Tsukinoki Rumi, Murakami Yoshitaka, Hayakawa Takehito, Kadota Aya, Harada Akiko, Kita Yoshikuni, Okayama Akira, Miura Katsuyuki, Okamura Tomonori, Ueshima Hirotsugu
Department of Public Health Nursing, Institute of Science Tokyo.
Department of Clinical Nursing, Shiga University of Medical Science.
J Epidemiol. 2025 Aug 5;35(8):349-354. doi: 10.2188/jea.JE20240298. Epub 2025 Jun 18.
Healthy life expectancy (HLE) is a population health indicator that is widely used in developed countries, but little is known about its relationships with combinations of non-communicable disease risk factors. This study was conducted to examine HLE at age 65 years according to combinations of blood pressure levels, body mass index, smoking status, and diabetes mellitus (DM) in a Japanese population.
In a nationwide cohort study (NIPPON DATA90), data on these risk factors were obtained from participants in 1990 through physical examinations, blood tests, interviews, and questionnaires. Subsequently, participants aged ≥65 years underwent surveys on activities of daily living in 1995 and 2000, and multistate life tables were used to calculate combination-specific HLEs and their 95% confidence intervals (CIs).
The study population comprised 6,569 participants (men: 2,797; women: 3,772) who were followed until 2010. HLE at age 65 years in men with grade II/III hypertension, obesity, current smoker status, and DM (HLE 12.9; 95% CI, 12.9-13.0 years) was 9.7 years shorter than men without these risk factors (HLE 22.6; 95% CI, 22.4-22.8 years). Similarly, HLE at age 65 years in women with grade II/III hypertension, obesity, current smoker status, and DM (HLE 16.2; 95% CI, 15.9-16.5 years) was 10.1 years shorter than women without these risk factors (HLE 26.3; 95% CI, 26.3-26.3 years).
The large discrepancies in HLEs underscore the impact of non-communicable disease risk factors, which should be considered when formulating health interventions to improve HLE in Japanese older adults.
健康预期寿命（HLE）是一项在发达国家广泛使用的人口健康指标，但对于其与非传染性疾病风险因素组合之间的关系，人们了解甚少。本研究旨在根据日本人群的血压水平、体重指数、吸烟状况和糖尿病（DM）组合情况，对65岁时的健康预期寿命进行研究。
在一项全国性队列研究（日本数据90）中，1990年通过体格检查、血液检测、访谈和问卷调查收集了这些风险因素的数据。随后，年龄≥65岁的参与者在1995年和2000年接受了日常生活活动调查，并使用多状态生命表计算特定组合的健康预期寿命及其95%置信区间（CI）。
研究人群包括6569名参与者（男性：2797名；女性：3772名），随访至2010年。患有II/III级高血压、肥胖、当前吸烟且患有糖尿病的65岁男性的健康预期寿命（HLE 12.9；95%CI，12.9 - 13.0年）比没有这些风险因素的男性短9.7年（HLE 22.6；95%CI，22.4 - 22.8年）。同样，患有II/III级高血压、肥胖、当前吸烟且患有糖尿病的65岁女性的健康预期寿命（HLE 16.2；95%CI，15.9 - 16.5年）比没有这些风险因素的女性短10.1年（HLE 26.3；95%CI，26.3 - 26.3年）。
健康预期寿命的巨大差异凸显了非传染性疾病风险因素的影响，在制定改善日本老年人健康预期寿命的健康干预措施时应予以考虑。
