Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
Department of Medicine, Larner College of Medicine, University of Vermont, Burlington.
JAMA Netw Open. 2024 Jun 3;7(6):e2417931. doi: 10.1001/jamanetworkopen.2024.17931.
Previous studies have reported that lifestyle factors were associated with life expectancy and/or mortality, but most of them studied the middle-aged or older age groups (aged ≥60 years), and few focused on people aged 80 years or older.
To examine healthy lifestyle and the likelihood of becoming centenarians among people aged 80 years or older in China.
DESIGN, SETTINGS, AND PARTICIPANTS: Using data from the Chinese Longitudinal Healthy Longevity Survey, a nationally representative and one of the largest prospective cohorts targeting people aged 80 years or older established in 1998, a community-based, prospective nested case-control study was performed. Data were analyzed from December 1, 2022, to April 15, 2024.
A healthy lifestyle score for 100 (HLS-100, ranging from 0 to 6), including smoking, exercise, and dietary diversity, was constructed, with higher scores indicating potentially better health outcomes.
The primary outcome was survivorship to becoming a centenarian by 2018 (the end of follow-up). Information on sociodemographic characteristics, lifestyle factors, and other covariates was collected.
The sample comprised 5222 individuals (61.7% women, mean [SD] age, 94.3 [3.3] years), including 1454 identified centenarians and 3768 controls (died before becoming centenarians) matched by age, sex, and year of entry. During a median follow-up of 5 (IQR, 3-7) years, 373 of 1486 individuals among the lowest HLS-100 (0-2) group and 276 of 851 individuals among the highest HLS-100 (5-6) group became centenarians. The adjusted odds ratio (AOR) comparing the highest vs the lowest HLS-100 groups was 1.61 (95% CI, 1.32-1.96; P < .001 for trend). An association was noted when we further treated centenarians with relatively healthy status as the outcome, as evaluated by self-reported chronic conditions, physical and cognitive function, and mental wellness (AOR, 1.54; 95% CI, 1.05-2.26). Similar results were observed in other sensitivity analyses.
In this case-control study of Chinese older adults, adhering to a healthy lifestyle appears to be important even at late ages, suggesting that constructing strategic plans to improve lifestyle behaviors among all older adults may play a key role in promoting healthy aging and longevity.
先前的研究报告称，生活方式因素与预期寿命和/或死亡率有关，但大多数研究都针对中年或老年人群（年龄≥60 岁），很少有研究关注 80 岁及以上的人群。
检验中国 80 岁及以上人群的健康生活方式与成为百岁老人的可能性。
设计、地点和参与者：使用 1998 年建立的全国代表性和最大的针对 80 岁及以上人群的前瞻性队列之一的中国长寿纵向研究的数据，进行了一项基于社区的前瞻性嵌套病例对照研究。数据分析于 2022 年 12 月 1 日至 2024 年 4 月 15 日进行。
构建了一个 100 分的健康生活方式评分（HLS-100，范围为 0 到 6），包括吸烟、运动和饮食多样性，得分越高表示潜在的健康结果越好。
主要结局是到 2018 年（随访结束时）成为百岁老人的生存情况。收集了社会人口特征、生活方式因素和其他协变量的信息。
样本包括 5222 人（61.7%为女性，平均[SD]年龄 94.3[3.3]岁），包括 1454 名确定的百岁老人和 3768 名对照者（在成为百岁老人之前死亡），按年龄、性别和入组年份匹配。在中位随访 5 年（IQR，3-7 年）期间，最低 HLS-100（0-2）组的 373 名个体和最高 HLS-100（5-6）组的 276 名个体成为了百岁老人。与最低 HLS-100 组相比，最高 HLS-100 组的调整后比值比（AOR）为 1.61（95%CI，1.32-1.96；趋势 P<0.001）。当我们进一步将自评身体健康状况较好的百岁老人作为结果进行评估时，这种关联仍然存在，评估指标包括慢性疾病、身体和认知功能以及心理健康状况（AOR，1.54；95%CI，1.05-2.26）。在其他敏感性分析中也观察到了类似的结果。
在这项针对中国老年人的病例对照研究中，即使在晚年，坚持健康的生活方式似乎也很重要，这表明制定改善所有老年人生活方式行为的战略计划可能在促进健康老龄化和长寿方面发挥关键作用。
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