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Pessimism May Lower Your Odds of Living a Long, Healthy Life

Optimism is associated with a lower risk of heart disease and dying young.

Last month, a Boston-based team of researchers affiliated with Harvard Medical School, Boston University Medical Center, and the VA's Center for PTSD published the results of a decades-long study on "exceptional longevity." This 30-year study found that women and men who exhibited a more optimistic mindset lived longer, on average, than study participants who tended to be pessimistic.

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This longitudinal study ( Lee et al., 2019 ) found a significant correlative association (not causal) between optimism and higher odds of living past the age of 85, which is a marker for "exceptional longevity." (See Optimism Study Gives Optimists More Reason to Be Optimistic )

Of course, because correlation does not imply causation, the $64,000 question remains: What specific aspects of optimism cause optimists to live longer, in general, than their pessimistic peers?

Researchers speculate that optimists may be more inclined to have healthier lifestyle habits such as staying physically active, eating a nutritious diet, maintaining face-to-face social connectedness, etc. But these lifestyle habits alone don't seem to explain the elixir-like power of optimism to decrease morbidity and increase longevity.

The potential life-extending power of optimism is perplexing to scientists. Nobody knows for sure which biobehavioral mechanisms are driving what appears to be a previously underestimated association between optimism (i.e., having a "positive outlook") and living longer.

This week, a systematic review and meta-analysis, " Association of Optimism with Cardiovascular Events and All-Cause Mortality ," was published in the journal JAMA Network Open . This analysis presents a comprehensive, up-to-date overview of the link between optimism and living a longer, healthier life.

For this meta-analysis, lead author Alan Rozanski , who is a professor of cardiology at Mount Sinai Hospital in New York City, and colleagues gathered the results and data from 15 studies involving 229,391 participants and an average follow-up of 14 years.

Rozanski and co-authors sum up the significance of their recent meta-analysis (2019):

"Optimism and pessimism can be easily measured and are potentially modifiable mindsets that may be associated with cardiovascular risk and all-cause mortality.

The findings of the current meta-analysis suggest that optimism is associated with cardiovascular benefits and that pessimism is associated with cardiovascular risk. The results of this meta-analysis appear to support the establishment of interventions that might diminish pessimism and promote optimism among clinical patients."

Overall, the researchers found that optimists had a 35 percent lower risk of experiencing the most severe complications related to heart disease in comparison to pessimists.

According to the latest research, people with a sunny disposition who look on the bright side and are inclined to see the proverbial glass as "half-full" may be up to 14 percent less likely to die young in comparison to their gloomier, pessimistic peers who tend to view the glass as "half-empty."

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Notably, the meta-analysis also showed that those with the highest ratings for optimism and a positive outlook had the lowest risk of heart problems and premature death on a continuum. Also, men and women who sustained a more positive viewpoint across their lifespan were more likely to maintain heart health as they got older.

Nonetheless, when evaluating these findings, it's important to re-emphasize that all of the research to date on a possible association between optimism and longevity has significant limitations and does not permit causal inferences.

Rozanski and colleagues emphatically state that their systematic review and meta-analysis does not prove a causal link or identify specific ways that optimism (in and of itself) might directly protect someone against heart disease or premature death.

In their conclusion, Rozanski et al. recommend: "Future studies should seek to better define the biobehavioral mechanisms underlying this association and evaluate the potential benefit of interventions designed to promote optimism or reduce pessimism."

The next step of Rozanski's team is to explore the efficacy of various mind-body interventions that may help reduce pessimism and boost optimism.

Where Will Optimism and Pessimism Research Go From Here?

This paper (2019) in JAMA Network Open is accompanied by an editorial, " Optimism and Health: Where Do We Go From Here? " written by Jeff C. Huffman of the Department of Psychiatry at Harvard's Massachusetts General Hospital, who was not directly involved in the meta-analysis.

In his editorial commentary, Huffman writes, "These results ( Rozanksi et al., 2019 ) are consistent with a large and growing literature finding that positive psychological well-being in general and optimism in particular appear to have an independent association with cardiovascular and overall health outcomes."

In closing, Huffman addresses the question, "Where does the field go from here?" His response:

"In terms of longitudinal studies, conducting studies that continue to examine the associations of more modifiable or state-based constructs with health outcomes will help to define clear, plausible, and important targets for interventions [that boost optimism and reduce pessimism].

Regarding intervention studies, interventions should focus on improving and measuring not only well-being, but also important additional downstream outcomes (e.g., physical activity and biomarkers) that are associated with health. Ongoing studies should also determine whether programs to promote psychological well-being might be best used alone or in conjunction with other, established behavioral interventions to boost their effect."

Update: Below are two follow-up posts,


Alan Rozanski, Chirag Bavishi, Laura D. Kubzansky, Randy Cohen. "Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-Analysis." JAMA Network Open (First published: September 27, 2019) DOI: 10.1001/jamanetworkopen.2019.12200

Invited editorial comment of original investigation by Jeff C. Huffman, "Optimism and Health: Where Do We Go From Here?" JAMA Network Open (First published: September 27, 2019) DOI: 10.1001/jamanetworkopen.2019.12211

Lewina O. Lee, Peter James, Emily S. Zevon, Eric S. Kim, Claudia Trudel-Fitzgerald, Avron Spiro III, Francine Grodstein, and Laura D. Kubzansky “Optimism Is Associated with Exceptional Longevity in 2 Epidemiologic Cohorts of Men and Women.” Proceedings of the National Academy of Sciences (First published: August 26, 2019) DOI: 10.1073/pnas.1900712116