Social participation of community-dwelling older adults in western China: A latent profile analysis

Physical health problems, views on ageing, and emotional distress among older Chinese population: a moderated mediation model

OBJECTIVES

This study aims to investigate the mediation effect of negative views on ageing (VoA) between physical health problems and emotional distress, and the moderation effect of urban/rural residence ('hukou').

METHODS

We adopted a sample of 936 older Chinese people aged 60 and above from the China General Social Survey (CGSS). A structural equation model (SEM) approach was adopted to test the measurement model of latent variables and the structural model examining the hypothesized pathway. The bootstrapping bias-corrected approach (5000 bootstrap samples) was adopted.

RESULTS

The SEM shows that negative VoA mediates physical health problems and emotional distress (β = 0.041, B = 0.063, 95% CI [0.029, 0.102], p = 0.001). The relationship between negative VoA and emotional distress is more pronounced among urban than rural older residents (β = 0.181, B = 0.168, 95% CI [0.004, 0.377], p = 0.076), which may suggest that being dependent on others is less desirable among urban older people.

CONCLUSION

This study underscores the importance of having positive VoA, especially for urban older residents. More studies on the formation and impacts of older people's expectations of their own ageing are warranted.

Exploring patterns of social participation and its relationship with loneliness among older adults in rural China through a person-centered approach: A cross-sectional study using latent profile analysis

OBJECTIVE

Identify social participation patterns and their predictors among older adults in rural China, and explore the association between these patterns and loneliness.

METHODS

This cross-sectional study was conducted from June to October 2023 in eight townships in Huzhou, China. Convenience sampling to recruit 500 rural older adults, of whom 467 completed the survey. Confirmatory factor analysis was used to validate the factor structure of the social participation scale. Latent profile analysis was conducted to identify social participation patterns based on ten items of social participation. Bivariate and multiple logistic regression analyses were used to explore the relationship between social participation patterns and sociodemographic variables among rural older adults. ANOVA was used to explore the association between social participation patterns and loneliness across potential profiles.

RESULTS

Three patterns of social participation were identified: high family personal activity-low social participation group (53.5 %, n = 250), moderate social participation group (31.3 %, n = 146), and high cultural organizational activity-high social participation group (15.2 %, n = 71). The results of multiple logistic regression analysis showed that age, sex, marital status, self-rated health status, and number of chronic diseases were predictors of different patterns of social participation among rural older adults. ANOVA results showed that the differences in loneliness between the different potential profiles of social participation patterns among rural older adults were all significant.

CONCLUSION

This study revealed three distinct social participation patterns among rural older adults and their strong link to loneliness. These findings can guide future research and inform nursing practice, enabling more tailored support aligned with older adults' family and personal lives, thus better addressing their needs and preferences. By understanding these patterns, nurses can develop personalized care plans that incorporate targeted social support, helping to reduce loneliness and improve well-being in rural older adults.

Disease burden of brucellosis among the elderly in Inner Mongolia, China: A cross-sectional data study from 2016 to 2020

Brucellosis is a zoonotic infection with an annually increasing incidence in the elderly. However, few research teams studied the brucellosis disease burden on this elderly population. This study assesses the brucellosis disease burden of elderly patients in Inner Mongolia, to explore its influencing factors, and provide a scientific basis for effectively reducing the disease burden in this demographic. This study described the disease burden of brucellosis in the elderly population in Inner Mongolia from 2016 to 2020. The incidence of brucellosis among the elderly showed an annually increasing trend, with concentrated incidences from April to July each year. The male and 60-69 age groups exhibit a high prevalence of brucellosis, while Xilingol, Ulanqab, and Hohhot exhibited high disease burdens. Meanwhile, Bayannur exhibited the fastest disease burden growth. Precipitation and the value of total pastoral production were positively correlated with the disease burden. In contrast, the sunshine duration, the number of health institutions, and GDP per capita exhibited negative correlations with the disease burden. The growing brucellosis incidence and disease burden among the elderly in Inner Mongolia is a serious issue. Relevant departments and agencies should focus on protecting the male population aged 60 to 69. Continuous attention should be directed to the western regions to prevent the emergence of new high-risk areas. Strengthening the rural healthcare system through increased medical personnel and financial investment is crucial to lowering the risk of brucellosis and alleviating its impact on the elderly population.

