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Sun J, Lin J, Shen W, Ding P, Yang W, Huang L, Chen H. Associations of body mass index, waist circumference and the weight-adjusted waist index with daily living ability impairment in older Chinese people: A cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey. Diabetes Obes Metab 2024; 26:4069-4077. [PMID: 38962934 DOI: 10.1111/dom.15762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
AIM To investigate the associations of body mass index (BMI), waist circumference (WC) and the weight-adjusted waist index (WWI) with the impairment of activities of daily living (ADL) in older Chinese people. METHODS A total of 13 260 participants aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey were included in this cross-sectional study. BMI, WC and the WWI were calculated from measurements of height, weight and WC. Binary logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Non-linear correlations were investigated using restricted cubic spline curves. RESULTS In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between WC and WWI and ADL impairment, with adjusted ORs (95% CI) of 1.01 (1.00, 1.01) and 1.08 (1.03, 1.12), respectively. Meanwhile, participants with a high WWI had a higher risk of ADL impairment compared with those with a low WWI, with an adjusted OR (95% CI) of 1.12 (1.02, 1.23). Subgroup analyses showed that only the association between WWI and ADL impairment did not differ in any of the different populations. In addition, we found that BMI, WC and WWI were non-linearly associated with ADL impairment. CONCLUSIONS There are significant associations between WC and WWI and ADL impairment in older Chinese people. The findings show the ability of the WWI to serve as a comprehensive and effective indicator of obesity in older Chinese people and emphasize the importance of assessing WWI in screening and preventing ADL impairment in older people.
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Affiliation(s)
- Jie Sun
- Guali Branch of the First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Jie Lin
- Guali Branch of the First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Wenqin Shen
- Guali Branch of the First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Pan Ding
- Department of Medical Record Statistics, Wenzhou People's Hospital, Wenzhou, China
| | - Wenjuan Yang
- Guali Branch of the First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Li Huang
- School of Public Health, Wenzhou Medical University, Wenzhou, China
| | - Huajian Chen
- School of Public Health, Wenzhou Medical University, Wenzhou, China
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Kim S, Woo S, Cui Y, Yon DK, Choi M. Unmet community care needs among older adults in China: an observational study on influencing factors. BMC Geriatr 2024; 24:719. [PMID: 39210252 PMCID: PMC11363479 DOI: 10.1186/s12877-024-05318-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND With the rapidly aging population in China, there is an urgent need to understand and address the community care needs of older adults. This study sought to examine these unmet community care needs of older adults in China and the factors influencing them, with the goal of providing essential groundwork for the development of community care health policies. METHODS This study used data from the 2018 China Longitudinal Healthy Longevity Survey of 8,870 adults aged 65 years and older. Logistic regression analysis was performed to identify factors related to unmet community care needs. RESULTS The results showed that lower number of children, increased years of schooling, poorer self-perceived economic and health status, residing in an institution rather than living with household members, not having public old-age pensions, and not having activity due to daily living impairments were associated with a higher likelihood of unmet community care needs among older adults. CONCLUSIONS These findings indicate the necessity for crafting policies that consider the factors affecting unmet community care needs of older adults, including their health vulnerabilities and individual needs. Implementing national initiatives aimed at enhancing the quality of services delivered to older adults is crucial, along with establishing programmes to proactively address their vulnerabilities and individual needs. This study can contribute to the formulation of policy measures aimed at enhancing community care services of older adults in China.
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Affiliation(s)
- Suyeon Kim
- Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Ying Cui
- Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Mankyu Choi
- School of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea.
