Scimex: Sustained enjoyment of life over several years in older age is associated with lower mortality, finds a study in the Christmas issue of The BMJ. The longer an individual reports enjoying life, the lower their risk of death, the findings show. Previous studies have shown that subjective wellbeing (feelings of enjoyment and satisfaction with life) is associated with greater longevity, but they measured wellbeing on a single occasion, and the importance of sustained wellbeing is not known.
So researchers at University College
London decided to test whether repeated reports of enjoyment of life
over a period of several years would have a stronger association with
mortality than a single occurrence.
The study involved 9,365 men
and women aged 50 and older (average age 63) who were taking part in the
English Longitudinal Study of Ageing (ELSA). Measures of enjoyment of
life were assessed three times at two-year intervals between 2002 and
2006 and associations with mortality were analysed up to 2013.
who responded ‘never or rarely’ to each of four questions about
enjoyment were classified as having no enjoyment, while those responding
‘sometimes or often’ were categorised as having high enjoyment. A range
of factors that could influence the results were also taken into
account, such as wealth, education, underlying health issues, and
A total of 2,264 (24%) of participants reported no
high levels of enjoyment of life on any occasion, with 1,833 (20%)
having one, 2,063 (22%) having two, and 3,205 (34%) having three reports
of high enjoyment.
The number of reports of high enjoyment of
life was greater in women, and in participants who were married or
cohabiting, well educated, wealthier, younger, and currently employed
were 1,310 deaths during the follow-up period. A graded effect was
seen, with progressively higher mortality among people with fewer
reports of high enjoyment.
For example, compared with the no high
enjoyment group, all-cause mortality risk was reduced by 17% among
people giving two, and by 24% in those giving three reports of high
enjoyment of life.
The authors point out that this association may
be biased by reverse causality, where serious illness leads to a lack
of enjoyment and also increases risk of dying.
In a bid to correct
for this, they carried out a further analysis restricted to deaths at
least two years after the last measurement point. But this made no
difference to the findings.
This is an observational study, so
causal conclusions cannot be drawn, they stress. Nonetheless, they say
these results “add a new dimension to understanding the significance of
subjective wellbeing for physical health outcomes by documenting a
dose-response association with sustained wellbeing.”