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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]

The demand for healthy old-age care is growing rapidly in China. The traditional old-age care model can no longer meet elderly patients' demands for medical care and old-age care. To promote the development of medical care-integrated old-age care, a solution covering multiple aspects is necessary. In the context of the global development of healthy aging, China recently issued many policies to integrate old-age care with medical care, establishing protection for a large number of disabled elderly people. The Integrated Care of Older People (ICOPE) project is an international program developed by the World Health Organization. This paper reviews China's medical and old-age care integration model and the opportunities and challenges in implementing the ICOPE in the context of healthy aging in China. [ABSTRACT FROM AUTHOR]

Social participation of older adults, an essential part of the active aging strategy, has drawn more attention in Chinese society and is noted in the literature as having positive outcomes on physical and mental health. Based on the 2000 'Survey of the Older Population in Rural and Urban Beijing' and follow-up surveys in 2006 and 2010, this paper focuses on a descriptive analysis of social participation and the resources necessary to participate and analyzes changing willingness and behaviors regarding social participation among older adults in Beijing. Data show that attitudes about social participation were increasingly positive, and a larger proportion of older adults expressed willingness to participate in society. Social participation among older adults increased between the years 2000 and 2006 but remained flat between 2006 and 2010. This paper analyzes the influence of gender, age, marital status, health, and financial stability on behaviors and attitudes of older adults related to social participation and argues that older adults' attitudes change before behaviors do. [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]

Background: Hearing impairment is a highly prevalent condition and potential risk factor of loneliness in older adults. There is little evidence on whether living arrangement modifies the effects of hearing impairment on loneliness in older adults. Aims: (1) Explore the relationship between hearing impairment and loneliness in old adults; (2) investigate the modifying effect of living arrangement on the association between hearing impairment and loneliness. Methods: A cross-sectional analysis was conducted of 7070 participants (aged 60–101) in Shandong province of China. Hearing impairment was measured by a single self-reported question. Variables about social demography and physical functioning were assessed using self-administered questionnaires, and loneliness using short-form UCLA Loneliness Scale. Linear regression models were performed to evaluate the association between hearing impairment and loneliness and possible effect modified by living arrangement. Results: After controlling variables, older adults with hearing impairment reported significantly higher levels of loneliness than those with normal hearing (β = 0.024; P < 0.001). Living arrangement has a significant modifying effect on association between hearing impairment and loneliness. Conclusions: Our results underscored the potential impact of hearing impairment on loneliness in older adults, and also suggested that having adult children in the same village/community may play a protective role in reducing the loneliness of older adults with hearing impairment. [ABSTRACT FROM AUTHOR]

Background: Chronic pain and cognitive decline are common age-related conditions affecting a large segment of older populations. Little is known about the pathway of cognitive functioning during the course of pain management in older adults. Aims: The study aimed to examine the association between chronic body pain management and cognitive function over time among Chinese older adults. Methods: A total of 792 respondents aged 60 and above from urban and rural households in 28 provinces, 150 counties/districts, and 450 communities were selected from the China Health and Retirement Longitudinal Study (2013–2015). Cognitive function was measured in three domains: episodic memory, mental status, and global cognitive function. Difference-in-differences approach and mixed-effects linear regression models were employed to assess the association between chronic body pain management and cognitive function over time. Results: Scores of mental status were found to decline slower by 0.49 unit (SE = 0.22, p < 0.05) in respondents who received pain management using analgesics, complementary and alternative medicine, or both from 2013 to 2015 after controlling for basic demographic and health confounders. Conclusion: Chronic pain management was associated with slower decline in domain-specific cognitive function, mental status over time. Findings of the study may contribute to understanding the mechanism of change in diverse cognitive abilities attributable to pain symptoms. More research is needed to elucidate the mediating effect of pain on cognitive decline, which could lead to testing of the impact of pain management on cognitive function among older population in both clinical and community settings. [ABSTRACT FROM AUTHOR]

