Health-related quality of life associated with sensory impairment in Chinese middle-aged and older adults: a cohort study

The quality of life and related factors in older adults with possible sarcopenia and sarcopenia in rural areas of Xinjiang, China: a cross sectional study

BACKGROUND

Studies have shown that sarcopenia prevalence in the Chinese population aged over 60 years was 14%. The quality of life of older adults with sarcopenia has drawn increasing attention. Sarcopenia-related quality of life has not been well studied. We explored the quality of life of patients with sarcopenia and the related influencing factors in Xinjiang.

METHODS

This study was conducted from July-September 2023 in the northern and southern regions of Xinjiang, China. Possible sarcopenia and sarcopenia were diagnosed according to the AWGS 2019. The Sarqol® questionnaire was used to evaluate quality of life. A linear regression model with a stepwise method was used to identify quality-of-life-associated factors for possible sarcopenia and sarcopenia.

RESULTS

A total of 987 older adults were enrolled,18.5% had possible sarcopenia, and 15.1% had sarcopenia. Quality of life scores: possible sarcopenia 26.46-92.55 (56.31 ± 14.69), sarcopenia 30.74-90.93 (56.91 ± 13.45).The indicators for which the difference analysis were meaningful, in the group with possible sarcopenia are gender, inhabiting information, ACCI score, hearing loss, social support level and self-rated risk of falling. In the sarcopenia group are gender, ACCI score, hearing loss, vision loss, self-rated health status, number of remaining teeth, self-rated risk for falling, and dysphagia status. The risk factors for quality of life in patients with possible sarcopenia were gender and hearing loss, whereas self-rated of general health, self-rated of poor health, self-rated of very poor health and falls were risk factors in the sarcopenia group.

CONCLUSION

This study focused on quality of life and factors in older adults with possible sarcopenia or sarcopenia. The research results showed that in order to prevent the decline in the quality of life of older adults with sarcopenia, it is very important to regularly examine the oral health status of the older adults, prevent the occurrence of chronic diseases.Multimodal interventions address common sensory impairments.Carry out aging-friendly renovation of the home environment and conduct balance training to prevent the occurrence of falls among the older adults.

Trajectories of health-related quality of life and their association with disability in older Australians

BACKGROUND

The relationship between various disabilities and the trajectories of HRQoL in older populations remains largely unexplored. Therefore, we aim to investigate the connections between HRQoL trajectories and different types of disabilities in older Australians.

METHODS

The study participants' HRQoL was measured using the SF-6D utility index. We applied the group-based trajectory model to identify distinct HRQoL trajectories and employed multinomial logistic regression to examine the relationship between HRQoL trajectories and various types of disabilities.

RESULTS

We identified three distinct trajectories of HRQoL among older Australians: low-declining, moderate-declining, and high-stable HRQoL groups. We found evidence indicating that the relative risks of being in the low-declining HRQoL group are greater for all types of disabilities. Older Australians living with physical disabilities (Relative Risk Ratio [RRR]: 6.62, 95 % CI: 4.76-9.22), psychosocial disabilities (RRR: 14.06, 95 % CI: 2.85-69.46), and other disabilities (RRR: 4.64, 95 % CI: 3.51-6.12) face a higher relative risk of being in the low-declining HRQoL group compared to their counterparts. Similarly, older Australians with work-limiting disabilities (RRR: 15.96, 95 % CI: 11.99- 21.24), disability onset (RRR: 10.61, 95 % CI: 8.19- 13.75), and multiple disabilities (RRR: 19.12, 95 % CI: 13.96- 26.18) also have a higher relative risk of being in a low-declining HRQoL group compared to their counterparts.

CONCLUSIONS

Our findings emphasise the urgent need for targeted interventions and support services for older Australians with physical, psychosocial, and work-limiting disabilities to address their elevated risk of declining HRQoL and enhance their overall well-being.