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Reinwarth AC, Wicke FS, Rückert KK, Schattenberg JM, Tüscher O, Wild PS, Münzel T, König J, Lackner KJ, Pfeiffer N, Beutel ME. Change of self-rated physical health predicts mortality in aging individuals: results of a population-based cohort study. Arch Public Health 2024; 82:130. [PMID: 39180092 PMCID: PMC11342511 DOI: 10.1186/s13690-024-01363-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/11/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Self-rated physical health (SRPH) is known as an important predictor of mortality. Previous studies mostly used baseline values of self-rated health to predict long-term mortality. The effect of change in self-rated physical health on mortality during the course of aging has rarely been researched. The present study aimed to determine SRPH over time in women and men of an aging population, assess whether and how change in SRPH affects mortality while adjusting for known determinants of mortality, and test effect modification by sex on the relation between course of SRPH and mortality. METHODS Data of N = 12,423 respondents of the 5-year follow-up of the Gutenberg Health Study (GHS) with participation at the baseline assessment were analysed. All-cause mortality from 5-year follow-up onwards was defined as the primary outcome. SRPH was assessed by a single item. Cox proportional hazards models with adjustment for age, sex, socio-economic status and physical diseases were fitted to assess the predictive power of baseline score and course of SRPH. Additionally, effect modification by sex was assessed. RESULTS During a median follow-up period of 7.3 years (quartiles 6.0-8.5 years), 618 (5%) participants died. Overall, 70.9% of the participants indicated good or very good SRPH at baseline (T1) and follow-up (T2), 6.9% rated their SRPH as not so good at T1 and T2, and 0.6% reported bad SRPH at T1 and T2. An improvement of SRPH was indicated by 9.6% and 12.0% indicated deterioration of their SRPH. Change in SRPH added substantial predictive information to the Cox proportional hazards models, when adjusting for relevant covariates. In men, deterioration and constantly bad SRPH were associated with the strongest increase in risk of mortality by 87%, resp. 228%. While improvements increased mortality risk in men (67%), women with an improved SRPH had a lower risk (57%). CONCLUSION A sizeable subgroup of aging participants reported deterioration of SRPH over five years. The association between change of SRPH and mortality is modified by sex. Deterioration of SRPH predicts mortality over baseline-assessment even when adjusted for relevant covariates. SRPH should be assessed regularly as part of an older individual's health evaluation. Deterioration, constantly bad and improved SRPH should be taken seriously as unfavorable prognostic indicators, the latter only in men.
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Affiliation(s)
- Anna Celine Reinwarth
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Zahlbacher Straße 8, 55131, Mainz, Germany.
| | - Felix S Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Zahlbacher Straße 8, 55131, Mainz, Germany
| | - Kamiar K Rückert
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Zahlbacher Straße 8, 55131, Mainz, Germany
| | - Jörn M Schattenberg
- Metabolic Liver Research Program, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Internal Medicine II, Saarland University Medical Center, Homburg and University of the Saarland, Saarbrücken, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Philipp S Wild
- Institute of Molecular Biology (IMB), Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Institute of Molecular Biology (IMB), Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute of Molecular Biology (IMB), Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Zahlbacher Straße 8, 55131, Mainz, Germany
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Saha A, Govil D, Muhammad T, Thomas AR. Unveiling the dynamics of social engagement and subjective health in older adults: A gendered perspective. Exp Gerontol 2024; 193:112472. [PMID: 38821323 DOI: 10.1016/j.exger.2024.112472] [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: 03/20/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES As populations age globally, understanding the dynamics that influence the well-being of older individuals become increasingly crucial. The research employs a comprehensive approach to unravel the multifaceted interplay between social engagements and subjective health perceptions of older Indians, with a special focus on gender differences. SUBJECTS AND METHODS This study used data from the Longitudinal Aging Study in India (LASI) wave 1, 2017-18 with a total sample of 30,533 older adults aged 60 years and above. Bivariate analysis, chi-square tests and unadjusted and adjusted average marginal effects from logistic regression models were used to assess the relationship between social engagements and subjective health among older adults, stratified by gender. RESULTS The prevalence of poor health status decreased with higher frequency of social networks among both men (pp. (percentage point) = 6.1; CI (Confidence Interval): 10.6, 1.6) and women (pp. = 9.2; CI: 14.9, 3.4). The adjusted average marginal effects demonstrate that with an increase in the overall score of social engagement, the likelihood of poor health is almost reduced by half. For men, the prevalence of poor health was 9.8 pp. (95 % CI: 13.7, 5.8), while for women, it was 9.3 pp. (95 % CI: 15.2, 3.1). CONCLUSION Gendered perspectives unveil unique patterns, highlighting how societal expectations and roles assigned to each gender may influence the subjective health perceptions of older individuals. This study adds to the expanding knowledge base to enhance the well-being and fulfillment of aging populations, considering the complex interplay of social dynamics and gendered perspectives.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, - 400088, India.
