Lyu Y B, Zhang J, Luo J S, Shi W H, Yin Z X, Su L Q, Fang J L, Wang J N, Shi X M
National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Nov 6;51(11):1028-1032. doi: 10.3760/cma.j.issn.0253-9624.2017.11.014.
To investigate the influence factors of survival outcome among elderly aged ≥80 years old. In baseline survey in 2009, 930 participants aged ≥80 years old were enrolled from 7 longevity areas, to collect the information of socioeconomic factors, life style, cognitive function, activities of daily living and diseases, as well as physical examination to test biomarkers of blood and urine. The survival status was followed up at 2012 and 2014 survey. Stepwise Cox proportional hazards models were used to screen influence factors of 5-year survival. During 5 years of follow-up, 571 participants died, 133 participants were lost to follow up, and the all-cause mortality was 63.4%. In stepwise Cox proportional hazards models, male, unmarried, self-reported poor life quality, disability in daily life, cognitive impairment, cardiovascular and cerebrovascular diseases, chronic kidney diseases were risk factors for elderly survival outcome, with the (95%) at 1.75 (1.40-2.12), 1.49 (1.10-2.03), 1.40 (1.16-1.69), 1.37 (1.11-1.70), 1.51 (1.22-1.88), 1.62 (1.18-2.23) and 1.48 (1.23-1.77) respectively. Each 1 year increase in age corresponded to 4% increase in mortality risk ( (95%)=1.04 (1.02-1.05)); each 1 kg/m(2) increase in BMI corresponded to 5% increase in mortality risk ( (95%)=0.95 (0.93-0.98)); each 1.0×10(9)/L increase in total lymphocyte count (TLC) corresponded to 13% increase in mortality risk ( (95%)=0.87 (0.76-0.99)). Additionally, the mortality risk decreased 19% ( (95%)=0.81 (0.66-0.98)) in participants with regularly physical exercise compared to those without; and the mortality risk decreased 41% ( (95% )=0.59 (0.40-0.88)) in participants with elevated triglycerides (TG, ≥2.26 mmol/L) compared to those without. In Chinese longevity areas, some nutritional and immune indices such as relatively higher level of BMI, TLC and TG were independent protective factors for 5-year survival outcome, which was different from general adults and younger elderly.
为探讨80岁及以上老年人生存结局的影响因素。在2009年的基线调查中，从7个长寿地区招募了930名80岁及以上的参与者，收集社会经济因素、生活方式、认知功能、日常生活活动和疾病信息，以及进行身体检查以检测血液和尿液中的生物标志物。在2012年和2014年的调查中对生存状况进行随访。采用逐步Cox比例风险模型筛选5年生存的影响因素。在5年的随访期间，571名参与者死亡。133名参与者失访，全因死亡率为63.4%。在逐步Cox比例风险模型中，男性、未婚、自我报告生活质量差、日常生活残疾、认知障碍、心脑血管疾病、慢性肾脏疾病是老年人生存结局的危险因素，其（95%）置信区间分别为1.75（1.40 - 2.12）、1.49（1.10 - 2.03）、1.40（1.16 - 1.69）、1.37（1.11 - 1.70）、1.51（1.22 - 1.88）、1.62（1.18 - 2.23）和1.48（1.23 - 1.77）。年龄每增加1岁，死亡风险增加4%（（95%）置信区间 = 1.04（1.02 - 1.05））；体重指数（BMI）每增加1kg/m²，死亡风险增加5%（（95%）置信区间 = 0.95（0.93 - 0.9））；总淋巴细胞计数（TLC）每增加1.0×10⁹/L，死亡风险增加13%（（95%）置信区间 = 0.87（0.76 - 0.99））。此外，与未进行定期体育锻炼的参与者相比，进行定期体育锻炼的参与者死亡风险降低19%（（95%）置信区间 = 0.81（0.66 - 0.98））；与甘油三酯（TG）正常的参与者相比，甘油三酯升高（TG≥2.26mmol/L）的参与者死亡风险降低41%（（95%）置信区间 = 0.59（0.40 - 0.88））。在中国长寿地区，一些营养和免疫指标，如相对较高水平的BMI、TLC和TG是5年生存结局的独立保护因素，这与一般成年人和年轻老年人不同。
