Associations of a behavioral and mental health score with all-cause and cause-specific mortality and life expectancy: two nationwide cohort studies from the UK and US.

Higher BMHS was significantly associated with lower risk of all-cause mortality compared to the lowest quintile.

• HR for highest vs. lowest quintile: 0.56 (95% CI: 0.47–0.67) after multivariable adjustment
• Study included 413,180 participants from UK Biobank (2006–2022) and NHANES (1999–2018)
• During a mean follow-up of 13.3 years, 34,155 deaths occurred
• Cox proportional hazards models were used to assess associations

Higher BMHS was significantly associated with lower cardiovascular disease mortality.

• HR for highest vs. lowest quintile: 0.64 (95% CI: 0.59–0.70)
• Association was observed after multivariable adjustment
• Analysis was conducted prospectively across both UK Biobank and NHANES cohorts

Higher BMHS was significantly associated with lower cancer mortality.

• HR for highest vs. lowest quintile: 0.62 (95% CI: 0.58–0.65)
• Association was observed after multivariable adjustment
• Cancer mortality was assessed as a cause-specific outcome alongside cardiovascular and other mortality

Higher BMHS was significantly associated with lower mortality from other causes.

• HR for highest vs. lowest quintile: 0.47 (95% CI: 0.31–0.70)
• This represented the strongest hazard ratio reduction among the cause-specific mortality outcomes
• Association was observed after multivariable adjustment

Higher BMHS was associated with longer life expectancy.

• Life expectancy was longer by 5.60 years (95% CI: 3.82–8.19) in the highest versus lowest BMHS quintile
• Life tables were used to assess life expectancy associations
• Analysis was prospective and drawn from two nationwide cohort studies

The associations between BMHS and mortality were stronger in specific subgroups.

• Associations were stronger in those aged less than 65 years compared to those aged 65 years or older
• Associations were stronger in those with BMI less than 25 kg/m² compared to those with higher BMI
• Subgroup analyses were conducted across both UK and US cohorts

The BMHS was constructed by incorporating sleep duration and depression in addition to traditional lifestyle factors.

• BMHS components included diet, physical activity, alcohol consumption, smoking, sleep duration, and depression
• The score was designed as an update to existing health scores that typically omit sleep and psychological health
• The score was evaluated in 413,180 participants across two nationwide cohorts from the UK and US