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Fu Y, Li X. Work status among middle-aged and older individuals in China: the effects on physical and mental health. Front Public Health 2024; 12:1322398. [PMID: 38605868 PMCID: PMC11006966 DOI: 10.3389/fpubh.2024.1322398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/14/2024] [Indexed: 04/13/2024] Open
Abstract
Objective China's middle-aged and older population is a rich source of human capital. Therefore, considering the health of this group is important when creating and using human resources. Methods Using data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 baseline survey of 19,000 adults ages 45 years and older, this study was an objective investigation of the effects of work on the physical and mental health of middle-aged and older adults. We conducted several types of analyses using details of participants' lifestyles and demographic characteristics (living environment, education, financial level, and access to medical services) with work (i.e., employment or volunteer work) as a primary input component of health production to examine their effects on the health status of middle-aged and older individuals. Results Six primary outcomes were identified: (1) Employment positively affects both the physical and mental health of middle-aged and older people; (2) Employment can influence the physical and mental health of middle-aged and older people through income, cognitive level, and social support networks; (3) Compared to non-self-employment, self-employment dramatically worsens physical health but has no apparent detrimental effects on mental health. Compared to non-agricultural employment, agricultural labor affects both physical and mental health. (4) Employment has more positive physical and mental health effects in Individuals with higher rather than lower levels of education. (5) Employment opportunities in the eastern region are more likely to promote better physical health than those in the central and western regions of China, although the effects on mental health are negative. (6) When considering groups at different ages of the lifespan, the 60-65-year-old group, who are just entering retirement probably benefit more from continuing work. Conclusion We provide some recommendations to encourage middle-aged and older people to work and utilize their experience, which will enhance their physical and mental well-being and help them in realize their own value and social integration.
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Affiliation(s)
| | - Xiaohan Li
- Business School, Central South University, Changsha, China
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Ye X, Zhang G, Han C, Wang P, Lu J, Zhang M. The association between Chinese visceral adiposity index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national cohort study. Front Endocrinol (Lausanne) 2024; 15:1381949. [PMID: 38601202 PMCID: PMC11004471 DOI: 10.3389/fendo.2024.1381949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
Objective This study aimed to explore the association between the Chinese visceral adiposity index (CVAI) and cardiometabolic multimorbidity in middle-aged and older Chinese adults. Methods The data used in this study were obtained from a national cohort, the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018 wave). The CVAI was measured using previously validated biomarker estimation formulas, which included sex, age, body mass index, waist circumference, triglycerides, and high-density lipoprotein cholesterol. The presence of two or more of these cardiometabolic diseases (diabetes, heart disease, and stroke) is considered as cardiometabolic multimorbidity. We used Cox proportional hazard regression models to examine the association between CVAI and cardiometabolic multimorbidity, adjusting for a set of covariates. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to show the strength of the associations. We also conducted a subgroup analysis between age and sex, as well as two sensitivity analyses. Receiver operator characteristic curves (ROC) were used to test the predictive capabilities and cutoff value of the CVAI for cardiometabolic multimorbidity. Results A total of 9028 participants were included in the final analysis, with a mean age of 59.3 years (standard deviation: 9.3) and women accounting for 53.7% of the sample population. In the fully-adjusted model, compared with participants in the Q1 of CVAI, the Q3 (HR = 2.203, 95% CI = 1.039 - 3.774) and Q4 of CVAI (HR = 3.547, 95% CI = 2.100 - 5.992) were associated with an increased risk of cardiometabolic multimorbidity. There was no evidence of an interaction between the CVAI quartiles and sex or age in association with cardiometabolic multimorbidity (P >0.05). The results of both sensitivity analyses suggested that the association between CVAI and cardiometabolic multimorbidity was robust. In addition, the area under ROC and ideal cutoff value for CVAI prediction of cardiometabolic multimorbidity were 0.685 (95% CI = 0.649-0.722) and 121.388. Conclusion The CVAI is a valid biomarker with good predictive capability for cardiometabolic multimorbidity and can be used by primary healthcare organizations in the future for early warning, prevention, and intervention with regard to cardiometabolic multimorbidity.
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Affiliation(s)
- Xiaomei Ye
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Guangru Zhang
- Department of General Practice, Community Health Service Center Xiayang Street, Shanghai, China
| | - Chenyu Han
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Ping Wang
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jiaping Lu
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Min Zhang
- Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
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Chen J, Wu Y, Li L, He F, Zou B, Zhuang Y, Tuersun Y, Yang J, Wu F, Kan Y, Lyu K, Lu Y, Ming WK, Sun X, Wang D. How is family health related to health-related quality of life among middle-aged and older adults in rural China? A cross-sectional study. Int J Older People Nurs 2024; 19:e12605. [PMID: 38374792 DOI: 10.1111/opn.12605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is unequal between countries and regions, and the emphasis on HRQOL of populations of low-income countries and regions is unprecedented. OBJECTIVES To examine the association between family health and HRQOL among middle-aged and older adults in rural China, and determine whether this association differs by age, gender and chronic disease subgroup. METHODS Cross-sectional survey carried out from July to September 2021. The participants were 1059 people aged 46 and over living in rural China. We used the European Quality of Life Five Dimension Five Level (EQ-5D-5L) and Family Health Scale-Short Form (FHS-SF) to assess health-related quality of life (HRQOL) and family health, respectively. RESULTS The mean EQ-VAS was 75.66, the mean EQ index score was 0.92, and the mean FHS was 37.90 in rural middle-aged and older adults. After Bonferroni correction, generalised linear regression models showed that FHS was significantly associated with the EQ-VAS (β = 0.829; 95% confidence interval [CI]: 0.660 to 0.997; p < .001) and the EQ index score (β = 0.003; 95%CI: 0.001 to 0.004; p < .001). Binary logistic regression models showed that FHS was associated with three dimensions of HRQOL (mobility, self-care and usual activities) (p < .01). Based on subgroup analyses, the effect of FHS on EQ-VAS and the EQ index score was significant in three subgroups after Bonferroni correction (p < .01), but the association between FHS and the dimensions of HRQOL differed by age, gender and chronic disease group (p > .01). CONCLUSIONS This study is the first to explore that family health and its dimensions are significant positive predictors of HRQOL among middle-aged and older adults in rural China. Family-based measures may have more potential and value because better family health significantly improves HRQOL. IMPLICATIONS FOR PRACTICE In the health strategy, the government and primary health care workers should include family health as an indicator and assess it before and after the implementation of the strategy.
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Affiliation(s)
- Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
- Institute of Health Management, Southern Medical University, Guangzhou, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Lehuan Li
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Feiying He
- Southern Medical University, Guangzhou, China
| | - Biqing Zou
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yishan Zhuang
- School of Public Health, Southern Medical University, Guangzhou, China
| | | | - Jiao Yang
- School of Public Health, Capital Medical University, Beijing, China
| | - Fangjing Wu
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yifan Kan
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Ke Lyu
- School of Public Health, China Medical University, Shenyang, China
| | - Yefeng Lu
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
- Institute of Health Management, Southern Medical University, Guangzhou, China
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Cunha C, Rodrigues P, Voss G, Martinez-Pecino R, Delerue-Matos A. Association between formal social participation and cognitive function in middle-aged and older adults: a longitudinal study using SHARE data. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2024:1-24. [PMID: 38402630 DOI: 10.1080/13825585.2024.2315769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/14/2023] [Indexed: 02/27/2024]
Abstract
Formal social participation significantly impacts health and well-being, potentially mitigating cognitive decline, although not consistently across all studies. Existing research often focuses solely on baseline participation levels, and age-related differences have primarily been explored among the Asian population. Therefore, this longitudinal study aims to assess the association between formal social participation and cognition across different age groups in individuals aged 50+ living in Europe and Israel, while capturing the dynamic nature of formal social participation. We use data from three waves (four, six, and eight) of the Survey of Health, Ageing, and Retirement in Europe (SHARE), comprising 85,601 respondents. Linear mixed-effects models were applied. The results show that participation in formal social activities mitigates cognitive decline in middle-aged and older adults, especially among those aged 70 to 79 and 80+. These findings support the need for social policies promoting formal social activities, for lasting cognitive health benefits.
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Affiliation(s)
- Cláudia Cunha
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Paula Rodrigues
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
| | - Gina Voss
- Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Alice Delerue-Matos
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, Braga, Portugal
- Department of Sociology, Institute of Social Sciences, University of Minho, Braga, Portugal
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Ai Z, Tang C, Wen X, Kartheepan K, Tang S. Examining the impact of chronic diseases on activities of daily living of middle-aged and older adults aged 45 years and above in China: a nationally representative cohort study. Front Public Health 2024; 11:1303137. [PMID: 38419813 PMCID: PMC10899675 DOI: 10.3389/fpubh.2023.1303137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/19/2023] [Indexed: 03/02/2024] Open
Abstract
Background China has by far one of the fastest-aging populations in the world. Increasing age is often accompanied by an increasing prevalence of chronic diseases and impaired Activities of Daily Living (ADL). The aim of this study was to analyze the effects of chronic diseases on ADL in Chinese middle-aged and older adults and to provide a scientific basis for delaying the impairment of ADL and prolonging the self-care life expectancy of middle-aged and older adults. Methods This investigation utilized the survey information of 10,096 middle-aged and older adults from the China Health and Aging Tracking Survey (CHARLS) of 2011 as baseline data, then followed up this cohort until 2018, and performed multifactorial analyses using Cox proportional risk models to explore the strength of the associations between chronic diseases and the risk of impaired ADL in middle-aged and older adults. Results Among the middle-aged and older adult population, the presence of hypertension was associated with a 38% higher risk of impaired ADL compared to those without the condition (HR = 1.38,95% CI:1.24-1.54); the involvement of heart disease was associated with a 27% higher risk of impaired ADL compared to those without the condition (HR = 1.27,95% CI:1.10- 1.46); the existence of arthritis was associated with a 38% higher risk of impaired ADL in middle-aged and older adults compared to those without arthritis (HR = 1.38,95% CI:1.25-2.08); additionally, the risk of impaired ADL with one or ≥ 2 chronic diseases was increased by 34% (HR = 1.34, 95% CI:1.18-1.52) and 84% (HR = 1.84, 95% CI:1.63-2.08) in middle-aged and older adult individuals, respectively. Conclusion Hypertension is a risk factor for impaired ADL at any age in the subjects of this study. Examining the association between the number of chronic diseases and impairment in activities of daily living, it was revealed that the risk of ADL impairment increased with the number of chronic diseases in both the middle-aged (45-59 years) and older adult (60-74 years) groups.
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Affiliation(s)
- Zhonghua Ai
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Churou Tang
- Department of Biology, University of Rochester, Rochester, NY, United States
| | - Xuan Wen
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Karthikesu Kartheepan
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- Department of Primary Health Care, Faculty of Health-Care Sciences, Eastern University, Chenkalady, Sri Lanka
| | - Songyuan Tang
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
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Sun B, Wang J, Wang Y, Xiao W, Liu Y, Wang Y, Chen Y, Lu W. Associations of Dynapenic Abdominal Obesity and Frailty Progression: Evidence from Two Nationwide Cohorts. Nutrients 2024; 16:518. [PMID: 38398843 PMCID: PMC10892768 DOI: 10.3390/nu16040518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
The associations of dynapenic abdominal obesity and transitions with frailty progression remain unclear among middle-aged and older adults. We included 6937 participants from the China Health and Retirement Longitudinal Study (CHARLS) and 3735 from the English Longitudinal Study of Aging (ELSA). Participants were divided into non-dynapenia and non-abdominal obesity (ND/NAO), abdominal obesity alone (AO), dynapenia alone (D), and dynapenic abdominal obesity (D/AO). Frailty status was assessed by the frailty index (FI), and a linear mixed-effect model was employed to analyze the associations of D, AO, D/AO, and transitions with frailty progression. Participants with AO, D, and D/AO had increased FI progression compared with ND/NAO in both cohorts. D/AO possessed the greatest additional annual FI increase of 0.383 (95% CI: 0.152 to 0.614), followed by D and AO in the CHARLS. Participants with D in the ELSA had the greatest magnitude of accelerated FI progression. Participants who transitioned from ND/NAO to D and from AO to D/AO presented accelerated FI progression in the CHARLS and ELSA. In conclusion, dynapenic abdominal obesity, especially for D/AO and D, presented accelerated frailty progression. Our findings highlighted the essential intervention targets of dynapenia and abdominal obesity for the prevention of frailty progression.
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Affiliation(s)
| | | | | | | | | | | | | | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (B.S.); (J.W.); (Y.W.); (W.X.); (Y.L.); (Y.W.); (Y.C.)
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Liu Y, Li T, Ding L, Cai Z, Nie S. A predictive model for social participation of middle-aged and older adult stroke survivors: the China Health and Retirement Longitudinal Study. Front Public Health 2024; 11:1271294. [PMID: 38283296 PMCID: PMC10810982 DOI: 10.3389/fpubh.2023.1271294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
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.
