The associations of joint exposure to various living environmental factors with the risk of frailty and all-cause mortality: a nationally representative cohort study

Jinqi Wang, Xiaoyu Zhao, Yanchen Zhao, Zhiyuan Wu, Xia Li, Jing Wei, Xiuhua Guo, Lixin Tao
{"title":"The associations of joint exposure to various living environmental factors with the risk of frailty and all-cause mortality: a nationally representative cohort study","authors":"Jinqi Wang, Xiaoyu Zhao, Yanchen Zhao, Zhiyuan Wu, Xia Li, Jing Wei, Xiuhua Guo, Lixin Tao","doi":"10.1093/gerona/glaf102","DOIUrl":null,"url":null,"abstract":"Background The relationships of joint exposure to various outdoor and indoor environmental factors with the risk of frailty and mortality remain unclear. Methods Based on the China Health and Retirement Longitudinal Study, we enrolled 13745 participants in the final analysis. The living environmental score incorporated seven factors: ambient fine particulate matter, residential greenness, household fuel use, indoor temperature, water sources, building types, and household cleanliness (ranged from 0 to 8). Frailty was assessed by a 40-item deficit-accumulation frailty index. Cox proportional hazards regressions were used to assess the longitudinal associations of individual and joint exposure to living environmental factors with risk of frailty and mortality. Results In this prospective study, 3389 participants developed frailty and 815 died during a 7-year follow-up. A higher living environmental score was linked to reduced risks of frailty (hazard ratio (HR): 0.872, 95% CI: 0.854-0.890) and mortality (HR: 0.893, 95% CI: 0.856-0.932). Population-attributable fraction analyses revealed that 23.5% of frailty and 17.2% of deaths could be attributed to lower living environmental scores. For single factors, solid fuel use and PM2.5 exposure had the greatest attribution to incident frailty and all-cause mortality, respectively. The effects of low living environmental score on all-cause mortality were mediated via frailty. Conclusion Multiple living environmental risk factors were separately and jointly associated with increased risks of frailty and mortality in an additive manner, emphasizing the importance of comprehensively assessing various environmental factors to promote healthy aging.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"25 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/gerona/glaf102","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background The relationships of joint exposure to various outdoor and indoor environmental factors with the risk of frailty and mortality remain unclear. Methods Based on the China Health and Retirement Longitudinal Study, we enrolled 13745 participants in the final analysis. The living environmental score incorporated seven factors: ambient fine particulate matter, residential greenness, household fuel use, indoor temperature, water sources, building types, and household cleanliness (ranged from 0 to 8). Frailty was assessed by a 40-item deficit-accumulation frailty index. Cox proportional hazards regressions were used to assess the longitudinal associations of individual and joint exposure to living environmental factors with risk of frailty and mortality. Results In this prospective study, 3389 participants developed frailty and 815 died during a 7-year follow-up. A higher living environmental score was linked to reduced risks of frailty (hazard ratio (HR): 0.872, 95% CI: 0.854-0.890) and mortality (HR: 0.893, 95% CI: 0.856-0.932). Population-attributable fraction analyses revealed that 23.5% of frailty and 17.2% of deaths could be attributed to lower living environmental scores. For single factors, solid fuel use and PM2.5 exposure had the greatest attribution to incident frailty and all-cause mortality, respectively. The effects of low living environmental score on all-cause mortality were mediated via frailty. Conclusion Multiple living environmental risk factors were separately and jointly associated with increased risks of frailty and mortality in an additive manner, emphasizing the importance of comprehensively assessing various environmental factors to promote healthy aging.
联合暴露于各种生活环境因素与虚弱和全因死亡风险的关系:一项具有全国代表性的队列研究
背景联合暴露于各种室外和室内环境因素与虚弱和死亡风险的关系尚不清楚。方法基于中国健康与退休纵向研究,我们招募了13745名参与者进行最终分析。生活环境得分包括七个因素:环境细颗粒物、住宅绿化、家庭燃料使用、室内温度、水源、建筑类型和家庭清洁度(范围从0到8)。脆弱性是通过40项赤字累积脆弱性指数来评估的。Cox比例风险回归用于评估个体和联合暴露于生活环境因素与虚弱和死亡风险的纵向关联。结果在这项前瞻性研究中,3389名参与者在7年随访期间出现虚弱,815人死亡。较高的生活环境评分与较低的衰弱风险(风险比(HR): 0.872, 95% CI: 0.854-0.890)和死亡率(HR: 0.893, 95% CI: 0.856-0.932)相关。人口归因分数分析显示,23.5%的虚弱和17.2%的死亡可归因于较低的生活环境得分。就单一因素而言,固体燃料使用和PM2.5暴露分别最大程度地导致了偶发性虚弱和全因死亡率。低生活环境评分对全因死亡率的影响是通过虚弱介导的。结论多种生活环境危险因素与老年人虚弱和死亡风险的增加存在单独或共同的叠加关系,强调综合评价各种环境因素对促进健康老龄化的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信