ImportanceIdentifying factors contributing to sustained physical functioning is critical for the health and well-being of the aging population, especially as physical functioning may precede and predict subsequent health outcomes. Prior work suggests optimism may protect health, but less is known about the association between optimism and objective physical functioning measures as individuals age.ObjectiveTo evaluate the longitudinal association between optimism and 3 physical functioning measures.Design, Setting, and ParticipantsThis was a prospective cohort study using data from the Women’s Health Initiative (WHI) with participants recruited from 1993 to 1998 and followed up over 6 years. Data analysis was conducted from January 2022 to July 2022. Participants included postmenopausal women older than 65 years recruited from 40 clinical centers in the US.ExposureOptimism was assessed at baseline using the Life Orientation Test–Revised.Main Outcomes and MeasuresPhysical functioning was measured at 4 time points across 6 years by study staff evaluating performance in grip strength, timed walk, and chair stands.ResultsThe final analytic sample included 5930 women (mean [SD] age, 70 [4] years). Linear mixed-effects models controlling for demographics, depression, health status, and health behaviors showed that higher optimism was associated with higher grip strength (β = 0.36; 95% CI, 0.21-0.50) and number of chair stands (β = 0.05; 95% CI, 0.01-0.10) but not timed walk at baseline. Higher optimism was also associated with slower rates of decline in timed walk (β = −0.09; 95% CI, −0.13 to −0.04) and number of chair stands (β = 0.01; 95% CI, 0-0.03) but not grip strength over time. Cox proportional hazards models showed that higher optimism was associated with lower hazards of reaching clinically defined thresholds of impairment for all 3 outcomes over 6 years of follow-up. For example, in fully adjusted models, for a 1-SD increase in optimism, hazard ratios for reaching impairment thresholds were 0.86 (95% CI, 0.80-0.92) for grip strength, 0.94 (95% CI, 0.88-1.01) for timed walk, and 0.91 (95% CI, 0.85-0.98) for chair stands.Conclusion and RelevanceIn this cohort study of postmenopausal women, at baseline, higher optimism was associated with higher grip strength and number of chair stands but not with the time it took to walk 6 m. Higher optimism at baseline was also associated with maintaining healthier functioning on 2 of the 3 performance measures over time, including less decline in walking speed and in number of chair stands women could perform over 6 years of follow-up. Given experimental studies suggesting that optimism is modifiable, it may be a promising target for interventions to slow age-related declines in physical functioning. Future work should explore associations of optimism with maintenance of physical functioning in diverse populations.

中文翻译：

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女性乐观情绪与客观身体机能测量之间的纵向关联

重要性识别有助于持续身体机能的因素对于老年人口的健康和福祉至关重要，特别是因为身体机能可能先于并预测随后的健康结果。先前的研究表明乐观可以保护健康，但随着个体年龄的增长，乐观情绪与客观身体机能测量之间的关联却知之甚少。目的评估乐观与 3 种身体机能测量之间的纵向关联。设计、设置和参与者这是一项前瞻性队列研究使用妇女健康倡议 (WHI) 的数据，参与者在 1993 年至 1998 年间招募，并进行了 6 年多的随访。数据分析于 2022 年 1 月至 2022 年 7 月进行。参与者包括从美国 40 个临床中心招募的 65 岁以上绝经后妇女。使用生命取向测试修订版在基线评估暴露乐观度。主要结果和措施在 4 时测量身体功能研究人员在 6 年的时间点上评估握力、定时步行和椅子站立的表现。结果最终分析样本包括 5930 名女性（平均 [SD] 年龄，70 [4] 岁）。控制人口统计、抑郁、健康状况和健康行为的线性混合效应模型表明，较高的乐观情绪与较高的握力（β = 0.36；95% CI，0.21-0.50）和椅子站立数量（β = 0.05；95% CI，0.21-0.50）相关。 95% CI, 0.01-0.10)，但基线时未定时步行。较高的乐观情绪还与定时行走（β = -0.09；95% CI，-0.13 至 -0.04）和椅子站立数量（β = 0.01；95% CI，0-0.03）下降速度较慢相关，但与握力无关随着时间的推移强度。 Cox 比例风险模型显示，在 6 年的随访期间，较高的乐观情绪与所有 3 个结果达到临床定义的损伤阈值的风险较低相关。例如，在完全调整的模型中，乐观情绪增加 1-SD，握力达到损伤阈值的风险比为 0.86（95% CI，0.80-0.92），定时训练为 0.94（95% CI，0.88-1.01）。步行，站立椅子为 0.91（95% CI，0.85-0.98）。结论和相关性在这项针对绝经后女性的队列研究中，在基线时，较高的乐观情绪与较高的握力和站立椅子的数量相关，但与站立所花费的时间无关。步行6 m。基线时较高的乐观情绪还与随着时间的推移在 3 项绩效指标中的 2 项上保持更健康的功能有关，包括步行速度和女性在 6 年多的随访中可以执行的椅子站立数量下降较少。鉴于实验研究表明乐观情绪是可以改变的，因此它可能是减缓与年龄相关的身体机能下降的干预措施的一个有希望的目标。未来的工作应该探索不同人群中乐观情绪与维持身体机能之间的关系。