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Willroth EC, Pfund GN, Rule PD, Hill PL, John A, Kyle K, Hassenstab J, James BD. A review of the literature on wellbeing and modifiable dementia risk factors. Ageing Res Rev 2024; 99:102380. [PMID: 38880341 PMCID: PMC11260526 DOI: 10.1016/j.arr.2024.102380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/31/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
Wellbeing-defined broadly as experiencing one's life as enjoyable and fulfilling-has been associated with lower risk for Alzheimer's disease and related dementias. The mechanisms underlying this association are largely unknown. However, prior research and theory suggest that wellbeing impacts health behaviors and biological systems that are relevant to cognitive and brain health. Several of these factors have also been identified by the 2020 Lancet Commission on Dementia Prevention, Intervention, and Care as modifiable dementia risk factors. In the current review, we summarize and evaluate the evidence for associations between wellbeing and each of the 12 Lancet Commission risk factors. We found relatively consistent evidence for associations between higher wellbeing and lower levels of most of the risk factors: physical inactivity, social isolation, smoking, depression, hypertension, diabetes, hearing loss, traumatic brain injury, and air pollution. By contrast, we found evidence for only modest associations between wellbeing and education and mixed evidence for associations of wellbeing with alcohol use and body weight. Although most of the reviewed evidence was observational, longitudinal and experimental evidence suggests that many of the observed associations are likely bidirectional. These findings suggest that modifiable dementia risk factors may be mediators (i.e., intermediate steps in the causal chain) and/or confounders (i.e., variables that impact both wellbeing and dementia, and thus could induce a spurious association) of the association between wellbeing and dementia. We conclude by discussing next steps to test mediation hypotheses and to account for potential confounding in the relation between wellbeing and dementia.
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Affiliation(s)
- Emily C Willroth
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States.
| | - Gabrielle N Pfund
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States
| | - Payton D Rule
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States
| | - Patrick L Hill
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States
| | - Amber John
- Department of Clinical, Educational, and Health Psychology, University College London, United Kingdom
| | - Kalista Kyle
- Department of Psychology, University of Toronto, Canada
| | - Jason Hassenstab
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States; Department of Neurology, Washington University in St. Louis, United States
| | - Bryan D James
- Rush Alzheimer's Disease Center, Department of Internal Medicine, Rush University Medical Center, United States; Rush Alzheimer's Disease Center, United States
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2
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Monroe AD, Judge ST, Bass CL, Crofford LJ, Segerstrom SC. Optimism and Sleep in Aging Women: Bidirectional Relationships. Psychosom Med 2024; 86:244-251. [PMID: 38193773 PMCID: PMC11081851 DOI: 10.1097/psy.0000000000001281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Sleep quality and duration are important for biological restoration and promotion of psychological well-being. Optimism may facilitate or result from sufficient sleep, but questions remain as to directionality. The present study tested how optimism is associated with levels of and variability in sleep quantity and quality in a longitudinal burst design. METHODS Midlife and older women ( N = 199) reported their sleep quantity and quality in online diaries for a 7-day period, every 3 months for 2 years. Optimism was measured at baseline and end-of-study. Multilevel models tested the effects of optimism on sleep. Linear regression models tested the effect of sleep on optimism. RESULTS Baseline optimism was associated with higher sleep quality ( γ = 2.13 [1.16 to 3.11], p < .0001) and lower intraindividual variability (IIV; night-to-night and wave-to-wave) in sleep quantity (night-to-night: γ = -0.07 [-0.13 to -0.005], p = .03; wave-to-wave: b = -0.07 [-0.12 to -0.02], p = .003). In turn, higher average sleep quality (but not quantity) was associated with higher optimism at end-of-study ( b = 0.02 [0.007 to 0.03], p = .002). Variability in sleep was unrelated to optimism. CONCLUSIONS Optimism may play an important role in maintaining sleep quality and consistency in sleep quantity, perhaps by buffering stress. Similarly, sleep quality may play an important role in maintaining optimism. The cycle whereby optimism and sleep enhance one another could improve physical health and psychological well-being among aging adults.
