An outcome-wide analysis of bidirectional associations between changes in meaningfulness of life and health, emotional, behavioural, and social factors

Bidirectional associations between meaning in life and the health, emotional ill-being and daily life functioning outcomes among older adults

OBJECTIVE

Meaning and purpose in life are recognised health determinants. Evidence on the factors contributing to the experience of meaning and purpose in life is limited. The bidirectional associations between the experience of meaning in life and physical health, emotional ill-being and daily life functioning from a 6-year perspective are examined.

METHODS AND MEASURES

Longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed using generalised estimating equations. The sample included 16,361 middle-aged and older adults from 13 countries.

RESULTS

Living a meaningful life was found to be associated with subsequent reduced risks of depression, loneliness, limitations in activities of daily living, and heart attack (at the 6-year follow-up). It was also found that prior experience of depression, loneliness and limited activities of daily living were associated with subsequent reduced sense of meaningful life. These associations were independent of demographics, socioeconomic status, personality, prior history of diseases and lifestyle. The sensitivity analyses provided evidence for the robustness of these associations.

CONCLUSIONS

Evidence for health practitioners and policymakers on factors that may hamper the development and maintenance of meaningful life as well as on the role of sense of meaning in life for healthy aging was presented.

Beyond the single-outcome approach: A comparison of outcome-wide analysis methods for exposome research

Outcome-wide analysis can offer several benefits, including increased power to detect weak signals and the ability to identify exposures with multiple effects on health, which may be good targets for preventive measures. Recently, advanced statistical multivariate techniques for outcome-wide analysis have been developed, but they have been rarely applied to exposome analysis. In this work, we provide an overview of a selection of methods that are well-suited for outcome-wide exposome analysis and are implemented in the R statistical software. Our work brings together six different methods presenting innovative solutions for typical problems arising from outcome-wide approaches in the context of the exposome, including dependencies among outcomes, high dimensionality, mixed-type outcomes, missing data records, and confounding effects. The identified methods can be grouped into four main categories: regularized multivariate regression techniques, multi-task learning approaches, dimensionality reduction approaches, and bayesian extensions of the multivariate regression framework. Here, we compare each technique presenting its main rationale, strengths, and limitations, and provide codes and guidelines for their application to exposome data. Additionally, we apply all selected methods to a real exposome dataset from the Human Early-Life Exposome (HELIX) project, demonstrating their suitability for exposome research. Although the choice of the best method will always depend on the challenges to be faced in each application, for an exposome-like analysis we find dimensionality reduction and bayesian methods such as reduced rank regression (RRR) or multivariate bayesian shrinkage priors (MBSP) particularly useful, given their ability to deal with critical issues such as collinearity, high-dimensionality, missing data or quantification of uncertainty.

Predicting wellbeing over one year using sociodemographic factors, personality, health behaviours, cognition, and life events

Various sociodemographic, psychosocial, cognitive, and life event factors are associated with mental wellbeing; however, it remains unclear which measures best explain variance in wellbeing in the context of related variables. This study uses data from 1017 healthy adults from the TWIN-E study of wellbeing to evaluate the sociodemographic, psychosocial, cognitive, and life event predictors of wellbeing using cross-sectional and repeated measures multiple regression models over one year. Sociodemographic (age, sex, education), psychosocial (personality, health behaviours, and lifestyle), emotion and cognitive processing, and life event (recent positive and negative life events) variables were considered. The results showed that while neuroticism, extraversion, conscientiousness, and cognitive reappraisal were the strongest predictors of wellbeing in the cross-sectional model, while extraversion, conscientiousness, exercise, and specific life events (work related and traumatic life events) were the strongest predictors of wellbeing in the repeated measures model. These results were confirmed using tenfold cross-validation procedures. Together, the results indicate that the variables that best explain differences in wellbeing between individuals at baseline can vary from the variables that predict change in wellbeing over time. This suggests that different variables may need to be targeted to improve population-level compared to individual-level wellbeing.