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Affiliation(s)
- Yan Liu
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tian Li
- Department of Coronary Heart Disease, Renmin Hospital of Wuhan University, Wuhan, China
| | - Linlin Ding
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - ZhongXiang Cai
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuke Nie
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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Du J, Guo W, Wang W, Chen K, Qiao H. Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study. Medicine (Baltimore) 2024; 103:e36746. [PMID: 38181282 PMCID: PMC10766289 DOI: 10.1097/md.0000000000036746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/30/2023] [Indexed: 01/07/2024] Open
Abstract
This study aims to identify multimorbidity patterns and examine whether health poverty vulnerability (HPV) varies among adults aged 45 years or more. Data from 4338 participants were extracted from a Chinese cross-sectional study. Latent class analysis was used to identify multimorbidity patterns based on 11 self-reported chronic diseases. A 3-stage feasible generalized least-squares method was used to measure the HPV. The associations and influencing factors were analyzed using the Tobit model. The mean HPV values were 0.105 ± 0.225 and 0.329 ± 0.357, based on extreme poverty and those of low- and middle-income countries' poverty line, respectively. Four latent multimorbidity patterns were identified, comprising hypertension (57.33%), cardiovascular diseases (19.94%), the musculoskeletal system (13.09%), and spine (9.64%). The HPV value from hypertension (coefficient [Coef] =0.03, 95% confidence interval (CI) = 0.00-0.05) was significantly higher than that of the musculoskeletal system based on extreme poverty. In addition, the HPV values for hypertension (Coef =0.08, 95% CI = 0.05-0.11), spine (Coef =0.06, 95% CI = 0.02-0.11), and cardiovascular diseases (Coef =0.07, 95% CI = 0.03-0.11) were significantly high based on low- and middle-income countries' poverty line. Age ≥75 years, registered poor households, catastrophic medical expenditure, and toilet style were major risk factors. Although the multimorbidity pattern-induced HPV has been significant improved on extreme poverty, it still poses a very serious challenge with regard to low- to middle-income countries' poverty line. The sensitivity analysis proved the robustness of the results. Policymakers should focus on adults with 3 multimorbidity patterns, namely, registered poor households, age ≥75 years, and catastrophic health expenditure, to adopt targeted interventions to prevent and eliminate HPV.
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Affiliation(s)
- Jiancai Du
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, Ningxia, China
- The Center for Disease Control and Prevention in Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
| | - Wenqin Guo
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, Ningxia, China
| | - Wenlong Wang
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, Ningxia, China
| | - Kexin Chen
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, Ningxia, China
| | - Hui Qiao
- School of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, Ningxia, China
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Ramos AK, Dinkel D, Trinidad N, Carvajal-Suarez M, Schmeits K, Molina D, Boron JB. Acceptability of Intergenerational Physical Activity Programming: A Mixed Methods Study of Latino Aging Adults in Nebraska. J Aging Health 2024; 36:14-24. [PMID: 36961752 DOI: 10.1177/08982643231166167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Objective: This study explored Hispanic/Latino aging adults' interest in and preferences for intergenerational physical activity programming. Methods: We used an exploratory sequential (Qual-QUAN) mixed methods design consisting of three focus groups (N = 13 participants; M age = 62.5 years old) and a quantitative survey (N = 105 participants; M age = 57.3 years old). Results: We found that most participants were interested in intergenerational physical activity programs: (1) to promote overall health and well-being, (2) increase opportunities for socialization and relationships, and (3) foster motivation and energy. Preferences for programming included cultural tailoring, bilingual and Spanish-language offerings, and being conducted in-person. Barriers to physical activity included cost, scheduling, transportation, and limited awareness of community resources. Discussion: Innovative public health initiatives incorporating an intergenerational approach may promote physical activity among aging adults. This study has implications for developing and refining intergenerational programming with Hispanic/Latino communities.
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Affiliation(s)
- Athena K Ramos
- Department of Health Promotion, Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE, USA
| | - Danae Dinkel
- School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Natalia Trinidad
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Marcela Carvajal-Suarez
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Karen Schmeits
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Diana Molina
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Julie B Boron
- Department of Gerontology, College of Public Affairs and Community Service, University of Nebraska, Omaha, NE, USA
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Zhao X, Zhang H, Yu J, Wang J. Association of possible sarcopenia with major chronic diseases and multimorbidity among middle-aged and older adults: Findings from a national cross-sectional study in China. Geriatr Gerontol Int 2023; 23:925-931. [PMID: 37915295 DOI: 10.1111/ggi.14720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 11/03/2023]
Abstract
AIM This study investigated the prevalence of possible sarcopenia (PSA) in a large sample of middle-aged and older adults, and determined the association between PSA, major chronic diseases and the number of chronic diseases. METHODS A total of 14 917 adults aged ≥40 years were included in the analysis. The handgrip strength and the five-time chair stand test were used to assess PSA. The participants' major chronic diseases were divided into 14 categories. Four categories were created based on the participants' number of chronic illnesses: 0, 1, 2 and ≥3. RESULTS The present study found an overall prevalence of PSA of 23.6% among Chinese middle-aged and older adults aged ≥40 years, with the risk increasing with advancing age. PSA was significantly associated with most categories of chronic diseases and multimorbidity. The closely independent associations were obtained for stroke; emotional, nervous or psychiatric problems; chronic lung disease, asthma, heart disease, hypertension and arthritis or rheumatism. Compared with participants with 0 chronic disease, those with two or more chronic diseases had higher odds for PSA. However, the association between PSA and the number of chronic diseases varied in different sex and age groups. CONCLUSIONS The findings suggest that PSA is associated with major chronic diseases among middle-aged and older adults. People with two or more chronic diseases have a greater likelihood of PSA compared with those without chronic diseases, and the association between PSA and the number of chronic diseases largely depended on sex and age. Geriatr Gerontol Int 2023; 23: 925-931.
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Affiliation(s)
- Xiaoguang Zhao
- Faculty of Sport Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Hongjun Zhang
- School of Physical Education, Liaoning Finance and Trade College, Xingcheng, China
| | - Jiabin Yu
- Faculty of Sport Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Jin Wang
- Faculty of Sport Science, Ningbo University, Ningbo, China
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Wang Y, Huang Y, Chen X. The relationship between low handgrip strength with or without asymmetry and fall risk among middle-aged and older males in China: evidence from the China Health and Retirement Longitudinal Study. Postgrad Med J 2023; 99:1246-1252. [PMID: 37740568 DOI: 10.1093/postmj/qgad085] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/26/2023] [Accepted: 09/01/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE This study sought to explore the potential correlation between low handgrip strength (HGS) with or without asymmetry and fall risk in middle-aged and older Chinese adults. METHODS Baseline characteristic data from participants 45+ years of age and data regarding fall events collected from two rounds (2011-2013) of the China Health and Retirement Longitudinal Study were utilized for the present analyses. HGS and HGS asymmetry was defined according to the updated American Society of Hand Therapist. Fall events were identified through self- or proxy-reported details. Logistic regression analyses were employed to gauge the potential relationship between abnormal HGS and fall risk. RESULTS In total, 10 563 participants were enrolled in this analysis, of whom 47.49% (5016/10 563) were male. The proportions of low HGS alone, HGS asymmetry alone, and low HGS with asymmetry were 22.23%, 18.34%, and 22.75%, respectively, in males, but just 3.64%, 35.12%, and 6.62% in females. A total of 693 and 1019 fall events were recorded for male (13.82%) and female (18.37%) participants over the 2-year follow-up period, respectively. Significant differences in fall event incidence among different HGS groups were only observed among males. An adjusted logistic regression analysis model confirmed that low HGS with dominant asymmetry was closely related to fall risk among middle-aged and older males [P = 0.014, odds ratio = 1.332, 95% confidence interval: 1.059-1.676). CONCLUSION These results demonstrated that low HGS with dominant asymmetry is a risk factor linked to increased fall risk among middle-aged and older Chinese males. What is already known on this topic Low HGS or HGS asymmetry is been reported to be linked to an increased risk of falls in middle-aged and older adults; however, little is known about the association between fall risk and low HGS and/or HGS asymmetry. Main messages The prevalence of low HGS alone and low HGS asymmetry in men was significantly higher than in women, while HGS alone asymmetry was more common in women than men. The risk factor for the increased risk of falls in Chinese middle-aged and older men is low and asymmetric HGS, rather than low or asymmetric HGS alone. Low HGS with dominant asymmetry rather than nondominant asymmetry is associated with future fall risk among middle-aged and older Chinese males. Current research questions What is the mechanism for the significant difference in the proportion of abnormal HGS components between the sexes? If female subjects with low HGS and asymmetric HGS were added, would an association be observed between low HGS and asymmetric HGS falls? Is there an association between the severity of asymmetric HGS with weakness and falls?
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Affiliation(s)
- Yilin Wang
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center , Zigong, Sichuan Province 643020, China
| | - Yalian Huang
- Sichuan Research Center of Applied Psychology, Chengdu Medical College, Chengdu, Sichuan Province 610500, China
| | - Xiaoyan Chen
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center , Zigong, Sichuan Province 643020, China
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Xu J, Xiao S, Xie X, Kang Y, Peng D, Lu Y. Latent Profile Analysis of Fear of Hypoglycemia in Middle-Aged and Elderly Hospitalized Patients with Type 2 Diabetes and Its Relationship with Sleep Quality. Diabetes Metab Syndr Obes 2023; 16:3641-3654. [PMID: 38028988 PMCID: PMC10656544 DOI: 10.2147/dmso.s431704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Hypoglycemia is an acute complication that can appear in people with type 2 diabetes treated with drugs which are associated with a risk of hypoglycemia, and it may lead to individual's fear of hypoglycemia (FoH). FoH adversely affects diabetic self-management, psychological well-being, and quality of life, and it is associated with sleep quality. Nevertheless, this problem is often underestimated. The purpose of this study was to explore the heterogeneous characteristics of FoH in middle-aged and elderly hospitalized patients with type 2 diabetes and assess its relationship with the sleeping quality. Patients and Methods A cross-sectional study was performed on 263 middle-aged and elderly patients with type 2 diabetes hospitalized at the Zhejiang Veteran Hospital in Jiaxing, China, from May to August 2022, selected by a convenient sampling method. A questionnaire containing general information, fear of hypoglycemia scale-15 (FH-15) and the Pittsburgh sleep quality index (PSQI) was provided to the participants. Latent profile analysis was performed to examine the potential latent groups in the distribution of answers on the individual FoH items. Results The results identified three latent classes: Class 1 - Low FoH group (33%); Class 2 - No FoH group (61%); Class 3 - High FoH group (6%). The latent FoH class was the influencing factor of sleep quality, which was better in the No FoH group than in the Low FoH group, while the sleep quality of the Low FoH group was better than that in the High FoH group. Conclusion A heterogeneity was found in the FoH of middle-aged and elderly hospitalized patients with type 2 diabetes. Health-care providers should pay more attention to these patients with high FoH and develop intervention strategies to mitigate it and improve their sleep quality.
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Affiliation(s)
- Junxian Xu
- College of Medicine, Jiaxing University, Jiaxing, Zhejiang, People’s Republic of China
| | - Suhong Xiao
- Zhejiang Veteran Hospital, Jiaxing, Zhejiang, People’s Republic of China
| | - Xiaoyun Xie
- College of Medicine, Jiaxing University, Jiaxing, Zhejiang, People’s Republic of China
| | - Yunqin Kang
- Zhejiang Veteran Hospital, Jiaxing, Zhejiang, People’s Republic of China
| | - Donghong Peng
- Zhejiang Veteran Hospital, Jiaxing, Zhejiang, People’s Republic of China
| | - Yanhong Lu
- Zhejiang Veteran Hospital, Jiaxing, Zhejiang, People’s Republic of China
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Zeng J, Lai X, Wang S, Zeng D, Ye J, Huang C, Liu M, Zhang W, Xu H. Association of depressive symptoms with chronic liver disease among middle-aged and older adults in China. Front Psychiatry 2023; 14:1273754. [PMID: 37941967 PMCID: PMC10628464 DOI: 10.3389/fpsyt.2023.1273754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/11/2023] [Indexed: 11/10/2023] Open
Abstract
Background The relationship between depressive symptoms and chronic liver disease (CLD) is still unclear. We aimed to determine whether depressive symptoms are associated with CLD in a large population sample. Methods The data was from the China Health and Retirement Longitudinal Study (CHARLS), an ongoing nationally representative prospective cohort study. Depressive symptoms were assessed with the catchment-area epidemiology survey-depression (CES-D). CLD was identified by the patient's self-report about a physician's diagnosis at each visit. Multi-adjusted logistic regression and Cox regression models were used. Results A total of 14,995 participants (53.1% female; mean age: 58.85 ± 9.87 years) and 13,405 participants (53.64% female; mean age: 58.58 ± 9.69 years) were included in the cross-sectional and longitudinal analyses, respectively. In the cross-sectional analysis, the odds ratio of CLD in patients with moderate and severe depressive symptoms were 1.46 [95% confidence interval (CI), 1.16-1.83] and 1.78 (95% CI, 1.23-2.56) than those with none/mild depressive symptoms, respectively. In the longitudinal analysis, compared to participants with none/mild depressive symptoms, the hazard rates of CLD in those with moderate and severe depressive symptoms were 1.65 (95%CI, 1.33-2.03) and 1.80 (95%CI, 1.24-2.60). And the 50th percentile difference of time (years) at the incidence of CLD in participants with moderate and severe depressive symptoms were - 0.83 (95%CI, -1.18, -0.49) and - 0.96 (95%CI, -1.56, -0.35), respectively. Conclusion Elevated depressive symptoms were associated with an increased risk of CLD among middle-aged and older adults in China.
