Introduction
Although risk factors often co-occur, previous studies examining lifestyle or psychosocial
factors often treat these factors as individual predictors of health. This study aims
to identify the underlying subgroups of women characterized by distinct lifestyle
and psychosocial risk patterns and to investigate the prospective associations between
risk patterns and mortality among postmenopausal women.
Methods
A total of 64,812 postmenopausal women aged 50–79 years without prevalent diabetes,
cardiovascular disease, and cancer at baseline (1993–1998) were followed until 2019
with a mean follow-up duration of 14.6 (SD=6.4) years. Latent class analysis was used
to identify the latent classes of women with homogeneous combinations of lifestyle
and psychosocial variables and to test whether the classes were prospectively associated
with mortality. Analyses were stratified by race/ethnicity and were performed in 2020.
Results
A total of 4 latent classes (Healthy Lifestyle and Psychosocial, Risky Psychosocial,
Risky Lifestyle, and Risky Lifestyle and Risky Psychosocial) were identified for Hispanic,
Black, and White women, and 2 classes (High Risk or Low Risk) were identified for
American Indian and Asian women. Women in the Risky Lifestyle and Risky Psychosocial
group had the highest hazard ratios for all outcomes studied for all race/ethnicity
groups than those in the Healthy Lifestyle and Psychosocial group, followed by those
in the Risky Lifestyle group. Risky Psychosocial class was significantly associated
with an elevated risk of overall and cardiovascular disease mortality only in Black
women.
Conclusions
The class with concurrent risky lifestyle and psychosocial factors conveyed the greatest
risk of all types of mortality than a low-risk ref group. Health promotion should
address both behavioral and psychosocial risks concurrently.
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Article Info
Publication History
Published online: July 05, 2021
Identification
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
