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Prospective study of the association between dispositional optimism and incident heart failure.

ABSTRACT: Although higher optimism has been linked with an array of positive health behaviors, biological processes, and cardiovascular outcomes, the relationship between optimism and heart failure has not been examined. In the United States, 80% of heart failures occur in adults aged 65+ years. Therefore, we examined whether higher optimism was linked with a reduced incidence of heart failure among older adults.Prospective data were from the Health and Retirement Study, a nationally representative study of older US adults. Our sample included 6808 participants who were followed for 4 years. Multiple logistic regression models were used to assess whether optimism was independently associated with incident heart failure. We adjusted for sociodemographic, behavioral, biological, and psychological covariates. Higher optimism was associated with a lower risk of incident heart failure during the follow-up period. In a model that adjusted for sociodemographic factors, each SD increase in optimism had an odds ratio of 0.74 (95% confidence interval, 0.63-0.85) for heart failure. Effects of optimism persisted even after adjusting for a wide range of covariates. There was also evidence of a dose-response relationship. As optimism increased, risk of developing heart failure decreased monotonically, with a 48% reduced odds among people with the highest versus lowest optimism.This is the first study to suggest that optimism is associated with a lower risk of heart failure. If future studies confirm these findings, they may be used to inform new strategies for preventing or delaying the onset of heart failure.

SUBMITTER: Kim ES

PROVIDER: S-EPMC4608236 | biostudies-literature | 2014 May

REPOSITORIES: biostudies-literature

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Prospective study of the association between dispositional optimism and incident heart failure.

Kim Eric S ES Smith Jacqui J Kubzansky Laura D LD

Circulation. Heart failure 20140319 3

<h4>Background</h4>Although higher optimism has been linked with an array of positive health behaviors, biological processes, and cardiovascular outcomes, the relationship between optimism and heart failure has not been examined. In the United States, 80% of heart failures occur in adults aged 65+ years. Therefore, we examined whether higher optimism was linked with a reduced incidence of heart failure among older adults.<h4>Methods and results</h4>Prospective data were from the Health and Retir ...[more]

PMID: 24647117

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Project description:Dispositional optimism is a potentially modifiable factor and has been associated with multiple physical health outcomes, but its relationship with depression, especially later in life, remains unclear. In the Nurses´ Health Study (n = 33,483), we examined associations between dispositional optimism and depression risk in women aged 57-85 (mean = 69.9, SD = 6.8), with 4,051 cases of incident depression and 10 years of follow-up (2004-2014). We defined depression as either having a physician/clinician-diagnosed depression, or regularly using antidepressants, or the presence of severe depressive symptoms using validated self-reported scales. Age- and multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs) across optimism quartiles and for a 1-standard deviation (SD) increment of the optimism score. In sensitivity analyses we explored more restrictive definitions of depression, potential mediators, and moderators. In multivariable-adjusted models, women with greater optimism (top vs. bottom quartile) had a 27% (95%CI = 19-34%) lower risk of depression. Every 1-SD increase in the optimism score was associated with a 15% (95%CI = 12-18%) lower depression risk. When applying a more restrictive definition for clinical depression, the association was considerably attenuated (every 1-SD increase in the optimism score was associated with a 6% (95%CI = 2-10%-) lower depression risk. Stratified analyses by baseline depressive symptoms, age, race, and birth region revealed comparable estimates, while mediators (emotional support, social network size, healthy lifestyle), when combined, explained approximately 10% of the optimism-depression association. As social and behavioral factors only explained a small proportion of the association, future research should investigate other potential pathways, such as coping strategies, that may relate optimism to depression risk.

Dataset Information

Prospective study of the association between dispositional optimism and incident heart failure.

Publications

Prospective study of the association between dispositional optimism and incident heart failure.

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