Mind-stimulating leisure activities: Prospective associations with health, wellbeing, and longevity

Introduction

This study examines prospective associations within a 6-year perspective between three mind-stimulating leisure activities (relaxed and solitary: reading; serious and solitary: doing number and word games; serious and social: playing cards and games) and 21 outcomes in (1) physical health, (2) wellbeing, (3) daily life functioning, (4) cognitive impairment, and (5) longevity domains.

Methods

Data were obtained from 19,821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Temporal associations were obtained using generalized estimating equations. All models were controlled for prior sociodemographic, personality, lifestyle factors, health behaviors, and pre-baseline leisure activity values and all outcome variables. The Bonferroni correction was used to correct for multiple testing. E-values were calculated to examine the sensitivity of the associations to unmeasured confounding. Secondary analyses (1) under the complete case scenario, (2) after excluding respondents with health conditions, and (3) using a limited set of covariates were conducted to provide evidence for the robustness of the results.

Results

The relaxed solitary activity of reading almost daily was prospectively associated with a lower risk of depression, experiencing pain, daily functioning limitations, cognitive impairment, lower loneliness scores, and more favorable wellbeing outcomes. Engaging in serious solitary leisure activities almost daily was prospectively associated with a lower risk of depression, feeling full of energy, and a lower risk of death by any cause. Occasionally engaging in these activities was prospectively associated with greater optimism and a lower risk of cognitive impairment. Engaging in serious social activities was prospectively associated with greater happiness, lower scores on the loneliness scale, a lower risk of Alzheimer's disease, and an increased risk of cancer. Additionally, occasionally engaging in serious social activities was associated with greater optimism and lower risk of depression, pain, and mobility limitations. These associations were independent of demographics, socioeconomic status, personality, history of diseases, and prior lifestyle. The sensitivity analyses provided substantial evidence for the robustness of these associations.

Discussion

Mind-engaging leisure activities can be considered a health and wellbeing resource. Practitioners may consider them tools that help middle-aged and older adults maintain their health and quality of life.

Correlated Change in Sense of Purpose and Romantic Relationship Quality

Sense of purpose, or feeling that that one has personally meaningful goals and directions guiding them through life, consistently predicts a variety of desirable well-being, health, and social outcomes. However, work has been limited with respect to evaluating it as a predictor and promoter of romantic relationships, or how purpose may develop in these contexts. For instance, healthy romantic relationships could also help individuals develop and maintain a higher sense of purpose. With cross-sectional evidence finding positive associations between sense of purpose and romantic relationship commitment and satisfaction, the current study expanded on past work by using longitudinal data with three months between two measurement occasions (Time 1: N = 2243; Time 2: N = 1284) to evaluate whether sense of purpose predicted relationship status over time and how changes in relationship quality and sense of purpose were associated. Results showed that greater sense of purpose predicted maintaining a romantic relationship, but did not predict later romantic relationship quality, while higher romantic relationship quality predicted an increase in sense of purpose. Findings are discussed regarding why people with a higher sense of purpose may be more likely to stay in relationships as well as the role that positive romantic relationships may play in helping maintain a higher sense of purpose.

The magnitude and importance of perceived health dimensions define effective tailor-made health-promoting interventions per targeted socioeconomic group

