The relationship between subjective well-being and mortality within discordant twin pairs from two independent samples

Association between subjective well-being and all-cause mortality among older adults in China

BACKGROUND

Although several studies in high-income countries have suggested a positive association between subjective well-being (SWB) and mortality, studies conducted in low- and middle-income countries, such as China, are scarce. The purpose of this study is to examine the association between SWB and all-cause mortality among the older Chinese population.

METHODS

Data were from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a population-based longitudinal cohort study in 22 of 31 provinces in mainland China. A total of 13,282 individuals aged 65 ≥ years who were recruited in 2002 and followed-up until 2018 were included. SWB was assessed with an eight-item tool covering life satisfaction, positive affect (including optimism, happiness, personal control and conscientiousness) and negative affect (including anxiety, loneliness and uselessness). Cox proportional hazards regression methods were carried out to estimate the association between SWB and total mortality, adjusting for a wide range of potential confounders. Subgroup analyses and interaction analyses were further conducted.

RESULTS

During the 16.5 years of follow-up, 8459 deaths were identified. Greater SWB was independently associated with a reduced risk of all-cause mortality (adjusted hazard ratio [HR] = 0.85, 95% confidence interval [CI] = 0.81-0.89) after adjustment for age, sex, marital status, education level, place of residence, smoking status, drinking, exercise, diet, BMI, hypertension, diabetes, heart disease, cerebrovascular diseases and cancer. Of the eight individual SWB symptoms, only 2 items, feelings of uselessness (adjusted HR = 0.94, 95% CI = 0.89-0.99) and happiness (adjusted HR = 0.91, 95% CI = 0.86-0.95), were significantly associated with total mortality. Associations remained significant across all subgroups regardless of different characteristics.

CONCLUSIONS

Higher SWB overall and 2 certain symptoms (feelings of uselessness and happiness) were independently associated with all-cause mortality risk among older Chinese adults. The association was consistent across different groups, suggesting that promoting a healthier SWB may be beneficial to all older individuals irrespective of their characteristics.

Health, Functional Ability, and Environmental Quality as Predictors of Life Satisfaction in Physically Active Older Adults

The factors that make physically active older people feel more satisfied in adulthood have not been extensively studied. For this reason, the aim of this work has been to evaluate, among physically active older adults, whether the level of physical activity they perform and the factors that foster their quality of life can be predictors of their satisfaction with life. For this, the IPAQ, CUBRECAVI and LSI-A scales were applied to a sample of 397 people between 61 and 93 years old (M = 69.65, SD = 4.71). The results show that health (β = 0.373), functional abilities (β = 0.159) and environmental quality (β = 0.105) are predictors of satisfaction in the most active adults. In conclusion, neither physical activity (to a greater or lesser extent) nor income are predictive variables of satisfaction with life but, rather, predict some of the components that cement their quality of life (health, fending for themselves and the home environment).

Productive Activities But Not Paid Work Relate to Well-Being in Older Adults

Productive activity engagement may positively contribute to the subjective well-being (SWB) of older adults during retirement. The current study explored the relationships between paid work and productive activities and SWB in Medicare beneficiary older adults predominantly living in the community. The 2015-2016 data (N = 2,916) from the National Health and Aging Trends Study were used. Multiple linear regressions with complex survey data were performed. Aside from paid work, the productive activities included in the analyses were volunteer work, caregiving role, social participation, online networking, and physical activity. After controlling for health-related, sociodemographic, and baseline SWB variables, three productive activities, but not paid work, were significantly related to SWB. Older adults who were physically active, engaged in volunteer work, and had increased social participation had significantly increased SWB. These findings encourage older adults to remain physically active and engage when possible in productive activities that are more social than economic in nature. [Research in Gerontological Nursing, 14(1), 24-32.].