Lafortune Louise, Martin Steven, Kelly Sarah, Kuhn Isla, Remes Olivia, Cowan Andy, Brayne Carol
Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom.
University of Cambridge Medical Library, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom.
PLoS One. 2016 Feb 4;11(2):e0144405. doi: 10.1371/journal.pone.0144405. eCollection 2016.
Smoking, alcohol consumption, poor diet and low levels of physical activity significantly contribute to the burden of illness in developed countries. Whilst the links between specific and multiple risk behaviours and individual chronic conditions are well documented, the impact of these behaviours in mid-life across a range of later life outcomes has yet to be comprehensively assessed. This review aimed to provide an overview of behavioural risk factors in mid-life that are associated with successful ageing and the primary prevention or delay of disability, dementia, frailty and non-communicable chronic conditions.
A literature search was conducted to identify cohort studies published in English since 2000 up to Dec 2014. Multivariate analyses and a minimum follow-up of five years were required for inclusion. Two reviewers screened titles, abstracts and papers independently. Studies were assessed for quality. Evidence was synthesised by mid-life behavioural risk for a range of late life outcomes.
This search located 10,338 individual references, of which 164 are included in this review. Follow-up data ranged from five years to 36 years. Outcomes include dementia, frailty, disability and cardiovascular disease. There is consistent evidence of beneficial associations between mid-life physical activity, healthy ageing and disease outcomes. Across all populations studied there is consistent evidence that mid-life smoking has a detrimental effect on health. Evidence specific to alcohol consumption was mixed. Limited, but supportive, evidence was available relating specifically to mid-life diet, leisure and social activities or health inequalities.
There is consistent evidence of associations between mid-life behaviours and a range of late life outcomes. The promotion of physical activity, healthy diet and smoking cessation in all mid-life populations should be encouraged for successful ageing and the prevention of disability and chronic disease.
在发达国家，吸烟、饮酒、不良饮食和低水平身体活动显著加重了疾病负担。虽然特定及多种风险行为与个体慢性病之间的关联已有充分记录，但这些行为在中年时期对一系列晚年生活结局的影响尚未得到全面评估。本综述旨在概述中年时期与成功老龄化以及残疾、痴呆、衰弱和非传染性慢性病的一级预防或延迟相关的行为风险因素。
进行文献检索，以识别2000年至2014年12月期间以英文发表的队列研究。纳入研究要求进行多变量分析且随访至少五年。两名评审员独立筛选标题、摘要和论文。对研究进行质量评估。根据中年行为风险对一系列晚年生活结局的证据进行综合分析。
本次检索共找到10338条参考文献，其中164条纳入本综述。随访数据从五年到36年不等。结局包括痴呆、衰弱、残疾和心血管疾病。有一致证据表明中年时期的身体活动与健康老龄化及疾病结局之间存在有益关联。在所有研究人群中，均有一致证据表明中年吸烟对健康有不利影响。关于饮酒的证据不一。有有限但支持性的证据专门涉及中年饮食、休闲和社交活动或健康不平等。
有一致证据表明中年行为与一系列晚年生活结局之间存在关联。为实现成功老龄化以及预防残疾和慢性病，应鼓励所有中年人群增加身体活动、保持健康饮食并戒烟。
