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Cheng S, Yin R, Wu K, Wang Q, Zhang H, Ling L, Chen W, Shi L. Trajectories and influencing factors of cognitive function and physical disability in Chinese older people. Front Public Health 2024; 12:1380657. [PMID: 39026589 PMCID: PMC11256785 DOI: 10.3389/fpubh.2024.1380657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Dementia and physical disability are serious problems faced by the aging population, and their occurrence and development interact. Methods Based on data from a national cohort of Chinese people aged 60 years and above from the China Health and Retirement Longitudinal Survey from 2011 to 2018, we applied the group-based trajectory model to identify the heterogeneous trajectories of cognitive function and physical disability in participants with different physical disability levels. Next, multinomial logistic regression models were used to explore the factors affecting these trajectories. Results The cognitive function trajectories of the Chinese older people could be divided into three characteristic groups: those who maintained the highest baseline level of cognitive function, those with a moderate baseline cognitive function and dramatic progression, and those with the worst baseline cognitive function and rapid-slow-rapid progression. The disability trajectories also fell into three characteristic groups: a consistently low baseline disability level, a low initial disability level with rapid development, and a high baseline disability level with rapid development. Compared with those free of physical disability at baseline, a greater proportion of participants who had physical disability at baseline experienced rapid cognitive deterioration. Education, income, type of medical insurance, gender, and marital status were instrumental in the progression of disability and cognitive decline in the participants. Discussion We suggest that the Chinese government, focusing on the central and western regions and rural areas, should develop education for the older people and increase their level of economic security to slow the rate of cognitive decline and disability among this age group. These could become important measures to cope with population aging.
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Affiliation(s)
- Shuyuan Cheng
- International Cooperation and Exchange Department, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Health Policy and Management Department, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Rong Yin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Kunpeng Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qiong Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hui Zhang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Zhang C, Zhang L, Zeng L, Wang Y, Chen L. Associations of serum albumin and dietary protein intake with all-cause mortality in community-dwelling older adults at risk of sarcopenia. Heliyon 2024; 10:e29734. [PMID: 38681582 PMCID: PMC11053289 DOI: 10.1016/j.heliyon.2024.e29734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Objective The Asian Working Group for Sarcopenia 2019 consensus emphasized nutritional assessment and intervention for community-dwelling older people with sarcopenia status. This study aimed to examine the association of serum albumin and dietary protein intake (DPI) with all-cause mortality among older adults at risk of sarcopenia. Methods We enrolled 1763 older adults at risk of sarcopenia in the Chinese Longitudinal Healthy Longevity Survey (2012-2018) using calf circumference and handgrip strength. Serum albumin concentrations were measured using bromocresol green methods, and DPI frequency was evaluated using a semi-quantitative questionnaire at baseline. Cox proportional hazards models were used to explore the association of serum albumin and DPI with all-cause mortality. Results During 5606.3 person-years of follow-up (median: 3.28 years), 802 older people died. After adjusting for socio-demographics, health behaviors, and clinical characteristics, we observed an inverse linear association between serum albumin and all-cause mortality (Pnon-linear = 0.429). Participants with low albumin levels (<40.0 g/L) had a 43 % higher risk of mortality than their counterparts (hazard ratio (HR) = 1.43, 95 % confidence interval (CI) = 1.22-1.66). There was no significant association between DPI and mortality (Ps > 0.05). Moreover, the association between low albumin and all-cause mortality remained significant in the lower DPI subgroup (HR = 1.47, 95 % CI = 1.18-1.85), but was not significant in the high DPI subgroup (HR = 1.15, 95 % CI = 0.92-1.39). Conclusions Serum albumin levels are inversely associated with all-cause mortality in community-based older adults at risk of sarcopenia. Sufficient dietary protein consumption may attenuate the effect of low serum albumin on increased mortality and potential mechanisms for the interaction warrant further exploration.
