Search

Mining user data and constructing web user profiles of older adults from the perspective of elderly services is conducive to understanding their behavioral habits, needs, and usage preferences on the web, which provides more targeted elderly care services. In this paper, IGA-SOMK + + , which is a novel clustering method for constructing web user profiles of older adults, is proposed based on the China Family Panel Studies (CFPS) survey data, which include 6596 older adults aged greater than 60 years. The selected data aspects include basic information, work situation, health situation, living habits, and web use services. To describe the web user profiles of older adults, a hybrid method based on improved genetic algorithm (IGA) feature selection, self-organizing feature maps (SOM), and K-means + + is proposed. Data on older adults' web use behaviors are first processed, and IGA is used for feature selection based on the adaptive crossover and mutation probabilities. SOM is then used to determine the initial center vectors of K-means + + for further clustering, which is referred to as SOMK + + (SOM-K-means + +). The results of IGA-SOMK + + are compared with those of the state-of-the-art methods, including the K-means, mini batch K-means, Agnes, K-modes, FCM, K-means + + , SOMK + + , and IHPSO-KM. In addition, the significance and robustness of IGA-SOMK + + are analyzed. The experimental results show that the IGA feature selection reduces the influence of the redundant feature factors and improves the performance of the clustering algorithm. SOMK + + overcomes the sensitivity of K-means to initial cluster centers. Moreover, IGA-SOMK + + has the best clustering effect among the compared algorithms in terms of silhouette coefficient (SC), calinski-harabaz (CH) index, and davies-bouldin (DB) metrics. For example, it increases the SC from 0.280 to 0.629. Finally, by analyzing the results, the user group of older adults is segmented to perform the deep mining of CFPS data, which verifies the feasibility of the user profile model. This paper summarizes the basic situation of the current web access of older adults in China in terms of web use services, as well as the importance of the web in their lives and in the information channels. It also provides suggestions for the current problems of older adults in accessing the web. [ABSTRACT FROM AUTHOR]

It has been found that people with disabilities remain at the margin as far as the different aspects of their lives are concerned. This paper tests the hypothesis that disability leads to lower quality of life among older adults in low and middle-income countries. The data from the Study on Global Ageing and Adult Health (SAGE) was used in this study which was conducted in Ghana, China, India, Russia, South Africa and Mexico. The disability scores have been made utilising Item Response Theory, Partial Credit Model and are centered on eight functioning and health areas. Bivariate analysis, binary logistic regression and pooled regression analysis have been used to fulfil the objectives of the paper. The findings reveal that disability acts as a hindrance in attaining a high quality of life (HQOL) amongst the older adults in the above mentioned low and middle-income countries. The older adults with disability are as much as 60% less likely to enjoy an HQOL with respect to the older adults without disability. Better socio-economic development like improved health care for disabled older adults with disability enhanced living standards for both abled and disabled, efficient pension schemes for older adults with disability and effective social service schemes would be very much essential to improve overall QOL among older adults. [ABSTRACT FROM AUTHOR]

In the era of the digital society, information has experienced rapid development, and individuals, including the elderly, are increasingly relying on various media to access the information they require. However, there has been limited research on how media usage as a behavior influences the subjective perceptions of older adults and the motivating factors driving their use of media in the digital age. Drawing on the activity theory and knowledge-gap theory, this study aims to investigate whether media use mediates the connection between social participation and subjective well-being among older adults in China. The study also pays specific attention to potential intergroup differences, such as age-group relationships and the types of media involved. We selected a nationally representative sample comprising 938 older adults aged 60 and above from the 2021 Chinese General Social Survey and incorporated them into the mediation analysis. Structural equation modeling (SEM) with path analysis and maximum likelihood procedures was used to analyze the data. Our findings revealed a positive association between social participation and media use, as well as a positive association between media use and subjective well-being. The path analysis further demonstrated that media use mediated the relationship between social participation and subjective well-being. Specifically, social participation through media use, acting as a mediating variable, accounting for 75.3% of the influence on subjective well-being. Distinct age groups exhibited significantly varied levels of social participation, with traditional media (paper-based) playing a more substantial role in our model compared to electronic media (such as television, radio, internet, social media, and mobile applications). The results suggest that older adults with a higher frequency of social participation exhibit stronger levels of media use, and high levels of media use are associated with elevated levels of subjective well-being. The results of this study highlight the positive indirect effects of social participation, media use, and subjective well-being, emphasizing the intricate interplay between these factors among older adults in China. [ABSTRACT FROM AUTHOR]

