1
|
Çakan F, Önalan O, Adar A, Akbay E, Çöllüoğlu IT, Köktürk U, Akin Y, Özçalik E. Clinical characteristics of atrial fibrillation in nonagenarian population and relationship with mortality. Minerva Cardiol Angiol 2024; 72:372-384. [PMID: 38934266 DOI: 10.23736/s2724-5683.24.06464-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
BACKGROUND There is a considerable amount of literature available on well-known risk factors for atrial fibrillation (AF); however, available data specifically focused on the ninth decade are scarce. The main objective of this study was to assess the demographic and clinical characteristics of AF and sinus rhythm in a nonagenarian population. METHODS All individuals aged >90 years who were admitted to the Cardiology outpatient clinic between April 2018 and January 2019 were enrolled in the study. The demographic and clinical characteristics of all patients were recorded. All deaths that occurred during the two-year follow-up period were recorded. RESULTS In total, 112 nonagenarian individuals were included in the study. Of these patients, 50 (44.6%) had AF. The groups showed similarities in demographic and clinical characteristics. During a mean follow-up period of 596±44 days, 39 patients (78%) in the AF group and 35 patients (56.5%) in the sinus group died. Patients with AF showed a lower overall survival distribution than those with sinus rhythm (P=0.005, log-rank test χ2=7.734). AF was associated with an increased risk of mortality (P=0.002, hazard ratio [HR] =2.104, 95% confidence interval [CI] = 1.326-3.339) in multivariate Cox regression analysis, while waist circumference and total cholesterol (P=0.003, HR=0.969, 95% CI=0.949-0.989 and P=0.046, HR=0.993, 95% CI=0.986-1.000, respectively) showed a decreased risk of mortality. CONCLUSIONS Atrial fibrillation is very common in individuals over the age of 90 years (44.6%). Well-known risk factors do not appear to be effective in this age group, and AF is associated with a 2.1-fold increase in the risk of mortality.
Collapse
Affiliation(s)
- Fahri Çakan
- Department of Cardiology, Faculty of Medicine, Karabuk University, Karabuk, Türkiye -
| | - Orhan Önalan
- Department of Cardiology, Faculty of Medicine, Karabuk University, Karabuk, Türkiye
| | - Adem Adar
- Department of Cardiology, Alanya Research and Application Center, Baskent University, Antalya, Türkiye
| | - Ertan Akbay
- Department of Cardiology, Alanya Research and Application Center, Baskent University, Antalya, Türkiye
| | - Inci T Çöllüoğlu
- Department of Cardiology, Faculty of Medicine, Karabuk University, Karabuk, Türkiye
| | - Uğur Köktürk
- Department of Cardiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Türkiye
| | - Yeşim Akin
- Department of Cardiology, Faculty of Medicine, Karabuk University, Karabuk, Türkiye
| | - Emre Özçalik
- Department of Cardiology, Zubeyde Hanim Hospital, Baskent University, Izmir, Türkiye
| |
Collapse
|
2
|
Wang S, Yang Z, Tan X, Lai F, Luo L, Ding Y. Association between standing height and physical disability among U.S. adults aged 60 years and older: findings from NHANES 2015-2018. BMC Geriatr 2024; 24:529. [PMID: 38890578 PMCID: PMC11186253 DOI: 10.1186/s12877-024-05100-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/21/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Physical disability is an important cause of affecting the quality of life in the elderly. The association between standing height and physical disability is less studied. PURPOSE The purpose of this study is to investigate the possible link between standing height and physical disability among U.S. adults aged 60 years and older. METHODS The cross-sectional data were obtained from the US National Health and Nutrition Examination Survey (NHANES) 2015-2018. Physical disability was assessed by six questions: "Have serious difficulty hearing (SDH)?", "Have serious difficulty seeing (SDS)?", "Have serious difficulty concentrating (SDC)?", "Have serious difficulty walking (SDW)?", "Have difficulty dressing or bathing (DDB)?" and "Have difficulty doing errands alone (DDEA)?". Responses to these questions were "yes" or "no". Answer yes to one of the above six questions was identified as physical disability. Standing height (cm) was measured with an altimeter. Multivariate logistic regression was performed to examine the possible link between standing height and physical disability after adjustment for all covariates. RESULTS A total of 2624 participants aged ≥ 60 years were included in our study, including 1279 (48.7%) females and 1345 (51.3%) males. The mean age of participants was 69.41 ± 6.82 years. After adjusting for all potential confounders, the inverse relationship between standing height and all physical disability (APD) was statistically significant (OR = 0.976, 95%CI:0.957-0.995). In addition, among six types of physical disability (SDH, SDS, SDC, SDW, DDB, DDEA), standing height was also a protective factor for SDW (OR = 0.961, 95%CI:0.939-0.983) and DDEA (OR = 0.944, 95%CI:0.915-0.975) in the full-adjusted model. CONCLUSION The cross-sectional population based study demonstrates that standing height is a protective factor for physical disability among U.S. adults aged 60 years and older.
Collapse
Affiliation(s)
- Shihong Wang
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Zihua Yang
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Xiwei Tan
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Fengxia Lai
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Ling Luo
- School of Public Health and Emergency Management, South University of Science and Technology of China, Shenzhen, Guangdong, China.
| | - Yuanlin Ding
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China.
| |
Collapse
|
3
|
Chen Y, Guo H, Li Z, Huang L, Hong T, Wang H. Association of self-reported arthritis with depression, anxiety, and comorbid depression/anxiety among the older Chinese adults: A cross-sectional study. J Affect Disord 2024; 354:323-330. [PMID: 38494138 DOI: 10.1016/j.jad.2024.03.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Arthritis is relatively common among middle-aged and older people and is a significant public health problem. However, research on the relationship between arthritis and mental health in older populations is currently limited. METHODS Data were obtained from the Chinese Longitudinal Healthy Longevity Survey. The 10-item Center for Epidemiologic Studies Depression Scale and 7-item Generalized Anxiety Disorder Scale were used to evaluate depressive and anxiety symptoms. Arthritis status was self-reported. Linear and logistic regression analyses were conducted to assess the impact of arthritis on depression, anxiety, and comorbid depression/anxiety symptoms. RESULTS A total of 11,104 participants aged ≥65 years (mean age, 83.1 ± 11.1 years) were included in the analysis. We detected positive associations of arthritis with depression symptoms (adjusted odds ratio [OR]: 1.57, 95 % confidence interval [CI] 1.33 to 1.86), anxiety symptoms (adjusted OR: 1.48, 95 % CI: 1.15 to 1.90), and comorbid depression/anxiety symptoms (adjusted OR: 1.88, 95 % CI: 1.41 to 2.5) in the older adult population. Participants with arthritis had higher anxiety (adjusted linear regression coefficient: 0.43, 95 % CI: 0.24 to 0.63) and depression (adjusted linear regression coefficient: 0.87, 95 % CI: 0.57 to 1.14) scores compared with those without arthritis. In addition, there were no significant interaction effects between arthritis and participant characteristics on depression symptoms, anxiety symptoms, or comorbid depression/anxiety symptoms. CONCLUSIONS Arthritis was positively associated with depression symptoms, anxiety symptoms, and comorbid depression/anxiety symptoms among older adults. Further cohort studies are needed to validate these associations.
