Pathways of Media Contact to Health Literacy in Middle-Aged and Older People: The Chain Mediation Effect of Perceived Social Support and Self-Efficacy

Objective

To understand the status of media exposure, social support, self-efficacy, and health literacy among middle-aged and older adults in China, and explore the impact path of media exposure on the health literacy of this population, providing a reference for promoting their physical and mental health.

Methods

From July to November 2022, a multi-stage random sampling method was employed to survey 16,938 Chinese middle-aged and older adults aged 46 and above. Structural equation modeling and statistical analysis were conducted using LISREL 8.8 and Mplus 8.3 software.

Results

The average score for media exposure among Chinese middle-aged and older adults was (18.55±5.36), perceived social support was (60.68±12.51), self-efficacy was (28.76±5.40), and health literacy was (35.49±6.05). Statistical results revealed that media exposure has a positive impact on the health literacy of middle-aged and older adults, with a direct effect of 0.091 (p < 0.001). Mediation analysis showed that media exposure can affect the health literacy of this population through the independent mediating effects of perceived social support (β = 0.013, p < 0.001) and self-efficacy (β = 0.029, p < 0.001), as well as through a chain mediation effect involving perceived social support and self-efficacy (β = 0.015, p < 0.001).

Conclusion

As a pathway for health information dissemination, media exposure plays a crucial role in the intervention of health literacy among middle-aged and older adults. Perceived social support and self-efficacy not only have independent mediating effects but also significant chain mediating effects in the relationship between media exposure and health literacy among this population. Therefore, improving the health literacy of middle-aged and older people can be popularized through media and improved in a multi-path, all-round, and precise way with the help of related technologies and social forces from which media literacy can be improved.

Association between Perceived Activity Restriction Due to People's Perception of Aging and Unmet Medical Needs among Middle-Aged and Elderly People: A Population-Based Study

Background and Objectives: The older members of a population might experience unmet medical needs, despite desiring medical care due to activity limitations driven by their perception of aging. This study conducted a cross-sectional analysis of the association between perceived activity restriction (PAR) due to people's own perception of aging and unmet medical needs (UMN) in late middle-aged and older Koreans based on the Korean National Health and Nutrition Examination Survey (KNHANES). Materials and Methods: The 2016-2020 KNHANES was used to analyze a total of 2008 participants among groups aged 45 years or older by applying individual weights imposed from the raw data. The independent variable of PAR was assessed using self-reported questionnaires based on the global activity limitation indicator. Also, the dependent variable of UMN, referring to the state in which a patient's medical care or service was insufficient, inadequate, or lacking, was assessed using a single question. After excluding missing values, the data on 2008 individuals were analyzed using a chi-square test, weighted logistic regression, and a stratified analysis of gender, age, and the presence of chronic illnesses. Results: The group that experienced PAR had an OR 2.13 higher (odds ratio [OR]: 2.13; 95% confidence interval [CI]: 1.27-3.56) to present UMN than the group that did not experience PAR. Furthermore, the results of the stratified analysis indicated that, in the group of female participants with chronic illness and in the group of elderly people, experiencing PAR was associated with a higher experience of UMN. Conclusions: There was a close association between PAR and UMN. In particular, when PAR occurred in the group of female participants with chronic illness and in the group of elderly people, the incidence rate of UMN was also found to be high. This finding highlights the need for policies and institutional measures to reduce UMN within vulnerable groups with an increased risk of medical inaccessibility due to activity restriction.

The relationship between physical activity and stroke in middle-aged and elderly people after controlling demography variables, health status and lifestyle variables

The increase in the number of stroke patients in China brain has led to the decline in quality of life and the burden of family economic conditions. This study explored the relationship between stroke and physical activity (PA) in middle-aged and elderly Chinese after controlling Demography, health status and lifestyle variables, providing a new basis for the prevention and treatment of stroke in the elderly. The data is from the 2018 China Health and Retirement Longitudinal study. Five thousand seventy people over 50 years old with complete information on PA, stroke, Demography, health status and lifestyle were included in the analysis. SPSS 27.0 software was used to conduct Z test, logistic regression analysis and linear hierarchical regression analysis on the collected data. The results showed that high-level physical exercise was significantly negatively correlated with stroke (P < .05). After adjusting Demographics characteristics (gender, registered residence type, education level, age, widowhood or not), health status characteristics and living habits (arthritis, bad mood, asthma, hyperlipidemia, disability, memory disease, health self-evaluation, hypertension, smoking, depression), There was still statistical significance (P < .05) between PA and stroke. This study concludes that middle-aged and elderly people with high PA have a lower risk of stroke. In the process of preventing and improving stroke symptoms in the elderly, it is important to maintain high PA while also paying attention to health management and a healthy lifestyle.

