健康衰老指数(HAI)最近被发展为衡量生物年龄的替代指标。然而，HAI与全因和特定原因的死亡率之间的关联程度以及这种关联是否在年轻和老年人中存在差异尚不清楚。我们旨在量化HAI与英国成年人死亡率之间的关联。在这项前瞻性队列研究中，我们获得了来自英国生物库的数据。根据性别特定的三分位数或临床相关切点，对五个HAI组成部分(收缩压、反应时间、胱抑素C、血清葡萄糖、强制用力容量)进行了评分(最健康为0分，最不健康为2分)，并求和以构建HAI(范围0-10)。我们使用Cox比例风险回归模型估计了HAI与全因和特定原因死亡风险的关联。共有387,794名中老年参与者接受了中位跟踪时间为8.9年(IQR 8.3-9.5)的随访。共记录到14,112例全因死亡。调整后，HAI每增加1分与全因死亡风险增加相关(HR为1.17，95%CI为1.15-1.18)。这种关联在60岁以下的成年人中更强(1.19，1.17-1.21)，而在60岁及以上人群中较弱(1.15，1.14-1.17) (P交互作用＜0.001)。每个HAI单位的增加，多元调整后的心血管疾病死亡风险(HRs)为1.28(1.25-1.31)，癌症风险为1.09(1.07-1.10)，消化系统疾病风险为1.36(1.29-1.44)，呼吸系统疾病风险为1.42(1.35-1.48)，传染病风险为1.42(1.33-1.51)，神经退行性疾病风险为1.15(1.09-1.21)。我们的研究结果表明，HAI与全因和特定原因的死亡率呈正相关，与年龄无关。我们的结果进一步强调了有效的早期干预对于延缓衰老和预防过早死亡的重要性。© 2023. 作者，由美国老化协会授予独家许可。

The healthy aging index (HAI) has been recently developed as a surrogate measure of biological age. However, to what extent the HAI is associated with all-cause and cause-specific mortality and whether this association differs in younger and older adults remains unknown. We aimed to quantify the association between the HAI and mortality in a population of UK adults. In the prospective cohort study, data are obtained from the UK Biobank. Five HAI components (systolic blood pressure, reaction time, cystatin C, serum glucose, forced vital capacity) were scored 0 (healthiest), 1, and 2 (unhealthiest) according to sex-specific tertiles or clinically relevant cut-points and summed to construct the HAI (range 0-10). Cox proportional hazard regression models were used to estimate the associations of the HAI with the risk of all-cause and cause-specific mortality. 387,794 middle-aged and older participants were followed up for a median of 8.9 years (IQR 8.3-9.5). A total of 14,112 all-cause deaths were documented. After adjustments, each 1-point increase in the HAI was related to a higher risk of all-cause mortality (hazards ratio [HR], 1.17; 95%CI, 1.15-1.18). Such association was stronger among adults younger than 60 years (1.19, 1.17-1.21) than that among those 60 years and older (1.15, 1.14-1.17) (P interaction < 0.001). For each unit increment of the HAI, the multivariate-adjusted HRs for risk of death were 1.28 (1.25-1.31) for cardiovascular diseases, 1.09 (1.07-1.10) for cancer, 1.36 (1.29-1.44) for digestive disease, 1.42 (1.35-1.48) for respiratory disease, 1.42 (1.33-1.51) for infectious diseases, and 1.15 (1.09-1.21) for neurodegenerative disease, respectively. Our findings indicate that the HAI is positively associated with all-cause and cause-specific mortality independent of chronological age. Our results further underscore the importance of effective early-life interventions to slow aging and prevent premature death.© 2023. The Author(s), under exclusive licence to American Aging Association.