Research Paper Volume 13, Issue 6 pp 8835—8848

Association between 4-dimension lifestyle pattern and 10-year mortality risk in Chinese individuals older than 65: a population-based cohort study

Guangqi Liu1,2, , Zheng Xie1,2, , Yuanjie Pang3, , Tao Huang3, , Yangmu Huang1,2, ,

  • 1 Department of Global Health, Peking University School of Public Health, Haidian 100191, Beijing, China
  • 2 Institute for Global Health, Peking University, Haidian 100191, Beijing, China
  • 3 Department of Epidemiology and Biostatistics, Peking University School of Public Health, Haidian 100191, Beijing, China

Received: October 26, 2020       Accepted: February 9, 2021       Published: March 19, 2021
How to Cite

Copyright: © 2021 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


While the impact of a 4-dimension lifestyle pattern (4DL) on older people’s mortality (aged ≥65 years) has been reported in high-income countries, few studies investigated the association between lifestyle pattern and disease-accompanied mortality, or examined the difference among different age or gender groups in low- and middle-income countries. We followed up 16,954 Chinese older participants from 2008 to 2018 and adopted the Cox proportional hazard model to evaluate the protective effect of 4DL. After adjustment for confounders, individuals with 3-4 4DL scores had a 38% reduction in all-cause mortality risk, and up to 36%, 42% and 41% reduced risk of mortality accompanied by hypertension, respiratory disease and dementia, respectively in contrast with those scored 0. Compared with octogenarians, nonagenarians, and centenarians, adhering to 3-4 4DL could further reduce the mortality risks in the younger elderly (aged 65-79 years). This study shows that among the elderly population in China, participants who adhered to 4DL had a lower all-cause mortality risk than those who did not. Additionally, hypertension, respiratory disease, or dementia accompanied mortality risk was also reduced significantly. The findings indicated that the positive effects of 4DL on longevity should be acknowledged in China’s older population, especially for the younger elderly.


CLHLS: Chinese Longitudinal Healthy longevity Survey; 4DL: 4-dimension lifestyle pattern; HD: heart disease; CVD: cerebrovascular disease; RD: respiratory disease; ICD-10: the 10th revision of the International Statistical Classification of Diseases; BMI: body mass index; HR: hazard ratio; CI: confidence intervals; SD: standard deviation.