School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144, USA.
BMC Public Health. 2012 Sep 18;12:803. doi: 10.1186/1471-2458-12-803.
This study examines the mortality risk associated with distinct combinations of multiple risk behaviors in middle-aged and older adults, and assesses whether the mortality risks of certain health behaviors are moderated by the presence of other risk behaviors.
Data for this prospective cohort study are from the Health and Retirement Study (HRS), a nationwide sample of adults older than 50 years. Baseline data are from respondents (n = 19,662) to the 1998 wave of the HRS. Twelve distinct health behavior profiles were created, based on each respondent's smoking, physical activity, and alcohol use status in 1998. Mortality risk was estimated through 2008 using Cox regression.
Smoking was associated with elevated risk for mortality within all behavioral profiles, but risk was greatest when combined with heavy drinking, both for middle-aged (ages 51-65) and older (ages 66+) adults. Profiles that included physical inactivity were also associated with increased mortality risk in both age groups. However, the impact of inactivity was clearly evident only among non-smokers; among smokers, the risk of inactivity was less evident, and seemingly overshadowed by the risk of smoking. Moderate drinking was protective relative to abstinence among non-smokers, and relative to heavy drinking among smokers.
In both middle-aged and older adults, multiple unhealthy behaviors increase mortality risk. However, the level of risk varies across unique combinations of unhealthy behaviors. These findings highlight the role that lifestyle improvements could play in promoting healthy aging, and provide insight into which behavioral combinations should receive top priority for intervention.
本研究考察了中年和老年人多种风险行为不同组合与死亡风险的相关性，并评估了某些健康行为的死亡风险是否受到其他风险行为的影响。
本前瞻性队列研究的数据来自健康与退休研究（HRS），这是一个全国性的 50 岁以上成年人样本。基线数据来自于 HRS 1998 年波次的受访者（n=19662）。根据受访者在 1998 年的吸烟、身体活动和饮酒状态，创建了 12 种不同的健康行为特征。通过 Cox 回归，利用 2008 年的死亡数据估计了死亡率风险。
吸烟与所有行为特征中的死亡风险增加相关，但在中年（51-65 岁）和老年（66 岁及以上）成年人中，与重度饮酒结合时风险最高。在两个年龄组中，包括身体不活动的特征也与死亡率风险增加相关。然而，不活动的影响仅在不吸烟者中明显；在吸烟者中，不活动的风险不太明显，且似乎被吸烟的风险所掩盖。与不吸烟者的戒酒相比，适度饮酒具有保护作用，与吸烟者的重度饮酒相比也是如此。
在中年和老年人中，多种不健康行为会增加死亡风险。然而，风险水平因不健康行为的独特组合而异。这些发现突出了生活方式改善在促进健康老龄化方面的作用，并提供了有关应优先干预哪些行为组合的见解。