Collapse
Affiliation(s)
- Yu Chen
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Huifang Guo
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Zheng Li
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Lina Huang
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tao Hong
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Haiyuan Wang
- Department of Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China.
| |
Collapse
|
4
|
Lin S, Yu Q, Li J, Yan X. Dentition status and risk of frailty in older Chinese people: a 16-year prospective cohort study. Arch Gerontol Geriatr 2024; 121:105367. [PMID: 38367564 DOI: 10.1016/j.archger.2024.105367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/23/2024] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To explore associations of dentition status with frailty and death. METHODS Based on the "Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2002-2018", a prospective cohort study was conducted that 21,159 participants not frail and aged ≥ 65 were included at baseline. The outcome was frailty and death. Frailty index (FI) was constructed based on 44 health items. The mediation role of high sensitivity C-reactive protein (hs-CRP) was examined using cross-sectional data in 2008, 2011 and 2014. RESULTS The incidence density of frailty was 50.1 (95%CI: 48.8∼51.4) per 1,000 person-years. Compared with ≥ 20 natural teeth, the odds of frailty hazards were 1.27 (95%CI: 1.16∼1.39) times higher for < 20 natural teeth with dental prostheses, and were 1.24 (95%CI: 1.14∼1.35) times higher for < 20 natural teeth without dental prostheses; the odds of death hazards for < 20 natural teeth without dental prostheses were 1.36 (95%CI: 1.26∼1.45) times higher. Among participants with <20 natural teeth and without dental prostheses at baseline, the odds of frailty hazards for using dental prostheses were 0.48 (95%CI: 0.41∼0.56) times as high as those remaining not to use, and the odds of death hazards were 0.44 (95%CI: 0.39∼0.48) times as high. The cross-sectional data showed higher levels of hs-CRP explained 5∼6% of associations between dentition status and frailty. CONCLUSION Natural teeth <20 was associated with higher odds of frailty and death. Mediation analysis based on cross-sectional data offered clues for chronic inflammation pathway, yet this finding is still needed to be further verified.
Collapse
Affiliation(s)
- Shiqi Lin
- School of Humanities and Social Science, Fuzhou University, Fujian, China.
| | - Qi Yu
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Jiajia Li
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Xiaojin Yan
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| |
Collapse
|
5
|
Zhang Y, Yin Z, Li S, Zhang JJ, Sun HZ, Liu K, Shirai K, Hu K, Qiu C, Liu X, Li Y, Zeng Y, Yao Y. Ambient PM 2.5, ozone and mortality in Chinese older adults: A nationwide cohort analysis (2005-2018). JOURNAL OF HAZARDOUS MATERIALS 2023; 454:131539. [PMID: 37149946 DOI: 10.1016/j.jhazmat.2023.131539] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/17/2023] [Accepted: 04/27/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Cohort evidence linking long-term survival with exposure to multiple air pollutants (e.g., fine particulate matter [PM2.5] and ozone) was extensively sparse in low- and middle-income countries, especially among older adults. This study aimed to investigate potential associations of long-term exposures to PM2.5 and ozone with all-cause mortality in Chinese older adults. METHODS A dynamic nationwide prospective cohort comprising 20,352 adults aged ≥65 years were enrolled from the Chinese Longitudinal Healthy Longevity Study and followed up through 2005-2018. Participants' annual exposures to warm-season ozone and year-round PM2.5 were assigned using satellite-derived spatiotemporal estimates. A directed acyclic graph (DAG) was developed to identify confounding variables. Associations of annual mean exposures to PM2.5 and ozone with mortality were evaluated using single- and two-pollutant Cox proportional hazards models, adjusting for time-dependent individual risk factors and ambient temperature. RESULTS During 100 thousand person-years of follow-up (median: 3.6 years), a total of 14,313 death events occurred. The participants were averagely aged 87.1 years at baseline and exposed to a wide range of annual average concentrations of warm-season maximum 8-hour ozone (mean, 54.4 ppb; range, 23.3-81.6 ppb) and year-round PM2.5 (mean, 65.5 μg/m3; range, 10.1-162.9 μg/m3). Approximately linear concentration-response relationship was identified for ozone, whereas significant increases in PM2.5-associated mortality risks were observed only when concentrations were above 60 μg/m3. Rises of 10 ppb in ozone and 10 µg/m3 in PM2.5 above 60 µg/m3 were associated with increases in all-cause mortality of 13.2% (95% confidence interval [CI]: 10.2-16.2%) and 6.2% (95% CI: 4.6-7.7%) in DAG-based single-pollutant model, and of 9.7% (95% CI: 6.6-13.0%) and 5.3% (95% CI: 3.7-6.9%) in DAG-based two-pollutant model, respectively. We detected significant effect modification by temperature in associations of mortality with ozone (P <0.001 for interaction), suggesting greater ozone-related risks among participants in warmer locations. CONCLUSIONS This study provided longitudinal evidence that long-term exposure to ambient PM2.5 and ozone significantly and independently contributed to elevated risks of all-cause mortality among older adults in China.
Collapse
Affiliation(s)
- Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Zhouxin Yin
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Shaojie Li
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Haitong Zhe Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK; Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita Shi, Osaka, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita Shi, Osaka, Japan
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Chengxuan Qiu
- Aging Research Center, Karolinska Institutet, Widerströmska Huset, SE-171 65 Solna, Sweden
| | - Xiaoyun Liu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yachen Li
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, US.
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China; Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
| |
Collapse
|
6
|
Song Q, Dai M, Lin T, Zhao Y, Peng X, Liang R, Su Q, Yue J. Biomass fuel usage for cooking and frailty among older adults in China: a population-based cohort study. Front Public Health 2023; 11:1122243. [PMID: 37124768 PMCID: PMC10131187 DOI: 10.3389/fpubh.2023.1122243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/28/2023] [Indexed: 05/02/2023] Open
Abstract
Background Although outdoor air pollution is reported to have a negative effect on frailty, evidence involving household air pollution is sparse. Methods A cohort study on older participants aged ≥65 years from the Chinese Longitudinal Healthy Longevity Survey was conducted between 2011/2012 and 2014. Household cooking fuel types were determined by self-reported questionaries, and were dichotomized into clean or biomass fuels. The frailty status was evaluated via a 46-item frailty index (FI) and the FRAIL scale, respectively. Frailty was identified if FI >0.21 or FRAIL score ≥3. Cox proportional hazards models were employed to examine the relationship between cooking fuels and incident frailty. And the effects of swapping cooking fuels on frailty risk were also explored. Results Among 4,643 participants (mean age at baseline 80.9 ± 9.6 years, 53.7% male) totaling 11,340 person-years, 923 (19.9%) incident frailty was identified using FI. Compared to clean fuels, cooking with biomass fuels was intricately linked to a 23% rise in frailty risk (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.06-1.43). A similar association was detected between biomass cooking fuels and frailty measured by the FRAIL scale (HR 1.24, 95% CI 1.04-1.50). Sensitive analyses supported the independent relationship between biomass fuels and frailty. Stratified analyses revealed that the frailty risk was higher among town residents (HR 1.44, 95% CI 1.13-1.84) and participants not exercising regularly (HR 1.35, 95% CI 1.11-1.64). In comparison with persistent biomass fuels usage, switching to clean fuels had a trend to reduce the frailty risk, and the opposite effect was observed when swapping from clean to biomass fuels. Conclusion Cooking with biomass fuels was associated with an increased frailty risk in older adults, especially amongst those living in town and those lacking regular exercise. More studies are needed to confirm our findings and to evaluate the potential benefits of reducing indoor biomass fuel usage.
Collapse
Affiliation(s)
- Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Miao Dai
- Department of Geriatrics, Jiujiang First People's Hospital, Jiujiang, China
| | - Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xuchao Peng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Liang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qiaoli Su
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
- Qiaoli Su
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Jirong Yue
| |
Collapse
|
7
|
Chen N, Cao J, Zhang W, Chen Y, Xu L. Gender differences in the correlation between body mass index and cognitive impairment among the community-dwelling oldest-old in China: a cross-sectional study. BMJ Open 2022; 12:e065125. [PMID: 36418136 PMCID: PMC9685246 DOI: 10.1136/bmjopen-2022-065125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study investigates gender differences in the correlation between body mass index (BMI) and cognitive impairment among Chinese community-dwelling oldest-old. SETTING Twenty-three provinces in China. Participants' mini-mental state examination (MMSE) scores <24 were considered cognitive impairment. Furthermore, the assessment standards of BMI status were classified into four categories: obese (BMI >30), overweight (25≤BMI≤30), normal (18.5≤BMI<25) and underweight (BMI <18.5). PARTICIPANTS A total of 9218 older adults (age 80+) were included from the 2018 wave of Chinese Longitudinal Healthy Longevity Study. METHODS Cognitive impairment, BMI and other covariates consisted of the sociodemographic variables, health behaviours and health status were collected. Cognitive impairment was assessed by the MMSE. Inverse probability weighting procedure was adopted to deal with bias due to dropout.Logistic regression was conducted to examine the correlation between BMI and cognitive impairment. RESULTS Among 9218 respondents, 3837 were males. Overall, the percentage of participants with cognitive impairment was 44.7%, with 32.1% among males and 53.7% among females. After controlling for other variables, males who were either overweight or underweight and females who were underweight were found to have higher risk of cognitive impairment among the oldest-old. Age, education, economic status, physical activity, activities of daily living, hypertension as well as heart disease were the predicting factors of cognitive impairment. CONCLUSIONS The relationship between BMI and cognitive impairment differs between male and female oldest-old, suggesting that we should pay attention to different BMI groups and adopt precise prevention strategies based on gender.