Though a continued increase in life expectancy is a significant public health achievement, keeping older adults active and maintaining their well-being is challenging. Active aging requires physical health, mental health, functional independence, economic stability, social participation, and spiritual identification. Among all these factors, social cohesion has significant importance, but there is a dearth of studies focusing on older adults' social cohesion. Thus, the present study focuses on the level of social cohesion among older adults and its variation among the different economic classes. This article uses data from the Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa during 2007–10. Social cohesion scores have been constructed using Item Response Theory Partial Credit Model. Also, bivariate analysis, concentration curves, concentration indices, and multivariate regressions have been used for the analysis presented in this paper. This study confirms the strong predictive power of age, wealth, education, and working status of older adults on their social cohesion across the countries. Higher social non-cohesion is found among the economically poor older adults in Mexico, Russia, India, and China. In contrast, it is just opposite in the case of older adults in South Africa. Governments should develop policies to foster a society with a high level of social inclusion, social capital, and social diversity, to achieve further advancement in social cohesion. [ABSTRACT FROM AUTHOR]

As a prevalent chronic disease later in life, hypertension affects physical health in older adults. In this paper, we investigated whether an integrated health care intervention improved health-related quality of life (HRQoL) and well-being among older patients with hypertension in rural China. An intervention focused on older patients with hypertension (395 participants in the intervention group and 394 in the control group) was implemented. In the intervention townships, the health care professionals from all three levels of health care institution work as a team and receive skills training and regular meeting, etc. Patients in the intervention group received health education and periodical follow-up interviews, etc. Patients' data including the blood presure, HRQoL and sociodemographic characteristics were collected at baseline (2016) and follow-up (2017). Symptom control and patient's compliance with healthy lifestyle were self-reported by participants using questionnaires. After the intervention, a decrease was observed in the number of patients reporting problems, such as anxiety or depression. About 31.4% of patients in the intervention group perceived that they had greater control over their physical conditions during the study. Although patients' health awareness and knowledge improved, their rate of compliance with a healthy lifestyle was low. [ABSTRACT FROM AUTHOR]

Chronic diseases are associated with depressive symptoms in older adults. However, the mechanism of this relation is not clear. In this study, we explored the mediating role of instrumental activities of daily living and the moderating role of area of residence in the relationship between chronic diseases and depression. The data was from the Chinese Longitudinal Healthy Longevity Study. Results showed that chronic diseases were positively correlated with depression, and negatively associated with instrumental activities of daily living (IADLs). Moreover, IADLs mediated the relationship between chronic diseases and depression. In addition, area of residence (rural/urban) moderated the relation between IADLs and depression, such that this negative relation was stronger for old adults lived in rural area than for urban area. These results have important significance for prevention and intervention of depression in the elderly. [ABSTRACT FROM AUTHOR]

Research has explored age-related and cultural differences in moral evaluations of dishonesty; however, this has not yet been examined in an aging context. The present study provided a novel account of how younger and older adults (in Canada, Singapore, and China; N = 401) morally evaluate adults' truths and lies in antisocial, modesty, and politeness settings. Participants completed a questionnaire assessing how acceptable it is for adults to tell the truth or a lie in given social scenarios, and they reported on their levels of collectivism and individualism. In all countries, older adults provided more favorable evaluations to blunt and immodest truths than younger adults did. Compared with younger adults, older adults provided harsher evaluations to Polite Lies (in Canada and China) and Modesty Lies (in Canada and Singapore). Thus, there may be an age-related increase in the acceptability of direct honesty over good-intentioned lies, and this age effect is somewhat stable across cultures. Older adults were also more lenient in evaluations of an antisocial lie to conceal an affair compared to younger adults. Overall, adults in China tended to rate lies less negatively, and their greater levels of collectivism mediated their greater approval of polite lies. The present results demonstrate that evaluations of (dis)honesty differ as a function of age and culture and these results can assist in developing a more complete lifespan model of the morality of dishonesty. [ABSTRACT FROM AUTHOR]