Social participation patterns and associations with subsequent cognitive function in older adults with cognitive impairment: a latent class analysis

Background

Social participation (SP) has been associated with cognitive benefits among older adults; however, little is known about SP patterns and their relationships with cognitive function in cognitively impaired populations. This study aimed to identify SP patterns among cognitively impaired older individuals and evaluate their associations with subsequent cognitive function, specifically mental intactness and episodic memory.

Methods

Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), including 5,673 individuals aged 60 years and older with cognitive impairment from 2015 to 2018. Latent class analysis (LCA) was used to identify SP patterns, and hierarchical linear regression analyses were conducted to examine associations between these patterns and cognitive function.

Results

Four distinct SP patterns were identified: "Offline Social Participation Group" (Class 1), "Intellectual Social Participation Only Group" (Class 2), "Club and Volunteer Activities Group" (Class 3), and "Minimal Social Participation Group" (Class 4). The Class 4 comprised the majority (73%) and exhibited the poorest cognitive outcomes. Compared to the Class 4, Class 2 showed significant improvements in mental intactness (p < 0.001) and episodic memory (p = 0.022), while Class 3 demonstrated significant improvements in mental intactness (p = 0.032) but not episodic memory. Class 1 showed significant improvements in episodic memory (p = 0.023).

Conclusion

This study highlights the cognitive benefits of social participation, particularly intellectual activities, for older adults with cognitive impairment. Targeted interventions promoting SP, especially intellectual activities, are essential to mitigate cognitive decline and improve cognitive resilience in vulnerable populations.

The relationship between social participation and cognitive function early after surgery of glioma patients

OBJECTIVE

Social Participation (SP) is known to benefit cognitive function. However, whether this positive relationship holds across the people with glioma has not been studied. The present study aimed to investigate the current status of SP and cognitive function of patients early after surgery with glioma, and therefore, explore the associations between cognitive function and SP.

METHODS

This study included 179 postoperative patients with gliomas within 6 months of surgery. Cognitive functioning was measured by the Montreal Cognitive Assessment (MoCA) including orientation, attention, learning and memory, executive functioning and verbal fluency. Social participation was obtained also by questionnaire survey with the Impact on Participation and Autonomy Questionnaire (IPA). The Pearson correlation analysis was used to explore the relation between cognitive functioning and social participation, and the efficacy of social participation in predicting cognitive functioning was evaluated using the receiver operating characteristic (ROC).

RESULTS

The prevalence of cognitive impairment in early postoperative glioma patients was 77.65%. The mean level of social participation was 37.96 ± 26.85 points, with poorer scores in the autonomy participation of family role and outdoor engagement dimensions. Patients' cognitive functioning was positively correlated with social participation (r = -0.64, P < 0.001). And The areas under the ROC curve for social participation predicting cognitive function were 0.884.

CONCLUSION

Early post-operative cognitive impairment was more common in glioma patients, which was positively correlated with social participation. Social rehabilitation programs for glioma patients should be actively constructed to promote the social participation of patients early after surgery in order to protect their cognitive function.

Nurses' work value patterns and their relationship with burnout: a cross-sectional study based on latent profile analysis

BACKGROUND

There is a significant association between work values and burnout. However, most studies have tended to focus on a single influencing factor or rely only on total scale scores to assess nurses' work values, lacking a comprehensive consideration of differences within groups of nurses. As a result, the specific relationship between different work value patterns and burnout has not been clarified.

OBJECTIVE

This study aimed to identify Chinese nurses' patterns of work values, analyze the sociodemographic differences between these patterns, and explore the associations between these patterns and burnout.

