Association between allostatic load and mortality among Chinese older adults: the Chinese Longitudinal Health and Longevity Study.

Journal Article (Journal Article)


Allostatic load (AL) has shown that high burden of AL is associated with increased risk of adverse outcomes, but little attention has been paid to China with largest ageing population in the world.


This study is to examine the association between AL and all-cause mortality among Chinese adults aged at least 60 years.


Population-based prospective cohort study.


In 2011-2012, an ancillary study, in which a blood test was added, including a total of 2439 participants, was conducted in eight longevity areas in the Chinese Longitudinal Healthy Longevity Survey.


The final analytical sample consisted of 1519 participants (mean±SD age: men 80.5±11.3 years; women 90.2±11.8 years and 53% women).

Primary outcome measure

Cox models were used to examine the association between AL and mortality among men and women, separately. Analyses were also adjusted for potential confounders including age, ethnicity, education and marital status, smoking and exercise.


Male with a medium AL burden (score: 2-4) and high AL burden (score: 5-9) had a 33% and 118% higher hazard of death, respectively, than those with a low AL burden (score: 0-1). We did not find significant difference between females with different levels of AL burden.


Higher AL burden was associated with increased all-cause mortality among Chinese men aged at least 60 years. However, we did not find strong association among women. In conclusion, Intervention programmes targeting modifiable components of the AL burden may help prolong lifespan for older adults, especially men, in China.

Full Text

Duke Authors

Cited Authors

  • Zhang, T; Yan, LL; Chen, H-S; Jin, H-Y; Wu, C

Published Date

  • August 2021

Published In

Volume / Issue

  • 11 / 8

Start / End Page

  • e045369 -

PubMed ID

  • 34344673

Pubmed Central ID

  • PMC8336121

Electronic International Standard Serial Number (EISSN)

  • 2044-6055

International Standard Serial Number (ISSN)

  • 2044-6055

Digital Object Identifier (DOI)

  • 10.1136/bmjopen-2020-045369


  • eng