Recent insights and developments on health and society urge a critical look at the positive relationship between socioeconomic status (SES) and health. We challenge the notions that it is sufficient to distinguish only between two groups of SES (low and high) and that only overall health is taken into account. A new grouping of SES was developed based on both income and education, resulting in six SES groups. Health was defined in terms of a new positive health concept, operationalized into six health dimensions generating a measure of total general health (TGH). Next, six socioeconomic and demographic determinants of health were included. Linear regression, T-tests and one-way ANOVA were applied to investigate the relationships in a Dutch sample. A subjective way to measure health was applied: self-rated health (SRH). As a result, four out of six dimensions of health determined TGH: bodily functions, daily functioning, quality of life, and social and societal participation. Three out of six socioeconomic and demographic determinants impacted TGH: housing situation, age, and difficulties meeting financial obligations. While this is the general picture for the entire sample, there were interesting similarities and differences between the six SES groups. The similarities lie in the positive impact of the evaluation of bodily functions and daily functioning on TGH in all SES groups. The other dimensions affected TGH in some groups, and some dimensions only in one SES group. None of the socioeconomic and demographic determinants affected TGH in all SES groups. New insights on health inequalities are provided. It is concluded, first that the well-known positive relationship between SES and health is confirmed in this study. Second, further refining the health concept into six dimensions provides more detailed insights on which dimensions impact health the most. The subjective approach applied offers more refined information to better understand which health issues really matter to people. This yields new insights to develop tailor-made interventions aimed at increasing healthy behaviour in specific societal groups.

Social Mobility and Sense of Purpose From Midlife to Old Age: Examining the Role of Major Life Events

Purpose in life (PIL) has been linked with numerous health benefits and adaptive aging, yet it diminishes with age, possibly due to loss of social or familial roles through life transitions. Drawing from the longitudinal surveys of the Midlife in the US study (n = 3418), we use time-varying coefficient models to investigate how the trajectory of PIL differs across cumulatively (dis)advantaged, upwardly mobile, and downwardly mobile groups and the role of major life events in shaping these trajectories. We found the upwardly mobile group exhibits higher PIL than the cumulatively disadvantaged and downwardly mobile groups. The consistently disadvantaged group experiences more adverse events at non-normative times. Socioeconomic status disparities in PIL during old age decrease after controlling for life events. We discuss how and why well-being changes and the role of structural and social factors in facilitating or impeding the development or maintenance of PIL over the life course.

Can adherence to moral standards and ethical behaviors help maintain a sense of purpose in life? Evidence from a longitudinal study of middle-aged and older adults

Personal factors, such as character strengths, have been shown to be favorably associated with concurrent and future well-being. Positive associations have also been reported between purpose in life and concurrent and subsequent health and well-being. Evidence on antecedents of purpose in life is, however, limited. This study examines whether the adherence to moral standards and ethical behaviors (AMSEB) is associated with subsequent purpose in life. Data from the Health and Retirement Study obtained from a sample of 8,788 middle-aged and older adults in the US (mean age = 64.9 years, age range 50–96 years) were used. The prospective associations between AMSEB and purpose in life were examined using generalized linear models. A rich set of covariates and prior outcomes were used as controls to reduce the risk of reverse causation. The robustness analyses included computation of sensitivity measures, E-values, and running a set of secondary analyses conducted on subsamples of respondents and using a limited set of covariates. It was found that middle-aged and older adults who demonstrated higher AMSEB reported a higher sense of purpose in life after the 4-year follow-up period. This association was found to be monotonic, moderately robust to potential unmeasured confounding and independent of demographics, prior socioeconomic status, prior health conditions, and health behaviors as well as prior psychological predispositions such as dispositional optimism and life satisfaction. It was also robust to missing data patterns. Policymakers and health practitioners may consider a predisposition to adherence to moral standards and ethical behaviors as a potential intervention target, as its improvement and/or maintenance has the potential to improve longevity and to help promote healthy and purposeful aging.

Prospective Associations Between Social Connectedness and Mental Health. Evidence From a Longitudinal Survey and Health Insurance Claims Data

Objectives: Evidence on social stimuli associated with mental health is based mostly on self-reported health measures. We aimed to examine prospective associations between social connectedness and clinical diagnosis of depression and of anxiety.

Methods: Longitudinal observational data merged with health insurance data comprising medical information on diagnosis of depression and anxiety were used. 1,209 randomly sampled employees of a US employer provided data for the analysis. Robust Poisson regression models were used. Multiple imputation was conducted to handle missing data on covariates.