DESIGN

Cross-sectional study.

METHODS

A total of 550 nurses were recruited for this study via convenience sampling, 505 of whom completed the survey. A pattern of nurses' work values was identified through a latent profile analysis of 30 items on the nurses' work values scale. The relationships between nurses' work value patterns and sociodemographic variables were subsequently explored via bivariate analysis and multiple logistic regression analyses. Moreover, ANOVA was used to assess the associations between different latent profile work value patterns and nurse burnout.

RESULTS

A total of three nurse work value patterns were identified: demand support (16.6%, n = 84), intrinsically driven (42.2%, n = 213), and overall identification (41.2%, n = 208). Age and marital status, such as being married, were the main predictors of demand support patterns. In contrast, years of working experience, a higher education level (a bachelor's or master's degree), and having a career establishment were predictors of intrinsically driven and overall identification patterns. In addition, the analyses revealed significant differences in burnout among nurses with different work value patterns.

CONCLUSION

This study provides new perspectives for understanding the work motivation and stressors of the nurse population, revealing significant differences in coping with burnout among nurses with different work value patterns. This finding not only provides an important reference for subsequent research but also provides a strong basis for developing interventions for nurse burnout.

CLINICAL TRIAL NUMBER

Not applicable.

Developmental trajectories and heterogeneity of social engagement among Chinese older adults: a growth mixture model

BACKGROUND

Social engagement is closely related to well-being among older adults. However, studies on the changing trajectory and influencing factors (especially time-varying factors) of social engagement are limited. This study aimed to examine the social engagement trajectory of older Chinese adults and explore its time-fixed and time-varying factors, thus providing evidence for the development of strategies to promote a rational implementation for healthy aging.

METHODS

This study included 2,195 participants from a subset of four surveys from the Chinese Longitudinal Healthy Longevity Survey conducted from 2008 to 2018 (with the latest survey completed in 2018), with follow-ups conducted approximately every three years. Growth mixture modeling was used to explore the social engagement trajectory of older adults and the effects of time-varying variables. In addition, multinomial logistic regression was employed to analyze the association between time-fixed variables and latent classes.

RESULTS

Three distinct trajectories of social engagement among older adults in China were identified: slow declining (n = 204; 9.3%), which meant social engagement score decreased continuously, but social engagement level improved; slow rising (n = 1,039; 47.3%), marked by an increased score of social engagement, but with an depressed engagement level; and middle stabilizing (n = 952; 43.4%), which meant social engagement score and engagement level remained quite stable. A time-fixed analysis indicated that age, marital status, educational level, and annual family income had a significant impact on social engagement (P < 0.05). In contrast, the time-varying analysis showed that a decline in functional ability, insufficient exercise (means no exercise at present), deteriorating self-reported health and quality of life, negative mood, monotonous diet, and reduced community services were closely related to the reduction in social engagement levels (P < 0.05).

CONCLUSION

Three trends were observed at the social engagement level. Older adults with initially high levels of social engagement exhibited a continuous upward trend, whereas those with initially low levels experienced a decline in their social engagement, and those with initially intermediate levels remained quite stable. Considering the primary heterogeneous factors, it is imperative for governments to enhance basic services and prioritize the well-being of older adults. Additionally, families should diligently monitor the emotional well-being of older adults and make appropriate arrangements for meals.

Dual trajectories of social participation and frailty in Chinese older adults: a longitudinal study based on CLHLS from 2008 to 2018

Introduction

This study aimed to identify the dual trajectories of social participation (SP) and frailty index (FI) among Chinese older adults, and investigate common influential factors of both trajectories.

Methods

Utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018 surveys, 1,645 individuals were analyzed. A group-based dual trajectory model and logistic regression were used to examine trajectories, their interrelations and shared influencing factors.

