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He Y, Ouyang W, Li Z, Wei B. Impact of the Industrialization of Older Adult Care Services on Older Individuals' Physical and Mental Health: Evidence from China's Quasi-Natural Experiment. J Multidiscip Healthc 2023; 16:3017-3033. [PMID: 37869611 PMCID: PMC10588744 DOI: 10.2147/jmdh.s426710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose Given the increasing longevity of the population, the consolidation of familial structures, and the scarcity of economic resources required to sustain an aging society, the Chinese government faces a complex and urgent challenge in effectively addressing the growing needs of older adults and establishing a long-term care services system that is both sustainable and equitable. Patients and Methods This study harnesses the comprehensive CLHLS data from 2011 to 2018 and utilizes the "Pilot Industrialization of Old-Age Service in a Market-Oriented Way" policy as a quasi-natural experiment. Employing the Difference-in-Differences (DID) method, our study aims to evaluate the impact of industrializing older adult care services on the physical and mental health outcomes of older adults in China. Results The findings strongly indicate that the government's adoption of a market-driven fiscal approach within its policies, aimed at attracting social capital and fostering the industrialization of older adult care services, positively influences the physical and mental well-being of the aged population. Furthermore, through heterogeneity analysis, it becomes evident that the health promotion effect is particularly pronounced among older individuals living without a spouse, lacking family care from children or grandchildren, or residing in financially underdeveloped regions. Conclusion In summary, these results underscore the potential efficacy of employing financial policy instruments to facilitate the industrialization of older adult care services, thereby advancing the promotion of a society characterized by healthy aging and ensuring equitable health outcomes for older people.
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Affiliation(s)
- Yang He
- School of Business, Xiangtan University, Xiangtan, 411105, People’s Republic of China
| | - Wenjing Ouyang
- Department of Business School, Hunan Normal University, Changsha, 410081, People’s Republic of China
| | - Zhenzhen Li
- Taylor’s University, Subang Jaya, 47500, Malaysia
| | - Baojian Wei
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271021, People’s Republic of China
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Galkin F, Kochetov K, Koldasbayeva D, Faria M, Fung HH, Chen AX, Zhavoronkov A. Psychological factors substantially contribute to biological aging: evidence from the aging rate in Chinese older adults. Aging (Albany NY) 2022; 14:7206-7222. [PMID: 36170009 PMCID: PMC9550255 DOI: 10.18632/aging.204264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022]
Abstract
We have developed a deep learning aging clock using blood test data from the China Health and Retirement Longitudinal Study, which has a mean absolute error of 5.68 years. We used the aging clock to demonstrate the connection between the physical and psychological aspects of aging. The clock detects accelerated aging in people with heart, liver, and lung conditions. We demonstrate that psychological factors, such as feeling unhappy or being lonely, add up to 1.65 years to one's biological age, and the aggregate effect exceeds the effects of biological sex, living area, marital status, and smoking status. We conclude that the psychological component should not be ignored in aging studies due to its significant impact on biological age.
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Affiliation(s)
- Fedor Galkin
- Deep Longevity Limited, Hong Kong, People's Republic of China
| | - Kirill Kochetov
- Deep Longevity Limited, Hong Kong, People's Republic of China
| | | | - Manuel Faria
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Helene H. Fung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Amber X. Chen
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Alex Zhavoronkov
- Deep Longevity Limited, Hong Kong, People's Republic of China
- Insilico Medicine, Hong Kong, People's Republic of China
- Buck Institute for Research on Aging, Novato, CA 94945, USA
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Tu R, He H, Wang S, Ding J, Zeng Q, Guo L, Li Y, Xu T, Lu G. The association between healthy aging index and trajectories of disability: a population-based cohort study. Aging Clin Exp Res 2022; 34:1893-1900. [PMID: 35524107 DOI: 10.1007/s40520-022-02117-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/13/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Healthy aging index (HAI) could predict adverse health consequences including mortality and disability independent of age and comorbidity. We investigated the role of HAI on trajectories of disability throughout later life based on a nationally representative sample. METHODS We examined 1733 participants aged over 60 years from the China Health and Retirement Longitudinal Study (CHARLS) followed for 7 years/4 waves repeatedly. Systolic blood pressure [SBP], cognitive function, cystatin C, peak expiratory flow [PEF], and fasting glucose were categorized using tertile or clinical reference range, and scored as 0 (healthiest), 1 (less healthy) and 2 (least healthy) respectively to further generate HAI summary scores (range 0-10). Disability was defined as the sum of impaired activities of daily living (ADL) and instrumental activities of daily living (IADL). We used linear mixed-effects model to study the association between HAI and trajectories of disability. RESULTS A total of 10.5% of participants represented in the healthiest group and 22.5% ended up as the least healthy. After adjusting for all potential confounders, disability progression was significantly faster (β = 0.27, 95% CI 0.11-0.42) in the least healthy group when comparing with the healthiest. CONCLUSION Our findings suggest that HAI is associated with disability progression among adults aged over 60 years old. It might be beneficial for future interventions to specifically target older adults with high HAI scores as a means of reducing disability.
