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Ruan J, Zheng W, Zhuang Y. Everyday life experiences of Chinese community-dwelling oldest old who live alone at home. Int J Qual Stud Health Well-being 2023; 18:2253937. [PMID: 37667880 PMCID: PMC10481758 DOI: 10.1080/17482631.2023.2253937] [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: 05/23/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023] Open
Abstract
PURPOSE Older adults aged ≥ 80 years living alone at home are more likely to experience challenges. Daily life experiences regarding living alone are still limited in the Asian context. This study explored the everyday life experiences of older Chinese residents living alone at home. Research questions included: (1) How do Chinese community-dwelling old people describe everyday life experiences related to living alone? (2) What kind of difficulties and needs do Chinese community-dwelling older people living alone face in everyday lives? (3) How do Chinese community-dwelling older people cope with challenges faced in their everyday lives related to living alone? METHODS This was qualitative descriptive research. Purposive sampling was adopted to recruit 13 participants aged 80-92 years of age from communities and one hospital. Semi-structured interviews were conducted to collect data which was analysed by conventional content analysis. RESULTS Three themes were identified: theme 1-difficulty in finding a sense of belonging, theme 2-striving to maintain independence, theme 3-hard to gain a sense of control. CONCLUSIONS This study provided novel insights into understanding the difficulties and needs of Chinese older people living alone at home. Three key challenges and associated strategies they used to cope with in daily lives were presented.
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Affiliation(s)
- Jiayin Ruan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China
| | - Weina Zheng
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yiyu Zhuang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Lin SL. Functional Disability Among Middle-Aged and Older Adults in China: The Intersecting Roles of Ethnicity, Social Class, and Urban/Rural Residency. Int J Aging Hum Dev 2023; 96:350-375. [PMID: 35422130 PMCID: PMC9932620 DOI: 10.1177/00914150221092129] [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] [Indexed: 11/16/2022]
Abstract
This study explores how ethnicity, family income, and education level differentiate patterns of functional limitations among urban and rural Chinese (aged 45 ≥ years). Based on the 2018 China Family Panel Studies (CFPS) (n = 16,589), this nationwide study employed binary/multinomial logistic regression analyses, stratified by urban/rural residency, to estimate the likelihood of instrumental activities of daily living (IADLs) disability (0/1-2/≥3 limitations) by social determinants of health (SDoH). The estimated overall prevalence of IADLs disability was 14.3%. The multivariable analyses did not find significant ethnic disparity in IADLs disability in urban China, while in rural China, ethnic minorities were 44% more likely to have IADLs disability than Han Chinese. Among rural residents, Mongolians, Tibetans, and Yi minority more than tripled the odds of having ≥3 limitations than Han Chinese; and the intersections of ethnicity and social class were associated with functional limitations. Long-term care and anti-poverty programs should target minority aging populations in rural China.
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Affiliation(s)
- Shen Lamson Lin
- Factor-Inwentash Faculty of Social Work, 152790University of Toronto, Toronto, Canada
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Wang Z, Ni X, Gao D, Fang S, Huang X, Jiang M, Zhou Q, Sun L, Zhu X, Su H, Li R, Huang B, Lv Y, Pang G, Hu C, Yang Z, Yuan H. The relationship between sleep duration and activities of daily living (ADL) disability in the Chinese oldest-old: A cross-sectional study. PeerJ 2023; 11:e14856. [PMID: 36815994 PMCID: PMC9936868 DOI: 10.7717/peerj.14856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/14/2023] [Indexed: 02/16/2023] Open
Abstract
Objective To investigate the relationship between sleep duration and activities of daily living (ADL) disability, and to explore the optimal sleep duration among oldest-old Chinese individuals. Methods In this cross-sectional study, 1,798 participants (73.2% female) were recruited from Dongxing and Shanglin in Guangxi Zhuang Autonomous Region, China in 2019. The restricted cubic spline function was used to assess the dose-response relationship between sleep duration and ADL disability, and the odds ratios (ORs) of the associations were estimated by logistic regression models. Results The overall prevalence of ADL disability was 63% (64% in females and 58% in males). The prevalence was 71% in the Han population (72% in females and 68% in males), 60% in the Zhuang population (62% in females and 54% in males) and 53% in other ethnic population (53% in females and 53% in males). A nonlinear relationship between sleep duration and ADL disability was observed. Sleep duration of 8-10 hours was associated with the lowest risk of ADL disability. Sleep duration (≥12 hours) was associated with the risk of ADL disability among the oldest-old individuals after adjusting for confounding factors (OR = 1.47, 95% CI [1.02, 2.10], p < 0.05). Conclusion Sleep duration more than 12 hours may be associated with an increased risk of ADL disability in the oldest-old individuals, and the optimal sleep duration among this population could be 8-10 h.
