Positive affect during adolescence and health and well-being in adulthood: An outcome-wide longitudinal approach.

BACKGROUND: Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes. METHODS AND FINDINGS: We conducted a longitudinal cohort study using data from Add Health-a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years-during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (ß = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (ß = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (ß = -0·09, 95% CI = -0·16, -0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality. CONCLUSIONS: Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes.

The silent epidemic of loneliness: identifying the antecedents of loneliness using a lagged exposure-wide approach.

BACKGROUND: A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness. METHODS: We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t0;2006/2008 to t1;2010/2012) were associated with subsequent loneliness 4 years later (t2;2014/2016). RESULTS: Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness. CONCLUSIONS: Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.

Epigenome-Wide Analysis of DNA Methylation and Optimism in Women and Men.

OBJECTIVE: Higher optimism is associated with reduced mortality and a lower risk of age-related chronic diseases. DNA methylation (DNAm) may provide insight into mechanisms underlying these relationships. We hypothesized that DNAm would differ among older individuals who are more versus less optimistic. METHODS: Using cross-sectional data from two population-based cohorts of women with diverse races/ethnicities ( n = 3816) and men (only White, n = 667), we investigated the associations of optimism with epigenome-wide leukocyte DNAm. Random-effects meta-analyses were subsequently used to pool the individual results. Significantly differentially methylated cytosine-phosphate-guanines (CpGs) were identified by the "number of independent degrees of freedom" approach: effective degrees of freedom correction using the number of principal components (PCs), explaining >95% of the variation of the DNAm data (PC-correction). We performed regional analyses using comb-p and pathway analyses using the Ingenuity Pathway Analysis software. RESULTS: We found that essentially all CpGs (total probe N = 359,862) were homogeneous across sex and race/ethnicity in the DNAm-optimism association. In the single CpG site analyses based on homogeneous CpGs, we identified 13 significantly differentially methylated probes using PC-correction. We found four significantly differentially methylated regions and two significantly differentially methylated pathways. The annotated genes from the single CpG site and regional analyses are involved in psychiatric disorders, cardiovascular disease, cognitive impairment, and cancer. Identified pathways were related to cancer, and neurodevelopmental and neurodegenerative disorders. CONCLUSION: Our findings provide new insights into possible mechanisms underlying optimism and health.

Who Benefits From Helping? Moderators of the Association Between Informal Helping and Mortality.

BACKGROUND: While informal helping has been linked to a reduced risk of mortality, it remains unclear if this association persists across different levels of key social structural moderators. PURPOSE: To examine whether the longitudinal association between informal helping and all-cause mortality differs by specific social structural moderators (including age, gender, race/ethnicity, wealth, income, and education) in a large, prospective, national, and diverse sample of older U.S. adults. METHODS: We analyzed data from the Health and Retirement Study, a national sample of U.S. adults aged >50 (N = 9,662). Using multivariable Poisson regression, we assessed effect modification by six social structural moderators (age, gender, race/ethnicity, wealth, income, and education) for the informal helping (2006/2008) to mortality (2010-2016/2012-2018) association on the additive and multiplicative scales. RESULTS: Participants who reported ≥100 hr/year of informal helping (vs. 0 hr/year), had a lower mortality risk. Those who engaged in 1-49 hr/year most consistently displayed lower mortality risk across moderators, while those who engaged in 50-99 and ≥100 hr/year only showed decreased mortality risk across some moderators. When formally testing effect modification, there was evidence that the informal helping-mortality associations were stronger among women and the wealthiest. CONCLUSIONS: Informal helping is associated with decreased mortality. Yet, there appear to be key differences in who benefits from higher amounts of informal helping across social structural moderators. Further research is needed to evaluate how the associations between informal helping and health and well-being are patterned across key social structural moderators.

