title: Self-reported life satisfaction and 20-year mortality in healthy Finnish adults.
abstract: The authors investigated the role of self-reported life satisfaction in mortality with a prospective cohort study (1976-1995). A nationwide sample of healthy adults (18-64 years, n = 22,461) from the Finnish Twin Cohort responded to a questionnaire about life satisfaction and known predictors of mortality in 1975. A summary score for life satisfaction (LS), defined as interest in life, happiness, loneliness, and general ease of living (scale range, 4-20), was determined and used as a three-category variable: the satisfied (LS, 4-6) (21%), the intermediate group (LS, 7-11) (65%), and the dissatisfied (LS, 12-20) (14%). Mortality data were analyzed with Cox regression. Dissatisfaction was linearly associated with increased mortality. The age-adjusted hazard ratios of all-cause, disease, or injury mortality among dissatisfied versus satisfied men were 2.11 (95% confidence interval (CI): 1.68, 2.64), 1.83 (95% CI: 1.40, 2.39), and 3.01 (95% CI: 1.94, 4.69), respectively. Adjusting for marital status, social class, smoking, alcohol use, and physical activity diminished these risks to 1.49 (95% CI: 1.16, 1.92), 1.35 (95% CI: 1.01, 1.82), and 1.93 (95% CI: 1.19, 3.12), respectively. Dissatisfaction was associated with increased disease mortality, particularly in men with heavy alcohol use (hazard ratio = 3.76, 95% CI: 1.61, 8.80). Women did not show similar associations between life satisfaction and mortality. Life dissatisfaction may predict mortality and serve as a general health risk indicator. This effect seems to be partially mediated through adverse health behavior.
authors.affiliation: Department of Psychiatry, University of Kuopio and Kuopio University Hospital, Finland. heli.koivumaa@kuh.fi
authors.forename: H
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.forename: R
authors.initials: R
authors.lastname: Honkanen
authors.forename: H
authors.initials: H
authors.lastname: Viinamäki
authors.forename: K
authors.initials: K
authors.lastname: Heikkilä
authors.forename: J
authors.initials: J
authors.lastname: Kaprio
authors.forename: M
authors.initials: M
authors.lastname: Koskenvuo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D016016:Proportional Hazards Models; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000401:mortality