As the number of persons older than 60 years has increased, cardiovascular disease and cancer have surpassed infectious diseases as the predominant causes of death in this age group. Lifestyle choices influence morbidity and mortality, making healthy lifestyle practices increasingly important among older persons. However, few studies have shown how lifestyle factors combine to promote health. Knoops and associates investigated the individual and combined effects of diet and lifestyle factors (i.e., smoking status, alcohol use, physical activity) on all-cause mortality rates in the older population.

Baseline information from the Healthy Aging: a Longitudinal study in Europe (HALE) population was evaluated. The HALE project included older participants from several extensive multicenter and multinational studies. Exclusion criteria were coronary heart disease (CHD), cardiovascular disease (CVD), cancer, and diabetes at baseline. the authors analyzed the diets and lifestyle factors of 2,339 patients and compared them with cause-of-death data from the 10-year study period. The analysis controlled for environmental exposures, subclinical disease, and other confounders.

the authors conclude that mortality rates, regardless of cause, are lower in persons who consume a Mediterranean diet, do not smoke, use alcohol moderately, and are physically active. Persons who lead a healthy lifestyle have a more than 50 percent lower rate of all-cause and cause-specific mortality compared with those who do not. In this study, nearly two thirds of deaths were associated with failure to adhere to a healthy lifestyle. The results did not change after multiple adjustments, including reincorporating those with known cardiac disease or diabetes at baseline.