Purpose:To compare self-reported diabetes treatments among Chinese urban residents,rural migrants in urban settings,and rural residents.Methods:Data from 993 diabetics at least 45 years of age were collected from the ...Purpose:To compare self-reported diabetes treatments among Chinese urban residents,rural migrants in urban settings,and rural residents.Methods:Data from 993 diabetics at least 45 years of age were collected from the China Health and Retirement Longitudinal Study conducted in 2011.Multiple logistic regressions were performed to examine the associations between individual characteristics and diabetes treatments.Results:In total,719/993(72.4%)of the respondents received treatment for diabetes;of which<8% used insulin therapy.Urban residents were more likely than rural residents to use insulin therapy[odds ratio(OR)=0.44,confidence interval(CI):0.20-0.99;p<0.05],and more likely to use traditional Chinese medicine than migrants(OR=0.30,CI:0.10-0.96;p<0.05).Overall,rural residents showed lower treatment rates than urban and migrant populations.Conclusion:Efforts to improve and enhance diabetes treatments,particularly among rural residents,are urgently needed in China.展开更多
Objective We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.Methods Adults≥65 years old(n=1,973)were interviewed at baseline in 2018 and 1,459 we...Objective We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.Methods Adults≥65 years old(n=1,973)were interviewed at baseline in 2018 and 1,459 were followed up in 2021.General and abdominal obesity were assessed,and serum C-reactive protein(CRP)levels were measured at baseline.Depression status was assessed at baseline and at follow-up.Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms,as well as the relationship between obesity and CRP levels.The associations of CRP levels with the geriatric depression scale,as well as with its three dimensions,were investigated using multiple linear regressions.Results General obesity was associated with worsening depression symptoms and incident depression,with an odds ratio(OR)[95%confidence interval(CI)]of 1.53(1.13-2.12)and 1.80(1.23-2.63),especially among old male subjects,with OR(95%CI)of 2.12(1.25-3.58)and 2.24(1.22-4.11),respectively;however,no significant relationship was observed between abdominal obesity and depression.In addition,general obesity was associated with high levels of CRP,with OR(95%CI)of 2.58(1.75-3.81),especially in subjects free of depression at baseline,with OR(95%CI)of 3.15(1.97-5.04),and CRP levels were positively correlated with a score of specific dimension(life satisfaction)of depression,P<0.05.Conclusion General obesity,rather than abdominal obesity,was associated with worsening depressive symptoms and incident depression,which can be partly explained by the systemic inflammatory response,and the impact of obesity on depression should be taken more seriously in the older male population.展开更多
Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. ...Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.展开更多
Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing sta...Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.展开更多
Background： Prevalence of atrial fibrillation （AF） is increasing as the world ages. AF is associated with higher risk of mortality and disease, including stroke, hypertension, heart failure, and dementia. Prevalenc...Background： Prevalence of atrial fibrillation （AF） is increasing as the world ages. AF is associated with higher risk of mortality and disease, including stroke, hypertension, heart failure, and dementia. Prevalence of AF differs with each population studied, and research on non-Western populations and the oldest old is scarce. Methods： We used data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey, a community-based study in eight longevity areas in China, to estimate AF prevalence in an elderly Chinese population （n = 1418, mean age = 85.6 years） and to identify risk factors. We determined the presence olAF in our participants using single-lead electrocardiograms. The weighted prevalence olAF was estimated in subjects stratified according to age groups （65-74, 75 84, 85-94, 95 years and above） and gender. We used logistic regressions to determine the potential risk factors of AF. Results： The overall prevalence of AF was 3.5%; 2.4% of men and 4.5% of women had AF （P 〈 0.05）. AF was associated with weight extremes of being underweight or overweight/obese. Finally, advanced age （85 94 years）, history of stroke or heart disease, low high-density lipoprotein levels, low triglyceride levels, and lack of regular physical activity were associated with AF. Conclusions： In urban elderly AF prevalence increased with age （P 〈 0.05）, and in rural elderly, women had higher AF prevalence （P 〈 0.05）. Further exploration of population-specific risk factors is needed to address the AF epidemic.展开更多
