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Publications

English Abstract Journal Article Ppublish

PubMed: 39238396 DOI: 10.3724/zdxbyxb-2024-0168

[Association between factors in life course and physiological dysregulation among the middle-aged and older population in Zhoushan city of Zhejiang province].

Zhejiang Da Xue Xue Bao Yi Xue Ban 54(1):39-48

Authors: Xingqi Cao, Cedric Zhang Bo Lua, Jia Li, Wei Shao, Chengguo Liu, Di He, Jingyun Zhang, Yongxing Lin, Yimin Zhu, Zuyun Liu

Affiliations

  • Center for Clinical Big Data and Analytics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
  • School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.
  • Zhejiang Key Laboratory of Intelligent Preventive Medicine, Hangzhou 310058, China.
  • Center for Clinical Big Data and Analytics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China. Zhejiang Key Laboratory of Intelligent Preventive Medicine, Hangzhou 310058, China.
  • Center for Clinical Big Data and Analytics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China. Zhejiang Key Laboratory of Intelligent Preventive Medicine, Hangzhou 310058, China.
  • Department of Endocrinology, Zhoushan Putuo District People's Hospital, Zhoushan 316100, Zhejiang Province, China.
  • School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China. Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
  • Center for Clinical Big Data and Analytics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
  • School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.
  • Zhejiang Key Laboratory of Intelligent Preventive Medicine, Hangzhou 310058, China.
  • Department of Intergrated Support, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
  • School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China. Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
  • Center for Clinical Big Data and Analytics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China. Zhejiang Key Laboratory of Intelligent Preventive Medicine, Hangzhou 310058, China.

Abstract

OBJECTIVES

To analyze the associations between factors in life course and physiological dysregulation in the middle-aged and elderly population in Zhoushan city of Zhejiang province, and the mediating roles of lifestyle and mental health.

METHODS

A total of 1553 island residents aged ≥45 years were enrolled from the Zhejiang Metabolic Syndrome Cohort Zhoushan Liuheng Sub-cohort. The demographic information, life course information, lifestyle, and mental health information of the participants were documented and blood samples were collected. The status of aging was evaluated by physiological dysregulation calculation model previously developed by the authors. The Shapley value decomposition method was used to assess the cumulative and relative contribution of multiple factors in life course to the aging. Principal component analysis and hierarchical clustering analysis were used to classify subgroups. General linear regression model was used to assess associations between the life course subgroups and physiological dysregulation, and the key factors associated with aging were finally identified. Logistic regression model, general linear regression model, and mediation analysis model were used to assess the complex associations between life course subgroups, key factors, unhealthy lifestyle, mental health, and aging.

RESULTS

Shapley value decomposition method indicated that eight types of life course factors explained 6.63% (=0.0008) of the individual physiological dysregulation variance, with the greatest relative contribution (2.78%) from adversity experiences in adulthood. The study participants were clustered into 4 subgroups, and subgroups experiencing more adversity in adulthood and having low educational attainment or experiencing more trauma and having poorer relationships in childhood had significantly higher levels of physiological dysregulation. Life course subgroups and key factors childhood trauma and health, adversity experience in adulthood, and lower education were positively associated with unhealthy lifestyles (=0.12-0.41, all <0.05). In addition, life course subgroups and key factor adversity experience in adulthood were positively associated with psychological problems (=2.14-4.68, all <0.05). Unhealthy lifestyle scores showed a marginal significant association with physiological dysregulation (=0.03, =0.055). However, no significant association was found between psychological problems and physiological dysregulation (0.03, =0.748). The results of the mediation analysis model suggested that unhealthy lifestyles partially mediated the associations between the life course subgroups, adversity experience in adulthood and physiological dysregulation, with the proportions mediating ranging from 3.9%-6.8%.

CONCLUSIONS

Multiple life course factors contribute about 6.63% of the variance in physiological dysregulation in the middle aged and elderly population of the study area; subgroups with adverse life course experiences have higher levels of aging; and the association may be partially mediated by unhealthy lifestyles.

MeSH

Life Style, Aging, Aged, Mediation Analysis, Education, Wounds And Injuries, Mental Health, Negotiating