Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study

Purpose: Recently, the World Health Organization has emphasized the importance of a healthy lifestyle in reducing severe illnesses and premature mortality. To evaluate this, the Healthy Lifestyle Score (HLS), which focuses on health protecting behaviors (e.g., smoking, alcohol consumption, physical...

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Main Authors: Jeong Min Yang, Jieun Hwang
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Experimental Gerontology
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Online Access:http://www.sciencedirect.com/science/article/pii/S0531556525000099
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author Jeong Min Yang
Jieun Hwang
author_facet Jeong Min Yang
Jieun Hwang
author_sort Jeong Min Yang
collection DOAJ
description Purpose: Recently, the World Health Organization has emphasized the importance of a healthy lifestyle in reducing severe illnesses and premature mortality. To evaluate this, the Healthy Lifestyle Score (HLS), which focuses on health protecting behaviors (e.g., smoking, alcohol consumption, physical activity, body mass index), is widely used. However, as HLS may fluctuate over time, there is increasing focus on monitoring HLS trends. Accordingly, this study aims to track HLS trajectories (HLST) and examine their association with mortality among middle-aged and older Koreans. Methods: After excluding missing values, data from 6249 participants were analyzed using the group-based trajectory model (GBTM) to classify HLST, based on the first to fourth waves of the Korean Longitudinal Study of Aging (KLoSA). The chi-square test and Cox proportional hazards model were employed to examine the association between HLST and all-cause mortality over a 10-year follow-up period (December 31, 2012, to December 31, 2022; 3650 days). Results: Three HLST groups were identified in the GBTM analysis. These were the Poor HLST (17.8 %), Average HLST (42.9 %), and Good HLST (39.4 %) groups. Compared to the good HLST, the poor HLST had higher mortality at 1 year (hazard ratio [HR]: 1.98, p: 0.029), 3 years (HR: 1.78, p: 0.001), 5 years (HR: 1.52, p: 0.002), 7 years (HR: 1.39, p: 0.002), and 10 years (HR: 1.40, p: 0.000). Furthermore, stratified analysis by sex, age, marital status and residential region showed that male, ≥65 years, single and urban area groups had a strong association between HLST and all-cause mortality. Conclusion: The findings of this study underscore the necessity of policies and institutional measures grounded in community networks to mitigate the risk of all-cause mortality among vulnerable groups with persistently poor HLST.
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spelling doaj-art-8c12ab86d5a643ba9c4ca566213f1cc52025-01-31T05:10:08ZengElsevierExperimental Gerontology1873-68152025-02-01200112681Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort studyJeong Min Yang0Jieun Hwang1Department of Public Health, General Graduate School of Dankook University, Cheonan, Republic of Korea; Institute of Convergence Healthcare, Dankook University, Cheonan, Republic of KoreaDepartment of Public Health, General Graduate School of Dankook University, Cheonan, Republic of Korea; Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea; Institute of Convergence Healthcare, Dankook University, Cheonan, Republic of Korea; Corresponding author at: Department of Health Administration, College of Health Science, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 330-714, Republic of Korea.Purpose: Recently, the World Health Organization has emphasized the importance of a healthy lifestyle in reducing severe illnesses and premature mortality. To evaluate this, the Healthy Lifestyle Score (HLS), which focuses on health protecting behaviors (e.g., smoking, alcohol consumption, physical activity, body mass index), is widely used. However, as HLS may fluctuate over time, there is increasing focus on monitoring HLS trends. Accordingly, this study aims to track HLS trajectories (HLST) and examine their association with mortality among middle-aged and older Koreans. Methods: After excluding missing values, data from 6249 participants were analyzed using the group-based trajectory model (GBTM) to classify HLST, based on the first to fourth waves of the Korean Longitudinal Study of Aging (KLoSA). The chi-square test and Cox proportional hazards model were employed to examine the association between HLST and all-cause mortality over a 10-year follow-up period (December 31, 2012, to December 31, 2022; 3650 days). Results: Three HLST groups were identified in the GBTM analysis. These were the Poor HLST (17.8 %), Average HLST (42.9 %), and Good HLST (39.4 %) groups. Compared to the good HLST, the poor HLST had higher mortality at 1 year (hazard ratio [HR]: 1.98, p: 0.029), 3 years (HR: 1.78, p: 0.001), 5 years (HR: 1.52, p: 0.002), 7 years (HR: 1.39, p: 0.002), and 10 years (HR: 1.40, p: 0.000). Furthermore, stratified analysis by sex, age, marital status and residential region showed that male, ≥65 years, single and urban area groups had a strong association between HLST and all-cause mortality. Conclusion: The findings of this study underscore the necessity of policies and institutional measures grounded in community networks to mitigate the risk of all-cause mortality among vulnerable groups with persistently poor HLST.http://www.sciencedirect.com/science/article/pii/S0531556525000099BMIDrinkingHealthy lifestyleMortalityPhysical activitySmoking
spellingShingle Jeong Min Yang
Jieun Hwang
Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study
Experimental Gerontology
BMI
Drinking
Healthy lifestyle
Mortality
Physical activity
Smoking
title Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study
title_full Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study
title_fullStr Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study
title_full_unstemmed Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study
title_short Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study
title_sort effect of healthy lifestyle score trajectory on all cause mortality in the late middle aged and older population finding from 17 year retrospective cohort study
topic BMI
Drinking
Healthy lifestyle
Mortality
Physical activity
Smoking
url http://www.sciencedirect.com/science/article/pii/S0531556525000099
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AT jieunhwang effectofhealthylifestylescoretrajectoryonallcausemortalityinthelatemiddleagedandolderpopulationfindingfrom17yearretrospectivecohortstudy