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Affiliation(s)
- Jingke Zeng
- Department of Hepatology, Ganzhou Institute of Liver Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Xiaohuan Lai
- Department of Hepatology, Ganzhou Institute of Liver Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Shuigen Wang
- Department of Hepatology, Ganzhou Institute of Liver Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Dijing Zeng
- Longnan First People's Hospital, Ganzhou, Jiangxi Province, China
| | - Jiangmin Ye
- Department of Hepatology, Ganzhou Institute of Liver Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Chunhua Huang
- Department of Hepatology, Ganzhou Institute of Liver Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Minhua Liu
- Department of Hepatology, Ganzhou Institute of Liver Diseases, The Fifth People’s Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Wenjuan Zhang
- School of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hui Xu
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Li Q, Liu Y, Yang L, Ge J, Chang X, Zhang X. The impact of urban green space on the health of middle-aged and older adults. Front Public Health 2023; 11:1244477. [PMID: 37900020 PMCID: PMC10602898 DOI: 10.3389/fpubh.2023.1244477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/01/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Urban green space is one of the most closely related ecosystem services to residents' lives, and it can be regarded as a preventive public health measure. Residents living in parks and other green environments can help improve their physical and mental health, reduce stress and even prevent crime and violence. Therefore, based on the actual situation in China, this paper analyzes the relationship between urban green space and the health of middle-aged and older adults and its mechanisms. Methods This study used multiple linear regression, based the data from the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015, and 2018, to explore the relationship between urban green space and the health of middle-aged and older adults. At the same time, group regression was conducted to identify the heterogeneity of health effects of urban green space. Results The research shows that the increase of urban green space areas can significantly improve the health status of middle-aged and older adults. After a series of robustness tests, the results are still valid. In addition, the health effects of urban green space are different because of gender, age, education level, marital status residence, geographical location of the respondents and park quantity distribution. Further research found that reducing hot weather and optimizing air quality are the potential mechanisms of urban green space affecting the health of middle-aged and older adults, providing new evidence for the causal mechanism between urban green space and the health of middle-aged and older adults. Discussion This study expanded the research scope of the impact of urban green space on the health of middle-aged and older adults, covering a representative sample in China. The results show that urban green space has an important impact on the health of middle-aged and older adults. Policy suggestions are made to help cities optimize the landscape and residents to enjoy ecology.
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Affiliation(s)
- Qiangyi Li
- School of Economics and Management, Guangxi Normal University, Guilin, China
- Development Institute of Zhujiang-Xijiang Economic Zone, Guangxi Normal University, Guilin, China
- Economics and Management School, Wuhan University, Wuhan, China
| | - Yangqing Liu
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | - Lan Yang
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | - Jiexiao Ge
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | - Xiaona Chang
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | - Xiaohui Zhang
- School of Economics and Management, Guangxi Normal University, Guilin, China
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15
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Kwak JW, Lee YJ, Park B, Jung DH. Combined effect of serum carcinoembryonic antigen and hepatic steatosis on new-onset ischemic heart disease among middle-aged and older Korean adults: a cohort study. Front Nutr 2023; 10:1275450. [PMID: 37904789 PMCID: PMC10613517 DOI: 10.3389/fnut.2023.1275450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/28/2023] [Indexed: 11/01/2023] Open
Abstract
Background Carcinoembryonic antigen (CEA) is a commonly used tumor marker in cancer screening. However, it has also been associated with metabolic alterations. Hepatic steatosis, the accumulation of fat in liver cells, is associated with various cardiovascular risk factors. This study investigated the risk of ischemic heart disease (IHD) in individuals with elevated CEA levels, hepatic steatosis, and their co-occurrence. Methods The study cohort comprised 5,580 Korean adults who underwent health examinations between November 2006 and June 2010. Data regarding baseline CEA levels, hepatic steatosis status, and development of IHD were collected. Hepatic steatosis was defined as more than two findings: deep attenuation, vascular blurring, and increased liver echogenicity on abdominal ultrasound. Participants were divided into four groups based on their CEA and hepatic steatosis status: no hepatic steatosis and low CEA (group 1), no hepatic steatosis and elevated CEA (group 2), low CEA and hepatic steatosis (group 3), and elevated CEA and hepatic steatosis (group 4). Results A total of 226 (4.1%) participants developed IHD during the follow-up period. Participants with elevated CEA levels and hepatic steatosis (group 4) had the highest cumulative incidence of IHD in comparison to other groups (p < 0.001). The combined effect of elevated CEA levels and hepatic steatosis showed significantly greater area under the receiver operating characteristic curve than hepatic steatosis alone (p < 0.001). Furthermore, participants with elevated CEA and hepatic steatosis (group 4) had higher risk of developing IHD compared to those with low CEA and no hepatic steatosis (group 1) (hazard ratio: 1.63, 95% confidence interval: 1.04-2.55, p = 0.034). Conclusion Co-occurrence of elevated CEA levels and hepatic steatosis increases the risk of IHD. Comprehensive risk assessment is crucial to guide interventions and improve cardiovascular health in individuals with both the conditions.
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Affiliation(s)
| | | | - Byoungjin Park
- Yonsei University Health System, Seoul, Republic of Korea
| | - Dong Hyuk Jung
- Yonsei University Health System, Seoul, Republic of Korea
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16
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Geng S, Chen X, Bai K, Ding J, Li H, Shi S. Association of the Clínica Universidad de Navarra-Body Adiposity Estimator With Type 2 Diabetes: A Retrospective Cohort Study. Int J Public Health 2023; 68:1606063. [PMID: 37810434 PMCID: PMC10551821 DOI: 10.3389/ijph.2023.1606063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives: Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) is considered to be a more accurate indicator of body fat estimation. We aimed to investigate the association of CUN-BAE with the risk of type 2 diabetes mellitus (T2DM) and to compare the strength of the association between CUN-BAE, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and T2DM. Methods: The data were obtained from the annual health checkup database of residents in Xinzheng, China. From January 2011 to December 2021, 80,555 subjects aged ≥45 years met the inclusion criteria. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CUN-BAE, BMI, WC, and WHtR in T2DM. Results: During a mean follow-up of 6.26 years, T2DM occurred in 12,967 subjects. The multivariable-adjusted HRs (95% CIs) of T2DM (highest vs. reference group) were 1.994 (1.811-2.196) for CUN-BAE, 1.751 (1.665-1.842) for WC, 1.715 (1.631-1.804) for WHtR, and 1.510 (1.436-1.588) for BMI, respectively. In addition, the risk of T2DM increased with baseline CUN-BAE (HR: 1.374; 95% CI: 1.328, 1.421), WC (HR: 1.236; 95% CI: 1.215, 1.256), WHtR (HR: 1.228; 95% CI: 1.208, 1.248), and BMI (HR: 1.175; 95% CI: 1.156, 1.195). Conclusion: Compared to BMI, WC or WHtR, CUN-BAE may more adequately reflect the adverse effects of adiposity on the risk of T2DM.
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Affiliation(s)
| | | | | | | | | | - Songhe Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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17
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Gao W, Lv M, Huang T. Effects of different types of exercise on hypertension in middle-aged and older adults: a network meta-analysis. Front Public Health 2023; 11:1194124. [PMID: 37799161 PMCID: PMC10549925 DOI: 10.3389/fpubh.2023.1194124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/15/2023] [Indexed: 10/07/2023] Open
Abstract
Objective This study mainly used network meta-analysis to explore the effect of different types of exercise on hypertension in middle-aged and older adults. Methods Several databases (e.g., PubMed, Embase, and the Cochrane Library) were used to search for randomized controlled trials on the effects of different types of exercise on hypertension in middle-aged and older adults. Results A total of 19 articles and 2,385 participants were included in the analysis. Aerobic exercise interventions [MD = -9.254, P < 0.05, 95% CI (-14.810, -3.698)] and static exercise interventions [MD = -10.465, P < 0.05, 95% CI (-18.135, -2.794)] had a significant effect on the improvement in systolic blood pressure (SBP). For diastolic blood pressure (DBP), aerobic exercise interventions [MD = -1.4096; P > 0.05, 95% CI (-8.2395, 5.4201)] and static exercise interventions [MD = -4.5206, P > 0.05, 95% CI (-14.0436, 5.0023)] were not statistically significant. The results of the surface under the cumulative ranking curve (SUCRA) showed that static exercise improved hypertension better than aerobic exercise. Conclusion Aerobic exercise and static exercise have been shown to have a good effect on the improvement of hypertension, but the effect on DBP is not significant.
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Affiliation(s)
- Wei Gao
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Moran Lv
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Tao Huang
- Institute of Physical Education, Huanggang Normal University, Huanggang, China
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18
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Wang M, Zhang L, Ma J, Sun H, Gao Z, Hu M, Liu H, Guo L. Mediating effect of successful aging on the relationship between psychological resilience and death anxiety among middle-aged and older adults with hypertension. Front Public Health 2023; 11:1116263. [PMID: 37808974 PMCID: PMC10552859 DOI: 10.3389/fpubh.2023.1116263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/06/2023] [Indexed: 10/10/2023] Open
Abstract
Objective The aging trend of China's population is severe and successful aging (SA) is imminent. Aging can lead to various chronic diseases, with hypertension being the most common. Due to this lifelong disease, patients suffer from many anxieties, as death anxiety (DA) can be the most prevalent. Studies have exhibited that middle-aged adults approaching the transition to an older state show more pronounced DA than the more senior. It has been suggested that psychological resilience (PR) can reduce DA. Therefore, this study aimed to analyze the mediating effect of SA between PR and DA in middle-aged and older adults with hypertension. Methods A cross-sectional survey was designed. From August to December 2021, 298 middle-aged and older adults with hypertension were selected by multistage cluster random sampling in three districts (Ling he District, Gu ta District, and Tai He District) of Jinzhou City, Liaoning Province. They were surveyed using the demographic questionnaires, the Conner-Davidson Resilience Scale, the Successful Aging Inventory, and the Chinese version of a Likert-type Templer-Death Anxiety Scale. Descriptive analyses, independent sample T-test, and one-way analysis of variance (ANOVA) were used to describe demographic characteristics among hypertensive patients with different characteristics, respectively. Statistics were considered significant when P < 0.05. Pearson correlation coefficients describe the relationship between PR, SA, and DA. The research model was shaped through Structural Equation Modeling (SEM). SPSS PROCESS macro was used to verify the mediation model. A binary logistic regression model was used with DA as the dependent variable. Results The scores for PR, SA, and DA in hypertensive patients are (49.52 ± 14.38) points, (51.22 ± 7.63) points, and (46.67 ± 9.03) points. PR was negatively correlated with DA (r = -0.307, P < 0.01). Moreover, incorporating SA as a mediating variable in PR and DA, SA was positively correlated with PR (r = 0.335, P < 0.01) and DA (r = 0.085, P > 0.05). The direct effect is opposite to the sign of the indirect effect. There is a suppression between PR and DA with a percentage of 20.7%. Good self-assessed health status [0.057 (0.018, 0.183)] may be a protective factor for DA. Conclusion Healthcare providers should improve the PR of middle-aged and older adults with hypertension through interventions that reduce DA and increase the likelihood of SA.
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Affiliation(s)
- Meiding Wang
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jianing Ma
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Hong Sun
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Ziyun Gao
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Mengya Hu
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Leilei Guo
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
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Liu C, Gao Y, Jia Z, Zhao L. Association of Public Sports Space Perception with Health-Related Quality of Life in Middle-Aged and Older Adults-Evidence from a Survey in Shandong, China. Behav Sci (Basel) 2023; 13:736. [PMID: 37754014 PMCID: PMC10525232 DOI: 10.3390/bs13090736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
Creating a healthy living environment for middle-aged and older adults is a key strategy for countries to address the aging challenge, but the effects of such an environment on the health-related quality of life (HRQoL) of middle-aged and older adults remain underexplored. This study aimed to examine the link between public sports facilities and the HRQoL of middle-aged and older adult residents in communities. A total of 1169 respondents (average age: 66.84; male: 46.19%) were selected from the Shandong, China. This study measured respondents 'physical activity (PA) using the International Physical Activity Questionnaire, the HRQoL of respondents using the 36-item Short Form Health Survey, and the Public Sports Space Perception Scale for respondents' public sports space perception. Correlation analysis and logistic regression analysis were employed to test the relationship among public sports space perception, physical activity (PA), and HRQoL. The mediating role of PA was conducted using the PROCESS macro for SPSS. The results revealed that public sports space perception only influenced the HRQoL of middle-aged and older adults through light-intensity PA (PCS: B = 0.09, 95% CI 0.01, 0.03; MCS: B = 0.02, 95% CI 0.01, 0.05) among light-intensity PA, moderate-intensity PA, vigorous-intensity PA., and this mediation model varied across different age groups of middle-aged and older adults. Moreover, digital inclusion only moderated the psychological aspect of HRQoL of middle-aged and older adults (p < 0.05). This study provided empirical evidence for enhancing the HRQoL of middle-aged and older adults and offered useful insights for the planning and design of public sports facilities and the formulation of health management policies for middle-aged and older adults.
