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Objectives: This study investigated the predictors of risk perception and its effect on older adults’ preventive behavior and/or medical care avoidance during the COVID-19 pandemic. Methods: Older respondents (age >50 years) from the MIT COVID-19 Preventive Health Survey reported their social distancing, hand washing, mask wearing, and medical care avoidance between July and October 2020 ( n = 4395). Structural equation models were used. Results: Significant predictors of higher risk perception were female gender, older age, poorer health, city residency, personally knowing someone who had COVID-19, and correct knowledge of vaccine/treatment. Higher risk perception was subsequently associated with higher frequency/probability of practicing preventive behavior and/or avoiding medical care. Knowledge had the strongest path coefficient with risk perception. Discussion: Disseminating correct information to older adults could help them evaluate infection risk accurately. Educational programs on the precautions implemented at clinical settings to ensure patient safety may encourage older adults to seek timely medical care.

Using a nationally representative sample of U.S. older adults (50+), this study investigates gender-based depression trajectories following heart disease onset and associated risk of disability and mortality over an 8-year period.Six waves of longitudinal data from the Health and Retirement Study (2006-2016) were used (Three distinct depression trajectories were identified, including persistent minimal depression (men: 68.65%; women: 60.17%), moderate depression (women: 29.70%; men: 17.97%), and chronic depression (women: 10.12%) or emerging depression (men: 13.38%). Younger age and depression status at baseline were associated with women's chronic depression and men's emerging depression. Chronic/emerging and moderate depression were associated with higher disability risks than was minimal depression among both women and men (hazard ratios [HR] ranged from 2.12 to 3.92,Longitudinal course of depression following onset of heart disease is heterogeneous in later life. Unfavorable depression trajectories (i.e. moderate, chronic, and emerging) were associated with higher disability risk compared to the minimal depression trajectory. Study findings characterize risk stratification regarding depression after heart disease onset, which can inform the development of interventions to improve health outcomes among older adults with heart conditions.

Objectives This study aimed to (1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and (2) evaluate whether there exists a rural–urban difference in such relationships. Methods Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Results Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. This association was consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

Face-saving represents a unique culturally salient construct among Chinese. However, our understanding regarding its relationship with psychological distress in this population remains limited. The objective of this cross-sectional study is to examine (1) the relationship between face-saving and depressive symptoms among U.S. Chinese older adults; and (2) whether face-saving mediates the relationship between acculturation and depressive symptoms. Data were from the Population Study of Chinese Elderly in Chicago (N = 3132), the largest epidemiologic study of Chinese older adults in Western countries. The relationship between face-saving and self-reported depressive symptoms was investigated by step-wise multivariable linear regression models. The Sobel test was used to test the mediating effect of face-saving. U.S. Chinese older adults with higher face-saving values experienced greater levels of depressive symptoms (B = 0.05, p < 0.001) than those with lower face-saving values, even after sociodemographic factors, health characteristics, and social support were accounted for. The mediation effect of face-saving was not statistically significant. The study findings underscore the significance of a unique cultural factor, specifically face-saving, in understanding U.S. Chinese older adults’ experience of depressive symptoms. Depression screening and treatment programs should pay attention to face-saving issues among U.S. Chinese older adults. Future studies need to incorporate cultural factors in mental health research in diverse populations.

This study examined the gap between need and provision of community services in China and its association with older adults' life satisfaction over time. Longitudinal data from the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014 were used (3 waves, N = 16,199). Respondents reported if they needed nine types of community service and if their community provided such service. Growth curve models analyzed whether individual- and/or province-level characteristics predicted the initial level and/or changes of life satisfaction over time. Results indicated the presence of major unmet service needs in China. Available community services were mismatched with older adults' perceived needs. Unmet service needs were associated with decreased life satisfaction at baseline. However, unmet service needs were not associated with changes in life satisfaction over time. Study findings highlighted the urgent need to optimize service design in accordance with older adults' needs, which ultimately could promote older adults' well-being.