Informal helping has been associated with a decreased mortality risk, but it remains unclear if this association persists across different levels of key social structural moderators. We examined whether the longitudinal association between informal helping and all-cause mortality differs across age, gender, race/ethnicity, wealth, income, and education, in a large sample of older U.S. adults from the Health and Retirement Study (N = 9,662). Participants who reported ≥100 hr/year of informal helping (vs. 0 hr/year), had a lower mortality risk. Those who engaged in 1­49 hr/year most consistently displayed lower mortality risk across moderators, while those who engaged in 50­99 and ≥100 hr/year only showed decreased mortality risk across some moderators. There was evidence that the informal helping­mortality associations were stronger among women and the wealthiest when testing effect modification. While informal helping was associated with decreased mortality, there appear to be key differences in who benefits from higher amounts of informal helping across social structural moderators. Further research is needed to evaluate how the associations between informal helping and health and well-being differ across important social structural factors.

Informal Helping and Subsequent Health and Well-Being in Older U.S. Adults.

BACKGROUND: Growing evidence suggests that informal helping (unpaid volunteering not coordinated by an organization or institution) is associated with improved health and well-being outcomes. However, studies have not investigated whether changes in informal helping are associated with subsequent health and well-being. METHODS: This study evaluated if changes in informal helping (between t0;2006/2008 and t1;2010/2012) were associated with 35 indicators of physical, behavioral, and psychosocial health and well-being (at t2;2014/2016) using data from 12,998 participants in the Health and Retirement study - a national cohort of US adults aged > 50. RESULTS: Over the four-year follow-up period, informal helping ≥ 100 (versus 0) hours/year was associated with a 32% lower mortality risk (95% CI [0.54, 0.86]), and improved physical health (e.g., 20% reduced risk of stroke (95% CI [0.65, 0.98])), health behaviors (e.g., 11% increased likelihood of frequent physical activity (95% CI [1.04, 1.20])), and psychosocial outcomes (e.g., higher purpose in life (ß = 0.15, 95% CI [0.07, 0.22])). However, there was little evidence of associations with various other outcomes. In secondary analyses, this study adjusted for formal volunteering and a variety of social factors (e.g., social network factors, receiving social support, and social participation) and results were largely unchanged. CONCLUSIONS: Encouraging informal helping may improve various aspects of individuals' health and well-being and also promote societal well-being.

Purpose in life and 8-year mortality by gender and race/ethnicity among older adults in the U.S.

We examined the associations between a sense of purpose and all-cause mortality by gender and race/ethnicity groups. Data were from the Health and Retirement Study, a nationally representative cohort study of U.S. adults aged >50 (n = 13,159). Sense of purpose was self-reported at baseline (2006/2008), and risk of all-cause mortality was assessed over an 8-year follow-up period. We also formally tested for potential effect modification by gender and race/ethnicity. We observed the associations between higher purpose and lower all-cause mortality risk across all gender and race/ethnicity groups. There was modest evidence that the highest level of purpose (versus lowest quartile) was associated with even lower risk of all-cause mortality among women (risk ratio = 0.66, 95% confidence interval: 0.56, 0.77) compared to men (risk ratio = 0.80, 95% confidence interval: 0.69, 0.93; p-value for multiplicative effect modification =0.07). However, we observed no evidence of effect modification by race/ethnicity. Having a higher sense of purpose appears protective against all-cause mortality regardless of gender and race/ethnicity. Purpose, a potentially modifiable factor, might be a health asset across diverse populations.

Optimism and risk of mortality among African-Americans: The Jackson heart study.