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Affiliation(s)
- Chenchen Liu
- School of Medical Information Engineering, Jining Medical University, Jining 272067, China;
| | - Yan Gao
- School of Physical Education, Shandong University, Jinan 250061, China; (Z.J.); (L.Z.)
| | - Zhihao Jia
- School of Physical Education, Shandong University, Jinan 250061, China; (Z.J.); (L.Z.)
| | - Liangyu Zhao
- School of Physical Education, Shandong University, Jinan 250061, China; (Z.J.); (L.Z.)
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Qu Y, Liu Z, Wang Y, Chang L, Fan H. Relationships among Square Dance, Group Cohesion, Perceived Social Support, and Psychological Capital in 2721 Middle-Aged and Older Adults in China. Healthcare (Basel) 2023; 11:2025. [PMID: 37510466 PMCID: PMC10379668 DOI: 10.3390/healthcare11142025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Aging is a global phenomenon, and China's aging is extensive and rapid and already at the middle to upper level worldwide. Promoting social interaction and increasing positive psychological qualities in individuals are key components in helping people adapt to the physical and mental changes of the aging process. Among them, how middle-aged and older adults improve their physical and mental health through physical activity is of great concern. (2) Methods: This study measured the physical activity of 2721 middle-aged and elderly square dance participants across China, and structural equation modeling was applied to explore the relationship between square dance exercise and group cohesion as well as the role of perceived social support and psychological capital. (3) Results: The results showed that (a) square dance exercise positively predicts group cohesion among middle-aged and older adults. (b) Perceived social support and psychological capital mediate the relationship between square dance exercise and group cohesion, and the mediating role consists of three pathways: perceived social support alone, psychological capital alone, and perceived social support-psychological capital chain mediation. (c) The mediating effect of psychological capital alone is greater than the mediating effect of perceived social support alone and the mediating effect of the perceived social support-psychological capital chain. (4) Conclusions: This study provides support for the theory and practice of square dance exercise and intervention guidance for increasing positive psychological qualities and group dynamic levels in middle-aged and older adults.
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Affiliation(s)
- Yujia Qu
- School of Art, Beijing Sport University, Beijing 100084, China
| | - Zhiyuan Liu
- School of Psychology, Beijing Sport University, Beijing 100084, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China
| | - Yan Wang
- School of Art, Beijing Sport University, Beijing 100084, China
| | - Lei Chang
- Sports Department, China Women's University, Beijing 100101, China
| | - Hongying Fan
- School of Psychology, Beijing Sport University, Beijing 100084, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China
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Wu M, Li C, Zhao X, Hu T, Zeng L, Yu Y, Yang F, Han Y. The effect of internet use on depressive symptoms in middle-aged and older adults with functional disability: the mediating role of social isolation. Front Public Health 2023; 11:1202541. [PMID: 37492141 PMCID: PMC10363719 DOI: 10.3389/fpubh.2023.1202541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023] Open
Abstract
Objective The popularization of the internet provides the possibility to improve the depressive symptoms (DS) and social isolation of middle-aged and older adults with functional disability. There was a significant correlation between internet use and DS in middle-aged and older adults with functional disability, but the relationship between internet use, social isolation, and DS remains to be confirmed. Methods Data were obtained from 7,955 middle-aged and older adults aged 45 years and older from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Multiple linear regression models were used to analyze the association between internet use and DS, and the Sobel test was used to explore mediating models. Results Results showed that internet use was negatively associated with DS among Chinese middle-aged and older adults. Among them, social needs (B = -0.770, p = 0.041), and information reception (B = -1.067, p = 0.007) were significantly related to DS in middle-aged and older adults. Only information reception (B = -3.161, p = 0.031) was significantly related to DS among middle-aged and older adults with functional disability. Social isolation partially mediated the association between internet use and DS in middle-aged and older adults without functional disability, whereas it was fully mediated in middle-aged and older adults with functional disability. Conclusion This study indicates that when formulating health policies to promote the mental health of Chinese middle-aged and older adults, the use of the internet should not be overlooked.
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Affiliation(s)
- Man Wu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Chaoyang Li
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xueyang Zhao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ting Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Lijuan Zeng
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yiqing Yu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yangyang Han
- School of Nursing, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
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Yan X, Wu W, Chen X, Xu G, Yu S, Li S. Intergenerational caregiving on mental health of middle-aged and older adults in China: empirical insights. Front Public Health 2023; 11:1224062. [PMID: 37483932 PMCID: PMC10358982 DOI: 10.3389/fpubh.2023.1224062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/16/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The impact of intergenerational caregiving on the mental health of providers remains a controversial topic, especially in countries like China where it is prevalent. Given the country's aging population and recent liberalization of the two-child policy, understanding the effects of intergenerational caregiving on the mental health of middle-aged and older adult(s) individuals is crucial. This study aimed to explore the impact of intergenerational caregiving on mental health among middle-aged and older adult(s) individuals. Methods We analyzed data from the China Health and Aging Tracking Survey (CHARLS) 2013, consisting of 6602 participants finally. Personal information, family structure, financial support, health status, and physical measurements were selected for analysis. Correlation and regression analyses were used for relationships among variables controlling for potential confounding variables. Mental health status was evaluated using the depression self-rating scale. Results There is a significant positive effect of intergenerational care on the mental health of middle-aged and older adult(s) people. Additionally, we re-profiled intergenerational care variables by considering the number and length of intergenerational caregivers, and found that the effects remained significant. Furthermore, the effects of intergenerational care vary across subgroups based on gender, age, nature of usual residence, marital status, and physical health status. Finally, we identified two mechanisms through which intergenerational caregiving positively affects mental health: intergenerational financial support and intergenerational spiritual support. Discussion These findings have important implications for policymakers, healthcare professionals, and family members in promoting the mental health of middle-aged and older adult(s) individuals in China.
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Affiliation(s)
- Xueling Yan
- Economics School, Sichuan University, Chengdu, Sichuan, China
| | - Wenjing Wu
- Department of Psychiatry, Qingdao Mental Health Center, Qingdao, Shandong, China
| | - Xiaoqin Chen
- Department of Psychiatry, Qingdao Mental Health Center, Qingdao, Shandong, China
| | - Guangming Xu
- Tianjin Anding Hospital, Institute of Mental Health, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shule Yu
- Economics School, Fudan University, Shanghai, China
| | - Shen Li
- Tianjin Anding Hospital, Institute of Mental Health, Mental Health Center of Tianjin Medical University, Tianjin, China
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Cui G, Li S, Ye H, Yang Y, Chu Y, Jia X, Feng Y, Lin M, Zhang X. Association between digestive diseases and sarcopenia among Chinese middle-aged and older adults: a prospective cohort study based on nationally representative survey. Front Nutr 2023; 10:1097860. [PMID: 37476407 PMCID: PMC10354238 DOI: 10.3389/fnut.2023.1097860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Objectives Patients with digestive diseases frequently suffer from dyspepsia and malabsorption, which may lead to muscle loss due to malnutrition. However, it is not clear whether digestive diseases are associated with sarcopenia. This study aims to explore the longitudinal association between digestive diseases and sarcopenia in middle-aged and older adults based on a nationally representative survey from China. Methods We used a prospective cohort study including 7,025 middle-aged and older adults aged ≥45 years from the 2011 to 2015 waves China Health and Retirement Longitudinal Study (CHARLS). Digestive diseases were identified using self-report. The assessment of sarcopenia was based on the Asian Working Group for Sarcopenia 2019 Consensus and included three components of muscle strength, physical performance, and muscle mass. Cox hazards regression was used to examine the association between digestive diseases and sarcopenia. Results The prevalence of digestive diseases and the incidence of sarcopenia in middle-aged and older adults were 22.6% (95% CI = 21.6-23.6%) and 8.5% (95% CI = 7.8-9.1%). After adjusting for 15 covariates composed of three sets (demographic characteristics, lifestyles, and health status), digestive diseases were associated with a higher risk of sarcopenia (HR = 1.241, 95% CI = 1.034-1.490, P < 0.05). The associations were more pronounced among men, older adults aged 60-79, rural residents, and married people. In addition, the association between digestive diseases and sarcopenia was robust in the sensitivity analysis. Conclusion Digestive diseases were associated with an increased risk of sarcopenia in middle-aged and older adults aged ≥45 years. Early intervention of digestive diseases may help to reduce the incidence of sarcopenia in middle-aged and older adults.
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Affiliation(s)
- Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Hui Ye
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Yao Yang
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Yingming Chu
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Xiaofen Jia
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Yue Feng
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Miaomiao Lin
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Xuezhi Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
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Guo L, Wang W, Shi J, Zheng X, Hua Y, Lu C. Evaluation of Social Isolation Trajectories and Incident Cardiovascular Disease Among Middle-Aged and Older Adults in China: National Cohort Study. JMIR Public Health Surveill 2023; 9:e45677. [PMID: 37389914 PMCID: PMC10365588 DOI: 10.2196/45677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Although the association between social isolation and the risk of subsequent cardiovascular disease (CVD) is well documented, most studies have only assessed social isolation at a single time point, and few studies have considered the association using repeatedly measured social isolation. OBJECTIVE This study aimed to examine the association between social isolation trajectories and incident CVD in a large cohort of middle-aged and older adults. METHODS This study used data from 4 waves (wave 1, wave 2, wave 3, and wave 4) of the China Health and Retirement Longitudinal Study. We defined the exposure period as from June 2011 to September 2015 (from wave 1 to wave 3) and the follow-up period as from September 2015 to March 2019 (wave 4). On the basis of the inclusion and exclusion criteria, our final analytic sample included 8422 individuals who had no CVD in the China Health and Retirement Longitudinal Study in waves 1 to 3 and were fully followed up in wave 4. Social isolation was ascertained using an extensively used questionnaire at 3 consecutive, biennial time points from waves 1 to 3, and individuals were assigned to 3 predefined social isolation trajectories based on their scores at each wave (consistently low, fluctuating, and consistently high). Incident CVD included self-reported physician-diagnosed heart disease and stroke combined. Cox proportional hazard models estimated the associations of social isolation trajectories with risks of incident CVD, adjusting for demographics, health behaviors, and health conditions. RESULTS Of the 8422 participants (mean age 59.76, SD 10.33 years at baseline), 4219 (50.09%) were male. Most of the participants (5267/8422, 62.54%) had consistently low social isolation over time and 16.62% (1400/8422) of the participants had consistently high social isolation over the exposure period. During the 4-year follow-up, 746 incident CVDs occurred (heart disease: 450 cases and stroke: 336 cases). Compared with individuals with consistently low social isolation, those with fluctuating social isolation (adjusted hazard ratio 1.27, 95% CI 1.01-1.59) and consistently high social isolation (adjusted hazard ratio 1.45, 95% CI 1.13-1.85) had higher risks for incident CVD after adjusting for demographics (ie, age, sex, residence, and educational level), health behaviors (ie, smoking status and drinking status), and health conditions (ie, BMI; history of diabetes, hypertension, dyslipidemia, chronic kidney disease; use of diabetes medications, hypertension medications, and lipid-lowering therapy; and depressive symptoms scores). CONCLUSIONS In this cohort study, middle-aged and older adults with fluctuating and consistently high social isolation exposure had higher risks of the onset of CVD than those without the exposure. The findings suggest that routine social isolation screenings and efforts to improve social connectedness merit increased attention for preventing CVD among middle-aged and older adults.
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Affiliation(s)
- Lan Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jingman Shi
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinyu Zheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yilin Hua
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
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Lu Z, He R, Zhang Y, Li B, Li F, Fu Y, Rong S. Relationship between Whole-Blood Magnesium and Cognitive Performance among Chinese Adults. Nutrients 2023; 15:2706. [PMID: 37375610 DOI: 10.3390/nu15122706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE To explore the association between magnesium levels and the odds of mild cognitive impairment (MCI). METHOD In this cross-sectional study of 1006 participants (≥55 years) from China, whole-blood magnesium concentration was measured using inductively coupled plasma mass spectrometry. MCI was diagnosed according to Petersen criteria using self-reported cognitive decline and a neuropsychological test battery, including the trail-making test-part B (TMT-B), auditory verbal learning test (AVLT), digit symbol substitution test (DSST), and verbal fluency test (VFT), which measured the assessment of executive, memory, attention, and language functioning, respectively. A logistic regression was used to assess the relationship between magnesium levels and MCI, and linear regression analyses were performed for the association between magnesium and cognitive function score. RESULTS The MCI group had a significantly lower concentration of magnesium compared to the Non-MCI group (34.7 ± 9.8 vs. 36.7 ± 9.7, p = 0.017). After adjusting for covariates, a negative association was observed between magnesium levels and MCI. Compared with the lowest quartile (median: 25.4 mg/L), the odds ratio for MCI was 0.53 (95%CI 0.32-0.90) for the highest quartile (median: 48.4 mg/L), and there was an inverse dose-response relationship (p for trend = 0.009). In addition, higher levels of magnesium were positively correlated with VFT scores (β = 0.37, 95%CI = 0.11-0.62) and DSST scores (β = 0.50, 95%CI = 0.01~0.98) and negatively correlated with TMT scores (β = -1.73, 95%CI = -3.40--0.07) in the middle-aged and older adults. CONCLUSIONS Whole-blood magnesium was inversely associated with the occurrence of MCI and positively associated with performance in neuropsychological tests assessing attention, executive, and language ability in middle-aged and older adults.
