W. Wilson's (1967) review of the area of subjective well-being (SWB) advanced several conclusions regarding those who report high levels of "happiness". A number of his conclusions have been overturned: youth and modest aspirations no longer are seen as prerequisites of SWB. E. Diener's (1984) review placed greater emphasis on theories that stressed psychological factors. In the current article, the authors review current evidence for Wilson's conclusions and discuss modern theories of SWB that stress dispositional influences, adaptation, goals, and coping strategies. The next steps in the evolution of the field are to comprehend the interaction of psychological factors with life circumstances in producing SWB, to understand the causal pathways leading to happiness, understand the processes underlying adaptation to events, and develop theories that explain why certain variables differentially influence the different components of SWV (life satisfaction, pleasant affect, and unpleasant affect).

Subjective Well-Being: Three Decades of Progress

W Wilson's (1967) review of the area of subjective well-being (SWB) advanced several conclusions regarding those who report high levels of "happiness" A number of his conclusions have been overturned: youth and modest aspirations no longer are seen as prerequisites of SWB E Diener's (1984) review placed greater emphasis on theories that stressed psychological factors In the current article, the authors review current evidence for Wilson's conclusions and discuss modern theories of SWB that stress dispositional influences, adaptation, goals, and coping strategies The next steps in the evolution of the field are to comprehend the interaction of psychological factors with life circumstances in producing SWB, to understand the causal pathways leading to happiness, understand the processes underlying adaptation to events, and develop theories that explain why certain variables differentially influence the different components of SWB (life satisfaction, pleasant affect, and unpleasant affect) In 1967, Warner Wilson presented a broad review of subjective well-being (SWB) research entitled, "Correlates of Avowed Happiness" Based on the limited data available at that time, Wilson concluded that the happy person is a "young, healthy, welleducated, well-paid, extroverted, optimistic, worry-free, religious, married person with high self-esteem, job morale, modest aspirations, of either sex and of a wide range of intelligence" (p 294) In the three decades since Wilson's review, investigations into SWB have evolved Although researchers now know a great deal more about the correlates of SWB, they are less interested in simply describing the demographic characteristics that correlate with it Instead, they focus their effort on understanding the processes that underlie happiness This trend represents a greater recognition of the central role played by people's goals, coping efforts, and dispositions In this article, we review research on several major theoretical approaches to well-being and then indicate how these theories clarify the findings on demographic correlates of SWB Throughout the review we suggest four directions that researchers should pursue in the decades ahead These are by no means the only questions left to answer, but we believe they are the most interesting issues left to resolve First, the causal direction of the correlates of happiness must be examined through more sophisticated methodologies Although the causal priority of demographic factors such as marriage and income is intuitively appealing, it is by no means certain Second, researchers must focus greater attention on the interaction between internal factors (such as personality traits) and external circumstances As we shall see, demographic factors have surprisingly small effects on SWB, but these effects may depend on the personalities of those individuals being studied Thus, future research must take Person X Situation interactions into account Third, researchers must strive to understand the processes underlying adaptation Considerable adaptation to both good and bad circumstances often occurs, yet the processes responsible for these effects are poorly understood Research that examines how habituation, coping strategies, and changing goals influence adaptation will shed much light on the processes responsible for SWB Finally, theories must be refined to make specific predictions about how input variables differentially influence the components of SWB In the past, many researchers have treated SWB as a monolithic entity, but it is now clear that there are separable components that exhibit unique patterns of relations with different variables In each section of this article we discuss progress and opportunities in these four areas

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Subjective well-being: Three decades of progress

