Association between life's essential 8 and activities of daily living disability in Chinese adults aged 80 years and older: a cross-sectional study from the CLHLS.

Background: Maintaining functional independence is a major goal of healthy ageing in the oldest-old, yet evidence on the association between Life's Essential 8 (LE8)and activities of daily living (ADL) disability in this population remains limited. We examined the associations between LE8 and ADL disability among Chinese adults aged ≥80 years. Methods: This cross-sectional studyincluded 909 adults aged ≥80 years from the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey biomarker sub-study. Cardiovascular health was assessed using the American Heart Association's LE8framework. ADL disability was defined as at least one limitation across six basic activities, and disability severity was categorized as 0, 1, or ≥2 limitations. Multivariable logistic regression and proportional odds ordinal logistic regression were used to examine associations of LE8 with ADL disability and disability severity. Results: In the fully adjusted model, each 10-point higher LE8 score was associated with reduced odds of ADL disability [odds ratio (OR): 0.77, 95% confidence interval (CI): 0.62-0.95], and participants in the highest tertile had reduced odds than those in the lowest tertile (OR: 0.57, 95% CI: 0.34-0.95). Similar associations were observed for disability severity (per 10-point increase: OR: 0.77, 95% CI: 0.62-0.94). Restricted cubic spline analysis showed a significant overall association without strong evidence of nonlinearity. In component-level analyses, physical activity and diet showed the most prominent inverse associations with ADL disability. Conclusion: Higher LE8 scores were associated with a lower ADL disability burden among Chinese adults aged ≥80 years. These fingdings support the potential value of LE8 as an integrated framework for characterizing functional vulnerability in the oldest-old.