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Affiliation(s)
- Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, 100730, China
| | - Luyao Zhang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Lvtao Zeng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, 100730, China
| | - Yongjun Wang
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong, 250014, China
| | - Liru Chen
- Department of Clinical Nutrition, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
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Zhu J, Wu Y, Lin S, Duan S, Wang X, Fang Y. Identifying and predicting physical limitation and cognitive decline trajectory group of older adults in China: A data-driven machine learning analysis. J Affect Disord 2024; 350:590-599. [PMID: 38218258 DOI: 10.1016/j.jad.2024.01.095] [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: 07/29/2023] [Revised: 11/24/2023] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVE This study aimed to utilize data-driven machine learning methods to identify and predict potential physical and cognitive function trajectory groups of older adults and determine their crucial factors for promoting active ageing in China. METHODS Longitudinal data on 3026 older adults from the Chinese Longitudinal Healthy Longevity and Happy Family Survey was used to identify potential physical and cognitive function trajectory groups using a group-based multi-trajectory model (GBMTM). Predictors were selected from sociodemographic characteristics, lifestyle factors, and physical and mental conditions. The trajectory groups were predicted using data-driven machine learning models and dynamic nomogram. Model performance was evaluated by area under the receiver operating characteristics curve (AUROC), area under the precision-recall curve (PRAUC), and confusion matrix. RESULTS Two physical and cognitive function trajectory groups were determined, including a trajectory group with physical limitation and cognitive decline (14.18 %) and a normal trajectory group (85.82 %). Logistic regression performed well in predicting trajectory groups (AUROC = 0.881, PRAUC = 0.649). Older adults with lower baseline score of activities of daily living, older age, less frequent housework, and fewer actual teeth were more likely to experience physical limitation and cognitive decline trajectory group. LIMITATION This study didn't carry out external validation. CONCLUSIONS This study shows that GBMTM and machine learning models effectively identify and predict physical limitation and cognitive decline trajectory group. The identified predictors might be essential for developing targeted interventions to promote healthy ageing.
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Affiliation(s)
- Junmin Zhu
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Yafei Wu
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Shaowu Lin
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, China; National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian, China
| | - Siyu Duan
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Xing Wang
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, Fujian, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, China; National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian, China.
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Ma Y, Zhu Y, Hong D, Zhao H, Li L. Association between tea drinking and disability levels in older Chinese adults: a longitudinal analysis. Front Nutr 2023; 10:1233664. [PMID: 38024372 PMCID: PMC10644393 DOI: 10.3389/fnut.2023.1233664] [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: 06/02/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objective As the global population ages, disability among the elderly presents unprecedented challenges for healthcare systems. However, limited research has examined whether dietary interventions like tea consumption may alleviate and prevent disability in older adults. As an important dietary therapy, the health benefits of tea drinking have gained recognition across research disciplines. Therefore, this study aimed to investigate the association between tea drinking habits and disability levels in the elderly Chinese population. Methods Leveraging data from the 2008 to 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, we disaggregated tea drinking frequency and activities of daily living (ADL) measures and deployed fixed-effect ordered logit models to examine the tea-disability association for the first time. We statistically adjusted for potential confounders and conducted stratified analyses to assess heterogeneity across subpopulations. Results Multivariable fixed-effect ordered logistic regression suggested tea drinking has protective effects against ADL disability. However, only daily tea drinking was associated with lower risks of basic activities of daily living (BADL) disability [odds ratio (OR) = 0.61; 95% confidence interval (CI), 0.41-0.92] and lower levels of instrumental activities of daily living (IADL) disability (OR = 0.78; 95% CI, 0.64-0.95). Stratified analyses indicated heterogeneous effects across age and income groups. Daily tea drinking protected against BADL (OR = 0.26 and OR = 0.28) and IADL disability (OR = 0.48 and OR = 0.45) for adults over 83 years old and high-income households, respectively. Conclusion We found that drinking tea almost daily was protective against disability in elderly people, warranting further research into optimal dosages. Future studies should utilize more rigorous causal inference methods and control for confounders.
