Aging adults who report greater enjoyment of life and no symptoms of depression can expect to live for a longer time in good health compared with older adults with low affective well-being, according to a study published in JAMA Network Open.
The researchers of this study sought to explore the associations between affective well-being (defined as the enjoyment of life coupled with lack of depressive symptoms), estimated life expectancy, and healthy life expectancy (defined as years free of disability and chronic illness).
The study included 9761 adults, aged 50 years and older, from the English Longitudinal Study of Aging; participants were followed for up to 10 years between 2002 and 2013. The primary outcome measure was the estimation of total life expectancy as well as disability-free and chronic disease-free life expectancies.
Disability was evaluated if participants had difficulty performing activities of daily living (dressing, bathing, eating, getting in and out of bed, using the toilet, and walking across a room) or instrumental activities of daily living (grocery shopping, cooking, taking medications, using a map, making phone calls, doing housework, and managing money). Chronic health conditions were assessed for the presence of coronary heart disease, cancer, diabetes, stroke, pulmonary disease (chronic bronchitis or emphysema), or arthritis.
Enjoyment of life and depressive symptoms were both measured at baseline using the CASP-19 quality of life instrument and the 8-item Center for Epidemiologic Studies Depression Scale, respectively. Analyses were adjusted for baseline socioeconomic status and marital or cohabiting status.
Overall, high affective well-being was associated with longer life expectancy and healthy life expectancy. Comparing women at age 50 years, individuals who reported high affective well-being were expected to live approximately 6 years longer than individuals who reported low life enjoyment and depression. Disability-free life expectancy at the age of 50 for participants with high enjoyment and no depression was an additional 29.4 years for men and 31.4 years for women. Disability-free life expectancy for participants with low affective well-being, on the other hand, was 19.7 years for men and 20.8 years for women. In other words, the estimated number of years living with a disability or chronic illness was greater among men and women with low affective well-being vs high affective well-being.
The difference in life expectancies of people experiencing high enjoyment of life and no depression vs those experiencing low enjoyment and depression showed a similar pattern when assessing participants at age 60, 70, and 80 years.
A limitation to the study included that the associations between well-being and healthy life expectancy were based on observational data in which causality could not be inferred. Affective well-being, socioeconomic, and cohabitating status were only measured at baseline and the study did not consider changes over time. Finally, a limited number of serious health problems were included among the index of chronic conditions and were self-reported.
Investigators concluded that older adults who experience greater enjoyment of life and no depressive symptoms live longer and healthier lives; improving the subjective well-being of older individuals can potentially increase the number of years they can expect to live in good health without disability or illness.
Zaninotto P, Steptoe A. Association between subjective well-being and living longer without disability or illness. JAMA Netw Open. 2019;2(7):e196870.