Factors Associated with Activities of Daily Life Disability among Centenarians in Rural Chongqing, China: A Cross-Sectional Study

Utilisation of community healthcare services among older adults with disabilities in Luohu district, Shenzhen: a community-based survey

OBJECTIVE

China faces the challenge of an ageing population with disabilities. Community healthcare centres (CHCs) serve as frontline community healthcare providers for older adults with and without disabilities. Despite their significance, there is a lack of literature examining the utilisation of CHC services among older adults. This study aims to examine and compare the utilisation and satisfaction of CHC healthcare services among older adults with and without disabilities.

SETTING

Data from the 2019 Community Health Diagnosis Questionnaire, which interviewed 259 older adults residing in the Luohu district of Shenzhen, were used in the current study.

PRIMARY OUTCOME MEASURES

Participants self-reported outcomes including use of CHCs, use of home health services from CHCs and satisfaction with CHCs. Five different disability types and an integrated disability variable were assessed as independent variables. Linear probability models were used to determine the relationship between disability types and outcome variables.

RESULTS

Among 259 older adults aged 60 years and older, 70.66% self-identified as having a disability. No statistically significant associations were found between the use of CHCs, the use of home health services from CHCs and satisfaction with CHCs, and disability status. However, older adults with mobility and cognitive disabilities were more likely to receive home health services from CHCs.

CONCLUSION

Community health promotion policies should be implemented to improve access to health services for older adults with and without disabilities. In addition, CHCs should implement effective health management plans to ensure the health needs of older adults with disabilities.

Impaired Activity of Daily Living Status of the Older Adults and Its Influencing Factors: A Cross-Sectional Study

This study aimed to explore the impaired activity of the daily living ability status and its influencing factors among older adults. A sample of 10,148 participants (≥60 years old) who met the requirements for the activity of daily living scale was used in this study, and the Health and Aging Tracking Survey was selected for data collection. The impaired activities of the daily living status of older adults and their influencing factors were analyzed by single-factor descriptive analysis and multi-factor logistic regression. The study results showed that the rate of impaired activities of the daily living ability of participants was 26.56%, among which the rate of mild impairment was 17.34% and severe impairment was 9.22%. Multi-factor binary logistic regression analysis results showed that demographic characteristics, lifestyle habits, and physical health status were associated with older adults' daily living activity ability. Among them, ages ≥80 years, male, habitual smoking, physical disability, and chronic diseases had a more significant impact.

Prevalence of Disability among the Chinese Older Population: A Systematic Review and Meta-Analysis

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.

Ideal Cardiovascular Health in the Oldest-Old and Centenarians and Its Association With Disability and Health-Related Quality of Life

Objective: This study aimed to investigate the distribution of ideal cardiovascular health (ICH) indicators among the oldest-old and centenarians and explore their relationships with disability and health-related quality of life of this population.

Methods: One thousand two centenarians from China Hainan Centenarian Cohort Study and 798 oldest-old from the China Hainan Oldest-old Cohort study were the target subjects in this analysis. ICH status, disability, and health-related quality of life of study subjects were assessed.

Findings: The median value of ICH indicators among centenarians and the oldest-old is 4 (4–5) and 3 (3–5), respectively. The ICH indicators with the highest percentage of ideal level/status are fasting plasm glucose (FPG) (90.2% of study subjects are at the ideal level), BMI (89.8% of study subjects are at the ideal level), and smoking (89.4% of study subjects are at the ideal status). The disability rates of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) decrease with the increasing number of ICH indicators. The EQ VAS and EQ-5D score show an increasing trend along with the increasing number of ICH indicators (p < 0.05). After adjusting related covariates, the risk of disability and lower health-related quality of life decreased gradually as the number of ICH metrics increased (p < 0.05).

Interpretation: The ICH metrics of centenarians and oldest-old were at a relatively good level, and there was a strong and independent relationship between the number of ICH indicators and disability as well as the lower health-related quality of life.

The association between nutritional status and functional limitations among centenarians: a cross-sectional study

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.

Needs Assessment Survey for a Food Safety Education through We-Media: A Cross-Sectional Survey among Junior Students of an Education and a Medical University in Chongqing, China

Many studies on food safety cognition and practice intervention among university students exist, but only few conduct needs assessment surveys. In recent years, We-media has been applied in the field of health education and promotion, but its application in food safety intervention is limited at home and abroad. This study aimed to explore the current situation of We-media use and assess the needs for food safety information through We-media among junior students of an education and a medical university. A cross-sectional survey was conducted among junior students of an education and a medical university in Chongqing, China in 2016. A total of 1,250 education students and 1,434 medical students participated in the questionnaire survey. Findings revealed that 71.4% and 64.8% of the education and medical students were willing to accept food safety educational information by We-media, respectively. In addition, 47.6% and 48.8% of the education and medical students were willing to accept food safety information through WeChat official accounts, respectively. Among the education students, 83.8%, 63.9%, 59.6%, and 13.0% wanted to acquire food safety knowledge by picture, text, video, and voice, respectively. Of the medical students, 84.7%, 67.7%, 62.3%, and 11.9% wanted to acquire food safety knowledge by picture, text, video, and voice, respectively. Gender, school category, and whether food safety information is given attention were the influencing factors of participants' willingness to accept such information through We-media (p<0.05). This study indicated that We-media could be an appropriate intervention approach for the junior students of an education and a medical university to accept food safety intervention. WeChat was also revealed as the best platform. Pictures, text messages, and videos were observed the most popular means for students to acquire food safety knowledge.

