January 1, 2008Open Access

Effect of Having a Sense of Purpose in Life on the Risk of Death from Cardiovascular Diseases

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease risk (n=1618). Intervention: Strong sense of purpose in life (ikigai) vs. Low sense of purpose in life. Primary outcome: All-cause mortality in men (HR 0.62, 95% CI 0.45-0.86, p=0.004).

Key Result

In Japanese men, having a strong sense of purpose in life significantly reduced the risk of all-cause mortality (HR 0.62) and stroke (HR 0.28) compared to those with a low sense of purpose.

Study Design

Type

Cohort (n=1,618)

Multicenter

PICO

Population

Cardiovascular disease risk (n=1,618)

Intervention / Comparator

Strong sense of purpose in life (ikigai) vs Low sense of purpose in life

Primary Outcome

All-cause mortality in men — HR 0.62 (0.45-0.86), p=0.004

Main Result

Effect estimate: HR 0.62 (95% CI 0.45-0.86)

p-value: p=0.004

Limitations

Small number of deaths, especially among women, limiting statistical power and gender-related comparisons
Study subjects were all from rural Japan and included many older adults, which may not be representative of the general population
Reliability and validity of the questionnaire have not been established to the same degree as other standardized questionnaires
Unable to examine the influence of the sense of purpose on specific subtypes of stroke or heart disease separately due to small numbers of deaths

Abstract

BACKGROUND: Many studies have focused on disease causality, but few of them deal with health-promoting factors. Thus, we examined the effect of having a sense of purpose in life (ikigai) on mortality from cardiovascular disease (CVD). METHODS: In 1988, we conducted a prospective cohort study of 2,959 Japanese subjects, ranging in age from 40 to 74 years, and followed them till the end of 2003. The level of their sense of purpose in life was evaluated by a self-administered questionnaire. After excluding those with a history of heart disease, stroke, or malignant tumor, 1,618 subjects (832 men and 786 women) who had completed the questionnaire were used in the analyses with Cox's proportional hazards model. RESULTS: During the average 13.3 years of follow up, 249 deaths (172 men and 77 women) occurred as a result of all causes: 32 from heart disease, 31 from stroke, 63 from CVD, and 104 from malignant tumors. The adjusted hazard ratios for death in men with a strong sense of purpose in life, as compared with those with a low sense of purpose, were 0.28 (95% confidence interval: 0.10-0.84) for stroke, 0.56 (0.28-1.10) for CVD, and 0.62 (0.45-0.86) as a result of all causes. In women, no significant relationship was found between having a sense of purpose in life and mortality; this was possibly because the smaller number of deaths reduced the statistical significance. CONCLUSION: We found that in men, having a sense of purpose in life affected the risk of death as a result of all causes, stroke, and CVD.

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Cite This Study

Koizumi et al. (Tue,) conducted a cohort in Cardiovascular disease risk (n=1,618). Strong sense of purpose in life (ikigai) vs. Low sense of purpose in life was evaluated on All-cause mortality in men (HR 0.62, 95% CI 0.45-0.86, p=0.004). In Japanese men, having a strong sense of purpose in life significantly reduced the risk of all-cause mortality (HR 0.62) and stroke (HR 0.28) compared to those with a low sense of purpose.

synapsesocial.com/papers/6a1c3eb05b8f4ede65a9b590 https://doi.org/https://doi.org/10.2188/jea.je2007388

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