Emotional well-being predicts subsequent functional independence and survival

OBJECTIVE: To determine whether positive affect has an independent effect o n functional status, mobility, and survival in an older Mexican American sa mple. DESIGN: A 2-year prospective cohort study. SETTING: Five Southwestern states: Texas, California, Arizona, New Mexico, and Colorado. PARTICPANTS: A population-based sample of 2282 Mexican Americans aged 65 to 99 who reported no functional limitations at baseline interview. MEASUREMENTS: In-home interviews in 1993-1994 and again in 1995-1996 assess ed demographic variables, health conditions, activities of daily living, pe rformance-based mobility, survival, and a rating of positive and negative a ffect. RESULTS: In multivariate analyses, there was a direct relationship between positive affect scores at baseline and mobility, functional status, and sur vival 2 years later, controlling for functional status, sociodemographic va riables, major chronic conditions, body mass index (BMI), smoking status, d rinking status, and negative affect at baseline. Subjects with high positiv e affect were half as likely (odds ratio (OR) = 0.48; 95% confidence interv al (CI) 0.29, 0.93) to become disabled in activities of daily living (ADLs) , two-thirds as likely (OR = 0.64; 95% CI 0.51, 0.79) to have a slow walkin g speed, and half as likely (OR 0.53; 95% CI 0.30, 0.93) to have died durin g the 2-year follow-up compared to those with lower positive affect scores. CONCLUSIONS: Our results support the concept that positive affect, or emoti onal well-being, is different from the absence of depression or negative af fect. Positive affect seems to protect individuals against physical decline s in old age.