The relationship between walking ability, self-rated health, and depressive symptoms in middle-aged and elderly people after controlling demographic, health status, and lifestyle variables

The global aging problem is very serious. With the increase of age, the risk of depression in the elderly is also increasing. It is necessary to find effective strategies to reduce the depressive symptoms of the elderly. This study investigated the relationship between depressive symptoms, walking ability, and self-evaluation health of middle-aged and elderly Chinese after controlling demographic variables, health status, and lifestyle. The data is from the China health and retirement longitudinal study database in 2018. Six thousand eight hundred thirty-five people over the age of 50 have complete information on walking ability, self-assessed health status, and depressive symptoms. SPSS 27.0 software was used to conduct Z-test, logistic regression and linear hierarchical regression analysis on the collected data. The results showed that poor walking ability and poor self-evaluation health status of middle-aged and elderly people were significantly related to depression. The study concluded that middle-aged and elderly people with good walking ability and self-rated health status had a lower risk of depression. This study can provide reference for formulating specific and effective intervention measures for senile depression.

Relationships between the Physical Activity Intensity and the Medical Expenditure of Middle-Aged and Elderly People: Parsing from the CHARLS Database

There are many studies on the impact of physical activity on health but few studies on the relationship between physical activity and medical expenditure among the elderly. Based on the China Health and Retirement Longitudinal Survey (CHARLS) database and selected 4456 valid samples, this paper used a two-part model to analyze the effects of high, moderate, and low physical activity intensity on medical expenditure. It is found that the intensity of physical activity was negatively correlated with medical expenditure, and the medical expenditure of the high physical activity intensity group was significantly lower than that of the low physical activity intensity group. For example, compared to people with no physical activity, the total medical expenditure decreased by 22.4%, 40.4%, and 62.5% per week in those with low, moderate, and high physical activity intensity. Thus, the government should provide more places for the elderly to exercise, planning special exercise areas for the elderly in community playgrounds, such as a dancing square, which will also help the elderly to increase their amount of exercise per week and develop a daily exercise habit.

Cross-sectional study of depression tendency and sleep quality in 1352 people practicing Tai Chi

This cross-sectional study aimed to analyse the relationship between Tai Chi exercise habits and depression tendency and sleep quality in people practicing Tai Chi in Chengdu, China. A total of 1352 Tai Chi practitioners aged 50-79 years old were divided into six groups according to age and gender for Tai Chi exercise habits, depression tendency and sleep quality. The frequency of weekly Tai Chi practice and duration of single Tai Chi practice have a significant positive correlation with the exercise years. For female subjects who had long-term Tai Chi exercise, depression decreased with the duration and weekly frequency of a single exercise. Tai Chi exercise habits reduced sleep disturbance scores (in the male group aged 60-69 years old, exercise years, r = -0.242, p = 0.004) and sleep duration (in the male and female group aged 70-79 years old, duration of single Tai Chi practice, r = -0.334, p = 0.035; r = -0.235, p = 0.029), suggesting that long-term Tai Chi exercise may reduce the trend of poor sleep quality due to increased ageing.

Effect of the number of unhealthy lifestyles in middle-aged and elderly people on hypertension and the first occurrence of ischemic stroke after the disease

Background

To determine the relationship between the number of controllable unhealthy lifestyles on the risk of the first occurrence of ischemic stroke after the disease in middle-aged and elderly people in the community, and to provide data support and basis for community physicians to guide hypertensive patients to control modifiable risk factors to prevent the first occurrence of ischemic stroke.

Methods

The relationship between the number of unhealthy lifestyles and the risk of hypertension was analyzed by binary logistic regression in 584 subjects using a medical record control study. A retrospective cohort study of 629 hypertensive patients was used to analyze the relationship between the number of unhealthy lifestyles and the risk of the first occurrence of ischemic stroke within 5 years of developing hypertensive disease using Cox proportional risk regression models.

Results

Logistic regression model analysis showed that taking an unhealthy lifestyle as a reference, the OR (95% CI) values of, 2, 3, 4 and 5 unhealthy lifestyle were 4.050 (2.595-6.324), 4 (2.251-7.108), 9.297 (3.81-22.686), and 16.806 (4.388-64.365), respectively. Cox Proportional risk regression model analysis showed that the risk of ischemic stroke within 5 years after developing hypertension was referenced to 5 unhealthy lifestyles, and the HR (95% CI) for 3, 2, and 1 unhealthy lifestyle were 0.134 (0.023-0.793), 0.118 (0.025-0.564), and 0.046 (0.008-0.256), respectively.

Conclusion

The number of controllable unhealthy lifestyles in middle-aged and elderly people was positively associated with the risk of hypertension and first ischemic stroke after hypertension, and there was a dose-effect relationship between them. The risk of hypertension and first ischemic stroke within 5 years after hypertension onset increased with the number of unhealthy lifestyles.

