeing and health are closely linked to age. Three aspects of subjective wellbeing can be distinguished-evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness, anger, stress, and pain), and eudemonic wellbeing (sense of purpose and meaning in life). We review recent advances in the specialty of psychological wellbeing, and present new analyses about the pattern of wellbeing across ages and the association between wellbeing and survival at older ages. The Gallup World Poll, a continuing survey in more than 160 countries, shows a U-shaped relation between evaluative wellbeing and age in high-income, English speaking countries, with the lowest levels of wellbeing in ages 45-54 years. But this pattern is not universal. For example, respondents from the former Soviet Union and eastern Europe show a large progressive reduction in wellbeing with age, respondents from Latin America also shows decreased wellbeing with age, whereas wellbeing in sub-Saharan Africa shows little change with age. The relation between physical health and subjective wellbeing is bidirectional. Older people with illnesses such as coronary heart disease, arthritis, and chronic lung disease show both increased levels of depressed mood and impaired hedonic and eudemonic wellbeing. Wellbeing might also have a protective role in health maintenance. In an analysis of the English Longitudinal Study of Ageing, we identify that eudemonic wellbeing is associated with increased survival; 29·3% of people in the lowest wellbeing quartile died during the average follow-up period of 8·5 years compared with 9·3% of those in the highest quartile. Associations were independent of age, sex, demographic factors, and baseline mental and physical health. We conclude that the wellbeing of elderly people is an important objective for both economic and health policy. Present psychological and economic theories do not adequately account for the variations in patterns of wellbeing with age across different parts of the world. The apparent association between wellbeing and survival is consistent with a protective role of high wellbeing, but alternative explanations cannot be ruled out at this stage.
主观幸福感与健康密切相关，与年龄有关。主观幸福感可以分为三个方面——评价幸福感（或生活满意度）、享乐幸福感（幸福感、悲伤感、愤怒感、压力感和疼痛感）和幸福幸福感（生活目的感和意义感）。我们回顾了心理幸福感专业的最新进展，并提出了关于幸福感在不同年龄段的模式以及幸福感与高龄人群生存之间关联的新分析。盖洛普世界民意调查是一项在 160 多个国家进行的持续调查，结果显示，在高收入、英语国家，评价幸福感与年龄之间呈 U 型关系，幸福感最低的年龄段是 45-54 岁。但这种模式并不是普遍存在的。例如，前苏联和东欧国家的受访者幸福感随年龄增长呈大幅下降趋势，拉丁美洲的受访者幸福感也随年龄增长而下降，而撒哈拉以南非洲的幸福感随年龄变化不大。身体健康与主观幸福感之间的关系是双向的。患有冠心病、关节炎和慢性肺病等疾病的老年人，其抑郁情绪水平以及享乐幸福感和幸福幸福感都会有所提高。幸福感在维护健康方面也可能起到保护作用。在对英国老龄化纵向研究的分析中，我们发现幸福幸福感与生存率增加有关；在平均 8.5 年的随访期间，幸福感最低的四分之一人群中有 29.3%的人死亡，而幸福感最高的四分之一人群中有 9.3%的人死亡。这些关联独立于年龄、性别、人口因素以及基线身心健康状况。我们的结论是，老年人的幸福感是经济和健康政策的一个重要目标。目前的心理和经济理论不能充分解释世界不同地区幸福感随年龄变化的模式。幸福感与生存率之间的明显关联与高幸福感的保护作用一致，但在现阶段，不能排除其他解释。
