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Background <p>With population ageing, multimorbidity has become a major public health concern. Although healthy lifestyles are associated with reduced risks of single chronic diseases and mortality, their relationship with multimorbidity patterns among older Chinese remains insufficiently explored.</p> Methods <p>Data from 16,820 participants aged 60 and older, from the 2008–2018 waves of the China Longitudinal Healthy Longevity Survey (CLHLS), were analyzed. Participants were categorized into three lifestyle groups (favorable, average, and unfavorable) based on five modifiable lifestyle factors: social engagement, physical activity, smoking, drinking, and diet. Disease progression was assessed using multimorbidity networks, and all-cause mortality was analyzed with Cox proportional hazards models.</p> Results <p>Compared to an unfavorable lifestyle, a favorable lifestyle was associated with a lower risk of all-cause mortality (HR = 1.63, 95% CI: 1.50–1.77). Among the five lifestyle factors, social engagement showed the strongest association with mortality (HR for inactive vs. active engagement = 1.36, 95% CI: 1.29–1.43). Multimorbidity networks revealed that individuals with favorable lifestyles exhibited denser, more interconnected disease networks, while those with unfavorable lifestyles showed more streamlined, linear disease progressions, primarily driven by hypertension, cardiovascular disease, and dementia.</p> Conclusions <p>A favorable lifestyle was linked to lower mortality and more complex multimorbidity networks, likely due to longer survival and the accumulation of chronic conditions. These findings underscore the need for interventions to reduce premature mortality and manage multimorbidity in aging populations.</p>

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Healthy Lifestyle, multimorbidity network, and all-cause mortality among older Chinese: a longitudinal analysis in Chinese longitudinal healthy longevity survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月16日

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  • Yilin Chen,
  • Huan Zhou,
  • Siqing Wang,
  • Lingqiu Dong,
  • Yi Tang,
  • Jiaxing Tan,
  • Wei Qin

摘要

Background

With population ageing, multimorbidity has become a major public health concern. Although healthy lifestyles are associated with reduced risks of single chronic diseases and mortality, their relationship with multimorbidity patterns among older Chinese remains insufficiently explored.

Methods

Data from 16,820 participants aged 60 and older, from the 2008–2018 waves of the China Longitudinal Healthy Longevity Survey (CLHLS), were analyzed. Participants were categorized into three lifestyle groups (favorable, average, and unfavorable) based on five modifiable lifestyle factors: social engagement, physical activity, smoking, drinking, and diet. Disease progression was assessed using multimorbidity networks, and all-cause mortality was analyzed with Cox proportional hazards models.

Results

Compared to an unfavorable lifestyle, a favorable lifestyle was associated with a lower risk of all-cause mortality (HR = 1.63, 95% CI: 1.50–1.77). Among the five lifestyle factors, social engagement showed the strongest association with mortality (HR for inactive vs. active engagement = 1.36, 95% CI: 1.29–1.43). Multimorbidity networks revealed that individuals with favorable lifestyles exhibited denser, more interconnected disease networks, while those with unfavorable lifestyles showed more streamlined, linear disease progressions, primarily driven by hypertension, cardiovascular disease, and dementia.

Conclusions

A favorable lifestyle was linked to lower mortality and more complex multimorbidity networks, likely due to longer survival and the accumulation of chronic conditions. These findings underscore the need for interventions to reduce premature mortality and manage multimorbidity in aging populations.