We aimed to report real-world longitudinal ambient air pollutants levels compared to WHO Air Quality Guidelines(AQG)and analyze multiple air pollutants’joint effect on longevity,and the modification and confounding f...We aimed to report real-world longitudinal ambient air pollutants levels compared to WHO Air Quality Guidelines(AQG)and analyze multiple air pollutants’joint effect on longevity,and the modification and confounding from the climate and urbanization with a focus on the oldest-old.This study included 13,207 old participants with 73.3%aged 80 and beyond,followed up from 2008 to 2018 in 23 Chinese provinces.We used the Cox-proportional hazards model and quantile-based g-computation model to measure separate and joint effects of the multiple pollutants.We adjusted for climate and area economic factors based on a directed acyclic graph.In 2018,no participants met the WHO AQG for PM_(2.5) and O_(3),and about one-third met the AQG for NO_(2).The hazard ratio(HR)for mortality was 1.07(95%confidence interval-CI:1.05,1.09)per decile increase in all three pollutants,with PM_(2.5) being the dominant contributor according to the quantile-based g-computation model.In the three-pollutant model,the HRs(95%CI)for PM_(2.5) and NO_(2) were 1.27(1.25,1.3)and 1.08(1.05,1.12)per 10μg/m3 increase,respectively.The oldest-old experienced a much lower mortality risk from air pollution compared to the young-old.The mortality risk of PM_(2.5) was higher in areas with higher annual average temperatures.The adjustment of road density considerably intensified the association between NO_(2) and mortality.The ambient PM_(2.5) and O_(3) levels in China exceeded the WHO AQG target substantially.Multiple pollutants coexposure,confounding,and modification of the district economic and climate factors should not be ignored in the association between air pollution and mortality.展开更多
This article presents analyses on dynamics of family households and elderly living arrangements in China mainly based on the micro data of 2010,2000 and 1990 censuses.We demonstrate and discuss the trends and rural-ur...This article presents analyses on dynamics of family households and elderly living arrangements in China mainly based on the micro data of 2010,2000 and 1990 censuses.We demonstrate and discuss the trends and rural-urban differentials of largely declined household size,quickly increasing one-person and one-couple-only households,substantially increased proportions of elderly living alone or with spouse only.It is strikingly interesting that proportion of three-generation family households increased by 18.9%in rural area but decreased by 23.7%in urban areas in 2010 compared to 1990,due to rural-urban differences in demographic effects of large fertility decline and socioeconomic/attitude changes.We also present and discuss two interesting demographic phenomenon which were relatively overlooked in the literature.First,increase in number of households is much larger than population growth,due to shrinking of the household size and decomposition of larger families into smaller ones,and very much slowed-down population growth.Second,increases in numbers of elderly(especially oldest-old)who live alone or with spouse only are dramatically larger than the increase in the corresponding proportions,due to the effects of rapid population aging,while later and larger birth cohorts become old.Such trends have important implications for the analyses on the current and future market demands of the products and services,of which households are the consumption units.We recommend that the studies on home-based energy use and sustainable development should be based on analyses of family household dynamics rather than population growth.展开更多
文摘Purpose:To compare self-reported diabetes treatments among Chinese urban residents,rural migrants in urban settings,and rural residents.Methods:Data from 993 diabetics at least 45 years of age were collected from the China Health and Retirement Longitudinal Study conducted in 2011.Multiple logistic regressions were performed to examine the associations between individual characteristics and diabetes treatments.Results:In total,719/993(72.4%)of the respondents received treatment for diabetes;of which<8% used insulin therapy.Urban residents were more likely than rural residents to use insulin therapy[odds ratio(OR)=0.44,confidence interval(CI):0.20-0.99;p<0.05],and more likely to use traditional Chinese medicine than migrants(OR=0.30,CI:0.10-0.96;p<0.05).Overall,rural residents showed lower treatment rates than urban and migrant populations.Conclusion:Efforts to improve and enhance diabetes treatments,particularly among rural residents,are urgently needed in China.
基金supported by the National Key R&D Program of China[2020 YFC2003000]。
文摘Objective We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.Methods Adults≥65 years old(n=1,973)were interviewed at baseline in 2018 and 1,459 were followed up in 2021.General and abdominal obesity were assessed,and serum C-reactive protein(CRP)levels were measured at baseline.Depression status was assessed at baseline and at follow-up.Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms,as well as the relationship between obesity and CRP levels.The associations of CRP levels with the geriatric depression scale,as well as with its three dimensions,were investigated using multiple linear regressions.Results General obesity was associated with worsening depression symptoms and incident depression,with an odds ratio(OR)[95%confidence interval(CI)]of 1.53(1.13-2.12)and 1.80(1.23-2.63),especially among old male subjects,with OR(95%CI)of 2.12(1.25-3.58)and 2.24(1.22-4.11),respectively;however,no significant relationship was observed between abdominal obesity and depression.In addition,general obesity was associated with high levels of CRP,with OR(95%CI)of 2.58(1.75-3.81),especially in subjects free of depression at baseline,with OR(95%CI)of 3.15(1.97-5.04),and CRP levels were positively correlated with a score of specific dimension(life satisfaction)of depression,P<0.05.Conclusion General obesity,rather than abdominal obesity,was associated with worsening depressive symptoms and incident depression,which can be partly explained by the systemic inflammatory response,and the impact of obesity on depression should be taken more seriously in the older male population.
基金supported by National Natural Science Founda on of China (70533010)NIH grant # 5R24 TW 007988the Fogarty Interna onal Clinical Research Scholars Support Center at Vanderbilt-AAMC
文摘Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.
