Key result
Each 10-point increase in Life's Essential 8 score is linked to ~23% lower all-cause mortality.
Why the study?
Diabetes increases all-cause, CVD, and cancer mortality risk, prompting investigation into the association between Life's Essential 8 and these mortality risks, alongside diabetes' potential modifying effect.
Does a higher Life's Essential 8 score reduce all-cause, CVD, and cancer mortality in US adults with and without diabetes?
Cohort (n=20,231)
Yes
Does a higher Life's Essential 8 score reduce all-cause, CVD, and cancer mortality in US adults with and without diabetes?
Hazard Ratio: 0.77 (95% CI 0.67–0.9)
Higher Life's Essential 8 scores are associated with reduced mortality, with a synergistic interaction between diabetes and suboptimal LE8 scores accelerating CVD death.
Introduction and Objective: Diabetes prevalence is high and increases all-cause, cardiovascular diseases (CVDs), and cancer mortality risk. This study investigates the association between Life's Essential 8 (LE8) and these mortality risks, and diabetes' potential modifying effect. Methods: We analyzed 20,231 US adults (3,497 with diabetes; 16,724 without) from National Health and Nutrition Examination Survey (NHANES) 2005-2018. LE8 scores (0-100) were categorized by weighted tertiles.Cox proportional hazards regression models assessed associations with prospectively tracked mortality (through 2019). Results: Over median 7.2 years, 1920 all-cause, 472 CVD, and 484 cancer deaths occurred. Mortality rates were higher in people with diabetes. Within the people without diabetes, a 10-point increment in the LE8 Score was linked to a significant 23% decrease in the risk of all-cause mortality (HR=0.77, 95% CI: 0.67-0.90), a 21% decrease in the risk of CVD mortality (HR=0.79, 95% CI: 0.64-0.98). However, no significant association was detected between LE8 Score and cancer mortality in people with diabetes (HR=0.89, 95% CI: 0.70-1.13). In non-diabetic population, the HRs for LE8 and all-cause, CVD, cancer mortality were 0.58(95% CI: 0.44-0.75), 0.63(95% CI: 0.40-0.98), 0.64(95% CI: 0.42-0.97). There was a synergistic additive interaction between diabetes and LE8 score on CVD death (RERI: 0.56, 95% CI: 0.04-1.09; AP: 0.30, 95% CI: 0.04-0.57; S: 2.91, 95% CI: 0.54-15.69). Conclusion: Higher LE8 score conferred greater mortality risk reduction in people with diabetes compared to people without diabetes. Diabetes and suboptimal LE8 scores might synergistically accelerate CVD death, underscoring the necessity for dual interventions addressing both glycemic control and cardiovascular health optimization in this population. Disclosure Y. Li: None. Y. Chu: None. A. Abudukeranmu: None. Z. Pang: None. Y. Zhuang: None. J. Chang: None. H. Fan: None. J. Li: None. P. Li: None. M. Li: None. Z. Song: None. H. Zhu: None.
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(38224) et al. (2026) conducted a cohort in Diabetes (n=20,231). Life's Essential 8 (LE8) score vs. Lower LE8 score was evaluated on all-cause mortality (HR 0.77, 95% CI 0.67-0.90). A 10-point increment in Life's Essential 8 score was associated with a 23% decrease in all-cause mortality risk (HR 0.77; 95% CI 0.67-0.90), conferring greater risk reduction in adults with diabetes.
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