Results

This study identified three SP, two FI trajectories and six distinct sub-groups of individuals. The study confirmed a long-term, interrelated relationship between two outcomes and identified some common factors. Compared to participants in the lower SP trajectory, those who followed the middle SP trajectory and higher SP trajectory had increased probabilities of belonging to the slow-growth FI trajectory (90.28 and 99.71%, respectively). And the participants in the slow-growth FI exhibited higher probabilities of belonging to the middle SP and the higher SP trajectory (37.64 and 25.34% higher, respectively) compared with those in the rapid-growth FI trajectory. Age, marital status, and drinking status were mutual factors associated with the dual trajectories.

Discussion

The results showed significant associations between higher levels of frailty and lower levels of social participation. Related intervention policies should consider the dual trajectories and the common factors that underlie these trajectories of SP and FI.

Heterogeneity of social participation in patients three months after total knee arthroplasty: a latent profile analysis

BACKGROUND

Social participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients' functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients.

METHODS

This cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants' data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients' social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups.

RESULTS

Three months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05).

CONCLUSION

These results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.

Chinese older adults' prior-to-death disability profiles and their correlates

BACKGROUND

Disability prior to death complicates end-of-life care. The present study aimed to explore the prior-to-death disability profiles of Chinese older adults, the profiles' links to end-of-life care arrangements and place of death, and predictors of the profiles.

METHODS

In total, data were extracted from the records of 10,529 deceased individuals from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent profile analyses, bivariate analysis, and multivariate logistic regression were applied to identify prior-to-death disability profiles, explore the profiles' links to end-of-life care arrangements and place of death, and examine predictors in the profiles, respectively.

RESULTS

Three prior-to-death disability profiles, namely, Disabled-Incontinent (37.6%), Disabled-Continent (34.6%), and Independent (27.8%), were identified. Those with the Independent profile were more likely to live alone or with a spouse and receive no care or care only from the spouse before death. Disabled-Continent older adults had a higher chance of dying at home. Being female, not "married and living with a spouse", suffering from hypertension, diabetes, stroke or cerebrovascular disease (CVD), bronchitis/emphysema/pneumonia, cancer, or dementia, and dying in a later year were associated with more severe prior-to-death disability patterns. Not having public old-age insurance predicted lower chances of having a Disabled-Incontinent profile, and advanced age increased the chance of having a Disabled-Continent profile.

CONCLUSIONS

Three prior-to-death disability patterns were identified for Chinese adults aged 65 years and older. These profiles were significantly linked with the end-of-life caregiving arrangements and place of death among older adults. Both demographic information and health status predicted prior-to-death disability profiles.

A predictive model for social participation of middle-aged and older adult stroke survivors: the China Health and Retirement Longitudinal Study

Objective

This study aims to develop and validate a prediction model for evaluating the social participation in the community middle-aged and older adult stroke survivors.

Methods

The predictive model is based on data from the China Health and Retirement Longitudinal Study (CHARLS), which focused on individuals aged 45 years or older. The study utilized subjects from the CHARLS 2015 and 2018 wave, eighteen factors including socio-demographic variables, behavioral and health status, mental health parameters, were analyzed in this study. To ensure the reliability of the model, the study cohort was randomly split into a training set (70%) and a validation set (30%). The Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was used to identify the most effective predictors of the model through a 10-fold cross-validation. The logistic regression model was employed to investigate the factors associated with social participation in stroke patients. A nomogram was constructed to develop a prediction model. Calibration curves were used to assess the accuracy of the nomogram model. The model's performance was evaluated using the area under the curve (AUC) and decision curve analysis (DCA).

Result

A total of 1,239 subjects with stroke from the CHARLS database collected in 2013 and 2015 wave were eligible in the final analysis. Out of these, 539 (43.5%) subjects had social participation. The model considered nineteen factors, the LASSO regression selected eleven factors, including age, gender, residence type, education level, pension, insurance, financial dependence, physical function (PF), self-reported healthy,cognition and satisfaction in the prediction model. These factors were used to construct the nomogram model, which showed a certain extent good concordance and accuracy. The AUC values of training and internal validation sets were 0.669 (95%CI 0.631-0.707) and 0.635 (95% CI 0.573-0.698), respectively. Hosmer-Lemeshow test values were p = 0.588 and p = 0.563. Calibration curves showed agreement between the nomogram model and actual observations. ROC and DCA indicated that the nomogram had predictive performance.

