Health and Social Sciences, Singapore Institute of Technology, 10 Dover Dr, Singapore, Singapore, 138683, Singapore.
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
BMC Geriatr. 2023 Jul 18;23(1):440. doi: 10.1186/s12877-023-04030-w.
Higher levels of happiness are associated with longer life expectancy. Our study assessed the extent to which various factors explain the protective effect of happiness on all-cause mortality risk, and whether the association differs between older men and women.
Using data from the Singapore Longitudinal Aging Studies (N = 6073) of community-dwelling older adults aged ≥ 55 years, we analyzed the association of baseline Likert score of happiness (1 = very sad to 5 = very happy) and mortality from mean 11.7 years of follow up. Cox regression models were used to assess the extent to which confounding risk factors attenuated the hazard ratio of association in the whole sample and sex-stratified analyses.
Happiness was significantly associated with lower mortality (p < .001) adjusted for age, sex and ethnicity: HR = 0.85 per integer score and HR = 0.57 for fairly-or-very happy versus fairly-or-very sad. The HR estimate (0.90 per integer score) was modestly attenuated (33.3%) in models that included socio-demographic and support, lifestyle or physical health and functioning factor, but remained statistically significant. The HR estimate (0.94 per integer score) was substantially attenuated (60%) and was insignificant in the model that included psychological health and functioning. Including all co-varying factors in the model resulted in statistically insignificant HR estimate (1.04 per integer score). Similar results were obtained for HR estimates for fairly-to-very happy versus fairly-to- very sad).
Much of the association between happiness and increased life expectancy could be explained by socio-demographic, lifestyle, health and functioning factors, and especially psychological health and functioning factors.
幸福感水平与预期寿命延长有关。本研究评估了各种因素在多大程度上解释了幸福感对全因死亡率风险的保护作用，以及这种关联在老年男性和女性之间是否存在差异。
使用来自新加坡老龄化纵向研究（N=6073）的数据，该研究纳入了年龄≥55 岁的社区居住的老年人，我们分析了幸福感的基线李克特评分（1=非常悲伤至 5=非常快乐）与平均 11.7 年随访期间的死亡率之间的关联。Cox 回归模型用于评估混杂风险因素在整个样本和性别分层分析中减弱关联的危险比的程度。
幸福感与死亡率显著相关（p<0.001），调整了年龄、性别和种族因素：每增加一个整数评分，HR=0.85；相当或非常快乐与相当或非常悲伤相比，HR=0.57。在包括社会人口学和支持、生活方式或身体健康和功能因素的模型中，HR 估计值（每增加一个整数评分 0.90）适度减弱（33.3%），但仍具有统计学意义。在包括心理健康和功能因素的模型中，HR 估计值（每增加一个整数评分 0.94）显著减弱（60%）且无统计学意义。在模型中纳入所有共变因素导致 HR 估计值（每增加一个整数评分 1.04）无统计学意义。相当快乐与相当悲伤相比，HR 估计值也得到了类似的结果。
幸福感与预期寿命延长之间的关联很大程度上可以用社会人口学、生活方式、健康和功能因素来解释，尤其是心理健康和功能因素。
