Positive affect measured using ecological momentary assessment and survival in older men and women

Abstract

Links between positive affect (PA) and health have predominantly been investigated by using measures of recollected emotional states. Ecological momentary assessment is regarded as a more precise measure of experienced well-being. We analyzed data from the English Longitudinal Study of Aging, a representative cohort of older men and women living in England. PA was assessed by aggregating momentary assessments over a single day in 3,853 individuals aged 52 to 79 y who were followed up for an average of 5 y. Respondents in the lowest third of PA had a death rate of 7.3%, compared with 4.6% in the medium-PA group and 3.6% in the high-PA group. Cox proportional-hazards regression showed a hazard ratio of 0.498 (95% confidence interval, 0.345-0.721) in the high-PA compared with the low-PA group, adjusted for age and sex. This was attenuated to 0.646 (95% confidence interval, 0.436-0.958) after controlling for demographic factors, negative affect, depressed mood, health indicators, and health behaviors. Negative affect and depressed mood were not related to survival after adjustment for covariates. These findings indicate that experienced PA, even over a single day, has a graded relationship with survival that is not caused by baseline health status or other covariates. Momentary PA may be causally related to survival, or may be a marker of underlying biological, behavioral, or temperamental factors, although reverse causality cannot be conclusively ruled out. The results endorse the value of assessing experienced affect, and the importance of evaluating interventions that promote happiness in older populations.

Fig. 1.

Proportion of individuals in the high-PA (red), medium-PA (green) and low-PA (blue groups) surviving over the follow-up period (indicated in months from baseline). Values are adjusted for age and sex.