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. 2023 Oct 11;23(1):646.
doi: 10.1186/s12877-023-04247-9.

Association of a healthy lifestyle with mortality in older people

Catherine Robb  1 , Prudence R Carr  2 , Jocasta Ball  2 , Alice Owen  2 , Lawrence J Beilin  3 , Anne B Newman  4 , Mark R Nelson  2   5 , Christopher M Reid  2   6 , Suzanne G Orchard  2 , Johannes T Neumann  2   7   8 , Andrew M Tonkin  2 , Rory Wolfe  2 , John J McNeil  2
Affiliations

Association of a healthy lifestyle with mortality in older people

Catherine Robb et al. BMC Geriatr. .

Abstract

Background: Unhealthy lifestyle behaviours such as smoking, high alcohol consumption, poor diet or low physical activity are associated with morbidity and mortality. Public health guidelines provide recommendations for adherence to these four factors, however, their relationship to the health of older people is less certain.

Methods: The study involved 11,340 Australian participants (median age 7.39 [Interquartile Range (IQR) 71.7, 77.3]) from the ASPirin in Reducing Events in the Elderly study, followed for a median of 6.8 years (IQR: 5.7, 7.9). We investigated whether a point-based lifestyle score based on adherence to guidelines for a healthy diet, physical activity, non-smoking and moderate alcohol consumption was associated with subsequent all-cause and cause-specific mortality.

Results: In multivariable adjusted models, compared to those in the unfavourable lifestyle group, individuals in the moderate lifestyle group (Hazard Ratio (HR) 0.73 [95% CI 0.61, 0.88]) and favourable lifestyle group (HR 0.68 [95% CI 0.56, 0.83]) had lower risk of all-cause mortality. A similar pattern was observed for cardiovascular related mortality and non-cancer/non-cardiovascular related mortality. There was no association of lifestyle with cancer-related mortality.

Conclusions: In a large cohort of initially healthy older people, reported adherence to a healthy lifestyle is associated with reduced risk of all-cause and cause-specific mortality. Adherence to all four lifestyle factors resulted in the strongest protection.

Keywords: Cohort study; Lifestyle; Mortality; Older people.

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Conflict of interest statement

A.M.T has received honoraria from Amgen, Boehinger-Ingelheim, Merck, Novartis and Pfizer. M.R.N served on a Novartis lipids advisory board. All other authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow of participant inclusion
Fig. 2
Fig. 2
Cumulative Incidence of all-cause and cause specific mortality by lifestyle categories. Shown is the cumulative incidence of death due to any cause and death according to major underlying causes (cancer, cardiovascular disease and ‘other’ non-CVD/non-cancer cause). For each cause of death, the cumulative incidence was based on a competing-risks model, stratified by lifestyle categories, with the remaining causes of death as competing events. Abbreviations: Unfav., unfavourable lifestyle category; Mod., moderate lifestyle category; Fav., favourable lifestyle category. Years = years since baseline visit
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