Links Between Mortality and Socioeconomic Characteristics, Disease Burden, and Biological and Physical Functioning in the Aging Chinese Population

Association of smart elderly care and quality of life among older adults: the mediating role of social support

BACKGROUND

In the current context of ageing, the field of smart elderly care has gradually developed, contributing to the promotion of health among older adults. While the positive impact on health has been established, there is a scarcity of research examining its impact on the quality of life (QoL). This study aims to investigate the mediating role of social support in the relationship between smart elderly care and QoL among older adults.

METHODS

A total of 1313 older adults from Zhejiang Province, China, participated in the study. Questionnaires were used to collect data on participants' basic demographic information, smart elderly care, social support, and QoL. The descriptive analyses of the demographic characteristics and correlation analyses of the three variables were calculated. Indirect effects were tested using bootstrapped confidence intervals (CI).

RESULTS

The analysis revealed a positive association between smart elderly care and social support (β = 0.42, p < 0.01), as well as a positive correlation between social support and QoL (β = 0.65, p < 0.01). Notably, social support emerged as an important independent mediator (effect size = 0.28, 95% bootstrap CI 0.24 to 0.32) in the relationship between smart elderly care and QoL.

CONCLUSIONS

The results of this study underscore the importance of promoting the utilization of smart elderly care and improving multi-faceted social support for older adults, as these factors positively contribute to the overall QoL.

Trend, regional variation and socioeconomic inequality in cardiovascular disease among the elderly population in China: evidence from a nationwide longitudinal study during 2011-2018

INTRODUCTION

Cardiovascular disease (CVD) continues to pose a significant burden among the elderly population in China. There is a knowledge gap in the temporal trends, regional variations and socioeconomic inequalities among this vulnerable population.

METHODS

This study conducted cross-sectional and cohort analyses based on four survey waves of the China Health and Retirement Longitudinal Study among adults aged ≥60 years spanning 2011-2018 across 28 provinces. Cross-sectional analyses examined temporal trends, regional variations and socioeconomic inequalities in CVD prevalence. Cohort analyses identified individuals without CVD in 2011 and followed them up until 2018 to calculate CVD incidence. Generalised estimating equations (GEE) were employed to identify associated factors.

RESULTS

A total of 5451, 7258, 8820 and 11 393 participants were eligible for cross-sectional analyses, and 4392 and 5396 participants were included in cohort analyses of CVD and comorbid CVD. In 2018, the age-adjusted and sex-adjusted prevalence of CVD and comorbid CVD was 31.21% (95% CI 27.25% to 35.17%) and 3.83% (95% CI 2.85% to 4.81%), respectively. Trend analyses revealed a significant increase in the adjusted prevalence from 2011 to 2018 (p for trend <0.001). There were substantial provincial variations in the adjusted prevalence of CVD and comorbid CVD. Higher socioeconomic status (SES) participants exhibited higher prevalence, and the concentration curves and concentration indices suggested persistent but narrowing inequalities in CVD and comorbid CVD across survey waves. Cohort analyses from 2011 to 2018 yielded overall CVD and comorbid CVD incidence densities of 17.96 and 2.65 per 1000 person-years, respectively. GEE results indicated increased CVD risks among older individuals, women, higher SES participants and northern residents.

CONCLUSION

More efforts should be taken to optimise strategies for high-quality CVD prevention and management in China's elderly population. Future interventions and policies should address age-specific and gender-specific, geographical, and socioeconomic disparities to ensure equitable access and outcomes for all.

Grip strength affects the association between platelet count and disability-free survival: Evidence from the China Health and Retirement Longitudinal Study

BACKGROUND AND AIMS

Previous studies found elevated platelet count (PLT), especially long-term persist high or increased PLT was associated with less likelihood disability-free survival (DFS). However, whether grip strength affects the relationship between them is still not elucidated.

METHODS

A total of 6252 participants were recruited in the analysis based on the China Health and Retirement Longitudinal Study. The primary outcome was DFS, evaluated by a composite endpoint based on the first occurrence of either disability (having difficulty in at least one of the 6 activities of daily living: namely, dressing, bathing, continence, eating, getting into or out of bed, and toileting) or all-cause mortality.

RESULTS

The association of PLT with primary outcome was significantly modified by grip strength (pinteraction = 0.022). The rates of primary outcome were significantly lower among participants with lower baseline PLT in participants with normal grip strength (multivariable odds ratio [OR], 0.67; 95% confidence interval [CI], 0.54-0.84; ptrend < 0.001), but not in those with low grip strength (multivariable OR, 1.70; 95% CI, 0.88-3.15; ptrend = 0.135), for the lowest quartile vs the highest quartile. Adding baseline PLT (quartiles or continuous) to a model containing conventional risk factors significantly improved risk reclassification for primary outcome among those with normal grip strength (most of p < 0.05).

CONCLUSION

An inverse dose-response association of PLT with DFS was found among participants with normal grip strength, but not among those with low grip strength. Low grip strength might weaken the benefit of low PLT on DFS among middle-aged and older Chinese.

The association between long-term platelet count and disability-free survival among middle-aged and older Chinese: Evidence from the China Health and Retirement Longitudinal Study

BACKGROUND AND AIMS

We aimed to assess the associations of baseline and long-term platelet count (PLT) with disability-free survival (DFS) among middle-aged and older Chinese.