The Relationship between the Dietary Inflammatory Index (DII) and Metabolic Syndrome (MetS) in Middle-Aged and Elderly Individuals in the United States

(1) Background: With the aging demographic shift in society, there is a growing number of middle-aged and elderly individuals affected by metabolic syndrome (MetS), a risk factor contributing to all causes of mortality. Inflammation plays a crucial role in the development of MetS. This study aims to examine the correlation between MetS and pro-inflammatory diets in middle-aged and elderly individuals, utilizing the Dietary Inflammation Index (DII) as a measure. (2) Methods: Data were extracted from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) database for individuals who were 45 years of age or older. The DII was determined for each participant through 24-h dietary recall interviews. The relationship between DII and MetS was assessed using binary logistic regression analysis, and the association between DII and MetS-related indicators was further explored through generalized linear model (GLM) and quantile regression analysis. (3) Results: A total of 3843 middle-aged and elderly individuals were included in the study. After controlling for confounding factors, the highest quartile of DII was associated with a higher risk of MetS (ORQ4:Q1 = 1.339; 95% CI: 1.013, 1.769; p for trend = 0.018). The top DII quartile also increased the risk of reduced HDL-C (ORQ4:Q1 = 1.499; 95% CI: 1.005, 2.234; p for trend = 0.048) and raised FG (ORQ4:Q1 = 1.432; 95% CI: 1.095, 1.873; p for trend = 0.010) compared to the lowest DII quartile. The levels of DII were found to be positively correlated with BMI (β = 0.258, p = 0.001), FPG (β = 0.019, p = 0.049), TG (β = 2.043, p = 0.013), waistline (β = 0.580, p = 0.002), and negatively correlated with HDL-C (β = -0.672, p = 0.003). (4) Conclusions: In middle-aged and elderly individuals in the United States, a high DII score has been linked to the presence of MetS, low HDL-C, and hyperglycemia. Therefore, dietary recommendations for the middle-aged and elderly should focus on reducing the DII by choosing foods rich in antioxidants, dietary fiber, and unsaturated fatty acids.

[Dietary consumption of branched-chain amino acids among Chinese middle-aged and elderly population aged 50 and over in 2015]

OBJECTIVE

To investigate the dietary consumption of branched-chain amino acids(BCAAs)intake status of middle-aged and elderly people 50 years and older in China, and to analyze the distribution differences between different ages, genders and regions.

METHODS

The research sample was derived from the 2015 Chinese adult chronic disease and nutrition monitoring data. The survey adopts the stratified multi-stage cluster random sampling method, and selects 298 monitoring points from 31 provinces(autonomous regions and municipalities), a total of 44 218 people aged 50 years and over were sampled. Condiment weighing method, 24-hour dietary review method, and weighing method were used to obtain individual dietary data, and the dietary BCAAs intake of middle-aged and elderly people was calculated based on the Chinese Food Composition Table.

RESULTS

In 2015, the dietary BCAAs of middle-aged and elderly people in China accounted for 45.1% of leucine, 29.8% of valine and 25.1% of isoleucine. The top six dietary sources were cereals, red meat, vegetables, fish and seafood, beans and eggs. There were differences in the intake of three branched-chain amino acids(F=1926.67, P&lt;0.01), the intake of leucine was greater than that of valine, and the intake of valine was greater than isoleucine. There were statistically significant differences in dietary BCAAs intake between different age groups, genders, urban and rural areas and regions(P&lt;0.01), among which men were greater than women(t=12.89, P&lt;0.01), and the south was greater than the north(t=-6.36, P&lt;0.01), the eastern part was larger than the central part, and the central part was larger than the western part(F=82.42, P&lt;0.01). The intake of BCAAs decreased with the increase of age groups(F=22.69, P&lt;0.01), and there was no significant difference in age groups over 70 years old. The dietary intake of BCAAs was higher in the eastern coastal areas and Inner Mongolia, Xinjiang and Tibet.

CONCLUSION

There were gender, age and geographical differences in dietary BCAAs intake among middle-aged and elderly people in China, and the contribution of various foods to dietary BCAAs was also different.

Determinants of arterial elastic function in middle-aged and elderly people: A population-based cross-sectional study from a low-income population in China

Background

Arterial stiffness is closely associated with the occurrence of many cardiovascular and cerebrovascular diseases. However, the risk factors and mechanisms related to arterial stiffness development have only been partially elucidated. We aimed to describe arterial elastic function and its influencing factors in middle-aged and elderly people in rural China.

Methods

This was a cross-sectional study conducted among residents, aged ≥45 years, of Tianjin, China, between April and July 2015. Data regarding participant demographics, medical history, lifestyle, and physical examination results were collected and assessed the association with arterial elastic function using linear regression.