Collapse
Affiliation(s)
- Na Chen
- School of Elderly Care Services and management, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - JiaWei Cao
- School of Elderly Care Services and management, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Wei Zhang
- School of Elderly Care Services and management, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Yanan Chen
- School of Elderly Care Services and management, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Ling Xu
- School of Elderly Care Services and management, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| |
Collapse
|
8
|
Association between frailty and cognitive function in older Chinese people: A moderated mediation of social relationships and depressive symptoms. J Affect Disord 2022; 316:223-232. [PMID: 35988782 DOI: 10.1016/j.jad.2022.08.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND To date, few studies have focused on examining either the direct or indirect effect of physical frailty on cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their individual components in the role of depressive symptoms as a mediator between frailty and cognitive impairment. METHODS This study included a total of 7525 Chinese older adults from the 2017-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mediation analyses and moderated mediation effect analysis fully adjusted for all potential confounding factors were conducted. RESULTS Significant correlations were found between frailty, depression, social relationships, and cognitive function. Depression partially mediated the association of frailty with cognitive function [B = -0.198; 95 % confidence interval (CI): (-0.258, -0.143)]. Social relationships moderated the effect of frailty on cognitive function through both path b (depression-cognitive function) [B = 0.137; 95 % CI: (0.045, 0.230)], and path c' (frailty-cognitive function) [B = 0.870; 95 % CI: (0.562, 1.178)]. In addition, social activities and social networks moderated both the direct and indirect effect of the moderated mediation model. Social support only moderated the direct effect. LIMITATIONS The cross-sectional design of this study precludes any conclusion from the results as to the causality of cognitive impairment. CONCLUSIONS Social relationships moderated both the direct and indirect effects of depressive symptoms on the association between frailty and cognitive impairment. The findings suggest that interventions, such as paying attention to the mental health of old people and improving the quality of social relationships, may help break the link between frailty and cognitive impairment.
Collapse
|
9
|
Deng Y, Zhao H, Liu Y, Liu H, Shi J, Zhao C, He M. Association of using biomass fuel for cooking with depression and anxiety symptoms in older Chinese adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 811:152256. [PMID: 34896507 DOI: 10.1016/j.scitotenv.2021.152256] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/10/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUNDS Household air pollution exposure is a crucial public concern and have the potential to seriously affect human health. Using biomass fuels for cooking is the main contributor to household air pollution. However, current evidence linked between cooking with biomass fuels and mental health remains limited. OBJECTIVES To explore whether cooking with biomass fuels is associated with depression and anxiety symptoms among older adults in China. METHODS We obtained data from Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Primary cooking fuel type was self-reported. We used logistic regression and linear regression to evaluate the effects of cooking with biomass fuels on depression and anxiety. RESULTS A total of 13,361 participants aged 65 years and older (mean age, 84.2 ± 11.5 years) were included in the presented study. A positive association was found between cooking with biomass fuels and both depression symptoms (adjusted odds ratio 1.23, 95% CI 1.03 to 1.47) and anxiety symptoms (adjusted odds ratio 1.31, 95% CI 1.02 to 1.68). Biomass fuel users had a higher depression scores (0.33, 95% CI 0.03 to 0.61) and a higher anxiety scores (0.20, 95% CI 0.02 to 0.38) compared to clean fuel users. We found no significant interactions between participant characteristics and biomass fuel use on either depression or anxiety symptoms. CONCLUSIONS Cooking with biomass fuels was associated with depression and anxiety symptoms in order adults. Further large prospective cohort studies are warranted to confirm this association.
Collapse
Affiliation(s)
- Yan Deng
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Hang Zhao
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Ying Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Huo Liu
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Jingang Shi
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Chenkai Zhao
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Miao He
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China.
| |
Collapse
|
10
|
Zheng PP, Guo ZL, Du XJ, Yang HM, Wang ZJ. Prevalence of Disability among the Chinese Older Population: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1656. [PMID: 35162679 PMCID: PMC8835133 DOI: 10.3390/ijerph19031656] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Disability is an important problem in aging societies globally. However, the research findings of the prevalence of disability have been inconsistent. This study aims to estimate the prevalence of disability and its influencing factors among the Chinese older population from 1979 to 31 July 2021. METHODS A systematic review and meta-analysis were conducted using both international (PubMed, Web of Science, CBMdisc, PsycINFO, the Cochrane Library, and EMBASE) and Chinese (CNKI, CQVIP, and WanFang) databases. Meta-analysis was performed using a random-effects model to account for heterogeneity. Subgroup analyses were also done. RESULTS The pooled prevalence of disability across all 97 studies was 26.2% (95% CI: 23.7-28.6%). The estimates varied according to the types of activities of daily living (ADL), gender, age, and region. Studies based on the identification of cases by using the complete ADL scale showed a higher prevalence than those using the basic ADL scale. The prevalence was slightly higher among female older individuals than among male older individuals. The highest rates were seen in older individuals aged 80 years or older. Elders in central China, southwest China, and northwest China were more likely to be BADL-disabled. CONCLUSION Prevalence of disability among the Chinese older population is high, around 26%. Using standardized diagnostic systems to correctly estimate the prevalence of disability would be helpful for public health professionals in China.
Collapse
Affiliation(s)
- Pian-Pian Zheng
- Institute of Population Research, Peking University, Beijing 100871, China; (P.-P.Z.); (Z.-L.G.)
| | - Zi-Le Guo
- Institute of Population Research, Peking University, Beijing 100871, China; (P.-P.Z.); (Z.-L.G.)
| | - Xiao-Jing Du
- School of Humanities and Social Sciences, Xi′an Jiaotong University, Xi′an 710049, China;
| | - Han-Mo Yang
- National School of Development, Peking University, Beijing 100871, China;
| | - Zhen-Jie Wang
- Institute of Population Research, Peking University, Beijing 100871, China; (P.-P.Z.); (Z.-L.G.)
| |
Collapse
|
11
|
Deng Y, Yang T, Gao Q, Yang D, Liu R, Wu B, Hu L, Liu Y, He M. Cooking with biomass fuels increased the risk for cognitive impairment and cognitive decline among the oldest-old Chinese adults (2011-2018): A prospective cohort study. ENVIRONMENT INTERNATIONAL 2021; 155:106593. [PMID: 33962234 DOI: 10.1016/j.envint.2021.106593] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/15/2021] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUNDS While the pernicious effects of outdoor air pollution on cognitive ability have been previously examined, evidence regarding household air pollution is scarce. METHODS Using data from the Chinese Longitudinal Healthy Longevity Survey, we explored the relationship between cooking with biomass fuel and cognitive impairment and cognitive decline using a Cox proportional hazards model. We further assessed the correlation of biomass fuels and cognitive score using a generalized estimating equation. Cognitive ability was measured based on the Chinese version of the Mini-Mental State Examination (MMSE) and cognitive impairment was defined as MMSE < 24 points and cognitive decline was defined as a reduction of MMSE ≥ 3 points. On follow-up, we investigated the effect of switch-cooking combustibles on cognitive ability. RESULTS The mean (SD) age of 4161 participants was 81.7 (10.0) years old. The reported cooking with biomass fuels was correlated with an elevated risk of cognitive impairment (hazard ratio (HR): 1.19, 95% confidence interval (CI): 1.04, 1.37) and cognitive decline (HR: 1.18, 95% CI: 1.04, 1.33). Besides, cooking with biomass fuels was related to a decrease in cognitive score (β: -0.43, 95% CI: -0.73, -0.14). In comparison to persistent biomass fuel users, participants who reported changing their primary cooking fuels from biomass to clean fuels exhibited a reduced risk of cognitive impairment (HR: 0.68, 95% CI: 0.57, 0.82) and cognitive decline (HR: 0.66, 95% CI: 0.56, 0.76) and a higher cognitive score (β: 0.72, 95% CI: 0.17, 1.26). Cooking without ventilated cookstoves was associated with a higher risk of cognitive impairment (HR: 1.31, 95% CI: 1.10, 1.58) and cognitive decline (HR: 1.18, 95% CI: 1.02, 1.38), regardless of types of cooking fuels. Interaction and stratified analyses showed relatively poor cognitive ability in participants who engaged in irregular exercise or were not living with family members. CONCLUSIONS Cooking with biomass fuels was correlated with a higher risk of cognitive impairment and cognitive decline. Among the oldest-old population, this risk may, however, be lower for those changing their primary cooking fuels from biomass to clean fuels.