Conclusion

The nomogram constructed in this study can be used to evaluate the probability of social participation in middle-aged individuals and identify those who may have low social participation after experiencing a stroke.

Social participation in older people with hearing impairment in Chinese community: A latent profile analysis

OBJECTIVES

Hearing impairment may lead to increased communication difficulties for older people, making their social participation less optimistic. However, there is little research on the social participation of older people with hearing impairment, especially based on the characteristics of their social participation. This study aimed to identify different social participation profiles in older people with hearing impairment and to explore sociodemographic characteristics, disease-related characteristics and psychosocial factors with different social participation profiles.

METHODS

A cross-sectional study of 300 older people with hearing impairment using the sociodemographic questionnaire, the Impact on Participation and Autonomy Questionnaire, the Lubben Social Network Scale-6, Medical Outcomes Study Social Support Survey and Geriatric Depression Scale-15 from May to August 2023 in a community of Beijing, China. Latent profile analysis was used to analyse the latent profiles of social participation in elderly with hearing impairment. Multiple logistic regression was used to explore the predictors of different profiles.

RESULTS

The social participation of older people with hearing impairment in the community can be classified into three potential profiles: Profile 1 - high social participation group (76.05 %), Profile 2 - moderate social participation group (17.34 %), Profile 3 - low social participation group (6.61 %). Age, types of chronic diseases, self-reported health, severity of hearing impairment, social network, social support and depression were predictors of different profiles.

CONCLUSIONS

Nurses should pay attention to the characteristics, depression, social network and support of older people with different hearing impairment to improve social participation in different profiles.

IMPLICATIONS AND RECOMMENDATIONS

This was the first study exploring latent profiles of social participation in older people with hearing impairment. Insights from this study are useful for gerontological nursing to distinguish different profiles and further identify the characteristics of different profiles in older people with hearing impairment by characterizing the level of social participation in the community and better implement interventions according to profiles.

Profiles of digital health literacy among university students and its association with mental health during the COVID-19 pandemic: A latent profile analysis

Objective

Investigating the digital health literacy of university students can facilitate their effective acquisition of health information and adoption of appropriate protective behaviors. This study aims to explore the subtypes of digital health literacy among university students during the COVID-19 pandemic and their association with mental health outcomes.

Methods

From 17 November to 14 December 2022, a stratified random sampling approach was used to conduct an online questionnaire survey on digital health literacy, fear of COVID-19, and depression status among students at Jilin University, China. A total of 1060 valid responses were obtained in the survey. Latent profile analysis identified subtypes of digital health literacy and linear regression analyses were used to examine the association of digital health literacy to the mental health outcome.

Results

Three latent profiles were identified: Profile 1-low digital health literacy (n = 66, 6.23%), Profile 2-moderate digital health literacy (n = 706, 66.60%), and Profile 3-high digital health literacy (n = 288, 27.17%). Results from linear regression demonstrated a negative correlation between digital health literacy and fear of COVID-19 (B = -2.954, P < 0.001) as well as depression (B = -2.619, P < 0.001) among university students.

Conclusions

This study indicated that the majority of university students exhibit a moderate level of digital health literacy during the COVID-19 pandemic. Additionally, the study validates a negative correlation between digital health literacy and mental health among university students.

Frailty index trajectories in Chinese older adults with diverse levels of social participation: findings from a national population-based longitudinal study

BACKGROUND

Aging and frailty pose significant challenges globally, placing a substantial burden on healthcare and social services due to their adverse consequences.

AIM

The primary objective of this study was to investigate the relationship between social participation and development of frailty transition and trajectory.