Background: Frailty is a public health concern in the ageing population. Little is known about the role of gender in the relationship between frailty and health care utilization in older adults. Aims: The study aims to examine gender differences in the association between different frailty status and health care utilization among Chinese older people. Methods: A total of 7070 older adults (60+) from Shandong Province, China, were enrolled in this study. Frailty was assessed by frailty index constructed using 45 health deficits. Multivariate logistic regression models were employed separately for men and women to examine the impact of frailty on self-care, outpatient, and inpatient utilization. Results: Overall, the prevalence of frailty was 7.9% in older adults, with 7.1% and 8.3% in men and women, respectively. 49.4% respondents reported they had self-care in the previous 2 weeks, and women were more likely to have self-care than men. Being pre-frail and frail was significantly associated with utilization of all types of health care among older men and women, and the relationship was stronger in the frail groups than that in the pre-frail groups except for self-care. Respective odds ratios for outpatient utilization were higher in men than that in women. Conclusions: Frailty is a frequent condition in Chinese older adults. The association between frailty and health care utilization (except outpatient) tended to be stronger in women than men. The gender differences should be considered when designing the preventing or delaying the installation of frailty and geriatric care plans. [ABSTRACT FROM AUTHOR]

Although people in China are experiencing rapid economic growth, higher income, and better living standards, the level of subjective wellbeing has not risen correspondingly. According to the 'Easterlin Paradox', economic growth does not necessarily bring about improvement in wellbeing, because an important part of happiness comes from making comparisons. This study investigates the relationship between income inequality and subjective wellbeing in China, focusing on older adults between 60 and 90 years. Empirical evidence is drawn from the Chinese Health and Nutrition Survey 2006, 2009, and 2011 waves. Using county-level fixed-effects estimation, the analyses show that generally, income inequality is negatively associated with subjective wellbeing, net of individual income. The association between inequality and wellbeing varies between people with rural or urban household registration status, and between people ranked within different income deciles. The association between inequality and wellbeing is stronger for people with urban household registration status, and for people ranked within higher income deciles. [ABSTRACT FROM AUTHOR]

Objective: To examine the diagnostic test accuracy (DTA) of the FRAIL-NH and four frailty screening instruments among institutionalized older adults. Design: Cross-sectional study. Setting: Institutionalized setting, Jinan, China. Participants: A total of 305 older adults (mean age 79.3 ± 8.4 years, 57.0% female) were enrolled from nursing homes. Measurements: Frailty was assessed by the FRAIL-NH, Physical Frailty Phenotype (PFP), FRAIL, Tilburg Frailty Indicator (TFI), and Groningen Frailty Indicator (GFI), respectively. The Comprehensive Geriatric Assessment (CGA) was used as a reference standard of frailty. The receiver operating characteristic (ROC) curve was plotted to examine the DTA of five frailty screening instruments against the CGA. The optimal cut-point was determined by the maximum value of the Youden index (YI, calculated as sensitivity + specificity − 1). Results: The prevalence of frailty ranged from 25.9% (FRAIL) to 56.4% (GFI). Areas under the curve (AUCs) against the CGA ranged from 0.80 [95% confidence interval (CI) 0.74–0.85: FRAIL] to 0.83 (95% CI 0.78–0.88: PFP). At their original cut-points, all five frailty screening instruments presented low sensitivity (32.9%–69.3%) and high specificity (80.0%–93.8%), as well as high positive predictive values (90.7%–94.9%) and low negative predictive values (33.2%–48.1%). At their optimal cut-points, the sensitivity and specificity of the FRAIL-NH, PFP, and FRAIL tended to be balanced, and their correctly classified rates (76.1%–81.3%) and kappa values (0.465–0.523) increased a lot. ROC contrasts showed that all five frailty screening instruments had similarly good diagnostic accuracy (χ2: 0.0003–1.38, P >.05). Conclusion: In the institutionalized setting, the specific FRAIL-NH, self-report FRAIL, TFI, and GFI as well as hybrid PFP, show similarly good diagnostic properties in identifying frailty against the CGA. [ABSTRACT FROM AUTHOR]