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)61729-2.pdf

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Background: There is no single generally accepted clinical definition of frailty. Previously developed tools to assess frailty that have been shown to be predictive of death or need for entry into an institutional facility have not gained acceptance among practising clinicians. We aimed to develop a tool that would be both predictive and easy to use. Methods: We developed the 7-point Clinical Frailty Scale and applied it and other established tools that measure frailty to 2305 elderly patients who participated in the second stage of the Canadian Study of Health and Aging (CSHA). We followed this cohort prospectively; after 5 years, we determined the ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools. Results: The CSHA Clinical Frailty Scale was highly correlated ( r = 0.80) with the Frailty Index. Each 1-category increment of our scale significantly increased the medium-term risks of death (21.2% within about 70 mo, 95% confidence interval [CI] 12.5%–30.6%) and entry into an institution (23.9%, 95% CI 8.8%–41.2%) in multivariable models that adjusted for age, sex and education. Analyses of receiver operating characteristic curves showed that our Clinical Frailty Scale performed better than measures of cognition, function or comorbidity in assessing risk for death (area under the curve 0.77 for 18-month and 0.70 for 70-month mortality). Interpretation: Frailty is a valid and clinically important construct that is recognizable by physicians. Clinical judgments about frailty can yield useful predictive information.

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A global clinical measure of fitness and frailty in elderly people

Context: Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. Objective: To conduct a systematic review and meta-analysis on the longitudinal relationship between depression, overweight, and obesity and to identify possible influencing factors. Data Sources: Studies were found using PubMed, PsycINFO, and EMBASE databases and selected on several criteria. Study Selection: Studies examining the longitudinal bidirectional relation between depression and overweight (body mass index 25-29.99) or obesity (body mass index >= 30) were selected. Data Extraction: Unadjusted and adjusted odds ratios (ORs) were extracted or provided by the authors. Data Synthesis: Overall, unadjusted ORs were calculated and subgroup analyses were performed for the 15 included studies (N = 58 745) to estimate the effect of possible moderators (sex, age, depression severity). Obesity at baseline increased the risk of onset of depression at follow-up (unadjusted OR, 1.55; 95% confidence interval [CI], 1.22-1.98; P = 60 years) but not among younger persons (aged < 20 years). Baseline depression (symptoms and disorder) was not predictive of overweight over time. However, depression increased the odds for developing obesity (OR, 1.58; 95% CI, 1.33-1.87; P < .001). Subgroup analyses did not reveal specific moderators of the association. Conclusions: This meta-analysis confirms a reciprocal link between depression and obesity. Obesity was found to increase the risk of depression, most pronounced among Americans and for clinically diagnosed depression. In addition, depression was found to be predictive of developing obesity.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/210608/yma90003_220_229.pdf

Overweight, Obesity, and Depression A Systematic Review and Meta-analysis of Longitudinal Studies

Previous studies assessing protective effects of physical activity on depression have had conflicting results; one recent study argued that excluding disabled subjects attenuated any observed effects. The authors' objective was to compare the effects of higher levels of physical activity on prevalent and incident depression with and without exclusion of disabled subjects. Participants were 1,947 community-dwelling adults from the Alameda County Study aged 50-94 years at baseline in 1994 with 5 years of follow-up. Depression was measured using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Washington, DC: American Psychiatric Association, 1994). Physical activity was measured with an eight-point scale; odds ratios are based upon a one-point increase on the scale. Even with adjustments for age, sex, ethnicity, financial strain, chronic conditions, disability, body mass index, alcohol consumption, smoking, and social relations, greater physical activity was protective for both prevalent depression (adjusted odds ratio (OR) = 0.90, 95% confidence interval (CI): 0.79, 1.01) and incident depression (adjusted OR = 0.83, 95% CI: 0.73, 0.96) over 5 years. Exclusion of disabled subjects did not attenuate the incidence results (adjusted OR = 0.79, 95% CI: 0.67, 0.92). Findings support the protective effects of physical activity on depression for older adults and argue against excluding disabled subjects from similar studies.