Results

Of the 3,519 participants, 1,457 were male (41.4%). Brachial artery distensibility (BAD) decreased by 0.5%/mmHg with every 10-year increment in age. The mean BAD value was 0.864%/mmHg lower in women than in men. With each unit increase in mean arterial pressure, the BAD decreased by 0.042%/mmHg. In patients with hypertension or diabetes, the BAD decreased by 0.726 and 0.183%/mmHg, respectively, compared with those without hypertension or diabetes. For each unit increase in triglyceride (TG) level, the mean BAD increased by 0.043%/mmHg. With each increase in body mass index (BMI) category, the BAD increased by 0.113%/mmHg. Brachial artery compliance (BAC) decreased by 0.007 ml/mmHg with each 10-year increase in age, and brachial artery resistance (BAR) increased by 30.237 dyn s^-1 cm^-5. The mean BAC in women was 0.036 ml/mmHg lower and the mean BAR was 155.231 dyn s^-1 cm^-5 higher in women than in men. In individuals with hypertension, the mean BAC decreased by 0.009 ml/mmHg and the mean BAR increased by 26.169 dyn s^-1 cm^-5. With each increase in BMI category, the mean BAC increased by 0.005 ml/mmHg and the mean BAR decreased by 31.345 dyn s^-1 cm^-5. For each unit increase in TG level, the mean BAC increased by 0.001 ml/mmHg.

Conclusion

These findings indicate that age, sex, mean arterial pressure, BMI, diabetes, hypertension, and TG level are independently associated with the components of peripheral arterial elasticity. Understanding the factors influencing arterial stiffness is important for developing interventions to minimize arterial aging and cardiovascular and cerebrovascular diseases caused by arterial aging.

The Increased Risk of Hypertension Caused by Irrational Dietary Pattern May Be Associated with Th17 Cell in the Middle-Aged and Elderly Rural Residents of Beijing City, Northern China: A 1:1 Matched Case-Control Study

An irrational diet has been widely considered as one of the vital risk factors of hypertension. Previous studies have indicated that immune dysfunction may be involved in the pathogenic process of hypertension, while fewer studies have mentioned whether CD4+ T cells are involved in the association between dietary pattern and hypertension. This present 1:1 matched case-control study was conducted to analyze the association among dietary pattern, CD4+ T cells and hypertension. A total of 56 patients with diagnosed hypertension and 56 subjects without diagnosed hypertension in the rural area of Beijing City, northern China, were matched by age and gender, and then classified into a case group and a control group, respectively. Compared with the control group, higher frequencies of pro-inflammatory CD4+ T cells, such as Th1, Th1(IFN-γ), Th17(IL-17A), and Th1/17 (IFN-γ/IL-17A), were found in the case group (p < 0.05). A significantly higher level of circulating IL-17A was also found in the case group (7.4 pg/mL vs. 8.2 pg/mL, p < 0.05). Five dietary patterns were identified using exploratory factor analysis. An irrational dietary pattern, characterized by high-factor loadings of refined wheat (0.65), meat (0.78), poultry (0.76), and alcoholic beverage (0.73), was positively associated with SBP (β = 5.38, 95%CI = 0.73~10.03, p < 0.05) in the multiple linear regression model with the adjustment of potential covariates. The other dietary patterns showed no significant association with blood pressure. Furthermore, meat, processed meat, and animal viscera were positively correlated with the peripheral Th17 or Th1/17. In conclusion, the irrational dietary pattern characterized by refined wheat, meat, poultry, and alcoholic beverage, was positively correlated with blood pressure, and may increase the risk of hypertension in the rural area of Beijing, northern China. Th17, a subset of the CD4+ T helper cells, may be involved in the association between irrational dietary pattern and hypertension.

The relationship between hypertension and physical activity in middle-aged and older adults controlling for demographic, chronic disease, and mental health variables

To explore the relationship between hypertension and physical activity (PA) in the middle-aged and elderly after controlling demographic characteristics, chronic diseases and mental health variables. The 2018 China Health and Retirement Longitudinal Study (CHARLS) was used to collect the data. A baseline survey of middle-aged and older people was carried out nationally using the PPS sample method to look into their demographic, health state, and other information. The investigation included 4593 adults over 50 with complete data on PA level and hypertension prevalence. Z-test, logistic regression analysis, and linear hierarchical regression analysis were performed on the gathered data using the SPSS 27.0 program. The prevalence of hypertension among middle-aged and senior persons was 12.2%, and the percentage of those who did not have it was 87.8%. Males were more likely than females to have hypertension. Participants who reported high levels of PA made up 49.2% of the total, while those who reported low levels of PA made up 50.8% of the total. High levels of PA were significantly inversely correlated with hypertension (P < .05). There was still a statistically significant relationship between PA and hypertension (P < .05) after controlling demographic factors (gender, age, household registration type, education level, widowhood), chronic disease (arthritis, diabetes, disability, asthma, self-assessment of health, memory disease, stroke, hyperlipidemia) and mental health variables (bad mood and depression). High-level PA is significantly related to the low risk of hypertension. After controlling demographic characteristics, chronic diseases and mental health variables, this correlation is still significant.