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Affiliation(s)
- Zijian Lu
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Ruikun He
- BYHEALTH Institute of Nutrition & Health, No.3 Kehui 3rd Street, No.99 Kexue Avenue Central, Huangpu District, Guangzhou 510663, China
| | - Ying Zhang
- BYHEALTH Institute of Nutrition & Health, No.3 Kehui 3rd Street, No.99 Kexue Avenue Central, Huangpu District, Guangzhou 510663, China
| | - Benchao Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Fengping Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yu Fu
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Shuang Rong
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
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Wang Y, Zhang X, Li Y, Gui J, Mei Y, Yang X, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Predicting depressive symptom by cardiometabolic indicators in mid-aged and older adults in China: a population-based cross-sectional study. Front Psychiatry 2023; 14:1153316. [PMID: 37351000 PMCID: PMC10282944 DOI: 10.3389/fpsyt.2023.1153316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
Objective Depressive symptom is a serious mental illness often accompanied by physical and emotional problems. The prevalence of depressive symptom in older adults has become an increasingly important public health priority. Our study used cardiometabolic indicators to predict depressive symptom in middle-aged and older adults in China. Methods The data came from the China Health and Retirement Longitudinal Study 2011 (CHARLS2011), which was a cross-sectional study. The analytic sample included 8,942 participants aged 45 years or above. The study evaluated the relationship between cardiometabolic indicators and depression by measuring 13 indicators, including body mass index (BMI), waist circumference, waist-height ratio (WHtR), conicity index, visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), a body shape index (ABSI), body roundness index (BRI), triglyceride glucose index (TyG-index) and its correlation index (TyG-BMI, TyG-waist circumference, TyG-WHtR). Binary logistic regression analysis was used to examine the association between thirteen cardiometabolic indicators and depressive symptom. In addition, the receiver operating characteristic (ROC) curve analysis and area under curve (AUC) were used to evaluate the predictive anthropometric index and to determine the optimum cut-off value. Results The study included 8,942 participants, of whom 4,146 (46.37%) and 4,796 (53.63%) were male and female. The prevalence of depressive symptom in mid-aged and older adults in China was 41.12% in males and 55.05% in females. The results revealed that BMI [AUC = 0.440, 95%CI: 0.422-0.457], waist circumference [AUC = 0.443, 95%CI: 0.425-0.460], WHtR [AUC = 0.459, 95%CI: 0.441-0.476], LAP [AUC = 0.455, 95%CI: 0.437-0.472], BRI [AUC = 0.459, 95%CI: 0.441-0.476], CVAI [AUC = 0.449, 95%CI: 0.432-0.467], TyG-BMI [AUC = 0.447, 95%CI: 0.429-0.465], and TyG-waist circumference [AUC =0.452, 95%CI: 0.434-0.470] were weak predictors of depressive symptom (p < 0.05) in males. In females, BMI [AUC = 0.470, 95%CI: 0.453-0.486], LAP [AUC = 0.484, 95%CI: 0.467-0.500], TyG-BMI [AUC = 0.470, 95%CI: 0.454-0.487], and TyG-waist circumference [AUC =0.481, 95%CI: 0.465-0.498] were weak predictors of depressive symptom (p < 0.05). On the other side, VAI, ABSI, conicity index and TyG index could not predict depressive symptom in middle-aged and older adults. Conclusion Most cardiometabolic indicators have important value in predicting depressive symptom. Our results can provide measures for the early identification of depressive symptom in middle-aged and older adults in China to reduce the prevalence of depressive symptom and improve health.
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Affiliation(s)
- Ying Wang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Yujin Mei
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Xue Yang
- Department of Graduate School, Wannan Medical College, Wuhu, An Hui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, An Hui, China
| | - Lei-lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Jinlong Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wanna Medical College, Wuhu, An Hui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, An Hui, China
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Yu Z, Chen Y, Xia Q, Qu Q, Dai T. Identification of status quo and association rules for chronic comorbidity among Chinese middle-aged and older adults rural residents. Front Public Health 2023; 11:1186248. [PMID: 37325337 PMCID: PMC10267321 DOI: 10.3389/fpubh.2023.1186248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/11/2023] [Indexed: 06/17/2023] Open
Abstract
Background Chronic comorbidity has become a major challenge in chronic disease prevention and control. This issue is particularly pronounced in rural areas of developing countries, where the prevalence of chronic disease comorbidity is high, especially among middle-aged and older adults populations. However, the health status of middle-aged and older adults individuals in rural areas of China has received inadequate attention. Therefore, it is crucial to investigate the correlation among chronic diseases to establish a reference basis for adjusting health policies aimed at promoting the prevention and management of chronic diseases among middle-aged and older adults individuals. Methods This study selected 2,262 middle-aged and older adults residents aged 50 years or older in Shangang Village, Jiangsu Province, China, as the study population. To analyze the chronic comorbidity of middle-aged and older adults residents with different characteristics, we used the χ2 test with SPSS statistical software. Data analysis was conducted using the Apriori algorithm of Python software, set to mine the strong association rules of positive correlation between chronic disease comorbidities of middle-aged and older adults residents. Results The prevalence of chronic comorbidity was 56.6%. The chronic disease comorbidity group with the highest prevalence rate was the lumbar osteopenia + hypertension group. There were significant differences in the prevalence of chronic disease comorbidity among middle-aged and older adults residents in terms of gender, BMI, and chronic disease management. The Apriori algorithm was used to screen 15 association rules for the whole population, 11 for genders, and 15 for age groups. According to the order of support, the most common association rules of comorbidity of three chronic diseases were: {lumbar osteopenia} → {hypertension} (support: 29.22%, confidence: 58.44%), {dyslipidemia} → {hypertension} (support: 19.14%, confidence: 65.91%) and {fatty liver} → {hypertension} (support: 17.82%, confidence: 64.17%). Conclusion The prevalence of chronic comorbidity among middle-aged and older adults rural residents in China is relatively high. We identified many association rules among chronic diseases, dyslipidemia is mostly the antecedent, and hypertension is primarily the result. In particular, the majority of comorbidity aggregation patterns consisted of hypertension and dyslipidemia. By implementing scientifically-proven prevention and control strategies, the development of healthy aging can be promoted.
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Affiliation(s)
- Zijing Yu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Qianhang Xia
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Qingru Qu
- PBC School of Finance, Tsinghua University, Beijing, China
| | - Tao Dai
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
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Kim J, Jeon SW, Byun H, Yi E. Exploring E-Health Literacy and Technology-Use Anxiety among Older Adults in Korea. Healthcare (Basel) 2023; 11:healthcare11111556. [PMID: 37297696 DOI: 10.3390/healthcare11111556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/20/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
The COVID-19 pandemic has increased the importance of health literacy in disseminating information on health in a non-contact society. This study focused on examining the acceptance capacity by older adults of smart devices in Korea and investigating the potential differences between men and women in terms of e-health literacy and technology-use anxiety. The study included 1369 respondents who were adults over 50 years of age and used welfare centers, public health centers, senior citizen centers, and exercise centers in Seoul and Incheon. An online survey was conducted from 1 June 2021 to 24 June 2021. The study found that the older adults' low levels of digital literacy could limit their access to health information and negatively impact their health. The difference between men and women in terms of technology-use anxiety was statistically significant, with the latent mean for men being higher than that for women. The effect sizes of the potential mean differences were found to be at a medium level for e-health literacy and a significant level for technology-use anxiety. With Korea's aging population and the need for the continuous management of chronic diseases among older adults, it is essential to discuss internet-based health information for disease maintenance and treatment.
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Affiliation(s)
- Jiyoun Kim
- Department of Exercise Rehabilitation, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea
| | - Sang-Wan Jeon
- Department of Exercise Rehabilitation, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea
| | - Hyun Byun
- Department of Exercise Rehabilitation, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea
| | - Eunsurk Yi
- Department of Exercise Rehabilitation, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea
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Chen Z, Li W, Bai Y, Chen Y, Alif SM, Wang D. Editorial: Occupational and environmental health in middle-aged and older adults. Front Public Health 2023; 11:1196186. [PMID: 37250087 PMCID: PMC10211500 DOI: 10.3389/fpubh.2023.1196186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 05/31/2023] Open
Affiliation(s)
- Zhaomin Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Li
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yansen Bai
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yufeng Chen
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Sheikh M. Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Wen W, Zhang Y, Shi W, Li J. Association Between Internet Use and Physical Health, Mental Health, and Subjective Health in Middle-aged and Older Adults: Nationally Representative Cross-sectional Survey in China. J Med Internet Res 2023; 25:e40956. [PMID: 36943368 PMCID: PMC10131878 DOI: 10.2196/40956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/20/2022] [Accepted: 02/24/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Internet use is an important means of accessing health-related information. Identifying the associations between internet use and health outcomes could provide insight into strategies for improving public health among middle-aged and older adults (45 years and up). OBJECTIVE This study aimed to examine the relationship between internet use and health outcomes in middle-aged and older adults. METHODS Data were obtained from the 2018 China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) Scale, the 10-item Center for Epidemiologic Studies Depression Scale, and the 3-level Self-Rated Health Scale, respectively. The chi-square test and rank sum test were used to explore whether internet use was associated with health status. A multivariate logistic regression model was used to determine this association further after controlling for the confounding factors. RESULTS Overall, 13% (1752/13,474) of the participants used the internet. Regression analyses revealed that the prevalence of depression (odds ratio [OR] 0.59, 95% CI 0.52-0.68; P<.001), negative self-rated health (OR 0.68, 95% CI 0.61-0.76; P<.001), and difficulty with ADL (OR 0.48, 95% CI 0.39-0.60; P<.001) in the participating middle-aged and older adult was lower in those using the internet than nonusers. After controlling for confounding factors, internet use was found to be negatively associated with difficulty with ADL (urban: OR 0.44, 95% CI 0.32-0.61; P<.001 vs rural: OR 0.55, 95% CI 0.41-0.75; P<.001), depression (urban: OR 0.69, 95% CI 0.57-0.84; P<.001 vs rural: OR 0.52, 95% CI: 0.43-0.63; P<.001), and self-rated health status (urban: OR 0.70, 95% CI 0.61-0.81; P<.001 vs rural: OR 0.67, 95% CI 0.57-0.78; P<.001) among middle-aged and older adults in both urban and rural areas. CONCLUSIONS Internet use had a positive effect on the physical and mental health of middle-aged and older adults who participated in this study. However, the internet usage rate remains low among older Chinese people. Therefore, the internet penetration rate should be a priority.
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Affiliation(s)
- Wen Wen
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Yaru Zhang
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Wenjie Shi
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
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Li S, Wang P, Xin X, Zhou X, Wang J, Zhao J, Wang X. The Effect of Low Intensity Resistance Training with Blood Flow Restriction on Fall Resistance in Middle-Aged and Older Adults: A Meta-Analysis. Int J Environ Res Public Health 2023; 20:4723. [PMID: 36981632 PMCID: PMC10049074 DOI: 10.3390/ijerph20064723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To systematically evaluate the effect of low intensity resistance training with blood flow restriction on fall resistance in middle-aged and older adults. METHODS PubMed, The Cochrane Library, Web of Science, Embase, EBSCO host, CNKI Database, VIP, Wanfang Database and CBMdisc were searched, and the retrieval period was from the beginning of each database to 25 July 2022. Randomized controlled trials were collected concerning the intervention of low intensity resistance training with blood flow restriction on lower limb muscle strength, muscle mass, muscle function, balance, walking and other fall resistance indicators in middle-aged and older adults. Cochrane Risk of Bias Tool was used for methodological quality assessment of the included literature. Statistical analysis was performed using RevMan 5.4 software and Stata 15.1. RESULTS A total of 14 randomized controlled trials (419 participants in total) were included in the study. Meta-analysis results revealed that low intensity resistance training with blood flow restriction significantly improved lower limb muscle strength (SMD = 0.51, 95%CI: [0.28, 0.74], p < 0.0001), lower limb muscle mass (MD = 1.99, 95%CI: [0.77, 3.22], p = 0.001) and walking ability (SMD = -0.89, 95% CI. [-1.71, -0.06], p = 0.03), while there was no apparent intervention effect on lower limb muscle function (SMD = 0.25, 95%CI: [-0.23, 0.73], p = 0.31) and balance (SMD = 0.22, 95%CI: [-0.08, 0.52], p = 0.15). The results of subgroup analysis showed that the intervention effect of low intensity resistance training with blood flow restriction on lower limb muscle strength was more significant in subjects aged 55-64 years, with exercise cycles of 4-8 weeks, exercise frequency of three times per week, exercise intensity of 20-30% 1RM, and vascular flow blocking pressure ≥ 120 mmHg. CONCLUSION Low intensity resistance training with blood flow restriction can effectively improve lower limb muscle strength, muscle mass and walking ability in middle-aged and older adults, and can serve as an important form of fall resistance training for the older adults.
