What is the clinical evidence from this study?

Study design: Cohort. Population: Stroke (n=15225). Intervention: Higher life satisfaction. Primary outcome: Incident stroke (HR 0.83, 95% CI 0.72-0.95).

What does this research mean for the field?

Higher life satisfaction is prospectively associated with a significantly reduced risk of incident stroke in middle-aged and older Chinese adults, with the protective effect being more pronounced in older adults, females, and individuals with chronic conditions or depressive symptoms. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the link between life satisfaction at baseline and the risk of having a stroke in older Chinese adults.

May 25, 2026Open Access

Association between Life Satisfaction and Incident Stroke in Middle-aged and Older Chinese Adults: A Prospective Cohort Study from the CHARLS

Key Result

Higher baseline life satisfaction was associated with a significantly reduced risk of incident stroke in middle-aged and older Chinese adults (HR 0.83; 95% CI 0.72-0.95).

Key Points

To investigate the link between life satisfaction at baseline and the risk of having a stroke in older Chinese adults.
Included 15,225 participants aged ≥45 years from CHARLS (2011-2020).
Life satisfaction assessed at baseline using a 5-point scale.
Cox proportional hazards models estimated hazard ratios, adjusting for various factors.
1,296 participants (8.5%) developed stroke over 9 years of follow-up.
Higher life satisfaction linked to a reduced stroke risk (HR: 0.83; 95% CI: 0.72–0.95).
Stronger protective association seen in older adults, females, and those with chronic conditions.

Study Design

Type

Cohort (n=15,225)

Structured PICO

Does higher life satisfaction reduce the risk of incident stroke in middle-aged and older Chinese adults?

Population

15,225 middle-aged and older Chinese adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS)

Intervention

Higher life satisfaction (assessed at baseline using a single-item 5-point scale)

Comparator

Lower life satisfaction

Outcome

Incident stroke (self-reported in follow-up waves)hard clinical

Higher baseline life satisfaction is associated with a significantly reduced risk of incident stroke over 9 years in middle-aged and older Chinese adults.

Main Result

Effect estimate: HR 0.83 (95% CI 0.72-0.95)

Limitations

Observational design
Reliance on self-reported measures

Abstract

Objective: To investigate the prospective association between baseline life satisfaction and incident stroke among middle-aged and older Chinese adults. Methods: 15,225 participants aged ≥45 years were included from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020). Life satisfaction was assessed at baseline using a single-item 5-point scale. Incident stroke was self-reported in follow-up waves. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sociodemographic factors, lifestyle behaviors, comorbidities, and depressive symptoms. Subgroup analyses were performed by age, gender, comorbidities, BMI, and depressive symptoms. Results: Over the follow-up of 9 years, 1,296 participants (8.5%) developed stroke. Higher life satisfaction was associated with a significantly reduced risk of stroke (HR: 0.83; 95% CI: 0.72–0.95). Subgroup analyses indicated that the protective association was more pronounced among older adults, females, participants with chronic conditions (hypertension, diabetes, heart disease), overweight individuals, and those with depressive symptoms. Conclusions: Higher life satisfaction was prospectively associated with a lower risk of incident stroke in middle-aged and older Chinese adults. Given the observational design and reliance on self-reported measures, these findings should be interpreted as evidence of association rather than causation. Future studies incorporating repeated assessments of well-being and clinically verified stroke outcomes are warranted.