Association of healthy lifestyle and the incidence of atrial fibrillation in senior adults: a prospective cohort study.

Background: Limited evidence was available on the association of the integrated effect of multidimensional lifestyle factors with AF incidence among Chinese old adults. This cohort study was to examine the effect of combined lifestyle factors on AF risk among Chinese older adults.
Methods: A total of 3,253 adults aged 60 years or more from the Guangzhou Heart Study were successfully followed up. The healthy lifestyle score (HLS) was established using a weighted approach from seven dimensions of lifestyles, including diet quality, leisure-time physical activity, sleep quality, alcohol drinking, smoking, mental status, and waist-to-hip ratio. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazard regression model.
Results: During a median of 31.13 months of follow-up, 76 (2.34%) new-onset of AF were observed. After adjustment for confounders, HLS was associated with a 46% (HR: 0.54, 95% CI: 0.32-0.93) reduced AF risk when comparing the high with low tertiles of weight HLS, with an exposure-response trend. Every 0.1-unit increment of HLS was associated with 49% reduced AF risk. The protective effect of HLS on AF incidence was remarkable in the young-old (HR: 0.47, 95% CI: 0.29-0.79) but not in the old-old (HR: 0.85, 95% CI: 0.29-2.48), when comparing the high with low tertiles.
Conclusion: The results suggest that higher HLS was associated with lower AF incidence among Chinese old adults, and the findings highlight the need to consider multi-dimensional lifestyles when developing health promotion strategies to lower the risk of new-onset AF the risk of new-onset AF.
Competing Interests: Declarations. Ethical approval: This study was approved by the Medical Research Ethics Committee of Guangdong Provincial People’s Hospital and by the Ethical Review Committee for Biomedical Research, School of Public Health, Sun Yat-sen University. The study was performed in line with the Declaration of Helsinki and all participants provided informed consent. Consent to participants: The participants were required to sign a written informed consent form before joining the study. Patients and/or the public were not involved in the design, conduct, reporting, or dissemination plans of this research. Consent for publication: All co-authors provided comments and approved the final version. Competing interests: The authors declare no competing interests.
(© 2025. The Author(s).)