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Association between allostatic load and mortality among Chinese older adults: the Chinese Longitudinal Health and
Tianhang Zhang1,2, Lijing L Yan1,3, Hua-Shuai Chen4
1Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
Insights
High allostatic load (AL) increases mortality risk in older Chinese men but not women. Targeted interventions for modifiable AL factors could extend lifespan for elderly men in China.
Area of Science:
- Gerontology and Public Health
- Epidemiology
- Biomedical Sciences
Background:
- Allostatic load (AL) is linked to adverse health outcomes, yet its impact on China's large aging population remains understudied.
- Understanding AL's role is crucial for public health strategies in aging societies.
Purpose of the Study:
- To investigate the association between allostatic load (AL) and all-cause mortality in Chinese adults aged 60 and above.
- To differentiate these associations by sex.
Main Methods:
- A population-based prospective cohort study utilizing data from the Chinese Longitudinal Healthy Longevity Survey (2011-2012).
- Included 1519 participants (mean age: men 80.5, women 90.2 years) with blood test data.
- Cox proportional hazards models analyzed AL and mortality, adjusting for confounders.
Main Results:
- Higher allostatic load (AL) burden (scores 2-9) was significantly associated with increased all-cause mortality in men (33% and 118% higher hazard for medium and high AL, respectively).
- No significant association between AL burden and all-cause mortality was observed in women.
- Key confounders adjusted for included age, ethnicity, education, marital status, smoking, and exercise.
Conclusions:
- Increased allostatic load (AL) burden is a significant predictor of all-cause mortality in older Chinese men.
- Intervention programs focusing on modifiable AL components may be effective in prolonging lifespan for older Chinese men.
- Further research is needed to understand the sex-specific differences in AL's impact on mortality.
Background:
Allostatic load (AL) has shown that high burden of AL is associated with increased risk of adverse outcomes, but little attention has been paid to China with largest ageing population in the world.
Objective:
This study is to examine the association between AL and all-cause mortality among Chinese adults aged at least 60 years.
Design:
Population-based prospective cohort study.
Setting:
In 2011-2012, an ancillary study, in which a blood test was added, including a total of 2439 participants, was conducted in eight longevity areas in the Chinese Longitudinal Healthy Longevity Survey.
Participants:
The final analytical sample consisted of 1519 participants (mean±SD age: men 80.5±11.3 years; women 90.2±11.8 years and 53% women).
Primary Outcome Measure:
Cox models were used to examine the association between AL and mortality among men and women, separately. Analyses were also adjusted for potential confounders including age, ethnicity, education and marital status, smoking and exercise.
Results:
Male with a medium AL burden (score: 2-4) and high AL burden (score: 5-9) had a 33% and 118% higher hazard of death, respectively, than those with a low AL burden (score: 0-1). We did not find significant difference between females with different levels of AL burden.
Conclusion:
Higher AL burden was associated with increased all-cause mortality among Chinese men aged at least 60 years. However, we did not find strong association among women. In conclusion, Intervention programmes targeting modifiable components of the AL burden may help prolong lifespan for older adults, especially men, in China.
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