How Does Internet Use Improve Mental Health among Middle-Aged and Elderly People in Rural Areas in China? A Quasi-Natural Experiment Based on the China Health and Retirement Longitudinal Study (CHARLS)

One of the most significant public health issues in rural China is how to improve the mental health of middle-aged and older individuals. Using 2013, 2015, and 2018 CHARLS panel data, this paper properly examined the effects of Internet use on the mental health of middle-aged and elderly people in rural China based on the difference-in-differences method. The findings are as follows: (1) Internet use effectively improves the mental health status of middle-aged and elderly people in rural China; (2) compared to the middle-aged group, Internet use has a more obvious effect on the mental health of the elderly; (3) further analysis showed that reading news, watching videos, and playing games online could significantly improve the mental health status of middle-aged and elderly people in rural China, while chatting online and other Internet activities cannot significantly improve mental health status; and (4) playing games, watching videos, and reading news have different effects on the mental health of middle-aged and elderly people in rural China. The results indicate that playing games have a better effect on depression levels than watching videos. In contrast, watching news had the lowest effect on depression levels among middle-aged and elderly people in rural China. The results of this study also show the latest evidence that Internet use can help China's rural middle-aged and elderly populations to reduce social isolation, establish new social connections, gain social support, and, ultimately, achieve active ageing. Therefore, promoting multiple forms of interaction is an effective path to prevent loneliness, which has become the new policy direction of the government to create an age-friendly Internet environment using various measures in the future to eliminate the barriers to Internet access affecting the middle-aged and elderly in rural China.

Evaluation and influencing factors of oral health-related quality of life of middle-aged and elderly in Chengdu

OBJECTIVES

This study aimed to investigate the oral health-related quality of life of middle-aged and elderly in Chengdu and analyze the influencing factors.

METHODS

Six hundred middle-aged and elderly people in Chengdu were randomly selected, and their demographic and social characteristics, general health status, oral health behavior, and other information were investigated. The oral health-related quality of life of these individuals was evaluated using the oral health impact profile (OHIP-14).

RESULTS

The score of oral health-related quality of life was 3.91±6.67, and regression analysis results indicated that its influencing factors included income level (OR=0.387, P<0.05), chronic diseases (OR=0.665, P<0.05), oral diseases (OR=0.260, P<0.05), self-evaluation of mental health status (OR=0.338, P<0.05), brushing teeth twice a day (OR=1.846, P<0.05), smoking (OR=0.566, P<0.05), oral health awareness (OR=2.431, P<0.05), and convenience of medical treatment (OR=0.499, P<0.05).

CONCLUSIONS

Oral health-related quality of life is affected by multiple factors. Comprehensive oral intervention measures should be actively carried out to improve the oral health behavior of residents and oral health-related quality of life of middle-aged and elderly people in communities.

Relationship between Children's Intergenerational Emotional Support and Subjective Well-Being among Middle-Aged and Elderly People in China: The Mediation Role of the Sense of Social Fairness

This study explored the relations between children's intergenerational emotional support and subjective well-being (SWB) among Chinese middle-aged (45-60 years old) and elderly people (over 60 years old) and the mediation effect of the sense of social fairness between such associations. Using the 2017 Chinese General Social Survey dataset, a nationally representative survey, we selected 2413 middle-aged and elderly people who are 45 years and older, who suited the study requirements with 1097 males and 1316 females, which accounts for 45.5% and 54.5%, respectively. The average of age was 61.62 years old (SD = 10.45). The mediation analyses were conducted by multivariate regression and the SPSS macro PROCESS program. The results indicated that there was a significant association between children's intergenerational emotional support and subjective well-being of middle-aged and elderly people (β = 0.0819, p < 0.001). Children's intergenerational emotional support also had an indirect impact on subjective well-being through one path: the mediating role of the sense of social fairness (0.012). Direct effect (0.0699) and mediation effect (0.012) accounting for the total effect proportion was 85.35% and 14.65%, respectively. The findings may offer some meaningful implications for improving subjective well-being of middle-aged and elderly people. Future research should pay attention to the aforementioned factors with more detailed and comprehensive studies.