Despite its highly developed economy and modernized outlook, Hong Kong has a surprisingly severe poverty problem, especially among the aged. While income poverty among Hong Kong’s elderly has been widely acknowledged and extensively investigated, this study examines asset poverty using survey data of 4306 Hong Kong residents aged 60 or above. To investigate the link between asset poverty and income poverty, the income-poverty threshold is taken as being half the median household income, adjusted by the square root of household size; the asset poor are defined as those whose household assets are inadequate to cover their basic needs for a period of three months. Factors associated with the asset poverty of Hong Kong’s elderly are also examined. This study provides valuable information concerning asset poverty among older adults in an Asian society (namely, Hong Kong) and contributes to the literature on asset poverty, in which estimates of asset poverty are available only for the general population of some Western countries. Policy implications of the findings are discussed, and an asset-building approach is recommended. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association between BMI and all-cause mortality in the oldest old (≥80 years).Design: The study used a prospective cohort study design.Setting: Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998/99 and 2011.Population: 8026 participants aged 80 years and older were followed every two to three years.Measurements: Body weight and knee height were measured. Height was calculated based on knee height using a validated equation. Deaths were ascertained from family members during follow-up.Results: The mean BMI was 19.8 (SD 4.5) kg/m2. The prevalence of underweight, overweight and obese was 37.5%, 10.2% and 4.4%, respectively. There were 5962 deaths during 29503 person-years of follow-up. Compared with normal weight, underweight was associated with a higher mortality risk (HRs: 1.20 (95%CI 1.13-1.27) but overweight (HR 0.89 (95%CI 0.81-0.99)) were associated with a lower risk. Obesity had a HR 0.91 (95%CI 0.78-1.05) for mortality.Conclusion: Among oldest old Chinese, underweight is associated with an increased risk of all-cause mortality but overweight is associated with a reduced risk. Interventions to reduce undernutrition should be given priority among the oldest old Chinese. [ABSTRACT FROM AUTHOR]

Homeownership is a key element to maintain social welfare and stability in an aging society. Yet, the existing literature on homeownership does not adequately address non-Western cultures and institutional factors. We used two nationwide surveys in 2006 and 2010 to investigate how institutional factors are associated with homeownership among older adults in China. Institutional factors were measured by proxy measures of job seniority, political status, type of work units, and hierarchy of cities. After controlling for demographics, resources, health needs, neighborhood characteristics, and cultural factors, we found that homeownership was strongly associated with these institutional factors among the current cohorts of older adults in China. Older adults who were more senior or who were from public sectors tended to have a higher odds of homeownership. Older adults in the top or bottom of the city hierarchy tended to have a lower odds of homeownership than those in other types of cities. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

This study explores the relationship between the life satisfaction of older adults and the social support from grandchildren in Hong Kong. Two hundred and fifteen older people (from the ages of 64 to 101, mean age 79.3), whose youngest grandchild was aged 12 or older, were recruited from elderly service agencies to participate in the study. Face-to-face interviews were conducted by trained interviewers using a standardized questionnaire, which included the Life Satisfaction Scale for Chinese, the Lubben Social Network Scale, the Chinese Tradition Scale, grandchildren social support measures, self-rated health, self-rated financial adequacy, and demographic variables. Hierarchical regression showed that the life satisfaction of older adults benefitted significantly from the social support from grandchildren ( R2 change = .05, Fchange = 7.15, p < .001); while controlling demographic characteristics, general social support, attitude towards Chinese tradition, self-rated health, and self-rated financial adequacy. The total explained variance was 51%. Emotional support and appraisal support from grandchildren were identified as significant contributing factors. The policy and practice implications for active aging policies are discussed in a Chinese context. [ABSTRACT FROM AUTHOR]