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Esch T, Stefano GB, Michaelsen MM. The foundations of mind-body medicine: Love, good relationships, and happiness modulate stress and promote health. Stress Health 2024; 40:e3387. [PMID: 38442034 DOI: 10.1002/smi.3387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/22/2023] [Accepted: 02/14/2024] [Indexed: 03/07/2024]
Abstract
Although stress is an everyday fact of life, it can lead to poor health outcomes, particularly when intense or prolonged. However, humans have unique cognitive abilities and thus may be able to combat stress by engaging critical psychological defence mechanisms. In this review, we discuss the field of mind-body medicine, which focuses on improving our understanding of the mechanisms underlying this response and developing interventions that might be used to limit the effects of chronic stress. We review the findings of past and current research in this field that has focused on the impact of psychological, emotional, and behavioural factors, including love, social connectedness, and happiness on human health and the amelioration of pain as well as other signs and symptoms of disease. While these studies have not yet led to confirmed, quantifiable conclusions, the overall weight of evidence suggests that happiness (defined as a personal sense of well-being) may be directly associated with improved health parameters and reductions in debilitating symptoms. Collectively, these findings suggest that interventions designed to promote stress mitigation, notably those that encourage social activity, may lead to significant improvements in human health.
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Affiliation(s)
- Tobias Esch
- Institute for Integrative Health Care and Health Promotion, Witten/Herdecke University, Witten, Germany
| | - George B Stefano
- Institute for Integrative Health Care and Health Promotion, Witten/Herdecke University, Witten, Germany
- First Faculty of Medicine, Department of Psychiatry of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Prague, Czech Republic
| | - Maren M Michaelsen
- Institute for Integrative Health Care and Health Promotion, Witten/Herdecke University, Witten, Germany
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Telles R, Whitney BM, Froelich S, Lutgendorf SK. Mindfulness-based psychosocial interventions and psychological wellbeing in cancer survivorship: a meta-analysis. Health Psychol Rev 2024:1-27. [PMID: 38561221 PMCID: PMC11556419 DOI: 10.1080/17437199.2024.2336014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Among cancer survivors, mindfulness-based interventions appear promising in decreasing distress for cancer patients, but little attention has been paid to the ultimate mindfulness goal of increasing psychological wellbeing. This meta-analysis aims to summarise and synthesise available evidence concerning the effectiveness of MBIs on positive psychological outcomes reflecting key aspects of psychological wellbeing in heterogeneous cancer patients. METHODS A literature search of mindfulness-based randomised clinical trials in cancer survivors was conducted across six electronic databases. Two reviewers independently screened studies and extracted data. Meta-analyses were conducted using R; standardised mean difference (SMD) was used to determine intervention effect. Moderators examined included therapeutic orientation, control group type, treatment modality, treatment target, heterogeneous vs. homogeneous cancer type, and facet of wellbeing. RESULTS Thirty-one studies were included (N = 2651). Those who received mindfulness-based interventions reported significantly higher eudaimonic, hedonic, and social wellbeing than respondents in control groups (SMD = 0.599). Interventions were equally effective across therapeutic orientation, control group type, treatment modality and treatment target. There were trend level differences favouring homogeneous cancer diagnosis groups over heterogeneous diagnosis groups. CONCLUSION MBIs provide an effective treatment for increasing psychological wellbeing in cancer survivors. This finding has important implications for clinical practice.
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Affiliation(s)
- Rachel Telles
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA
| | - Brendan M. Whitney
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA
| | - Sarah Froelich
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA
| | - Susan K. Lutgendorf
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA
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Demir ZG, Yılmaz M. Loneliness, Psychological Well-being, Depression, and Social Participation in the Older Persons: Rural and Urban Differences. Curr Aging Sci 2024; 17:247-261. [PMID: 38638048 DOI: 10.2174/0118746098297063240409070531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION The purpose of this study is to compare the loneliness, psychological well- being, depression, and social participation of elderly people living in Turkish society between rural and urban areas. The sample group of the study, in which a correlational survey model was used, consisted of 610 elderly adults. METHOD The study population consists of two groups: the first group consists of individuals over 65 years of age living in the city (Istanbul) (n= 291), and the second group consists of individuals over 65 years of age living in rural areas (rural areas of Ordu) (n= 319). Socio-demographic Information Form, Loneliness in the Elderly Scale, Geriatric Depression Scale, Psychological Well-Being in the Elderly Scale, and Social Inclusion Scale were applied online. Statistical analyses of the study were conducted using SPSS 27.00, and the Independent Samples t-test and ANOVA test were used. RESULTS According to the findings of this study, statistically significant results were found in psychological well-being, social inclusion, social relations, loneliness and depression, and place of residence. It was observed that the social isolation and social acceptance levels of those living in urban areas were higher than those living in rural areas. Social, loneliness, and depression scores of those living in the village/town were found to be higher than those living in the city centre. Furthermore, the social relationship scores of those living in the village/town were found to be higher than those living in the city centre. CONCLUSION The increasing elderly population worldwide has become an issue that requires global measures. Place of residence is one of the factors thought to affect older people's health and well- being. It is thought that the study data will contribute to new policies that will ensure the protection and promotion of elderly health and those working in this field. In addition, the study, which provides information about Turkish culture, will also enable intercultural comparisons.
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Affiliation(s)
| | - Mahmut Yılmaz
- Specialised Clinical Psychologist, Istanbul Aydın University, Istanbul, Turkey
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Ishikawa S, Konta T, Susa S, Ishizawa K, Makino N, Ueno Y, Okuyama N, Iino M. Associations between subjective well-being, number of teeth, and self-rated mastication in Japanese adults: A cross-sectional study. Medicine (Baltimore) 2023; 102:e36354. [PMID: 38050319 PMCID: PMC10695613 DOI: 10.1097/md.0000000000036354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023] Open
Abstract
This cross-sectional study aimed to investigate the risk factors for low levels of subjective well-being (SWB) in the general population of Japan, specifically, the impact of the number of teeth and self-rated mastication. The surveyed population consisted of individuals aged between 40 and 79 years from Yamagata prefecture, Japan. A postal self-administered questionnaire survey of respondents lifestyles, medical history, oral health, and dietary intake, was conducted from 2017 to 2021. We included 6846 participants to confirm the independent associations between SWB and several parameters using multivariate ordinal logistic regression analysis to estimate adjusted odds ratios and 95% confidence intervals. Individuals with < 20 teeth and poor mastication ability had a 1.3-fold risk for low levels of SWB compared with individuals with ≥ 20 teeth with good mastication ability (adjusted odds ratios = 1.300, 95% confidence intervals = 1.043-1.621, P = .020). There were no differences between individuals with good mastication ability, regardless of the number of remaining teeth. Our study emphasizes not only the importance of having ≥ 20 teeth and good mastication ability for high levels of SWB but also the importance of restoring mastication ability using some form of prosthesis, to facilitate a high level of SWB when the number of remaining teeth is < 20.