Relationship of frequency of participation in a physical checkup and physical fitness in middle-aged and elderly people: the Yakumo study

An annual physical checkup is provided as part of the long-term Yakumo study. The checkup is voluntary and there is variation in the frequency of participation. The aim of this study was to examine relationship of physical fitness with frequency of participation in this checkup. The subjects had all attended at least one annual physical checkup from 2006 to 2018. Data from 1,804 initial checkups were used for analysis. At the checkups, age, gender, height, weight, body mass index (BMI), and bone mineral density (BMD) were recorded, and physical activity was measured. The average number of physical checkups per participant for 13 years was 2.4 (1-13). Daily exercise habits were found to be significantly associated with higher participation in physical checkups. Furthermore, between groups with low (1-5 times; <90th percentile of participants) and high (≥6 times) participation, weight and BMI were significantly higher, and BMD, grip strength, 10-m gait time, back muscle strength, and two-step test were all significantly lower in the group with lower frequency of participation in the checkup. In conclusions, our results show that frequency of participation in a voluntary annual physical checkup is significantly associated with physical fitness in middle-aged and elderly people.

Effect of baduanjin on the fall and balance function in middle-aged and elderly people: A protocol for systematic review and meta-analysis

BACKGROUND

The risk of fall seriously affects the health and quality of life of the middle-aged and elderly people, especially the injury and disability caused by fall of the middle-aged and elderly people, which imposes a huge burden on family and social medical care. Baduanjin exercise may be an effective intervention to enhance the muscle strength and stability of lower limbs, improve the balance ability and gait of middle-aged and elderly people, reduce the incidence of falls, improve the quality of life, and promote the health of middle-aged and elderly people. The aim of this study is to summarize evidence and systematically review the efficacy and safety of Baduanjin on the fall and balance function in middle-aged and elderly people.

METHODS

We conducted a systematic search of English and Chinese RCTs in the following 8 electronic databases: PubMed, EMBASE, Web of Science, The Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, from their respective dates of inception to July 2021. Other resources will be searched if necessary. The primary outcome is the fall rate in middle-aged and elderly people and the secondary outcomes include the Single-Leg Standing (SLS) Test, Berg Balance Scale (BBS), Timed Up and Go (TUG) Test. The study selection, data extraction, risk of bias, data synthesis and analysis, reporting biases, and the quality of evidence will be independently conducted by 2 reviewers who use the EndNote X9 software, Cochrane handbook assessment tool, RevMan 5.3 software, a funnel plot and GRADE system.

RESULTS

This study will evaluate the effect of Baduanjin on falls and balance function of middle-aged and elderly people from multiple outcome evaluation indicators such as fall rate, and provide high-quality evidence.

CONCLUSION

This study will provide evidence for whether Baduanjin has an effect on falls and balance function in middle-aged and elderly people.

ETHICS AND DISSEMINATION

Ethics approval is not required for systematic review, since it does not infringe on personal interests. The results will be submitted to peer-review journals or disseminated at scientific conferences.

Gender-specific association between non-alcoholic fatty liver disease and type 2 diabetes mellitus among a middle-aged and elderly Chinese population: An observational study

ABSTRACT

Limited data are available regarding the association of non-alcoholic fatty liver disease (NAFLD) with the risk of type 2 diabetes mellitus (T2DM) in China. Therefore, the purpose of this study is to evaluate the gender-specific association between NAFLD and T2DM risk in a middle-aged and elderly Chinese population.This cross-sectional study was carried out in a group of 1492 Chinese adults (60.30% males) aged between 45 and 69 years old, in Hangzhou city, Zhejiang province who were attending their annual health check-up from June 2015 to December 2016 in the Medical Center for Physical Examination, Zhejiang Hospital. Face-to-face interviews were conducted using a written questionnaire. NAFLD was divided into none, mild, moderate/severe based on ultrasound examination. Logistic regression analyses were employed to determine the relationship between NAFLD and the risk of T2DM, with adjustment of potential confounding variables.Of the 1492 participants, 163 (10.92%) were diagnosed with T2DM. Educational level, smoking, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), triglycerides (TG), alanine aminotransferase (ALT), asparagine aminotransferase (AST)and the prevalence of T2DM were significantly higher in males than in females (P < .05). Besides, females had significantly higher levels of high density lipoprotein-cholesterol (HDL-C) (1.51 ± 0.37 vs 1.29 ± 0.42, P < .001) than males. Pearson bivariate correlation analysis indicated that FG was positively associated with weight, BMI, WC, WHR, SBP, DBP, TG, TC, ALT and AST in both males and females (P < .05). Besides, FG was inversely associated with HDL-C in females (P < .001). After adjusting for confounding variables, NAFLD was positively associated with the risk of T2DM, and the effect of NAFLD on T2DM was stronger in males (OR = 2.442, 95%CI: 1.003-3.757) than in females (OR = 1.814, 95%CI: 1.011-3.257).Our data showed that NAFLD was significantly associated with the risk of T2DM in middle-aged and elderly males than in females. Further prospective cohort studies are needed to determine the causal effect of NAFLD on T2DM.

