Living longer tied to gratitude for positives in life, Harvard study suggests

NEW YORK, July 3 (UPI) -- An attitude of gratitude for the positives in life may help older adults live longer, a new Harvard study suggests.

The research, conducted at the T.H. Chan School of Public Health in Boston, was published Wednesday in JAMA Psychiatry.

In this study of older U.S. female nurses, those who maintained a grateful outlook had a decreased risk of death.

People in the highest level of gratitude, compared with those in the lowest level, had a 9% reduced hazard of death from any cause. When researchers considered specific causes of death, gratitude lessened the risk of death from cardiovascular disease by 15%.

These findings persisted after researchers adjusted for sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function and mental health.

"In addition to reducing risk factors and illness, there has been increasing interest in positive psychological factors that may enhance health and well-being in older adults. Gratitude may be one of such positive factors," the study's lead author, Ying Chen, a research scientist in the Department of Epidemiology at Harvard Chan School, told UPI via email.

"Gratitude is a facet of positive psychological functioning that may be particularly relevant for generating a sense of meaning and connection among older adults," Chen said.

"The findings of this study pave the way for future investigations into the roles of gratitude in enhancing health and longevity in older adults."

While gratitude has been associated with lower risks of mental distress, as well as greater emotional and social well-being, she noted that its impact on physical health remains less clear.

"To the best of our knowledge, no studies to date have examined the association between gratitude and mortality," Chen said. "Therefore, we conducted this study, hoping to begin addressing this knowledge gap."

Researchers used data from self-reported questionnaires and medical records of 49,275 U.S. older female registered nurses who participated in Harvard's Nurses' Health Study.

The six-item Gratitude Questionnaire is a validated and widely employed measure of an individual's tendency to experience grateful affect, researchers said.

Information on mortality came from the National Death Index, state statistics records, next-of-kin reports and the Postal Service. Physicians who reviewed death certificates and medical records confirmed the causes of death.

Among the participants, who averaged 79 years at the study's outset, researchers identified 4,608 incident deaths over 151,496 person-years of follow-up.

These figures included 1,364 deaths from cardiovascular disease, 273 from cancer, 406 from respiratory disease, 492 from neurodegenerative disease, 114 from infection, 70 from injury and 1,889 from other causes.

Further research with more representative samples will be necessary to replicate the findings, Chen noted.

"It would also be worthwhile to better understand the roles of gratitude in shaping health and well-being in other age groups, other sociodemographic groups and in other cultures," she said.

Although the study was limited primarily to White nurses, the relationship between higher levels of gratitude and lower risk of death aligns with established factors that influence longevity, said Dr. Katie Drago, a geriatrician at Oregon Health & Science University in Portland. She was not involved in the study.

"Most of the longevity benefit demonstrated in the study seems to be in prevention of death from cardiovascular conditions, which we already know to be related to chronic stress, loneliness and other psychosocial and socioeconomic factors," Drago said.

"Based on this study, high levels of gratitude could protect against cardiovascular death and be an important self-care tool for adults as we age."

Clinical trials indicate that the practice of gratitude has many health benefits, such as lowering blood pressure, improving immune function and promoting more efficient sleep, said Robert Emmons, a professor emeritus of psychology at the University of California-Davis.

"I know there is a myth that gratitude ignores suffering, pain and the harsh realities of life, but that assumption does not stand up to scientific scrutiny," said Emmons, who is editor-in-chief of The Journal of Positive Psychology.

"In fact, many studies have shown that gratitude is often deepened and strengthened in trying times, as they lead us to not take things for granted. Gratitude is not simply a switch that we turn on when life is going well, but gratitude also shines a light in the darkness."

The fact that the Harvard researchers' data came from the Nurses' Health Study is significant, said Nicole Casbarro, a nurse practitioner and clinical assistant professor in the School of Nursing at Quinnipiac University in North Haven, Conn.

"Because nurses witness people in life-or-death challenges, we tend to have an innate gratitude for the simple things, such as a healthy child, good friends, arriving home safe after a road trip, a refrigerator full of food -- things maybe people in other professions don't think of," Casbarro said.

Countering negative thought patterns to recognize life's positive aspects can help build psychological resilience. This process enhances the brain's ability to form new neural connections, even as people age, she noted.

"A gratitude journal can be a great place to start. Simply write down a few things each day to be grateful for," she said. "There may be days when this is easier than others, but as you practice, you will begin to see more and more things to be grateful for in your life."

For many people, experiencing gratitude may not come naturally, but it's still a skill anyone can acquire, said Susan Evans, a psychologist and founder of the virtual Mindfulness Based Stress Reduction Program at Weill Cornell Medicine in New York City.

"I often tell my patients that while we may not have a lot of control over stressors in our lives, there are things we can do to boost our mental well-being," Evans said. For instance, "couples seeking help may also derive benefit by spending a few minutes expressing gratitude to their partner."

Dr. David Spiegel, a psychiatrist and director of the Center on Stress and Health at Stanford Medicine in Palo Alto, Calif., added that the study's overarching message is: "Count your blessings, and you'll have more time to count your years."