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Levasseur M, Lussier-Therrien M, Biron ML, Dubois MF, Boissy P, Naud D, Dubuc N, Coallier JC, Calvé J, Audet M. Scoping study of definitions and instruments measuring vulnerability in older adults. J Am Geriatr Soc 2021; 70:269-280. [PMID: 34669967 DOI: 10.1111/jgs.17451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/02/2021] [Accepted: 08/08/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND It is important to foster social participation and health equity, especially for older adults in situations of vulnerability. Despite growing interest in vulnerability, there is no consensus regarding how to define or measure this concept. This paper provides an inventory and synthesis of definitions of and instruments measuring vulnerability in older adults. METHODS Using a scoping study framework, eight databases (Abstracts in Social Gerontology, Academic Search Complete, AgeLine, CINAHL, MEDLINE, SocINDEX, PsycInfo, Scopus) were searched with relevant keywords [Vulnerab* AND (Concept*, Defin*, Meaning, Terminology, Measurement, Assessment*, Indicator*, Instrument*, Scale*, Questionnaire* OR Test*) AND (Aging, Aging, Elder*, Gerontolog*, Older OR Senior*)]. RESULTS Thirty-one original definitions and five measuring instruments were identified, content-analyzed, and compared. Vulnerability definitions mostly focused on people under conditions that increased their risk of harm because of individual physical factors, the environment, and their interaction. Considering these definitions, experts in the field of aging, including two representing older adults, participated in a workshop, and a consensus was reached to define a situation of vulnerability as "a set of circumstances in which one or more individuals experience, at a specific moment in time, one or multiple physiological, psychological, socioeconomic or social difficulties that may interact to increase their risk of being harmed or having coping challenges that have a negative impact on their life." Although none of the measures fully targeted this definition, the Perceived Vulnerability Scale (PVS) is one of the most complete measures, with 22 items considering feelings of vulnerability toward personal and environmental factors, and good psychometric properties. CONCLUSIONS The proposed definition and the PVS help to provide a common language and measure in health and social sciences research, policy and practice identifying and reaching older adults in situations of vulnerability and intervening to foster social participation and health equity.
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Affiliation(s)
- Mélanie Levasseur
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada.,School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada
| | - Marika Lussier-Therrien
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada
| | - Marie Lee Biron
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada
| | - Marie-France Dubois
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada.,Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada
| | - Patrick Boissy
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada.,Department of Surgery, Orthopedic Division, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada
| | - Daniel Naud
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada
| | - Nicole Dubuc
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada.,School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada
| | - Jean-Claude Coallier
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada.,Department of Career Counseling, Faculty of Education, Université de Sherbrooke, Québec, Canada
| | | | - Mélisa Audet
- Research Centre on Aging, Eastern Townships Integrated University Health and Social Services Centre - Sherbrooke University Hospital Centre, Québec, Canada
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Vulnerable Older Adults' Identification, Geographic Distribution, and Policy Implications in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010642. [PMID: 34682392 PMCID: PMC8535285 DOI: 10.3390/ijerph182010642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
With the population aging and urbanization in China, vulnerable older adults tend to show more complex characteristics, bringing great challenges to public health policies. Using China Longitudinal Aging Social Survey data 2014, this paper builds a comprehensive index system for the identification of vulnerable older adults from three dimensions, including health, economy, and social support, then divides older adults into four support levels and six small classes by using the typological method. The results show that older adults in urgent need of assistance or priority are those poor in health and economic conditions, 1.46% of them are highly vulnerable because of the lack of social support; 12.76% of them obtain a certain social support are moderately vulnerable; and 34.72% of them are slightly vulnerable with disadvantage in only one dimension. The geographic distribution of different types of vulnerable older adults varies significantly. The paper provides evidence to design more feasible and specific policies with comprehensive considerations for different types of vulnerable older adults residing in different regions.