| | - Dipti Govil
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, - 400088, India
| | - T Muhammad
- Department of Human Development and Family Studies, The Pennsylvania State University, PA- 16802, USA
| | - Arya Rachel Thomas
- School of Humanities and Social Sciences, Indian Institute of Technology, Madras, India
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Almevall A, Almevall AD, Öhlin J, Gustafson Y, Zingmark K, Niklasson J, Nordström P, Rosendahl E, Söderberg S, Olofsson B. Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort. Arch Gerontol Geriatr 2024; 122:105392. [PMID: 38492492 DOI: 10.1016/j.archger.2024.105392] [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: 11/28/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population. AIM To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival. METHODS All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests. FINDINGS Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05). CONCLUSION This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.
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Affiliation(s)
- Ariel Almevall
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden.
| | | | - Jerry Öhlin
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Yngve Gustafson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Karin Zingmark
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Johan Niklasson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Section of Medicine Umeå University, Umeå, Sweden
| | - Birgitta Olofsson
- Department of Nursing, Department of Diagnostics and Intervention, Orthopedics, Umeå University, Umeå, Sweden
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Prieto L. Exploring the Influence of Social Class and Sex on Self-Reported Health: Insights from a Representative Population-Based Study. Life (Basel) 2024; 14:184. [PMID: 38398693 PMCID: PMC10890034 DOI: 10.3390/life14020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
This study investigates the intricate interplay between social class, sex, and self-reported health (SRH) using data from the European Health Survey of Spain 2020 (EESE2020). Employing a cross-sectional design and a representative sample of 22,072 individuals, the analysis explores the persistence of disparities after adjusting for covariates, focusing on health-related variables. The study employs logistic regression models and directed acyclic graphs (DAGs) to delineate the direct effects of social class and sex on SRH, identifying a minimum adjustment set to control for confounding variables. Results reveal a gradient effect of social class on SRH, emphasizing the enduring impact of socioeconomic factors. Sex-based disparities in SRH diminish after considering additional health-related variables, highlighting the importance of a holistic approach. DAGs serve as transparent tools in disentangling complex relationships, guiding the identification of essential covariates. The study concludes that addressing health inequalities requires comprehensive strategies considering both individual health behaviours and socio-economic contexts. While recognizing limitations, such as the cross-sectional design, the findings contribute to a nuanced understanding of health disparities, informing evidence-based interventions and policies for a more equitable healthcare system.
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Affiliation(s)
- Luis Prieto
- Distance Learning, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Lu Z, Yu D, Wang L, Fu P. Association between depression status and hearing loss among older adults: The role of outdoor activity engagement. J Affect Disord 2024; 345:404-409. [PMID: 37879413 DOI: 10.1016/j.jad.2023.10.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/07/2023] [Accepted: 10/08/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND More than half of Chinese older adults over 60 are suffering from hearing loss, which might increase the risk of depression. Outdoor activity engagement is a key factor to alleviate depression symptoms. This study is conducted to analyze the associations between hearing loss and depression, and explore the role of outdoor activity engagement on depression. METHODS This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which collected the health and demographic information of elderly people in 23 provinces in China. In total, 12,333 older adults over 60 were recruited in the final analysis. Participants' risk of depressive symptoms was assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). The relationship between self-reported hearing loss and depression in older adults was tested using logistic regression models. RESULTS The findings suggested a significant relationship between self-reported hearing loss and depressive symptoms (OR = 1.513, 95%CI = 1.391-1.646, P < 0.001). In addition, outdoor activity engagement have a moderation effect on self-reported hearing loss, among which entertainment and physical activities can better reduce the risk of depression. CONCLUSION Evidence from this study suggests that older adults with self-reported hearing loss can perform appropriate outdoor activities. Early recognition and intervention in hearing loss may reduce the risk of depression.
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Affiliation(s)
- Zhihong Lu
- College of management, Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Dongyue Yu
- College of management, Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Lijun Wang
- College of management, Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Peipei Fu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong 250012, China.