Biometric indicators can be early signs of declines in activities of daily living functioning among the Indonesian elderly

BACKGROUND

Signs associated with the onset of disability can be useful in disability projection and have significant implications in elderly care policy.

OBJECTIVE

To explored the associations between biometric screening indicators and declines in activities of daily life (ADLs) functioning among the Indonesian elderly.

METHODS

This is a prospective longitudinal cohort study. The Indonesian Family Life Survey (IFLS) 4 conducted in 2007-2008, and IFLS 5 conducted in 2014-2015 were used to assess the association between biometric indicators and ADLs at baseline and follow-up.

RESULTS

Findings revealed that 22.3% of participants surveyed in 2007-2014 had become disabled in terms of ADLs. Anemia status, stage 2 hypertension, lung capacity, and a longer sit-to-stand time were associated with ADLs.

CONCLUSION

These findings are important to help early detection and potentially help the prevention of ADLs in elderly people in the future. Accuracy of disability estimation could possibly be improved if including biometric parameters.

Heart Rate Variability and Exceptional Longevity

Centenarians are the paradigm of human extreme longevity and healthy aging, because they have postponed, if not avoided, mayor age-related diseases. The purpose of this study was to investigate potential differences in resting heart rate variability (HRV) between young adults, octogenarians, and centenarians and assess whether HRV variables are predictors of all-cause mortality in centenarians. To this end, three groups of participants: young adults (N = 20; 20.6 ± 2.3 years), octogenarians (N = 18; 84.1 ± 2.6 years), and centenarians (N = 17; 101.9 ± 1.9 years) were monitored for 15 min at rest (seated, without moving or talking) to measure RR intervals, from which HRV was evaluated. Our results showed a clear decrease with age in the main parasympathetic HRV variables, as well as in the standard deviation (SD) of the RR series [SD of normal-to-normal interval (SDNN)] and in low frequency (LF) heart rate (HR) oscillations, although differences between octogenarians and centenarians did not reach statistical significance. In 14 centenarians followed until death, only SDNN showed significant correlation (ρ = 0.536; p = 0.048) with survival prognosis. Additionally, SDNN <19 ms was associated with early mortality (≤1 year) in centenarians (Hazard Ratio = 5.72). In conclusion, HRV indices reflecting parasympathetic outflow as well as SDNN and LF all present an age-related reduction, which could be representative of a natural exhaustion of allostatic systems related to age. Moreover, low SDNN values (<19 ms) could be associated with early mortality in centenarians. HRV seems to play a role in exceptional longevity, which could be accounted for by centenarians' exposome.

Third follow-up of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) cohort investigating determinants of cognitive, physical, and psychosocial wellbeing among the oldest old: the CAIDE85+ study protocol

BACKGROUND

The oldest old is the fastest growing age group worldwide and the most prone to severe disability, especially in relation to loss of cognitive function. Improving our understanding of the predictors of cognitive, physical and psychosocial wellbeing among the oldest old can result in substantial benefits for the individuals and for the society as a whole. The Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study investigated risk factors and determinants of cognitive impairment in a population-based longitudinal cohort, which was first examined between 1972 and 1992, when individuals were in their midlife, and re-assessed in 1998 and 2005-2009. Most of the study participants are currently aged 85 years or older. We aim to re-examine the cohort's survivors and gain further insights on the mechanisms underlying both cognitive and overall healthy ageing at old age.

METHODS

CAIDE85+ is the third follow-up of the CAIDE study participants. All individuals still alive and living in the Kuopio and Joensuu areas of Eastern Finland, from the original CAIDE cohort (two random samples, N = 2000 + ~ 900), will be invited to a re-examination. The assessment includes self-reported data related to basic demographics and lifestyle, as well as psychosocial and physical health status. Cognitive and physical evaluations are also conducted. Blood biomarkers relevant for dementia and ageing are assessed. Primary outcomes are the measurements related to cognition and daily life functioning (CERAD, Trail Making Test-A, Letter-Digit Substitution Test, Clinical Dementia Rating and Activities of Daily Living). Secondary endpoints of the study are outcomes related to physical health status, psychosocial wellbeing, as well as age-related health indicators.

DISCUSSION

Through a follow-up of more than 40 years, CAIDE85+ will provide invaluable information on the risk and protective factors that contribute to cognitive and physical health, as well as ageing and longevity.