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Affiliation(s)
- Yinghui Ma
- School of Economics and Management, Jiangsu University of Science and Technology, Zhenjiang, China
- School of Economics and Management, Beijing Forestry University, Beijing, China
| | - Yuying Zhu
- School of Economics and Management, Jiangsu University of Science and Technology, Zhenjiang, China
| | - Dandan Hong
- School of Economics and Management, Jiangsu University of Science and Technology, Zhenjiang, China
| | - Haiyue Zhao
- School of Economics and Management, Jiangsu University of Science and Technology, Zhenjiang, China
| | - Lei Li
- College of Economics and Management, Zhejiang A & F University, Hangzhou, China
- Research Academy for Rural Revitalization of Zhejiang, Zhejiang A & F University, Hangzhou, China
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Zhang P, Wang L, Zhou Q, Dong X, Guo Y, Wang P, He W, Wang R, Wu T, Yao Z, Hu B, Wang Y, Zhang Q, Sun C. A network analysis of anxiety and depression symptoms in Chinese disabled elderly. J Affect Disord 2023; 333:535-542. [PMID: 37086797 DOI: 10.1016/j.jad.2023.04.065] [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: 12/31/2022] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Mental health is an essential dimension of healthy aging. The number and severity of disabled elderly in China show an increasing tendency year by year. Due to their impaired ability of daily activities, reduced social participation and reduced self-care ability, they are more prone to depression and anxiety. METHOD We included 2131 individuals aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017-2018). We used the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the Generalized Anxiety Disorder scale-7 (GAD-7) to assess depression and anxiety, respectively. The structure of depressive and anxiety symptoms was characterized using "Expected Influence" and "Bridge Expected Influence" as centrality indices in the symptom network. Network stability was tested using a case-dropping bootstrap procedure. Finally, a Network Comparison Test (NCT) was conducted to examine whether network characteristics differed by gender. RESULTS Network analysis revealed that nodes CESD3 (Felt sadness), GAD2 (Uncontrollable worry), and GAD4 (Trouble relaxing) were the primary symptoms of the anxiety-depression network. Anxiety and depression were united by the symptoms of CESD9 (Could not get going), GAD1 (Nervousness or anxiety), CESD10 (Sleep quality), and GAD4 (Trouble relaxing). Additionally, Gender did not significantly affect the network structure. CONCLUSION Central symptoms (e.g., felt sadness, uncontrollable worry and trouble relaxing) and key bridge symptoms (e.g., could not get going, nervousness and anxiety) in the depressive and anxiety symptoms network may be used as potential targets for intervention among disabled elderly who is at risk for or suffer from depressive and anxiety symptoms.
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Affiliation(s)
- Peijia Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lianke Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Qianyu Zhou
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xiaofang Dong
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yuanli Guo
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Wenqian He
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Rongrong Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Tiantian Wu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zihui Yao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Bo Hu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yu Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Qiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Changqing Sun
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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Chen LK. Mapping the trajectory of healthy aging: Insights from longitudinal cohort studies examining lifestyle factors. Exp Gerontol 2023; 178:112222. [PMID: 37244374 DOI: 10.1016/j.exger.2023.112222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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Zhang C, Li J, Shi H, Liu Y, Cui J, Luo XM, Zeng LT, Fan GQ, Chang XM, Zhang PJ, Shen J. Independent and combined associations of upper and lower limb strength with all-cause mortality in community-based older adults: findings from the Chinese Longitudinal Healthy Longevity Survey. Public Health 2023; 220:57-64. [PMID: 37270853 DOI: 10.1016/j.puhe.2023.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE With the acceleration of aging progress, China is projected to have the largest older population globally. This study aimed to examine the association of upper limb strength (ULS) and lower limb strength (LLS) with all-cause mortality based on the Chinese Longitudinal Healthy Longevity Survey (2012-2018). STUDY DESIGN This is a prospective cohort study. METHODS Participants were 2442 older adults (aged 84.98 ± 11.94 years) recruited from eight longevity areas in China. Limb muscle strength was evaluated using handgrip strength and objective physical examinations. Cox proportional hazards regression was used to analyze the association of limb muscle strength with all-cause mortality. Demographic characteristics, health status, and biological markers were included as confounders. RESULTS Over a median follow-up period of 42.2 months, 993 older people died. After adjusting for all covariates, low ULS was associated with higher mortality risk (hazard ratio [HR] = 1.51, 95% confidence interval [CI] = 1.25-1.84), and the association of low LLS with all-cause mortality was only significant in women (HR = 1.36, 95% CI = 1.04-1.79). Participants with combined low ULS and low LLS had the highest risk of mortality than those with normal limb muscle strength (hazard ratio = 2.06, 95% confidence interval = 1.61-2.63). The combined association of ULS and LLS with mortality was robust in subgroup and sensitivity analyses. CONCLUSION Low ULS and low LLS were independently and synergistically associated with higher all-cause mortality risk. Considering the high prevalence of limb muscle weakness among Chinese older adults, especially the oldest-old, limb strength could be considered as a potential doable mortality predictor for community health care.
