Abstract
BackgroundPositive and negative psychological factors are associated with mortality and cardiovascular disease. This study prospectively investigated associations of daily frequency of laughter with mortality and cardiovascular disease in a community-based population.MethodsThis study included 17,152 subjects ≥40 years old who participated in an annual health check in Yamagata Prefecture. Self-reported daily frequency of laughter was grouped into three categories (≥1/week; ≥1/month but <1/week; <1/month). Associations of daily frequency of laughter with increase in all-cause mortality and cardiovascular disease incidence were determined using Cox proportional hazards modeling.ResultsDuring follow-up (median, 5.4 years), 257 subjects died and 138 subjects experienced cardiovascular events. Kaplan-Meier analysis revealed that all-cause mortality and cardiovascular disease incidence were significantly higher among subjects with a low frequency of laughter (log-rank P < 0.01). Cox proportional hazard model analysis adjusted for age, gender, hypertension, smoking, and alcohol drinking status showed that risk of all-cause mortality was significantly higher in subjects who laughed <1/month than in subjects who laughed ≥1/week (hazard ratio [HR] 1.95; 95% confidence interval [CI], 1.16–3.09). Similarly, risk of cardiovascular events was higher in subjects who laughed ≥1/month but <1/week than in subjects who laughed ≥1/week (HR 1.62; 95% CI, 1.07–2.40).ConclusionDaily frequency of laughter represents an independent risk factor for all-cause mortality and cardiovascular disease in a Japanese general population.
Highlights
Previous studies have revealed that positive psychological factors promote longevity and reduce the risk of cardiovascular disease, whereas physical disability and negative psychological factors, such as depression, anxiety, and psychological distress, are associated with increased risk of coronary heart disease and cerebrovascular disease.[1,2] In Japan, similar findings have been observed, such as associations between perceived level of life enjoyment[3] and positive psychological factors, such as “ikigai”,4 with risk of cardiovascular disease incidence and mortality
In subjects with a low frequency of laughter, physical inactivity and proportions of males, present smokers, those with diabetes, single, and physical inactivity were significantly higher than in subjects showing a high frequency of laughter
All-cause mortality was significantly higher in subjects with a low frequency of laughter (Figure 1)
Summary
Previous studies have revealed that positive psychological factors promote longevity and reduce the risk of cardiovascular disease, whereas physical disability and negative psychological factors, such as depression, anxiety, and psychological distress, are associated with increased risk of coronary heart disease and cerebrovascular disease.[1,2] In Japan, similar findings have been observed, such as associations between perceived level of life enjoyment[3] and positive psychological factors, such as “ikigai”,4 with risk of cardiovascular disease incidence and mortality. Hayashi et al analyzed cross-sectional data in 20,394 individuals aged 65 years or older who participated in the Japan Gerontological Evaluation Study in 2013. They showed that a higher daily frequency of laughter was associated with lower prevalence of cardiovascular diseases among older Japanese adults.[8] Due to its cross-sectional nature, their study did not clearly show any preventive effect of laughter on cardiovascular disease. No longitudinal prospective study of the daily frequency of laughter and all-cause mortality and cardiovascular disease incidence has yet appeared. This study prospectively investigated associations of daily frequency of laughter with mortality and cardiovascular disease in a communitybased population
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