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Affiliation(s)
- Shigeo Ishikawa
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University Graduate School of Medicine, Yamagata, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata, Japan
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Naohiko Makino
- Yamagata University Health Administration Center, Yamagata, Japan
| | - Yoshiyuki Ueno
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Naoki Okuyama
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Putra IGNE, Daly M, Sutin A, Steptoe A, Robinson E. The psychological legacy of past obesity and early mortality: evidence from two longitudinal studies. BMC Med 2023; 21:448. [PMID: 37974151 PMCID: PMC10655273 DOI: 10.1186/s12916-023-03148-3] [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] [Received: 05/12/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND We test a novel 'weight scarring' hypothesis which suggests that past obesity is associated with impairments in current psychological well-being and this increases risk of negative physical health outcomes associated with obesity. Across two nationally representative studies, we tested whether past obesity is associated with current psychological outcomes and whether these psychological outcomes explain the association between past obesity and subsequent early mortality. METHODS Data were from the National Health and Nutrition Examination Survey (NHANES) (n = 29,047) and the Health and Retirement Study (HRS) (n = 11,998). Past obesity was defined based on maximum lifetime weight in NHANES and the highest weight from past study waves in the HRS. Across both studies, current depressive symptoms were analysed. A set of 10 additional well-being measures were combined to produce an 'index of impaired well-being' in HRS. Subsequent all-cause mortality was examined using National Deaths Index records in NHANES and household interviews in HRS. Linear or logistic regression, Cox proportional hazard regression, and causal mediation models were used. RESULTS We found that past obesity was associated with greater current depressive symptoms after controlling for current weight status and in analyses limited to those who were no longer classified as having obesity in NHANES (β = 0.17; 95% CI: 0.13, 0.22) and HRS (β = 0.20; 95% CI: 0.08, 0.31). In HRS, past obesity was also associated with a range of current negative psychological outcomes, including an index of impaired psychological well-being (β = 0.16; 95% CI: 0.05, 0.27). Past obesity was associated with a higher risk of early mortality in both NHANES and HRS (HR = 1.31; 95% CI: 1.16, 1.48 and HR = 1.34; 95% CI: 1.20, 1.50, respectively). Depressive symptoms explained 6% (95% CI: 0.01, 0.10) and 5% (95% CI: 0.01, 0.09) of the association between past obesity and premature mortality in NHANES and HRS, respectively. Impaired psychological well-being partly mediated the association between past obesity and premature mortality by 10% (95% CI: 0.04, 0.16) in HRS. CONCLUSIONS Our findings suggest that there may be a psychological legacy of past obesity that is associated with raised mortality risk. Ensuring people with obesity receive psychological support even after experiencing weight loss may be important.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- Department of Psychology, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Michael Daly
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Angelina Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, USA
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Eric Robinson
- Department of Psychology, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
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Song CF, Tay PKC, Gwee X, Wee SL, Ng TP. Happy people live longer because they are healthy people. BMC Geriatr 2023; 23:440. [PMID: 37464330 DOI: 10.1186/s12877-023-04030-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/09/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES 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. METHODS 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. RESULTS 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). DISCUSSION 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.
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Affiliation(s)
- Cai Feng Song
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Dr, Singapore, Singapore, 138683, Singapore
| | - Peter Kay Chai Tay
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Dr, Singapore, Singapore, 138683, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shiou Liang Wee
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Dr, Singapore, Singapore, 138683, Singapore.
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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El Keshky MES, Khusaifan SJ, Kong F. Gratitude and Life Satisfaction among Older Adults in Saudi Arabia: Social Support and Enjoyment of Life as Mediators. Behav Sci (Basel) 2023; 13:527. [PMID: 37503974 PMCID: PMC10376453 DOI: 10.3390/bs13070527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
This cross-sectional study aimed to investigate the relationship between gratitude and life satisfaction, and the mediation role of social support and enjoyment of life among older individuals. The measures employed include the Gratitude, Resentment, and Appreciation test; the Enjoyment of Life scale; the Satisfaction with Life scale; and the Multidimensional Scale of Perceived Social Support. These were administered to a sample of 260 older individuals aged between 60 and 80. The main findings revealed a positive association between gratitude and life satisfaction, and social support was a partial mediator in this relationship. Although enjoyment of life was not a direct mediator in the relationship between gratitude and life satisfaction, the final model indicated a significant serial pathway from gratitude to social support and then through enjoyment of life to life satisfaction. In conclusion, enhancing gratitude, promoting the enjoyment of life, and social support to older individuals might increase their life satisfaction, which in turn might contribute to their successful aging.