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Affiliation(s)
- Zhaoping Wang
- 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
| | - Xiaolin Ni
- 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
| | - Danni Gao
- 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,Peking University Fifth School of Clinical Medicine (Beijing Hospital), Beijing, China
| | - Sihang Fang
- 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
| | - Xiuqing Huang
- 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
| | - Mingjun Jiang
- Respiratory Department, Beijing Children’s Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children’s Health, Beijing, China
| | - Qi Zhou
- 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
| | - Liang Sun
- 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
| | - Xiaoquan Zhu
- 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
| | - Huabin Su
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Rongqiao Li
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Bin Huang
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Yuan Lv
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Guofang Pang
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Caiyou Hu
- Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Ze Yang
- 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
| | - Huiping Yuan
- 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,Peking University Fifth School of Clinical Medicine (Beijing Hospital), Beijing, China
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Gao Y, Du L, Cai J, Hu T. Effects of functional limitations and activities of daily living on the mortality of the older people: A cohort study in China. Front Public Health 2023; 10:1098794. [PMID: 36743188 PMCID: PMC9895937 DOI: 10.3389/fpubh.2022.1098794] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction Prevalence of functional limitations (FLs) and disabled activities of daily living (ADL) cause heavy burdens to the health of the older people. Stratified by gender, this study aimed to explore the effects of FL and ADL on the mortality of the older people in China, and the mechanism was then discussed. Methods We used survey data of a prospective 10-year cohort (2008-2018), from the China Longitudinal Healthy Longevity Survey (CLHLS). The primary outcome was all-cause mortality, and Independent variables included FL, basic ADL (BADL), and instrumental ADL (IADL). Covariates involved socio-demographic characteristics, health-related behaviors, and health status of the participants in the CLHLS project. Results There were 967 (19.20%) male and 2,235 (32.36%) female older people performed functional limitations, and their survival time was 60.98 (SE = 0.66) and 55.19 (SE = 0.55) months, respectively. Old adults with FL had significantly poorer survival than the ones without (Log-rank test, P < 0.001). Weibull regression suggested that FL (P < 0.001), abnormal BADL (P < 0.001) and IADL (P < 0.001) were negatively associated with the survival of the older people. Further analysis showed that BADL and IADL performed significantly mediating roles in the relation of FL and survival time in old adults; additionally, for female older people, BADL also exhibited a significant moderating role in the effect of FL on survival. Conclusions Prevalence of FL was serious among the older people in China, especially for the women. Disabilities of BADL and IADL and FL were negatively associated with the survival time of the older people in China. Regarding the effect of FL on survival, BADL and IADL performed significantly mediating roles, and the moderating role of BADL existed only for the female. These suggested evidence to implement strategies to maintain health in the older people.
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Affiliation(s)
- Yumeng Gao
- Department of Medical Insurance, Jinshan Hospital of Fudan University, Shanghai, China,*Correspondence: Yumeng Gao ✉
| | - Liang Du
- School of Public Health, Fudan University, Shanghai, China
| | - Jianping Cai
- Department of Medical Insurance, Jinshan Hospital of Fudan University, Shanghai, China
| | - Tingfa Hu
- Department of Medical Insurance, Jinshan Hospital of Fudan University, Shanghai, China
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Luo D, Yu S, Wang J, Zhu Y, Yang L, Bai R, Rao Q, Zhang Q, Wu D, Wang F, Zhao Q, Xiao M. Social participation of community-dwelling older adults in western China: A latent profile analysis. Front Public Health 2022; 10:874204. [PMID: 36081484 PMCID: PMC9446436 DOI: 10.3389/fpubh.2022.874204] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/06/2022] [Indexed: 01/21/2023] Open
Abstract
Objective Social participation has become a policy framework to address population aging. However, little is known about the social participation of older adults in western China, and extensive, multicenter, regional research is lacking. This research investigated the profiles of social participation of older adults in western China and explored the characteristics and factors influencing social participation. Method This cross-sectional study was conducted in 3 provinces (Chongqing, Sichuan, and Inner Mongolia) in western China from March 2021 to December 2021 and included 3,456 participants aged 60 years or older. Social participation was assessed using the Chinese version of the Impact on Participation and Autonomy Questionnaire (IPA). Latent profile analysis (LPA) was performed to extract latent classes of social participation among older adults in western China. The chi-square test and multinomial regression analyses were used to identify differences between these classes. Results Three social participation classes were identified by LPA: high social participation (25.2%), moderate social participation (55.1%), and low social participation (19.7%). Being older, having a primary school education level, having mobility or speaking impairment, using assistive devices, and having a chronic disease were highly associated with the low social participation class (P < 0.05). Furthermore, older adults with no dependence (OR = 0.018, 95% CI = 0.005-0.062) or mild dependence (OR = 0.039, 95% CI = 0.011-0.139) in activities of daily living (ADLs) were less likely to be in the low social participation class. Older adults who were cared for by non-spouse primary caregivers were more likely to be assigned to the moderate social participation group (OR = 2.097, 95% CI = 1.501-2.930) than to the high social participation group. Conclusions Most older adults in western China have a moderate level of social participation. Advanced age, reduced ADL ability, reduced speech ability, reduced mobility, and non-spouse care are related to the level of social participation. Healthcare professionals should pay attention to the predictors for different classes, identifying high-risk groups as early as possible.
