Optimism and Healthy Aging in Women
Open accessAbstract
Introduction Optimism-the expectation that good things will happen-has emerged as a promising health asset, as it appears to be related to healthier behaviors and reduced disease risk. Growing research finds that higher optimism is associated with lower mortality, yet it is critical to understand whether this prolonged longevity is accompanied by good health. This study tested whether higher optimism was associated with increased likelihood of healthy aging. Methods Prospective data analyzed in 2018 from the Nurses' Health Study included 33,326 women with no major chronic diseases at baseline. Poisson regression models evaluated if optimism was associated with healthy aging 8 years later, considering potential confounders (sociodemographic variables, depression) and intermediate variables (health behaviors). Optimism was assessed in 2004 by validated self-report using mailed questionnaires and healthy aging was assessed in 2012, defined as (1) remaining free of major chronic diseases; (2) having no subjective memory impairment; (3) having intact physical function; and (4) surviving through follow-up. Results Overall, 20.5% of women (n=6,823) fulfilled the definition of healthy aging in 2012. After adjusting for sociodemographic factors and depression, the most (top quartile) versus least (bottom quartile) optimistic women had a 23% greater likelihood of healthy aging (95% CI=1.16, 1.30). Associations were similar in white and black participants, although the sample of black women was small (n=354). Conclusions Higher optimism was associated with increased likelihood of healthy aging, suggesting that optimism, a potentially modifiable health asset, merits further research for its potential to improve health in aging.
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An optimistic frame of mind is associated with healthy aging and a lower risk of CVD, including stroke and heart failure, and a lower risk of all-cause mortality.
“An optimistic frame of mind has been shown to be associated with healthy aging 60 and a lower risk of CVD, 61 including stroke 62 and heart failure, 63 and a lower risk of all-cause mortality. 64”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [60]
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“Well-being associates positively with longevity and health (James et al., 2019; Kim et al., 2019; Steptoe, 2019; Zaninotto & Steptoe, 2019), satisfaction with marital relationships, productivity at work, prosocial behavior and educational achievement (Chapman & Guven, 2016; Lyubomirsky et al.,…”
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“In addition, earlier studies have demonstrated that optimism promotes healthy aging (James et al., 2019).”
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“Additionally, Asian Americans do not derive similar emotional and health benefits from optimism as White Americans do (Leong et al., 2022), while Black American derive similar health benefits from optimism that White Americans do (Hernandez et al., 2015; James et al., 2019; Tindle et al., 2009).”
Self-citationThe association between metabolite concentrations and wellbeing in adults
Azcona-Granada, N., Geijsen, A. J. M. R., Pool, R., Pelt, D. H. M., & Bartels, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-91558-z · Cited by 4 · see citing works
Guimond, A., Ke, S., Tworoger, S. S., Huang, T., Chan, A. T., Kubzansky, L. D., & Liu, Y. (2024) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001278 · Cited by 4 · see citing works
“An emerging body of research suggests that there are modifiable health assets that might contribute to a reduced risk of age-related chronic diseases and impairments (3 – 5).”
BackgroundSelf-citationDispositional Optimism and All-Cause Mortality in Older Adults: A Cohort Study
Craig, H., Ryan, J. L., Freak‐Poli, R., Owen, A. J., McNeil, J. J., Woods, R. L., Ward, S. A., Britt, C. J., & Gašević, D. (2021) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000989 · Cited by 6 · see citing works
“age) in men and women (20,21) and with a greater likelihood of individuals surviving to 85 years of age (22).”
BackgroundPosis, A., Yarish, N. M., Ryu, R. H., Tindle, H., Michael, Y., Wactawski-Wende, J., & Bellettiere, J. (2023) · Journal of Women's Health · doi:10.1089/jwh.2023.0056 · Cited by 2 · see citing works
“11,12 In older women, higher optimism is associated with lower mortality and incident coronary heart disease, 13 and nonsmoking behaviors, 14 as well as higher physical activity, 15 and better diet quality.”
Optimism and Telomere Length among African American Adults in the Jackson Heart Study
Lee, H. H., Okuzono, S. S., Kim, E. S., Vivo, I. D., Raffield, L., Glover, L. M., Sims, M., Grodstein, F., & Kubzansky, L. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.105124 · Cited by 2 · see citing works
“However, the populations examined in these studies have been predominantly White, although the existing studies conducted in African Americans have reported similar protective relations between higher optimism and reduced risk of morbidity/mortality (Chopik et al., 2015; James et al., 2019; Kim et al., 2019a; Tindle e…”
ResultSelf-citationThe Bright Side of Life: Optimism and Risk of Dementia
Stenlund, S., Koga, H. K., James, P., Farmer, J., McGrath, C. B., Grodstein, F., & Kubzansky, L. D. (2026) · Journal of the American Geriatrics Society · doi:10.1111/jgs.70392 · Cited by 1 · see citing works
“Recent studies have linked optimism with exceptional longevity and healthy aging more generally [4–7], suggesting it may also contribute to protecting cognitive health in aging [4, 7–9].”
Self-citationYıldırım, M., Dilekçi, Ü., Aksoy, Ş., & Alkhulayfi, A. M. A. (2025) · BMC Psychology · doi:10.1186/s40359-025-03618-8 · Cited by 1 · see citing works
MacNeil, A. (2025) · Discover Psychology · doi:10.1007/s44202-025-00464-y · Cited by 1 · see citing works
“In aging research, realistic optimism has been linked to healthier behaviors, lower risk of chronic illness, and even reduced mortality [38, 39].”
