Optimism, lifestyle, and longevity in a racially diverse cohort of women
[COMPLETE ACCEPTED MANUSCRIPT READ IN FULL AT SOURCE, including all three tables, from the author copy at a university repository under the publisher's self-archiving licence; the typeset published version was not read] Koga, H. K., Trudel-Fitzgerald, C., Lee, L. O., James, P., Kroenke, C., Garcia, L., Shadyab, A. H., Salmoirago-Blotcher, E., Manson, J. E., Grodstein, F., & Kubzansky, L. D. (2022). 'Optimism, lifestyle, and longevity in a racially diverse cohort of women.' Journal of the American Geriatrics Society 70(10), 2793-2804. doi:10.1111/jgs.17897. KOGA IS FIRST AND CORRESPONDING AUTHOR; the brief attributed this work to Lee, who is third author. Women's Health Initiative, 159,255 women aged 50 to 79 at enrolment between 1993 and 1998 from 40 clinical centres, followed to 1 March 2019, so up to 26 years; 1,095 who died in the first two years excluded; 64,301 women, 40.3 per cent, died. Composition: 131,666 non-Hispanic White, 14,261 Black, 6,287 Hispanic or Latina, 4,144 Asian, 693 American Indian or Alaskan Native, 1,810 other. Optimism on the six-item revised Life Orientation Test, alpha 0.75. Model 2, adjusted for demographics including income, occupation, health insurance and partner's education plus chronic conditions on a modified Charlson index and depression: highest against lowest quartile, 5.4 per cent longer life span (4.5 to 6.4), falling to 4.59 with lifestyle added. By group, model 2: non-Hispanic White 5.05 (4.01 to 6.11); Black 7.58 (3.62 to 11.69); Hispanic or Latina 5.40 (-0.10 to 11.22); Asian 1.52 (-4.99 to 8.49). TWO OF FOUR INTERVALS CROSS ZERO; for reaching 90 the Asian risk ratio is 0.94 (0.84 to 1.06) and the Hispanic or Latina 1.02 (0.89 to 1.18), both null. The authors report no significant interaction by race or ethnicity and attribute the imprecision to sample size. Exceptional longevity here is survival to 90, achieved by 53 per cent of eligible women, risk ratio 1.10 (1.08 to 1.13) in model 2. SUBSCALE RESULT: highest against lowest quartile of pessimism, 5.2 per cent shorter life span (4.3 to 6.1); of optimism, 2.5 per cent longer (1.6 to 3.4), with the pessimism half more than twice the size. Formal counterfactual mediation with exposure-mediator interaction put the lifestyle-mediated share at 24 per cent overall, and by group 25 per cent non-Hispanic White, 10 per cent Black, 24 per cent Hispanic or Latina, 43 per cent Asian; the lifestyle composite, scored 0 to 5 on diet quality, physical activity, body mass index, smoking and alcohol, was measured three years after the optimism assessment to fix the temporal order. Their Table 1, least against most optimistic quartile: depression 22 per cent against 4; less than high school 22 against 9; family income under twenty thousand dollars 23 against 10; managerial or professional occupation 29 against 50; no health insurance 6 against 4; mean Charlson index 0.6 against 0.4. The four-years figure is theirs and labelled an extrapolation: taking 2018 United States female life expectancy of 81.2 years, 5.4 per cent 'can be extrapolated as adding 4.4 years of life on average', compared by them to the 0.4 to 4.2 years reported for regular exercise. Their own limitations: participants were better educated than average, 53 per cent achieved exceptional longevity which suggests they were healthier than average, and unmeasured confounding by heritability and childhood environment may be possible.