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Affiliation(s)
- Addison D. Monroe
- Department of Counseling and Human Development Services, University of Georgia
| | | | | | - Leslie J. Crofford
- Department of Internal Medicine, Vanderbilt University School of Medicine
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3
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Doyle SJ, Feingold JH, Van Gilder TJ. Modeling the Future of Prevention in Primary Mental Health Care: A Narrative Literature Review. AJPM FOCUS 2023; 2:100092. [PMID: 37790673 PMCID: PMC10546580 DOI: 10.1016/j.focus.2023.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Adults in the U.S. have had poor and worsening mental health for years. Poor mental health exacts a high human and economic cost. Methods Using PubMed, we conducted a focused narrative literature review on mental well-being and its role in mental and physical health care. Results Mental well-being is essential for mental and physical health. High mental well-being is associated with a lower incidence of psychiatric disorder diagnosis and better function for those who do carry a formal diagnosis. High mental well-being also improves health outcomes for several physical diseases. Cultivating mental well-being is both a primary and secondary prevention strategy for mental and physical illness. There is a growing number of low-cost and accessible interventions to promote mental well-being, rooted in the research of positive psychology. These interventions improve mental well-being in multiple populations from different cultural backgrounds. There have been some efforts to incorporate these interventions to improve mental well-being in the clinical setting. Conclusions Our mental healthcare system would substantially improve its ability to protect against mental illness and promote positive function if mental well-being was routinely measured in the clinical setting, and interventions to improve mental well-being were routinely incorporated into standard primary and specialty care.
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Affiliation(s)
- Sara J. Doyle
- Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- UW Health, Madison, Wisconsin
| | - Jordyn H. Feingold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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4
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Adamowicz JL, Vélez-Bermúdez ME, Thomas EBK, Kershaw KN, Kiefe CI, Allen NB, Whitaker KM. Psychological resources and incident hypertension in the coronary artery risk development in young adults (CARDIA) study. Health Psychol 2023; 42:368-377. [PMID: 37227879 PMCID: PMC10283072 DOI: 10.1037/hea0001291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Examining factors that may protect against the development of hypertension is critical, as hypertension is a major public health concern. We examined the individual and combined associations of psychological resources (optimism and mastery) on incident hypertension over 15 years. METHOD We used data from four exams of the Coronary Artery Risk Development in Young Adults (CARDIA) study over 15 years (CARDIA exam years 15-30). Optimism and mastery were standardized to a z-score separately and summed to generate a psychological resources score. We examined the incidence of hypertension (stages 1 and 2; systolic blood pressure [SBP] ≥ 130 mmHg or diastolic blood pressure [DBP] ≥ 80 mmHg) and stage 2 hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) among participants without hypertension at baseline. Multivariable logistic regressions adjusted for sociodemographic factors, behavioral factors, and depressive symptoms. RESULTS Of 2,927 participants, 58% were women, 42% were Black, and the average age at the study baseline was 40 years (3.63). A higher psychological resources score was associated with lower odds of developing hypertension (stages 1 and 2; odds ratio [OR]: 0.89, 95% CI [-0.21, -0.03], p < .01) and stage 2 hypertension (OR: 0.88, [-0.21, -0.04], p < .01), after adjustment for sociodemographic factors. However, following adjustment for behavioral factors and depressive symptoms, the associations for hypertension (stages 1 and 2) and stage 2 hypertension were no longer statistically significant. CONCLUSIONS Greater psychological resources are associated with lower odds of hypertension. Associations were attenuated after additional adjustment for behavioral factors, indicating these factors may be important confounders or mediators. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Emily B K Thomas
- Department of Psychological and Brain Sciences, University of Iowa
| | - Kiarri N Kershaw
- Department of Preventative Medicine, Northwestern University Feinberg School of Medicine
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School
| | - Norinna B Allen
- Department of Preventative Medicine, Northwestern University Feinberg School of Medicine
| | - Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa
