Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health,Boston, Massachusetts.
Am J Prev Med. 2019 Jan;56(1):116-124. doi: 10.1016/j.amepre.2018.07.037.
Optimism-the expectation that good things will happen-has emerged as a promising health asset, as it appears to be related to healthier behaviors and reduced disease risk. Growing research finds that higher optimism is associated with lower mortality, yet it is critical to understand whether this prolonged longevity is accompanied by good health. This study tested whether higher optimism was associated with increased likelihood of healthy aging.
Prospective data analyzed in 2018 from the Nurses' Health Study included 33,326 women with no major chronic diseases at baseline. Poisson regression models evaluated if optimism was associated with healthy aging 8 years later, considering potential confounders (sociodemographic variables, depression) and intermediate variables (health behaviors). Optimism was assessed in 2004 by validated self-report using mailed questionnaires and healthy aging was assessed in 2012, defined as (1) remaining free of major chronic diseases; (2) having no subjective memory impairment; (3) having intact physical function; and (4) surviving through follow-up.
Overall, 20.5% of women (n=6,823) fulfilled the definition of healthy aging in 2012. After adjusting for sociodemographic factors and depression, the most (top quartile) versus least (bottom quartile) optimistic women had a 23% greater likelihood of healthy aging (95% CI=1.16, 1.30). Associations were similar in white and black participants, although the sample of black women was small (n=354).
Higher optimism was associated with increased likelihood of healthy aging, suggesting that optimism, a potentially modifiable health asset, merits further research for its potential to improve health in aging.
乐观主义——即对美好事物的期待——已成为一种有前途的健康资产,因为它似乎与更健康的行为和降低疾病风险有关。越来越多的研究发现,更高的乐观主义与更低的死亡率相关,但关键是要了解这种长寿是否伴随着健康。本研究测试了更高的乐观主义是否与更有可能健康衰老相关。
2018 年对护士健康研究中的前瞻性数据进行了分析,共纳入 33326 名基线时无重大慢性疾病的女性。泊松回归模型评估了乐观主义是否与 8 年后的健康衰老相关,同时考虑了潜在的混杂因素(社会人口统计学变量、抑郁)和中间变量(健康行为)。2004 年通过邮寄问卷使用经过验证的自我报告评估了乐观主义,健康衰老在 2012 年进行评估,定义为(1)无主要慢性疾病;(2)无主观记忆障碍;(3)身体功能完好;(4)通过随访生存。
总体而言,20.5%的女性(n=6823)在 2012 年符合健康衰老的定义。在调整社会人口统计学因素和抑郁后,最乐观(前四分位)与最不乐观(后四分位)的女性健康衰老的可能性高 23%(95%CI=1.16,1.30)。白人和黑人参与者的相关性相似,尽管黑人女性的样本量较小(n=354)。
更高的乐观主义与更有可能健康衰老相关,这表明乐观主义是一种潜在可改变的健康资产,值得进一步研究其在衰老过程中改善健康的潜力。