Gratitude may extend lifespan of older women

Gratitude is associated with increased longevity among older females, a population-based study has shown.

“Gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults,” wrote the researchers. “However, the association between gratitude and mortality has not been studied.”

In a population-based prospective cohort study involving 49,275 US older (mean age, 79 years) female registered nurses, the researchers examined the association of gratitude with all-cause mortality and cause-specific mortality in later life. [JAMA Psychiatry 2024;doi:10.1001/jamapsychiatry.2024.1687]

Level of gratitude was categorized into three groups based on 6-item Gratitude Questionnaire score tertile: Lowest (n=15,814), middle (n=15,115), and highest (n=18,346). “Those who reported greater gratitude were slightly younger and more likely to be married or in a relationship; had higher socioeconomic status; had greater social participation, religious involvement, and optimism; and were healthier and less depressed at baseline,” noted the researchers.

Individuals in the highest tertile of gratitude had a 9 percent lower risk of all-cause mortality vs those in the lowest tertile (hazard ratio [HR], 0.91; 95 percent confidence interval [CI], 0.84–0.99), after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health.

“It was posited that gratitude can shape health directly via increasing restorative biological functioning and healthy lifestyles as well as indirectly through increased social support, prosociality, and adaptive coping strategies,” explained the researchers. “Experiencing gratitude may be particularly relevant for generating a sense of meaning and connectedness in older adults, which facilitates coping with ageing-related changes.”

Of note, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95 percent CI, 0.73–0.995; p=0.04). This finding was consistent with previous research showing gratitude was associated with favourable profiles of cardiovascular biomarkers (eg, endothelial function), inflammatory markers, and lipids. [JAMA Psychiatry 2024;doi:10.1001/jamapsychiatry.2024.1687; J Posit Psychol 2021;16:348-355]

However, no significant associations were found between gratitude and death from cancer, respiratory disease, neurodegenerative disease, infection, injury, or other causes (all p>0.05).

“This study provides the first empirical evidence suggesting that gratitude may be a psychological resource associated with increased longevity in later life,” said the researchers. “It is the first, to our knowledge, to evaluate the association between gratitude and mortality. The study was conducted in a large sample, with rigorous control for potential confounding.”

“Promoting healthy ageing is a public health priority. We hope further studies will improve our understanding of gratitude as psychological resource for enhancing longevity,” said the researchers. This is because there are low-cost and easy-to-implement techniques (eg, gratitude journaling, the Three Good Things exercise, grateful contemplation, and behavioural expression of gratitude) that can enhance gratitude.

“While this study provides preliminary evidence for an inverse association between gratitude and mortality among older female nurses, the findings will need to be replicated in future studies with more representative samples,” they commented.