METHODS

This study utilized data from the CLHLS Cohort, a 10-year follow-up study involving 6713 participants, to investigate the association between social participation and development of frailty. Frailty reflects a comprehensive decline in various body functions. The study employed a group-based trajectory model to analyze the development trajectory of the frailty index and used logistic regression to assess the odds ratio (OR) of frailty risk.

RESULTS

We identified two distinct groups of frailty progression trajectories: the "stable development group" and the "rapid growth group." Individuals who engaged in social activities at least once a month, but not daily, exhibited a significant association with an increased risk of transitioning into the "rapid growth group" (OR 1.305, 95% CI 1.032-1.649). Those with social participation less than once a month had an even greater risk (OR 1.872, 95% CI 1.423-2.463). Moreover, low social participation frequency (occasionally/never) has a more pronounced impact on frailty progression in males.

CONCLUSION

A higher frequency of social participation is associated with a lower risk of being classified into the "rapid growth group" and a slower rate of frailty index progression. Preventing the progression of frailty can contribute to enhanced support for healthy aging among older adults.

Development of the Self-efficacy for Social Participation scale (SOSA) for community-dwelling older adults

BACKGROUND

Social participation is important for the health of older adults and super-aging societies. However, relatively few independent older adults in advanced countries actually participate in society, even though many of them have the capacity to do so. One possible reason for this could be a lack of self-efficacy for social participation. However, few scales have been developed to measure self-efficacy for social participation among community-dwelling independent older adults. Therefore, we developed the "Self-efficacy for Social Participation" scale (SOSA) to assess the self-efficacy of community-dwelling independent older adults, and examined the scale's reliability and validity.

METHODS

We distributed a self-administered mail survey to approximately 5,000 randomly selected independent older adults throughout Japan. The construct validity of the SOSA was determined using exploratory and confirmatory factor analyses. Criterion-related validity was assessed using the General Self-Efficacy Scale (GSES) and according to subjective health status.

RESULTS

In total, 1,336 older adults responded to the survey. Exploratory and confirmatory factor analyses identified 12 items distributed among four factors: instrumental self-efficacy, managerial self-efficacy, interpersonal self-efficacy and cultural self-efficacy. The final model had a Cronbach's alpha of 0.90, goodness-of-fit index of 0.948, adjusted goodness-of-fit index of 0.915, comparative fit index of 0.952, and root mean square error of approximation of 0.078. Significant correlations existed between the SOSA score and GSES (r = 0.550, p < 0.01) and subjective health status (r = 0.384, p < 0.01) scores.

CONCLUSIONS

The SOSA showed sufficient reliability and validity to assess self-efficacy for social participation among older adults. This scale could aid efforts to improve the physical and mental health, and longevity, of older adults through increased behavioralizing social participation.

Cardiovascular disease risk perception among community adults in South China: a latent profile analysis

Objective

Risk perception, a critical psychological construct, influences health behavior modification and maintenance of individuals with cardiovascular disease (CVD) risk. Little is known about CVD risk perception among Chinese adults. This research examined the profiles of CVD risk perception of community adults in South China, and explored the characteristics and factors that influence their perception of CVD risk.

Method

This cross-sectional study was conducted in Hangzhou, Zhejiang Province, in South China from March to July 2022 and included 692 participants. Risk perception was assessed using the Chinese version of the Attitude and Beliefs about Cardiovascular Disease Risk Questionnaire. Latent profile analysis (LPA) was performed to extract latent classes of CVD risk perception. These classes of CVD risk perception were compared with 10-year CVD risk categories to define correctness of estimation. Chi-square tests and multinomial regression analyses were used to identify differences between these categories.

