Traditional Chinese medicine constitutions and mortality risk in the elderly: A single-center retrospective cohort study and survival analysis of over 17,000 individuals

The theory of traditional Chinese Medicine (TCM) constitution plays a crucial role in personalized diagnosis, treatment, and health management. However, survival analyses related to TCM are rarely conducted. This study aims to investigate the survival patterns of different TCM constitution types among the elderly in China, exploring their relationship with longevity and providing insights for personalized geriatric care. A retrospective cohort study was conducted using electronic records of elderly individuals (≥60 years) from Deyang City, Sichuan (2017-2024). Exclusions included incomplete follow-up, missing TCM constitution data, and demographic gaps. Sample size was adjusted for Bonferroni correction (α = 0.05/36). Kaplan-Meier and Cox proportional hazards models were used for survival analysis. Statistical analyses were performed using R, with P < .05 considered significant. A total of 9 TCM constitution types were identified, with Balanced constitutions representing the largest proportion (61.15%) and Phlegm-dampness constitutions the second largest (24.04%). Significant differences in survival rates were observed among constitution types (P = .0149). The Balanced type consistently was observed to exhibit higher survival probabilities. Age, sex, exercise frequency, dietary habits, BMI, and smoking status were significant factors that influenced mortality risk across the majority of constitutions. The results of time-dependent Cox regression analysis revealed that Qi-deficiency was associated with the highest mortality risk (hazard ratio = 1.83, P = .00), while Phlegm-dampness was associated with a reduced risk (hazard ratio = 0.66, P = .00). This study provides evidence for the objectivity the theory of TCM constitution and its potential significance in predicting longevity. Our findings imply that personalized health management strategies based on TCM constitutions may be beneficial for improving health outcomes among the elderly population.