Guo Yujia, Yang Fan
School of Social Development and Public Policy, Fudan University, Shanghai, China.
School of Public Health, Fudan University, Shanghai, China.
J Glob Health. 2025 Jul 1;15:04181. doi: 10.7189/jogh.15.04181.
Global population ageing necessitates identifying modifiable factors for healthy longevity. Hobby engagement emerges as a promising yet unexplored factor; evidence of its protective effects on all-cause and cause-specific mortality risk has never been examined at a multinational level.
We investigated hobby engagement and mortality risk among 79 464 adults aged ≥50 across 19 countries using harmonised longitudinal ageing cohorts. Cox proportional hazards models examined associations between hobby engagement and all-cause mortality. Competing risk models assessed cause-specific mortality. Marginal structural models evaluated the impact of change patterns in hobby engagement over time.
Hobby engagement was associated with a 29% reduction in all-cause mortality risk across 19 countries (pooled hazard ratio (HR) = 0.71; 95% confidence interval (CI) = 0.67, 0.75). Population attributable fractions ranged from 3.03% (in Denmark) to 23.56% (in China), with potential gains in life expectancy from 0.06 years (in China) to 1.02 years (in Sweden) over five years. Region-specific protective effects emerged: reduced mortality from endocrine/metabolic (subhazard ratio (SHR) = 0.31) and neurological conditions (SHR = 0.51) in the USA; cardiovascular mortality (SHR = 0.56) in England; and heart attack (SHR = 0.77), stroke (SHR = 0.62), other cardiovascular-related illnesses (SHR = 0.82), and respiratory disease (SHR = 0.68) in Europe. Hobby engagement patterns varied dramatically across countries, from predominant non-engagement in China (65.1%) to high sustained engagement in Northern Europe (>90%). Both initiating (pooled HR = 0.62) and sustaining (pooled HR = 0.45) hobby engagement were associated with a reduction in mortality risk compared to sustained non-engagement, while cessation eliminated these protective associations (pooled HR = 0.96; 95% CI = 0.88, 1.04). Benefits were more pronounced among adults aged ≥65 and married individuals.
Hobby engagement is a potentially universal, modifiable factor for promoting global healthy longevity. Public health strategies prioritising initiating and maintaining hobby engagement could yield substantial survival benefits, particularly in countries with predominant non-engagement patterns and high preventable mortality.
全球人口老龄化使得确定健康长寿的可改变因素成为必要。参与业余爱好成为一个有前景但尚未被探索的因素；其对全因死亡率和特定病因死亡率风险的保护作用从未在跨国层面进行过研究。
我们使用统一的纵向老龄化队列，调查了19个国家中79464名年龄≥50岁的成年人的业余爱好参与情况和死亡风险。Cox比例风险模型检验了业余爱好参与与全因死亡率之间的关联。竞争风险模型评估特定病因死亡率。边际结构模型评估了业余爱好参与随时间变化模式的影响。
在19个国家中，业余爱好参与与全因死亡率风险降低29%相关（合并风险比（HR）=0.71；95%置信区间（CI）=0.67，0.75）。人群归因分数从3.03%（丹麦）到23.56%（中国）不等，在五年内预期寿命的潜在增加从0.06年（中国）到1.02年（瑞典）。出现了特定区域的保护作用：在美国，内分泌/代谢疾病（亚风险比（SHR）=0.31）和神经系统疾病导致的死亡率降低；在英国，心血管疾病死亡率（SHR=0.56）降低；在欧洲，心脏病发作（SHR=0.77）、中风（SHR=0.62）、其他心血管相关疾病（SHR=0.82）和呼吸系统疾病（SHR=0.68）导致的死亡率降低。各国的业余爱好参与模式差异很大，从中国主要不参与（65.1%）到北欧持续高参与（>90%）。与持续不参与相比，开始（合并HR=0.62）和持续（合并HR=0.45）参与业余爱好都与死亡风险降低相关，而停止参与则消除了这些保护关联（合并HR=0.96；95%CI=0.88，1.04）。在65岁及以上的成年人和已婚个体中，益处更为明显。
业余爱好参与是促进全球健康长寿的一个潜在普遍且可改变的因素。优先考虑开始和维持业余爱好参与的公共卫生策略可能会带来显著的生存益处，特别是在主要为不参与模式且可预防死亡率高的国家。
