Impact of modifiable healthy lifestyles on mortality in Chinese older adults

In China, unhealthy lifestyles, including smoking, alcohol consumption, a lack of exercise, and irrational diets, are relatively common among the elderly population. The objective of this study was to examine the specific associations between poor health-related behaviours and all-cause and cause-specific mortality in older adults. This study involved 5,015 subjects ≥ 60 years of age from the CHARLS database over a 10-year follow-up period. The average age was (67.96 ± 6.39) years. We examined whether lifestyle groups, based on adherence to non-smoking, no-alcohol, moderate exercise, and 18.5 kg/m² ≤ BMI< 24 kg/m², were linked with subsequent mortality. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence intervals for all-cause and cause-specific mortality of maintaining a healthy lifestyle. In multivariate adjustment model, the risk of all-cause mortality was reduced by 59.2% [HR 0.408 (95% CI 0.333, 0.499)] in the moderate group compared with the unfavorable group. In addition, the risk of all-cause mortality was reduced to 80.5% [HR 0.195 (95% CI 0.150, 0.253)] in the favorable group. The risks of cardiovascular and cerebrovascular diseases, chronic respiratory disease, cancers, and diabetes increased with similar dose-response patterns. The combination of all four healthy lifestyles provided the greatest protection, reducing mortality by 84.5%. In the elderly population, adherence to a healthy lifestyle is associated with a significant reduction in the risk of all-cause and cause-specific mortality.