Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China.
Department of Biostatistics, School of Public Health, Peking University, Beijing, China.
Geroscience. 2024 Feb;46(1):1241-1257. doi: 10.1007/s11357-023-00891-6. Epub 2023 Aug 1.
The healthy aging index (HAI) has been recently developed as a surrogate measure of biological age. However, to what extent the HAI is associated with all-cause and cause-specific mortality and whether this association differs in younger and older adults remains unknown. We aimed to quantify the association between the HAI and mortality in a population of UK adults. In the prospective cohort study, data are obtained from the UK Biobank. Five HAI components (systolic blood pressure, reaction time, cystatin C, serum glucose, forced vital capacity) were scored 0 (healthiest), 1, and 2 (unhealthiest) according to sex-specific tertiles or clinically relevant cut-points and summed to construct the HAI (range 0-10). Cox proportional hazard regression models were used to estimate the associations of the HAI with the risk of all-cause and cause-specific mortality. 387,794 middle-aged and older participants were followed up for a median of 8.9 years (IQR 8.3-9.5). A total of 14,112 all-cause deaths were documented. After adjustments, each 1-point increase in the HAI was related to a higher risk of all-cause mortality (hazards ratio [HR], 1.17; 95%CI, 1.15-1.18). Such association was stronger among adults younger than 60 years (1.19, 1.17-1.21) than that among those 60 years and older (1.15, 1.14-1.17) (P interaction < 0.001). For each unit increment of the HAI, the multivariate-adjusted HRs for risk of death were 1.28 (1.25-1.31) for cardiovascular diseases, 1.09 (1.07-1.10) for cancer, 1.36 (1.29-1.44) for digestive disease, 1.42 (1.35-1.48) for respiratory disease, 1.42 (1.33-1.51) for infectious diseases, and 1.15 (1.09-1.21) for neurodegenerative disease, respectively. Our findings indicate that the HAI is positively associated with all-cause and cause-specific mortality independent of chronological age. Our results further underscore the importance of effective early-life interventions to slow aging and prevent premature death.
健康老龄化指数 (HAI) 最近被作为生物年龄的替代指标而发展起来。然而，HAI 与全因死亡率和特定原因死亡率的关联程度，以及这种关联在年轻和老年人群中的差异程度尚不清楚。我们旨在量化英国成年人中 HAI 与死亡率之间的关联。在这项前瞻性队列研究中，数据来自英国生物库。根据性别特异性三分位或临床相关切点，将 5 个 HAI 成分（收缩压、反应时间、胱抑素 C、血清葡萄糖、用力肺活量）评为 0（最健康）、1 和 2（最不健康），并将其相加构建 HAI（范围 0-10）。使用 Cox 比例风险回归模型估计 HAI 与全因死亡率和特定原因死亡率风险的关联。387794 名中老年人中位随访时间为 8.9 年（IQR 8.3-9.5）。共记录到 14112 例全因死亡。调整后，HAI 每增加 1 分，全因死亡率的风险就会增加（风险比 [HR]，1.17；95%CI，1.15-1.18）。这种关联在 60 岁以下成年人中更强（1.19，1.17-1.21），而在 60 岁及以上成年人中较弱（1.15，1.14-1.17）（P 交互<0.001）。对于 HAI 的每一个单位增加，多变量调整后的 HR 分别为心血管疾病 1.28（1.25-1.31）、癌症 1.09（1.07-1.10）、消化疾病 1.36（1.29-1.44）、呼吸疾病 1.42（1.35-1.48）、传染病 1.42（1.33-1.51）和神经退行性疾病 1.15（1.09-1.21）。我们的研究结果表明，HAI 与全因死亡率和特定原因死亡率呈正相关，与实际年龄无关。我们的结果进一步强调了在生命早期进行有效干预以减缓衰老和预防过早死亡的重要性。
