# The Role of Psychological Strength Factors in Long-term Survival of Older Adults with Advanced Heart Diseases, Requesting Open-heart Surgery, & Underlying Mechanisms

> **NIH NIH R03** · FLORIDA STATE UNIVERSITY · 2020 · $77,000

## Abstract

Recent work posits that certain character strengths (CS) could inform future strategies for both 
public health and individualized, patient-centered care (PCC) in the United States; yet to date, 
health providers pay little attention to modifiable patient psychological  strengths that could be 
harnessed to improve the patient-provider collaborative care. In addition to medical risk factors, 
certain psychosocial factors (e.g., depression) are associated with heart disease (HD) mortality, a 
leading cause of death, especially in late life. Recent studies, mostly in general populations, 
have found health benefits of certain CSs, especially notable is the survival  effect of optimism 
and spirituality indicators. These studies, however, are limited by small size, short study 
duration, and lack of information on medical confounders. Clearly, more clinical research is needed 
to provide reliable and robust evidence on the long-term effect of CSs in HD patients. Open-heart 
surgery (OHS), a life­ saving/extending intervention for HD, can be a stressful life event. Pl's 
(Ai) prior research showed the desirable effect of certain CSs (e.g., secular reverence, optimism) 
on optimal recovery (e.g., shorter hospitalization and low depression) in 30 months after OHS. To 
date, no information is available about the role of CS in post-OHS long-term survival. Further, 
women may fare worse after OHS (e.g., cardiac mortality, postop survival), and the Pl's earlier 
work indicates sex/gender differences in certain CSs (e.g., reverence, private prayer coping) and 
that some CSs and comorbidities could explain sex differences in post-OHS short-term recovery. It 
is not yet known if a sex difference in the CS-survival link exists, or if CSs interact with the 
trajectory of depression as a HD-mortality risk over time in men and women. To add scientific 
knowledge and to inform optimal cardiac  PCC, this interdisciplinary study will evaluate the 
long-term survival effect of psychological CSs in an existing cohort of older patients, 
prospectively evaluated before OHS and followed for 30-months post OHS (N=481, female 42%, age=63±
at OHS). The proposed study aims to address novel research questions:  1. Does any CSs predict 
long-term survival (over one decade) in patients following OHS, adjusting known predictors (e.g., 
demographics, depression, medical confounders)? 2. Are there sex differences in the effects of CSs 
on post­ OHS survival? 3. How does a CS mitigate the detrimental effect of depression as a known 
HD-mortality risk?
To achieve our intended specific aims, we will perform multivariate analyses of the combined 
National Index of Death (NDI) records, existing interdisciplinary information obtained from prospective surveys, 
and patient­ level information from the Society of Thoracic Surgeons' (STS) national database, as 
well as some stress­ sensitive biomarkers, of this cohort. The study is innovative because it will 
be the first to evaluate the lo...

## Key facts

- **NIH application ID:** 10017800
- **Project number:** 5R03AG060212-02
- **Recipient organization:** FLORIDA STATE UNIVERSITY
- **Principal Investigator:** Amy Lee Ai
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $77,000
- **Award type:** 5
- **Project period:** 2019-09-15 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017800

## Citation

> US National Institutes of Health, RePORTER application 10017800, The Role of Psychological Strength Factors in Long-term Survival of Older Adults with Advanced Heart Diseases, Requesting Open-heart Surgery, & Underlying Mechanisms (5R03AG060212-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10017800. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*