Abstract

Purpose: Positive psychological factors have been reported to be effective in preventing lifestyle-related diseases. People with high frequency of gratitude are considered to have positive psychological factors and to be in a state of social participation. Serum levels of IL-6, an inflammatory marker, have also been reported to decrease in grateful individuals. However, the association between frequency of gratitude and lifestyle-related diseases has not been reported. Methods: Participants of the study was 25,036 (11,656 men and 13,346 women) who responded to the question about gratitude among those who answered the JAGES2019 questionnaire. To the question, "In your daily life, how often do you say "thank you" to those around you?", possible answers were "1. several times a day or more," "2. about once a day," "3. several times a week," "4. several times a month," or "5. almost never. Multivariate odds ratios and 95% confidence interval of hypertension, diabetes, hyperlipidemia, depression, stroke, heart disease, cancer, and dementia were calculated using logistic regression analysis for those who were less grateful compared to those who were grateful "several times a day or more" and the same analyses were conducted for men and women. Covariates were smoking habits, drinking habits, whether they lived alone, exercise time, and body mass index. Results: The prevalence of hypertension, diabetes, depression, and dementia was higher among those who were less frequently grateful compared to those who were more frequently grateful. Multivariate odds ratios (95% confidence interval) were 1.08 (1.00-1.16) for hypertension, 1.12 (1.02-1.24) for diabetes, 1.82 (1.25-2.64) for depression, and 1.81 (1.16-2.8) for dementia, respectively. In men, the association was more pronounced for dementia for 2.37 (1.16-4.87), and similar trends for hypertension, diabetes, and depression. For women, the association was more pronounced for depression for 1.86 (1.17-2.95) and similar trends for hypertension, diabetes, and depression. The prevalence of cancer was lower with lower frequency of gratitude. Discussion: The prevalence of hypertension, diabetes, depression, and dementia was higher among those who were less frequently grateful, and the associations were particularly pronounced for hypertension, diabetes, and depression, especially among women, and for dementia, especially among men. The frequency of gratitude was thought to be influenced by the frequency of social participation, and there is a possibility of a causal reversal in depression, dementia, and cancer. We will examine the association more in detail longitudinally.

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