ImportanceSupporting healthy aging is a US public health priority, and gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults. However, the association between gratitude and mortality has not been studied.ObjectiveTo examine the association of gratitude with all-cause and cause-specific mortality in later life.Design, Setting, and ParticipantsThis population-based prospective cohort study used data from self-reported questionnaires and medical records of 49 275 US older female registered nurses who participated in the Nurses’ Health Study (2016 questionnaire wave to December 2019). Cox proportional hazards regression models estimated the hazard ratio (HR) of deaths by self-reported levels of gratitude at baseline. These models adjusted for baseline sociodemographic characteristics, social participation, physical health, lifestyle factors, cognitive function, and mental health. Data analysis was conducted from December 2022 to April 2024.ExposureGratitude was assessed with the 6-item Gratitude Questionnaire, a validated and widely used measure of one’s tendency to experience grateful affect.Main Outcomes and MeasuresDeaths were identified from the National Death Index, state statistics records, reports by next of kin, and the postal system. Causes of death were ascertained by physicians through reviewing death certificates and medical records.ResultsAmong the 49 275 participants (all female; mean [SD] age at baseline, 79 [6.16] years), 4608 incident deaths were identified over 151 496 person-years of follow-up. Greater gratitude at baseline was associated with a lower hazard of mortality in a monotonic fashion. For instance, the highest tertile of gratitude, compared with the lowest tertile, was associated with a lower hazard of all-cause deaths (HR, 0.91; 95% CI, 0.84-0.99) after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health. When considering cause-specific deaths, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95% CI, 0.73-0.995).Conclusions and RelevanceThis study provides the first empirical evidence suggesting that experiencing grateful affect is associated with increased longevity among older adults. The findings will need to be replicated in future studies with more representative samples.

中文翻译：

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美国老年女护士的感恩和死亡率


重要性支持健康老龄化是美国公共卫生的优先事项，感恩是一个潜在的可改变的心理因素，可能会提高老年人的健康和福祉。然而，感恩与死亡之间的关联尚未得到研究。目的研究感恩与晚年全因死亡率和特定原因死亡率的相关性。设计、设置和参与者这项基于人群的前瞻性队列研究使用了 49 275 名参与护士健康研究（2016 年问卷浪潮至 2019 年 12 月）的美国老年女性注册护士的自我报告问卷和医疗记录的数据。Cox 比例风险回归模型通过基线时自我报告的感恩水平估计死亡的风险比 （HR）。这些模型根据基线社会人口学特征、社会参与、身体健康、生活方式因素、认知功能和心理健康进行了调整。数据分析于 2022 年 12 月至 2024 年 4 月进行，暴露感恩是通过 6 项感恩问卷进行评估的，这是一种经过验证且广泛使用的衡量一个人体验感恩情感倾向的衡量标准。主要结果和措施死亡人数是从全国死亡指数、州统计记录、直系亲属报告和邮政系统中确定的。医生通过审查死亡证明和医疗记录来确定死因。结果在 49 275 名参与者 （均为女性;基线时的平均 [SD] 年龄，79 [6.16] 岁） 中，在 151 496 人年的随访中确定了 4608 例事件死亡。基线时更大的感激之情与单调方式的较低死亡风险相关。 例如，在调整基线社会人口学特征、社会参与、宗教参与、身体健康、生活方式因素、认知功能和心理健康后，与最低的三分位数相比，最高的感恩三分位数与较低的全因死亡风险相关（HR，0.91;95% CI，0.84-0.99）。当考虑特定原因死亡时，心血管疾病死亡与感恩呈负相关 （HR， 0.85;95% CI， 0.73-0.995）。结论和相关性本研究提供了第一个实证证据表明，体验感恩情感与老年人寿命延长有关。这些发现需要在未来的研究中用更具代表性的样本进行复制。