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5
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Huangfu N, Lu Y, Ma H, Hu Z, Cui H, Yang F. Genetic liability to mental disorders in relation to the risk of hypertension. Front Cardiovasc Med 2023; 10:1087251. [PMID: 36923957 PMCID: PMC10008891 DOI: 10.3389/fcvm.2023.1087251] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/10/2023] [Indexed: 03/02/2023] Open
Abstract
Background Observational studies have indicated that psychosocial factors contribute to hypertension; however, the causality of these associations remains unclear due to reverse causality and confounders. We aim to assess the causal associations of mental health disorders with hypertension. Methods Instrumental variables of anxiety disorder, attention deficit/hyperactivity disorder, autism spectrum disorder, depression, obsessive-compulsive disorder, post-traumatic stress disorder, schizophrenia, and subjective well-being measure were obtained from the corresponding largest genome-wide association studies. Summary statistics for the association of essential hypertension were obtained from the FinnGen Study (42,857 cases and 162,837 controls) and UK Biobank cohort (54,358 cases and 408,652 controls). The multiplicative random-effects inverse-variance weighted method was utilized as the primary analysis and three other statistical methods were conducted in the supplementary analyses. The results were combined using the fixed-effects method. Results In the pooled analyses, genetic liability to depression was associated with higher risk of hypertension (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.17-1.35; p < 0.001). Besides, a suggestive association was found between genetically predicted higher weighted neuroticism sum-score and increased risk of hypertension (OR, 1.16; 95% CI, 1.02-1.33; p < 0.05). No associations were found for other mental health disorders. Sensitivity analyses revealed consistent evidence as the main results. Conclusion We provide consistent evidence for the causal effect of genetic liability to depression on hypertension, which highlights the importance of blood pressure measurement and monitoring in patients with depression.
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Affiliation(s)
- Ning Huangfu
- Department of Cardiology, Ningbo First Hospital, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China.,Cardiovascular Disease Clinical Medical Research Center of Ningbo, Ningbo, China
| | - Yunlong Lu
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongchuang Ma
- Department of Cardiology, Ningbo First Hospital, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China
| | - Ziwei Hu
- Department of Cardiology, Ningbo First Hospital, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China
| | - Hanbin Cui
- Department of Cardiology, Ningbo First Hospital, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China.,Cardiovascular Disease Clinical Medical Research Center of Ningbo, Ningbo, China
| | - Fangkun Yang
- Department of Cardiology, Ningbo First Hospital, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China.,Cardiovascular Disease Clinical Medical Research Center of Ningbo, Ningbo, China
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6
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Li G, Su W, Zhong Q, Hu M, He J, Lu H, Hu W, Liu J, Li X, Hao J, Huang F. Individual PM 2.5 component exposure model, elevated blood pressure and hypertension in middle-aged and older adults: A nationwide cohort study from 125 cities in China. ENVIRONMENTAL RESEARCH 2022; 215:114360. [PMID: 36184965 DOI: 10.1016/j.envres.2022.114360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Recently, elevated blood pressure (BP) and hypertension (HTN) have caused a huge burden of health loss. Previous studies used ambient air pollutants as a proxy for individual exposure, limiting the assessment of its multiple exposure to health effects. For the first time, this study constructed individual PM2.5 component (SO42-, NO3-, NH4+, OM, and BC) exposure model DAG (Directed Acyclic Graph), DAG-oriented generalized linear model and random forest model, and explored the effects of single and multiple exposures to PM2.5 components on BP at different stages by the generalized linear model (GLM) and Quantile g-Computation (QgC) model based on a large cohort study in China. We defined BP in four stages according to the 2017 ACC/AHA guidelines. After excluding the lack of key information, the cohort analyses ultimately included 9031 participants. Our results showed that the individual PM2.5 component exposure model had good efficacy. Single or multiple exposure to PM2.5 components had significant positive effects on normal BP to elevated BP and elevated BP to stage 1 HTN. In addition, males, the elderly and urban residents were more sensitive to PM2.5 components. This study provided implications for environmental exposure assessment and control of particulate pollution in the future.