[Association between sleep duration and mild cognitive impairment in people aged 55 and above in 4 provinces of China]

OBJECTIVE

To explore the association between sleep duration and mild cognitive impairment(MCI) in people aged 55 and above in 4 provinces of China.

METHODS

A stratified multi-stage cluster random sampling method was adopted. From May to August 2018 in 32 survey districts and counties in 4 provinces of Hebei, Zhejiang, Shaanxi, and Hunan, 5334 55-year-old and older persons who met the inclusion criteria were randomly selected. Among them, there were 2362 males and 2972 females, with an average age of(67. 43±7. 48) years. A questionnaire survey was conducted to collect their basic information, lifestyle, disease history, sleep duration, etc. MCI were screened based on the Montreal cognitive assessment(MoCA). Multivariate Logistic regression was used to analyze the association between sleep duration and MCI.

RESULTS

16. 76% of them slept for less than 7. 0 hours, 19. 10% of the middle-aged and elderly people slept for 9 hours or more, and 36. 24% of them were found to be MCI. After adjusted the area, age, gender, education level, work status, family monthly income per capita, smoking, drinking, physical activity, meditation time, depression, hypertension, diabetes, myocardial infarction and stroke, the result of multivariate Logistic regression analysis shown that, compared with 7. 0-7. 9 hours of sleep, the risk of MCI among middle-aged and elderly people over 55 years old with &lt;6. 0 hours and 8. 0-8. 9 hours of sleep were 1. 417 times(95%CI 1. 012-1. 984)and 1. 191 times(95%CI 1. 001-1. 418)of the former, respectively, and the differences were statistically significant(P&lt;0. 05). The risk of men suffering from MCI for sleep duration &lt;6. 0 hours was 2. 083 times(95%CI 1. 145-3. 789)that of the former, and the risk of women suffering from MCI for sleep duration ≥ 9. 0 hours was 1. 741 times(95%CI 1. 301-2. 331)that of MCI. The differences are statistically significant(P&lt;0. 05).

CONCLUSION

Shorter or longer sleep time is an important factor independently related to MCI. Insufficient sleep in men and longer sleep time in women can increase the risk of MCI.

Dietary Intake of Riboflavin and Unsaturated Fatty Acid Can Improve the Multi-Domain Cognitive Function in Middle-Aged and Elderly Populations: A 2-Year Prospective Cohort Study

Objective

This study was aimed to explore the effects of dietary nutrients on cognitive function among the middle-aged and elderly populations.

Methods

A prospective cohort study of 1,385 middle-aged and elderly people was conducted from January 2014 to December 2017. Dietary nutrients were assessed according to the food frequency questionnaire (FFQ) and China Food Composition Database (CFCD). Montreal cognitive assessment (MoCA) was used to evaluate the participants’ global cognitive function. Six other neuropsychological measures [auditory verbal learning test-immediate recall (AVLT-IR), auditory verbal learning test-short recall (AVLT-SR), auditory verbal learning test-long recall (AVLT-LR), logical memory test (LMT), digit span forward (DST-F), and digit span backward (DST-B)] were used to assess the verbal memory domain and the attention domain by principal component analysis (PCA). Multiple linear regressions were conducted to explore associations between nutrients and cognition. Sensitivity analyses were performed to confirm the results.

Results

Dietary riboflavin was protective for global cognitive function (β = 1.31, 95% CI: 0.26, 2.35) and the verbal memory domain (β = 0.37, 95% CI: 0.02, 0.71). Unsaturated fatty acid (USFA) played a protective role in global cognitive function (β = 1.15, 95% CI: 0.16, 2.14). The protective effects of riboflavin and USFA on cognitive function were consistent and reliable when different confounders were adjusted during sensitivity analyses. During the follow-up, neuropsychological measure scores revealed a reduced decline in the high-riboflavin group (d-MoCA, P = 0.025; d-AVLT-IR, P = 0.001; d-DST-B, P = 0.004; and d-composite score, P = 0.004) and the high-USFA group (d-AVLT-IR, P = 0.007; d-LMT, P = 0.032; d-DST-B, P = 0.002; and d-composite score, P = 0.008).

Conclusion

Higher intake of riboflavin and USFA can improve multi-dimensional cognitive functioning in middle-aged and elderly people. These findings were consistent in different models of sensitivity analyses.

