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Optimism and Healthy Aging in Women.

ABSTRACT: INTRODUCTION:Optimism-the expectation that good things will happen-has emerged as a promising health asset, as it appears to be related to healthier behaviors and reduced disease risk. Growing research finds that higher optimism is associated with lower mortality, yet it is critical to understand whether this prolonged longevity is accompanied by good health. This study tested whether higher optimism was associated with increased likelihood of healthy aging. METHODS:Prospective data analyzed in 2018 from the Nurses' Health Study included 33,326 women with no major chronic diseases at baseline. Poisson regression models evaluated if optimism was associated with healthy aging 8 years later, considering potential confounders (sociodemographic variables, depression) and intermediate variables (health behaviors). Optimism was assessed in 2004 by validated self-report using mailed questionnaires and healthy aging was assessed in 2012, defined as (1) remaining free of major chronic diseases; (2) having no subjective memory impairment; (3) having intact physical function; and (4) surviving through follow-up. RESULTS:Overall, 20.5% of women (n=6,823) fulfilled the definition of healthy aging in 2012. After adjusting for sociodemographic factors and depression, the most (top quartile) versus least (bottom quartile) optimistic women had a 23% greater likelihood of healthy aging (95% CI=1.16, 1.30). Associations were similar in white and black participants, although the sample of black women was small (n=354). CONCLUSIONS:Higher optimism was associated with increased likelihood of healthy aging, suggesting that optimism, a potentially modifiable health asset, merits further research for its potential to improve health in aging.

SUBMITTER: James P

PROVIDER: S-EPMC6310050 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Project description:BackgroundResearch has suggested optimism is associated with healthy aging and exceptional longevity, but most studies were conducted among non-Hispanic White populations. We examined associations of optimism to longevity across racial and ethnic groups and assessed healthy lifestyle as a possible mediating pathway.MethodsParticipants from the Women's Health Initiative (N = 159,255) completed a validated measure of optimism and provided other demographic and health data at baseline. We evaluated associations of optimism with increments in lifespan using accelerated failure time models, and with likelihood of exceptional longevity (survival to age ≥90) using Poisson regression models. Causal mediation analysis explored whether lifestyle-related factors mediated optimism-lifespan associations.ResultsAfter covariate adjustment, the highest versus lowest optimism quartile was associated with 5.4% (95% confidence interval [CI] = 4.5, 6.4%) longer lifespan. Within racial and ethnic subgroups, these estimates were 5.1% (95%CI = 4.0, 6.1%) in non-Hispanic White, 7.6% (95%CI = 3.6, 11.7%) in Black, 5.4% (95%CI = -0.1, 11.2%) in Hispanic/Latina, and 1.5% (95% CI = -5.0, 8.5) in Asian women. A high proportion (53%) of the women achieved exceptional longevity. Participants in the highest versus lowest optimism quartile had greater likelihood of achieving exceptional longevity (e.g., full sample risk ratio = 1.1, 95%CI = 1.1, 1.1). Lifestyle mediated 24% of the optimism-lifespan association in the full sample, 25% in non-Hispanic White, 10% in Black, 24% in Hispanic/Latina, and 43% in Asian women.ConclusionsHigher optimism was associated with longer lifespan and a greater likelihood of achieving exceptional longevity overall and across racial and ethnic groups. The contribution of lifestyle to these associations was modest. Optimism may promote health and longevity in diverse racial and ethnic groups. Future research should investigate these associations in less long-lived populations.

Project description:Background: Adversity in early development seems to increase the risk of stress-related somatic disorders later in life. Physiologically, functioning of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes is often discussed as long-term mediators of risk. In particular, DNA methylation in the glucocorticoid receptor gene promoter (NR3C1) has been associated with type and strength of early life adversity and subsequent effects on HPA axis signaling in humans. Animal studies, moreover, suggest changes in DNA methylation in the estrogen receptor gene (ER?) upon early life adversity. We investigated the association of type and severity of childhood adversity with methylation in NR3C1 and ER? and additionally considered associations between methylation and steroid hormone secretion. Methods: The percentage of methylation within the NR3C1 promoter and the ER? shore was investigated using dried blood spot samples of 103 healthy women aged 40-73 years. Childhood adversity was examined with the Childhood Trauma Questionnaire. Linear regression analyses were performed with methylation as dependent variable and the experience of emotional abuse and neglect, physical abuse and neglect, and sexual abuse (compared to non-experience) as independent variables. All analyses were controlled for age, BMI, annual household income, and smoking status and were adjusted for multiple testing. Results: Overall, over 70% of the sample reported having experienced any kind of abuse or neglect of at least low intensity. There were no significant associations between childhood adversity and methylation in the NR3C1 promoter (all p > .10). Participants reporting emotional abuse showed significantly higher methylation in the ER? shore than those who did not (p = .001). Additionally, higher levels of adversity were associated with higher levels of ER? shore methylation (p = .001). Conclusion: In healthy women, early life adversity does not seem to result in NR3C1 promoter hypermethylation in midlife and older age. This is the first study in humans to suggest that childhood adversity might, however, epigenetically modify the ER? shore. Further studies are needed to gain a better understanding of why some individuals remain healthy and others develop psychopathologies in the face of childhood adversity.

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Optimism and Healthy Aging in Women.

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