Optimism is associated with reduced mortality risk among Whites, but evidence for this relationship is limited among African-Americans, whose life expectancy is shorter than Whites. This study examined the association between optimism and mortality rate in African-Americans. Data were from African-American women (n = 2652) and men (n = 1444) in the United States from the Jackson Heart Study. Optimism was measured using the Life Orientation Test-Revised at the baseline period (2000-2004), and mortality data were obtained until 2018. Using Cox proportional hazards models, we estimated hazard ratios (HRs) of mortality by optimism level, controlling for sociodemographic factors, depressive symptoms, health conditions, and health behaviors. In secondary analyses, we evaluated potential effect modification by sex, age, income, and education. Higher optimism was related to lower mortality rates (HR = 0.85, 95% confidence interval [CI] = 0.74, 0.99), controlling for sociodemographic factors and depressive symptoms. After further adjusting for health conditions and health behaviors, associations were slightly attenuated (HR = 0.89; 95%CI = 0.77, 1.02). Stronger associations between optimism and mortality were observed in men, among those with higher income or education, and with age ≤ 55 (all p's for interaction terms <0.06). In summary, optimism was associated with lower mortality rates among African-Americans in the Jackson Heart Study. Effect modification by sociodemographic factors should be further explored in additional research considering optimism and mortality in diverse populations. Positive factors, such as optimism, may provide important health assets that can complement ongoing public health efforts to reduce health disparities, which have traditionally focused primarily on risk factors.

Are all domains of life satisfaction equal? Differential associations with health and well-being in older adults.

PURPOSE: Growing evidence documents strong associations between overall life satisfaction and favorable health and well-being outcomes. However, because most previous studies have assessed satisfaction with one's life as a whole, we know little about whether specific domains of life satisfaction (e.g., satisfaction with family life, income) might be responsible for longitudinally driving better health and well-being. METHODS: Data were from 13,752 participants in the Health and Retirement Study-a prospective and nationally representative cohort of US adults aged > 50. We evaluated if positive changes in seven individual domains of life satisfaction (between t0; 2008/2010 and t1; 2012/2014) were associated with 35 indicators of physical, behavioral, and psychosocial health and well-being (at t2; 2016/2018). RESULTS: Most domains of life satisfaction were associated with psychological outcomes: satisfaction with family and non-work activities showed the largest associations (sometimes double in magnitude) with subsequent psychological factors, followed by satisfaction with financial situation and income. Further, some domains showed associations with specific physical health outcomes (e.g., mortality, number of chronic conditions, physical functioning limitations), health behaviors (e.g., sleep problems), and social factors (e.g., loneliness). CONCLUSIONS: As countries seek innovative and cost-effective methods of enhancing the health and well-being of our rapidly aging populations, findings from our study suggest that some domains of life satisfaction have a substantially larger influence on health and well-being outcomes than others. Individual domains of life satisfaction might be novel targets for interventions and policies seeking to enhance specific facets of health and well-being.

Optimism is associated with exceptional longevity in 2 epidemiologic cohorts of men and women.

Most research on exceptional longevity has investigated biomedical factors associated with survival, but recent work suggests nonbiological factors are also important. Thus, we tested whether higher optimism was associated with longer life span and greater likelihood of exceptional longevity. Data are from 2 cohorts, women from the Nurses' Health Study (NHS) and men from the Veterans Affairs Normative Aging Study (NAS), with follow-up of 10 y (2004 to 2014) and 30 y (1986 to 2016), respectively. Optimism was assessed using the Life Orientation Test-Revised in NHS and the Revised Optimism-Pessimism Scale from the Minnesota Multiphasic Personality Inventory-2 in NAS. Exceptional longevity was defined as survival to age 85 or older. Primary analyses used accelerated failure time models to assess differences in life span associated with optimism; models adjusted for demographic confounders and health conditions, and subsequently considered the role of health behaviors. Further analyses used logistic regression to evaluate the likelihood of exceptional longevity. In both sexes, we found a dose-dependent association of higher optimism levels at baseline with increased longevity (P trend < 0.01). For example, adjusting for demographics and health conditions, women in the highest versus lowest optimism quartile had 14.9% (95% confidence interval, 11.9 to 18.0) longer life span. Findings were similar in men. Participants with highest versus lowest optimism levels had 1.5 (women) and 1.7 (men) greater odds of surviving to age 85; these relationships were maintained after adjusting for health behaviors. Given work indicating optimism is modifiable, these findings suggest optimism may provide a valuable target to test for strategies to promote longevity.

Early-life stress, depressive symptoms, and inflammation: the role of social factors.

