尽管一些来自高收入国家的研究表明主观幸福感（SWB）与死亡率呈正相关，但在中国等中低收入国家缺乏类似的研究。本研究的目的是研究老年中国人口中SWB与全因死亡率之间的关联。数据来自于中国长寿健康纵向调查（CLHLS），这是一项在中国大陆31个省份中的22个省份进行的基于人群的纵向队列研究。纳入了2002年招募并追踪至2018年的13282名年龄≥65岁的个体。SWB使用了一个包括生活满意度、积极情绪（包括乐观、快乐、个人控制和责任心）和消极情绪（包括焦虑、孤独和无用感）的八项工具进行评估。使用Cox比例风险回归方法估计SWB与总死亡率之间的关联，同时调整了一系列潜在混杂因素。进一步进行了亚组分析和交互作用分析。在16.5年的随访中，共确认了8459例死亡。在调整年龄、性别、婚姻状况、教育程度、居住地、吸烟状况、饮酒、运动、饮食、BMI、高血压、糖尿病、心脏病、脑血管疾病和癌症等各种潜在混杂因素后，SWB的提高与全因死亡率降低的风险独立相关（校正风险比[HR] = 0.85，95％置信区间[CI] = 0.81-0.89）。在八个SWB症状中，仅有两个项目，即无用感（调整HR = 0.94，95％ CI = 0.89-0.99）和快乐感（调整HR = 0.91，95％ CI = 0.86-0.95），与总死亡率显著相关。不论不同特征，该关联在所有亚组中均保持显著。总体而言，更高的SWB以及两个特定症状（无用感和快乐感）与老年中国成人的全因死亡风险独立相关。此关联在不同人群中一致存在，表明促进更健康的SWB可能对所有老年人有益，不论他们的特征如何。©2023 BioMed Central Ltd., part of Springer Nature.

Although several studies in high-income countries have suggested a positive association between subjective well-being (SWB) and mortality, studies conducted in low- and middle-income countries, such as China, are scarce. The purpose of this study is to examine the association between SWB and all-cause mortality among the older Chinese population.Data were from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a population-based longitudinal cohort study in 22 of 31 provinces in mainland China. A total of 13,282 individuals aged 65 ≥ years who were recruited in 2002 and followed-up until 2018 were included. SWB was assessed with an eight-item tool covering life satisfaction, positive affect (including optimism, happiness, personal control and conscientiousness) and negative affect (including anxiety, loneliness and uselessness). Cox proportional hazards regression methods were carried out to estimate the association between SWB and total mortality, adjusting for a wide range of potential confounders. Subgroup analyses and interaction analyses were further conducted.During the 16.5 years of follow-up, 8459 deaths were identified. Greater SWB was independently associated with a reduced risk of all-cause mortality (adjusted hazard ratio [HR] = 0.85, 95% confidence interval [CI] = 0.81-0.89) after adjustment for age, sex, marital status, education level, place of residence, smoking status, drinking, exercise, diet, BMI, hypertension, diabetes, heart disease, cerebrovascular diseases and cancer. Of the eight individual SWB symptoms, only 2 items, feelings of uselessness (adjusted HR = 0.94, 95% CI = 0.89-0.99) and happiness (adjusted HR = 0.91, 95% CI = 0.86-0.95), were significantly associated with total mortality. Associations remained significant across all subgroups regardless of different characteristics.Higher SWB overall and 2 certain symptoms (feelings of uselessness and happiness) were independently associated with all-cause mortality risk among older Chinese adults. The association was consistent across different groups, suggesting that promoting a healthier SWB may be beneficial to all older individuals irrespective of their characteristics.© 2023. BioMed Central Ltd., part of Springer Nature.