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Affiliation(s)
- Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Qi Zhong
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Mingjun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wenlei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Xue Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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7
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Koga HK, Trudel-Fitzgerald C, Lee LO, James P, Kroenke C, Garcia L, Shadyab AH, Salmoirago-Blotcher E, Manson JE, Grodstein F, Kubzansky LD. Optimism, lifestyle, and longevity in a racially diverse cohort of women. J Am Geriatr Soc 2022; 70:2793-2804. [PMID: 35674052 PMCID: PMC9588526 DOI: 10.1111/jgs.17897] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 04/13/2022] [Accepted: 04/23/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Hayami K. Koga
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA,Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health,Department of Psychology, Université du Québec à Trois-Rivières, and the Research Center of Institut Universitaire en Santé Mentale de Montréal
| | - Lewina O. Lee
- National Center for Posttraumatic Stress Disorder at VA Boston Healthcare System, Boston, MA,Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Candyce Kroenke
- Division of Research, Kaiser Permanente, Oakland, California
| | - Lorena Garcia
- Department of Public Health Sciences, School of Medicine, University of California-Davis, Davis, CA
| | - Aladdin H. Shadyab
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, California
| | | | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA,Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health
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8
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Okuzono SS, Shiba K, Lee HH, Shirai K, Koga HK, Kondo N, Fujiwara T, Kondo K, Grodstein F, Kubzansky LD, Trudel-Fitzgerald C. Optimism and Longevity Among Japanese Older Adults. JOURNAL OF HAPPINESS STUDIES 2022; 23:2581-2595. [PMID: 36919080 PMCID: PMC10010677 DOI: 10.1007/s10902-022-00511-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Optimism has been linked to better physical health across various outcomes, including greater longevity. However, most evidence is from Western populations, leaving it unclear whether these relationships may generalize to other cultural backgrounds. Using secondary data analysis, we evaluated the associations of optimism among older Japanese adults. METHODS Data were from a nationwide cohort study of Japanese older adults aged ≥65 years (Japan Gerontological Evaluation Study; n = 10,472). In 2010, optimism and relevant covariates (i.e., sociodemographic factors, physical health conditions, depressive symptoms, and health behaviors) were self-reported. Optimism was measured using the Japanese version of the Life Orientation Test-Revised (LOT-R). Lifespan was determined using mortality information from the public long-term care insurance database through 2017 (7-year follow-up). Accelerated failure time models examined optimism (quintiles or standardized continuous scores) in relation to percent differences in lifespan. Potential effect modification by gender, income, and education was also investigated. RESULTS Overall, 733 individuals (7%) died during the follow-up period. Neither continuous nor categorical levels of optimism were associated with lifespan after progressive adjustment for covariates (e.g., in fully-adjusted models: percent differences in lifespan per 1-SD increase in continuous optimism scores= -1.2%, 95%CI: -3.4, 1.1 higher versus lower optimism quintiles= -4.1%, 95%CI: -11.2, 3.6). The association between optimism and lifespan was null across all sociodemographic strata as well. CONCLUSION Contrary to the existing evidence from Western populations, optimism was unrelated to longevity among Japanese older adults. The association between optimism, as evaluated by the LOT-R, and longevity may differ across cultural contexts.
