Association of a Healthy Lifestyle With All-Cause and Cause-Specific Mortality Among Individuals With Probable Sarcopenia: Population-Based Cohort Study.

Abstract

Background: Individuals with probable sarcopenia have shown excess mortality, yet no specific treatment regimen has been established. While lifestyle factors improve health and longevity in general populations, their role in probable patients with sarcopenia remains unclear due to differing lifestyle patterns. Clarifying this could inform strategies to address this unmet need.

Objective: We aim to quantify the impact of a healthy lifestyle on all-cause and cause-specific mortality in probable sarcopenic populations using a large-scale prospective cohort study.

Methods: Participants were selected from the UK Biobank, aged 40-69 years, during 2006-2010. Probable sarcopenia was identified according to EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria, resulting in 20,654 participants being included in this study. Death dates and underlying causes were obtained from the National Health Service Information Center. Cox proportional hazard models and population-attributable risk were used to assess the associations between healthy lifestyle factors and premature mortality risk.

Results: A total of 20,654 individuals with probable sarcopenia were included in this study. The median age of the population was 62.0 (IQR 56.0-66.0) years, and 60.6% (n=12,528) were women. During a median follow-up duration of 11.5 (IQR 10.8-12.3) years, 2447 participants died. All healthy lifestyle factors, including nonsmoking (P<.001), moderate alcohol intake (P<.001), regular physical activity (P<.001), a healthy diet (P=.01), limited television-watching time (P<.001), adequate sleep duration (P=.001), and strong social connections (P<.001), were independently associated with lower mortality risk. To evaluate the cumulative associations between modifiable lifestyle factors and mortality outcomes (all-cause and cause-specific) among patients with probable sarcopenia, we developed a healthy lifestyle index. Participants were assigned one point per adherence to each optimal lifestyle factor. Compared with individuals with 0-2 healthy lifestyle scores, hazard ratios of all-cause mortality for those with 3 to 6-7 factors were 0.67 (95% CI 0.59-0.76), 0.51 (95% CI 0.45-0.57), 0.43 (95% CI 0.38-0.49), and 0.33 (95% CI 0.29-0.39), respectively (P for trend <.001). There was also a dose-response relationship between the number of healthy lifestyle factors and mortality from cancer, cardiovascular disease, respiratory disease, digestive disease, and other causes (all P for trend<.001). Population-attributable risk analysis indicated that 25.7% (95% CI 22%-29%) of deaths were attributable to a poor lifestyle (scoring 0-5).

Conclusions: A healthy lifestyle is associated with a lower risk of all-cause mortality and mortality due to cancer, cardiovascular disease, respiratory disease, and digestive disease among individuals with probable sarcopenia. Adopting a healthy lifestyle (scoring 6-7) could prevent 25.7% of deaths in this population.