Correlation between healthy lifestyle score and all-cause death in rural and urban elderly of Beijing
Objective To explore the correlation between healthy lifestyle score and all-cause death in rural and urban elderly of Beijing,and provide the scientific basis for health behaviour intervention for elderly in different residence areas.Methods The data were from the Beijing Elderly Comprehensive Health Cohort Study(BECHCS).In 2009 and 2014,the multi-stage cluster random sampling method was used to selecct 4 499 elderly residents(≥60 years old)from Wanshou road of Haidian district,Jugezhuang town and fengjiayu town of Miyun district in Beijing as the subjents.The investigation was performed with questionnaires,physical examinations and laboratory testing.Follow-up visits were conducted every 2 to 3 years until March 31,2021.According to smoking,drinking,exercise and physique,healthy lifestyle score(0-4 scores)was established.The healthy lifestyle score was divided into low risk healthy lifestyle group(4 scores),medium-risk healthy lifestyle group(2-3 scores)and high risk healthy lifestyle group(0-1 scores).The t test,x2 test and non-parametric test were used to analyze the data,the used softwares were SPSS 26.0 and R 4.2.1.Cumulative risk curves of the urban and rural elderly population under different healthy lifestyle scores were drawn by the Kaplan-Meier method.The log-rank test was used to compare survival rates and survival time under different healthy lifestyle scores.The multivariable Cox proportional risk regression model was used to analyze the correlation between healthy lifestyle score and all-cause death of urban and rural elderly residents.Effect analysis was conducted on single healthy lifestyle and interaction.Results Among 4 499 elderly residents,numbers of rural residents and urban residents were 2 397 cases(53.3％)and 2 102 cases(46.7％),respectively.Median follow-up time was 6.76 years(P25-P75:6.63-11.27 years).The numbers of elderly residents with healthy lifestyle score 0-4 scores were 201 cases(4.5％),823 cases(18.3％),1 442 cases(32.0％),1 468 cases(32.6％)and 565 cases(12.6％),respectively.A total of 667 cases died during follow-up.The death density was 182.26/104 person-years,the rural death density was 191.06/104 person-years,and urban death density was 177.46/104 person-years.Multivariate Cox regression analysis revealed that when one healthy lifestyle increased,the risk of all-cause death in the total elderly reduced by 13.7％(HR=0.863,95％CI:0.747-0.997,P＜0.05);the risk of all-cause death in urban elderly decreased by 24.1％(HR=0.759,95％CI:0.631-0.915,P＜0.01).The Cox regression analysis of a single healthy lifestyle factor showed that the risk of all-cause death in never smoking subjects decreased by 26.2％(HR=0.738,95％CI:0.610-0.893,P＜0.01).The risk of all-cause death in urban never smoking and exercise subjects decreased by 31.0％(HR=0.690,95％CI:0.544-0.875)and 24.7％(HR=0.753,95％CI:0.600-0.946,P＜0.05 or P＜0.01).There were multiplicative interactions between smoking status and healthy body shape in urban elderly residents(HR=0.639,95％CI:0.415-0.986,P＜0.05),and between smoking status and exercise in rural elderly residents status(HR=0.557,95％CI:0.343-0.904,P＜0.05).Conclusion The low-risk healthy lifestyle score positively correlated to the reduced all-cause death in the urban elderly residents of Beijing.However,there is no significant corrlation between low-risk healthy lifestyle score and all-cause death.It should take the investigation in further.
Healthy lifestyleElderlyUrban-rural differencesAll-cause death
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NSTL
万方数据