OBJECTIVE: To identify modifiable, social factors that moderate the relationship between early-life stress (ELS) and health outcomes as measured by depressive symptoms and inflammation. METHODS: Data were from 3,416 adults (58.28% female), ages 36 - 97 (Mage = 68.41; SDage = 10.24) who participated in the 2006 wave of the Health and Retirement Study, a nationally representative sample of older adults in the United States. This study used hierarchical regression analyses to first test the main effects of ELS on depressive symptoms and inflammation (high-sensitivity C-reactive protein). Four social factors (perceived support, frequency of social contact, network size, and volunteer activity) were assessed as moderators of the ELS-depression and ELS-inflammation relationships. RESULTS: There was a small, positive association between ELS and depressive symptoms (B = 0.17, SE = 0.05, p = .002), which was moderated by social contact and perceived support. Specifically, ELS was only associated with elevated depressive symptoms for participants with limited social contact (B = 0.24, SE = 0.07, p < .001) and low perceived support (B = 0.24, SE = 0.07, p < .001). These associations remained after accounting for potential confounds (age, body-mass index, adulthood stress, and marital status). CONCLUSIONS: Increased social contact and perceived support may be protective for individuals at a higher risk of developing depressive symptoms as a result of ELS. Future interventions may benefit from leveraging these social factors to improve quality of life in adults with ELS.

A Changing Landscape of Health Opportunity in the United States: Increases in the Strength of Association Between Childhood Socioeconomic Disadvantage and Adult Health Between the 1990s and the 2010s.

Understanding the changing health consequences of childhood socioeconomic disadvantage (SED) is highly relevant to policy debates on inequality and national and state goals to improve population health. However, changes in the strength of association between childhood SED and adult health over historic time are largely unexamined in the United States. The present study begins to address this knowledge gap. Data were from 2 national samples of adults collected in 1995 (n = 7,108) and 2012 (n = 3,577) as part of the Midlife in the United States study. Three measures of childhood SED (parents' occupational prestige, childhood poverty exposure, and parents' education) were combined into an aggregate index and examined separately. The association between childhood SED (aggregate index) and 5 health outcomes (body mass index, waist circumference, chronic conditions, functional limitations, and self-rated health) was stronger in the 2012 sample than the 1995 sample, with the magnitude of associations being approximately twice as large in the more recent sample. Results persisted after adjusting for age, sex, race, marital status, and number of children, and were similar across all 3 measures of childhood SED. The findings suggest that the socioeconomic circumstances of childhood might have become a stronger predictor of adult health in recent decades.

Life Satisfaction and Subsequent Physical, Behavioral, and Psychosocial Health in Older Adults.

Policy Points Several intergovernmental organizations (Organisation for Economic Co-operation and Development, World Health Organization, United Nations) are urging countries to use well-being indicators (e.g., life satisfaction) in addition to traditional economic indicators when making important policy decisions. As the number of governments implementing this new approach grows, so does the need to continue evaluating the health and well-being outcomes we might observe from policies aimed at improving life satisfaction. The results of this study suggest that life satisfaction is a valuable target for policies aiming to enhance several indicators of psychosocial well-being, health behaviors, and physical health outcomes. CONTEXT: Several intergovernmental organizations (Organisation for Economic Co-operation and Development, World Health Organization, United Nations) are urging countries to use well-being indicators (e.g., life satisfaction) in addition to traditional economic indicators when making important policy decisions. As the number of governments implementing this new approach grows, so does the need to continue evaluating the health and well-being outcomes we might observe from policies aimed at improving life satisfaction. METHODS: We evaluated whether positive change in life satisfaction (between t0 ;2006/2008 and t1 ;2010/2012) was associated with better outcomes on 35 indicators of physical, behavioral, and psychosocial health and well-being (in t2 ;2014/2016). Data were from 12,998 participants in the University of Michigan's Health and Retirement Study-a prospective and nationally representative cohort of US adults over age 50. FINDINGS: Participants with the highest (versus lowest) life satisfaction had better subsequent outcomes on some physical health indicators (lower risk of pain, physical functioning limitations, and mortality; lower number of chronic conditions; and higher self-rated health) and health behaviors (lower risk of sleep problems and more frequent physical activity), and nearly all psychosocial indicators (higher positive affect, optimism, purpose in life, mastery, health mastery, financial mastery, and likelihood of living with spouse/partner; and lower depression, depressive symptoms, hopelessness, negative affect, perceived constraints, and loneliness) over the 4-year follow-up period. However, life satisfaction was not subsequently associated with many specific health conditions (i.e., diabetes, hypertension, stroke, cancer, heart disease, lung disease, arthritis, overweight/obesity, or cognitive impairment), other health behaviors (i.e., binge drinking or smoking), or frequency of contact with children, family, or friends. CONCLUSIONS: These results suggest that life satisfaction is a valuable target for policies aiming to enhance several indicators of psychosocial well-being, health behaviors, and physical health outcomes.