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Affiliation(s)
- Sakurako S. Okuzono
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Department of Global Health Promotion, Tokyo Medical and Dental University, Japan
| | - Koichiro Shiba
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, MA, USA
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, MA, USA
| | - Harold H. Lee
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
| | - Kokoro Shirai
- Department of Public Health, Graduate School of Medicine, Osaka University, Japan
| | - Hayami K. Koga
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
| | - Naoki Kondo
- Department of Social Epidemiology, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Fran Grodstein
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
- Rush Alzheimer’s Disease Center, Rush Medical College, Chicago, IL, USA
| | - Laura D. Kubzansky
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
| | - Claudia Trudel-Fitzgerald
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
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9
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Natt Och Dag Y, Engström G, Rosvall M. Cross-sectional associations of optimism with artery calcification and function: The SCAPIS study. J Public Health Res 2022; 11:22799036221110021. [PMID: 36185414 PMCID: PMC9523866 DOI: 10.1177/22799036221110021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background: An increasing amount of research indicates that positive psychological factors, such as optimism, might be beneficial for cardiovascular health. However, most studies have focused on cardiovascular events. The present study aimed to investigate associations between optimism and subclinical outcomes related to cardiovascular health. Methods: This cross-sectional study used data from SCAPIS Malmö, Sweden, including 6251 randomly selected men and women from the Malmö municipality area, aged 50 to 64 years. Optimism was assessed via the LOT-R questionnaire, but also by using the two subscales of LOT-R, assessing optimism and pessimism separately. Arterial health was assessed as the coronary artery calcium score, ankle-brachial index, and aortic augmentation index. Cardiovascular risk was estimated using the SCORE instrument. Adjustments were made for sociodemographic factors, depression, and cardiovascular risk factors. Results: Those who were most optimistic had lower odds of coronary artery calcification, with an odds ratio of 0.74 (95% confidence interval 0.58, 0.93), compared to those who were least optimistic. Also, higher levels of optimism were associated with a general pattern of lower aortic augmentation index, and with higher ankle-brachial index on both left and right side. For coronary artery calcification associations seemed to be mediated primarily through an absence of pessimism. The associations were reduced after adjustments, but persisted for measures of arterial function. Conclusions: The results indicate that optimism might be health protective with regard to arterial function, but with regard to coronary artery calcification it was rather the absence of pessimism that was of importance.
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Affiliation(s)
- Yvonne Natt Och Dag
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Maria Rosvall
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Social Medicine, Primary Health Care, Regionhälsan, Region Västra Götaland, Gothenburg, Sweden
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10
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Qu Y, Lv Y, Ji S, Ding L, Zhao F, Zhu Y, Zhang W, Hu X, Lu Y, Li Y, Zhang X, Zhang M, Yang Y, Li C, Zhang M, Li Z, Chen C, Zheng L, Gu H, Zhu H, Sun Q, Cai J, Song S, Ying B, Lin S, Cao Z, Liang D, Ji JS, Ryan PB, Barr DB, Shi X. Effect of exposures to mixtures of lead and various metals on hypertension, pre-hypertension, and blood pressure: A cross-sectional study from the China National Human Biomonitoring. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 299:118864. [PMID: 35063540 DOI: 10.1016/j.envpol.2022.118864] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
We aimed to explore the effects of mixtures of lead and various metals on blood pressure (BP) and the odds of pre-hypertension (systolic blood pressure (SBP) 120-139 mmHg, and/or diastolic blood pressure (DBP) 80-89 mmHg) and hypertension (SBP/DBP ≥140/90 mmHg) among Chinese adults in a cross-sectional study. This study included 11,037 adults aged 18 years or older from the 2017-2018 China National Human Biomonitoring. Average BP and 13 metals (lead, antimony, arsenic, cadmium, mercury, thallium, chromium, cobalt, molybdenum, manganese, nickel, selenium, and tin) in blood and urine were measured and lifestyle and demographic data were collected. Weighted multiple linear regressions were used to estimate associations of metals with BP in both single and multiple metal models. Weighted quantile sum (WQS) regression was performed to assess the relationship between metal mixture levels and BP. In the single metal model, after adjusting for potential confounding factors, the blood lead levels in the highest quartile were associated with the greater odds of both pre-hypertension (odds ratio (OR): 1.56, 95% CI: 1.22-1.99) and hypertension (OR:1.75, 95% CI: 1.28-2.40) when compared with the lowest quartile. We also found that blood arsenic levels were associated with increased odds of pre-hypertension (OR:1.31, 95% CI:1.00-1.74), while urinary molybdenum levels were associated with lower odds of hypertension (OR:0.68, 95% CI:0.50-0.93). No significant associations were found for the other 10 metals. WQS regression analysis showed that metal mixture levels in blood were significantly associated with higher SBP (β = 1.56, P < 0.05) and DBP (β = 1.56, P < 0.05), with the largest contributor being lead (49.9% and 66.8%, respectively). The finding suggests that exposure to mixtures of metals as measured in blood were positively associated with BP, and that lead exposure may play a critical role in hypertension development.
