Risk Factors for Cerebrovascular Disease Mortality among the Elderly in Beijing: A Competing Risk Analysis

OBJECTIVE To examine the associations of combined lifestyle factors and physical conditions with cerebrovascular diseases (CBVD) mortality, after accounting for competing risk events, including death from cardiovascular diseases, cancers and other diseases. METHODS Data on 2010 subjects aged over 55 years were finally analyzed using competing risk models. All the subjects were interviewed by the Beijing Longitudinal Study of Aging (BLSA), in China, between 1 January 1992 and 30 August 2009. RESULTS Elderly females were at a lower risk of death from CBVD than elderly males (HR = 0.639, 95% CI = 0.457-0.895). Increasing age (HR = 1.543, 95% CI = 1.013-2.349), poor self-rated health (HR = 1.652, 95% CI = 1.198-2.277), hypertension (HR = 2.201, 95% CI = 1.524-3.178) and overweight (HR = 1.473, 95% CI = 1.013-2.142) or obesity (HR = 1.711, 95% CI = 1.1754-2.490) was associated with higher CBVD mortality risk. Normal cognition function (HR = 0.650, 95% CI = 0.434-0.973) and living in urban (HR = 0.456, 95% CI = 0.286-0.727) was associated with lower CBVD mortality risk. Gray's test also confirmed the cumulative incidence (CIF) of CBVD was lower in the 'married' group than those without spouse, and the mortality was lowest in the 'nutrition sufficient' group among the 'frequent consumption of meat group' and the 'medial type group' (P value<0.001). CONCLUSIONS CBVD mortality was associated with gender, age, blood pressure, residence, BMI, cognitive function, nutrition and the result of self-rated health assessment in the elderly in Beijing, China.