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Affiliation(s)
- Mogeda El Sayed El Keshky
- Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Psychology, Faculty of Arts, Assiut University, Asyut 71515, Egypt
| | - Shatha Jamil Khusaifan
- Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Feng Kong
- School of Psychology, Shaanxi Normal University, Xi'an 710062, China
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Shi X, He X, Pan D, Qiao H, Li J. Happiness, depression, physical activity and cognition among the middle and old-aged population in China: a conditional process analysis. PeerJ 2022; 10:e13673. [PMID: 35782096 PMCID: PMC9248807 DOI: 10.7717/peerj.13673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/13/2022] [Indexed: 01/17/2023] Open
Abstract
Background Happiness is one variable of subjective well-being, which has been increasingly shown to have protective effects on health. Although the association between happiness and cognition has been established, the mechanism by which happiness leads to cognition remains unclear. Since happiness, depression, and physical activity may all be related to cognition, and happiness is related to depression and physical activity, this study explored the effect of depression and physical activity on the relationship between happiness and cognition among middle and old-aged individuals in China. Methods Data on 14,344 participants above 45 years of age were obtained from the 2018 China Family Panel Studies survey. A multiple linear regression analysis was performed to identify the correlation factors of cognition. The conditional process analysis was used to assess the mediatory effect of depression and physical activity on the relationship between happiness and cognition. Results Residence, age, sex, income level, social status, smoking, napping, reading, education, exercise times, satisfaction, happiness, and depression had associations with cognition. When other variables were held constant, cognition score increased by 0.029 standard deviation(SD) for every 1 SD increased in happiness. Mediation analysis showed that happiness had a significant positive total effect on cognition. The direct effect of happiness was significant and accounted for 57.86% of the total effect. The mediatory effect of depression (path of happiness→depression→cognition) accounted for 38.31% of the total effect, whereas that of physical activity (path of happiness→exercise times→cognition) accounted for 3.02% of the total effect. Conclusion Happiness has a positive correlation with cognitive function, and depression and physical activity play mediatory roles in this association. Effective interventions to improve happiness levels of middle and old-aged population will not only improve their subjective well-being but also improve their cognitive function, which carries great potential for reducing public health burdens related to cognitive aging.
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Affiliation(s)
- Xiaojuan Shi
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Xiaoxue He
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Degong Pan
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Hui Qiao
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
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The development and validation of a universal enjoyment measure: The enjoy scale. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02967-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Factors Influencing Quality of Life Among Older Persons Living With Osteoarthritis Using 3 Different Definitions. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Di Gessa G, Corna L, Price D, Glaser K. Lifetime employment histories and their relationship with 10-year health trajectories in later life: evidence from England. Eur J Public Health 2021; 30:793-799. [PMID: 32091579 PMCID: PMC7445040 DOI: 10.1093/eurpub/ckaa008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Employment histories influence health. However, most studies have so far investigated cross-sectional associations between employment histories and health, failing to recognize health as a dynamic process in later life. Methods We use Waves 3–8 of the English Longitudinal Study of Ageing, including retrospective information on respondents’ employment activities. We used dynamic hamming distances to summarize lifetime employment histories up to state pension age (64 for men and 59 for women). Multilevel growth curve models were then used to estimate the influence of lifetime employment histories on later life health trajectories over a 10-year period using quality of life (QoL), somatic health, and depression. Results Net of selection effect and a host of contemporaneous material and social resources, men who exited early started off with poorer health than those with continuous attachment to the labour market but had a very similar health profile by the end of the 10-year period considered. Among women, better somatic health and higher QoL were observed among those who had employment breaks for family care, and this health advantage was maintained over time. Lifetime employment histories are not related to depression for either men or women. Conclusion Overall, differences in health by employment histories level off only among men who left earlier and those continuously employed. Flexible arrangements for men in poor health who benefit from leaving the labour market early and supporting women who wish to take breaks for family care may help reduce health inequalities in later life.
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Affiliation(s)
- Giorgio Di Gessa
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK
| | - Laurie Corna
- Department of Business Economics, Health and Social Care, Centre of Competence on Ageing, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Debora Price
- School of Social Sciences, Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, UK
| | - Karen Glaser
- Department of Global Health and Social Medicine, Institute of Gerontology, King's College London, London, UK
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Jacobs JM, Maaravi Y, Stessman J. Optimism and longevity beyond age 85. J Gerontol A Biol Sci Med Sci 2021; 76:1806-1813. [PMID: 33609364 DOI: 10.1093/gerona/glab051] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Optimism is associated with health benefits and improved survival among adults aged >65. Whether or not optimism beyond age 85 continues to confer survival benefits is poorly documented. We examine the hypothesis that being optimistic at ages 85 and 90 is associated with improved survival. METHODS The Jerusalem Longitudinal Study (1990-2020) assessed comorbidity, depression, cognition, social and functional status, and 5-year mortality among a representative community sample, born 1920-1921, at age 85 (n=1096) and age 90 (n=533). Overall optimism (Op-Total) was measured using a validated 7-item score from the Scale of Subjective Wellbeing for Older Persons. The four questions concerning positive future expectations (Op-Future) and three questions concerning positive experiences (Op-Happy) were also analyzed separately. We determined unadjusted mortality Hazards Ratios, and also adjusted for gender, financial difficulty, marital status, educational status, ADL dependence, physical activity, diabetes mellitus, hypertension, ischemic heart disease, cognitive impairment and depression. RESULTS Between ages 85-90 and 90-95 years, 33.2% (364/1096) and 44.3% (236/533) people died respectively. All mean optimism scores declined from age 85 to 90, with males significantly more optimistic than females throughout. All measures of optimism (Op-Total, Op-Future, Op-Happy) at age 85 and 90 were significantly associated with improved 5-year survival from age 85-90 and 90-95 respectively, in both unadjusted and adjusted models. Findings remained unchanged after separately excluding depressed subjects, cognitively impaired subjects, and subjects dying within 6 months from baseline. CONCLUSIONS These finding support the hypothesis that being optimistic continues to confer a survival benefit irrespective of advancing age.