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Affiliation(s)
- Yingli Qu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Saisai Ji
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Liang Ding
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Ying Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Wenli Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Xiaojian Hu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Yifu Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Yawei Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Xu Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Mingyuan Zhang
- School of Public Health, Jilin University, 2699 Qianjin Street, Changchun, Jilin, 130012, China
| | - Yanwei Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Chengcheng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Miao Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Zheng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Lei Zheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Heng Gu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Huijuan Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Qi Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Jiayi Cai
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Shixun Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Bo Ying
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Shaobin Lin
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Zhaojin Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, United States
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, 30 Shuangqing Street, Haidian, Beijing, 100084, China; Environmental Research Center, Duke Kunshan University, 8 Duke Avenue, Kunshan, Jiangsu, 215316, China; Nicholas School of the Environment, Duke University, 2080 Duke University Road, Durham, NC, 27708, United States
| | - P Barry Ryan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, United States
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, United States
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 7 Panjiayuan Nanli, Chaoyang, Beijing, 100021, China.
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11
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Vargas EA, Chirinos DA, Wong M, Carnethon MR, Carroll AJ, Kiefe CI, Carson AP, Kershaw KN. Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study. J Behav Med 2022; 45:172-185. [PMID: 34671896 PMCID: PMC10083095 DOI: 10.1007/s10865-021-00259-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 09/22/2021] [Indexed: 11/24/2022]
Abstract
Psychosocial factors are associated with the achievement of optimal cardiovascular disease risk factor (CVDRF) levels. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing psychosocial profiles among individuals with CVDRF. Further, it is unknown whether profiles are associated with achievement of CVDRF levels longitudinally. Therefore, we characterized psychosocial profiles of individuals with CVDRF and assessed whether they are associated with achievement of optimal CVDRF levels over 15 years. We included 1148 CARDIA participants with prevalent hypertension, hypercholesterolemia and/or diabetes mellitus in 2000-2001. Eleven psychosocial variables reflecting psychological health, personality traits, and social factors were included. Optimal levels were deemed achieved if: Hemoglobin A1c (HbA1c) < 7.0%, low-density lipoprotein (LDL) cholesterol < 100 mg/dl, and systolic blood pressure (SBP) < 140 mm Hg. Latent profile analysis revealed three psychosocial profile groups "Healthy", "Distressed and Disadvantaged" and "Discriminated Against". There were no significant differences in achievement of CVDRF levels of the 3 targets combined across profiles. Participants in the "Distressed and Disadvantaged" profile were less likely to meet optimal HbA1c levels compared to individuals in the "Healthy" profile after demographic adjustment. Associations were attenuated after full covariate adjustment. Distinct psychosocial profiles exist among individuals with CVDRF, representing meaningful differences. Implications for CVDRF management are discussed.