Results: Better social connectedness was associated with lower risks of subsequently diagnosed depression and anxiety, over a one-year follow-up period. Reports of feeling lonely were associated with increased risks of depression and anxiety. Association between community-related social connectedness and subsequent diagnosis of depression, but not of anxiety, was found. The associations were independent of demographics, socioeconomic status, lifestyle, and work characteristics. They were also robust to unmeasured confounding, missing data patterns, and prior health conditions.

Conclusion: Social connectedness may be an important factor for reducing risks of depression and anxiety. Loneliness should be perceived as a risk factor for depression and anxiety.

Associations of recognition at work with subsequent health and quality of life among older working adults

PURPOSE

Recognition for work-an act of conveying non-financial appreciation for an outstanding accomplishment or performance-is the top motivator of employee performance and important contributor to psychologically healthy work. Employee recognition programs are offered by many companies and have been shown to retain top talent, increase job satisfaction, and performance. Yet, evidence on the role of received employee recognition for health and quality of life remains limited. This study examined whether receiving recognition for work was prospectively associated with six indicators of health, quality of life, and loneliness.

METHODS

Data were retrieved from the Survey of Health, Ageing and Retirement in Europe (SHARE), a biennial cross-national panel database of people aged > 50 years. Our sample included 5,048 middle-aged and older working adults.

RESULTS

The results indicated that employees receiving recognition for work reported higher quality of life ([Formula: see text]=0.065, 95% CI = 0.047, 0.082), had lower risks of hypertension (RR = 0.932; 95% CI = 0.899, 0.966) and high blood cholesterol (RR = 0.922; 95% CI = 0.879, 0.967). These associations were independent of demographics, socioeconomic status, personality, prior history of diseases, depression, lifestyle, and work conditions. The set of sensitivity analyses provided substantial evidence for the robustness of the associations between recognition for work and quality of life as well as hypertension but not necessarily with high blood cholesterol.

CONCLUSIONS

Promotion of employee recognition might emerge as a valuable business resource and health policy tool helping middle-aged and older adults maintain health and good quality of life. It may also help willing older adults to remain on the labour market until older age.

Ikigai and subsequent health and wellbeing among Japanese older adults: Longitudinal outcome-wide analysis

Background

Methods

Findings

Interpretation

Funding

Positive health during the COVID-19 pandemic: a survey among community-dwelling older individuals in the Netherlands

Background

Coronavirus Disease 2019 (COVID-19) reached the Netherlands in February 2020. To minimize the spread of the virus, the Dutch government announced an “intelligent lockdown”. Older individuals were urged to socially isolate completely, because they are at risk of a severe disease course. Although isolation reduces the medical impact of the virus, the non-medical impact should also be considered.

Aim

To investigate the impact of COVID-19 pandemic and associated restrictive measures on the six dimensions of Positive Health in community-dwelling older individuals living in the Netherlands, and to identify differences within subgroups.

Methods

In May/June 2020, community-dwelling older individuals aged ≥ 65 years completed an online survey based on Huber’s model of Positive Health. Positive Health was measured regarding the appreciation of the six dimensions (categorized as poor/satisfactory/excellent) and a comparison with a year before (categorized as decreased/unchanged/increased) using frequencies (%) and a chi-square test.

Results

834 older individuals participated (51% women, 38% aged ≥ 76 years, 35% living alone, 16% self-rated poor health). Most respondents assessed their bodily functions, mental well-being and daily functioning as satisfactory, their meaningfulness and quality of life (QoL) as excellent, and their social participation as poor. 12% of the respondents reported a deterioration of 4–6 dimensions and 73% in 1–3 dimensions, compared to the past year. Deterioration was most frequently experienced in the dimension social participation (73%), the dimension mental well-being was most frequently improved (37%) and quality of life was in 71% rated as unchanged. Women more often observed a deterioration of 4–6 dimensions than men (15% vs. 8%, p = 0.001), and individuals with self-rated poor health more often than individuals with self-rated good health (22% vs. 10%, p < 0.001). Older individuals living alone experienced more frequently a decrease in meaningfulness compared to older individuals living together.

