Spirituality and Aging

Helen Lavretsky

Disclosures

Aging Health. 2010;6(6):749-769. 

In This Article

Spirituality & Physical Health

Empirical research helps bring clarity to the health benefits of spiritual and religious practices. Many large community surveys, such as the Established Populations for Epidemiological Studies of the Elderly, have included items assessing religious and spiritual practices.[54] Despite racial, religious and cultural variations, the main exception is diminished attendance at religious services among the elderly who have problems of health and mobility. Their reduced participation in organizational religiosity, however, is often accompanied by high levels of nonorganizational religiosity: praying, listening to religious radio programs and music, and gaining help from religion to understand their own lives.[55] The differential survival hypothesis suggests that people who are more spiritual and religiously committed have lifestyles that lead to reduced mortality. They are less likely than others to use tobacco, abuse alcohol and drugs, engage in premarital sex or become divorced. They are more likely to belong to supportive social networks, and to experience serenity and peace with themselves, other people and God. Their lower age-specific mortality throughout adulthood could be a significant source of the high average spirituality in each older generation. A study of over 20,000 US adults estimates that religious involvement prolongs life by approxiately 7 years.[56]

Various systematic reviews and meta-analyses have demonstrated that religious involvement correlates with decreased morbidity and mortality.[57–64] In patients after heart surgery, Contrada and colleagues found stronger religious beliefs were associated with shorter hospital stays and fewer complications.[65] On the other hand, Hodges and authors did not find that spiritual beliefs affected recovery from spinal surgery.[66] Some studies suggest that members of different religions may have different mortality and morbidity, even when adjusting for major biological, behavioral and socioeconomic differences.[67,68] Both religious affiliation and regular attendance at religious services appear to buffer the need for, and length of, hospitalization.[69] Most studies find positive correlations between religious beliefs, behaviors and mental and physical health.[3] For example, various studies have revealed an inverse relationship between religious commitment and hypertension, fewer strokes, less pain from cancer and other illnesses, than similar people with a low religious commitment.[3,70–73] In Comstock's and Partridge's analysis of 91,000 people in Maryland (USA), those who attended church had a lower prevalence of cirrhosis, emphysema, suicide and death from ischemic heart disease. There has been a surge in the popularity of spiritual interventions, such as yoga or meditation, to improve and maintain health.[74–76] In three studies of prayer, large groups were invited to participate in a group prayer for patients with acute cardiovascular problems. Those who were prayed for did overall better than the control group in terms of the number of cardiovascular arrests, congestive heart failure, pneumonia, intubation and antibiotic use.[77–79]

Studies have compared people with high and low religiosity on healthier and less risky lifestyles, which might account for the association with better health. Religion may provide structure teaching, positive role models and support to individuals, which would prevent risky behaviors. Compared with the general population, Mormons and Seventh Day Adventists have been found to have lower incidences and mortality rates from cancers that can be linked to tobacco and alcohol use.[80,81] However, other studies have not supported this relationship.[82,83]

Although many patients consider religion and spirituality to be important in their healthcare, it is rarely used in the healing process. There has been a surge in the popularity of spiritual activities, such as yoga or meditation, to improve and maintain health.[74,75] Religious beliefs may help patients cope and provide them with a meaning to their diseases.[84–86] In addition, along with encouraging healthy lifestyles, religious groups may promote access to better healthcare and sponsor preventive programs (e.g., blood pressure and diabetes screening, soup kitchens and food drives).[87,88]

Although most studies have shown the positive effects of religion and spirituality on health, a few systematic studies have shown that religious involvement and spirituality are associated with negative physical and mental health outcomes. Religious beliefs can affect a person's health by encouraging avoidance or discontinuation of traditional treatments, or leading to a delay or failure to seek timely medical care, such as transfusions or contraception, leading to higher mortality.[89] In addition, religions can stigmatize those with certain diseases, and prevent those from seeking proper medical care.[90,91] Religious practices, such as exorcism, can be dangerous and lead to death.[92] Finally, fanatic religious beliefs can affect physical and mental health adversely.[93]

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