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Affiliation(s)
- C Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - J Li
- Department of Pharmacy, Children's Hospital Affiliated Capital Pediatric Research Institute, Beijing, China
| | - H Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Y Liu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - J Cui
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - X M Luo
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - L T Zeng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - G Q Fan
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - X M Chang
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - P J Zhang
- Department of Science Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
| | - J Shen
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
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Huang X, Zhu W, Gao X, Yu D, Jin H, Huang J, Yu W, Lv Y, Zhou L, Chen N, Yang Y, Wang Z, Shi J. Relationship Between Old-Aged Preferences Regarding Various Types of Physical Activity and Chronic Disease Status: A Cross-Sectional Study in Shanghai, China. Front Public Health 2022; 10:865328. [PMID: 35433623 PMCID: PMC9006984 DOI: 10.3389/fpubh.2022.865328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background A lack of physical activity (PA) is a threat to public health. However, for the elderly, most PA abilities are limited. By focusing on the types and intensity of PA that the elderly can bear, this study aimed to reveal whether preferences regarding types of PA (including housework, transportation, and recreational activities) and their intensity were associated with health status. The main forms of PA include shopping, cooking, cleaning, walking, cycling, various fitness activities and other activities with a certain intensity. Methods Surveillance data on chronic diseases and their risk factors were collected from one district of Shanghai in 2017-2018. A Kish table was used for sampling 500 older adults, including the diagnosed group (chronic diseases diagnosed by physicians, n = 119), the abnormal group (not diagnosed but abnormal indicators detected in this investigation, n = 287) and the healthy group (n = 94). Multiple regressions were used to test the relationship between the various types, durations and intensities of PA the elderly individuals participated in and their health status. Results All three groups included a large proportion of older adults who participated in housework- and transport-related PA. The diagnosed group had the largest proportion (63.06% for housework-related PA; 87.39% for transport-related PA) and median minutes (17.14 min of housework-related PA per day; 30.00 min of transport-related PA per day). The diagnosed group had more metabolic equivalents (METs) of moderate-intensity PA than the two other groups (H = 33.01, P < 0.01), and more people met the WHO recommendation (χ2 = 34.71, P < 0.01). Diagnosis was associated with performing housework- and transport-related PA and moderate-intensity PA and with meeting the WHO's recommendation. Higher education levels were a positive factor for elderly individuals to participate in PA. Conclusions Transportation and housework activities are good targets for increasing PA in older adults. Diagnosis is associated with older adults' more PA.
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Affiliation(s)
- Xiaojing Huang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Wenqing Zhu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiang Gao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dehua Yu
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Academic Department of General Practice, Tongji University School of Medicine, Shanghai, China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, China
| | - Hua Jin
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Academic Department of General Practice, Tongji University School of Medicine, Shanghai, China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, China
| | - Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenya Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yipeng Lv
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang Zhou
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Yang
- School of Economics and Management, Tongji University, Shanghai, China
| | - Zhaoxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jianwei Shi
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Social Medicine and Health Management of School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhaoxin Wang
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