Data_Sheet_2_The Relationship Between Successful Aging and All-Cause Mortality Risk in Older Adults: A Systematic Review and Meta-Analysis of Cohort Studies.DOCX

BackgroundThis meta-analysis aimed to explore the effect of successful aging (SA) on all-cause mortality risk in older people to provide a theoretical basis for promoting SA.
MethodsPubMed, Embase, CINAHL, CNKI, and WanFang databases (inception to March 4, 2021) were searched for cohort studies to evaluate the relationship between SA and mortality in older people. A random-effects model was used to synthesis hazard ratio and 95% confidence intervals. Quality assessment was performed using the Newcastle–Ottawa scale. All statistical analyses were conducted in STATA 16.0.
ResultsIn total, 21,158 older adults from 10 studies were included in the current systematic review and meta-analysis. The SA group tended to have 50% lower risk of all-cause mortality than the non-SA group (pooled hazard ratio = 0.50, 95% confidence intervals: 0.35–0.65, P < 0.001; I2 = 58.3%). The risk of all-cause mortality in older people increased by 17% for each unit increment in the healthy aging index (HAI) (I2 = 0%, P = 0.964). Compared with the reference group (HAI 0-2), older people with HAI 3-4, HAI 5-6, and HAI 7-10 had 1.31-fold, 1.73-fold, and 2.58-fold greater risk of all-cause mortality, respectively. Subgroup analysis did not reveal possible sources of heterogeneity.
ConclusionsThis meta-analysis suggests that older adults with SA reduced the risk of all-cause mortality by 50%. However, few interventional studies have been conducted. Therefore, healthcare providers must be aware of the relationship between SA and mortality risk and actively develop intervention methods for helping old people achieve SA.

**背景** 本项元分析旨在探讨成功老龄化（successful aging, SA）对老年人群全因死亡风险的影响，为促进成功老龄化提供理论依据。
**方法** 检索PubMed、Embase、CINAHL、中国知网（CNKI）及万方数据库（建库至2021年3月4日）中探讨老年人群成功老龄化与死亡风险关系的队列研究。采用随机效应模型合并风险比（hazard ratio, HR）及95%置信区间（95% confidence intervals, 95%CI）。使用纽卡斯尔-渥太华量表（Newcastle–Ottawa Scale, NOS）进行质量评价。所有统计分析均通过STATA 16.0软件完成。
**结果** 本项系统评价与元分析共纳入10项研究、21158名老年受试者。成功老龄化组的全因死亡风险较非成功老龄化组降低50%（合并风险比=0.50，95%置信区间：0.35~0.65，P<0.001；I²=58.3%）。健康老龄化指数（healthy aging index, HAI）每升高1个单位，老年人群的全因死亡风险升高17%（I²=0%，P=0.964）。以HAI 0~2分组为参照，HAI 3~4、5~6及7~10分组的老年人群全因死亡风险分别为参照组的1.31倍、1.73倍及2.58倍。亚组分析未明确异质性的潜在来源。
**结论** 本项元分析显示，成功老龄化的老年人群全因死亡风险可降低50%。但目前相关干预研究仍较为匮乏。因此，医疗服务从业者应充分认识成功老龄化与死亡风险的关联，并积极探索帮助老年人实现成功老龄化的干预手段。