Is More, Better? Relationships of Multiple Psychological Well-Being Facets With Cardiometabolic Disease

Objective: Cardiometabolic disease (CMD) is a leading cause of death and disability worldwide.Assessments of psychological well-being taken at one time point are linked to reduced cardiometabolic risk, but psychological well-being may change over time and how longitudinal trajectories of psychological well-being may be related to CMD risk remains unclear. Furthermore, psychological well-being is a multidimensional construct comprised of distinct facets, but no work has examined whether sustaining high levels of multiple facets may confer additive protection. This study tested if trajectories of four psychological well-being facets would be associated with lower risk of selfreported nonfatal CMD. Method: Participants were 4,006 adults aged ≥50 years in the English Longitudinal study of Ageing followed for 18 years at biyearly intervals. Psychological well-being facets were measured in Waves 1–5 using subscales of the Control, Autonomy, Satisfaction, and Pleasure scale. Latent class growth modeling defined trajectories of each facet. Incident CMD cases were self-reported at Waves 6–9. Cox regression models estimated likelihood of incident CMD associated with trajectories of each facet individually and additively (i.e., having persistently high levels on multiple facets over time). Results: After adjusting for relevant covariates, CMD risk was lower for adults with persistently high versus persistently low levels of control and autonomy. When considering potential additive effects, lower CMD risk was also related to experiencing persistently high levels of ≥2 versus 0 psychological well-being facets.