Association between sensory impairment and sarcopenia in older Chinese adults: a 4-Year longitudinal study

OBJECTIVES

Sarcopenia is a common geriatric syndrome that significantly increases the risk of falls, fractures, disability, and death in older adults. Sensory impairments are also prevalent among the elderly and may exacerbate the decline in physical function, even affecting muscle health. Understanding whether sensory impairments are risk factors affecting sarcopenia in older adults is crucial for developing effective public health policies and intervention strategies. Therefore, this study aims to explore the association between sensory impairments and sarcopenia and its components.

METHODS

This study, based on the Chinese Health and Retirement Longitudinal Study (CHARLS), included 4,195 participants aged 60 and above. The assessment of sensory impairment was based on self-reported visual and hearing capabilities. The diagnosis of sarcopenia followed the consensus of the Asian Working Group on Sarcopenia (AWGS) from 2019. Data analysis was conducted using an ordered logistic regression model, and the results report the odds ratios (ORs) and their 95% confidence intervals (CI).

RESULTS

Single sensory impairments at baseline showed no significant correlation with sarcopenia four years later, while dual sensory impairments (DSI) at baseline were significantly associated with sarcopenia (ORs: 1.308, 95% CI: 1.126-1.519). In the analysis of trends over time, transitions from no sensory impairments (NSI) to DSI (ORs: 1.372, 95% CI: 1.028-1.830), from hearing impairments (HI) to DSI (ORs: 1.334, 95% CI: 1.002-1.778), and persistent DSI (ORs: 1.470, 95% CI: 1.159-1.864) were all significantly associated with sarcopenia. Additionally, we found DSI is associated with poor physical performance and muscle mass but not muscle strength.

CONCLUSIONS

Our study indicates that DSI have a more severe impact on sarcopenia compared to single sensory impairments. Our findings offer a new perspective for prevention and intervention strategies, suggesting the inclusion of sensory impairment assessments in the clinical evaluation of sarcopenia risk. For elderly individuals with DSI, comprehensive intervention measures should be provided, such as sensory rehabilitation, nutritional support, and guidance on physical activities. For those with only a single sensory impairment, proactive preventive measures should be taken to prevent the progression to DSI.

Does work after retirement affect health-related quality of life: Evidence from a propensity score matching study in China

AIM

Extending working life is considered as an important initiative to respond to the population aging and pension payment dilemma. This study aimed to investigate whether work after retirement is related to improved health-related quality of life.

METHODS

We used two waves of data from the China Health and Retirement Longitudinal Study in 2011 and 2018. Work after retirement was ascertained based on self-reported retirement and work status, and health-related quality of life (HRQOL) was measured with the three-level EuroQol five-dimensions. The impact of work after retirement on HRQOL was analyzed using the propensity score matching with difference-in-difference approach.

RESULTS

A total of 1043 retirees were included. The results showed that work after retirement was associated with significant improvement in HRQOL among retirees (β = 0.072, P < 0.001). Heterogeneity analyses did not show specificity on sex (P for sex interaction >0.05), but older-aged retirees seemed more sensitive to the benefits of work after retirement on HRQOL than their younger-aged counterparts (≥65 years: β = 0.167, P < 0.001 vs <65 years: β = -0.047, P > 0.05; P for age interaction = 0.010).

CONCLUSIONS

Work after retirement shows a positive impact on HRQOL among community-dwelling adults in China. Policy-makers should take the health of retirees into account when implementing policies related to delayed retirement, and reduce health inequity. Geriatr Gerontol Int 2024; 24: 722-729.

The association between dual sensory loss and healthcare expenditure: Mediating effect of depression

BACKGROUND

Previous studies have suggested the dual sensory loss (DSL) is linked to depression, and that they are associated with higher healthcare expenditures, respectively. However, the association between DSL, depression and healthcare expenditures remains ambiguous.

OBJECTIVES

The current study aims to examine the association between DSL, depression and healthcare expenditures as well as catastrophic health expenditures (CHE) among Chinese people aged 45 and above.