The development of information technology has brought the driving force for the development of modern education, and has provided rich information resources and tools for modern education. The application of information technology has become one of the characteristics of modern education technology. Refrigeration Principles and Equipment is a practical professional course for energy and power engineering. The main content includes refrigeration methods, basic theories of refrigeration systems, system composition, thermal processes and cycles, thermal analysis and calculations, and properties of refrigerants. Refrigeration equipment, etc. In order to use modern education informatization to achieve the goal of cultivating applied-skilled talents, the author uses an online learning platform, implements a hybrid online and offline teaching mode, redesigns the teaching content, and at the same time integrates ideological and political education into all teaching links. Teachers make full use of network resources online, push diversified learning resources, conduct online discussions, tests, interactive Q&A, assessments, etc., to meet the needs of students’ personalized learning. Offline learning is mainly used for in-depth learning through activities such as teacher’s face-to-face instruction and Q&A. Through curriculum ideological and political education, students can establish the core values of socialism, cultivate their innovative thinking ability and practical ability, guide students to behave correctly and do things correctly, and make students become talents with both ability and political integrity and comprehensive development.

OBJECTIVES: This study aims to investigate the relationship between quantity, quality, and composition of social networks and depressive symptoms among U.S. Chinese older adults. METHODS: Data were derived from the Population Study of Chinese Elderly (PINE) (N = 3,157), a study of Chinese older adults aged 60 and above in Chicago. We assessed quantitative (network size and volume of contact), qualitative (emotional closeness), and composition (proportion kin, proportion female and proportion coresident) aspects of social networks. Depressive symptoms were measured by the Patient Health Questionnaire-9. Negative binomial and logistic regressions were conducted. RESULTS: Older adults who had three to five network members with strong ties, a medium level of contact, and a high level of emotional closeness were less likely to experience depression than their counterparts. Quantitative and qualitative dimensions of social networks have stronger protective effects than the composition dimension. CONCLUSIONS: U.S. Chinese older immigrants with different levels of social network characteristics have different risks of depression, suggesting targeted subpopulation assessments to facilitate the delivery of more appropriate and effective treatment to those most in need. CLINICAL IMPLICATIONS: Health-care professionals and social service agencies are suggested to develop intervention programs to promote mental health through increasing strong ties and improving the quality of social networks for U.S. Chinese older immigrants.

Objectives To examine the factors of advance directive (AD) completion among older Chinese Americans. Design Cross-sectional survey. Setting and Participants Data came from 435 Chinese Americans aged 55 years and older living in 2 metropolitan areas through self-administered questionnaires and research assistant–administered interviews in 2018. Participants' average age was 75 years (standard deviation = 9.4). Methods Logistic regression was used to examine factors associated with AD completion. Results Approximately 14% of participants completed an AD. Older age [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02-1.12], higher level of acculturation (OR 2.15, 95% CI 1.39-3.33), higher expectation for intergenerational support (OR 1.52, 95% CI 1.02-2.27), and having US citizenship (OR 3.02, 95% CI 1.26-7.23) were positively associated with AD completion. Physical and mental health needs were not significantly associated with AD completion. Conclusions and Implications This study is among the first focusing on AD completion among Chinese Americans, one of the fastest-growing older minority populations in the United States. Findings highlight the influence of socioeconomic and cultural factors on AD completion and illustrate the importance of developing culturally sensitive interventions to promote end-of-life care decision making among older Chinese Americans.

OBJECTIVES: To examine the added effect of having both cognitive deficit and physical frailty, compared to having either one only, on hospitalization and emergency department (ED) visits. METHODS: Data from a population-based study of 3,157 community-dwelling older (≥60 years) Chinese adults in the U.S. were used. Cognitive deficit was measured by the Mini-Mental State Examination (i.e., education-adjusted score: 16 [illiterate], 19 [primary school], and 23 [≥middle school]). Physical frailty was identified using the Short Performance Physical Battery (0–6 out of 15). The numbers of hospitalizations and ED visits in the previous two years were self-reported. RESULTS: In this sample, 12.63% had cognitive deficit alone, 5.95% had physical frailty alone, and 4.26% had both. Compared with participants having neither cognitive deficit nor physical frailty, those having physical frailty alone were 1.5 times as likely to have hospitalizations (Rate Ratio [RR]=1.52 [1.07, 2.16], p=0.02) and ED visits (RR=1.52 [1.07, 2.15], p=0.02). Having cognitive deficit alone was not significantly related to either outcome. However, having cognitive deficit with existing physical frailty increased the likelihood of both hospitalization (RR=2.00 [1.36, 2.96], p

