Department of Epidemiology and Public Health, University College London, London, United Kingdom.
JAMA Netw Open. 2019 Jul 3;2(7):e196870. doi: 10.1001/jamanetworkopen.2019.6870.
Subjective well-being is associated with reduced mortality, but it is not clear whether additional time is spent in good health or with chronic disease and disability.
To evaluate the associations between affective well-being, total life expectancy, and life expectancy free of disability and chronic disease.
DESIGN, SETTING, AND PARTICIPANTS: This survey study used data on 9761 participants from the English Longitudinal Study of Ageing who were followed up for a maximum of 10 years (mean [SD] follow-up, 6 [3.7] years). Discrete-time multistate life table models were used to estimate total life expectancy and life expectancy free of disability or chronic disease. Data were collected between March 2002 and March 2013 and analyzed from December 2018 to April 2019. Analyses were adjusted for wealth and cohabiting status.
The main outcome was life expectancy free of disability and chronic disease. Affective well-being was assessed at baseline as a combination of enjoyment of life and the lack of significant depressive symptoms. Disability was measured in terms of impaired activities of daily living and instrumental activities of daily living, and chronic disease as the occurrence of 6 serious illnesses.
Data were analyzed from 9761 participants (5297 [54%] female; mean [SD] age at baseline, 64 [9.9] years). High affective well-being was associated with longer life expectancy and with longer disability-free and chronic disease-free life expectancies. For example, a woman aged 50 years who reported high affective well-being could expect to live 6 years longer than a woman of similar age with low well-being; 31.4 of her remaining years (95% CI, 30.5-31.9 years) would be likely to be free of disability, compared with 20.8 years (95% CI, 20.1-22.1 years) for a woman with low affective well-being. A man aged 50 years with high affective well-being could expect to live 20.8 years (95% CI, 18.7-22.4 years) without chronic disease, compared with 11.4 years (95% CI, 8.5-14.6 years) for a man reporting low well-being. Similar patterns were observed at the ages of 60, 70, and 80 years.
This study suggests that people who report high levels of subjective well-being live longer and also healthier lives than those with lower well-being. These findings add weight to endeavors to promote the subjective well-being of older people.
主观幸福感与降低死亡率有关，但尚不清楚额外的时间是用于身体健康还是用于慢性疾病和残疾。
评估情感幸福感、总预期寿命以及无残疾和慢性疾病的预期寿命之间的关联。
设计、设置和参与者：这项调查研究使用了来自英国老龄化纵向研究的 9761 名参与者的数据，这些参与者的随访时间最长为 10 年（平均[SD]随访时间为 6[3.7]年）。离散时间多状态生命表模型用于估计总预期寿命和无残疾或慢性疾病的预期寿命。数据收集于 2002 年 3 月至 2013 年 3 月，分析于 2018 年 12 月至 2019 年 4 月进行。分析考虑了财富和同居状况。
主要结果是无残疾和慢性疾病的预期寿命。情感幸福感在基线时作为享受生活和没有明显抑郁症状的组合进行评估。残疾是根据日常生活活动受损和工具性日常生活活动受损来衡量的，慢性疾病是指发生 6 种严重疾病。
对 9761 名参与者（5297[54%]名女性；基线时的平均[SD]年龄为 64[9.9]岁）进行了数据分析。高情感幸福感与更长的预期寿命以及更长的无残疾和无慢性疾病预期寿命相关。例如，一位 50 岁的女性，如果报告情感幸福感高，可能会比年龄相似但幸福感低的女性多活 6 年；她剩余的 31.4 年（95%CI，30.5-31.9 年）可能没有残疾，而幸福感低的女性为 20.8 年（95%CI，20.1-22.1 年）。一位 50 岁的幸福感高的男性可能没有慢性疾病，预期寿命为 20.8 年（95%CI，18.7-22.4 年），而幸福感低的男性预期寿命为 11.4 年（95%CI，8.5-14.6 年）。在 60、70 和 80 岁时也观察到类似的模式。
这项研究表明，报告主观幸福感水平较高的人比幸福感水平较低的人寿命更长，生活也更健康。这些发现为努力促进老年人的主观幸福感提供了更多依据。
