Aging Well Despite Chronic Illness

Physical health is an important aspect of successful aging. However, given the fact that almost three-fourths of older adults in the United States have two or more chronic conditions, it is inevitable that many need to find ways to live well in the face of chronic illness. What can research reveal about maintaining one’s well-being while suffering from chronic illness? Do mental traits or behaviors exist that can moderate the negative influences of chronic illness? A forthcoming article in the Journals of Gerontology aims to answer these questions by examining whether high levels of psychological function offer certain biological advantages in dealing with chronic illness.

Researchers analyzed data from the Midlife in the United States (MIDUS) survey, a national probability sample of community-dwelling older adults in the continental United States. Based on earlier research on chronic illness and psychological well-being, they hypothesized that positive psychological function might assist individuals with chronic illnesses in a fairly specific fashion—through levels of inflammatory proteins in the blood.

Why might they draw this hypothesis? Interestingly, two inflammatory proteins are associated with multiple chronic conditions common among older adults (such as hypertensions) as well as with aspects of psychological wellbeing (such as depression). Because of these shared associations, researchers have hypothesized that these proteins—proinflammatory cytokine interleukin-6 (IL-6) and acute-phase protein C-reactive protein (CRP)—might play a role in the well-established but unexplained relationship between social well-being and physical health.

In their analysis, the researchers examined data from 998 participants, which included information on chronic conditions, various measures of psychological well-being, IL-6 and CRP levels in the blood, and a variety of demographic factors. The data analyzed in the article were all cross-sectional, and thus cannot be used to establish causal relationships, but can be used to identify the correlation of these multiple factors.

It does appear that positive psychological function can have an influence on both the emotional and the biological reaction to disease. The researchers found that individuals with higher levels of purpose in life, positive relationships with others, and positive mood had lower levels of inflammation. Although certain psychological factors were strongly associated with chronic illness, many psychological variables were unrelated the number of chronic conditions, such as positive mood and sense of purpose in life.

The effects of chronic illness should not be minimized. In this study, the number of chronic conditions was associated with a lower sense of overall life satisfaction, which fits with other research that shows that physical health is a significant determinant of many areas of well-being. However, these findings also suggest that the presence of a chronic illness does not condemn one to low all-around well-being, and that psychological resources may be a useful way to moderate the effects of illness and other misfortune, biologically as well as mentally.


Friedman EM and Ryff CD, (2012). Living well with medical comorbidities: a biopsychosocial perspective. J Gerontol B Psychol Sci Soc Sci, epub ahead of print.