Abstract
Background: Psychological well-being (PWB) is predictive of future health and mortality. Midlife is a pivotal time in women's lives and may impact future PWB. This study, based on a longitudinal cohort of women, sought to identify how personal and social resources and modifiable behaviors at midlife relate to women's PWB in later life, and to determine if psychological resilience in later life moderates the impact of health problems on PWB. Materials and Methods: We assessed the association of midlife factors with PWB ∼9 years later in 1693 women from the multiracial/ethnic Study of Women's Health Across the Nation (SWAN) cohort. PWB was a composite score with cognitive and affective components. Midlife factors included sociodemographics, health, menopause-related, and psychosocial factors collected over the course of midlife. Results: In a multivariable model, greater PWB at an older age was associated with the following at midlife: less financial strain, greater physical activity, not smoking, better physical functioning, and fewer sleep problems. More positive attitudes toward menopause and aging, less cynicism, greater optimism, less trait anxiety, greater spirituality, and greater resilience were also independently associated with better PWB. Chinese women reported lower PWB compared with whites. Later life resilience moderated the impact of sleep problems on PWB. Conclusions: Several modifiable factors at midlife are associated with better PWB in older women and highlight the importance of healthy behaviors such as physical activity and good sleep hygiene at midlife. Interventions to increase optimism, spirituality, and resilience are also worth exploring.