Conclusion

The COVID-19 pandemic and associated restrictive measures had a substantial impact on all six dimensions of Positive Health in community-dwelling older individuals, especially in women, respondents living alone and respondents with self-rated poor general health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02737-2.

Searching for meaning is associated with costly prosociality

The study of meaning in life has largely centered on its relationship with personal well-being, while a focus on how meaning is related to enhancing the well-being of others has received less research attention. Although searching for meaning may imply lower personal well-being, we find that meaning-seekers are more motivated to perform costly prosocial actions for the sake of others’ well-being, given the perceived meaningfulness of these behaviors. Studies 1–4 (N = 780) show that meaning-seeking correlates with the motivation to engage in a range of costly prosocial behaviors. Meaning-seeking is further shown to be distinct from pursuing happiness in its relationship with costly prosociality (Study 2 & 3) and to share a stronger association with high-cost than low-cost prosociality (Study 3 & 4). Study 5 (N = 370; pre-registered) further shows that the search for meaning is related to costly prosocial behavior in the recent past. While our studies are cross-sectional, the pattern of findings suggests that seeking meaning (rather than happiness) may play an important role in motivating altruistic tendencies.

Maintaining Sense of Purpose Following Health Adversity in Older Adulthood: A Propensity Score Matching Examination

OBJECTIVES

Research has demonstrated sense of purpose predicts better health in older adulthood. However, work is limited with respect to understanding how experiencing a health event or illness diagnosis impacts older adults' sense of purpose.

METHOD

The current study employed a propensity score matching approach to compare older adults who did or did not experience an adverse health event on changes in sense of purpose across 3 waves of the Health and Retirement Study. Sense of purpose was assessed at each wave, and changes were compared between people who did versus did not experience one of 7 diagnoses and health events.

RESULTS

When propensity score matching was employed, no differences in trajectories of change for sense of purpose were found with respect to all 7 events. Individual differences in trajectories, however, were evidenced across groups.

DISCUSSION

The current findings suggest that even when health events impact older adults' physical functioning or place limitations on their activity, they may hold little ramifications for their sense of purpose. Future research should consider this potential for resilience, focusing on how adults compensate for losses.

The Role of Financial Fragility and Financial Control for Well-Being

Financial fragility is recognized as a substantial issue for individual well-being. Various estimates show that between 46 and 59% of American adults are financially fragile and thus vulnerable in terms of their well-being. We argue that the role of financial control in shaping well-being outcomes-despite being less recognized in the literature than the role of financial fragility-is equally or even more important. Our study is a longitudinal cohort study that made use of observational data. Two waves of the Well-Being Survey data from 1448 U.S. adults were used in the analysis. Impacts of financial fragility and financial control on 17 well-being outcomes were examined, including emotional well-being (nine outcomes), physical well-being (four outcomes), social well-being (two outcomes), in addition to an unhealthy days summary measure and the flourishing index. Financial fragility was shown to be on average less influential for the well-being outcomes than financial control. Our results suggest that financial control plays a protective role for complete well-being. Less evidence in support of a harmful role of financial fragility for well-being is provided. Tests for moderation effects revealed no interaction between financial control and financial fragility within our sample, indicating that financial control did not modify the relationship between financial fragility and well-being.

Purpose by design or disaster: Preserving a sense of purpose amid environmental uncertainty

Psychological research suggests a sense of purpose in life is a coveted asset, with well-established linkages to well-being and healthy functioning. But how do individuals preserve this sense when previously reliable settings - and the opportunities they afford - are profoundly disrupted? The current moment provides a formidable test of this question, as widespread transmission of Covid-19 and intense efforts to slow it drastically transform our environment. Here, we consider how the experience of purpose may be impacted by disruptions in three key person-environment interactions: how we engage with work, how we engage in education, and how we manage physical proximity. We hope to motivate critical thinking about how this pandemic, and our collective responses to it, influence the experience of purpose and delineate a research agenda that may inform how individuals' can preserve a sense of engagement and contribution.