Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
School of Public Health, Imperial College London, London, UK.
BMJ Open. 2021 Aug 3;11(8):e045369. doi: 10.1136/bmjopen-2020-045369.
Allostatic load (AL) has shown that high burden of AL is associated with increased risk of adverse outcomes, but little attention has been paid to China with largest ageing population in the world.
This study is to examine the association between AL and all-cause mortality among Chinese adults aged at least 60 years.
Population-based prospective cohort study.
In 2011-2012, an ancillary study, in which a blood test was added, including a total of 2439 participants, was conducted in eight longevity areas in the Chinese Longitudinal Healthy Longevity Survey.
The final analytical sample consisted of 1519 participants (mean±SD age: men 80.5±11.3 years; women 90.2±11.8 years and 53% women).
Cox models were used to examine the association between AL and mortality among men and women, separately. Analyses were also adjusted for potential confounders including age, ethnicity, education and marital status, smoking and exercise.
Male with a medium AL burden (score: 2-4) and high AL burden (score: 5-9) had a 33% and 118% higher hazard of death, respectively, than those with a low AL burden (score: 0-1). We did not find significant difference between females with different levels of AL burden.
Higher AL burden was associated with increased all-cause mortality among Chinese men aged at least 60 years. However, we did not find strong association among women. In conclusion, Intervention programmes targeting modifiable components of the AL burden may help prolong lifespan for older adults, especially men, in China.
压力负荷(AL)表明,高 AL 负担与不良结局风险增加相关,但对于拥有全球最大老年人口的中国,这方面的关注较少。
本研究旨在检验中国≥60 岁成年人的 AL 与全因死亡率之间的关系。
基于人群的前瞻性队列研究。
2011-2012 年,在中国长寿地区开展了一项辅助研究,其中包括了 2439 名参与者的血液检测。
最终分析样本包括 1519 名参与者(男性平均年龄±标准差为 80.5±11.3 岁,女性为 90.2±11.8 岁,女性占 53%)。
分别使用 Cox 模型检验男性和女性 AL 与死亡率之间的关系。分析还调整了潜在的混杂因素,包括年龄、种族、教育程度和婚姻状况、吸烟和运动。
中 AL 负担(评分:2-4)和高 AL 负担(评分:5-9)的男性死亡风险分别比低 AL 负担(评分:0-1)的男性高 33%和 118%。我们没有发现女性不同 AL 负担水平之间存在显著差异。
较高的 AL 负担与中国≥60 岁男性的全因死亡率增加相关。然而,我们没有发现女性之间有很强的关联。总之,针对 AL 负担可改变成分的干预计划可能有助于延长中国老年人,尤其是男性的寿命。