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Affiliation(s)
- Jeremy M Jacobs
- The Jerusalem Institute of Aging Research, Faculty of Medicine, Hebrew University of Jerusalem, Israel.,Department of Geriatric Rehabilitation and the Center for Palliative Care, Hadassah Medical Center, Mt Scopus, Jerusalem, Israel
| | - Yoram Maaravi
- The Jerusalem Institute of Aging Research, Faculty of Medicine, Hebrew University of Jerusalem, Israel.,Department of Geriatric Rehabilitation and the Center for Palliative Care, Hadassah Medical Center, Mt Scopus, Jerusalem, Israel
| | - Jochanan Stessman
- The Jerusalem Institute of Aging Research, Faculty of Medicine, Hebrew University of Jerusalem, Israel.,Department of Geriatric Rehabilitation and the Center for Palliative Care, Hadassah Medical Center, Mt Scopus, Jerusalem, Israel
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Abstract
IMPORTANCE There is increasing recognition that positive affective states have a protective association for all-cause mortality. However, positive states of happiness and excitement vary over time, and little is known about the association of fluctuations in positive affect with survival. OBJECTIVE To investigate the association of positive affect instability, conceptualized as fluctuations in momentary positive affect, with mortality in a population-based sample of older adults in England. DESIGN, SETTING, AND PARTICIPANTS This survey study used data from a longitudinal survey collected in wave 2 (2004) of the English Longitudinal Study of Ageing, a nationally representative sample of older men and women living in England, with follow-up continuing until March 2018. Participants included people aged 50 years or older at recruitment. Data were analyzed from September 2019 to April 2020. MAIN OUTCOMES AND MEASURES The main outcome was all-cause mortality. Positive and negative affect were measured at 4 time points over the course of 1 day: soon after waking, 30 minutes after waking, at 7:00 pm, and at bedtime. RESULTS Data were analyzed from 3834 participants (mean [SD] age at baseline, 64.0 [7.4] years; 2082 [54.3%] women) with a mean (SD) follow-up of 12.25 (2.60) years. Adjusting for demographic characteristics, baseline illness, health behaviors, and mean level and instability in negative affect, Cox proportional hazards regression showed that high positive affect instability was associated with greater mortality, with a hazard ratio of 1.25 (95% CI, 1.04-1.49; P = .02). Associations did not differ by age, suggesting that the increased mortality risk associated with high positive affect instability was not restricted to older ages. CONCLUSION AND RELEVANCE These findings suggest that temporal fluctuations in positive affect were associated with mortality risk in older adults. These findings illustrate the value of incorporating dynamic assessments of positive affect in distal health outcomes such as mortality.
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Affiliation(s)
- Anthony D Ong
- Department of Human Development, Cornell University, Ithaca, New York
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Abstract
Lower socioeconomic status (SES) is a determinant of many of the health problems that emerge at older ages. The extent to which lower SES is associated with faster decline in age-related functions and phenotypes independently of health conditions is less clear. This study demonstrates that lower SES (defined by wealth) is related to accelerated decline over 6 to 8 y in 16 outcomes from physical, sensory, physiological, cognitive, emotional, and social domains, independently of diagnosed health conditions, self-rated health, education, and other factors. It provides evidence for the pervasive role of social circumstances on core aging processes and suggests that less affluent sectors of society age more rapidly than more privileged groups. Aging involves decline in a range of functional abilities and phenotypes, many of which are also associated with socioeconomic status (SES). Here we assessed whether lower SES is a determinant of the rate of decline over 8 y in six domains—physical capability, sensory function, physiological function, cognitive performance, emotional well-being, and social function—in a sample of 5,018 men and women aged 64.44 (SD 8.49) y on average at baseline. Wealth was used as the marker of SES, and all analyses controlled for age, gender, ethnicity, educational attainment, and long-term health conditions. Lower SES was associated with greater adverse changes in physical capability (grip strength, gait speed, and physical activity), sensory function (sight impairment), physiological function (plasma fibrinogen concentration and lung function), cognitive performance (memory, executive function, and processing speed), emotional well-being (enjoyment of life and depressive symptoms), and social function (organizational membership, number of close friends, volunteering, and cultural engagement). Effects were maintained when controlling statistically for other factors such as smoking, marital/partnership status, and self-rated health and were also present when analyses were limited to participants aged ≤75 y. We conclude that lower SES is related to accelerated aging across a broad range of functional abilities and phenotypes independently of the presence of health conditions and that social circumstances impinge on multiple aspects of aging.
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De Prophetis E, Goel V, Watson T, Rosella LC. Relationship between life satisfaction and preventable hospitalisations: a population-based cohort study in Ontario, Canada. BMJ Open 2020; 10:e032837. [PMID: 32102809 PMCID: PMC7045202 DOI: 10.1136/bmjopen-2019-032837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To examine if low life satisfaction is associated with an increased risk of being hospitalised for an ambulatory care sensitive condition (ACSC), in comparison to high life satisfaction DESIGN AND SETTING: Population-based cohort study of adults from Ontario, Canada. Baseline data were captured through the Canadian Community Health Survey (CCHS) and linked to health administrative data for follow-up information. PARTICIPANTS 129 467 men and women between the ages 18 and 74. MAIN OUTCOME MEASURES Time to avoidable hospitalisations defined by ACSCs. RESULTS Life satisfaction was measured at baseline through the CCHS and follow-up information on ACSC hospitalisations were captured by linking participant respondents to hospitalisation records covered under a single payer health system. Within the study time frame (maximum of 14 years), 3037 individuals were hospitalised. Older men in the lowest household income quintile were more likely to be hospitalised with an ACSC. After controlling for age, sex, socioeconomic status (SES) and other behavioural factors, low life satisfaction at baseline had a strong relationship with future hospitalisations for ACSCs (HR 2.71; 95% CI 1.87 to 3.93). The hazards were highest for those who jointly had the lowest levels of life satisfaction and low household income (HR 3.80; 95% CI 2.13 to 6.73). Results did not meaningful change after running a competing risk survival analysis. CONCLUSIONS This study demonstrates that poor life satisfaction is associated with hospitalisations for ACSCs after adjustment for several confounders. Furthermore, the magnitude of this relationship was greater for those who were more socioeconomically disadvantaged. This study adds to the existing literature on the impact of life satisfaction on health system outcomes by documenting its impact on avoidable hospitalisations in a universal health system.
