Dong Chao, Mather Karen A, Brodaty Henry, Sachdev Perminder S, Trollor Julian, Harrison Fleur, Bliuc Dana, Ivers Rebecca, Rhee Joel, Dai Zhaoli
Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney 2052, Australia.
Australia National Centre of Excellence in Intellectual Disability Health, School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney 2052, Australia.
Nutrients. 2025 Feb 25;17(5):796. doi: 10.3390/nu17050796.
Limited research has examined how older adults' lifestyles intersect with multimorbidity to influence mortality risk. In this community-dwelling prospective cohort, the Sydney Memory and Ageing Study, principal component analysis was used to identify lifestyle patterns using baseline self-reported data on nutrition, lifestyle factors, and social engagement activities. Multimorbidity was defined by self-reported physician diagnoses. Multivariable logistic regression was used to estimate odds ratios (ORs) for multimorbidity cross-sectionally, and Cox proportional hazards models were used to assess hazard ratios (HRs) for mortality risk longitudinally. Of 895 participants (mean age: 78.2 years; 56.3% female) with complete lifestyle data, 597 had multimorbidity. Two distinct lifestyle patterns emerged: (i) a nutrition pattern characterised by higher intakes of protein, fibre, iron, zinc, magnesium, potassium, and folate, and (ii) an exercise-sleep-social pattern marked by weekly physical activities like bowling, bicycling, sleep quality (low snoring/sleepiness), and high social engagement. Neither pattern was associated with multimorbidity cross-sectionally. Over a median 5.8-year follow-up (n = 869; 140 deaths), participants in the upper tertiles for combined lifestyle pattern scores had a 20% lower mortality risk than those in the lowest tertile [adjusted HR: 0.80 (95% CI: 0.65-0.97); -trend = 0.02]. This association was stronger in participants with multimorbidity, with a 29% lower risk [0.71 (0.56-0.89); -trend = 0.01], likely due to multimorbidity modifying the relationship between nutrition and mortality risk (-interaction < 0.05). While multimorbidity did not modify the relationship between the exercise-sleep-social pattern and risk of mortality, it was consistently associated with a 19-20% lower risk (-trend < 0.03), regardless of the multimorbidity status. Older adults with multimorbidity may particularly benefit from adopting healthy lifestyles focusing on nutrition, physical activity, sleep quality, and social engagement to reduce their mortality risk.
仅有有限的研究探讨了老年人的生活方式与多种疾病并存如何相互作用以影响死亡风险。在这项名为悉尼记忆与衰老研究的社区居住前瞻性队列研究中，主成分分析被用于利用关于营养、生活方式因素和社交活动的基线自我报告数据来确定生活方式模式。多种疾病并存由自我报告的医生诊断来定义。多变量逻辑回归用于横断面估计多种疾病并存的优势比（OR），而Cox比例风险模型用于纵向评估死亡风险的风险比（HR）。在895名拥有完整生活方式数据的参与者（平均年龄：78.2岁；56.3%为女性）中，597人患有多种疾病。出现了两种不同的生活方式模式：（i）一种营养模式，其特征是蛋白质、纤维、铁、锌、镁、钾和叶酸的摄入量较高，以及（ii）一种运动 - 睡眠 - 社交模式，其特点是每周进行保龄球、骑自行车等体育活动、睡眠质量（低打鼾/嗜睡）以及高社交参与度。这两种模式在横断面上均与多种疾病并存无关。在中位5.8年的随访期（n = 869；140例死亡）内，综合生活方式模式得分处于上三分位数的参与者的死亡风险比处于最低三分位数的参与者低20%[调整后的HR：0.80（95%CI：0.65 - 0.97）；P趋势 = 0.02]。这种关联在患有多种疾病的参与者中更强，风险降低29%[0.71（0.56 - 0.89）；P趋势 = 0.01]，这可能是因为多种疾病并存改变了营养与死亡风险之间的关系（交互作用P < 0.05）。虽然多种疾病并存并未改变运动 - 睡眠 - 社交模式与死亡风险之间的关系，但无论多种疾病并存状态如何，它始终与风险降低19 - 20%相关（P趋势 < 0.03）。患有多种疾病的老年人可能尤其受益于采取注重营养、体育活动、睡眠质量和社交参与的健康生活方式，以降低他们的死亡风险。
