The impact of social stress and healthy lifestyle on the mortality of Chinese older adults: a prospective cohort study (Preprint)

UNSTRUCTURED Objectives:This study aimed to investigate the effects of social stress (SS) on older Chinese adults and whether lifestyle factors mediate this association. Methods:Three groups of social stress were defined through latent class analysis: low, medium, and high. We created a healthy lifestyle index based on smoking, alcohol consumption, physical activity, and diet.Multivariable Cox proportional hazards models, interaction analyses, and mediation analyses were conducted. Result:Among 27,585 participants above 65years old the hazard ratios for all-cause mortality in the moderate and high SS groups were 1.15 and 1.28, respectively. For individuals aged ≥80 years, the medium SS group had a 28% (HR=1.28, 95% CI: 1.22-1.34) increased mortality risk, and the high SS group had a 38% (HR=1.38, 95% CI: 1.26-1.52) increased risk compared to the low SS group.A healthy lifestyle mediated a small proportion of the association between SS and mortality. Conclusion:A healthy lifestyle only partially mediates the relationship between SS and survival in the elderly, and other effective measures are needed to reduce the risk of death in the elderly.