Collapse
Affiliation(s)
- Yan Deng
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tianyao Yang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Dan Yang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Ruxi Liu
- Department of Immunology and Rheumatology, First Hospital, China Medical University, Shenyang 110001, China
| | - Bo Wu
- Department of Anal and Rectal Diseases, First Hospital, China Medical University, Shenyang 110001, China
| | - Liwen Hu
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yang Liu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Miao He
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China.
| |
Collapse
|
12
|
Wei Y, Lv Y, Zhou J, Gao X, Duan J, Zhao C, Yin Z, Kang Q, Wu B, Chen C, Mao C, Li J, Shi X. Smoking cessation in late life is associated with increased risk of all-cause mortality amongst oldest old people: a community-based prospective cohort study. Age Ageing 2021; 50:1298-1305. [PMID: 33492360 DOI: 10.1093/ageing/afaa280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE we aimed to investigate the association of smoking cessation with risk of all-cause mortality amongst oldest old people (aged ≥ 80 years). DESIGN this was a prospective cohort study. SETTING the Chinese Longitudinal Healthy Longevity Survey, implemented in 23 provinces of China. PARTICIPANTS a total of 28,643 community-dwelling oldest old people (mean age, 92.9 ± 7.5 years) were included. METHODS in this community-based cohort study, Cox proportional hazards models were used to examine the association of smoking cessation with risk of all-cause mortality. RESULTS during 136,585 person-years of follow-up from baseline to 1 September 2014, compared with never smokers, hazard ratios and 95% confidence intervals for all-cause mortality were 1.06 (1.02-1.10) for current smokers, 1.23 (1.09-1.39) for transient quitters (≤1 consecutive years since smoking cessation), 1.22 (1.12-1.32) for recent quitters (2-6 consecutive years since smoking cessation) and 1.11 (1.02-1.22) for long-term quitters (>6 consecutive years since smoking cessation). Cox models with penalised splines revealed an increased risk of all-cause mortality after smoking cessation; the highest mortality risk was observed within 2-4 years after smoking cessation and the risk gradually decreased with duration of smoking cessation. We further conducted subgroup analyses and sensitivity analyses to reduce the impact of reverse causation. CONCLUSIONS smoking is harmful to health in all populations. Our study findings indicated smoking cessation in late life to be associated with increased risk of all-cause mortality amongst oldest old people who have smoked for a long time.
Collapse
Affiliation(s)
- Yuan Wei
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Hygienic Inspection, School of Public Health, Jilin University, Jilin, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinhui Zhou
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Gao
- Nutritional Epidemiology Lab, Pennsylvania State University, University Park, PA, USA
| | - Jun Duan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chao Zhao
- Department of Hygienic Inspection, School of Public Health, Jilin University, Jilin, China
| | - Zhaoxue Yin
- Office of Non-communicable Disease and Ageing Health Management, Chinese Center for Disease Control and Prevention Beijing, China
| | - Qi Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, China
| | - Bing Wu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Mao
- Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Juan Li
- Department of Hygienic Inspection, School of Public Health, Jilin University, Jilin, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| |
Collapse
|
13
|
Chua KY, Lin X, Wang Y, Chong YS, Lim WS, Koh WP. Visceral fat area is the measure of obesity best associated with mobility disability in community dwelling oldest-old Chinese adults. BMC Geriatr 2021; 21:282. [PMID: 33910516 PMCID: PMC8082923 DOI: 10.1186/s12877-021-02226-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 01/23/2023] Open
Abstract
Background Although obesity can be clinically defined by body mass index (BMI), waist circumference, percent body fat, or visceral fat area, it is unclear which specific measure is best associated with mobility disability in oldest-old adults. Methods Among 589 Chinese participants aged 85 years and older in a population-based cohort in Singapore, we measured waist circumference, computed BMI, estimated appendicular skeletal muscle mass, percent body fat, and visceral fat area using bioelectrical impedance analysis, and evaluated mobility disability using the Loco-Check questionnaire. We computed areas under the receiver operating characteristic curves (AUCROC) to compare how well these measures discriminated between those with and without mobility disability. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between obesity defined by these measures and mobility disability. Results Compared to BMI, which had an AUCROC (95% CI) of 0.68 (0.64–0.72) for the discrimination of mobility disability, only visceral fat area had a significantly higher discriminative performance [AUCROC (95% CI) of 0.71 (0.67–0.75) (Padjusted = 0.002)]. The optimal cut-offs of visceral fat area for the discrimination of mobility disability were ≥ 104 cm2 in men and ≥ 137 cm2 in women. In fully adjusted models, only obesity defined by visceral fat area was significantly associated with mobility disability [OR (95% CI) of 2.04 (1.10–3.77)]; obesity defined by the other measures were not associated with mobility disability after adjusting for visceral fat. Conclusion In oldest-old adults, visceral fat area was the best discriminator for obesity associated with mobility disability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02226-6.
Collapse
Affiliation(s)
- Kevin Yiqiang Chua
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Xinyi Lin
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.,Singapore Clinical Research Institute, Singapore, Singapore
| | - Yeli Wang
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Wee-Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| |
Collapse
|
14
|
Yang S, Wang S, Tai P, Jia W, Han K, Liu M, He Y. Central and Peripheral Adiposity Had Different Effect on Disability in Centenarians. Front Endocrinol (Lausanne) 2021; 12:635205. [PMID: 33796073 PMCID: PMC8008817 DOI: 10.3389/fendo.2021.635205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the correlations between waist circumference, body mass index, calf circumference (CC), and waist-calf circumference ratio (WCR) and activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in Hainan centenarians. Patients and Methods A total of 1,002 Hainan centenarians were selected by full sample household survey. ADLs and IADLs were used to investigate the ability of activity and instrumental activity in daily living. The possible non-linear associations were further analyzed using restricted cubic spline. Results After adjusting for demographic characteristics (gender, age, ethnicity, marital status, educational level, and type of residence) and lifestyle (smoking, drinking, and exercise), the odds ratio (OR) of CC (continuous variable) on ADL disability in centenarians was 0.90 (95% CI: 0.85-0.96), while high WCR (continuous variable) was related with high risk of ADL disability (OR=1.73; 95% confidence interval[CI], 1.07-2.80). The ORs of CC and WCR for IADL severe disability were 0.86 (95% CI, 0.82-0.91) and 2.23 (95% CI, 1.52-3.28), respectively. Conclusion Central (WCR) and peripheral (CC) adiposity had different effects on disability (ADL and IADL) in centenarians. Even in centenarians, maintaining muscle mass (with higher calf circumference) and avoiding central obesity are of positive significance for the prevention of ADL/IADL disability.
Collapse
Affiliation(s)
- Shanshan Yang
- Department of Disease Control and Prevention, The Medical Center, Chinese PLA General Hospital, Beijing, China
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Penggang Tai
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Wangping Jia
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Ke Han
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Yao He
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Medical Center, Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
15
|
Kuzuya M. Nutritional status related to poor health outcomes in older people: Which is better, obese or lean? Geriatr Gerontol Int 2020; 21:5-13. [PMID: 33200583 DOI: 10.1111/ggi.14088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 12/30/2022]
Abstract
Good nutritional status is crucial for maintaining growth and health in all stages of life. However, the relationship between nutritional status and health and the effect on various health-related outcomes differ, depending on the life stage. Many adverse outcomes in older adults, directly linked to different nutritional status, are not present in middle-aged adults, and their ideal nutritional status may differ. This article will review the optimal nutritional status, mainly evaluated by anthropometric measurements such as body mass index, for older adults from various perspectives. Overall, in older adults low body mass index is at higher risk of health problems such as mortality and difficulties in physical functioning compared with middle-aged adults, reducing the risk of health problems for overweight and (abdominal) obesity. Overweight may be more beneficial than lower level of normal weight in older-old and vulnerable older people. While, with or without obesity, skeletal muscle loss or weakness as well as unintentional weight loss induces health problems in older adults. The impact of metabolic syndrome on the prognosis of older adults is clearly reduced compared with middle-aged adults, requiring a shift in medical attention in older adults from metabolic syndrome to frailty. There are still many unclear points regarding the optimal nutritional status of older people, and further research is needed to support healthy longevity. Geriatr Gerontol Int 2021; 21: 5-13.