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Physical Activity Reduces the Risk of Subsequent Depression for Older Adults

OBJECTIVES: This study analyzed the long-term association between religious attendance and mortality to determine whether the association is explained by improvements in health practices and social connections for frequent attenders. METHODS: The association between frequent attendance and mortality over 28 years for 5286 Alameda Country Study respondents was examined. Logistic regression models analyzed associations between attendance and subsequent improvements in health practices and social connections. RESULTS: Frequent attenders had lower mortality rates than infrequent attenders (relative hazard [RH] = 0.64;95% confidence interval [CI] = 0.53,0.77). Results were stronger for females. Health adjustments had little impact, but adjustments for social connections and health practices reduced the relationship (RH = 0.77; 95% CI = 0.64, 0.93). During follow-up, frequent attenders were more likely to stop smoking, increase exercising, increase social contacts, and stay married. CONCLUSIONS: Lower mortality...

Frequent attendance at religious services and mortality over 28 years

OBJECTIVE: To examine the temporal relation between obesity and depression to determine if each constitutes a risk factor for the other. DESIGN: A two-wave, 5-y-observational study with all measures at both times. SUBJECTS: A total of 2123 subjects, 50 y of age and older, who participated in the 1994 and 1999 waves of the Alameda County Study. MEASUREMENTS: Obesity defined as body mass index (BMI)⩽30. Depression assessed using DSM-IV symptom criteria for major depressive episodes. Covariates include indicators of age, gender, education, marital status, social support, life events, physical health problems, and functional limitations. RESULTS: Obesity at baseline was associated with increased risk of depression 5 y later, even after controlling for depression at baseline and an array of covariates. The reverse was not true; depression did not increase the risk of future obesity. CONCLUSION: These results, the first ever on reciprocal effects between obesity and depression, add to a growing body of evidence concerning the adverse effects of obesity on mental health. More studies are needed on the relation between obesity and mental health and implications for prevention and treatment.

Prospective association between obesity and depression: evidence from the Alameda County Study.

Purpose: This research evaluates the utility of two different definitions of successful aging in predicting well-being. Design and Methods: We assessed the definitions of (a) self-rating and (b) Rowe and Kahn’s criteria of absence of disease, disability, and risk factors; maintaining physical and mental functioning; and active engagement with life. We made associations with well-being for each definition using data from 867 Alameda County Study participants aged 65‐99 years. Results: The percentage of those rating themselves as aging successfully was 50.3% compared with 18.8% classified according to Rowe and Kahn’s criteria. Although absence of chronic conditions and maintaining functioning were positively associated with successful aging for both definitions, many participants with chronic conditions and with functional difficulties still rated themselves as aging successfully; none were so classified according to Rowe and Kahn’s criteria. On 14 of 15 measures, self-rated successful aging resulted in sharper contrasts for well-being. Implications: Understanding criteria used by older persons to assess their own successful aging should enhance the conceptualization and measurement of this elusive concept.

Successful Aging and Well-Being Self-Rated Compared With Rowe and Kahn

Several recent prospective analyses involving community-based populations have demonstrated a protective effect on survival for frequent attendance at religious services. How such involvement increases survival are unclear. To test the hypothesis that religious attendance might serve to improve and maintain good health behaviors, mental health, and social relationships, changes and consistencies in these variables were studied between 1965 and 1994 for 2,676 Alameda County Study participants, from 17 to 65 years of age in 1965, who survived to 1994. Measures included smoking, physical activity, alcohol consumption, medical checkups, depression, social interactions, and marital status. Those reporting weekly religious attendance in 1965 were more likely to both improve poor health behaviors and maintain good ones by 1994 than were those whose attendance was less or none. Weekly attendance was also associated with improving and maintaining good mental health, increased social relationships, and marital stability. Results were stronger for women in improving poor health behaviors and mental health, consistent with known gender differences in associations between religious attendance and survival. Further understanding the mechanisms involved could aid health promotion and intervention efforts.

William J. Strawbridge

Papers

Physical Activity Reduces the Risk of Subsequent Depression for Older Adults

Frequent attendance at religious services and mortality over 28 years

Prospective association between obesity and depression: evidence from the Alameda County Study.

Successful Aging and Well-Being Self-Rated Compared With Rowe and Kahn

Religious attendance increases survival by improving and maintaining good health behaviors, mental health, and social relationships.