Positive Mental Attitude Associated with Lower 35-Year Mortality: The Leisure World Cohort Study

Table 5

Prospective cohort studies of mental attitude and mortality in the elderly.

First author, date [reference]	Study name; Population	Number	Age (years)	Follow-up (years)	Sex	Mental attitude instrument	HR, 95% CI^†Age- and sex-adjusted Most adjusted model
Gitlay, 2004 [30]	Arnhem Elderly Study; The Netherlands	999	65–85	Mean = 9	M,F	Scale of Subjective Well-Being for Older Persons	0.55, 0.42–0.77; 0.71, 0.52–0.97
Pitkala, 2004 [32]	Helsinki Aging Study; Finland	491	75, 80, 85	10	M,F	6 questions on positive life orientation	0.67, 0.53–0.87^‡; 0.89, 0.83–0.93
Tindle, 2009 [13]	Women’s Health Initiative; USA	97,253	50–79	8	F	Life Orientation Test-Revised	—; 0.86, 0.79–0.93
Koopmans, 2010 [14]	Arnhem Elderly Study; The Netherlands	861	65–85	15	M,F	2 “happiness” questions	0.78, 0.64–0.95; 0.92, 0.75–1.14
Benito-Leon, 2010 [29]	Neurological Disorders in Central Spain	2516	65+	7	M,F	Philadelphia Geriatric Center Morale Scale	1.60, 1.29–2.21^‡; 1.35, 1.00–1.81
Tilvis, 2012 [35]	National Sample; Finland	2490	>75	5	M,F	6 questions on positive life orientation	0.65, 0.53–0.81; 0.85, 0.67–1.08
Niklasson, 2015 [31]	GERDA; Sweden and Finland	646	85+	5	M,F	Philadelphia Geriatric Center Morale Scale	1.73, 1.33–2.26; 1.36, 1.03–1.80
St John, 2015 [33]	Manitoba Study of Health and Aging, Canada	1751	65+	5	M,F	Terrible-Delightful Scale	0.75, 0.66–0.86; 0.90, 0.78–1.04
Steptoe, 2015 [34]	English Longitudinal Study of Aging	9050	Mean = 65	Mean = 8	M,F	Eudemonic well-being	0.42, 0.36–0.49; 0.70, 0.58–0.83
Anthony, 2016 [28]	Rancho Bernardo Study; USA	876	50+	< = 12 mean = 8	M,F	Life Orientation Test-Revised	0.98, 0.94–1.02; 0.99, 0.94–1.03
Gong, 2016 [10]	Chinese Longitudinal Healthy Longevity Survey	18,676	80–122	16	M,F	7 items on psychological well-being	—; 0.84, 0.79–0.88
Liu, 2016 [12]	Million Women Study; United Kingdom	719,671	50–69	10	F	“How often do you feel happy?”	1.29, 1.25–1.33; 0.98, 0.94–1.01
Kim, 2017 [11]	Nurses’ Health Study; USA	70,021	Mean = 70	6	F	Life Orientation Test-Revised	0.71, 0.66–0.76^∗; 0.91, 0.85–0.97
Okely, 2018 [15]	Survey of Health Aging and Retirement in Europe	13,596	50+	∼12	M,F	CASP-12	0.41, 0.38–0.43; 0.57, 0.53–0.61

^†HR for high vs. low category of positive mental attitude, except for Benito-Leon, Niklasson, and Liu studies which compared low vs. high category. ^‡Unadjusted HR. ^∗Adjusted for additional demographic factors as well.