基金Partial support for this project was provided by Grant#66636 from the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative program(Interdisciplinary Mobility Team Approach to Reduction of Facility-Acquired Pressure Ulcers)Tracey L.Yap(PI).Trial Registration:clinicaltrials.gov Identifier:NCT01008254+1 种基金Partial support was also provided by the National Institute for Occupational Safety and Health Pilot Research Project Training Program of the University of Cincinnati Education and Research Center Grant No.T42/H008432-06Susan Kennerly&Tracey Yap(co-PI’s).
文摘Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.
文摘Background： Prevalence of atrial fibrillation （AF） is increasing as the world ages. AF is associated with higher risk of mortality and disease, including stroke, hypertension, heart failure, and dementia. Prevalence of AF differs with each population studied, and research on non-Western populations and the oldest old is scarce. Methods： We used data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey, a community-based study in eight longevity areas in China, to estimate AF prevalence in an elderly Chinese population （n = 1418, mean age = 85.6 years） and to identify risk factors. We determined the presence olAF in our participants using single-lead electrocardiograms. The weighted prevalence olAF was estimated in subjects stratified according to age groups （65-74, 75 84, 85-94, 95 years and above） and gender. We used logistic regressions to determine the potential risk factors of AF. Results： The overall prevalence of AF was 3.5%; 2.4% of men and 4.5% of women had AF （P 〈 0.05）. AF was associated with weight extremes of being underweight or overweight/obese. Finally, advanced age （85 94 years）, history of stroke or heart disease, low high-density lipoprotein levels, low triglyceride levels, and lack of regular physical activity were associated with AF. Conclusions： In urban elderly AF prevalence increased with age （P 〈 0.05）, and in rural elderly, women had higher AF prevalence （P 〈 0.05）. Further exploration of population-specific risk factors is needed to address the AF epidemic.
基金supported by the National Key R&D Program of China (2018YFC2000400 to Y.Z.)National Natural Sciences Foundation of China (72061137004,71490732 to Y.Z.)+4 种基金the U.S.National Institute of Aging of National Institute of Health (P01AG031719 to Y.Z.)supported by the National Natural Sciences Foundation of China (82250610230 to J.J.S.)Natural Science Foundation of Beijing (IS23105 to J.J.S.)Tsinghua University Vanke School of Public Health Research Grant (2021PY001 to J.J.S.)Tsinghua University Initiative Scientific Research Program (20233080015 to J.J.S.).
文摘We aimed to report real-world longitudinal ambient air pollutants levels compared to WHO Air Quality Guidelines(AQG)and analyze multiple air pollutants’joint effect on longevity,and the modification and confounding from the climate and urbanization with a focus on the oldest-old.This study included 13,207 old participants with 73.3%aged 80 and beyond,followed up from 2008 to 2018 in 23 Chinese provinces.We used the Cox-proportional hazards model and quantile-based g-computation model to measure separate and joint effects of the multiple pollutants.We adjusted for climate and area economic factors based on a directed acyclic graph.In 2018,no participants met the WHO AQG for PM_(2.5) and O_(3),and about one-third met the AQG for NO_(2).The hazard ratio(HR)for mortality was 1.07(95%confidence interval-CI:1.05,1.09)per decile increase in all three pollutants,with PM_(2.5) being the dominant contributor according to the quantile-based g-computation model.In the three-pollutant model,the HRs(95%CI)for PM_(2.5) and NO_(2) were 1.27(1.25,1.3)and 1.08(1.05,1.12)per 10μg/m3 increase,respectively.The oldest-old experienced a much lower mortality risk from air pollution compared to the young-old.The mortality risk of PM_(2.5) was higher in areas with higher annual average temperatures.The adjustment of road density considerably intensified the association between NO_(2) and mortality.The ambient PM_(2.5) and O_(3) levels in China exceeded the WHO AQG target substantially.Multiple pollutants coexposure,confounding,and modification of the district economic and climate factors should not be ignored in the association between air pollution and mortality.
基金supported by National Natural Sciences Foundation of China(71490732).
文摘This article presents analyses on dynamics of family households and elderly living arrangements in China mainly based on the micro data of 2010,2000 and 1990 censuses.We demonstrate and discuss the trends and rural-urban differentials of largely declined household size,quickly increasing one-person and one-couple-only households,substantially increased proportions of elderly living alone or with spouse only.It is strikingly interesting that proportion of three-generation family households increased by 18.9%in rural area but decreased by 23.7%in urban areas in 2010 compared to 1990,due to rural-urban differences in demographic effects of large fertility decline and socioeconomic/attitude changes.We also present and discuss two interesting demographic phenomenon which were relatively overlooked in the literature.First,increase in number of households is much larger than population growth,due to shrinking of the household size and decomposition of larger families into smaller ones,and very much slowed-down population growth.Second,increases in numbers of elderly(especially oldest-old)who live alone or with spouse only are dramatically larger than the increase in the corresponding proportions,due to the effects of rapid population aging,while later and larger birth cohorts become old.Such trends have important implications for the analyses on the current and future market demands of the products and services,of which households are the consumption units.We recommend that the studies on home-based energy use and sustainable development should be based on analyses of family household dynamics rather than population growth.