METHODS

We first utilized the China Health and Retirement Longitudinal Survey (CHARLS) 2018 to obtain data from a total of 13,412 Chinese individuals aged 45 and above to conduct a cross-sectional study. DSL was defined as a combined variable of self-reported vision loss and hearing loss. Depression was measured using The Center for Epidemiologic Studies Depression Scale (CESD-10). The healthcare expenditures, including outpatient out-of-pocket cost and inpatient out-of-pocket cost, were obtained from the Harmonized CHARLS section. CHE were defined as out-of-pocket (OOP) health spending equal to or higher than 40 % of a household's capacity to pay. A Tobit linear regression with three models and a path analysis were conducted to estimate the association between DSL, depression and healthcare expenditures and CHE. Then we utilized 2011CHARLS and 2018CHARLS to present a longitudinal analysis. A path analysis was conducted to estimate the association between 2011DSL, 2018depression and 2018healthcare expenditures and CHE.

RESULTS

Depression has a significant mediating effect between DSL and healthcare expenditures. (For outpatient OOP cost: a = 0.453, b = 23.559, c = 25.257, the proportion of mediating effect in total effect = 29.71 %; for inpatient OOP cost: a = 0.453, b = 13.606, c = 15.463, the proportion of mediating effect in total effect = 28.50 %; all P < 0.05). The mediating effect of depression also exists in the association between DSL and CHE (a = 0.453, b = 0.018, c = 0.043, the proportion of mediating effect in total effect = 15.90 %; P < 0.05). The mediation effect of depression on healthcare expenditures and CHE also exists in the longitudinal analysis using CHARLS 2011 and CHARLS 2018 (all P < 0.05).

LIMITATIONS

The DSL status were based on self-report and we used 2018CHARLS to conduct the study, which may cause some bias.

CONCLUSION

Significant mediating effect of depression exists between DSL and higher healthcare expenditures and CHE. The mental health of elder people with DSL should be focused on, and we should have an overall viewpoint on the topic of healthcare expenditures and CHE.

The overall and domain-specific quality of life of Chinese community-dwelling older adults: the role of intrinsic capacity and disease burden

Objective

This study aimed to investigate the impact of the different domains of intrinsic capacity (IC) and chronic disease burden on health-related quality of life (HRQoL) and domain-specific HRQoL in Chinese community-dwelling older adults.

Design

A cross-sectional observational study of a community-based cohort.

Participants

We evaluated Chinese older adults (n = 429, mean age, 72.91 ± 7.014 years; female proportion, 57.30%).

Measurements

IC contains five domains, namely locomotion, vitality, cognition, psychological, and sensory capacity. Locomotion dysfunction was defined as grip and/or gait decline. Vitality decline was defined if two of the following three parameters were present: fatigue, physical inactivity, and weight loss or overweight. Cognition was classified into normal cognition, pre-mild cognitive impairment (pre-MCI), and MCI according to the normative z-scores of the neuropsychological test battery. Psychological dysfunction was diagnosed based on depressive symptoms. Sensory dysfunction was defined as hearing and/or vision impairment. HRQoL was assessed using the AQoL-8D scale, which comprised physical (including independent living, senses, and pain) and psychosocial (including mental health, happiness, self-worth, coping, and relationships) dimensions. Low HRQoL (HRQoL score or subscores in the highest quintile) was used as a dependent variable in logistic regression analyses adjusted for demographic, health-related, and psychological confounders.

Results

Sensory impairment was an independent determinant of senses, and locomotion impairment was significantly associated with overall HRQoL, independent living, and pain in the physical dimension of HRQoL. Cognition was an independent determinant of the senses. Vitality was independently associated with overall HRQoL, senses, and pain in the physical dimension and mental health and relationships in the psychological dimension of HRQoL. The psychological domain of IC was independently associated with overall and domain-specific HRQoL apart from senses after adjustment for all confounders. The number of multimorbidities mainly had a significant impact on independent living after adjustment for all confounders.

Conclusion

IC domains and chronic disease burden had heterogeneous influences on overall and domain-specific HRQoL. The impairment of sensory and locomotion domains had a synergistic impact on the overall and physical dimensions of HRQoL. The vitality and psychological domains of IC had more profound effects on HRQoL. Older people with high morbidity might have a higher risk of poor independent living.