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Affiliation(s)
- Eric De Prophetis
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vivek Goel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Tristan Watson
- Populations and Public Health, ICES, Toronto, Ontario, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Barger SD, Broom TW, Esposito MV, Lane TS. Is subjective well-being independently associated with mortality? A 14-year prospective cohort study in a representative sample of 25 139 US men and women. BMJ Open 2020; 10:e031776. [PMID: 31941764 PMCID: PMC7045262 DOI: 10.1136/bmjopen-2019-031776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To examine whether the inverse association of subjective well-being with mortality is independent of self-rated health and socioeconomic status in healthy adults. DESIGN A population-based prospective cohort study based on an in-person interview. Cox regression was used to examine mortality hazards for happiness alone and for a standardised summary well-being measure that included happiness, life satisfaction and negative emotions. Using prespecified analyses, we first adjusted for age and then additionally adjusted for self-rated health and then race/ethnicity, marital status, smoking and socioeconomic status. SETTING Probability sample of adult US residents interviewed in their homes in 2001. PARTICIPANTS 25 139 adults free of cardiovascular disease and cancer at baseline. PRIMARY OUTCOME MEASURE All-cause mortality 14 years after the baseline interview as assessed by probabilistic matching using the National Death Index. RESULTS Age-adjusted unhappiness was associated with mortality (HR 1.27; 95% CI 1.11 to 1.45, p=0.001) but the association attenuated after adjusting for self-rated health (HR 1.01; 95% CI 0.88 to 1.16, p=0.85). A similar pattern was seen for the summary well-being measure in fully adjusted models (HR 1.00; 95% CI 0.99 to 1.00, p=0.30). In contrast, self-rated health was strongly associated with mortality. In the fully adjusted model with the summary well-being measure the hazards for good, very good and excellent self-rated health were 0.71 (95% CI 0.62 to 0.80, p<0.001), 0.63 (95% CI 0.55 to 0.71, p<0.001) and 0.45 (95% CI 0.39 to 0.51, p<0.001), respectively. CONCLUSIONS In this representative sample of US adults, the association between well-being and mortality was strongly attenuated by self-rated health and to a lesser extent socioeconomic status.
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Affiliation(s)
- Steven D Barger
- Psychological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Timothy W Broom
- Psychological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Michael V Esposito
- Psychological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Taylor S Lane
- Psychological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
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Luna E, Ruiz M, Malyutina S, Titarenko A, Kozela M, Pająk A, Kubinova R, Bobak M. The prospective association between frequency of contact with friends and relatives and quality of life in older adults from Central and Eastern Europe. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1001-1010. [PMID: 32040668 PMCID: PMC7394932 DOI: 10.1007/s00127-020-01834-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 02/03/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Studies suggest that frequent contact with friends and relatives promote mental wellbeing in later life, but most evidence comes from Western populations. We investigated the prospective relationship between frequency of contact with friends and relatives and quality of life (QoL) among older Central and Eastern European (CEE) adults and whether depressive symptoms mediated the hypothesised longitudinal relationship. METHODS Data from 6106 participants from the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study were used. Frequency of contact with friends and relatives was measured at baseline. QoL, at baseline and follow-up, was measured by the Control, Autonomy, Self-realisation, and Pleasure (CASP) 12-item scale. After assessing the prospective association using multivariable linear regression, the mediational hypothesis was tested using path analysis. RESULTS There was a significant prospective association between frequency of contact with friends and relatives and CASP-12 score (0-36) in fully adjusted models. Per every one unit increase in frequency of contact, there was a 0.12 (95% CI 0.06, 0.17) increase in CASP-12 score at follow-up, accounting for sociodemographic, health-related and baseline QoL. Pathway results showed that 81% of the longitudinal effect of frequency of contact on QoL was mediated through depressive symptoms. CONCLUSIONS Frequent contact with friends and relatives improves QoL of older Central and Eastern European adults, partly through buffering against depressive symptoms. Interventions to improve QoL at older ages should incorporate effective management of common mental disorders such as depression.
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Affiliation(s)
- Eliazar Luna
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
- Faculty of Physical Education and Sport, Charles University, José Martího 31162 52, Prague, Czech Republic
| | - Sofia Malyutina
- Laboratory of Ethipathogenesis and Clinics of Internal Diseases, Institute of Internal and Preventive Medicine, 175/1, Borisa Bogatkova street, Novosibirsk, Russia
| | - Anastasiya Titarenko
- Laboratory of Ethipathogenesis and Clinics of Internal Diseases, Institute of Internal and Preventive Medicine, 175/1, Borisa Bogatkova street, Novosibirsk, Russia
| | - Magdalena Kozela
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531, Krakow, Poland
| | - Andrzej Pająk
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531, Krakow, Poland
| | - Ruzena Kubinova
- Centre for Environmental Health Monitoring, National Institute of Public Health, Srobarova 48, 10042, Prague, Czech Republic
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
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Steptoe A. Investing in Happiness: The Gerontological Perspective. Gerontology 2019; 65:634-639. [PMID: 31505514 PMCID: PMC6878748 DOI: 10.1159/000501124] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/23/2019] [Indexed: 12/12/2022] Open
Abstract
Optimising happiness is a desirable societal aim in itself, but there are four more specific reasons why research on happiness is an important emerging theme in gerontology. First, happiness is not merely the mirror of depression, anxiety or distress, but has distinct relationships with a range of outcomes, so benefits from study in itself. Second, happiness appears to be a protective factor for morbidity and mortality; although studies are complex and take a long time to complete, there is accumulating evidence that greater happiness predicts survival among older people independently of covariates including health status and depression. Third, happiness has broad ramifications at older ages, being related to personal and social relationships, economic prosperity, biological risk factors, health behaviours, and time use as well as health. Fourth, happiness is malleable, and can potentially be modified in ways that will enhance the health and well-being of older people.