BACKGROUND AND OBJECTIVES: Depressive symptomatology is a significant predictor of increased health services utilization and health care cost in the general older adult population. However, there is scant information on the relationship between depressive symptoms and health service utilization among U.S. Chinese older adults. The objective of this study was to examine the relationship between depressive symptoms and physician visits, emergency department (ED) visits, and hospitalization. RESEARCH DESIGN AND METHODS: Cross-sectional data were derived from the Population Study of Chinese Elderly in Chicago (PINE) collected between July 2011 and June 2013 (N = 3,159). Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). Bivariate and multivariate logistic regression analyses were conducted to examine the relationship between depressive symptoms and physician visits, ED visits, and hospitalization. RESULTS: U.S. Chinese older adults with depressive symptoms were more likely to have at least one ED visit (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.44–2.28) and hospitalization (OR = 1.9, 95% CI = 1.47–2.33) in the past 2 years than those without depressive symptoms, while adjusting for sociodemographic and health-related covariates. Other significant factors associated with health services utilization in this population included number of people in household, health insurance coverage, and acculturation. DISCUSSION AND IMPLICATIONS: Depressive symptoms are positively associated with hospitalization and ED visits among U.S. Chinese older adults. Routine screenings of depressive symptoms should be part of the clinical encounter in these care settings so that appropriate treatment or timely mental health service referrals could be provided to this population to ultimately optimize their utilization of health services.

Preventive healthcare utilization is an important aspect of medical practice that facilitates the identification of chronic diseases at an early stage and increases options for treatment. Cognitive function plays an important role in individuals’ utilization of preventive care services. However, our understanding of the relationship between cognitive function and preventive care utilization is limited, particularly in older minority aging populations. The study aims to assess the association between cognitive function and preventive healthcare utilization among U.S. Chinese older adults. Data were obtained from the Population Study of Chinese Elderly in Chicago (PINE). Five instruments were used to measure global cognition, including the Mini-Mental State Examination, East Boston Memory Test Immediate Recall and Delayed Recall, Digit Span Backwards, and Symbol Digit Modalities Test. Preventive care services included immunization (i.e. flu, pneumonia, and hepatitis B vaccines) and cancer screenings (i.e. colorectal, breast, cervical, and prostate). Multivariable regression analyses were used. The findings showed that higher level of global cognition was associated with higher utilization of pneumonia vaccination (OR=1.32, 95% CI= 1.14-1.52), hepatitis B vaccination (OR=1.24, 95% CI= 1.05-1.47), colon exam (OR=1.23, 95% CI= 1.07-1.41), mammogram (OR=1.46, 95% CI= 1.22-1.73), breast exam (OR=1.23, 95% CI= 1.04-1.46), and cervical exam (OR=1.38, 95% CI= 1.15-1.65). Future longitudinal studies are needed to elucidate potential mechanisms underlying the relationship between cognitive function and preventive care utilization among U.S. Chinese older adults. Study findings underscore the need to understand preventive care utilization patterns among U.S. Chinese older adults with low cognitive function.

Today’s world is in a wave of energy transition. Relying on the advantages of low carbon and rapid cost reduction, renewable energy has gradually become the core of many countries to promote energy transition and an important way to deal with energy crisis and environmental pollution. Renewable energy power generation has also become the main source of new power generation. Combining energy development, this article analyzes the problems of China’s renewable energy power, puts forward suggestions on related issues, promotes energy transition, and contributes to the establishment of a green and low-carbon circular economic system.