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Affiliation(s)
- Di Luo
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shiqi Yu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Wang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Zhu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lining Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruonan Bai
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qianyi Rao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Zhang
- Service Center of Rehabilitation Assistive Technology of Sichuan Province, Sichuan, China
| | - Di Wu
- Inner Mongolia Autonomous Region Rehabilitation Assistive Device Center, Inner Mongolia, China
| | - Feng Wang
- Panzhihua Wuyue Technology Co., Ltd, Pan Zhihua, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Mingzhao Xiao
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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.
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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.)
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Song Y, Liu M, Jia WP, Han K, Wang SS, He Y. The association between nutritional status and functional limitations among centenarians: a cross-sectional study. BMC Geriatr 2021; 21:376. [PMID: 34154543 PMCID: PMC8218470 DOI: 10.1186/s12877-021-02312-9] [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: 02/02/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022] Open
Abstract
Background Although there have been studies on the association between nutritional status and functional limitations, there were few studies on Asian centenarians in community. Therefore, this study aims to identify associations between nutritional status and functional limitations among centenarians in China. Methods This cross-sectional study was conducted with the data from the China Hainan Centenarian Cohort Study. These data ultimately included basic characteristics, hematologic indicators, and chronic disease status for 1,002 centenarians. The nutritional status was evaluated using the Mini Nutritional Assessment Short-Form scale. The functional limitations were assessed using the activities of daily living (ADL) scale, namely Barthel Index and Lawton Scale. The association between nutritional status and ADL was assessed using multivariate logistic regression models. Results In this study, the prevalence of malnutrition was 20.8 % among centenarians, basic ADL (BADL) limitation was 28.6 %, and instrumental ADL (IADL) limitation was 64.7 %. As the nutritional status deteriorated, the risk of ADL limitations increased in total population (BADL limitation: OR = 17.060, 95 % CI: 8.093-35.964; IADL limitation: OR = 11.221, 95 % CI: 5.853-21.511; p for trend < 0.001). Similar results were found in both men and women after stratifying sex but were more prominent in women. Conclusions Malnutrition is associated with functional limitations among centenarians in China and more pronounced among women.
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Affiliation(s)
- Yang Song
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Miao Liu
- Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Wang-Ping Jia
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Ke Han
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Sheng-Shu Wang
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Yao He
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.
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彭 顺, 付 茜, 冯 星. [Association between education and the onset of disability in activities of daily living in middle-aged and older Chinese adults: The mediator role of social participation]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:549-554. [PMID: 34145859 PMCID: PMC8220058 DOI: 10.19723/j.issn.1671-167x.2021.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the association between educational attainment and the onset of disability in activities of daily living (ADL), and to explore the mediating effect of social participation on such association. METHODS A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARLS, 2015 to 2018). The measurements of educational attainment, social participation and other covariates were identified from 2015, while the outcome measurement of ADL disability was constructed with data from survey 2018. Descriptive analyses were conducted, and basic characteristics and social engagement of the respondents were compared between illiterates and non-illite-rates using Chi-square test. Logistic regression was used to investigate the associations of educational attainment and social participation on the onset of ADL disability. Mediation analysis was employed to examine the mediator role of the social participation on the linkage from being illiterate to the ADL disability onset. RESULTS A total of 11 359 adults aged 45 years and above were included in the sample, of whom 3 222 were illiterates. The incidence of the onset of ADL disability of illiterates and non-illiterates were 10.4% and 6.2%, respectively. Among these respondents, only half of them were involved in social activities. Of all the 8 social activities, the percentage of interacting with friends (34. 1%) was the highest, and the lowest percentage was observed in participating in an educational or training course (0.6%). Moreover, the percentages of participation in all these 8 social activities among illiterates were significantly lower than that of their educated counterparts (all P < 0.001). The illiterate middle-aged and older adults were less likely to develop ADL disability in the follow-up period [adjusted odds ratio (aOR)=1.22, 95%CI: 1.02-1.45], and social participation was significantly associated with ADL disability onset (aOR=0.73, 95%CI: 0.63-0.85). Findings from mediation analysis illustrated that social participation accounted for 12.22% of the adverse effect of being illiterate on ADL disability onset. CONCLUSION Social participation could buffer the negative effect of being illiterate on ADL disability onset in middle-aged and older adults, suggesting that engagement in social activities might have impact on prevention of impairments in physical function, especially for middle-aged and older illiterates.
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Affiliation(s)
- 顺壮 彭
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
| | - 茜茜 付
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
| | - 星淋 冯
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
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