The Interview Schedule for Social Interaction (ISSI) is a measurement widely used to evaluate social support. Based on the two dimensions (the availability of attachment and the availability of social integration) of ISSI, the Structural-Functional Social Support Scale (SFSSS) is used to assess the availability of social support, which consists of structural and functional social support dimensions. However, the factor structure, reliability, and validity of this scale have not been tested. This study examined the psychometric properties of SFSSS in a sample of 1,631 Chinese older adults. In Study 1 (n = 306), the SFSSS was found to demonstrate an adequate fit to a two-factor structure; this structure was replicated in Study 2 (n = 1,325). The measure was found to have an adequate internal consistency, acceptable composite reliability, and reasonably high four-week test-retest reliability. It also showed good convergent, discriminant, and concurrent validity. The measurement invariant across gender was supported. Overall, the SFSSS was a valuable tool for assessing the structural and functional aspects of social support among older adults in China. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the independent impact of threat-related and deprivation-related adverse childhood experiences (ACEs) on depressive symptoms among middle-aged and older adults, and to evaluate the moderating role of current economic status in these associations. Methods: This cross-sectional study included 11,048 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study. We captured five threat-related ACEs and five deprivation-related ACEs by questionnaires. Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale. Current economic status was reflected by annual per capita household consumption expenditure. We performed logistic regression analyses to evaluate the independent association of childhood threat and deprivation with depressive symptoms, and conducted stratified analyses and tests for interaction to explore the moderation effect of current economic status in such associations. Results: Compared with the nonexposed group, the experience of both childhood threat and deprivation were independently associated with greater risks of depressive symptoms later in life (odds ratio [OR] 1.75, 95% CI 1.49–2.05 for ≥ 2 threat-related ACEs; OR 2.02, 95% CI 1.67–2.43 for ≥ 2 deprivation-related ACEs). High current economic status significantly ameliorated the impact of childhood deprivation, but not threat, on depressive symptoms (P value for interaction 0.038). Conclusions: Both threat-related and deprivation-related ACEs were associated with the risk of depressive symptoms among middle-aged and older adults, while current economic status was a significant moderator in such risks only for childhood deprivation. The findings implied that prioritising targeted interventions for individuals with ACEs, especially for childhood deprivation victims who were economically disadvantaged in adulthood, may help mitigate depressive symptoms in later life. [ABSTRACT FROM AUTHOR]

Many older adults in China are facing a severe shortage of social support. Although siblings play a crucial role in providing support for older adults, their importance has not received enough attention in China. Applying multilevel logistic regression models to the data from the 2018 Chinese Longitudinal Healthy Longevity Survey, we explored the influence of gender composition and birth order on older adults' sibling relationships in the context of Chinese cultures (Patrilocality, Patriarchality, and Ti). We found that the gender composition of the sibling and elder was significantly associated with the frequency of visits, with the male sibling-male elder dyad interacted most. Siblings were more likely to frequently visit an elder whose birth order was higher than their own. While the gender composition-frequency of visits association was only significant in the urban areas, birth order had a significant influence on the frequency of visits both in the rural and urban areas. [ABSTRACT FROM AUTHOR]