Objectives This prospective cohort study examined the relationship between depressive symptoms and onset of functional disability over 2 years among US Chinese older adults, a rapidly growing minority older adult population. Design and setting This study used survey data from 2713 Chinese older adults who completed both baseline (2011-2013) and follow-up (2013-2015) interviews of the Population Study of Chinese Elderly in Chicago. Depressive symptoms were assessed at baseline by the nine-item Patient Health Questionnaire. Functional disability was measured by three validated scales, Katz Index of Independence in Activities of Daily Living (ADLs), the Lawton Instrumental Activities of Daily Living (IADLs) scale, and the Rosow and Breslau mobility scale. Multivariate logistic regression was conducted to examine the relationship between baseline depressive symptoms and the development of functional disability (ADLs, IADLs, mobility) at 2-year follow-up while adjusting for covariates. Results Of the 2713 participants, 5.2% experienced ADL disability onset, 35.6% experienced IADL disability onset, and 23.3% experienced mobility disability onset over 2 years. After adjusting for covariates, the odds of ADL disability onset (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02-1.11), IADL disability onset (OR = 1.05; 95% CI = 1.01-1.09), and mobility disability onset (OR = 1.05; 95% CI = 1.01-1.09) were consistently higher in US Chinese older adults with higher levels of depressive symptoms than their less-depressed counterparts. Other significant risk factors included older age and more chronic physical conditions. Conclusion Study findings underscore a significant relationship between depressive symptoms and onset of functional disability. Screening and, subsequently, treating depressive symptoms have the potential to reduce disability among US Chinese older adults. Culturally relevant depressive symptom screening may help identify Chinese older adults who are at greater risks for the development of functional disability. J Am Geriatr Soc 67:S538-S544, 2019.

Survey research is an essential component of epidemiological research to understand the health of older adults. However, there are several limitations to conventional data collection methods that may serve as barriers for recruitment and retention of research participants, especially from minority populations. With recent technological advancements, our research team developed an innovative data collection and management system to address linguistic and cultural barriers, data quality, data security, and data preparation issues. This platform has been utilized in the Population Study of Chinese Elderly in Chicago since 2011. Future use and improvement of this system will facilitate research among minority older adults and increase research participation and representativeness to ultimately understand and improve the health and well-being of diverse populations. J Am Geriatr Soc 67:S479-S485, 2019.

Objectives The prevalence and health consequences of comorbid depressive symptoms (DSs) and chronic medical conditions (CMCs) among older ethnic minority populations remain poorly understood. To bridge this gap, the present cross-sectional study examined the prevalence of comorbid DS-CMC and the association between such comorbidity and health services use among US Chinese older adults. Design and setting Data were from the Population Study of Chinese Elderly in Chicago (N = 3157). The relationship between comorbid DS-CMC and health service use (ie, emergency department [ED] visits and hospitalizations) was investigated by stratifying the sample into four groups: (1) neither DSs nor CMCs (ie, heart disease, stroke, cancer, high cholesterol, diabetes, high blood pressure, hip fraction, thyroid, and osteoarthritis); (2) DSs only; (3) CMCs only; and (4) comorbid DS-CMC. Multivariate negative binomial regression models were conducted to determine the relationship between comorbid DS-CMC and health service use. Results Participants were 73 years old on average. The prevalence of comorbid DSs ranged between 0.7% and 4.6% across various CMCs. The odds of DSs were at least twice as high among US Chinese older adults with CMCs than those without the various conditions. Compared with US Chinese older adults with neither DSs nor CMCs, those with comorbid DS-CMC had more ED visits (rate ratio [RR] = 3.32; 95% confidence interval [CI] = 2.03-5.42) and hospitalizations (RR = 3.12; 95% CI = 1.95-4.97). Conclusion Recognition and treatment of comorbid DS-CMC warrant increased policy and clinical attention. The findings underscore the potential need to develop effective services targeting DSs among US Chinese older adults with CMCs. J Am Geriatr Soc 67:S545-S550, 2019.