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Affiliation(s)
- Emily A Vargas
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Diana A Chirinos
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mandy Wong
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Allison J Carroll
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Services, University of Massachusetts Medical School, Worcester, MA, USA
| | - April P Carson
- Departments of Medicine and Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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12
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Qureshi F, Soo J, Chen Y, Roy B, Lloyd-Jones DM, Kubzansky LD, Boehm JK. Optimism and Lipid Profiles in Midlife: A 15-Year Study of Black and White Adults. Am J Prev Med 2022; 62:e169-e177. [PMID: 35067361 PMCID: PMC8863618 DOI: 10.1016/j.amepre.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/03/2021] [Accepted: 09/26/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Optimism is associated with better cardiovascular health, yet little is known about the underlying mechanisms and whether protective relationships are consistently observed across diverse groups. This study examines optimism's association with lipid profiles over time and separately among Black and White men and women. METHODS Data were from 3,206 middle-aged adults in the Coronary Artery Risk Development in Young Adults study. Optimism was measured in 2000-2001 using the Revised Life Orientation Test. Triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol measurements were obtained at 5-year intervals through 2015-2016. Linear mixed models evaluated relationships between optimism and lipids, adjusting for covariates, including prebaseline lipids. Subgroup differences were examined using interaction terms and stratification. All analyses were conducted in 2020. RESULTS Higher optimism was associated with both lower baseline total cholesterol (β= -2.33, 95% CI= -4.31, -0.36) and low-density lipoprotein cholesterol levels (β= -1.93, 95% CI= -3.65, -0.21) and a more rapid incremental increase in both markers over time (total cholesterol: β=0.09, 95% CI=0.00, 0.18; low-density lipoprotein cholesterol: β=0.09, 95% CI=0.01, 0.16). No associations were apparent with baseline triglycerides, high-density lipoprotein cholesterol, or changes in either lipid over time. Tests for interaction only found evidence of heterogeneous associations with baseline triglyceride levels, but stratified models hinted at stronger protective associations with baseline levels of total cholesterol and low-density lipoprotein cholesterol among White women. CONCLUSIONS Optimism may help diverse individuals establish healthy total cholesterol and low-density lipoprotein cholesterol levels before midlife. Although associations were largely consistent across subgroups, stronger associations among White men and White women highlight a need to study optimism's health impact in diverse samples.
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Affiliation(s)
- Farah Qureshi
- 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.
| | - Jackie Soo
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brita Roy
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Laura D Kubzansky
- 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
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, California
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13
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Guimond AJ, Kubzansky LD, Boehm JK, Kivimaki M, Trudel-Fitzgerald C. Does life satisfaction reduce risk of incident hypertension and stroke? Evidence from the Whitehall II cohort. J Psychosom Res 2021; 144:110414. [PMID: 33711634 DOI: 10.1016/j.jpsychores.2021.110414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/15/2021] [Accepted: 03/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies showed life satisfaction is related to reduced risk of coronary heart disease and diabetes, but its association with other cardiometabolic endpoints including hypertension and stroke remains unexplored. This study examined life satisfaction's prospective association with incident hypertension and stroke in middle-aged adults. METHODS At baseline (1985-1988), 6225 healthy British civil servants aged 35-55 from the Whitehall II cohort completed the validated Satisfaction with Life Scale and provided information regarding sociodemographics, a range of health-related factors, and psychological distress. Incident hypertension was ascertained according to clinic-derived measures of systolic or diastolic blood pressure of ≥140/90 mmHg, respectively, or self-reports of either physician-diagnosed hypertension or hypertensive medication use. Incident stroke and transient ischemic attack (TIA) were ascertained by self-reported physician diagnosis. Follow-up assessments occurred every 2-5 years through 2017. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) of hypertension and stroke/TIA risk separately. RESULTS Over a 31-year follow-up, 2703 cases of hypertension and 370 cases of stroke/TIA occurred. Life satisfaction was not related to risk of developing hypertension but was associated with 12% decreased risk of stroke/TIA after controlling for sociodemographics, health status, and health behaviors (HRper 1-SD = 0.88; 95%CI = 0.79-0.98). However, the association was attenuated after adjustment for psychological distress. CONCLUSIONS No robust associations were found between life satisfaction and incident hypertension and stroke/TIA, respectively, after accounting for well-established risk factors and psychological distress. More research is needed to understand why associations of life satisfaction with cardiometabolic health seem to vary across endpoints.