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Affiliation(s)
- Shufan Li
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Peng Wang
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Xin Xin
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
| | - Xiaojing Zhou
- Department of Sports and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Jing Wang
- Department of Sports and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Jinlei Zhao
- Department of Sports and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Xing Wang
- School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
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Wang X, Yan M, Zhang Y, Wang W, Zhang W, Luo J, Gan D, Yang H, Zhu S, He W. Breastfeeding in infancy and mortality in middle and late adulthood: A prospective cohort study and meta-analysis. J Intern Med 2023; 293:624-635. [PMID: 36815686 DOI: 10.1111/joim.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND Breastfeeding in infancy is associated with a lower risk of mortality among children, but the impact on mortality in middle and late adulthood remains unknown. OBJECTIVES To assess the association between breastfeeding in infancy and mortality in middle and late adulthood. METHODS We included 383,627 participants aged 40-73 from the UK Biobank (2006-2010) and followed up until 2021. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality according to breastfeeding in infancy were estimated with Cox proportional hazards regression models. We further did a meta-analysis, including results from our present study and three other cohort studies (PROSPERO; number CRD42022348925). RESULTS During a total of 4732,751 person-years of follow-up, 25,581 deaths were identified. Breastfeeding in infancy was associated with lower risks of mortality in middle and late adulthood, with adjusted HRs (95% CIs) of 0.95 (0.93-0.98) for all-cause mortality; 0.91 (0.87-0.96) for cardiovascular mortality and 0.94 (0.874-0.999) for respiratory mortality. Specifically, the association with mortality seemed to attenuate with age - stronger in middle-aged adults than in older adults. A similar association between breastfeeding in infancy and all-cause mortality was found in the meta-analysis. CONCLUSION Breastfeeding in infancy is associated with a lower risk of mortality - even decades later - in middle and late adulthood.
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Affiliation(s)
- Xiaoyan Wang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Mengsha Yan
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yanyu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Wenjie Wang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Weiwei Zhang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Junkai Luo
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Da Gan
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Haomin Yang
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Shankuan Zhu
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei He
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Liu T, Liu H, You S. Analysis of the Impact of Environmental Perception on the Health Status of Middle-Aged and Older Adults: A Study Based on CFPS 2020 Data. Int J Environ Res Public Health 2023; 20:2422. [PMID: 36767790 PMCID: PMC9915848 DOI: 10.3390/ijerph20032422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Health risks and hazards caused by the environment have long been one of the most important public issues of concern to the state, society, and the public. At the same time, population aging is becoming a global issue, and residents' health is the most important component of people's livelihood, and residents can only pursue other rights and interests if they can protect their own health. Therefore, based on the micro data from the fifth round of the China Family Panel Studies (CFPS), this paper uses binary logistic regression with propensity score matching (PSM) to analyze the effect of environmental perception on the health status (including mental health and physical health) of middle-aged and older adults. It was found that environmental perceptions significantly affect the depressive state and sickness status of middle-aged and older adults. Among them, middle-aged and older adults who were female, of rural households, with low education and relatively low income were more affected by environmental shocks on their health. Therefore, we should pay attention to the mental and physical health of middle-aged and older adults and change the existing design concept of aging policy: the government should formulate effective policies and increase corresponding social support; and society and families should also give corresponding care and encourage middle-aged and older adults to exercise more and provide reasonable psychological guidance.
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Fu Y, Zhu Z, Huang Z, He R, Zhang Y, Li Y, Tan W, Rong S. Association between Vitamin B and Obesity in Middle-Aged and Older Chinese Adults. Nutrients 2023; 15. [PMID: 36771189 DOI: 10.3390/nu15030483] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Previous studies have found that obese people have lower levels of vitamin B, but most have focused on obesity as defined by body mass index (BMI), and its relationship with other types of obesity is unclear. The aim of this study was to explore the relationship between vitamin B levels and obesity assessed by different definitions among Chinese middle-aged and older community-dwelling adults. METHODS This cross-sectional study included 887 participants aged 45 years and older (45-82 years). The concentrations of vitamin B (B1, B2, B6, and B9) were measured by robotic dry blood spot extraction systems in combination with liquid chromatography-tandem mass spectrometry. BMI, body fat percentage (BF%), visceral fat area (VFA), and waist circumference (WC) were used to diagnose obesity. VFA and BF% were assessed by bioelectrical impedance analysis. The logistic regression model was used to assess the associations between vitamin B levels and the odds of obesity. RESULTS The average age of all participants was 60.77 (SD 6.33) years. The prevalence of obesity varied from 8.6% to 52.4% depending on different diagnostic criteria. After adjusting for covariates, a negative correlation was observed between vitamin B1 level and obesity according to the criteria of WC, VFA, and BF%, and the adjusted odds ratio (OR) was 0.47, 0.52, and 0.46, respectively. When using WC and BF% to define obesity, higher quartiles of vitamin B2 were negatively associated with the odds of obesity (OR: 0.62 and 0.62, respectively). Vitamin B6 was inversely associated with VFA-defined and BF%-defined obesity (OR: 0.64 and 0.64, respectively). When using VFA and BF% to define obesity, a negative correlation was observed in vitamin B9 (OR: 0.61 and 0.67, respectively). CONCLUSIONS Vitamin B (B1, B2, B6, and B9) level was negatively related to obesity (defined by WC, VFA, or BF%) in Chinese middle-aged and older adults.
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Ai Z, Tang C, Peng P, Wen X, Tang S. Prevalence and influencing factors of chronic pain in middle-aged and older adults in China: results of a nationally representative survey. Front Public Health 2023; 11:1110216. [PMID: 37139366 PMCID: PMC10149800 DOI: 10.3389/fpubh.2023.1110216] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Background With China's rapidly aging population, chronic pain has become a major public health issue. This article aims at determining associations between chronic pain and multiple factors, including demographic characteristics, health status, and health service utilization of middle-aged and older adults in China. Methods We selected all the 19,829 respondents who were over 45 years old from the China Health and Aging Tracking Survey 2018 (CHARLS) as our study population. The key information in terms of the body pain, demographic characteristics, health status, behaviors and health services use was extracted and analyzed. Logistic regression model was used to determine the influencing factors of chronic pain. Results Analysis revealed that 60.02% (9,257) of the data from this survey reported physical pain, with pain sites concentrated at the head (40.9%), lower back (62.2%) and knees (47.2%). Pain was positively associated with influencing factors for pain: being a female (OR = 2.10, 95% CI 1.90-2.33, p < 0.001), living in a western region (OR = 1.28, 95% CI 1.16-1.41, p < 0.001), living in a rural area (OR = 1.14, 95% CI 1.06-1.23, p < 0.001), smoked (OR = 1.26, 95% CI 1.14-1.38, p < 0.001), drank alcohol (OR = 1.16, 95% CI 1.06-1.26, p = 0.001), and had poor self-rated health (OR = 6.84, 95% CI 5.41-8.65, p < 0.001), had hearing problems (OR = 1.23, 95% CI 1.11-3.37, p < 0.001), were depressed (OR = 1.56, 95% CI 1.03-1.29, p < 0.001), had arthritis (OR = 2.21, 95% CI 2.02-2.41, p < 0.001), stomach disorders (OR = 1.69, 95% CI 1.55-1.85, p < 0.001), visited a Western medicine hospital (OR = 1.28, 95% CI 1.10-1.50, p = 0.002), and visits to other medical institutions (OR = 1.42, 95%CI 1.22-1.64, p < 0.001). On the other side, as a protective factor for pain, having nighttime sleep ≥7 h (OR = 0.74, 95%CI 0.68-0.80, p < 0.001) was negatively associated with pain. Conclusion Physical pain affects many older adults. Women, regional, rural residents, smokers, alcohol drinkers, people with poor self-rated health, those having <7 h of sleep at night, those with hearing problems, depression, arthritis, stomach disorders, and people who visits Western hospitals or other medical institutions are at greater risk for pain and deserve the attention of health care providers and policy makers to focus on pain prevention and management in middle-aged and older adults. Future research studies should also focus on the impact of health literacy on pain prevention and management outcomes.
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Affiliation(s)
- Zhonghua Ai
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Churou Tang
- Department of Biology, University of Rochester, Rochester, NY, United States
| | - Puxian Peng
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Xuan Wen
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Songyuan Tang
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- *Correspondence: Songyuan Tang
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Zhang J, Zhang F, Xin C, Duan Z, Wei J, Zhang X, Han S, Niu Z. Associations of long-term exposure to air pollution, physical activity with blood pressure and prevalence of hypertension: the China Health and Retirement Longitudinal Study. Front Public Health 2023; 11:1137118. [PMID: 37206865 PMCID: PMC10189054 DOI: 10.3389/fpubh.2023.1137118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/10/2023] [Indexed: 05/21/2023] Open
Abstract
Background Long-term exposure to air pollution and physical activity (PA) are linked to blood pressure and hypertension. However, the joint effect of air pollution and PA on blood pressure and hypertension are still unknown in Chinese middle-aged and older adults. Methods A total of 14,622 middle-aged and older adults from the China Health and Retirement Longitudinal Study wave 3 were included in this study. Ambient air pollution [particulate matter with diameter ≤ 2.5 μm (PM2.5), or ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbonic oxide (CO)] were estimated using satellite-based spatiotemporal models. PA was investigated using International Physical Activity Questionnaire. Generalized linear models were used to examine the associations of air pollution, PA score with blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP)], and the prevalence of hypertension. Subgroup analysis was conducted to investigate the effects of air pollution on blood pressure and the prevalence of hypertension in different PA groups. Results The results showed that for each inter-quartile range (IQR) increase in PM2.5 (25.45 μg/m3), PM10 (40.56 μg/m3), SO2 (18.61 μg/m3), NO2 (11.16 μg/m3), CO (0.42 mg/m3) and PA score (161.3 MET/h-week), the adjusted odd ratio (OR) of hypertension was 1.207 (95% confidence interval (CI): 1.137, 1.281), 1.189 (95%CI: 1.122, 1.260), 1.186 (95%CI: 1.112, 1.266), 1.186 (95%CI: 1.116, 1.260), 1.288 (95%CI: 1.223, 1.357), 0.948 (95%CI: 0.899, 0.999), respectively. Long-term exposure to PM2.5, PM10, SO2, NO2, and CO was associated with increased SBP, DBP, and MAP levels. For example, each IQR increase in PM2.5 was associated with 1.20 mmHg (95%CI: 0.69, 1.72) change in SBP, 0.66 mmHg (95%CI: 0.36, 0.97) change in DBP, and 0.84 mmHg (95%CI: 0.49, 1.19) change in MAP levels, respectively. Each IQR increase in PA score was associated with -0.56 mmHg (95%CI: -1.03, -0.09) change in SBP, -0.32 mmHg (95%CI: -0.59, -0.05) change in DBP, and -0.33 mmHg (95%CI: -0.64, -0.02) change in MAP levels, respectively. Subgroup analysis found that the estimated effects in the sufficient PA group were lower than that in the insufficient PA group. Conclusion Long-term exposure to air pollutants is associated with increased blood pressure and hypertension risk, while high-level PA is associated with decreased blood pressure and hypertension risk. Strengthening PA might attenuate the adverse effects of air pollution on blood pressure and hypertension risk.
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Affiliation(s)
- Jinglong Zhang
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Fen Zhang
- Department of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chao Xin
- PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, United States
| | - Xi Zhang
- The First Clinical Medical College, Anhui Medical University, Hefei, Anhui, China
| | - Shichao Han
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
- *Correspondence: Shichao Han, ; Zhiping Niu,
| | - Zhiping Niu
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
- *Correspondence: Shichao Han, ; Zhiping Niu,
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Spector AL, Quinn KG, Wang I, Gliedt JA, Fillingim RB, Cruz-Almeida Y. More Problems, More Pain: The Role of Chronic Life Stressors and Racial/Ethnic Identity on Chronic Pain Among Middle-Aged and Older Adults in the United States. Chronic Stress (Thousand Oaks) 2023; 7:24705470231208281. [PMID: 37881639 PMCID: PMC10594967 DOI: 10.1177/24705470231208281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/03/2023] [Indexed: 10/27/2023]
Abstract
There is a high prevalence of chronic pain among middle-aged and older adults in the United States. Chronic life stressors have been shown to have detrimental consequences for myriad health conditions, including chronic pain. However, there is limited evidence on the types of chronic life stressors that affect middle-aged and older adults and how these stressors influence the chronic pain burden in this population. Moreover, the interaction between chronic life stressors and racial/ethnic identity remains poorly understood as it relates to chronic pain. The current analysis used the 2018 Health and Retirement Study to investigate relationships between chronic life stressors and odds to experience any chronic pain and high-impact chronic pain. Chronic life stressors were characterized, overall and by racial/ethnic identity, and the main and interaction effects were calculated to evaluate relationships between chronic life stressors, racial/ethnic identity, and odds of experiencing any chronic pain and high-impact chronic pain. Results indicate that in 2018, the most common chronic life stressor among middle-aged and older adults was dealing with their own health problems (68%), followed by dealing with the physical or emotional issues affecting a spouse or child (46%). Adjusted analyses showed that a higher total of chronic life stressors increased the odds of middle-aged and older adults experiencing any chronic pain and high-impact chronic pain. There were no significant interactions between the overall chronic life stress burden and racial/ethnic identity as a predictor of odds to experience any chronic pain or high-impact chronic pain, but significant interaction effects were found related to specific chronic life stressors. Findings underscore the significant impact of chronic life stressors on the chronic pain burden among middle-aged and older adults in the United States, which cut across racial/ethnic identity.