STUDY REGISTRATION

The present study protocol has been registered at https://clinicaltrials.gov/ (registration nr NCT03938727 , date 03.05.2019).

Higher Normal Levels of Triglyceride and Low and High-Density Lipoprotein Cholesterol Might Have a Protective Effect Against Activities of Daily Living Disability Within Chinese Female Centenarians: A Cross-Sectional, Complete Sample Study

Background and Objective

Activities of daily living (ADL) disability seriously affects the quality of life in the elderly. This study aims to examine the prevalence of ADL disability and its possible correlation with lipid profile indicators (LDL-C, TG and HDL-C) among female centenarians in Hainan, China.

Methods

A cross-section of complete sample study including 822 female centenarians was conducted from the China Hainan Centenarians Cohort Study (CHCCS) from June 2014 to December 2016. Barthel index was used to estimate ADL disability and multivariate logistic regression model was used to explore the relationship between lipid profile indicator and ADL disability.

Results

A total of 822 female centenarians were recruited in Hainan province, and the median age was 102 (IQR: 101–104) years, and 244 (29.7%) centenarians had ADL disability. After adjustment, 1 mmol/L increment in LDL-C, TG and HDL-C were associated with 26.4% (aOR=0.736, 95% CI:0.592–0.915), 29.8% (aOR=0.702, 95% CI:0.521–0.948) and 60.5% (aOR=0.395, 95% CI:0.257–0.610) decline in ADL disability of female centenarian, respectively. The prevalence of ADL disability showed downward trend with the increase of the quintile of LDL-C, TG and HDL-C (P_trend<0.05). Increment of HDL-C levels had the strongest protective effect against ADL disability.

Conclusion

We concluded that a new possible association of higher normal lipid profile indicators, especially HDL-C, might have a protective effect on ADL disability among female centenarians.

Association of Anemia with Activities of Daily Living in Chinese Female Centenarian

OBJECTIVES

Although anemia and activities of daily living (ADL) disability in female elderly are common conditions and are more likely to occur as people age, little is known about the association of anemia with ADL in female centenarians. The objective of this study was to examine the relationship between anemia and ADL disability in Chinese female centenarians.

DESIGN, SETTING AND PARTICIPANTS

We conducted a population-based cross-sectional study of a sample of 822 Chinese female centenarians from 2014 to 2016.

MEASUREMENTS

Blood analysis, home interview, and physical examination were performed following standard procedures. ADL disability was defined as a Barthel Index total score≤60.

RESULTS

The prevalence of anemia and ADL disability were 66.8% and 29.7% respectively in Chinese female centenarians. Multiple logistic regression analyses revealed that inflammation (OR = 2.280, 95% CI, 1.524-3.410), underweight (OR = 1.653, 95% CI, 1.186-2.303), anemia (OR = 1.775, 95% CI, 1.250-2.521), and living with family (OR = 0.518, 95% CI, 0.302-0.888) were significant factors related to ADL disability. Centenarians with severe anemia had an approximately fourfold greater likelihood of ADL disability than those without anemia (OR =3.747; 95% CI 1.525-9.206). An apparent dose-response relationship was found between anemia and ADL disability.

CONCLUSION

These findings may provide some insights into targeted intervention for maintaining ADL independence in female centenarians, especially encouraging the interventions of anemia to improve ADL.

A more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, China

Background

No previous study has evaluated disability in older persons according to the International Classification of Functioning, Disability and Health Framework guidelines. We conducted a more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, a city in the central Guangdong Province of Southern China.

Methods

A total of 819 individuals aged ≥60 years were recruited from Dongguan home-based care system of via a two-stage selection process. We interviewed participants and assessed their ability level using the Ability Assessment for Older Adults, which defined by a combination of activity of daily living, sensory perception, mental status and social involvement. Conditional probability and Logistic regression approaches were used to assess the strength of association between each pair of conditions. Factors significantly associated with disability were identified via χ² tests and multinomial ordinal logistic regression.

Results

Of the 819 included participants (mean age 87 ±4.7 years), 75.5% were female, 76.7% had any disability, and 62.3% had a mild disability. The occurrence of any deficits significantly increased the likelihood of the co-occurrence of other deficits (odds ratio [OR] > 1, P < 0.05), with the lowest prevalence odds ratio observed among individuals with sensory and communication deficiency (OR: 2.99; 95% confidence interval [CI]: 2.21–4.05). Multivariable ordinal logistic regression analysis indicated that physical activity (OR: 0.96; 95% CI: 0.93–0.99), sedentary behavior (OR: 1.25; 95% CI: 1.13–1.38), not watching television (OR: 1.7; 95% CI: 1.07–2.72) and age (OR: 1.09; 95% CI: 1.02–1.17) were significantly associated with disability.

Conclusions

Impairment of ADL, sensory perception, mental status or social involvement increased the likelihood of risk of the co-occurrence of other deficits. Comprehensive disability among older adults receiving home-based care is associated with age, sedentariness, physical activity and TV viewing.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0852-x) contains supplementary material, which is available to authorized users.