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Purpose in Life and Its Relationship to All-Cause Mortality and Cardiovascular Events: A Meta-Analysis

Cohen, Randy MD, MS; Bavishi, Chirag MD, MPH; Rozanski, Alan MD

doi: 10.1097/PSY.0000000000000274
Systematic Review/Meta-Analysis

Objective To assess the net impact of purpose in life on all-cause mortality and cardiovascular events.

Methods The electronic databases PubMed, Embase, and PsycINFO were systematically searched through June 2015 to identify all studies investigating the relationship between purpose in life, mortality, and cardiovascular events. Articles were selected for inclusion if, a) they were prospective, b) evaluated the association between some measure of purpose in life and all-cause mortality and/or cardiovascular events, and c) unadjusted and/or adjusted risk estimates and confidence intervals (CIs) were reported.

Results Ten prospective studies with a total of 136,265 participants were included in the analysis. A significant association was observed between having a higher purpose in life and reduced all-cause mortality (adjusted pooled relative risk = 0.83 [CI = 0.75–0.91], p < .001) and cardiovascular events (adjusted pooled relative risk = 0.83 [CI = 0.75–0.92], p = .001). Subgroup analyses by study country of origin, questionnaire used to measure purpose in life, age, and whether or not participants with baseline cardiovascular disease were included in the study all yielded similar results.

Conclusions Possessing a high sense of purpose in life is associated with a reduced risk for all-cause mortality and cardiovascular events. Future research should focus on mechanisms linking purpose in life to health outcomes, as well as interventions to assist individuals identified as having a low sense of purpose in life.

Supplemental digital content is available in the text.

From the Division of Cardiology, Mt Sinai St Luke's and Roosevelt Hospitals and the Icahn School of Medicine at Mount Sinai, New York, New York.

Supplemental Content

Address correspondence and reprint requests to Alan Rozanski, MD, FACC, Mt Sinai St Luke's–Roosevelt Hospital, 1111 Amsterdam Ave, New York, NY 10025. E-mail: arozansk@chpnet.org

Received for publication April 14, 2015; revision received September 16, 2015.

Copyright © 2016 by American Psychosomatic Society
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