Tourism experiences and the lower risk of mortality in the Chinese elderly: a national cohort study

Min Du,Liyuan Tao,Jue Liu,Min Liu

doi:10.1186/s12889-021-11099-8

Abstract

BackgroundCohort studies about the effects of tourism experiences on the risk of death among Chinese older adults are still lacking. We aimed to examine the association between tourism experiences and mortality in Chinese aged 65 or above.MethodsWe included 9520 participants aged 65 years or above from the Chinese Longitudinal Healthy Longevity Survey at baseline in 23 provinces in 2011. They were followed up in 2014 and 2018. Cox proportional hazards models were used to assess the association between tourism experiences and the risk of death.ResultsAmong 9520 participants, 7.85% had at least one tourism experience outside of their local city/county during the past 2 years. During 35,994.26 person-years of follow-up, in total 4635 deaths were observed. The crude rate of death was greater in participants who had no tourism experience than in older travelers (incidence rate: 13.70 versus 5.24 per 100 person-years). Elderly travelers had a significantly lower risk for all-cause mortality (crude hazard ratio: 0.38, 95% CI: 0.33–0.44) compared with non-travelers. After adjustment for all covariates, the risk of all-cause mortality was 27% lower among those with at least one tourism experience than among non-travelers (adjusted hazard ratio: 0.73, 95% CI: 0.62–0.85). Subgroup analysis showed that the associations between tourism and the decreased risk of mortality were stable.ConclusionsTourism decreases the risk of mortality in the Chinese elderly. Tourism should be considered as a modifiable lifestyle factor and an effective way to reduce mortality and promote longevity and healthy aging.

Highlights

Cohort studies about the effects of tourism experiences on the risk of death among Chinese older adults are still lacking
Chang et al demonstrated that participation in domestic nature-based tourism served as a tonic to improve autonomic nervous system function [18]
No interaction was observed within the other groups (Table 3). To our knowledge, this is the first nationwide cohort study that examined the association of tourism experiences with all-cause deaths among Chinese older people aged ≥65 years

Summary

Introduction

Cohort studies about the effects of tourism experiences on the risk of death among Chinese older adults are still lacking. Previous studies in Brazil [3], Japan [12], Spain [13], and Korea [14] reported that physical activity can reduce the risk of death among elderly, and absence of outdoor activities can increase the risk of death among older people [15]. One previous study reported that “forest bathing” (shinrin-yoku) trips have a positive effect on health among older patients with chronic obstructive pulmonary disease by reducing inflammation and stress levels [16]. Another crosssectional study found that tourism was positively associated with better self-rated health among Chinese people [17]. Tourism has been reported to be beneficial for the psychological state, including wellbeing perception [19], perceived accessibility, and life satisfaction [20]

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