Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years.
Level 3 - non-randomized controlled study
Prospective cohort study
PubMed 31125099 · doi:10.1001/jamanetworkopen.2019.4270
What was done
The study analyzed prospective cohort data from the Health and Retirement Study (HRS) comprising 6,985 US adults older than 50 years (mean age 68.6 years; 57.5% women) who completed a psychological questionnaire in 2006. Purpose in life was assessed using a 7-item modified Ryff and Keyes Scales of Psychological Well-being score categorized into 5 groups (1.00-2.99, 3.00-3.99, 4.00-4.99, 5.00-5.99, and 6.00). Participants were followed for all-cause and cause-specific mortality between 2006 and 2010 using weighted Cox proportional hazards models.
What was found
Over follow-up (mean survival time for decedents was 31.21 months, range 1.00-71.00 months), individuals in the lowest life purpose category had significantly higher all-cause mortality compared with those in the highest category (hazard ratio, 2.43; 95% CI, 1.57-3.75). Mortality from heart, circulatory, and blood conditions was also significantly higher in the lowest category (hazard ratio, 2.66; 95% CI, 1.62-4.38).
Why it matters
This study demonstrates a prospective association between low purpose in life and increased mortality risk, suggesting psychological purpose may be relevant to health and longevity in older adults.
Limits
The observational design cannot establish causality or exclude reverse causation. Follow-up was relatively short (2006 to 2010), life purpose was measured at only one time point, and 1,434 participants were excluded due to missing data or loss to follow-up.
Cited by
- supports Among adults aged 70 and older, having a strong sense of purpose in life is the single most important psychological predictor of longevity.