Collapse
Affiliation(s)
- Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
| |
Collapse
|
16
|
Zhou J, Lv Y, Mao C, Duan J, Gao X, Wang J, Yin Z, Shi W, Luo J, Kang Q, Zhang X, Wei Y, Kraus VB, Shi X. Development and Validation of a Nomogram for Predicting the 6-Year Risk of Cognitive Impairment Among Chinese Older Adults. J Am Med Dir Assoc 2020; 21:864-871.e6. [PMID: 32507532 DOI: 10.1016/j.jamda.2020.03.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 03/21/2020] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Although some people with mild cognitive impairment may not suffer from dementia lifelong, about 5% of them will progress to dementia within 1 year in community settings. However, a general tool for predicting the risk of cognitive impairment was not adequately studied among older adults. DESIGN Prospective cohort study. SETTING Community-living, older adults from 22 provinces in China. PARTICIPANTS We included 10,066 older adults aged 65 years and above (mean age, 83.2 ± 11.1 years), with normal cognition at baseline in the 2002-2008 cohort and 9354 older adults (mean age, 83.5 ± 10.8 years) in the 2008-2014 cohort of the Chinese Longitudinal Healthy Longevity Survey. METHODS We measured cognitive function using the Chinese version of the Mini-Mental State Examination. Demographic, medical, and lifestyle information was used to develop the nomogram via a Lasso selection procedure using a Cox proportional hazards regression model. We validated the nomogram internally with 2000 bootstrap resamples and externally in a later cohort. The predictive accuracy and discriminative ability of the nomogram were measured by area-under-the-curves and calibration curves, respectively. RESULTS Eight factors were identified with which to construct the nomogram: age, baseline of the Mini-Mental State Examination, activities of daily living and instrumental activities of daily living score, chewing ability, visual function, history of stroke, watching TV or listening to the radio, and growing flowers or raising pets. The area-under-the-curves for internal and external validation were 0.891 and 0.867, respectively, for predicting incident cognitive impairment. The calibration curves showed good consistency between nomogram-based predictions and observations. CONCLUSIONS AND IMPLICATIONS The nomogram-based prediction yielded consistent results in 2 separate large cohorts. This feasible prognostic nomogram constructed using readily ascertained information may assist public health practitioners or physicians to provide preventive interventions of cognitive impairment.
Collapse
Affiliation(s)
- Jinhui Zhou
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Mao
- Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Jiaonan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhaoxue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wanying Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiesi Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaochang Zhang
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuan Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
17
|
Deng Y, Gao Q, Yang D, Hua H, Wang N, Ou F, Liu R, Wu B, Liu Y. Association between biomass fuel use and risk of hypertension among Chinese older people: A cohort study. ENVIRONMENT INTERNATIONAL 2020; 138:105620. [PMID: 32179315 DOI: 10.1016/j.envint.2020.105620] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/19/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUNDS Previous studies linking biomass fuel use to hypertension have been inconsistent. We investigated the association between biomass fuel use and the risk of hypertension and blood pressure measures in older Chinese people. METHODS The prospective cohort study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) included participants aged 65 years and older in 2011/2012 who were followed up until 2014 in 23 provinces in China. We explored the association between biomass fuel use and hypertension using the Cox proportional hazards model and examined the relationship of biomass fuel use with blood pressure measures using the generalized estimating equation. Additionally, we examined the effect of switching cooking fuels on hypertension during the follow-up. RESULTS Among 3754 participants who were without hypertension at baseline, the mean age was 86 years old, and 47.5% of participants were men. Reported use of biomass fuel for cooking (50.2%) was associated with a higher risk of hypertension (incidence rate (IR) per 100 person-years: 13.15 versus 12.99, hazard ratio (HR) = 1.15, 95% confidence interval (CI) = 1.01-1.31). Biomass fuel use was related to systolic blood pressure (SBP) (β 1.10 mmHg, 95% CI: 0.48-1.72), diastolic blood pressure (DBP) (β 1.02 mmHg, 95% CI: 0.61-1.43) and mean arterial pressure (MAP) (β 1.03 mmHg, 95% CI: 0.63-1.43) elevation. Compared with persistent clean fuel users, participants who reported switching from clean to biomass fuels for cooking had a noticeably higher risk of hypertension (IR per 100 person-years: 14.27 versus 12.81, HR 1.49, 95% CI: 1.16-1.90) and higher SBP (3.71 mmHg), DBP (2.44 mmHg) and MAP (2.86 mmHg). Interaction and stratified analyses showed greater effect estimates of SBP and MAP in the oldest oldpeople (≥85). CONCLUSIONS The use of biomass fuel for cooking was associated with greater hypertension risk, and the risk may be higher among those who switched from clean fuels to biomass fuels in the Chinese elderly population. Biomass fuel use was associated with a statistically significant but small absolute increase in blood pressure measures.
Collapse
Affiliation(s)
- Yan Deng
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Dan Yang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Hui Hua
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Nan Wang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Fengrong Ou
- Academic Affairs Office, China Medical University, Shenyang 110122, China
| | - Ruxi Liu
- Department of Immunology and Rheumatology, First Hospital, China Medical University, Shenyang 110001, China
| | - Bo Wu
- Department of Anal and Rectal Diseases, First Hospital, China Medical University, Shenyang 110001, China
| | - Yang Liu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China.
| |
Collapse
|
18
|
Wang S, Liu M, Yang S, Wang J, Jia W, Cao W, Han K, He Y. Higher Normal Levels of Triglyceride and Low and High-Density Lipoprotein Cholesterol Might Have a Protective Effect Against Activities of Daily Living Disability Within Chinese Female Centenarians: A Cross-Sectional, Complete Sample Study. Clin Interv Aging 2020; 15:225-237. [PMID: 32110002 PMCID: PMC7034296 DOI: 10.2147/cia.s237505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background and Objective Activities of daily living (ADL) disability seriously affects the quality of life in the elderly. This study aims to examine the prevalence of ADL disability and its possible correlation with lipid profile indicators (LDL-C, TG and HDL-C) among female centenarians in Hainan, China. Methods A cross-section of complete sample study including 822 female centenarians was conducted from the China Hainan Centenarians Cohort Study (CHCCS) from June 2014 to December 2016. Barthel index was used to estimate ADL disability and multivariate logistic regression model was used to explore the relationship between lipid profile indicator and ADL disability. Results A total of 822 female centenarians were recruited in Hainan province, and the median age was 102 (IQR: 101–104) years, and 244 (29.7%) centenarians had ADL disability. After adjustment, 1 mmol/L increment in LDL-C, TG and HDL-C were associated with 26.4% (aOR=0.736, 95% CI:0.592–0.915), 29.8% (aOR=0.702, 95% CI:0.521–0.948) and 60.5% (aOR=0.395, 95% CI:0.257–0.610) decline in ADL disability of female centenarian, respectively. The prevalence of ADL disability showed downward trend with the increase of the quintile of LDL-C, TG and HDL-C (Ptrend<0.05). Increment of HDL-C levels had the strongest protective effect against ADL disability. Conclusion We concluded that a new possible association of higher normal lipid profile indicators, especially HDL-C, might have a protective effect on ADL disability among female centenarians.
