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Purpose in Life Is Associated With Mortality Among Community-Dwelling Older Persons

From the Rush Alzheimer’s Disease Center (P.A.B., L.L.B., A.S.B., D.A.B.), and the Departments of Behavioral Sciences (P.A.B., L.L.B.) and Neurological Sciences (L.L.B., A.S.B., D.A.B.), Rush University Medical Center, Chicago, Illinois.

Address correspondence and reprint requests to Patricia Boyle, Rush Alzheimer’s Disease Center, 600 S. Paulina, Suite 1020B, Chicago, IL 60612. E-mail: Patricia_Boyle{at}rush.edu

Objective: To assess the association between purpose in life and all-cause mortality in community-dwelling elderly persons.

Methods: We used data from 1238 older persons without dementia from two longitudinal cohort studies (Rush Memory and Aging Project and Minority Aging Research Study) with baseline evaluations of purpose in life and up to 5 years of follow-up to test the hypothesis that greater purpose in life is associated with a reduced risk of mortality among community-dwelling older persons.

Results: The mean ± standard deviation score on the purpose in life measure at baseline was 3.7 ± 0.5 (range = 2–5), with higher scores indicating greater purpose in life. During the 5-year follow-up (mean = 2.7 years), 151 of 1238 persons (12.2%) died. In a proportional hazards model adjusted for age, sex, education, and race, a higher level of purpose in life was associated with a substantially reduced risk of mortality (hazard ratio = 0.60, 95% Confidence Interval = 0.42, 0.87). Thus, the hazard rate for a person with a high score on the purpose in life measure (score = 4.2, 90th percentile) was about 57% of the hazard rate of a person with a low score (score = 3.1, 10th percentile). The association of purpose in life with mortality did not differ among men and women or whites and blacks. Further, the finding persisted after the addition of terms for several potential confounders, including depressive symptoms, disability, neuroticism, the number of chronic medical conditions, and income.

Conclusion: Greater purpose in life is associated with a reduced risk of all-cause mortality among community-dwelling older persons.

Key Words: purpose in life • mortality • longevity • well-being • successful aging • goal-directedness

Abbreviations: MAP = Memory and Aging Project; MARS = Minority Aging Research Study; CES-D = Center for Epidemiologic Studies Depression scale.