China Population and Development Research Center, Beijing 100081, China.
Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China.
Nutrients. 2024 Apr 26;16(9):1297. doi: 10.3390/nu16091297.
Both cognitive decline and unhealthy lifestyles have been linked to an elevated risk of mortality in older people. We aimed to investigate whether a healthy lifestyle might modify the association between cognitive function and all-cause mortality in Chinese older populations.
The final analysis included 5124 individuals free of dementia, selected from the Chinese Longitudinal Healthy Longevity Survey from 2011 to 2018. Cognitive function was assessed in 2011 using the Mini-Mental State Examination (MMSE). A lifestyle score was calculated based on five lifestyle factors, including smoking, alcohol consumption, physical activity, diet, and body mass index. Cox proportional hazards models were performed to evaluate the association between baseline cognitive function and the risk of all-cause mortality, with an interaction term of cognitive function and lifestyle score being added to the models.
The average age of participants was 81.87 years old at baseline. During a median follow-up of 6.4 years, 1461 deaths were documented. Both higher cognitive function (HR: 0.96; 95% CI: 0.96-0.97) and a healthier lifestyle (HR: 0.92; 95% CI: 0.87-0.97) were significantly associated with a reduced risk of mortality. We found that lifestyle significantly modified the association of cognitive function with mortality ( for interaction = 0.004). The inverse relation between cognitive function and mortality was found to be more pronounced among participants with a healthier lifestyle. Of note, among the lifestyle scores component, diet showed a significant interaction with mortality ( for interaction = 0.003), and the protective HR of the all-cause mortality associated with higher MMSE scores was more prominent among participants with healthy diets compared with unhealthy diets.
Our study indicates that cognitive decline is associated with a higher risk of mortality, and such associations are attenuated by maintaining a healthy lifestyle, with a particular emphasis on healthy diet.
认知能力下降和不健康的生活方式与老年人死亡率升高有关。我们旨在探讨健康的生活方式是否可以改变中国老年人群认知功能与全因死亡率之间的关联。
最终分析纳入了 2011 年至 2018 年中国长寿纵向研究中无痴呆的 5124 名个体。2011 年使用简易精神状态检查（MMSE）评估认知功能。基于 5 个生活方式因素（包括吸烟、饮酒、身体活动、饮食和体重指数）计算生活方式评分。使用 Cox 比例风险模型评估基线认知功能与全因死亡率之间的关系，并在模型中加入认知功能与生活方式评分的交互项。
参与者的平均年龄为 81.87 岁。在中位随访 6.4 年期间，记录了 1461 例死亡。较高的认知功能（HR：0.96；95%CI：0.96-0.97）和更健康的生活方式（HR：0.92；95%CI：0.87-0.97）均与死亡率降低显著相关。我们发现生活方式显著改变了认知功能与死亡率之间的关系（交互作用检验=0.004）。在生活方式评分中，饮食与死亡率的交互作用具有统计学意义（交互作用检验=0.003），与较高的 MMSE 评分相关的全因死亡率的保护 HR 在饮食健康的参与者中比饮食不健康的参与者更为显著。
本研究表明认知能力下降与死亡率升高相关，而通过保持健康的生活方式可以减弱这种关联，特别是要注意健康饮食。
