Cheerfulness May Save Your Life

Abstract & Commentary

By Mary Elina Ferris, MD, Clinical Associate Professor, University of Southern California. Dr. Ferris reports no financial relationship to this field of study.

Synopsis: Elderly men with optimistic dispositions had a lower risk of death from cardiovascular disease when followed over a 15-year period.

Source: Giltay EJ, et al. Dispositional optimism and the risk of cardiovascular death: the Zutphen Elderly Study. Arch Intern Med. 2006;166:431-436.

Researchers in the netherlands followed a group of 545 men aged 64-84 years old who were initially free of preexisting cardiovascular disease and cancer for 15 years. At intervals of 5 years the participants were assessed with a questionnaire rating 4 statements: "I still expect much from life," "I do not look forward to what lies ahead for me in the years to come," "My days seem to be passing by slowly," and "I am still full of plans." Socioeconomic characteristics and cardiovascular risk factors were collected and all were physically examined at baseline; these were used to adjust the results. Dispositional optimism was found to be reliable over time, with an overall reliability coefficient of 0.78; this was similar to 0.77 for mean arterial pressure or 0.88 for total cholesterol in the same time period.

Men who fell in the top tertile of optimism had a 55% lower multivariate-adjusted hazard ration of cardiovascular death at 15 years compared to the lowest tertile (22.1% died in the top group vs 43.5% in the low group). This difference increased with time, being slightly less at 10 years (20% vs 34.7%). Even when 77 men who were depressed at baseline were excluded from the analysis, the fully adjusted hazard ration for cardiovascular death remained at 0.50.

Commentary

Can a positive approach to life influence your longevity? Psychosomatic research supports the notion that happiness is associated with better health, and this current study shows an inverse relationship between "optimism" and future cardiovascular death. It further supports the conclusion that a cheerful disposition is stable over a prolonged time period and can be used to predict health outcomes.

"Optimism" can be defined in various ways, and in this study they used "generalized positive expectancies for one's future" as opposed to "explanatory style" optimism in response to adverse events. While my first response was skepticism when considering all the other variables that might be associated with these positive outcomes, there actually is research support for both improved pulmonary function1 and cell-mediated immunity2 in optimistic persons. This evidence reminds us of the mind-body connection and the importance of addressing our patient's psychological health as well as other more quantifiable health issues.

References

1. Kubzansky LD, et al. Breathing easy: a prospective study of optimism and pulmonary function in the normative aging study. Ann Behav Med. 2002;24:345-353.

2. Kamen-Siegel L, et al. Explanatory style and cell-mediated immunity in elderly men and women. Health Psychol. 1991;10:229-235.