Many studies have proven the relationship between air pollutants and respiratory diseases, but few studies have assessed the impacts of air particulate matter exposure on older patients with pneumonia. This study aimed to reveal the impacts of short-term exposure to air particulate matter on the daily number of older adult patients hospitalized due to pneumonia and calculate the economic costs attributable to this exposure. We collected inpatient data from 9 city hospitals in Sichuan Province, China, from January 1, 2018, to December 31, 2019, and calculated odds ratios and 95% confidence intervals using a time-stratified case-crossover study design and an attributable risk model to calculate the economic burden due to particulate matter pollution. It was found that for every 10 μg/m3 increase in PM2.5 and PM10 concentrations, the daily number of older adult pneumonia inpatients increased by 1.5% (95% CI: 1.010–1.021) and 1.0% (95% CI: 1.006–1.014), respectively. Those 65 ~ 79 years old were more susceptible to air particulate pollutants (P < 0.05). During the study period, the total hospitalization costs and out-of-pocket expenses attributable to PM2.5 and PM10 exposure were 44.60 million CNY (6.22%) and 16.03 million CNY (6.21%), respectively, with PM2.5 being the primary influencing factor. This study revealed the relationship between particulate matter pollution and pneumonia among older adults. The role of policies to limit particulate matter concentrations in reducing disease burden among older adults can be further explored. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies have reported that among participants with impaired cognitive, overweight and mild obesity are associated with substantially improved survival, this finding has been termed the "obesity paradox" and has led to uncertainty about secondary prevention. Aims: To explore whether the association of BMI with mortality differed in different MMSE score, and whether the obesity paradox in patient with cognitive impairment (CI) is real. Methods: The study used data from CLHLS, a representative prospective population-based cohort study in China, which included 8348 participants aged ≥ 60 years between 2011 and 2018. The independent association between BMI and mortality in differed MMSE score by calculating hazard ratios (HRs) in multivariate Cox regression analysis. Results: During a median (IQR) follow-up of 41.18 months, a total of 4216 participants died. In the total population, underweight increased the risk of all-cause mortality (HRs, 1.33; 95% CI 1.23–1.44), compared with normal weight, and overweight was associated with a decreased risk of all-cause mortality (HR 0.83; 95% CI 0.74–0.93). However, compared to normal weight, only underweight was associated with increased mortality risk among participants with MMSE scores of 0–23, 24–26, 27–29, and 30, and the fully-adjusted HRs (95% CIs) for mortality were 1.30 (1.18, 1.43), 1.31 (1.07, 1.59), 1.55 (1.34, 1.80) and 1.66 (1.26, 2.20), respectively. The obesity paradox was not found in individuals with CI. Sensitivity analyses carried out had hardly any impact on this result. Conclusion: We found no evidence of an obesity paradox in patients with CI, compared with patients of normal weight. But underweight individuals may have increased mortality risk whether in the population with CI or not. And overweight/obese people with CI should continue to aim for normal weight. [ABSTRACT FROM AUTHOR]

Purpose: Food insecurity and multimoribidity (i.e., ≥ 2 chronic conditions) may be linked bidirectionally, but there are no studies on this topic from LMICs. Therefore, the aim of the present study was to examine the association between food insecurity and physical multimorbidity in a large representative sample of older adults from six LMICs. Methods: Cross-sectional, community-based data on adults aged ≥ 50 years from the World Health Organization's Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa were analyzed. A total of 11 chronic physical conditions were assessed. Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the associations. Results: Data on 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 47.9% males] were analyzed. After adjustment for potential confounders, in the overall sample, compared to being food secure, moderate and severe food insecurity were associated with 1.29 (95% CI 1.06–1.56) and 1.56 (95% CI 1.13–2.16) times higher odds for multimorbidity, respectively Conclusion: Food insecurity was associated with greater odds for multimorbidity in older adults from LMICs. Addressing food insecurity in the general population may reduce risk for multimorbidity, while screening for food insecurity and addressing it among those with multimorbidity may lead to better clinical outcomes, pending future longitudinal research [ABSTRACT FROM AUTHOR]

Objectives: To comprehensively evaluate the association between BMI and death risk in people aged 65 years and over in Shenzhen, China, and suggest the optimal range of body mass index (BMI) for the older adults. Design: A prospective cohort study. Setting: A population-based study of elderly adults in Shenzhen, China. Participants: 359044 Shenzhen Healthy Ageing Research participants aged 65 and over with 4682 deaths during a mean of 1.5 years of follow-up were included in this analysis. Measures: Hazard ratio of all-cause and cause specific mortality risks associated with BMI categories. The association between BMI and all-cause and cause specific mortality were independently estimated by Cox regression model. Results: Regardless of gender, BMI of 24–29.9 kg/m2 was a protective factor for death in all ages, while BMI above 30 kg/m2 was still a protective factor for older adults under 70 years old. Regardless of age, BMI at 24–25.9 kg/m2 was associated with lower mortality in men, while BMI at 26–27.9 kg/m2 was associated with lower mortality in women. For the older adults without chronic diseases, BMI at 24–25.9 kg/m2 was also significantly associated with lower mortality. In the analysis of BMI and cause of death, we also found that BMI of 24–25.9 kg/m2 was significantly associated with the lower mortality from cardiovascular disease, cancer, chronic respiratory disease and digestive system disease in China. Conclusion: BMI in the range of 24–25.9 kg/m2 may be protective for mortality in Chinese older adults. Additional more large-scale, multicenter and long-term follow-up studies are needed to confirm these findings in different populations. [ABSTRACT FROM AUTHOR]

