AbstractIntroduction Previous studies suggest that the additional benefits of adhering to a healthy lifestyle may not be considerable for older adults. This study aimed to examine the associations of various lifestyle factors and an integrated healthy lifestyle score with survival and health status in old age. Methods A total of 36,403 participants from the China Kadoorie Biobank were included, with a mean age of 71 years at baseline. Three survival and health statuses were defined: death before age 80, and living beyond age 80 either with or without major chronic diseases (MCDs) including ischemic heart disease, cerebrovascular disease, cancer, and chronic obstructive pulmonary disease. Multinomial logistic regression models were used to examine the associations of smoking, alcohol consumption, dietary habits, total physical activity, body mass index (BMI), waist circumference (WC), body shape, and healthy lifestyle score with survival and health status. The association of BMI with survival and health status was further analyzed through stratified analyses by WC. Results During a median follow-up of 11.5 years, 13,496 participants died and 22,665 developed at least one MCD. Participants who smoked, quit drinking alcohol, had unhealthy dietary habits, and had low levels of physical activity were more likely to die before 80 than their reference group, after controlling for potential confounders. For participants with WC (men/women) 2 increment in BMI were 0.68 (0.62, 0.74) for death before age 80 and 1.09 (1.01, 1.17) for living past 80 with MCDs compared to living past 80 without MCDs. In contrast, for those with WC ≥85/80 cm, the corresponding ORs were 1.11 (1.02, 1.21) and 1.16 (1.09, 1.24), respectively. The ORs per 1 additional healthy lifestyle score were 1.16 (1.13, 1.19) for those over 80 with MCDs and 1.25 (1.22, 1.29) for those over 80 without MCDs compared to those dying before 80. Conclusions Adults approximately 70 years old who maintain favorable lifestyle habits may be more likely to have a better health status in later life.
Zhang et al. (2026) studied this question.