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Yu Y, Zhang J, Chen C, Petrovic M, Pei X, Zhang WH. Longitudinal Association Between Perceived Availability of Home- and Community-Based Services and All-Cause Mortality Among Chinese Older Adults: A National Cohort Study. J Aging Soc Policy 2023:1-36. [PMID: 37889943 DOI: 10.1080/08959420.2023.2265771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/30/2023] [Indexed: 10/29/2023]
Abstract
Home- and community-based services (HCBS) may contribute to lowering mortality and enhancing quality of life among older adults. Limited research, however, has examined this relationship in the Chinese context. This study explored the longitudinal association between perceived availability of HCBS and all-cause mortality among Chinese older adults. This cohort study included 8,102 individuals aged 65 years and older from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. HCBS included daily life assistance, medical care services, emotional support and social services, and reconciliation and legal aid services. The association between perceived availability of HCBS and all-cause mortality was investigated using Cox proportional hazards models. Emotional support and social services were negatively associated with all-cause mortality (HR = 0.86, 95% CI: 0.78 ~ 0.95, P = .004). Daily life assistance, medical care services, and reconciliation and legal aid services were not significantly associated with all-cause mortality. Providing community-level emotional support and social services may reduce the risk of death. Focusing on the mental health and social well-being of older adults is just as important as caring for their physical health.
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Affiliation(s)
- Yushan Yu
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jun Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- The Research Center for Medical Sociology, Tsinghua University, Beijing, China
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Xiaomei Pei
- Department of Sociology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- School of Public Health, Université libre de Bruxelles (ULB), Bruxelles, Belgium
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Zhao Z, Yu B, Hu F, Zheng C, Gui J, Liu J, Sun J, Shi J, Yuan L. Decomposition and comparative analysis of health inequities between the male and female older adults in China: a national cross-sectional study. BMC Public Health 2023; 23:2045. [PMID: 37858126 PMCID: PMC10588259 DOI: 10.1186/s12889-023-15814-5] [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: 12/22/2022] [Accepted: 05/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND This study aimed to examine the factors influencing self-rated health (SRH) among Chinese older adults by gender differences and provide suggestions and theoretical references to help make policies for older adults' health concerns by government agencies. METHODS Chinese Longitudinal Health Longevity Survey (CLHLS) in 2018 was adopted, the chi-squared test and the logistic regression analysis were performed to analyse self-rated health reported by Chinese female and male older adults and its influencing factors. In addition, Fairlie decomposition analysis was performed to quantify the contribution level of different influencing factors. RESULTS Among older adults, males (48.0%) reported a significantly higher level of good self-rated health than females (42.3%). Residence, body mass index (BMI), self-reported income, smoking, drinking, exercise, and social activity were the factors that influenced SRH reported by male and female respondents, with age, marital status and education reaching the significance level only in women. The Fairlie decomposition model can explain the underlying reasons for 86.7% of the gender differences in SRH, with self-reported income (15.3%), smoking (32.7%), drinking (42.5%), exercise (17.4%), social activity (15.1%) and education (-14.6%) being the major factors affecting gender differences in SRH. CONCLUSIONS The study results can help promote the implementation of the Healthy China Initiative, inform intervention measures, and offer new proposals on creating policies for older adults' health issues by the Chinese government to improve health equity.
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Affiliation(s)
- Zhe Zhao
- Department of Health Management, Second Military Medical University, Shanghai, China
| | - Boyang Yu
- Department of Military Health Service, Second Military Medical University, Shanghai, China
| | - Fangyuan Hu
- Department of Medical Service, Naval Hospital of Eastern Theater, Zhoushan, China
| | - Chao Zheng
- Department of Acupuncture and Rehabilitation, the Second Affiliated Hospital of Guizhou, University of Traditional Chinese Medicine, Guiyang, China
| | - Jing Gui
- Department of Military Health Service Training, Second Military Medical University, Shanghai, China
| | - Jiahao Liu
- Xiamen Special Service Health Center of The Army, Xiamen, China
| | - Jinhai Sun
- Department of Health Management, Second Military Medical University, Shanghai, China.
| | - Jinhao Shi
- Department of Research and Academic Management, Second Military Medical University, Shanghai, China.
| | - Lei Yuan
- Department of Health Management, Second Military Medical University, Shanghai, China.