Objectives Research has examined the relationships between positive social support (PSS) and elder mistreatment (EM) but less is known regarding the negative aspect of social support (NSS), especially among minority groups in the United States. This study aimed to investigate the relationships between PSS/NSS from different sources and EM among US Chinese older adults. Design Population-based cross-sectional study. Setting Greater Chicago, IL, area. Participants A representative sample of Chinese older adults aged 60 years or older (N = 3157) from the Population Study of ChINese Elderly in Chicago in 2011 to 2013. Measurements We applied a 10-item widely used instrument to assess EM. PSS and NSS from spouse/family members/friends were measured by a 12-item scale. Multivariate logistic regression analyses were conducted to examine the relationships. Results After adjusting for confounders, higher levels of overall PSS from all three sources, including spouse, family members, and friends (odds ratio [OR] = 0.88 [95% confidence interval {CI} = 0.85-0.91]), were associated with lower risk of EM. But participants with a higher level of overall NSS from all three sources (OR = 1.51 [95% CI = 1.41-1.61]) were more likely to experience EM. The results on the relationships between PSS from spouse (OR = 0.70 [95% CI = 0.64-0.76]), PSS from family members (OR = 0.73 [95% CI = 0.68-0.79]), and EM were similar to overall PSS. But PSS from friends had a nonsignificant association with EM. Greater levels of NSS from spouse (OR = 1.84 [95% CI = 1.64-2.07]), family members (OR = 2.36 [95% CI = 2.03-2.75]), and friends (OR = 1.69 [95% CI = 1.32-2.17]) were associated with increased risks of EM. Conclusion Higher levels of SS were not always associated with lower risks of EM among US Chinese older adults. NSS might have counter effects. Future qualitative or longitudinal research needs to explore detailed cultural explanations and casual relationships between SS and EM. J Am Geriatr Soc 67:S499-S505, 2019.

Background and ObjectivesThere exists an imperative need to comprehensively evaluate the effectiveness of psychosocial interventions for Chinese geriatric populations’ mental wellbeing. This study conducted a systematic review and meta-analysis of psychosocial services for Chinese older adults’ depression and anxiety.Research Design and MethodsA search of nine electronic databases, five geriatric mental health journals, and reference lists was conducted for studies published between 1980 and April. 2018. Thirty-three studies (including totally 3,478 participants, 107 effect sizes) of true and quasiexperimental controlled trials were eligible and included for meta-analysis using robust variance estimation in meta-regression. Outcome indicators were geriatric depression and anxiety.ResultsAn overall significant treatment effect was identified for geriatric depression and anxiety (d = 0.577, 95% confidence interval [CI]: 0.288, 0.867, p < .001). Outcomes, geographic area, participants’ marriage, service setting, and types of control group were moderators for treatment effects. Subgroup analysis observed statistically significant effect size among studies in Taiwan, used innovative service methods and small group interventions. Both in-person, home-based interventions and interventions provided by nurse practitioners and specially trained providers were statistically significant.Discussion and ImplicationsPsychosocial services can benefit Chinese geriatric populations. Innovative and culturally relevant programs received strongest research supports. Future research should incorporate social interaction as an important component for serving Chinese older adults’ mental wellbeing.

Since 2020, under the market trend of the "carbon peak" and "post-coal reform" era, clean energy heating has ushered in development opportunities. This article mainly introduces the current status of solar combined heat pump, biomass energy, electricity, photovoltaic and other heating methods, compares the differences of various types of energy heating, analyzes the advantages and limitations of solar heating, and puts forward reasonable suggestions.