Collapse
Affiliation(s)
- Shengshu Wang
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Miao Liu
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China.,State Key Laboratory of Kidney Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Shanshan Yang
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Jianhua Wang
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China.,State Key Laboratory of Kidney Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Wangping Jia
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Wenzhe Cao
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Ke Han
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Yao He
- Institute of Geriatrics, The 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China.,State Key Laboratory of Kidney Diseases, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| |
Collapse
|
19
|
Yang S, Liu M, Wang S, Jia W, Han K, He Y. Waist-Calf Circumference Ratio Is an Independent Risk Factor of HRQoL in Centenarians. Diabetes Metab Syndr Obes 2020; 13:277-287. [PMID: 32099434 PMCID: PMC7007801 DOI: 10.2147/dmso.s231435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/15/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To analyze the associations between waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), calf circumference, waist-calf circumference ratio (WCR), and quality of life in Hainan centenarians. PATIENTS AND METHODS A total of 1002 centenarians in Hainan were selected by a full sample survey. The EQ-5D visual analogue scale (EQ-5D-VAS) was used to investigate the quality of life. Restricted cubic splines were used to analyze and visualize the linear relationships. RESULTS After adjustment, the standard β values for BMI, WC, WHR, WHtR, calf circumference, and WCR associated with EQ-5D score were 0.101, 0.126, -0.018, 0.100, 0.302, and -0.219, respectively; all associations except for WHR were significant (P < 0.01). With increasing BMI, WC, and calf circumference, the risk of EQ-5D score <1 decreased (odds ratios [ORs] 0.91 [95% confidence interval (CI): 0.86-0.97), 0.97 [95% CI: 0.95-0.99], and 0.87 [95% CI: 0.82-0.92] after adjustment, respectively). With increasing WCR, the risk also increased (OR 2.70 [95% CI: 1.54-4.75]). CONCLUSION After excluding nutritional and muscle retention factors, fat central distribution negatively impacted the health-related quality of life of the oldest old population.
Collapse
Affiliation(s)
- Shanshan Yang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
- Department of Disease Control, Northern Military Area Center for Disease Control and Prevention, Jinan, People’s Republic of China
| | - Miao Liu
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Shengshu Wang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Wangping Jia
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Ke Han
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
| | - Yao He
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, Beijing100853, People’s Republic of China
- Correspondence: Yao He Institute of Geriatrics State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing100853, People’s Republic of ChinaTel +86-10-66876411Fax +86-10-68219351 Email
| |
Collapse
|
20
|
Li T, Zhang Y, Wang J, Xu D, Yin Z, Chen H, Lv Y, Luo J, Zeng Y, Liu Y, Kinney PL, Shi X. All-cause mortality risk associated with long-term exposure to ambient PM 2·5 in China: a cohort study. LANCET PUBLIC HEALTH 2019; 3:e470-e477. [PMID: 30314593 DOI: 10.1016/s2468-2667(18)30144-0] [Citation(s) in RCA: 166] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 07/20/2018] [Accepted: 07/20/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Evidence from cohort studies in North America and Europe indicates that long-term exposure to fine particulate matter (PM2·5) is associated with an increased mortality risk. However, this association has rarely been quantified at higher ambient concentrations. We estimated the hazard ratio (HR) for all-cause mortality from long-term exposure to PM2·5 in a well established Chinese cohort of older adults. METHODS The Chinese Longitudinal Healthy Longevity Survey (CLHLS) is a prospective cohort study of men and women aged 65 years and older enrolled in 2008 and followed up through 2014 for mortality events. We studied individuals for whom residential locations were available in 2008 for linkage to 1 km grids of PM2·5 concentrations, derived from satellite remote sensing. Cox proportional hazards models were used to estimate the effect of long-term exposure to PM2·5 on all-cause mortality, controlling for age, sex, smoking status, drinking status, physical activity, body-mass index, household income, marital status, and education. We then used our results to estimate premature mortality related to PM2·5 exposure in the population aged 65 years and older in China in 2010. FINDINGS 13 344 individuals in the CLHLS cohort had data for all timepoints, yielding follow-up data for 49 440 person-years. In a 3-year window, these individuals were exposed to a median PM2·5 concentration of 50·7 μg/m3 (range 6·7-113·3). The overall HR for a 10 μg/m3 increase in this value was 1·08 (95% CI 1·06-1·09). In stratified analyses, HRs were higher in rural than in urban locations, in southern versus northern regions, and with exposure to lower versus higher PM2·5 concentrations. Based on the overall HR, we estimated that 1 765 820 people aged 65 years and older in China in 2010 had premature mortality related to PM2·5 exposure. INTERPRETATION Long-term exposure to PM2·5 is associated with an increased risk of all-cause mortality among adults aged 65 years and older in China, but the magnitude of the risk declines as the concentration of PM2·5 increases. FUNDING National Natural Science Foundation of China, National High-Level Talents Special Support Plan of China for Young Talents, US National Aeronautics and Space Administration, and the Columbia University Global Policy Initiative.
Collapse
Affiliation(s)
- Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zhang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaonan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dandan Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaoxue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huashuai Chen
- Center for the Study of Aging and Human Development, and the Geriatric Division of the School of Medicine, Duke University, Durham, NC, USA
| | - Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiesi Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zeng
- Center for the Study of Aging and Human Development, and the Geriatric Division of the School of Medicine, Duke University, Durham, NC, USA; Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
21
|
Chen N, Li X, Wang J, Zhou C, Wang C. Rural-urban differences in the association between disability and body mass index among the oldest-old in China. Arch Gerontol Geriatr 2018; 81:98-104. [PMID: 30529805 DOI: 10.1016/j.archger.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The issue of disability prevention is considered as a priority for research in geriatrics in modern society, especially for the oldest-old. There are many evidences certificated that obesity is associated with disability in developed countries. However, few studies pay attention to relationship between them in developing countries. Furthermore, it is also unknown whether the association is similar among the oldest-old in rural and urban areas. The purpose of this study is to explore rural-urban differences in the association between disability and BMI among the oldest-old in China. METHODS 4076 seniors (80+) were included from the 2014 wave of Chinese Longitudinal Healthy Study. Disability, body mass index and other information including socio-demographic variables, health behavior conditions and health status were collected. Logistic regression analysis was employed to examine the association. RESULTS Of 4076 respondents, 1817 (44.6%) were urban elderly. Overall, 26.6% of the participants had disability, and 31.8% for urban, 22.4% for rural. After controlling for other variables, the significant association between BMI and disability was found for urban oldest seniors, but not for rural ones. Age, living arrangement, Non-communicable disease and annual physical examination were important determinants related to disability. CONCLUSIONS The association between BMI and disability differed according to residence. Both overweight and underweight were red flags of disability among Chines seniors (80+) in urban areas. Therefore, proper weight management is important for preventing disability among urban oldest-old. Additionally, annual physical examination, prevention and control of chronic diseases should be recommended to all of the oldest-old.
Collapse
Affiliation(s)
- Na Chen
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, PR China
| | - Xin Li
- School of Pharmacy, Nanjing Medical University, Nanjing, PR China
| | - Jin Wang
- Institute of Literature in Chinese Medicine, Nanjing Medical University, Nanjing, PR China.
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan, PR China.
| | | |
Collapse
|
22
|
Lv YB, Yuan JQ, Mao C, Gao X, Yin ZX, Kraus VB, Luo JS, Chen HS, Zeng Y, Wang WT, Wang JN, Shi XM. Association of Body Mass Index With Disability in Activities of Daily Living Among Chinese Adults 80 Years of Age or Older. JAMA Netw Open 2018; 1:e181915. [PMID: 30646143 PMCID: PMC6324469 DOI: 10.1001/jamanetworkopen.2018.1915] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging. OBJECTIVE To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older. DESIGN, SETTING, AND PARTICIPANTS Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014. MAIN OUTCOMES AND MEASURES Disability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence. RESULTS Among the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P < .001 for trend). When BMI was categorized by Chinese guidelines, the underweight group (BMI <18.5) showed significantly increased risk of disability in ADL (hazard ratio, 1.34; 95% CI, 1.28-1.41) and the overweight or obese group (BMI ≥24.0) showed significantly decreased risk of disability in ADL (hazard ratio, 0.84; 95% CI, 0.78-0.91) compared with the normal weight group (BMI 18.5 to <24.0) (P < .001 for trend). CONCLUSIONS AND RELEVANCE Higher BMI was associated with a lower risk of disability in ADL among Chinese adults age 80 years or older, which suggests that current recommendations for BMI may need to be revisited. More attention should be paid on underweight, rather than overweight or obesity, for the prevention of disability in ADL after age 80 years.