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Huang M, Liu K, Liang C, Wang Y, Guo Z. The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety. BMC Geriatr 2023; 23:506. [PMID: 37608361 PMCID: PMC10463962 DOI: 10.1186/s12877-023-04161-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/10/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms. METHODS This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms. RESULTS Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively). CONCLUSIONS Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.
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Affiliation(s)
- Mina Huang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Kun Liu
- Department of Medical College, The Jinzhou Medical University, Jinzhou, China
| | - Chunguang Liang
- Department of Nursing, The Jinzhou Medical University, Jinzhou, China
| | - Yongzhu Wang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China
| | - Zhanpeng Guo
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Jinzhou, Liaoning, 121001, China.
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Ren W, Xing Y, Tarimo CS, He R, Liang Z. A study on the equity of self-rated health of older adults at the family level. Int J Equity Health 2023; 22:72. [PMID: 37098613 PMCID: PMC10131322 DOI: 10.1186/s12939-023-01895-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/18/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The self-rated health of older adults (SHOA) plays an important role in enhancing their medical service utilization and quality of life. However, the determinants and magnitude variations in SHOA at the family level (SHOAFL) remain unknown. The purpose of this study was to assess the status and equitable level of SHOAFL in China, as well as to analyze the influencing factors and the precise nature and scope of their impacts. METHODS This study analyzed the data from the "Chinese residents' health service needs survey in the New Era", and included a total of 1413 families with older adults. The status and influencing factors of SHOAFL were analyzed using mean comparison and Logistic regression (LR) models. The Concentration Index method was used to explore the equity of the distribution of SHOAFL. The relationship between differences in personal characteristics among family members and differences in SHOA was determined by the method of Coupling Coordination Degree (CCD). RESULTS The total score of SHOAFL was 66.36 ± 15.47, and LR results revealed that the factors with a significant impact on SHOAFL were number of people living in family, distance to the nearest medical service institution, travel time to the nearest medical service institution, annual family income, yearly family medical and health expenditures, average age, and residence (all P < 0.05). The Concentration index of SHOAFL ranged from -0.0315 to 0.0560. CCD of the differences between SHOA and medical insurance and smoking status were 0.9534 and 0.7132, respectively. CONCLUSION The SHOAFL was found to be generally but more inclined towards urban families with high incomes and a short time to medical service institution. The observed disparities in SHOA among family members were mostly attributable to differences in health insurance and pre-retirement occupations. The status and equality of SHOAFL may be improved if policymakers prioritize making services more accessible to older rural residents with low incomes. Concurrently, reducing the existing discrepancy in health insurance coverage between older couples may also enhance their health.
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Affiliation(s)
- Weicun Ren
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Yiqing Xing
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Clifford Silver Tarimo
- College of Public Health, Zhengzhou University, Zhengzhou, China
- Dares Salaam Institute of Technology, Department of Science and Laboratory Technology, Dares Salaam, Tanzania
| | - Ruibo He
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Zhang Liang
- School of Political Science and Public Administration, Wuhan University, Wuhan, China.
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12
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Chu L. Health Trajectories of Older Chinese Adults: Gender Disparities and Cohort Differences. AGEING INTERNATIONAL 2023. [DOI: 10.1007/s12126-023-09520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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13
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Jiang D, Yan Y, Zhou H, Wang Q. The association between personal social capital and health-related quality of life among Chinese older people: A cross-sectional study. Front Nutr 2022; 9:995729. [PMID: 36570148 PMCID: PMC9773083 DOI: 10.3389/fnut.2022.995729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Background Lower health-related quality of life (HRQoL) can result in adverse effects on the health of older people. This study aims to explore the relationship between personal social capital (PSC) and HRQoL among Chinese elderly people from rural-and-urban perspective. Materials and methods 4,802 samples were included from China's health-related quality of life Survey for Older Adults 2018 (CHRQLS-OA 2018). The PSC, including bonding and bridging social capital (BOC and BRC), was measured by the Chinese version of the Personal Social Capital Scale (PSCS-16). The HRQoL was evaluated by the European Five Dimensions Questionnaire (EQ-5D-3L). Linear and Tobit regression models were conducted to examine the relationship between PSC and HRQoL. Results The BOC and BRC of rural older people were significantly lower than those of urban older people. Pain/discomfort and anxiety/depression were the most significant health problems affecting the older samples. In the five dimensions, the proportion of rural older people with problems was higher than that of urban older people. Among rural older people, BOC was significantly related to self-rated health and EQ-5D utility index (p < 0.05); while BRC was insignificantly associated with self-rated health (p > 0.05) but related to EQ-5D utility index (p < 0.05). Both BOC and BRC were significantly correlated with self-rated health and EQ-5D utility index (p < 0.05) among urban older people. Conclusion Our study reveals older people's worrying PSC and HRQoL status. The relationship between PSC and HRQoL suggested that more social support and care of intimates should be encouraged to increase the PSC of older people, especially rural older people.
