Kou Minghao, Ma Hao, Wang Xuan, Heianza Yoriko, Qi Lu
Department of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
NPJ Aging. 2025 Jan 25;11(1):3. doi: 10.1038/s41514-024-00190-0.
Objective and subjective aging indicators reflect diverse biological and psychosocial processes, yet their combined association with premature mortality remains underexplored. This study aimed to investigate the association between a multidomain framework of aging indicators and premature mortality, addressing gaps in understanding cumulative effects. We included 369,741 UK Biobank participants initially free of cardiovascular disease (CVD) and cancer, followed until December 31, 2022. Four indicators, hearing loss, tooth loss, falls and subjective aging, were counted, and their joint associations with all-cause and cause-specific premature mortality were analyzed using the Cox proportional hazard models. During a median follow-up of 13.74 years, we documented 22,934 premature mortality. Participants with all indicators had an 81% (95%CI: 59-107%), 96% (47-160%), 55% (26-91%), and 114% (73-165%) higher risk of all-cause, CVD, cancer, and other-cause premature mortality, respectively, compared to those without indicators. The associations were particularly elevated among younger participants, those with unhealthy lifestyles, and those of lower socioeconomic status (P for interactions <0.05). Additive interaction with frailty contributed an additional 16.08% (7.91-24.25%) risk of premature mortality. Findings were replicated in the Health and Retirement Study, supporting the robustness of the multidomain aging framework. This study highlights the potential of integrating objective and subjective aging indicators to refine risk assessments and inform interventions targeting aging-related diseases.
客观和主观衰老指标反映了不同的生物和心理社会过程,然而它们与过早死亡的综合关联仍未得到充分探索。本研究旨在调查衰老指标多领域框架与过早死亡之间的关联,以填补对累积效应理解上的空白。我们纳入了369741名英国生物银行的参与者,这些参与者最初没有心血管疾病(CVD)和癌症,随访至2022年12月31日。统计了听力损失、牙齿脱落、跌倒和主观衰老这四个指标,并使用Cox比例风险模型分析了它们与全因和特定病因过早死亡的联合关联。在中位随访13.74年期间,我们记录了22934例过早死亡。与没有这些指标的参与者相比,有所有指标的参与者全因过早死亡风险高81%(95%CI:59 - 107%)、CVD过早死亡风险高96%(47 - 160%)、癌症过早死亡风险高55%(26 - 91%)、其他病因过早死亡风险高114%(73 - 165%)。这些关联在年轻参与者、生活方式不健康的参与者以及社会经济地位较低的参与者中尤为明显(交互作用P<0.05)。与衰弱的相加交互作用导致过早死亡风险额外增加16.08%(7.91 - 24.25%)。研究结果在健康与退休研究中得到了重复,支持了多领域衰老框架的稳健性。本研究强调了整合客观和主观衰老指标以完善风险评估并为针对衰老相关疾病的干预提供信息的潜力。