Hansen, J. L., Plotke, R. L., Kanaya, M. R., Webster, S. N., Popok, P., Walsh, E. A., Ream, M. E., Krueger, M. J., Saez-Clarke, E., Perdomo, D. M., et al. (2025) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2025.100626 · Cited by 1 · see citing works
“…results of this study are consistent with previous literature documenting associations between optimism and cognitive impairment in older adults (Dos Santos et al., 2018; Gawronski et al., 2016; James et al., 2019; Kim et al., 2019; Sachs et al., 2023) and cancer populations (Taber et al., 2016).”
Yi, L., Trudel‐Fitzgerald, C., Hu, C., Wilt, G. E., Chavarro, J. E., Onnela, J.-P. “., Grodstein, F., Kubzansky, L. D., & James, P. (2025) · JMIR mhealth and uhealth · doi:10.2196/71375 · Cited by 3 · see citing works
Self-citationAge, happiness, and health: Exploring the synergy of positive emotions in healthy aging.
Chen, L.-K. (2023) · Archives of gerontology and geriatrics (Print) · doi:10.1016/j.archger.2023.105167 · Cited by 1 · see citing works
Flament, F., Porcher, E., Jiang, R., Haykal, D., Rousseau, L., Seyfaie, S., & Houghton, J. (2026) · International Journal of Cosmetic Science · doi:10.1111/ics.70148
Differences in wellbeing: Current and future directions
Bartels, M., Azcona-Granada, N., Leitritz, D., Sametoğlu, S., Mayerhofer, L., Fey, I. F. A., Geijsen, A. J. M. R., Pelt, D. H. M., & de Vries, L. P. (2026) · Personality and Individual Differences · doi:10.1016/j.paid.2026.114066
Perception and coping with aging among middle-aged women: a qualitative study
Lei, Y.-J., Li, K.-N., Zhuo, H.-X., Li, Z.-X., Li, W.-J., Chen, N.-F., & Han, H.-W. (2026) · BMC Public Health · doi:10.1186/s12889-026-29009-1
“But its progression can be slowed and chronic diseases potentially prevented through health-promoting lifestyles and behaviors, such as physical activity [20], balanced nutrition [21], adequate sleep [22], and psychological well-being [23].”
Balance of Promoting Optimism in Older Patients
de Leo, D., & Zammarrelli, J. (2026) · Encyclopedia · doi:10.3390/encyclopedia6040091
“Among older adults, higher optimism has been linked with healthier aging trajectories, lower rates of frailty, improved cardiovascular outcomes, and greater longevity or increased likelihood of exceptional survival, rather than a literal “reduction of mortality” [4,5].”
Hlungwani, T., Sigudu, T., Rathebe, P., Masekameni, M., & Oguttu, J. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1812671
“These include financial strain, food insecurity, domestic conflict, child neglect, and reduced social cohesion (12, 13).”
CONTRIBUIÇÕES DO OTIMISMO NO PERÍODO GESTACIONAL: REVISÃO SISTEMÁTICA DA LITERATURA
de Souza, I. S., Carvalho, P. F. D. A., Dias, C. M., Lago, M. F. D., Pereira, A. F., Fernandes, C., dos Santos, A. B., Vieira, A. G., Soares, D. L., & Andrade, C. D. J. (2025) · Revista contemporânea · doi:10.56083/rcv5n6-118
Antecedents of Life Satisfaction Among Women in Kashmir: An Empirical Study From India
Shahzadi, S., & Khan, W. (2024) · The Family Journal · doi:10.1177/10664807241283130
Kuang, K., Liu, Y.-L., & Wang, Y.-J. (2023) · 全球传媒学刊 · doi:10.26599/gjms.2023.9330065
Longitudinal Health Consequences of Childhood Adversity: The Mediating Role of Purpose in Life
Homan, K. J., & Kong, J. (2020) · Journal of gerontological social work · doi:10.1080/01634372.2020.1808140
“They also are associated with positive outcomes such as reduced vulnerability to infection and chronic illness (Cohen et al., 2003; James et al., 2019), better self-rated health and functional status, and lower mortality (Seeman & Lewis, 1995; Shifren & Anzaldi, 2018).”
- Authors
- James, P., Kim, E. S., Kubzansky, L. D., Zevon, E. S., Trudel-Fitzgerald, C., & Grodstein, F.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- James, Peter
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 56
- Issue
- 1
- Pages
- 116-124
- ISSN
- 0749-3797 (ISSN-L)
- PMC
- PMC6310050
- OpenAlex
- W2904542136
- Cited by
- 121
- References
- 39
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 9 · 2023: 51 · 2022: 15 · 2021: 13 · 2020: 9 · 2019: 4
- FWCI
- 8.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH
- Topics
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Keywords
- optimism, healthy aging, women, chronic disease, subjective memory impairment, physical function, health behavior, depression, longevity, Nurses' Health Study
- MeSH terms
- Optimism, Healthy Aging, Aged, Aging, Black or African American, Female, Humans, Middle Aged, Prospective Studies, Surveys and Questionnaires, Health Behavior, White People
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