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Affiliation(s)
- Dongdong Jiang
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China,School of Public Health, Zhejiang University, Hangzhou, China
| | - Yajie Yan
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China
| | - Han Zhou
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Quan Wang
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Quan Wang,
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Zhang M, Rong J, Liu S, Zhang B, Zhao Y, Wang H, Ding H. Factors related to self-rated health of older adults in rural China: A study based on decision tree and logistic regression model. Front Public Health 2022; 10:952714. [PMID: 36530664 PMCID: PMC9748102 DOI: 10.3389/fpubh.2022.952714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to explore the related factors of self-rated health (SRH) by using decision tree and logistic regression models among older adults in rural China. Methods Convenience sampling was employed with 1,223 enrolled respondents who met the inclusion criteria from 10 randomly selected villages in M County in China. The content of the questionnaire covered demographic characteristics, physical and mental health, sleep status, and risk of falling. The Pittsburgh Sleep Quality Index (PSQI) and the Morse Falls Risk Scale (MFS) were used to evaluate sleep status and risk of falling, respectively. The decision tree and logistic regression models were employed to analyze the related factors of SRH. Results Notably, 817 (68.7%) subjects had good SRH. The logistic regression model showed that living standard, alcohol consumption, sleep quality, labor, hospitalization, discomfort, the number of chronic diseases, and mental health were associated with SRH (P-value < 0.05), while the decision tree model showed that the number of chronic diseases, sleep quality, mental health, hospitalization, gender, and drinking were associated with SRH. The sensitivity and specificity of the logistic regression model were 67.7 and 75.5%, respectively, and the area under the ROC curve was 0.789 (0.763, 0.816); the sensitivity and specificity of the decision tree model were 71.5, and 61.4% respectively, and the area under the ROC curve was 0.733 (0.703, 0.763). Conclusion Decision tree and logistic regression models complement each other and can describe the factors related to the SRH of the elderly in rural China from different aspects. Our findings indicated that mental health, hospitalization, drinking, and sleep quality were the important associated factors.
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Affiliation(s)
- Min Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Jian Rong
- Department of Scientific Research, The Second Hospital of Anhui Medical University, Anhui, China
| | - Song Liu
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Beibei Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Yaodong Zhao
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Haibo Wang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Hong Ding
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China,*Correspondence: Hong Ding
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Ding P, Li J, Chen H, Zhong C, Ye X, Shi H. Independent and joint effects of sleep duration and sleep quality on suboptimal self-rated health in medical students: A cross-sectional study. Front Public Health 2022; 10:957409. [PMID: 36276404 PMCID: PMC9583520 DOI: 10.3389/fpubh.2022.957409] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/20/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Studies on the association between sleep behavior and health often ignored the confounding effects of biorhythm-related factors. This study aims to explore the independent and joint effects of sleep duration and sleep quality on suboptimal self-rated health (SRH) in medical students. Methods Cross-sectional study. Proportional stratified cluster sampling was used to randomly recruit students from various medical specialties at a medical university in eastern China. Our questionnaire mainly included information on basic demographic characteristics, SRH, sleep behavior, and biorhythm-related factors. The independent and joint effects of sleep duration and sleep quality on suboptimal SRH were assessed by logistic regression after controlling for potential confounders. Results Of 1,524 medical students (mean age = 19.9 years, SD = 1.2 years; 59.1% female), 652 (42.8%) had suboptimal SRH. Most medical students (51.5%) slept for 7 h/night, followed by ≥8 (29.1%) and ≤ 6 h (19.4%). After adjusting for basic demographic characteristics and biorhythm-related factors, compared with students who slept for ≥8 h/night, the adjusted ORs (95%CI) for those who slept 7 and ≤ 6 h/night were 1.36 (1.03, 1.81) and 2.28 (1.60, 3.26), respectively (P < 0.001 for trend); compared with those who had good sleep quality, the adjusted ORs (95%CI) for those who had fair and poor sleep quality were 4.12 (3.11, 5.45) and 11.60 (6.57, 20.46), respectively (P < 0.001 for trend). Further, compared with those who slept for ≥8 h/night and good sleep quality, those who slept ≤ 6 h and poor sleep quality had the highest odds of suboptimal SRH (OR 24.25, 95%CI 8.73, 67.34). Conclusions Short sleep and poor sleep quality were independently and jointly associated with higher odds of suboptimal SRH among medical students.