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Affiliation(s)
- Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom,
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19
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Abstract
IMPORTANCE Subjective well-being is associated with reduced mortality, but it is not clear whether additional time is spent in good health or with chronic disease and disability. OBJECTIVE To evaluate the associations between affective well-being, total life expectancy, and life expectancy free of disability and chronic disease. DESIGN, SETTING, AND PARTICIPANTS This survey study used data on 9761 participants from the English Longitudinal Study of Ageing who were followed up for a maximum of 10 years (mean [SD] follow-up, 6 [3.7] years). Discrete-time multistate life table models were used to estimate total life expectancy and life expectancy free of disability or chronic disease. Data were collected between March 2002 and March 2013 and analyzed from December 2018 to April 2019. Analyses were adjusted for wealth and cohabiting status. MAIN OUTCOMES AND MEASURES The main outcome was life expectancy free of disability and chronic disease. Affective well-being was assessed at baseline as a combination of enjoyment of life and the lack of significant depressive symptoms. Disability was measured in terms of impaired activities of daily living and instrumental activities of daily living, and chronic disease as the occurrence of 6 serious illnesses. RESULTS Data were analyzed from 9761 participants (5297 [54%] female; mean [SD] age at baseline, 64 [9.9] years). High affective well-being was associated with longer life expectancy and with longer disability-free and chronic disease-free life expectancies. For example, a woman aged 50 years who reported high affective well-being could expect to live 6 years longer than a woman of similar age with low well-being; 31.4 of her remaining years (95% CI, 30.5-31.9 years) would be likely to be free of disability, compared with 20.8 years (95% CI, 20.1-22.1 years) for a woman with low affective well-being. A man aged 50 years with high affective well-being could expect to live 20.8 years (95% CI, 18.7-22.4 years) without chronic disease, compared with 11.4 years (95% CI, 8.5-14.6 years) for a man reporting low well-being. Similar patterns were observed at the ages of 60, 70, and 80 years. CONCLUSIONS AND RELEVANCE This study suggests that people who report high levels of subjective well-being live longer and also healthier lives than those with lower well-being. These findings add weight to endeavors to promote the subjective well-being of older people.
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Affiliation(s)
- Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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20
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Chakraborty TS, Gendron CM, Lyu Y, Munneke AS, DeMarco MN, Hoisington ZW, Pletcher SD. Sensory perception of dead conspecifics induces aversive cues and modulates lifespan through serotonin in Drosophila. Nat Commun 2019; 10:2365. [PMID: 31147540 PMCID: PMC6542802 DOI: 10.1038/s41467-019-10285-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/02/2019] [Indexed: 01/29/2023] Open
Abstract
Sensory perception modulates health and aging across taxa. Understanding the nature of relevant cues and the mechanisms underlying their action may lead to novel interventions that improve the length and quality of life. We found that in the vinegar fly, Drosophila melanogaster, exposure to dead conspecifics in the environment induced cues that were aversive to other flies, modulated physiology, and impaired longevity. The effects of exposure to dead conspecifics on aversiveness and lifespan required visual and olfactory function in the exposed flies. Furthermore, the sight of dead flies was sufficient to produce aversive cues and to induce changes in the head metabolome. Genetic and pharmacologic attenuation of serotonergic signaling eliminated the effects of exposure on aversiveness and lifespan. Our results indicate that Drosophila have an ability to perceive dead conspecifics in their environment and suggest conserved mechanistic links between neural state, health, and aging; the roots of which might be unearthed using invertebrate model systems.
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Affiliation(s)
- Tuhin S Chakraborty
- Department of Molecular and Integrative Physiology and Geriatrics Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Christi M Gendron
- Department of Molecular and Integrative Physiology and Geriatrics Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yang Lyu
- Department of Molecular and Integrative Physiology and Geriatrics Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Allyson S Munneke
- Program in Cellular and Molecular Biology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Madeline N DeMarco
- Department of Molecular and Integrative Physiology and Geriatrics Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Zachary W Hoisington
- Department of Molecular and Integrative Physiology and Geriatrics Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Scott D Pletcher
- Department of Molecular and Integrative Physiology and Geriatrics Center, University of Michigan, Ann Arbor, MI, 48109, USA. .,Program in Cellular and Molecular Biology, University of Michigan, Ann Arbor, MI, 48109, USA.
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Schumacher M, Hieke S, Ihorst G, Engelhardt M. Dynamic prediction: A challenge for biostatisticians, but greatly needed by patients, physicians and the public. Biom J 2019; 62:822-835. [PMID: 30908745 DOI: 10.1002/bimj.201800248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/22/2019] [Accepted: 01/25/2019] [Indexed: 12/12/2022]
Abstract
Prognosis is usually expressed in terms of the probability that a patient will or will not have experienced an event of interest t years after diagnosis of a disease. This quantity, however, is of little informative value for a patient who is still event-free after a number of years. Such a patient would be much more interested in the conditional probability of being event-free in the upcoming t years, given that he/she did not experience the event in the s years after diagnosis, called "conditional survival." It is the simplest form of a dynamic prediction and can be dealt with using straightforward extensions of standard time-to-event analyses in clinical cohort studies. For a healthy individual, a related problem with further complications is the so-called "age-conditional probability of developing cancer" in the next t years. Here, the competing risk of dying from other diseases has to be taken into account. For both situations, the hazard function provides the central dynamic concept, which can be further extended in a natural way to build dynamic prediction models that incorporate both baseline and time-dependent characteristics. Such models are able to exploit the most current information accumulating over time in order to accurately predict the further course or development of a disease. In this article, the biostatistical challenges as well as the relevance and importance of dynamic prediction are illustrated using studies of multiple myeloma, a hematologic malignancy with a formerly rather poor prognosis which has improved over the last few years.
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Affiliation(s)
- Martin Schumacher
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Stefanie Hieke
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Monika Engelhardt
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Rosella LC, Fu L, Buajitti E, Goel V. Death and Chronic Disease Risk Associated With Poor Life Satisfaction: A Population-Based Cohort Study. Am J Epidemiol 2019; 188:323-331. [PMID: 30371732 PMCID: PMC6357802 DOI: 10.1093/aje/kwy245] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 10/24/2018] [Indexed: 01/01/2023] Open
Abstract
Life satisfaction is increasingly recognized as an important determinant of health; however, prospective population-based studies on this topic are limited. We estimated the risk of chronic disease and death according to life satisfaction among a population-based cohort in Ontario, Canada (n = 73,904). The cohort included 3 pooled cycles of the Canadian Community Health Survey (2003–2008) linked to 6 years of follow-up (to 2015), using population-based health databases and validated disease-specific registries. The databases capture incident and prevalent cases of diabetes, cancer, chronic obstructive pulmonary disease, heart disease, and death. Multivariable Cox proportional hazard models were used to estimate hazards of incident chronic disease and death, and were adjusted for sociodemographic, behavioral, and clinical confounders, including age, sex, comorbidity, mood disorder, smoking, alcohol consumption, physical activity, body mass index, immigrant status, education, and income. In the fully adjusted models, risk of both death and incident chronic disease was highest for those most dissatisfied with life (for mortality, hazard ratio = 1.59, 95% confidence interval: 1.15, 2.19; for chronic disease, hazard ratio = 1.70, 95% confidence interval: 1.16, 2.51). In this population-based cohort, poor life satisfaction was an independent risk factor for incident chronic disease and death, supporting the idea that interventions and programs that improve life satisfaction will affect population health.
