Optimism and Cause-Specific Mortality: A Prospective Cohort Study

Optimism is healthy. Is your doctor telling you about this? Even though pessimists live longer?
I'm a complete optimist, I'm going to live to 98 and have fun the rest of my life. Life is great.
http://aje.oxfordjournals.org/content/early/2016/12/02/aje.kww182.short?rss=1

1. Eric S. Kim*,
2. Kaitlin A. Hagan,
3. Francine Grodstein,
4. Dawn L. DeMeo,
5. Immaculata De Vivo and
6. Laura D. Kubzansky

1. ↵*Correspondence to Dr. Eric S. Kim, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02215 (e-mail: eskim@hsph.harvard.edu).

1. Abbreviations: CI, confidence interval; HR, hazard ratio; MET, metabolic equivalent of task.

• Received May 19, 2016.
• Accepted October 28, 2016.

Abstract

Growing evidence has linked positive psychological attributes like optimism to a lower risk of poor health outcomes, especially cardiovascular disease. It has been demonstrated in randomized trials that optimism can be learned. If associations between optimism and broader health outcomes are established, it may lead to novel interventions that improve public health and longevity. In the present study, we evaluated the association between optimism and cause-specific mortality in women after considering the role of potential confounding (sociodemographic characteristics, depression) and intermediary (health behaviors, health conditions) variables. We used prospective data from the Nurses’ Health Study (n = 70,021). Dispositional optimism was measured in 2004; all-cause and cause-specific mortality rates were assessed from 2006 to 2012. Using Cox proportional hazard models, we found that a higher degree of optimism was associated with a lower mortality risk. After adjustment for sociodemographic confounders, compared with women in the lowest quartile of optimism, women in the highest quartile had a hazard ratio of 0.71 (95% confidence interval: 0.66, 0.76) for all-cause mortality. Adding health behaviors, health conditions, and depression attenuated but did not eliminate the associations (hazard ratio = 0.91, 95% confidence interval: 0.85, 0.97). Associations were maintained for various causes of death, including cancer, heart disease, stroke, respiratory disease, and infection. Given that optimism was associated with numerous causes of mortality, it may provide a valuable target for new research on strategies to improve health. 

The top 25% most optimistic women compared with the least optimistic quartile had:

• 38% lower risk of dying from heart disease
• 16% lower risk of dying from cancer
• 39% lower risk of dying from stroke
• 38% lower risk of dying from respiratory disease
• 52% lower risk of dying from infection