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Affiliation(s)
- Pan Ding
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Jinyong Li
- Renji College, Wenzhou Medical University, Wenzhou, China
| | - Huajian Chen
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Chongzhou Zhong
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xiaoli Ye
- Propaganda Department, Wenzhou Medical University, Wenzhou, China,Xiaoli Ye
| | - Hongying Shi
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China,*Correspondence: Hongying Shi
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Pu X, Wang Y, Zhang W, Zeng M. Can Basic Medical Insurance Reduce Elderly Family Income Inequality in China? Front Public Health 2022; 10:838733. [PMID: 35242735 PMCID: PMC8885622 DOI: 10.3389/fpubh.2022.838733] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Basic medical insurance is the critical medical security system to realize common prosperity in China. This study explores the impact of basic medical insurance on elderly family income inequality in China using the China Family Panel Studies (CFPS) data in 2018. Our finding shows that basic medical insurance is significantly negatively correlated with elderly family income inequality, indicating basic medical insurance has a positive impact on narrowing the elderly family income inequality. The heterogeneity analysis shows that basic medical insurance has a more significant reduction effect among the eastern elderly and the younger elderly family. The results also suggest that health performance significantly mediates the relationship between basic medical insurance and elderly family income inequality. This study implies that the Chinese government should increase the proportion of basic medical insurance reimbursement and expand the scope of reimbursement for basic medical insurance to realize income fairness among elderly families.
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Affiliation(s)
- Xiaohong Pu
- School of Public Administration, Sichuan University, Chengdu, China
| | - Yilong Wang
- School of Public Administration, Sichuan University, Chengdu, China
- School of Management, Northwest Minzu University, Lanzhou, China
| | - Weike Zhang
- School of Public Administration, Sichuan University, Chengdu, China
- *Correspondence: Weike Zhang
| | - Ming Zeng
- School of Public Administration, Sichuan University, Chengdu, China
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Ilić S, Radević S, Janićijević K, Miljanović A, Andrić D, Iković M, Pantović M. Socioeconomic determinants of gender differences in self-reported health status among older population. SANAMED 2022. [DOI: 10.5937/sanamed17-39390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Self-reported health status is considered one of the highly significant indicators of general health and overall quality of life. Aim: to examine whether there are gender differences in self-reported health status among the older population depending on the socioeconomic determinants. Methods: The analysis was carried out based on the data collected from the fourth National Health Survey of the population of Serbia, which was designed as a cross-sectional study. The research was conducted in accordance with the methodological guidelines and research instruments of the European Health Interview Survey. Results: A statistically significant correlation was observed between gender and the self-reported health status of the respondents. Women were significantly more likely to report poor self-rated health (27.8%), whereas men reported better self-rated health (21.3%). The results of the multivariate logistic regression analysis showed that poor self-rated health status among women was more likely to be affected by age, educational level, and region, whereas age and economic status were significant factors associated with poor self-rated health status among men. Conclusion: Taking into consideration the fact that the advantages of increased life expectancy will achieved only if these extra years of life gained through increased longevity are spent in good health, the importance of conducting additional research on gender differences is more than evident, particularly in terms of providing meaningful insight into the development of action plans devised to deal with gender differences in health status, simultaneously promoting healthy and active aging for both men and women.
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