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Affiliation(s)
- Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Longdi Fu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Emmalin Buajitti
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vivek Goel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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Abstract
Research into the relationship between happiness and health is developing rapidly, exploring the possibility that impaired happiness is not only a consequence of ill-health but also a potential contributor to disease risk. Happiness encompasses several constructs, including affective well-being (feelings of joy and pleasure), eudaimonic well-being (sense of meaning and purpose in life), and evaluative well-being (life satisfaction). Happiness is generally associated with reduced mortality in prospective observational studies, albeit with several discrepant results. Confounding and reverse causation are major concerns. Associations with morbidity and disease prognosis have also been identified for a limited range of health conditions. The mechanisms potentially linking happiness with health include lifestyle factors, such as physical activity and dietary choice, and biological processes, involving neuroendocrine, inflammatory, and metabolic pathways. Interventions have yet to demonstrate substantial, sustained improvements in subjective well-being or direct impact on physical health outcomes. Nevertheless, this field shows great potential, with the promise of establishing a favorable effect on population health.
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Affiliation(s)
- Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, United Kingdom;
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Psychological well-being and mortality: longitudinal findings from Lithuanian middle-aged and older adults study. Soc Psychiatry Psychiatr Epidemiol 2019; 54:803-811. [PMID: 30627758 PMCID: PMC6656792 DOI: 10.1007/s00127-019-01657-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/07/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The study aimed to examine whether after confounding by possible socio-demographic and other risk factors, psychological well-being is independently associated with reduced all-cause and cardiovascular mortality. METHODS Initial data were collected within the framework of the international project HAPIEE in 2006-2008. A random sample of 7115 individuals aged 45-72 years was screened. Deaths were evaluated by death register of Kaunas city (Lithuania) in a follow-up study till 2016. Psychological well-being was evaluated by a CASP-12 questionnaire. Socio-demographic, lifestyle, biologic factors and depressive symptoms were evaluated. RESULTS Age-adjusted survival curves revealed that psychological well-being predicts longevity in men and women (p < 0.001). After adjustment for many possible confounders psychological well-being was independently associated with all-cause mortality in men (HR 0.77; 95% CI 0.62-0.94) and women (HR 0.73; 95% CI 0.56-0.96). However, psychological well-being association with cardiovascular mortality attained statistical significance only in the women's group (HR 0.53; 95% CI 0.33-0.87), but not in men (HR 0.98; 95% CI 0.72-1.33). CONCLUSIONS Psychological well-being is an important predictor of longevity, controlling well-recognized risk factors such as age, education, cardiovascular diseases, social status, marital status, lifestyle and biological factors and depressive symptoms. Positive psychological well-being should be taken into account when screening older people to prevent negative health outcomes.
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Sapranaviciute-Zabazlajeva L, Luksiene D, Virviciute D, Kranciukaite-Butylkiniene D, Bobak M, Tamosiunas A. Changes in psychological well-being among older Lithuanian city dwellers: Results from a cohort study. Int J Clin Health Psychol 2018; 18:218-226. [PMID: 30487927 PMCID: PMC6224859 DOI: 10.1016/j.ijchp.2018.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/23/2018] [Indexed: 11/18/2022] Open
Abstract
Background/Objective: The purpose of this study is to evaluate changes of psychological well-being (PWB) in older Lithuanian city dwellers during ten years of follow-up, and to establish factors associated with it. Method: 7,115 men and women of age 45-72 years participated in the initial survey in 2006-2008. In 2016 the follow-up survey was performed among all 6,210 participants who survived. 4,266 individuals responded to postal questionnaires. PWB was evaluated by using CASP-12 questionnaire. Depressive symptoms were evaluated by CES-D-10 scale. Quality of life, self-rated health, and social activity were evaluated.Socio-demographic, socio-economic factors were included into standard questionnaire. Results: PWB deteriorated in all age groups during 10-years follow-up. Poor quality of life, poor self-rated health, having depressive symptoms, and not being member of social organization are associated with lower PWB after 10 years in men and women. Employed-retired, retired, and not socially active women have higher possibility to have lower PWB over 10 years. Conclusions: PWB in older Lithuanian city dwellers deteriorates as many other socio-economic and psychosocial indicators during ten-year follow-up. Mostly psychosocial factors, but not the socio-demographic, and socio-economic ones predict PWB over 10 years. It is crucial to understand and promote predictors of PWB in older age.
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Affiliation(s)
| | - Dalia Luksiene
- Institute of Cardiology, Lithuanian University of Health Sciences, Lithuania
| | - Dalia Virviciute
- Institute of Cardiology, Lithuanian University of Health Sciences, Lithuania
| | | | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, United Kigdom
| | - Abdonas Tamosiunas
- Institute of Cardiology, Lithuanian University of Health Sciences, Lithuania
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Di Gessa G, Corna L, Price D, Glaser K. The decision to work after state pension age and how it affects quality of life: evidence from a 6-year English panel study. Age Ageing 2018; 47:450-457. [PMID: 29329400 PMCID: PMC5920338 DOI: 10.1093/ageing/afx181] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 11/17/2017] [Indexed: 11/12/2022] Open
Abstract
Background despite an increasing proportion of older people working beyond State Pension Age (SPA), little is known about neither the motivations for this decision nor whether, and to what extent, working beyond SPA affects quality of life (QoL). Methods QoL was measured using the CASP-19 scale. Respondents in paid work beyond SPA were distinguished based on whether they reported financial constraints as the main reason for continuing in work. Linear regression models were used to assess the associations between paid work beyond SPA and CASP-19 scores among men aged 65-74 and women aged 60-69 (n = 2,502) cross-sectionally and over time using Wave 4 and Wave 7 of the English Longitudinal Study of Ageing. Results approximately, one in five respondents were in paid work beyond SPA, one-third of whom reported financial issues as the main reason. These individuals reported significantly lower CASP-19 scores (β = -1.21) compared with those who retired at the expected/usual age. Respondents who declared being in paid work beyond SPA because they enjoyed their work or wanted to remain active, reported significantly higher QoL (β = 1.62). Longitudinal analyses suggest that those who were working post-SPA by choice, but who had stopped working at follow-up, also reported marginally (P < 0.10) higher CASP-19 scores. Conclusions potential QoL benefits of working beyond SPA need to be considered in light of individual motivations for extending working life. Given the trend towards working longer and the abolishment of mandatory retirement ages, it is important that older people maintain control over their decision to work in later life.