This study investigates if there is an age-related positivity effect on how older adults in eastern cultures perform trustworthiness evaluations based on facial cues. Furthermore, it explores the potential method information processing affected by the positivity effect during trustworthiness evaluations. The results show that the level of trustworthiness older adults in China assign to faces is significantly higher than that of younger adults; older adults' trustworthiness evaluations based on facial cues in the valid cueing condition is significantly higher than in the invalid cueing condition; and for younger adults, trustworthiness evaluation of untrustworthy faces in the valid cueing condition was significantly lower than in the invalid cueing condition. Overall, these results show that positive information processing in older adults is regulated by attention capacity, while negative information processing by young adults is regulated by attention capacity, which indicates that the age-related positivity effect in older adults is due to increased positive information processing. [ABSTRACT FROM AUTHOR]

Aim: The association between visual impairment and mild cognitive impairment (MCI) has not been investigated to date. Thus, we assessed this association among older adults from six low- and middle-income countries (LMICs) (China, India, Ghana, Mexico, Russia, and South Africa) using nationally representative datasets. Methods: Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment (at distance and near) was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better-seeing eye. The definition of MCI was based on the National Institute on Aging-Alzheimer's Association criteria. Multivariable logistic regression was conducted. Results: Data on 32,715 individuals aged ≥ 50 years [mean (SD) age 62.1 (15.6) years; 51.2% females] were analyzed. Compared to those without far or near vision impairment, those with near vision impairment but not far vision impairment (OR = 1.33; 95% CI = 1.16–1.52), and those with both far and near vision impairment (OR = 1.70; 95% CI = 1.27–2.29) had significantly higher odds for MCI. Only having far vision impairment was not significantly associated with MCI. Conclusions: Visual impairment is associated with increased odds for MCI among older adults in LMICs with the exception of far vision impairment only. Future longitudinal and intervention studies should examine causality and whether improvements in visual acuity, or early intervention, can reduce risk for MCI and ultimately, dementia. [ABSTRACT FROM AUTHOR]

To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002 to 2018. Baseline BMI and BMI change were available for 12,027 adults aged older than 65 years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score lower than 18. Multivariable Cox proportional hazard model was used. Among 12,027 participants (mean age was 81.23 years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9 years' follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75–0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94–1.10) in underweight and 1.01 (95% CI 0.80–1.28) in obese participants. Large weight loss (< −10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29–1.56), compared to stable weight status group (−5% ~ 5%). In the restricted cubic spline models, BMI change showed a reverse J-shaped association with cognitive impairment. BMI-defined overweight, but not obesity, was associated with a lower risk of cognitive impairment among elderly Chinese adults, while large weight loss was associated with an increased risk. These findings are consistent with weight loss in the prodromal phase of dementia. [ABSTRACT FROM AUTHOR]

Summary: China is a middle-risk country for hip fracture at present, which differs from previous data that it was low-risk. By 2050, the total number of hip fractures in people older than 65 years is predicted to be 1.3 million. Introduction: To assess hip fracture incidence in China and examine the heterogeneity of hip fracture in seven geographical regions of China. Methods: There were 238,230 hip fracture patients aged 65 years or older from 2013 to 2016 from a large national in-patients database (HQMS) involving 30.6 million hospitalizations. Taking into account the total national hospitalization rate per calendar year, we estimated the incidence of hip fracture per 100,000 residents older than 65 years in China overall and in seven geographical Chinese regions. Results: The proportion of men and women older than 65 years with hip fractures was 1.00:1.95. Between 2013 and 2016, the number of hip fractures per 100,000 people age 65+ was 278. China has vast territories; the number of hip fractures per 100,000 people over 65 years old was 202 in Northeast China and 374 in Northwest China. Northwest has higher altitude, lower population density, is less developed with lower urbanization than Northeast China which is low altitude, and highly urbanized. Conclusions: China should no longer be regarded as a low-risk country for hip fracture. By 2050, the total number of hip fractures in people older than 65 years in China is predicted to be 1.3 million. Higher altitude areas had higher hip fracture rates than lower altitude, higher urbanized areas. [ABSTRACT FROM AUTHOR]