[Association between lifestyle and risk for all-cause mortality in middle-aged and elderly residents in China: a...

Objective: To investigate the prospective association between lifestyle and the risk for all-cause mortality in middle-aged and elderly residents in China. Methods: The data from China Health and Retirement Longitudinal Study were used. Baseline information about the lifestyle were collected through questionnaire survey and physical measurements, and the mortality data were obtained through surveys conducted at 2-3 year intervals. A total of 5 436 study participants were included. A comprehensive lifestyle including smoking, alcohol consumption, sleep, BMI and physical activity was constructed, and a multivariate-adjusted Cox proportional hazards regression model was used to estimate the association between lifestyle and the risk for all-cause mortality. Results: During the follow-up of average 8.2 years, 695 deaths were recorded. The comprehensive lifestyle score was linearly associated with the risk for all-cause mortality. Compared with the study participants with comprehensive lifestyle score of 0-1, those with score of 2-5 all had lower risk for all-cause mortality, with HRs of 0.78 (95%CI: 0.62-0.98), 0.56 (95%CI: 0.44-0.72), 0.36 (95%CI:0.27-0.48), and 0.33 (95%CI: 0.21-0.52), respectively. The results of Cox proportional hazards regression model analysis of single lifestyle showed that compared with those with unhealthy lifestyles, the HRs of all-cause mortality for study participants who never smoked, had moderate alcohol consumption, had appropriate night sleep, maintained healthy body weight and kept active physical activity were 0.70 (95%CI: 0.57-0.84), 0.76 (95%CI: 0.64-0.90), 0.79 (95%CI: 0.67-0.94), 0.73 (95%CI: 0.62-0.87), and 0.68 (95%CI: 0.58-0.80), respectively. Conclusions: Keeping healthy lifestyles can significantly reduce the risk for all-cause mortality in middle-aged and elderly residents China. The higher the healthy lifestyle level, the lower the risk for all-cause mortality.