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BMJ. 2016 Dec 13;355:i6267. doi: 10.1136/bmj.i6267.

Sustained enjoyment of life and mortality at older ages: analysis of the English Longitudinal Study of Ageing.

Author information

1
Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
2
Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK a.steptoe@ucl.ac.uk.

Abstract

OBJECTIVE:

 To test whether the number of reports of enjoyment of life over a four year period is quantitatively associated with all cause mortality, and with death from cardiovascular disease and from other causes.

DESIGN AND SETTING:

 Longitudinal observational population study using the English Longitudinal Study of Ageing (ELSA), a nationally representative sample of older men and women living in England.

PARTICIPANTS:

 9365 men and women aged 50 years or older (mean 63, standard deviation 9.3) at recruitment.

MAIN OUTCOME MEASURES:

 Time to death, based on mortality between the third phase of data collection (wave 3 in 2006) and March 2013 (up to seven years).

RESULTS:

 Subjective wellbeing with measures of enjoyment of life were assessed in 2002 (wave 1), 2004 (wave 2), and 2006 (wave 3). 2264 (24%) respondents reported no enjoyment of life on any assessment, with 1833 (20%) reporting high enjoyment on one report of high enjoyment of life, 2063 (22%) on two reports, and 3205 (34%) on all three occasions. 1310 deaths were recorded during follow-up. Mortality was inversely associated with the number of occasions on which participants reported high enjoyment of life. Compared with the no high enjoyment group, the hazard ratio for all cause mortality was 0.83 (95% confidence interval 0.70 to 0.99) for two reports of enjoyment of life, and 0.76 (0.64 to 0.89) for three reports, after adjustment for demographic factors, baseline health, mobility impairment, and depressive symptoms. The same association was observed after deaths occurring within two years of the third enjoyment measure were excluded (0.90 (0.85 to 0.95) for every additional report of enjoyment), and in the complete case analysis (0.90 (0.83 to 0.96)).

CONCLUSIONS:

 This is an observational study, so causal conclusions cannot be drawn. Nonetheless, the results add a new dimension to understanding the significance of subjective wellbeing for health outcomes by documenting the importance of sustained wellbeing over time.

PMID:
27965194
PMCID:
PMC5154976
DOI:
10.1136/bmj.i6267
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: support from the US National Institute for Aging and a consortium of UK government departments coordinated by the Economic and Social Research Council for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

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