Reference: JAMA Psychiatry. 2024 Oct 1;81(10):1030-1038
Practice Point: Being grateful is linked to improvements in all-cause mortality and cardiovascular disease.
EBM Pearl: An intervention being linked to an outcome in observational studies opens the door for questions about “the chicken or the egg.”
As Thanksgiving rolls around in the United States, it’s the perfect time to indulge in more than just pumpkin pie and mashed potatoes—it's a chance to savor the sweet, oft-forgotten dish of gratitude. Sure, you’re a pro at giving care, but when was the last time you took a moment to appreciate your own resilience (or even the fact that you survived another hectic shift)? Yet another study from the Harvard School of Public Health has been published demonstrating that gratitude seems to make life not only sweeter but longer, this time in older adults.
Researchers working with the Nurses’ Health Study have uncovered a potential link between gratitude and short-term mortality. 49,275 female participants with a mean age of 79 were asked questions about gratitude and then followed over a 3-year period. Death in the study population was evaluated, tracing all-cause mortality as well as specific causes such as cardiovascular disease, cancer, respiratory diseases, neurodegenerative disease, infection, and injury.
A total of 4,608 deaths were reported during a mean follow-up of 3.07 years. Nurses with higher gratitude scores measured on a 6-item scale appeared to have a slightly lower risk of dying from any cause compared to those with lower gratitude levels. Specifically, those reporting the highest gratitude had an adjusted hazard ratio (HR) of 0.91 (95% CI 0.84-0.99) of dying over the study period. While the overall magnitude of effect on mortality was small, the association was particularly notable in deaths related to cardiovascular disease, where the highest gratitude scores were linked to a 15% reduction in risk (adjusted HR 0.85, 95% CI 0.73-0.995). No significant associations were found between gratitude and death from cancer, respiratory disease, or neurodegenerative conditions, indicating that the effect might be more pronounced in certain types of mortality.
This study suggests that a higher sense of gratitude, or at least a higher gratitude score, may be associated with a lower risk of death. However, we can’t necessarily assume a directional association: Is it that participants who were most grateful tended to maintain partnerships and social or religious participation, be more educated, live independently, and take better care of their physical and mental health? OR is it that folks with these traits were more likely to be grateful? In either case, these findings add to a growing body of evidence suggesting that positive psychological traits, like gratitude, may play a role in longevity and well-being.
So, this holiday season consider indulging in one leftover from Thanksgiving that is unlikely to get many complaints: a habit of gratitude. Pick up a pen and write down what you are grateful for or discuss it a few times a week with family, a friend, or a colleague. Spoiler alert: It could be good for your heart in more ways than one.
PS — We are grateful to you, our readers, for coming back week after week!
For more information, see the topic Aging in Adults in DynaMed.
DynaMed EBM Focus Editorial Team
This EBM Focus was written by Rich Lamkin, MPH, MPAS, PA-C, Clinical Writer at DynaMed. Edited by Alan Ehrlich, MD, FAAFP, Executive Editor at DynaMed and Associate Professor in Family Medicine at the University of Massachusetts Medical School; Katharine DeGeorge, MD, MS, Senior Deputy Editor at DynaMed and Associate Professor of Family Medicine at the University of Virginia; Dan Randall, MD, MPH, FACP, Senior Deputy Editor at DynaMed; McKenzie Ferguson, PharmD, BCPS, Senior Clinical Writer at DynaMed; Matthew Lavoie, Senior Medical Copyeditor, BA, at DynaMed; Hannah Ekeh, MA, Senior Associate Editor II at DynaMed; and Jennifer Wallace, BA, Senior Associate Editor at DynaMed.