Shoulder pain has most impact on poor quality of life among various types of musculoskeletal pain in middle-aged and elderly people: Yakumo study

Objectives: To investigate the severity and effect on quality of life (QOL) of various types of pain in healthy volunteers.Methods: A total of 384 subjects (male: 158, female: 226, average age: 63 years) were included in a prospective cohort study (Yakumo study). Shoulder pain, low back pain (LBP), sciatica, knee pain, and the American Shoulder and Elbow Surgeons (ASES) shoulder score were evaluated with SF-36.Results: The prevalence of shoulder pain, LBP, sciatica, and knee pain was 42%, 44%, 16%, and 48%, respectively, with similar severities of pain. Shoulder pain visual analogue scale (VAS) and ASES shoulder scores were significantly correlated with SF-36 domains. Subjects with poor physical QOL had significantly higher VAS scores for all pain types and a lower ASES shoulder score. Shoulder pain VAS was also significantly related to poor mental QOL. Multivariate regression analysis adjusted for age and gender showed that shoulder pain VAS (OR: 1.25, p < .05) and 10-m gait speed (OR: 1.82, p < .05) were significant independent risk factors for poor physical QOL.Conclusion: Only shoulder pain of similar severity to other pain and shoulder complaints impacted on both physical and mental QOL. The severity of shoulder pain was an independent risk factor for poor physical QOL.

[Prevalence and risk factors of low body weight among 45 years old and over residents in general rural areas in 2010-2012 in China]

OBJECTIVE

To know the prevalence of low body weight among middleaged and elderly people in general rural areas of China and investigate the influence factors.

METHODS

A total of 25 464 participants who were 45 years old and above from2010-2012 China National Nutrition and Health Surveillance as subjects to investigate the prevalence of low body weight. For 545 low body weight participants, we performed a1∶ 2 case-control study to investigate the influence factors. The content of survey included3-condecutive days-24-hour dietary recall, physical examinations, physical activity and social economic factor.

RESULTS

The prevalence of low body weight among middle-aged and elderly people was 5. 27%, 5. 52% for male and 5. 05% for female. The prevalence of low body weight increased with the age( P < 0. 01). The daily intake of energy, total proteins, high quality proteins, fat and fruits were lower in low body weight than normal body weight among middle-aged and elderly people( P < 0. 01), however, the consumption of smoking and alcohol were higher in low body weight than normal body weight( P < 0. 01). Multivariate conditional Logistic regression analysis showed that the daily intake of total proteins, vegetables and fruits were protective factors and unhealthy lifestyle such as smoking were risk factors among low body weight people.

CONCLUSION

The prevalence of low body weight at a higher level among middle-aged and elderly people in general rural areas of China. It is necessary to promote the middle-aged and elderly people to increase the consumption of high-protein foods, vegetables and fruits, quit smoking and control drinking.

Influence of sagittal balance and physical ability associated with exercise on quality of life in middle-aged and elderly people

We examined 304 persons (135 males and 169 females) who underwent a basic health checkup to evaluate the relationship of quality of life (QOL) with osteoporosis, spinal sagittal balance, spinal mobility, muscle strength, and physical ability, including daily exercise. QOL of middle-aged and elderly subjects was strongly related to sagittal balance and physical ability.

INTRODUCTION

Spinal kyphosis with compression fracture and osteoporosis decrease QOL and increase mortality. However, it is unclear if kyphosis, spinal sagittal balance, muscle strength, and physical ability influence QOL.

PURPOSE

The goal of the study was to evaluate the relationship of QOL with osteoporosis, spinal sagittal balance, spinal mobility, back muscle strength, and physical ability, including daily exercise, in middle-aged and elderly people.

METHODS

The subjects were 304 persons (135 males and 169 females) who underwent a basic health checkup. Lumbar lateral radiograph findings, sagittal balance and spinal mobility determined with SpinalMouse®, grip, back muscle strength, and 10-m gait time were evaluated.

RESULTS

SF-36 physical component summary (PCS) scores showed a significant negative correlation with age (r = -0.375), spinal inclination angle (r = -0.322), and 10-m gait time (r = -0.470), and a significant positive correlation with percent of the young adult mean of bone mineral density (r = 0.223), lumbar lordosis angle (r = 0.184), thoracic spinal range of motion (ROM; r = 0.136), lumbar spinal ROM (r = 0.130), grip strength (r = 0.211), and back muscle strength (r = 0.301). In multiple regression analysis, age (r = -0.372, p < 0.0005), spinal inclination angle (r = -0.336, p < 0.05) and 10-m gait time (r = -2.898, p < 0.0001) were significantly associated with SF-36 PCS (R(2) = 0.288). In the exercise group, SF-36 PCS scores were significantly better (p < 0.05) due to good spinal balance, thoracic spinal ROM, back muscle strength, and gait speed.

CONCLUSIONS

QOL of middle-aged and elderly subjects was related to sagittal balance and physical ability. Thus, exercises for spine, muscle, and physical ability may improve QOL in middle-aged and elderly people.