Koga · Journal of the American Geriatrics Society 2022 · Prospective cohort study · n=159,255

Optimism, lifestyle, and longevity in a racially diverse cohort of women.

Cited 25 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective observational cohort study

PubMed 35674052 · doi:10.1111/jgs.17897 · record verified 2026-08-29

What was done

Data from 159,255 female participants in the Women's Health Initiative were analyzed to evaluate associations between baseline optimism (measured by a validated tool) and longevity across racial and ethnic groups. Accelerated failure time models estimated lifespan increments, Poisson regression evaluated exceptional longevity (survival to age ≥90), and causal mediation analysis assessed the mediating role of healthy lifestyle factors.

What was found

After covariate adjustment, the highest versus lowest optimism quartile was associated with a 5.4% (95% CI: 4.5% to 6.4%) longer lifespan in the full cohort. In racial and ethnic subgroups, estimates were 5.1% (95% CI: 4.0% to 6.1%) in non-Hispanic White, 7.6% (95% CI: 3.6% to 11.7%) in Black, 5.4% (95% CI: -0.1% to 11.2%) in Hispanic/Latina, and 1.5% (95% CI: -5.0% to 8.5%) in Asian women. Exceptional longevity was achieved by 53% of participants, with higher optimism predicting greater likelihood of reaching age ≥90 (risk ratio = 1.1, 95% CI: 1.1 to 1.1). Lifestyle mediated 24% of the optimism-lifespan association overall (25% in White, 10% in Black, 24% in Hispanic/Latina, and 43% in Asian women).

Why it matters

This study extends evidence linking optimism to extended lifespan and exceptional longevity beyond predominantly White cohorts to racially and ethnically diverse populations, demonstrating that the association is only partially explained by lifestyle habits.

Limits

The study is observational, so residual confounding cannot be ruled out and causality cannot be determined. The cohort consisted entirely of women, limiting generalizability to men. Subgroup analyses for Hispanic/Latina and Asian women had wide confidence intervals crossing zero.

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