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Affiliation(s)
- Antoinette L. Spector
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Katherine G. Quinn
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Inga Wang
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jordan A. Gliedt
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
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Hong C, Xiong X, Li J, Ning X, Qi D, Yang Y, Liu Y, Luo Y. Urbanization and depressive symptoms among middle-aged and older adults in China. Front Public Health 2022; 10:1086248. [PMID: 36620302 PMCID: PMC9816896 DOI: 10.3389/fpubh.2022.1086248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/05/2022] [Indexed: 12/25/2022] Open
Abstract
Aims Urbanization plays an important role in individuals' health. However, it is difficult to isolate healthy migrant effect between urbanization and health. This study examined the effects of urbanization on depressive symptoms and its possible pathways among Chinese middle-aged and older adults independent of the influence of health-selective migration. Methods Using the baseline survey of the China Health and Retirement Longitudinal Study, this study compared the depressive symptoms among three groups (urbanized rural residents, rural non-migrants and urban non-migrants). The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) short form was used to measure depressive symptoms. Logistic regression models and Structural Equation Model (SEM) were applied to examine the association between urbanization and depressive symptoms and the corresponding potential mechanisms. Results Our final sample contained 11,156 respondents with an average age of 58.91 (SD = 9.48), with 5,142 males (46.09%) and 6,014 females (53.91%). Compared with urbanized rural residents, rural residents were more likely to have depressive symptoms (OR = 1.19, 95% CI = 1.07, 1.32), and urban residents were associated with a decreased risk of depressive symptoms (OR = 0.81, 95% CI: 0.70, 0.94). A large proportion of the association between urbanization and depressive symptoms were mainly mediated by social participation, income and living conditions. Conclusions Planned urbanization had an independent impact on decreased depressive symptoms. Improvements in social participation, income and living conditions are the main drivers behind this relationship. Additionally, urbanization compensates for the negative impact of depressive symptoms from disadvantaged early life conditions, but it cannot eliminate the gap between urbanized rural people and urban non-migrants.
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Affiliation(s)
- Chenlu Hong
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | | | - Jun Li
- School of Nursing, Peking University, Beijing, China
| | - Xin Ning
- School of Nursing, Kunming Medical University, Kunming, Yunnan, China
| | - Dawei Qi
- Central Health Center of Qingyundian Town, Beijing, China
| | - Yingkai Yang
- School of Nursing, Peking University, Beijing, China
| | - Yating Liu
- School of Nursing, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China,Institute for Global Health and Development, Peking University, Beijing, China,*Correspondence: Yanan Luo ✉
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Liu Y, Zeng S, Huang C, Wang C, Zhu J, Peng J, Ding F, Li J, Qin G, Chen J. Indoor Solid Fuel Use and Non-Neoplastic Digestive System Diseases: A Population-Based Cohort Study Among Chinese Middle-Aged and Older Population. Int J Public Health 2022; 67:1605419. [PMID: 36618433 PMCID: PMC9810631 DOI: 10.3389/ijph.2022.1605419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives: We tended to explore the association of indoor air pollution (IAP) and non-neoplastic digestive system diseases (NNDSD) among the Chinese middle-aged and older population. Methods: From 2011 to 2018, we included 7884 NNDSD-free adults from the China Health and Retirement Longitudinal Study (CHARLS). Physician-diagnosed NNDSD was obtained by self-reported information at baseline and updated across follow-up surveys. We investigated the associations between baseline exposure of solid fuel use for cooking and/or heating and NNDSD diagnosed during follow-up through Cox proportional hazard models. Furthermore, we examined the relationship between cooking fuel switching and NNDSD diagnosed during follow-up. Results: Solid fuel use for cooking and/or heating was positively associated with NNDSD after adjusting for potential confounders. The risk of NNDSD among subjects who always use solid fuel for cooking (adjusted hazard ratio [aHR]: 1.42; 95% confidence interval [CI]: 1.09, 1.84) was higher than those with always clean fuels. Moreover, we found a lower NNDSD risk among participants who switched from solid to clean cooking fuel (aHR: 0.65; 95% CI: 0.49, 0.87) than those with always solid fuels. Conclusion: Our present study shows that indoor solid fuel use is a dependent risk factor for NNDSD. Moreover, switching to clean fuel may contribute to the prevention of digestive system illnesses.
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Affiliation(s)
- Yahang Liu
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Silu Zeng
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Ce Wang
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jingjing Zhu
- Clinical Research Unit, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiahuan Peng
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Fengfei Ding
- Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jiong Li
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Guoyou Qin
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jiaohua Chen
- Department of Health Management, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Jiaohua Chen,
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Adinkrah E, Najand B, Rahmani A, Maharlouei N, Ekwegh T, Cobb S, Zare H. Social Determinants of Mental, Physical, and Oral Health of Middle-Aged and Older African Americans in South Los Angeles. Int J Environ Res Public Health 2022; 19:16765. [PMID: 36554645 PMCID: PMC9779480 DOI: 10.3390/ijerph192416765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/10/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND A growing body of research suggests that financial difficulties could weaken the protective effects of socioeconomic status (SES) indicators, including education and income, on the health status of marginalized communities, such as African Americans. AIM We investigated the separate and joint effects of education, income, and financial difficulties on mental, physical, and oral self-rated health (SRH) outcomes in African American middle-aged and older adults. METHODS This cross-sectional study enrolled 150 middle-aged and older African Americans residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics (education, income, and financial difficulties), and self-rated health (mental, physical, and oral health) were collected. Three linear regression models were used to analyze the data. RESULTS Higher education and income were associated with a lower level of financial strain in a bivariate analysis. However, according to multivariable models, only financial difficulties were associated with poor mental, physical, and oral health. As similar patterns emerged for all three health outcomes, the risk associated with financial difficulties seems robust. CONCLUSIONS According to our multivariable models, financial strain is a more salient social determinant of health within African American communities than education and income in economically constrained urban environments such as South Los Angeles. While education and income lose some protective effects, financial strain continues to deteriorate the health of African American communities across domains.
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Affiliation(s)
- Edward Adinkrah
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Babak Najand
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA 90059, USA
| | - Arash Rahmani
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA 90059, USA
| | - Najmeh Maharlouei
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA 90059, USA
| | - Tavonia Ekwegh
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Sharon Cobb
- Mervyn M. Dymally School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, Garden City, NY 20783, USA
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Guo B, Zhang X, Zhang R, Chen G. The Association between Internet Use and Physical Exercise among Middle-Aged and Older Adults-Evidence from China. Int J Environ Res Public Health 2022; 19:16401. [PMID: 36554283 PMCID: PMC9778177 DOI: 10.3390/ijerph192416401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In an aging and digital society, Internet use is significantly associated with residents' physical exercise. This study aimed to explore the association between Internet use and physical exercise among Chinese middle-aged and older adults in two respects: Internet use and the purpose of Internet use. METHODS The data used in this study were obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS) conducted by Peking University. The logit model and the ordered probit model were used to analyze the association between Internet use and physical exercise, and the substitution variable method was used to examine the robustness of the results. RESULTS (1) Internet use and the frequency of Internet use significantly increased the probability and frequency of middle-aged and older adults' participation in physical exercise (p < 0.001). (2) "Watching news", "chatting" and "watching videos" via the Internet were positively associated with physical exercise, while "playing games" had no impact. (3) Internet use had a greater impact on physical exercise participation among middle-aged adults and those living in urban areas than among older adults and those living in rural areas. CONCLUSIONS This study suggests that Internet use among middle-aged and older adults is positively associated with their participation in physical exercise; the government should try to increase the popularity of Internet use to encourage their participation in physical exercise.
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Affiliation(s)
- Bin Guo
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Xiaodong Zhang
- Institute of Population Research, Peking University, Beijing 100871, China
| | - Rui Zhang
- Department of Physical Education, Peking University, Beijing 100871, China
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing 100871, China
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Zhang J, Liu X, Gong D, Peng Y, Li H, Yang Y. Health beliefs, lifestyle, and cognitive aging among Chinese community residents: A structural equation model analysis. Front Public Health 2022; 10:1028679. [PMID: 36536778 PMCID: PMC9758699 DOI: 10.3389/fpubh.2022.1028679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/16/2022] [Indexed: 12/07/2022] Open
Abstract
Background Lifestyle factors may could help maintain cognitive function and reduce the risk of dementia. The application of the Health Belief Model (HBM) has been verified by incorporating lifestyle changes for dementia risk reduction; however, the influence of health beliefs on cognitive aging through lifestyle remains unknown. To facilitate research-based interventions to promote successful cognitive aging, we explored the relationship between health beliefs, lifestyle, and cognitive aging based on the HBM using path analysis. Methods This cross-sectional study recruited middle-aged and older community residents from a community health service center in Chongqing, China, through convenience sampling. Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR), Lifestyle for Dementia Risk Reduction (LDRR), and the Montreal Cognitive Assessment (MoCA) were employed to measure participants' beliefs, lifestyle, and cognitive function, respectively. The associations between the beliefs, lifestyle, and cognitive function were analyzed, and a structural equation model was constructed. Results A total of 202 participants completed the questionnaires, of whom only 17 (8.4%) were classified as having successful cognitive aging. The model demonstrated the data to have an acceptable fit and elucidated 39.3 and 18.2% of the variance in lifestyle and the grade of cognitive aging, respectively. Positive and negative beliefs had opposite effects on the grade of cognitive aging through lifestyle. Cues to action had opposite effects on the grades of cognitive aging through positive and negative beliefs; however, the total effects canceled each other out. Conclusions Positive beliefs have a positive effect on lifestyle, thereby promoting successful cognitive aging, whereas negative beliefs have a negative effect on lifestyle, thereby hindering successful cognitive aging. Health education and media publicity, as specific aspects of cues to action, can have a meaningful impact on healthy behavior and successful cognitive aging by promoting positive beliefs and controlling negative beliefs. The model suggests the strengthening and weakening of the positive and negative beliefs, respectively, of middle-aged and older community residents in the formulation of relevant public health strategies in the future, thereby enabling them to adapt to a healthy lifestyle promoting successful cognitive aging.
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Su J, Xiao X. Factors leading to the trajectory of cognitive decline in middle-aged and older adults using group-based trajectory modeling: A cohort study. Medicine (Baltimore) 2022; 101:e31817. [PMID: 36451491 PMCID: PMC9704883 DOI: 10.1097/md.0000000000031817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Currently, studies exploring factors associated with the cognition at some time point and no study identifying the trajectories of cognitive changes and factors might associate with the trajectories of cognitive changes in people. This study was to identify factors associated with the trend of cognitive decline in middle-aged and older people. In this cohort study, the data of 6954 subjects were collected from China Health and Retirement Longitudinal Survey database. Group-based trajectory modeling was applied for identifying three different trajectories of cognitive function change [high initial level and slow decline group (n = 1024), moderate initial level and moderate decline group (n = 2673) and low initial level and rapid decline (LRD) group (n = 3277)]. Univariate and multivariate logistic regression analysis was conducted to identify variables influencing factors of the trajectories of cognitive function in middle-aged and older people. The follow-up interval was 2 years from 2011 to 2015, and 3 years from 2015 to 2018 via face-to-face interview. High initial level and slow decline group versus LRD group, age (OR = 2.591, 95% CI: 1.962-3.421), gender (OR = 1.398, 95% CI: 1.133-1.725), education (OR = 0.051, 95% CI: 0.039-0.068), place of residence (OR = 2.768, 95% CI: 1.663-4.606), disabled (OR = 1.557, 95% CI: 1.189-2.039), family annual income (OR = 0.757, 95% CI: 0.618-0.929), sleep duration (OR = 1.266, 95% CI: 1.023-1.567), instrumental activity of daily living impairment (OR = 2.513, 95% CI: 1.947-3.245), community activities participation (OR = 0.611, 95% CI: 0.500-0.748), depression (OR = 1.471, 95% CI: 1.185-1.828), and systolic blood pressure (OR = 1.005, 95% CI: 1.001-1.009) were factors influencing the trajectories of cognitive function. Comparing moderate initial level and moderate decline group and LRD group, age (OR = 1.245, 95% CI: 1.052-1.474), gender (OR = 1.244, 95% CI: 1.062-1.458), education (OR = 0.244, 95% CI: 0.190-0.314), marital status (OR = 1.291, 95% CI: 1.079-1.546), place of residence (OR = 1.677, 95% CI: 1.358-2.071), disability (OR = 1.396, 95% CI: 1.180-1.652), smoking (OR = 1.249, 95% CI: 1.071-1.457), family annual income (OR = 0.863, 95% CI: 0.768-0.970), sleep duration (OR = 1.215, 95% CI: 0.973-1.541), instrumental activity of daily living impairment (OR = 1.309, 95% CI: 1.098-1.560), community activities participation (OR = 0.804, 95% CI: 0.718-0.900) and depression (OR = 1.383, 95% CI: 1.217-1.571) were factors associated with the trajectories of cognitive function changes. Middle-aged and older adults who had characteristics associated with increased risk of cognitive decline might be provided with timely interventions.