METHODS AND RESULTS

A total of 7296 participants were recruited in the analysis. Updated mean PLT was defined as the mean of the two PLT measurements (4 years between wave 1-3). The long-term status of PLT was defined as persistent low, attenuated, increased and persistent high PLT according to the optimal cut points from the receiver operating characteristic curves of the two PLT measurements, respectively. The primary outcome was DFS, evaluated by the first occurrence of either disability or mortality. During 6-year visit, 1579 participants experienced disability or all-cause mortality. The rates of primary outcome were significantly higher among participants with elevated baseline PLT and updated mean PLT. Multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of primary outcome were 1.253 (1.049-1.496) for highest baseline PLT tertile and 1.532 (1.124-2.088) for highest updated mean PLT tertile, comparing to the lowest tertiles. Multivariable-adjusted spline regression models showed a linear association of baseline PLT (p_linearity < 0.001) and updated mean PLT (p_linearity = 0.005) with primary outcome. Moreover, participants with persistent high PLT and increased PLT had increased risk of primary outcome (ORs [95% CIs]: 1.825 [1.282-2.597] and 1.767 [1.046-2.985], respectively), compared with the reference of those with persistent low PLT.

CONCLUSION

This study proved elevated baseline PLT, especially long-term persist high or increased PLT was associated with less likelihood of DFS among middle-aged and older Chinese.

Natural population cohort study on long-lived adults: West China longevity and ageing procedure (WCLAP)

PURPOSE

The West China longevity and ageing procedure (WCLAP) cohort study aims to provide guidance for older adults in western China with the aim of improving quality of life, reducing the burden of family care, summarising the characteristics of longevity lifestyles, building a Chinese-longevity-population biobank and exploring the mechanisms underlying population ageing.

PARTICIPANTS

Since the establishment of the WCLAP research baseline in 2018, a population of 1537 adults aged 80 years and above, living in the community, have been enrolled in the programme as research participants. Of these, 231 are aged 100 years and above. Participants are followed up every year.

FINDING TO DATA

WCLAP data are collected in five hospital research subcentres strategically located adjacent to the national 'Longevity Townships' of Chengdu Ziyang, Leshan, Yibin and Pengshan. Data collection included a comprehensive assessment of the participant's health (including physical, psychological, social and common chronic disease assessments), instrumental tests (body composition and muscle percentage) and the collection of biomedical-biobank samples (include blood, urine, faeces, hair and urine).

FUTURE PLANS

Through the annual cohort follow-up, survival-related information is collected at a group level. Analysis of biological samples facilitates biological characterisation at the microscopic level through proteomics, metabolomics, genomics and other techniques. Baseline data, group-level follow-up data and microbiological examination data are integrated together to provide an evaluation tool, exploring sarcopenia, disability, dementia, caregiver burden, ageing biomarkers and other influencing factors.

TRIAL REGISTRATION NUMBERS

2018-463; ChiCTR1900020754.

Association Between Functional Limitations and Incident Cardiovascular Diseases and All-Cause Mortality Among the Middle-Aged and Older Adults in China: A Population-Based Prospective Cohort Study

Background

The prevalence of functional limitations is relatively high among the middle-aged and older adults. However, the contribution of functional limitations to subsequent incident cardiovascular diseases (CVD) and death is unclear. This study aims to examine the association between functional limitations and incident CVD and all-cause mortality among the middle-aged and older adults.

Methods

This is a nationally representative prospective cohort study. Participants were middle-aged and older Chinese adults from The China Health and Retirement Longitudinal Study. Functional limitations were measured using activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale. Incident CVD and death were recorded at followed-up from June 1, 2011, up until August 31, 2018. Cox proportional hazards model was used to assess the association between functional limitations and incident CVD and all-cause mortality.

Results

A total of 11,013 participants were included in this study. During the 7 years of follow-up, 1,914 incident CVD and 1,182 incident deaths were identified. Participants with functional limitations were associated with a 23% increased risk of incident CVD (HR, 1.23, 95% CI:1.08,1.39) after adjusting for age, gender, residential area, marital status, education, smoking, alcohol drinking, sleep duration, nap duration, depression symptoms, social participation, history of hypertension, diabetes, dyslipidemia, use of hypertension medications, diabetes medications, and lipid-lowering therapy. Moreover, participants with functional limitations were associated with a 63% increased risk of all-cause mortality (HR,1.63, 95%CI: 1.41,1.89) after adjusting for potential confounders.

Conclusions

Functional limitations were significantly associated with subsequent incident CVD and death among the middle-aged and older Chinese adults.

Helicobacter pylori Infection in Geriatric Patients: Current Situation and Treatment Regimens

Helicobacter pylori (H. pylori) has so far infected more than half the global population. It is the most important and controllable risk factor for gastric cancer. The elderly, who are at a higher incidence of the infection, are also commonly found to develop antibiotic resistance. The symptoms, diagnosis, clinical features (of gastric or extra-digestive diseases), and treatment of H. pylori infection in the elderly, are different from that in the non-elderly. Health conditions, including comorbidities and combined medication have limited the use of regular therapies in elderly patients. However, they can still benefit from eradication therapy, thus preventing gastric mucosal lesions and gastric cancer. In addition, new approaches, such as dual therapy and complementary therapy, have the potential to treat older patients with H. pylori infection.