The positive influence of sense of control on physical, behavioral, and psychosocial health in older adults: An outcome-wide approach.

Accumulating research indicates robust associations between sense of control and salutary health and well-being outcomes. However, whether change in sense of control is associated with subsequent outcomes has been under-evaluated. Participants (N = 12,998) were from the Health and Retirement Study-a diverse, nationally representative, and longitudinal sample of U.S. adults aged >50 years. We examined how increase in sense of control (from t0:2006/2008 to t1: 2010/2012) was associated with better outcomes on 35 indicators of: physical-, behavioral-, and psychosocial-health (t2:2014/2016). We used multiple logistic-, linear-, and generalized-linear regression models and controlled for sociodemographic characteristics, personality traits, sense of control, and all outcomes in the pre-baseline wave (t0:2006/2008). During the 4-year follow-up, people in the highest (vs. lowest) quartile of sense of control, conditional on prior sense of control, had reduced risk of mortality and improved physical-health outcomes (lower risk of: stroke, lung disease, physical limitations, cognitive impairment, chronic pain and higher self-rated health). Sense of control was related to better health-behaviors (increased physical activity, reduced sleep problems), higher psychological well-being (positive affect, life satisfaction, optimism, purpose, personal-, health-, financial-mastery), lower psychological distress (depression, hopelessness, negative affect, perceived constraints), decreased loneliness, and increased contact with friends. Sense of control was unrelated to other physical health indicators (diabetes, hypertension, heart disease, cancer, arthritis, overweight/obesity), health behaviors (binge drinking, smoking), and social factors (living with spouse/partner, frequency of contact with children and other family). These findings underscore the importance of sense of control as a potential intervention target for fostering physical-, behavioral-, and psychosocial-health.

Social Media as an Emerging Data Resource for Epidemiologic Research: Characteristics of Regular and Nonregular Social Media Users in Nurses' Health Study II.

With advances in natural language processing and machine learning, researchers are leveraging social media as a low-cost, low-burden method for measuring various psychosocial factors. However, it is unclear whether information derived from social media is generalizable to broader populations, especially middle-aged and older adults. Using data on women aged 53-70 years from Nurses' Health Study II (2017-2018; n = 49,045), we assessed differences in sociodemographic characteristics, health conditions, behaviors, and psychosocial factors between regular and nonregular users of Facebook (Facebook, Inc., Menlo Park, California). We evaluated effect sizes with phi (φ) coefficients (categorical data) or Cohen's d (continuous data) and calculated odds ratios with 95% confidence intervals. While most comparisons between regular and nonregular users achieved statistical significance in this large sample, effect sizes were mostly "very small" (conventionally defined as φ or d <0.01) (e.g., optimism score: meanregular users = 19 vs. meannonregular users = 19 (d = -0.03); physical activity: meanregular users = 24 metabolic equivalent of task (MET)-hours/week vs. meannonregular users = 24 MET-hours/week (d = 0.01)). Some factors had slightly larger differences for regular users versus nonregular users (e.g., depression: 28% vs. 23% (φ = 0.05); odds ratio = 1.27 (95% confidence interval: 1.22, 1.33); obesity: 34% vs. 26% (φ = 0.07); odds ratio = 1.42 (95% confidence interval: 1.36, 1.48)). Results suggest that regular Facebook users were similar to nonregular users across sociodemographic and psychosocial factors, with modestly worse health regarding obesity and depressive symptoms. In future research, investigators should evaluate other demographic groups.