Collapse
Affiliation(s)
- Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin-Qiu Yuan
- Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, Philadelphia
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Shuai Chen
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
- Center for Study of Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Wen-Tao Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiao-Nan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
23
|
Silveira EA, Vieira LL, Souza JDD. [High prevalence of abdominal obesity among the elderly and its association with diabetes, hypertension and respiratory diseases]. CIENCIA & SAUDE COLETIVA 2018. [PMID: 29538570 DOI: 10.1590/1413-81232018233.01612016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Rapid population aging and abdominal obesity (AO) are worldwide public health problems among the elderly and have been insufficiently investigated. This article sets out to identify the prevalence of AO among the elderly, its association with different morbidities, sociodemographic variables, and lifestyle according to sex. It is a cross-sectional study with a representative sample of elderly people resident in Goiânia, Brazil. Home visits were conducted to measure weight, height, waist circumference (WC), blood pressure, and to fill out a standardized form. The outcome variable, was calculated at WC> 102 cm for men and> 88 cm for women. Multiple Poisson regression was performed using a hierarchical model, adopting a significance level of 5%. The prevalence of AO was 55.1%, with 65.5% in women and 34.8% in men, with a significant difference (p <0.001). In men, AO was associated with age range between 70 and 74 years, the presence of respiratory diseases and high blood pressure. In women, AO continued to be associated with the presence of diabetes mellitus. The results contribute to the understanding of AO and developing preventive approaches in public health.
Collapse
Affiliation(s)
- Erika Aparecida Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG). Primeira Avenida s/n, Setor Universitário. 74605-020 Goiânia GO
| | | | - Jacqueline Danesio de Souza
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG). Primeira Avenida s/n, Setor Universitário. 74605-020 Goiânia GO
| |
Collapse
|
24
|
Lv YB, Zhu PF, Yin ZX, Kraus VB, Threapleton D, Chei CL, Brasher MS, Zhang J, Qian HZ, Mao C, Matchar DB, Luo JS, Zeng Y, Shi XM. A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly. J Am Med Dir Assoc 2017; 18:193.e7-193.e13. [PMID: 28126139 PMCID: PMC5294228 DOI: 10.1016/j.jamda.2016.11.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 11/10/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Higher or lower blood pressure may relate to cognitive impairment, whereas the relationship between blood pressure and cognitive impairment among the elderly is not well-studied. The study objective was to determine whether blood pressure is associated with cognitive impairment in the elderly, and, if so, to accurately describe the association. DESIGN Cross-sectional data from the sixth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2011. SETTING Community-based setting in longevity areas in China. PARTICIPANTS A total of 7144 Chinese elderly aged 65 years and older were included in the sample. MEASURES Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured, pulse pressure (PP) was calculated as (SBP) - (DBP) and mean arterial pressures (MAP) was calculated as 1/3(SBP) + 2/3(DBP). Cognitive function was assessed via a validated Mini-Mental State Examination (MMSE). RESULTS Based on the results of generalized additive models (GAMs), U-shaped associations were identified between cognitive impairment and SBP, DBP, PP, and MAP. The cutpoints at which risk for cognitive impairment (MMSE <24) was minimized were determined by quadratic models as 141 mm Hg, 85 mm Hg, 62 mm Hg, and 103 mm Hg, respectively. In the logistic models, U-shaped associations remained for SBP, DBP, and MAP but not PP. Below the identified cutpoints, each 1-mm Hg decrease in blood pressure corresponded to 0.7%, 1.1%, and 1.1% greater risk in the risk of cognitive impairment, respectively. Above the cutpoints, each 1-mm Hg increase in blood pressure corresponded to 1.2%, 1.8%, and 2.1% greater risk of cognitive impairment for SBP, DBP, and MAP, respectively. CONCLUSION A U-shaped association between blood pressure and cognitive function in an elderly Chinese population was found. Recognition of these instances is important in identifying the high-risk population for cognitive impairment and to individualize blood pressure management for cognitive impairment prevention.
Collapse
Affiliation(s)
- Yue-Bin Lv
- Institute of Environmental Health and Related Products Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng-Fei Zhu
- Institute of Environmental Health and Related Products Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Diane Threapleton
- Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Choy-Lye Chei
- Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Melanie Sereny Brasher
- Department of Sociology and Anthropology, Department of Human Development and Family Studies, University of Rhode Island, Kingston, RI
| | - Juan Zhang
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Han-Zhu Qian
- Vanderbilt Institute for Global Health, Division of Epidemiology, Department of Medicine, Vanderbilt University, Nashville, TN
| | - Chen Mao
- Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - David Bruce Matchar
- Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zeng
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC; Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China
| | - Xiao-Ming Shi
- Institute of Environmental Health and Related Products Safety, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
25
|
Wu T, Lu L, Luo L, Guo Y, Ying L, Tao Q, Zeng H, Han L, Shi Z, Zhao Y. Factors Associated with Activities of Daily Life Disability among Centenarians in Rural Chongqing, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111364. [PMID: 29120382 PMCID: PMC5708003 DOI: 10.3390/ijerph14111364] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/06/2017] [Accepted: 11/06/2017] [Indexed: 12/16/2022]
Abstract
Objective: This study aims to ascertain the health and lifestyle factors associated with the activities of daily living (ADL) disability of centenarians in rural Chongqing, China. Method: 564 centenarians living in rural Chongqing were selected for this cross-sectional study. Demographic characteristics and self-reported lifestyle factors were obtained from face-to-face interviews. ADL disability was measured using the Katz Activities of Daily Living Scale. Result: Among the respondents, 65.7% were considered ADL disability centenarians. Multivariable logistic regression analysis showed that preference for salt, drinking habits, social activities, physical activity, and failure to follow good diet habits were significantly associated with the ADL disability of centenarians. Conclusion: ADL disability of centenarians was associated with certain lifestyle habits. This outcome suggested that target intervention may help maintain ADL independence even among the oldest of the elderly population.
Collapse
Affiliation(s)
- Tingting Wu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Lu Lu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Li Luo
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Yingqi Guo
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China.
| | - Liying Ying
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310000, China.
| | - Qingliu Tao
- Chongqing Health Education Institute, Chongqing 404000, China.
| | - Huan Zeng
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Lingli Han
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Zumin Shi
- Adelaide Medical School, University of Adelaide, Adelaide 5000, Australia.
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| |
Collapse
|
26
|
Lisko I, Tiainen K, Raitanen J, Jylhävä J, Hurme M, Hervonen A, Jylhä M, Stenholm S. Body Mass Index and Waist Circumference as Predictors of Disability in Nonagenarians: The Vitality 90+ Study. J Gerontol A Biol Sci Med Sci 2017; 72:1569-1574. [DOI: 10.1093/gerona/glx032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
|
27
|
Ma C, Yin Z, Zhu P, Luo J, Shi X, Gao X. Blood cholesterol in late-life and cognitive decline: a longitudinal study of the Chinese elderly. Mol Neurodegener 2017; 12:24. [PMID: 28270179 PMCID: PMC5341475 DOI: 10.1186/s13024-017-0167-y] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/25/2017] [Indexed: 01/18/2023] Open
Abstract
Background Previous studies regarding the lipid-cognition relation in older adults are limited and have generated mixed results. We thus examined whether higher blood cholesterol concentrations were associated with faster cognitive decline in a community-based longitudinal study of Chinese elderly. Methods The study included 1,159 Chinese adults aged over 60 years (women: 48.7%, mean age: 79.4 years), who were free of dementia, Parkinson disease and stroke at the baseline. Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), were assessed at the baseline. Global cognitive functions were assessed using the Chinese Mini-Mental State Examination (MMSE) at in 2009, 2012 and 2014. Association between blood cholesterol and repeated cognitive function was analyzed with linear mixed models, adjusting for sociodemographic information, behavior and lifestyle, depression symptoms, physical examination, hypertension, and laboratory indexes. Results Higher baseline TC and LDL-C concentrations were significantly associated with greater cognitive decline. Adjusted mean difference in cognitive decline rate, comparing two extreme quartiles, was 0.28 points (MMSE score) per year (95% confident interval (CI): -0.54,–0.02; P-trend = 0.005) for TC and 0.42 points per year (95% CI: -0.69, -0.16; P-trend = 0.006) for LDL-C. In a subgroup analysis, the associations between all lipids and cognitive decline appeared to be more pronounced among individuals aged 100 years or older (n = 90), relative to others. Conclusions Higher blood concentrations of TC and LDL-C in late-life were associated with faster global cognitive decline. Electronic supplementary material The online version of this article (doi:10.1186/s13024-017-0167-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Chaoran Ma
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Zhaoxue Yin
- Division of Chronic Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Pengfei Zhu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Jiesi Luo
- Division of Chronic Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA.
