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Am J Epidemiol. 2019 Mar 5. pii: kwz056. doi: 10.1093/aje/kwz056. [Epub ahead of print]

Optimism and Healthy Aging in Women and Men.

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Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA.
Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA.
Program on Integrative Knowledge and Human Flourishing, Institute for Quantitative Social Science, Harvard University, Cambridge, MA.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.


Mounting evidence indicates specific associations between higher levels of optimism and healthier behaviors, reduced risk of chronic diseases, and lower mortality. Yet, for public health purposes, it is critical to consider how optimism may be related to a full scope of health conditions in aging-from cognitive to physical health. Using prospective data from the Health and Retirement Study (N=5,698), we examined if higher baseline optimism was associated with subsequent increased likelihood of maintaining healthy aging over 6-8 years of follow-up. Optimism was assessed at study baseline (2006 or 2008), and components of healthy aging were assessed every two years, defined as: 1) remaining free of major chronic diseases; 2) having no cognitive impairment; and 3) good physical functioning. Hazard ratios were obtained using Cox proportional hazards models, and a range of relevant covariates were considered (sociodemographics, depressive symptoms, health behaviors). After adjusting for sociodemographics and depression, the most (top quartile) versus least (bottom quartile) optimistic participants had a 24% increased likelihood of maintaining healthy aging (95% CI: 1.11, 1.38). Further adjustment for health behaviors did not meaningfully change the findings. Optimism, a potentially modifiable health asset, merits further research for its potential to improve likelihood of health in aging.


chronic disease ; cognitive function ; health psychology ; healthy aging ; optimism ; physical function ; psychological well-being; resilience


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