Association between feelings of happiness among community-dwelling, independent, elderly individuals in an Okinawan farm village and survival three years later

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  • 沖縄県農村地域在住の自立高齢者における幸福感と3年後の生存との関連
  • オキナワケン ノウソン チイキ ザイジュウ ノ ジリツ コウレイシャ ニ オケル コウフクカン ト 3ネンゴ ノ セイゾン ト ノ カンレン

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Abstract

<p>Objectives　As an indicator of subjective wellbeing, feelings of happiness assessed based on simple items have not been fully elucidated in terms of its relation to survival during old age. The purpose of this study was to examine whether the predictive validity of feelings of happiness assessed using a 4-item measure is high as an indicator of assessing survival three years later, using a variety of factors as adjustment variables among independent, elderly individuals living in a farm village in Okinawa, wherein a spirit of mutual help is prevalent among the residents.</p><p>Methods　From a longitudinal study conducted in 2012, a total of 1,471 respondents (638 men, 833 women), excluding participants who needed long-term care and non-respondents of their feelings of happiness, completed a detailed questionnaire. A 4-item measure of feelings of happiness and other indicators of subjective wellbeing, including a 5-item measure of cooked food consumption, were considered as ordinal scales. From the results of the principal component (PC) analysis, we named the first PC “diet variety,” of which cooked food was less consumed. The Cox proportional hazard model was used for 734 subjects’ data, excluding missing values, to examine comprehensive associations among feelings of happiness, survival times, and health indicators in a multivariate model that adjusted for age, sex, and body mass index, among others. A correlation analysis between survival after three years was performed to select indicators used simultaneously in the analysis. Kaplan-Meier analysis was also conducted to examine the cumulative survival rate over three years.</p><p>Results　A total of 1,387 participants (94.3%) survived during the three-year follow-up. The survival rate was significantly higher in those who indicated “very happy” items (95.9%) than in those who indicated “unhappy” items (86.4%). Meanwhile, the mortality rate was significantly higher in those who indicated “unhappy” items (13.6%) than in those who indicated “very happy” items (4.1%). Within the multivariate model, the hazard ratio (HR) for mortality three years later was significantly reduced in those with feelings of happiness (HR=0.56, 95% confidence interval [CI]: 0.32-0.99), in those who did not experiences falls and fractures (HR=0.26, 95% CI:0.11-0.62), and in those who were non-smokers (HR=0.44, 95% CI:0.25-0.77). The cumulative survival rate in those who experienced good feelings of happiness was significantly higher than in the others.</p><p>Conclusion　The predictive validity of feelings of happiness assessed by a 4-item measure might be high as an indicator to assess survival three years later among independent, elderly individuals living in a farm village in Okinawa.</p>

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