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Affiliation(s)
- Jun Su
- Department of Neurology, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- * Correspondence: Jun Su, Department of Neurology, the First Affiliated Hospital of Shenzhen University, No. 3002 Sungang West Road, Futian District, Shenzhen 518035, China (e-mail: )
| | - Xiaohua Xiao
- Department of Geriatric Medicine, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
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Zhang C, Wang Y, Wang J, Liu X. Does internet use promote mental health among middle-aged and older adults in China? Front Psychol 2022; 13:999498. [PMID: 36457930 PMCID: PMC9706203 DOI: 10.3389/fpsyg.2022.999498] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/12/2022] [Indexed: 09/28/2023] Open
Abstract
In recent years, China's Internet penetration rate has increased, and the scale of middle-aged and older adults' netizen has continued to expand. However, the impact of internet use on mental health remains controversial. This paper analyzes 14,497 middle-aged and older adults' valid respondents in the 2018 Chinese Family Panel Study (CFPS2018) to evaluate the impact of Internet use on the mental health of middle-aged and older adults and its intermediary mechanisms. The findings show that moderate use of the Internet can significantly reduce depression levels and boost cognitive function in middle-aged and older adults. But excessive internet use will also lead to increased levels of depression and decreased cognitive function. Different Internet use purposes will also lead to different psychological states. Online socializing, entertainment and business activities can significantly reduce depression levels and promote cognitive functions. Online studying and working only have positive effects on cognitive functions, which have no significant relationship to depression levels. In addition, analysis of the mediation effect found that life satisfaction is a path mechanism for Internet use and affect different dimensions of mental health.
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Affiliation(s)
- Chong Zhang
- Institute of Network Society Governance, School of Marxism, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Wang
- School of Law and Sociology, XiHua University, Chengdu, China
| | - Jing Wang
- Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Xin Liu
- School of Law and Sociology, XiHua University, Chengdu, China
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45
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Ding Y, Chen L, Zhang Z. The relationship between social participation and depressive symptoms among Chinese middle-aged and older adults: A cross-lagged panel analysis. Front Public Health 2022; 10:996606. [PMID: 36311600 PMCID: PMC9608247 DOI: 10.3389/fpubh.2022.996606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/22/2022] [Indexed: 01/26/2023] Open
Abstract
Objectives This study examined the mutual effects of social participation and depressive symptoms in middle-aged and older Chinese adults from offline and online perspectives. Reciprocal relationships between depressive symptoms and the four subtypes of offline participation were also examined. Methods Based on China Health and Retirement Longitudinal Study data (CHARLS), this study conducted ID matching for three waves of data from 2013, 2015, and 2018. One thousand nine hundred ninety-nine samples for individuals over 50 were obtained. A series of cross-lagged analyses were conducted to examine the mutual influence of social participation and depressive symptoms. Depressive symptoms were assessed using the short version of the Center for Epidemiologic Studies Depression Scale (CESD-10). The social participation questionnaire included nine items referring to offline participation (eight items) and online participation (one item). Several demographic variables were adjusted when conducting the cross-lagged analyses. Results Social and offline participation had significant two-way associations with depressive symptoms. Depressive symptoms had greater impacts on social and offline participation than in the opposite direction. Online participation has a significant one-way impact on depressive symptoms. The relationship between specific types of offline participation and depressive symptoms varied in existence and direction. Discussion Overall, there was significant bidirectional causality between social participation and depressive symptoms. Social participation, both offline and online, played a positive role in alleviating depressive symptoms. Depressive symptoms also affected the level of social participation to some extent among middle-aged and older Chinese adults over time.
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Affiliation(s)
- Yifei Ding
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lanshuang Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhen Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,*Correspondence: Zhen Zhang
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Ye X, Zhu D, He P. Direct and indirect associations between childhood socioeconomic status and cognitive function in the middle-aged and older adults in China. Aging Ment Health 2022; 26:1730-1737. [PMID: 34125634 DOI: 10.1080/13607863.2021.1935459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate whether childhood socioeconomic status (SES) is associated with cognitive function, and what factors might mediate the associations. METHOD Using data from the China Health and Retirement Longitudinal Study (CHARLS) and within frameworks of the latency model, the pathway model and the accumulation model, we quantified direct and indirect pathways between childhood SES and cognitive function for Chinese middle-aged and older adults aged 45+ by structural equations modeling. RESULTS We found significant direct, indirect and total effects of childhood SES on cognitive function at baseline. The indirect effects were mediated through educational attainment, household consumption, smoking behaviors and social engagement. At follow-ups, cognitive enhancement can be made by indirect pathways through educational attainment, improvement of household consumption and social engagement. CONCLUSION Our results supported the latency model, the pathway model and the accumulation model when considering pathways linking childhood SES to cognitive function. The findings underscored the value of taking early interventions to improve SES and cognitive function, especially among those with low childhood SES.
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Affiliation(s)
- Xin Ye
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
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Gao J, Zhu D, Deal JA, Lin FR, He P. Hearing impairment, family financial support, and depressive symptoms among Chinese middle-aged and older adults. Int J Geriatr Psychiatry 2022; 37. [PMID: 36004947 DOI: 10.1002/gps.5788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 07/11/2022] [Indexed: 11/07/2022]
Abstract
AIMS Hearing impairment (HI) is prevalent among middle-aged and older adults, but few studies have examined its mental health consequences in China. This study investigated the association of HI with depressive symptoms and whether family financial support moderated the association among adults aged 45 in China. METHODS Data were obtained from three waves of the China Health and Retirement Longitudinal Study (2011, 2013 and 2015). Hearing impairment was defined as a self-reported hearing problem in one or both ears. Depressive symptoms were measured with CESD-10. Associations between HI and depressive symptoms were modeled using fixed-effect models. RESULTS People with self-reported hearing loss were more likely than those without hearing loss to have depressive symptoms, with an odds ratio of 1.25 [1.07-1.47]. The association remained significant after adjusting for socio-demographic characteristics, lifestyle behaviors, and health conditions. Family financial support moderated this association. Among those with HI, adults with a higher level of family financial support tend to have better performance on symptoms of depression. CONCLUSIONS HI was positively associated with depressive symptoms among adults aged ≥45 in China, and family financial support played a buffering role in the relationship between HI and depressive symptoms.
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Affiliation(s)
- Jiamin Gao
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Frank R Lin
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,Johns Hopkins Bloomberg School of Public Health, Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
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Murayama Y, Yamazaki S, Hasebe M, Takahashi T, Yamaguchi J, Kobayashi E. Psychological Factors That Suppress Help-Seeking among Middle-Aged and Older Adults Living Alone. Int J Environ Res Public Health 2022; 19:10620. [PMID: 36078335 PMCID: PMC9518183 DOI: 10.3390/ijerph191710620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
Help-seeking among destitute adults has not been adequately investigated. Therefore, this study clarifies the mechanisms that suppress help-seeking in middle-aged and older adults living alone. Data were collected from 1274 individuals (aged 50-79 years) who were living alone, using a survey that measured future time perspective, barriers to help-seeking, help-seeking intentions, and current and childhood economic statuses. Men living alone experienced lower help-seeking intention than women, were more likely to try to solve problems by themselves, and experienced greater distrust in others. No sex differences were observed in "future anxiety" and "resignation to the future." Poor economic status was associated with high "resignation to the future," "future anxiety," and "distrust of others" for both sexes. "Resignation to the future" was particularly higher among men with a poorer current economic status, which suppressed help-seeking. Abandoning hope for the future, which is characteristic of middle-aged and older men living alone, may inhibit help-seeking behavior.
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Affiliation(s)
- Yoh Murayama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan
| | - Sachiko Yamazaki
- Department of Human Studies, Bunkyo Gakuin University, Saitama-ken 356-8533, Japan
| | - Masami Hasebe
- Department of Human Welfare, Seigakuin University, Saitama-ken 362-8585, Japan
| | - Tomoya Takahashi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan
| | - Jun Yamaguchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan
| | - Erika Kobayashi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan
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Zhang N, Wang C, Li Y, Yang M, Yang J, Chen F, Yan P. Gender-Specific Association Between Nighttime Sleep Duration and Falls Among Community-Dwelling Middle-Aged and Older Adults in China. J Appl Gerontol 2022; 41:2511-2519. [PMID: 35943209 DOI: 10.1177/07334648221118904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study was conducted using the data from 2015 China Health and Retirement Longitudinal Study (CHARLS). Gender-specific association between nighttime sleep duration (NSD) and falls were evaluated through multiple logistic regression by adjusting for confounding variables. Of the 22,899 respondents, 18,446 were eligible and 3,144 (16.99%) had more than a single fall. Short and long NSD were associated with high occurrences of falls in the total and female population, but only a short NSD was associated with a high occurrence of falls in the male population. In conclusion, NSD was strongly and significantly associated with falls, but the association was gender-specific. Accordingly, increasing targeted, evidence-based and gender-specific preventions for NSD and sleep disturbance are necessary among primary care interventions to prevent falls.
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Affiliation(s)
- Nan Zhang
- School of Nursing, 74790Xinjiang Medical University, Urumqi, China
| | - Cui Wang
- School of Nursing, 12465Peking University, Beijing, China
| | - Yuli Li
- School of Nursing and Rehabilitaion, 12589Shandong University, Jinan, China
| | - Mei Yang
- Xingfu road Community Health Service Center, 418584Xinjiang Traditional Chinese Medicine Hospital, Urumqi, China
| | - Jing Yang
- 426111Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Fenghui Chen
- School of Nursing, 74790Xinjiang Medical University, Urumqi, China
| | - Ping Yan
- School of Nursing, 74790Xinjiang Medical University, Urumqi, China
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Zhou J, Wei MY, Zhang J, Liu H, Wu C. Association of multimorbidity patterns with incident disability and recovery of independence among middle-aged and older adults. Age Ageing 2022; 51:afac177. [PMID: 35930720 DOI: 10.1093/ageing/afac177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/17/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE to identify multimorbidity patterns among middle-aged and older adults in China and examine how these patterns are associated with incident disability and recovery of independence. METHODS data were from The China Health and Retirement Longitudinal Study. We included 14,613 persons aged ≥45 years. Latent class analysis (LCA) was conducted to identify multimorbidity patterns with clinical meaningfulness. Multinomial logistic models were used to determine the adjusted association between multimorbidity patterns and incident disability and recovery of independence. RESULTS we identified four multimorbidity patterns: 'low morbidity' (67.91% of the sample), 'pulmonary-digestive-rheumatic' (17.28%), 'cardiovascular-metabolic-neuro' (10.77%) and 'high morbidity' (4.04%). Compared to the 'low morbidity' group, 'high morbidity' (OR = 2.63, 95% CI = 1.97-3.51), 'pulmonary-digestive-rheumatic' (OR = 1.89, 95% CI = 1.63-2.21) and 'cardiovascular-metabolic-neuro' pattern (OR = 1.61, 95% CI = 1.31-1.97) had higher odds of incident disability in adjusted multinomial logistic models. The 'cardiovascular-metabolic-neuro' (OR = 0.60, 95% CI = 0.44-0.81), 'high morbidity' (OR = 0.68, 95% CI = 0.47-0.98) and 'pulmonary-digestive-rheumatic' group (OR = 0.75, 95% CI = 0.60-0.95) had lower odds of recovery from disability than the 'low morbidity' group. Among people without disability, the 'cardiovascular-endocrine-neuro' pattern was associated with the highest 2-year mortality (OR = 2.42, 95% CI = 1.56-3.72). CONCLUSIONS multimorbidity is complex and heterogeneous, but our study demonstrates that clinically meaningful patterns can be obtained using LCA. We highlight four multimorbidity patterns with differential effects on incident disability and recovery from disability. These studies suggest that targeted prevention and treatment approaches are needed for people with multimorbidity.
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Affiliation(s)
- Jiayi Zhou
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong 999077, China
- Global Health Research Center, Duke Kunshan University, Kunshan 215316, China
| | - Melissa Y Wei
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Jingyi Zhang
- College of Arts and Sciences, Hanover, NH 02747, USA
| | - Hua Liu
- Department of Neurosurgery, The Affiliated Kunshan Hospital of Jiangsu University, Suzhou, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan 215316, China
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