Older adults visit emergency departments (EDs) at a disproportionally higher rate than other age groups. Prior studies examining racial disparities in ED utilization focus on African Americans and Hispanics. There is a dearth of information on ED utilization patterns among older Asian Americans despite the evidence that ED expenditures in Asian Americans are comparable to that of Caucasians. To address this knowledge gap, we examined factors associated with ED service utilization in the largest Asian subgroup, U.S. Chinese older adults. Cross-sectional data from the Population Study of Chinese Elderly in Chicago (PINE) (N = 3,157) were used. Multivariate negative binomial regression analyses were conducted to examine significant factors associated with ED use. Higher education (rate ratio [RR] = 1.03, 95% confidence interval [CI] 1.00–1.05) and acculturation levels (RR = 1.02, CI 1.00–1.04), fewer people in the household (RR = 0.94, CI 0.88–0.99), health insurance coverage (RR = 1.34, CI 1.01–1.78), lower income (RR = 0.89, CI 0.80–0.99), poorer perceived health (RR = 0.67, CI 0.58–0.77), more functional limitations (RR = 1.09, CI 1.06–1.13) and depressive symptoms (RR = 1.04, CI 1.02–1.07), and a history of heart disease (RR = 2.28, CI 1.83–2.84), stroke (RR = 1.68, CI 1.20–2.35), cancer (RR = 1.86, CI 1.31–2.63), and hip fracture (RR = 1.42, CI 1.02–1.98) were associated with higher rates of ED visits. Our findings highlight several significant correlates of ED use in U.S. Chinese older adults. Culturally-appropriate interventions modifying these factors have the potential to decrease ED visits and improve care outcomes in this population.

Depressive and anxiety disorders are highly prevalent and detrimental in primary care settings. However, there are gaps in the literature concerning effectiveness and generalizability of empirically supported interventions and treatment of both depression and anxiety in primary care settings. The aim of this review is to systematically assess and meta-analyze the effectiveness of brief empirically-supported psychotherapies for treating depression and/or anxiety in primary care.Seven electronic databases, five professional websites and manual search of reference lists were searched through April 2017 for randomized controlled trials (RCTs) of four psychotherapies treating primary care depression and anxiety: cognitive-behavior therapy (CBT), problem-solving therapy (PST), motivational interviewing (MI), and solution-focused brief therapy (SFBT).From an initial pool of 1140 articles, 179 articles were eligible for full-text review and 65 articles were included for final analysis. Sixty-five articles containing 198 effect sizes reported an overall treatment effect size of d = 0.462, p 0.001. Single-predictor meta-regression indicated that marital status, treatment modality (individual versus group), and treatment composition were significant moderators. Multiple-predictor meta-regression discovered treatment setting (inside versus outside primary care) significantly moderated treatment effect, b = -0.863, p = 0.039 after controlling for other intervention characteristics.Treatment effects were found for CBT and PST, both for depressive and anxiety disorders. Interventions delivered outside primary care settings were more effective than those within, individual treatment had greater treatment effects compared to group treatment, and both technology-assisted and in-person treatments were found to be effective.

In this study, we aimed to examine the relationship of social support with hospitalizations and emergency department (ED) visits among older Chinese adults in the United States and its possible mechanism. This was a secondary analysis of data from the Population Study of Chinese Elderly (July 2011-June 2013; N = 3,157). After adjusting for demographic, clinical, and functional covariates in logistic regression analyses, significant interaction between social support from spouse and the number of functional limitations in (instrumental) activities of daily living was related to lower odds of hospitalization (odds ratio [OR] = 0.97 [0.95-0.99]) and ED visits (OR = 0.98 [0.96-0.99]). This finding suggests that among older Chinese American adults with functional limitations, more spousal support was related to lower odds of hospitalizations and ED visits. Future studies should comprehensively measure social support (e.g., content, amount) from other sources and investigate how unnecessary acute health service utilization in this population may be reduced by social support interventions.

