Author:
Wang Ziqiong,Zheng Yi,Ruan Haiyan,Li Liying,He Sen
Abstract
Abstract
Background
Whether healthy lifestyles mediate the association of socioeconomic status (SES) with mortality in older people is largely unknown.
Methods
A total of 22,093 older participants (age ≥ 65 years) from 5 waves (2002–2014) of Chinese Longitudinal Healthy Longevity Survey cohort were included for analysis. Mediation analysis of lifestyles on the association of SES with all-cause mortality was conducted.
Results
During a mean follow-up period of 4.92 ± 4.03 years, 15,721 (71.76%) deaths occurred. Compared with high SES, medium SES increased the risk of mortality by 13.5% (HR [total effect]: 1.135, 95% CI 1.067–1.205, p < 0.001), and the total effect was not mediated by healthy lifestyles (mediation proportion: − 0.1%, 95% CI − 3.8 to 3.3%, p = 0.936). The total effect when participants of low SES were compared with participants of high SES was HR = 1.161 (95% CI 1.088–1.229, p < 0.001) for mortality, and the total effect was modestly mediated through healthy lifestyles (mediation proportion: − 8.9%, 95% CI − 16.6 to − 5.1%, p < 0.001). Stratification analyses by sex, age and comorbidities, as well as a series of sensitivity analyses indicated similar results. In addition, mortality risk showed a downward trend with increased number of healthy lifestyles within each SES level (all p for trend < 0.050).
Conclusion
Promotion of healthy lifestyles alone can only reduce a small proportion of socioeconomic inequity-related mortality risk in older Chinese people. Even so, healthy lifestyles are important in reducing the overall mortality risk within each SES level.
Funder
Sichuan Science and Technology Program, China
National Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Cited by
2 articles.
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