| |
Collapse
|
28
|
Lv YB, Yin ZX, Chei CL, Brasher MS, Zhang J, Kraus VB, Qian F, Shi XM, Matchar DB, Zeng Y. Serum Cholesterol Levels within the High Normal Range Are Associated with Better Cognitive Performance among Chinese Elderly. J Nutr Health Aging 2017. [PMID: 26892577 DOI: 10.1007/s12603-016-0701-6.] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The association between cognitive function and cholesterol levels is poorly understood and inconsistent results exist among the elderly. The purpose of this study is to investigate the association of cholesterol level with cognitive performance among Chinese elderly. DESIGN A cross-sectional study was implemented in 2012 and data were analyzed using generalized additive models, linear regression models and logistic regression models. SETTING Community-based setting in eight longevity areas in China. SUBJECTS A total of 2000 elderly aged 65 years and over (mean 85.8±12.0 years) participated in this study. MEASUREMENTS Total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) concentration were determined and cognitive impairment was defined as Mini-Mental State Examination (MMSE) score ≤23. RESULTS There was a significant positive linear association between TC, TG, LDL-C, HDL-C and MMSE score in linear regression models. Each 1 mmol/L increase in TC, TG, LDL-C and HDL-C corresponded to a decreased risk of cognitive impairment in logistic regression models. Compared with the lowest tertile, the highest tertile of TC, LDL-C and HDL-C had a lower risk of cognitive impairment. The adjusted odds ratios and 95% CI were 0.73(0.62-0.84) for TC, 0.81(0.70-0.94) for LDL-C and 0.81(0.70-0.94) for HDL-C. There was no gender difference in the protective effects of high TC and LDL-C levels on cognitive impairment. However, for high HDL-C levels the effect was only observed in women. High TC, LDL-C and HDL-C levels were associated with lower risk of cognitive impairment in the oldest old (aged 80 and older), but not in the younger elderly (aged 65 to 79 years). CONCLUSIONS These findings suggest that cholesterol levels within the high normal range are associated with better cognitive performance in Chinese elderly, specifically in the oldest old. With further validation, low cholesterol may serve a clinical indicator of risk for cognitive impairment in the elderly.
Collapse
Affiliation(s)
- Y-B Lv
- Dr. Xiaoming Shi, No. 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China. Telephone: (+86) 1050930101, Fax:(+86)1050930115, E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Danon-Hersch N, Fustinoni S, Bovet P, Spagnoli J, Santos-Eggimann B. Association between Adiposity and disability in the Lc65+ Cohort. J Nutr Health Aging 2017; 21:799-810. [PMID: 28717810 DOI: 10.1007/s12603-016-0813-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the longitudinal association between body mass index (BMI) and waist circumference (WC) with mortality and incident disability in Lc65+ cohort. DESIGN Population-based cohort of non-institutionalized adults with up to 8.9 years of follow-up. SETTING City of Lausanne, Switzerland. PARTICIPANTS 1,293 individuals aged 65 to 70 at baseline (58% women). MEASUREMENTS BMI, WC and covariates were measured at baseline in 2004-2005. Vital status was obtained up to the 31st December 2013 and difficulty with basic activities of daily living (BADL) was reported in a self-administered questionnaire sent to participants every year. Main outcomes were total mortality and disability, defined as difficulty with BADL for ≥2 years or institutionalization. Cox regression was used with BMI/WC quintiles 2 as the reference. RESULTS 130 persons died over a median follow-up of 8.47 years (crude mortality rate, men: 16.5/1,000 person-years, women: 9.7/1,000 person-years). In Cox regression adjusted for age, sex, education, financial situation, smoking and involuntary weight loss (IWL) at baseline, mortality was significantly associated with neither BMI nor WC, but there were trends towards non-significant J-curves across both BMI and WC quintiles. Disability (231 cases) tended to increase monotonically across both BMI and WC quintiles and was significantly associated with BMI quintile 5 (HR=2.44, 95% CI [1.65-3.63]), and WC quintiles 4 (HR=1.81 [1.15-2.85]) and 5 (HR=2.58, [1.67-4.00]). CONCLUSION Almost half of the study population had a substantially increased HR of disability, as compared to the reference BMI/WC categories. This observation emphasizes the need for life-long strategies aimed at preventing excess weight, muscle loss and functional decline through adequate nutrition and regular physical activity, starting at early age and extending throughout life.
Collapse
Affiliation(s)
- N Danon-Hersch
- Nadia Danon-Hersch, Institute of Social and Preventive Medicine (IUMSP), University and University Hospital Center, Biopole 2, Route de la Corniche 10, 1010 Lausanne, Switzerland, Tel : +41 21 314 91 09; Fax: +41 21 314 97 67; ;
| | | | | | | | | |
Collapse
|
30
|
Yin Z, Fei Z, Qiu C, Brasher MS, Kraus VB, Zhao W, Shi X, Zeng Y. Dietary Diversity and Cognitive Function among Elderly People: A Population-Based Study. J Nutr Health Aging 2017; 21:1089-1094. [PMID: 29188865 PMCID: PMC5726290 DOI: 10.1007/s12603-017-0912-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To explore associations of dietary diversity with cognitive function among Chinese elderly. DESIGN This cross-sectional study was conducted in 2011-2012, data were analyzed using multiple linear regression and logistic regression models. SETTING community-based setting in the 23 provinces in China. SUBJECTS 8,571 elderly participants, including 2984 younger elderly aged 65-79 and 5587 oldest old aged 80+ participated in this study. MEASUREMENT Intake frequencies of food groups was collected and dietary diversity (DD) was assessed based on the mean of DD score. Cognitive function was assessed using the Chinese version of Mini-Mental State Examination (MMSE), and cognitive impairment was defined using education-based cutoffs. Information about socio-demographics, lifestyles, resilience and health status was also collected. RESULTS Poor dietary diversity was significantly associated with cognitive function, with β (95% CI) of -0.11(-0.14, -0.08) for -log (31-MMSE score) and odds ratio (95% CI) of 1.29 (1.14, 1.47) for cognitive impairment. Interaction effect of age with DD was observed on cognitive impairment (P interaction=0.018), but not on -log (31-MMSE score) (P interaction=0.08). Further separate analysis showed that poor DD was significantly associated with increased risk of cognitive impairment in the oldest old (p<0.01), with odds ratio (95% CI) of 1.34 (1.17, 1.54), while not in the younger elderly (p>0.05), with OR (95% CI) being 1.09 (0.80, 1.47) in the fully adjusted model. Similar results were obtained when DD was categorized into four groups. CONCLUSIONS Poor dietary diversity was associated with worse global cognitive function among Chinese elderly, and particularly for the oldest old. This finding would be very meaningful for prevention of cognitive impairment.
Collapse
Affiliation(s)
- Z Yin
- Dr. Wenhua Zhao, Xiaoming Shi and Yi Zeng are co-corresponding authors. Please send email to Dr. Wenhua Zhao, 27 Nanwei Road, Xi Cheng District, Beijing 100050, China. Tel.: 86-10-66237006,
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Lv YB, Yin ZX, Chei CL, Brasher MS, Zhang J, Kraus VB, Qian F, Shi XM, Matchar DB, Zeng Y. Serum cholesterol levels within the high normal range are associated with better cognitive performance among Chinese elderly. J Nutr Health Aging 2016; 20:280-7. [PMID: 26892577 DOI: 10.1007/s12603-016-0701-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Y-B Lv
- Dr. Xiaoming Shi, No. 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China. Telephone: (+86) 1050930101, Fax:(+86)1050930115, E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|