What is the clinical evidence from this study?

Study design: Cohort. Population: Diabetes (n=3388). Intervention: Positive affect vs. Comparison group without chronic illness. Primary outcome: Mortality.

What does this research mean for the field?

Positive affect is significantly associated with a lower risk of all-cause mortality in people with diabetes, independent of negative affect or other mortality predictors. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2008

Positive affect uniquely predicts lower risk of mortality in people with diabetes.

Key Result

Positive affect was significantly associated with a lower risk of all-cause mortality in 715 people with diabetes, independent of negative affect or other predictors.

Study Design

Type

Cohort (n=3,388)

Structured PICO

Does positive affect reduce mortality in people with diabetes?

Population

People with diabetes (N=715) and a comparison group with no chronic health conditions (N=2,673)

Intervention

Positive affect (e.g., enjoyed life, hopeful)

Outcome

All-cause mortalityhard clinical

Positive affect, particularly enjoying life, is associated with a lower risk of mortality in people with diabetes and older adults without chronic illness.

Abstract

OBJECTIVE: To determine whether positive affect predicts mortality among people with diabetes and among a comparison group of people with no chronic health conditions. DESIGN: Longitudinal cohort study. MAIN OUTCOME MEASURE: Mortality. RESULTS: Positive affect was significantly associated with lower risk of all-cause mortality in people with diabetes (N = 715). Enjoyed life was associated with lower risk of mortality over and above the effects of negative affect or other significant predictors of mortality. In a comparison sample without chronic illness (N = 2,673), positive affect was not associated with mortality. However, when the analysis was restricted to those over the age of 65, specific positive affects, in particular hopeful and enjoyed life were significantly associated with lower risk of mortality, again independent of negative affect. Enjoyed life remained significantly predictive of lower risk of mortality in the older sample when other predictors of mortality were statistically controlled. Positive affect was particularly protective among those over the age of 65 who reported higher levels of stress. CONCLUSION: These findings are discussed in light of possible stress-buffering functions of positive affect.

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