Sense of Coherence and Mortality: A Systematic Review and Meta-Analysis

Abstract

Objective The aim of the study was to investigate the association between sense of coherence (SOC) and all-cause mortality in the general adult population. Methods We conducted a systematic review and meta-analysis of prospective cohort studies. We searched eight electronic bibliographic databases for eligible studies. A random effects model and the restricted maximum likelihood method were used to calculate the pooled effect size. Results Eight studies were eligible for the meta-analysis. The studies included 48,138 participants, of whom 5307 died during a median follow-up of 14.1 years (range, 8–29.5 years). Their age ranged from 20 to 80 years, and 53% of them were men. In the meta-analysis model of crude values, the risk of all-cause mortality for individuals with a weak SOC (lowest tertile) was 1.30 (95% confidence interval [CI] = 1.09–1.55, p = .003, I 2 = 78.84%) compared with individuals with a strong SOC (highest tertile). In the model adjusted for age, the risk remained almost the same (risk ratio = 1.26, 95% CI = 1.15–1.38, p < .001, I 2 = 69.59%). In the model adjusted for several other risk factors for mortality, the risk was still 1.17 (95% CI = 1.07–1.27, p < .001, I 2 = 57.85%). Conclusions This meta-analysis shows that a weak SOC is associated with an increased risk of all-cause mortality in the general adult population. Future studies are needed to further develop assessment tools for SOC with good psychometric properties and to determine the disease processes that mediate the association of SOC with mortality.

Interview-Rated Meaning and Survival Over 17 Years in People Living With HIV

“…In a meta-analysis of 66 studies of meaning in life and health, researchers found an average effect size for longitudinal studies of 0.306, which they describe as moderate (15). Finally, in a meta-analysis of eight studies, those with a higher sense of coherence were 1.3 times more likely to survive than those in the lowest tertile (19). Although this is not as strong as our HRs of 2.66 to 3.45, sense of coherence is only one aspect of meaning.…”

The Impact of Place of Residence on the Sense of Coherence of Population Aged 60–89: Evidence from Poland

“…The effect of these works was establishing the dependencies which occur between SOC and health [34][35][36]; its quality [37], as well as life satisfaction. The newest research [38] proves that a high level of coherence not only improves life satisfaction but also decreases the death risk in adults independent of the cause of death while also lowering the level of death depression [39]. This may be of significance, especially when it comes to seniors.…”

Strengthening sense of coherence: Evidence from a physical activity intervention targeting vulnerable adults

“…Still, Togari et al (2007) argued that the SOC-3 scale showed some convergent and concurrent validities with more elaborate SOC scales. Further, if indeed the criticisms of the SOC-3 scale’s validity are accurate, then we should expect a larger change in SOC with a more elaborate scale ( Piiroinen et al, 2020 ). Given that we found a sizeable, significant change in SOC, this does not appear to have been a problem in our study.…”

“…Sense of coherence (SOC) is a concept that refers to individuals’ abilities to manage, comprehend, and find meaning in their lives and the world around them ( Antonovsky, 1987 , Super et al, 2016 , Eriksson, 2016 ). Research has found that stronger SOC is associated with improved health outcomes, including lower stress and better tension management ( Amirkhan and Greaves, 2003 ), healthier behavior and lifestyle choices ( Wainwright et al, 2007 ), and reduced risk of all-cause mortality ( Piiroinen et al, 2020 , Super et al, 2014 ). Strengthening SOC may therefore be a valuable way of improving a variety of health outcomes.…”