[COMPLETE ACCEPTED MANUSCRIPT READ IN FULL AT SOURCE, including all three tables, from the author copy at a university repository under the publisher's self-archiving licence; the typeset published version was not read] Koga, H. K., Trudel-Fitzgerald, C., Lee, L. O., James, P., Kroenke, C., Garcia, L., Shadyab, A. H., Salmoirago-Blotcher, E., Manson, J. E., Grodstein, F., & Kubzansky, L. D. (2022). 'Optimism, lifestyle, and longevity in a racially diverse cohort of women.' Journal of the American Geriatrics Society 70(10), 2793-2804. doi:10.1111/jgs.17897. KOGA IS FIRST AND CORRESPONDING AUTHOR; the brief attributed this work to Lee, who is third author. Women's Health Initiative, 159,255 women aged 50 to 79 at enrolment between 1993 and 1998 from 40 clinical centres, followed to 1 March 2019, so up to 26 years; 1,095 who died in the first two years excluded; 64,301 women, 40.3 per cent, died. Composition: 131,666 non-Hispanic White, 14,261 Black, 6,287 Hispanic or Latina, 4,144 Asian, 693 American Indian or Alaskan Native, 1,810 other. Optimism on the six-item revised Life Orientation Test, alpha 0.75. Model 2, adjusted for demographics including income, occupation, health insurance and partner's education plus chronic conditions on a modified Charlson index and depression: highest against lowest quartile, 5.4 per cent longer life span (4.5 to 6.4), falling to 4.59 with lifestyle added. By group, model 2: non-Hispanic White 5.05 (4.01 to 6.11); Black 7.58 (3.62 to 11.69); Hispanic or Latina 5.40 (-0.10 to 11.22); Asian 1.52 (-4.99 to 8.49). TWO OF FOUR INTERVALS CROSS ZERO; for reaching 90 the Asian risk ratio is 0.94 (0.84 to 1.06) and the Hispanic or Latina 1.02 (0.89 to 1.18), both null. The authors report no significant interaction by race or ethnicity and attribute the imprecision to sample size. Exceptional longevity here is survival to 90, achieved by 53 per cent of eligible women, risk ratio 1.10 (1.08 to 1.13) in model 2. SUBSCALE RESULT: highest against lowest quartile of pessimism, 5.2 per cent shorter life span (4.3 to 6.1); of optimism, 2.5 per cent longer (1.6 to 3.4), with the pessimism half more than twice the size. Formal counterfactual mediation with exposure-mediator interaction put the lifestyle-mediated share at 24 per cent overall, and by group 25 per cent non-Hispanic White, 10 per cent Black, 24 per cent Hispanic or Latina, 43 per cent Asian; the lifestyle composite, scored 0 to 5 on diet quality, physical activity, body mass index, smoking and alcohol, was measured three years after the optimism assessment to fix the temporal order. Their Table 1, least against most optimistic quartile: depression 22 per cent against 4; less than high school 22 against 9; family income under twenty thousand dollars 23 against 10; managerial or professional occupation 29 against 50; no health insurance 6 against 4; mean Charlson index 0.6 against 0.4. The four-years figure is theirs and labelled an extrapolation: taking 2018 United States female life expectancy of 81.2 years, 5.4 per cent 'can be extrapolated as adding 4.4 years of life on average', compared by them to the 0.4 to 4.2 years reported for regular exercise. Their own limitations: participants were better educated than average, 53 per cent achieved exceptional longevity which suggests they were healthier than average, and unmeasured confounding by heritability and childhood environment may be possible.
Written from the cOMPLETE ACCEPTED MANUSCRIPT READ IN FULL AT SOURCE, including all three tables, from the author copy at a university repository under the publisher's self-archiving licence; the typeset published version was not read.
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Koga, H. K., Trudel-Fitzgerald, C., Lee, L. O., James, P., Kroenke, C., Garcia, L., Shadyab, A. H., Salmoirago-Blotcher, E., Manson, J. E., Grodstein, F., & Kubzansky, L. D. (2022). Optimism, lifestyle, and longevity in a racially diverse cohort of women. Journal of the American Geriatrics Society, 70(10), 2793-2804. doi:10.1111/jgs.17897