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Affiliation(s)
- Anne-Josée Guimond
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, CA, USA
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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14
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Towards an Integrative "Lightness" of Being. J Altern Complement Med 2021; 27:290-293. [PMID: 33872061 DOI: 10.1089/acm.2021.29091.mbr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Boehm JK. Positive psychological well‐being and cardiovascular disease: Exploring mechanistic and developmental pathways. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2021; 15:e12599. [PMID: 35860033 PMCID: PMC9285725 DOI: 10.1111/spc3.12599] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/15/2021] [Accepted: 03/18/2021] [Indexed: 12/29/2022]
Abstract
Empirical research regarding the health benefits of positive psychological well‐being (e.g., positive emotions, life satisfaction, purpose in life, and optimism) has flourished in recent years, particularly with regard to cardiovascular disease. This paper reviews the state of evidence for well‐being's association with cardiovascular disease in both healthy individuals and those diagnosed with a disease. Prospective studies consistently indicate well‐being reduces cardiovascular events in healthy and, to a lesser extent, patient populations. Potential pathways that link well‐being with cardiovascular disease are discussed (including health behaviors, physiological processes, and stress buffering), although the existing evidence is mostly cross‐sectional which limits conclusions about directionality. Issues related to development across the lifespan are considered and childhood is identified as a crucial period for establishing healthy cardiovascular trajectories. Outstanding questions for future research are provided with recommendations to focus on well‐powered and prospective study designs with rigorous assessment of both well‐being and cardiovascular‐related outcomes.
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Affiliation(s)
- Julia K. Boehm
- Department of Psychology Chapman University Orange California USA
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16
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Lee HH, Okuzono SS, Kim ES, De Vivo I, Raffield LM, Glover L, Sims M, Grodstein F, Kubzansky LD. Optimism and telomere length among African American adults in the Jackson Heart Study. Psychoneuroendocrinology 2021; 125:105124. [PMID: 33434830 PMCID: PMC8052931 DOI: 10.1016/j.psyneuen.2020.105124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/20/2020] [Accepted: 12/27/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Optimism is linked with greater longevity in both White and African American populations. Optimism may enhance longevity by slowing cellular aging, for which leukocyte telomere shortening is a biomarker. However, limited studies have examined the association of optimism with leukocyte telomere length among African Americans. METHODS Data are from 723 men and 1244 women participating in the Jackson Heart Study (age = 21-93 years). We used multivariable linear regression models to conduct cross-sectional analyses examining whether higher optimism was associated with longer mean absolute leukocyte telomere length (assayed with Southern blot analysis). Models adjusted for sociodemographic characteristics, depressive symptomatology, health conditions, and health behavior-related factors. We also considered potential effect modification by key factors. RESULTS In the age-adjusted model, optimism, measured as a continuous variable, was not associated with leukocyte telomere length (β = 0.01, 95%CI: -0.02, 0.04). This association remained null in the fully-adjusted model (β = 0.02, 95%CI: -0.02, 0.05) and was also null when considering optimism as a binary measure (higher vs. lower optimism). We found no evidence of effect modification by sex, age, body mass index, income, or chronic conditions. CONCLUSIONS Optimism was not associated with leukocyte telomere length among African American adults. Future studies should investigate alternate biological and behavioral mechanisms that may explain the optimism-health association.
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Affiliation(s)
- Harold H. Lee
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (Address: 677 Huntington Ave, Boston, MA 02115)
| | - Sakurako S. Okuzono
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (Address: 677 Huntington Ave, Boston, MA 02115)
| | - Eric S. Kim
- Department of Psychology, University of British Columbia (Address: 2136 West Mall, Vancouver, BC V6T 1Z4, Canada)
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, (Address: 677 Huntington Ave, Boston, MA 02115)
| | - Laura M. Raffield
- Department of Genetics, University of North Carolina at Chapel Hill (Address: Genetic Medicine Building, 120 Mason Farm Rd, Chapel Hill, NC 27514)
| | - LáShauntá Glover
- Department of Epidemiology, University of North Carolina at Chapel Hill (Address: 135 Dauer Dr, Chapel Hill, NC 27599)
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center (Address: 2500 N State St, Jackson, MS 39216)
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center (Address: 600 South Paulina Street, Suite 1028, Chicago, IL 60612)
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (Address: 677 Huntington Ave, Boston, MA 02115)
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