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Accumulating evidence suggests that positive psychological well-being (e.g., optimism, life satisfaction) is associated with a reduced risk of cardiovascular disease. One possible explanation for this association is that individuals with greater positive psychological well-being tend to engage in health behaviors that are relevant to the prevention of cardiovascular disease (e.g., exercising, eating a healthy diet, avoiding smoking). If positive psychological well-being actually precedes and induces healthy behaviors such that it is a true causal factor, then well-being may be a useful target for intervention. In this article, we briefly review evidence linking well-being with health behaviors. We also describe possible strategies to enhance well-being (e.g., expressing gratitude, mindfulness meditation) and evaluate how effective such strategies may be for fostering behavior change.

Key Points Question Are higher levels of predeployment optimism among US Army soldiers associated with fewer reports of new pain after deployment? Findings Among 20 734 US Army soldiers in this longitudinal cohort study, optimism was associated with 11% lower odds of reporting new postdeployment pain, even while adjusting for demographic, military, and combat factors, including traumatic experiences and combat injury. In addition, 37.3% of soldiers reported pain in at least 1 new area of the body after deployment. Meaning The findings suggest that soldiers with low levels of predeployment optimism may be at greater risk of developing new postdeployment pain and may benefit from scalable interventions designed to increase optimism., This longitudinal cohort study examines the association between predeployment factors and the onset of new pain after deployment in US Army soldiers., Importance Pain after deployment is a major health care concern. While risk factors have been previously studied, few studies have explored protective factors. Objective To examine the prospective association between predeployment optimism and the onset of new pain after deployment in US Army soldiers. Design, Setting, and Participants This prospective longitudinal cohort study examined US Army soldiers (active duty, Reserve, and National Guard) who deployed to Afghanistan or Iraq between February 12, 2010, and August 29, 2014, and completed the necessary psychological and health assessments before and after deployment. Analyses were performed in the Person-Event Data Environment between July 2016 and November 2018. This study relied exclusively on existing, secondary Army data. Of the 413 763 Army soldiers who met the specified deployment criteria, 385 925 soldiers were missing 1 or more of the required assessment forms. Of the remaining 27 838 soldiers who were examined for eligibility, 7104 soldiers were excluded because of preexisting back pain, joint pain, or frequent headaches. These exclusions resulted in a final analytic sample of 20 734 eligible soldiers. Main Outcomes and Measures This study examined new reports of pain after deployment, including new back pain, joint pain, and frequent headaches. Results Among 20 734 US Army soldiers (87.8% male; mean [SD] age, 29.06 [8.42] years), 37.3% reported pain in at least 1 new area of the body after deployment: 25.3% reported new back pain, 23.1% reported new joint pain, and 12.1% reported new frequent headaches. As a continuous measure, each 1-U increase in optimism was associated with 11% lower odds of reporting any new pain after deployment, even while adjusting for demographic, military, and combat factors (odds ratio, 0.89; 95% CI, 0.86-0.93). Tertile analyses revealed that compared with soldiers with high optimism (lowest odds of new pain) soldiers with low optimism had 35% greater odds of reporting new pain in any of the 3 sites evaluated (odds ratio, 1.35; 95% CI, 1.21-1.50). In addition, a larger increase in risk of new pain was observed when comparing the moderate-optimism and low-optimism groups rather than the high-optimism and moderate-optimism groups. Conclusions and Relevance Higher levels of optimism were associated with lower odds of reporting new pain after deployment, over and above other common determinants of pain, including demographic and military characteristics and combat experiences. Soldiers with low levels of optimism before deployment could benefit from programs geared toward enhancing optimism.

The gene encoding sortilin receptor 1 (SORL1) has been associated with Alzheimer's disease risk. We examined 15 SORL1 variants and single nucleotide polymorphism (SNP) set risk scores in relation to longitudinal verbal, spatial, memory, and perceptual speed performance, testing for age trends and sex-specific effects. Altogether, 1609 individuals from 3 population-based Swedish twin studies were assessed up to 5 times across 16 years. Controlling for apolipoprotein E genotype (APOE), multiple simple and sex-moderated associations were observed for spatial, episodic memory, and verbal trajectories (p = 1.25E-03 to p = 4.83E-02). Five variants (rs11600875, rs753780, rs7105365, rs11820794, rs2070045) were associated across domains. Notably, in those homozygous for the rs2070045 risk allele, men demonstrated initially favorable performance but accelerating declines, and women showed overall lower performance. SNP set risk scores predicted spatial (Card Rotations, p = 5.92E-03) and episodic memory trajectories (Thurstone Picture Memory, p = 3.34E-02), where higher risk scores benefited men's versus women's performance up to age 75 but with accelerating declines. SORL1 is associated with cognitive aging, and might contribute differentially to change in men and women.