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Zhang C, Cui J, Li S, Shen J, Luo X, Yao Y, Shi H. Combined effects of vitamin D deficiency and systemic inflammation on all-cause mortality and cause-specific mortality in older adults. BMC Geriatr 2024; 24:122. [PMID: 38302956 PMCID: PMC10836043 DOI: 10.1186/s12877-024-04706-x] [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: 07/31/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Vitamin D deficiency and systemic inflammation share common pathological mechanisms in muscle loss, cardio-pulmonary function decline, and abnormal metabolism, which are linked to chronic conditions, senescence, and early mortality. However, their combined effect on mortality in older adults has not been well established. This study longitudinal aimed to explore the independent and combined associations of serum 25-hydroxyvitamin D [25(OH)D] and high sensitivity C-reactive protein (hs-CRP) with mortality risk in Chinese community-based older people. METHODS 3072 older adults (86.07 ± 11.87 years, 54.52% female) from the Chinese Longitudinal Healthy Longevity Survey (2012-2018) were enrolled. Baseline 25(OH)D and hs-CRP levels were collected, and survival information was recorded in the 2014 and 2018 follow-up waves. Cox proportional hazard regressions were conducted to explore the associations between 25(OH)D, hs-CRP, and mortality. Demographic characteristics, health behaviors, and chronic disease biomarkers were adjusted. RESULTS During 10,622.3 person-years of follow-up (median: 3.51 years), 1321 older adults died, including 448 deaths due to cardiovascular disease (CVD). Increased mortality risk was associated with lower 25(OH)D and higher hs-CRP quantiles, even after adjusting for each other and multiple covariates (all P-trend < 0.05). In combined analyses, the highest all-cause mortality (HR: 2.18, 95% CI: 1.73 ~ 2.56), CVD mortality (HR: 2.30, 95% CI: 1.64 ~ 3.21), and non-CVD mortality (HR: 2.19, 95% CI: 1.79 ~ 2.49) were obtained in participants with both 25(OH)D deficiency (< 50 nmol/L) and high hs-CRP (≥ 3.0 mg/L), respectively. We observed significant additive interactions of 25(OH)D and hs-CRP on all-cause mortality and non-CVD mortality (RERIS>0). CONCLUSIONS Low 25(OH)D and high hs-CRP, both independently and jointly, increase mortality risk in Chinese community-dwelling older adults. Thus, priority should be given to early detection and appropriate intervention in older individuals with combined vitamin D deficiency and systemic inflammation. Molecular mechanisms of related adverse health effect are worthy of further investigation.
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Affiliation(s)
- Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Ju Cui
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Shaojie Li
- China Center for Health Development Studies, National School of Development, Peking University, Haidian District, 100191, Beijing, China
| | - Ji Shen
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dongcheng District, 100730, Beijing, China
| | - Xuanmei Luo
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Yao Yao
- China Center for Health Development Studies, National School of Development, Peking University, Haidian District, 100191, Beijing, China.
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dongcheng District, 100730, Beijing, China.
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Zhang Y, Sun L. The health status, social support, and subjective well-being of older individuals: evidence from the Chinese General Social Survey. Front Public Health 2024; 12:1312841. [PMID: 38333739 PMCID: PMC10850324 DOI: 10.3389/fpubh.2024.1312841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/05/2024] [Indexed: 02/10/2024] Open
Abstract
Objectives This study aims to investigate the impact of health status and social support on the subjective well-being of older individuals. Methods Using data from the China General Social Survey 2017, this research analyzed 5,187 Chinese citizens aged 60 years and older. The predicted effect of each variable on subjective well-being was evaluated through hierarchical regression analysis. The direct and indirect effects of social support and health status on subjective well-being are examined based on a structural equation model. Results The mental health and social support positively impact subjective well-being. Mental health mediates the effect of physical health on subjective well-being, and social support mediates the relationship between physical and mental health and subjective well-being. Conclusion The findings provide strong evidence for the interrelationship mechanisms among the factors influencing subjective well-being. Consequently, improving mental health services and social support systems is advantageous for enhancing the well-being of Chinese seniors.
