Lifestyles, leisure activities, subjective well-being, and long-term survival after age 80 in China: a...

Evidence on whether modifiable behaviours, leisure engagement, and subjective well-being jointly shape longevity in the oldest-old (≥80 years) remains limited, especially in China. We aimed to examine the associations between modifiable factors and survival after age 80 in China.

This study comprised 30,398 participants aged 80 years and over, drawn from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 1998-2018). Lifestyles (smoking status, drinking status, physical activity, and plant-based diet index), leisure activities (mental, physical, productive, and social activity), and subjective well-being were assessed using structured interviews. Median age at death after age 80 was estimated using Laplace regression.

During follow-up, 21,648 (71.2%) participants died. Having healthy lifestyles (never smoking [4.2 months], never drinking [1.6 months], engaging in physical activity [3.4 months], eating healthful diet [2.2 months]), engaging in leisure activities (mental: 3.2 months; physical: 8.7 months; productive: 2.0 months; social: 2.8 months), and reporting high subjective well-being (5.4 months), were found to have significantly longer survival times. The median survival of people with a low-risk profile (maintained at least three healthy lifestyles, engaged in at least one leisure activity, and reported medium or high subjective well-being) was 18 months (95% CI 15.5 to 19.8) longer than that of those with a high-risk profile (unhealthy lifestyle, engaged in no leisure activities, and reported low subjective well-being).

The study findings have demonstrated that adopting a healthy lifestyle, engaging in leisure activities, and fostering subjective well-being are associated with longer life expectancy among the oldest old in China.