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Liu Y, Zheng J, Zhu W. Identity Crisis in the Life Stories of Rural Chinese Older Adults. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.1921943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Yanping Liu
- Department of Psychology, Honghe University, Mengzi City, China
| | - Jianhong Zheng
- Key Laboratory of Psychological Assessment and Rehabilitation for Exceptional Children, Department of Psychology, Lingnan Normal University, Zhanjiang, China
- Guangdong Provincial Key Laboratory of Development and Education for Special Needs Children, Lingnan Normal University, Zhanjiang, Chin
| | - Wenyi Zhu
- Honghe Health Vocational College, Mengzi City, China
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Macinko J, Cristina Drumond Andrade F, Bof de Andrade F, Lima-Costa MF. Universal Health Coverage: Are Older Adults Being Left Behind? Evidence From Aging Cohorts In Twenty-Three Countries. Health Aff (Millwood) 2020; 39:1951-1960. [DOI: 10.1377/hlthaff.2019.01570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- James Macinko
- James Macinko is a professor in the Fielding School of Public Health at the University of California Los Angeles, in Los Angeles, California
| | - Flavia Cristina Drumond Andrade
- Flavia Cristina Drumond Andrade is an associate professor in the School of Social Work at the University of Illinois at Urbana-Champaign, in Urbana, Illinois
| | - Fabiola Bof de Andrade
- Fabiola Bof de Andrade is an assistant professor in the Rene Rachou Research Institute at the Fundação Oswaldo Cruz, in Belo Horizonte, Minas Gerais, Brazil
| | - Maria Fernanda Lima-Costa
- Maria Fernanda Lima-Costa is a professor in the Rene Rachou Research Institute, Fundação Oswaldo Cruz, and the Public Health Postgraduate Program at the Federal University of Minas Gerais, in Belo Horizonte, Brazil
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Nan Y, Feng T, Hu Y, Qi X. Understanding Aging Policies in China: A Bibliometric Analysis of Policy Documents, 1978-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5956. [PMID: 32824512 PMCID: PMC7459736 DOI: 10.3390/ijerph17165956] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 12/31/2022]
Abstract
Aging poses a big challenge in all aspects of social governance in China. A coherent and focused aging policy response that spans multiple sectors of government has been undertaken to achieve the goal of "Healthy Aging". From an historical perspective, this paper uses a bibliometric analysis method to probe into the evolution of Chinese aging policies from 1978 to 2019, and the roles of core government agencies in policy-making. We obtained 226 Chinese aging policies from the PKULaw Database and the websites of the government departments. Co-word analyses and network analyses were applied in mapping the topics of aging policies and collaboration among the agencies. Gephi software was used to visualize the most frequently used keywords and their network graphs. Findings are as follows. Firstly, the development of the aging policy system in China has undergone two phases, from focusing on basic security to emphasizing the rights and health of the elderly. Secondly, the network structure of aging policy-making departments presents a distinct edge-core layer. More and more government agencies have become involved in the formulation of aging policies. But collaboration among the agencies is insufficient. Thirdly, pilot promotion is the main tool for implementing aging policies.
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Affiliation(s)
| | - Tieying Feng
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China; (Y.N.); (Y.H.); (X.Q.)
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