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Affiliation(s)
- Yuchen Zhang
- Department of Sociology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Longyu Sun
- School of Foreign Languages, Shandong Jianzhu University, Jinan, China
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Lim ST, Kwak HB, Kang JH, Chang E, Joa KL, Park HJ, Park DH. Effects of physical activity participation on cognitive impairment in older adults population with disabilities. Front Public Health 2024; 12:1293023. [PMID: 38327569 PMCID: PMC10847270 DOI: 10.3389/fpubh.2024.1293023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Background Existing research on the association between cognitive function and physical activity in the older adults population with disabilities is limited. Additionally, there is a need to explore avenues for enhancing the longevity and quality of life among these individuals. Objective This study aimed to investigate the independent and joint associations between cognitive function and levels of physical activity in the older adults population with disabilities. Methods A total of 315 older adults adults (men = 182, women = 133), identified with disabilities based on medical evaluation, were recruited from the first survey of the Korean Longitudinal Study of Aging (KLoSA). Participants underwent assessments for cognitive function, physical activity (PA), activities of daily living (ADLs), instrumental activities of daily living (IADLs), and grip strength. Results ADLs (p < 0.001) and IADLs (p < 0.001) scores were significantly higher in the male normal cognitive group compared to both the male and female cognitive impairment groups. In an unadjusted model, disabled older adults individuals who did not meet the recommended PA guidelines showed an increased odds ratio for cognitive dysfunction (OR = 2.29, 95% CI = 1.32-3.97). Those participating in PA at least 1 day per week also demonstrated an elevated odds ratio (OR = 1.22, 95% CI = 1.08-1.38) for cognitive dysfunction compared to those who engaged in regular PA. A negative correlation was observed between K-MMSE scores and grip strength (r = 0.448, p < 0.001). Conclusion This study provides robust evidence that disabled older adults individuals who do not meet the recommended guidelines for PA or who do not participate in PA at least once a week have an increased likelihood of cognitive impairment compared to those who are regularly active.
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Affiliation(s)
- Seung-Taek Lim
- College of General Education, Kookmin University, Seoul, Republic of Korea
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
| | - Hyo-Bum Kwak
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
| | - Ju-Hee Kang
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
- Department of Pharmacology and Research Center for Controlling Intercellular Communication, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Eunwook Chang
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
| | - Kyung-Lim Joa
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Physical and Rehabilitation Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Hee-Jung Park
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
| | - Dong-Ho Park
- Institute of Sports and Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, Republic of Korea
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Zhou L, Zhu C, Walsh CA, Zhang X. Assessing the effect of health status on multidimensional poverty among older adults: the Chinese longitudinal healthy longevity survey. Front Public Health 2023; 11:1150344. [PMID: 37475773 PMCID: PMC10355057 DOI: 10.3389/fpubh.2023.1150344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
Background This study aimed to explore the association between health status (physical, mental, and self-rated health) and multidimensional poverty (subjective and objective poverty) in older adults. Method A panel binary logit regression approach was applied to four waves of CLHLS data (2008, 2011, 2014, and 2018). In total,1,445 individuals were included after data cleaning. Results The mean values and proportion of physical, mental, and self-rated health were 5.73 (87.42%), 0.93 (93.06%), and 3.46 (86.7%), respectively, and mean values and proportion of subjective and objective poverty were 0.19 (18.51%) and 0.21(21.4%). In addition, physical, mental, and self-rated health were all found to be associated with subjective poverty among older adults (r = -0.181, r = -0.630, r = -0.321, p < 0.05), that is, the better the physical, mental, and self-rated health, the lower the probability of subjective poverty. A comparable connection between self-rated health and objective poverty also exists (r = -0.157, p < 0.05). Furthermore, medical expenditure played a mediation role in the association between the health status and poverty of older adults. Conclusion In order to effectively alleviate the poverty of older adults, strategies should be taken to improve the health level of older adults, especially the physical and mental health of high-aged older adults, and the self-rated health of middle-aged older adults. Furthermore, social security and pensions should be further developed to adequately reimburse medical expenditures.
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Affiliation(s)
- Lulin Zhou
- Department of Management, Jiangsu University, Zhenjiang, China
| | - Change Zhu
- Department of Management, Jiangsu University, Zhenjiang, China
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | | | - Xinjie Zhang
- Department of Management, Jiangsu University, Zhenjiang, China
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