Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
J Am Geriatr Soc. 2022 Oct;70(10):2793-2804. doi: 10.1111/jgs.17897. Epub 2022 Jun 8.
Research has suggested optimism is associated with healthy aging and exceptional longevity, but most studies were conducted among non-Hispanic White populations. We examined associations of optimism to longevity across racial and ethnic groups and assessed healthy lifestyle as a possible mediating pathway.
Participants from the Women's Health Initiative (N = 159,255) completed a validated measure of optimism and provided other demographic and health data at baseline. We evaluated associations of optimism with increments in lifespan using accelerated failure time models, and with likelihood of exceptional longevity (survival to age ≥90) using Poisson regression models. Causal mediation analysis explored whether lifestyle-related factors mediated optimism-lifespan associations.
After covariate adjustment, the highest versus lowest optimism quartile was associated with 5.4% (95% confidence interval [CI] = 4.5, 6.4%) longer lifespan. Within racial and ethnic subgroups, these estimates were 5.1% (95%CI = 4.0, 6.1%) in non-Hispanic White, 7.6% (95%CI = 3.6, 11.7%) in Black, 5.4% (95%CI = -0.1, 11.2%) in Hispanic/Latina, and 1.5% (95% CI = -5.0, 8.5) in Asian women. A high proportion (53%) of the women achieved exceptional longevity. Participants in the highest versus lowest optimism quartile had greater likelihood of achieving exceptional longevity (e.g., full sample risk ratio = 1.1, 95%CI = 1.1, 1.1). Lifestyle mediated 24% of the optimism-lifespan association in the full sample, 25% in non-Hispanic White, 10% in Black, 24% in Hispanic/Latina, and 43% in Asian women.
Higher optimism was associated with longer lifespan and a greater likelihood of achieving exceptional longevity overall and across racial and ethnic groups. The contribution of lifestyle to these associations was modest. Optimism may promote health and longevity in diverse racial and ethnic groups. Future research should investigate these associations in less long-lived populations.
研究表明乐观与健康衰老和长寿有关，但大多数研究都是在非西班牙裔白人群体中进行的。我们研究了乐观与不同种族和族裔群体长寿的关系，并评估了健康生活方式作为可能的中介途径。
妇女健康倡议（Women's Health Initiative，WHI）的参与者（N=159255）完成了一项乐观的验证性测量，并在基线时提供了其他人口统计学和健康数据。我们使用加速失效时间模型评估了乐观与寿命增加的关系，使用泊松回归模型评估了乐观与非凡长寿（存活至 90 岁以上）的可能性。因果中介分析探讨了生活方式相关因素是否调节了乐观与寿命的关系。
在调整了协变量后，最高与最低乐观四分位的参与者的寿命分别延长了 5.4%（95%置信区间[CI]为 4.5%，6.4%）。在种族和族裔亚组中，非西班牙裔白人的估计值为 5.1%（95%CI为 4.0%，6.1%），黑人的估计值为 7.6%（95%CI为 3.6%，11.7%），西班牙裔/拉丁裔的估计值为 5.4%（95%CI为-0.1%，11.2%），亚裔女性的估计值为 1.5%（95%CI为-5.0%，8.5%）。大多数（53%）女性达到了非凡的长寿。与最低四分位数相比，最高四分位数的参与者达到非凡长寿的可能性更大（例如，全样本风险比为 1.1，95%CI 为 1.1，1.1）。在全样本中，生活方式解释了乐观与寿命之间 24%的关联，在非西班牙裔白人群体中解释了 25%的关联，在黑人中解释了 10%的关联，在西班牙裔/拉丁裔中解释了 24%的关联，在亚裔女性中解释了 43%的关联。
总体而言，较高的乐观与寿命较长和达到非凡长寿的可能性更大有关，且这种关联在不同种族和族裔群体中是一致的。生活方式对这些关联的贡献是适度的。乐观可能会促进不同种族和族裔群体的健康和长寿。未来的研究应该在寿命较短的人群中研究这些关联。