Sense of Purpose in Life and Likelihood of Future Illicit Drug Use or Prescription Medication Misuse.

OBJECTIVE: In the United States, 28.6 million people used illicit drugs or misused prescription drugs in the last 30 days. Thus, identifying factors linked with lower likelihood of future drug misuse is an important target for research and practice. Sense of purpose in life has been linked with better behavioral and physical health outcomes. Furthermore, a higher sense of purpose may reduce the likelihood of drug misuse because it has been linked with several protective factors including enhanced ability to handle stress, higher pain tolerance, and lower impulsivity. However, the association between sense of purpose and drug misuse has been understudied. Thus, we tested whether people with a higher sense of purpose at baseline had a lower likelihood of future drug misuse 9 to 10 years later. METHODS: This study included 3535 middle-aged adults from the Midlife in the United States Study who were not misusing drugs at baseline. Using multiple logistic regression models, we assessed whether baseline purpose in life was associated with risk of misusing drugs 9 to 10 years later. RESULTS: Among respondents not misusing drugs at baseline, people in the highest quartile of purpose (versus lowest quartile) had a substantially lower likelihood of future drug misuse in a model adjusting for demographic variables (odds ratio = 0.50, 95% confidence interval = 0.31-0.83). Associations remained evident after additionally adjusting for psychological distress, baseline health, and health behaviors. CONCLUSIONS: A growing knowledge base suggests that a sense of purpose can be increased. Additional research is needed to evaluate sense of purpose as a novel target in the prevention and reduction of drug misuse.

The Relation of Optimism to Relative Telomere Length in Older Men and Women.

OBJECTIVE: Mounting evidence suggests that higher optimism is associated with reduced risk of age-related morbidities and premature mortality. However, possible biological mechanisms underlying these associations remain understudied. One hypothesized mechanism is a slower rate of cellular aging, which in turn delays age-related declines in health. METHODS: We used data from two large cohort studies to test the hypothesis that higher optimism is associated with longer leukocyte telomere length. With cross-sectional data from the Health and Retirement Study (HRS; n = 6417; mean age = 70 years) and the Women's Health Initiative (WHI; N = 3582; mean age = 63 years), we used linear regression models to examine the association of optimism with relative telomere length (assessed in leukocytes from saliva [HRS] or plasma [WHI]). Models adjusted for sociodemographics, depression, health status, and health behaviors. RESULTS: Considering both optimism and telomere length as continuous variables, we found consistently null associations in both cohorts, regardless of which covariates were included in the models. In models adjusting for demographics, depression, comorbidities, and health behaviors, optimism was not associated with mean relative telomere length (HRS: ß = -0.002, 95% confidence interval = -0.014 to 0.011; WHI: ß = -0.004, 95% confidence interval = -0.017 to 0.009). CONCLUSIONS: Findings do not support mean telomere length as a mechanism that explains observed relations of optimism with reduced risk of chronic disease in older adults. Future research is needed to evaluate other potential biological markers and pathways.

Sense of purpose in life and five health behaviors in older adults.

Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. Prospective data were from the Health and Retirement Study, a national sample of U.S. older adults. Our sample included 13,770 adults assessed up to five times across eight years. Among people who met recommended guidelines for a given health behavior outcome at baseline, those in the top versus lowest quartile of purpose in life had 24% lower likelihood of becoming physically inactive (95% CI: 0.68-0.85), 33% lower likelihood of developing sleep problems (95% CI: 0.58-0.79), and 22% lower likelihood of developing unhealthy body mass index (BMI) (95% CI: 0.69-0.87) in sociodemographic-adjusted models. Further there was a marginal reduction in smoking relapse (HR = 0.65, 95% CI: 0.41-1.03) and no association with heavy alcohol use (HR = 1.02, 95% CI: 0.81-1.29). Findings for physical inactivity, sleep problems, and unhealthy BMI remained evident after further adjusting for baseline health status and depression. Our results, suggest that a sense of purpose in life might emerge (with further research) as a valuable target to consider for interventions aimed at helping older adults maintain some health behaviors.

Current recommendations on the selection of measures for well-being.

Measures of well-being have proliferated over the past decades. Very little guidance has been available as to which measures to use in what contexts. This paper provides a series of recommendations, based on the present state of knowledge and the existing measures available, of what measures might be preferred in which contexts. The recommendations came out of an interdisciplinary workshop on the measurement of well-being. The recommendations are shaped around the number of items that can be included in a survey, and also based on the differing potential contexts and purposes of data collection such as, for example, government surveys, or multi-use cohort studies, or studies specifically about psychological well-being. The recommendations are not intended to be definitive, but to stimulate discussion and refinement, and to provide guidance to those relatively new to the study of well-being.

The association between actor/partner optimism and cognitive functioning among older couples.

OBJECTIVE: Higher optimism has been linked with health, well-being, and cognitive functioning. Spouses also play an important role on people's health, especially in older adulthood. Yet, whether a spouse's optimism is associated with an individual's cognitive functioning is understudied. Thus, we examined this question. METHOD: Participants were 4,457 heterosexual couples (N = 8,914; Mage  = 66.73, SD = 9.67) from the Health and Retirement Study-a large, diverse, prospective, and nationally representative sample of U.S. adults aged >50. Optimism was assessed at baseline (t1 ) and cognition was measured every two years with up to five repeated assessments of cognition data over the 8-year follow-up period (t1 ; t2 ; t3 ; t4 ; t5 ). RESULTS: Results from multi-level dyadic data analyses showed small but positive associations between actor optimism and actor cognitive functioning (memory: r = .16, mental status = .10), as well as partner optimism and actor cognitive functioning (memory: r = .04, mental status = .03). These associations mostly persisted over time. CONCLUSIONS: Participants' own optimism and their partner's optimism were both positively associated with cognitive functioning.Thus, with further research, optimism (at both the individual and couple level) might emerge as an innovative intervention target that helps adults maintain cognitive functioning as they age.

Mediators of the Association Between Religious Service Attendance and Mortality.

Mounting evidence consistently shows associations between religious service attendance and reduced mortality risk, yet research identifying mediators remains limited. Using prospective data from the Health and Retirement Study (2006-2014; n = 5,200 US adults), we evaluated a range of potential mediators. After robust control for confounders (demographic, health, health-behavior, and social factors), among positive psychological factors, we observed mediation through increased life satisfaction (5.27%; P ≤ 0.001) and possibly positive affect (1.52%; P = 0.06) but not optimism, mastery, or purpose. Among dimensions of psychological distress, we observed mediation through reductions in hopelessness (1.92%; P = 0.01), trait anger (1.98%; P = 0.03), state anger (2.23%; P = 0.03), and possibly loneliness (1.21%; P = 0.06), but not cynical hostility or negative affect, and some evidence that increased anxiety (-3.61%; P = 0.008) and possibly depressive symptoms (-1.14%; P = 0.05) increased mortality odds. Among social factors, we observed mediation through contact with friends (10.73%; P = 0.005) but not living with a spouse or contact with children or other family. Among health behaviors, we observed mediation through exercise (5.38%; P ≤ 0.001) and negative mediation through alcohol frequency (-2.55%; P = 0.03) and possibly body mass index (-2.34%; P = 0.08) but not smoking. These results highlight a range of mediators that might underlie the association between religious service attendance and reduced risk of mortality.