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Affiliation(s)
- Giorgio Di Gessa
- Institute of Gerontology, Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Laurie Corna
- Institute of Gerontology, Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Debora Price
- School of Social Sciences, University of Manchester, Manchester, UK
| | - Karen Glaser
- Institute of Gerontology, Department of Global Health and Social Medicine, King’s College London, London, UK
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Olde Rikkert MGM, van der Wees PJ, Schoon Y, Westert GP. Using Patient Reported Outcomes Measures to Promote Integrated Care. Int J Integr Care 2018; 18:8. [PMID: 30127692 PMCID: PMC6095063 DOI: 10.5334/ijic.3961] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 04/04/2018] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Patient reported outcome measures (PROMs) have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life. DISCUSSION We describe innovative multipurpose implementation of PROMs as evidenced by two best practices of PROMs application in geriatric and physiotherapy practice. We show that PROMs can show meaningful outcomes in older subjects' patient journeys, which can at the same time serve individuals and groups of both patients and professionals. KEY LESSON PROMs can deliver generic outcomes relevant for older patients, may improve patient-physician relationship, quality of care and prediction of future outcomes in geriatric care, if they are valid, reliable and responsive, but still short and simple. A precondition to make the hard tip from research to practice is that PROMs are carefully positioned in the clinical encounters and in electronic health records.
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Affiliation(s)
- Marcel G. M. Olde Rikkert
- Chair Dept Geriatrics and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, NL
| | | | - Yvonne Schoon
- Department Geriatrics and Chair Emergency Department, Radboud University Medical Center, Nijmegen, NL
| | - Gert P. Westert
- Chair IQ healthcare and Theme leader Health care Improvement Science, Radboud University Medical Center, Nijmegen, NL
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Hülür G, Heckhausen J, Hoppmann CA, Infurna FJ, Wagner GG, Ram N, Gerstorf D. Levels of and changes in life satisfaction predict mortality hazards: Disentangling the role of physical health, perceived control, and social orientation. Psychol Aging 2017; 32:507-520. [PMID: 28891665 DOI: 10.1037/pag0000187] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
It is well documented that well-being typically evinces precipitous decrements at the end of life. However, research has primarily taken a postdictive approach by knowing the outcome (date of death) and aligning, in retrospect, how well-being has changed for people with documented death events. In the present study, we made use of a predictive approach by examining whether and how levels of and changes in life satisfaction prospectively predict mortality hazards and delineate the role of contributing factors, including health, perceived control, and social orientation. To do so, we applied shared parameter growth-survival models to 20-year longitudinal data from 10,597 participants (n = 1,560 [15%] deceased; age at baseline: M = 44 years, SD = 17, range = 18-98 years) from the national German Socio-Economic Panel Study. Our findings showed that lower levels and steeper declines of life satisfaction each uniquely predicted higher mortality risks. Results also revealed moderating effects of age and perceived control: Life satisfaction levels and changes had stronger predictive effects for mortality hazards among older adults. Perceived control was associated with lower mortality hazards; however, this effect was diminished for those who experienced accelerated life satisfaction decline. Variance decomposition suggests that predictive effects of life satisfaction trajectories were partially unique (3%-6%) and partially shared with physical health, perceived control, and social orientation (17%-19%). Our discussion focuses on the strengths and challenges of a predictive approach to link developmental changes (in life satisfaction) to mortality hazards, and considers implications of our findings for healthy aging. (PsycINFO Database Record
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Affiliation(s)
- Gizem Hülür
- Department of Psychology, University of Zurich
| | | | | | | | | | - Nilam Ram
- Department of Human Development and Family Studies, Pennsylvania State University
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Magnavita N, Garbarino S. Sleep, Health and Wellness at Work: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1347. [PMID: 29113118 PMCID: PMC5707986 DOI: 10.3390/ijerph14111347] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/22/2017] [Accepted: 11/02/2017] [Indexed: 12/31/2022]
Abstract
Many occupational factors may interfere with sleep. Sleep disturbances can, in turn, endanger the health and safety of workers. This rapid review of the literature identifies the main factors that alter the quantity and quality of sleep, indicates the effects these alterations have on the wellbeing of workers and suggests some health promotion measures.
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Affiliation(s)
- Nicola Magnavita
- Occupational Health Unit, Institute of Public Health, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168 Rome, Italy.
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy.
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa, 16132 Genoa, Italy.
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Abstract
Life skills play a key role in promoting educational and occupational success in early life, but their relevance at older ages is uncertain. Here we measured five life skills-conscientiousness, emotional stability, determination, control, and optimism-in 8,119 men and women aged 52 and older (mean 66.7 y). We show that the number of skills is associated with wealth, income, subjective wellbeing, less depression, low social isolation and loneliness, more close relationships, better self-rated health, fewer chronic diseases and impaired activities of daily living, faster walking speed, and favorable objective biomarkers (concentration of high-density lipoprotein cholesterol, vitamin D and C-reactive protein, and less central obesity). Life skills also predicted sustained psychological wellbeing, less loneliness, and a lower incidence of new chronic disease and physical impairment over a 4-y period. These analyses took account of age, sex, parental socioeconomic background, education, and cognitive function. No single life skill was responsible for the associations we observed, nor were they driven by factors such as socioeconomic status or health. Despite the vicissitudes of later life, life skills impact a range of outcomes, and the maintenance of these attributes may benefit the older population.
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Füeßl HS. [Not Available]. MMW Fortschr Med 2017; 159:36. [PMID: 28265925 DOI: 10.1007/s15006-017-9328-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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