Supplementary Material for: Association of multi-dimensional factors with Accelerating Age and constructing a Healthy Lifestyle Index: Guangzhou Biobank Cohort Study

Introduction Ageing process is influenced by multi-dimensional factors collectively. Previous studies examined association of one separate factor with mortality without considering different manifestations of ageing process. We investigated associations of multi-dimensional factors with Accelerating Age (AA), a proxy to quantify ageing, in older Chinese. Methods 9,831 participants from Guangzhou Biobank Cohort Study were included. Four exposure domains of 15 variables including demographic and socioeconomic factors, lifestyle factors, stress across the life course and common diseases were assessed. AA was calculated based on chronological age and eight biomarkers. Traditional multivariable linear and Bayesian Network (BN) models were used. Results In both traditional and BN models, male sex, smoking, alcohol use, physical inactivity, greater waist circumference and body mass index (BMI) were associated with higher AA, with the adjusted β (95% confidence intervals (CI)) being 2.75 (2.40 to 3.09), 1.31 (0.87 to 1.76), 1.35 (0.55 to 2.15), 0.64 (0.40 to 0.88), 0.09 (0.06 to 0.11) and 0.13 (0.07 to 0.19) years, respectively. A Healthy Lifestyle Index (HLI) was constructed including the above lifestyle factors (non-smoking, non-alcohol use, physically active, non-central and non-general obesity) with a point assigned for each. A higher index indicates healthier lifestyle. Compared with participants with an HLI of 5, those with an HLI of 0-2 had 2.90 (2.48 to 3.32) years older AA. Conclusions Male sex, smoking, alcohol use, physical inactivity, greater waist circumference and BMI were associated with higher AA by 0.09 to 2.75 years, suggesting that adopting a healthy lifestyle may alleviate process of phenotypic ageing.