Environmental risks and pain associated with lower successful aging in Chinese cohort

Researchers analyzed 3,756 adults aged 60 years or older enrolled in the 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS), with follow-up through 2018. They assessed six living environmental risk domains—outdoor PM₂.₅, household energy, water source, housing type, indoor temperature and relative humidity—and self-reported pain. Successful aging was defined using the Rowe and Kahn framework. Cox regression assessed associations, and restricted cubic splines characterized the environmental-risk dose–response relationship.

A higher environmental-risk score was associated with a lower probability of successful aging (HR 0.80, 95% CI 0.72–0.89); the association was linear. Participants reporting pain also had a lower probability than those without pain (HR 0.44, 95% CI 0.31–0.64). Compared with participants with lower environmental risks and no pain, those with higher risks and pain had the lowest probability (HR 0.26, 95% CI 0.15–0.44). Associations were more pronounced in women, people with kidney disease and those with lower educational attainment.

The findings identify environmental conditions and pain as factors associated with successful aging, but the cohort design cannot establish that either causes changes in aging outcomes. The study’s recommendation for combined environmental and pain interventions was not tested as an intervention in this analysis.