Results

Three CVD risk perception classes were identified by LPA: low risk perception (14.2% of participants), moderate risk perception (46.8%), high risk perception (39.0%). Individuals who were aged with 40-60 year (OR = 6.94, 95% CI = 1.86-25.84), diabetes (OR = 6.26, 95% CI = 1.34-29.17), married (OR = 4.52, 95% CI = 2.30-8.90), better subjective health status (OR = 3.23, 95% CI = 1.15-9.10) and perceived benefits and intention to change physical activity (OR = 1.16, 95% CI = 1.05-1.27) were more likely to be in the high-risk perception class. Compared to absolute 10-year CVD risk based on China-PAR, a third of participants (30.1%) correctly estimated their CVD risk, 63.3% overestimated it and 6.6% underestimated it. CVD risk underestimation was associated with hypertension (OR = 3.91, 95% CI = 1.79-8.54), drinking (OR = 3.05, 95% CI = 1.22-7.64), better subjective health status (OR = 2.67, 95% CI = 1.18-6.03).

Conclusions

Most adults in South China possess a moderate level of CVD risk perception. Advanced age, higher monthly income, diabetes and better health status were significantly related to higher perceived CVD risk. Individuals with hypertension, drinking and better subjective health status were associated with CVD risk underestimation. Healthcare professionals should pay attention to the indicators for different classes and identify underestimation group as early as possible.

Trajectories of Social Participation and Its Predictors in Older Adults: Based on the CLHLS Cohorts from 2002 to 2018

Social participation is a key factor in achieving active aging. This study aimed to explore the trajectories and predictors of social participation changes among older adults in China. The data used in this study are from the ongoing national longitudinal study CLHLS. A total of 2492 older adults from the cohort study were included. Group-based trajectory models (GBTM) were used to identify potential heterogeneity in longitudinal changes over time and investigate associations between baseline predictors and trajectories for different cohort members using logistic regression. Four different trajectories of social participation were reported in older adults, namely, stable (8.9%), slow decline (15.7%), lower score with decline (42.2%), and higher score with decline (9.5%). On multivariate analyses, age, years of schooling, pension, mental health, cognitive function, instrumental activities of daily living, and initial social participation scores significantly impact the rate of change in social participation over time. Four trajectories of social participation were identified in the Chinese elderly population. Management of mental health, physical function, and cognitive function appear to be important in maintaining the long-term social participation of older people in the community. Early identification of factors influencing the rapid decline in social participation and timely interventions can maintain or improve social participation levels in older adults.

Effects of functional limitations and activities of daily living on the mortality of the older people: A cohort study in China

Introduction

Prevalence of functional limitations (FLs) and disabled activities of daily living (ADL) cause heavy burdens to the health of the older people. Stratified by gender, this study aimed to explore the effects of FL and ADL on the mortality of the older people in China, and the mechanism was then discussed.

Methods

We used survey data of a prospective 10-year cohort (2008-2018), from the China Longitudinal Healthy Longevity Survey (CLHLS). The primary outcome was all-cause mortality, and Independent variables included FL, basic ADL (BADL), and instrumental ADL (IADL). Covariates involved socio-demographic characteristics, health-related behaviors, and health status of the participants in the CLHLS project.

Results

There were 967 (19.20%) male and 2,235 (32.36%) female older people performed functional limitations, and their survival time was 60.98 (SE = 0.66) and 55.19 (SE = 0.55) months, respectively. Old adults with FL had significantly poorer survival than the ones without (Log-rank test, P < 0.001). Weibull regression suggested that FL (P < 0.001), abnormal BADL (P < 0.001) and IADL (P < 0.001) were negatively associated with the survival of the older people. Further analysis showed that BADL and IADL performed significantly mediating roles in the relation of FL and survival time in old adults; additionally, for female older people, BADL also exhibited a significant moderating role in the effect of FL on survival.

Conclusions

Prevalence of FL was serious among the older people in China, especially for the women. Disabilities of BADL and IADL and FL were negatively associated with the survival time of the older people in China. Regarding the effect of FL on survival, BADL and IADL performed significantly mediating roles, and the moderating role of BADL existed only for the female. These suggested evidence to implement strategies to maintain health in the older people.