Preventing adverse events among chronically ill older adults living in the community is a national health priority. The purpose of this study was to generate distinct risk profiles and compare these profiles in time to: hospitalization, emergency department (ED) visit or death in 371 community-dwelling older adults enrolled in a Medicare demonstration project. Guided by the Behavioral Model of Health Service Use, a secondary analysis was conducted using Latent Class Analysis to generate the risk profiles with Kaplan Meier methodology and log rank statistics to compare risk profiles. The Vuong-Lo-Mendell-Rubin Likelihood Ratio Test demonstrated optimal fit for three risk profiles (High, Medium, and Low Risk). The High Risk profile had significantly shorter time to hospitalization, ED visit, and death (p < 0.001 for each). These findings provide a road map for generating risk profiles that could enable more effective targeting of interventions and be instrumental in reducing health care costs for subgroups of chronically ill community-dwelling older adults.

For centuries, in traditional Chinese culture, filial piety are considered as the highest of all virtues. A previous cross-sectional study reported a significant relationship between filial discrepancy and psychological well-being among U.S. Chinese older adults. However, less is known regarding the longitudinal relationship between filial discrepancy and psychological wellbeing over time. This study aimed to examine the relationship between filial discrepancy and depressive symptoms using two-wave data. Depressive symptoms were measured by nine-item Patient Health Questionnaire. Change of depressive symptoms was calculated by wave 2 minus wave 1 scores. Negative binomial and linear regressions were performed. Filial expectation was associated with increase in depressive symptoms during two years (b = .03, SE = .01). Larger filial expectation than receipt was associated with larger increase in depressive symptoms (b = .04, SE = .01) and higher level of depressive symptoms after two years (RR, 1.02 [1.00, 1.03]). The result showed a positive association between filial discrepancy and depressive symptoms; intensified depressive symptoms that prolonged in the two years of research. Our findings suggested that early identification and intervention for Chinese older adults with filial discrepancy are necessary to help them maintain optimal psychological wellbeing in later life. Depressive symptoms have a wide range of intensity, can lead to a serious condition that requires immediate medical treatment which also interferes with daily life. Due to the cultural differences, findings suggested that Chinese older adults mainly have high filial expectations and low receipt; recognizing depressive symptoms may require extra attention.

This study aims to examine the relationship between religiosity and depressive symptoms in a large cohort of community-dwelling U.S. Chinese older adults living in the Greater Chicago area, which has received relatively little research attention. Cross-sectional self-report data was obtained from the Population Study of Chinese Elderly in Chicago between 2011 and 2013 (N=3,157). Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). A score of 5 and above indicated the presence of clinically significant depressive symptoms. Logistic regression analyses were conducted to examine the association between religiosity and depressive symptoms. Out of 3,157 participants, 20.3% participants had a score of or above 5 on PHQ-9. 35.4% reported religiosity as being “important” (24.7%) and “very important” (10.7%); 16% reported attending organized religious services at least once a month (3.1% reported once a month; 12.3% reported once a week; 0.6% reported almost every day); 23% reported having religious services at home at least once a month (10.3% reported once a month; 3.2% reported once a week; 9.5% reported almost daily). Results showed that recognizing religiosity as important is significantly negatively associated with depressive symptoms (odds ratio [OR]=0.94, 95% confidence interval [CI]=0.89-0.99). However, no significant associations between depressive symptoms and religious activity attendance or religious service at home were observed. Findings suggest that senses of belonging and life meaning may help reduce depressive symptoms, rather than the religious activities per se. Future interventions could reduce depressive symptoms of U.S. Chinese older adults through religiosity.

Among 2,038 older Chinese adults in the U.S., we examined the relationship between physical function (Short Performance Physical Battery [SPPB], [instrumental] activities of daily living [ADL/IADL] limitations) at baseline (2011-2013) and changes in cognitive function in the two-year follow-up (2013-2015). Cognitive function was measured by the East Boston Memory Test (EBMT), the Digit Span Backwards assessment (DSB), the Symbol Digit Modalities Test (SDMT), and the Mini-Mental State Examination (MMSE). During the two-year follow-up, 41.8%-50.88% of the participants decreased in cognitive function and 32.88%-44.8% increased. In linear regression that adjusted for baseline cognitive function, education, age, and other covariates, baseline SPPB and ADL/IADL limitations were significantly associated with changes in cognitive function in the two-year follow-up (SPPB: βEBMT=0.0149, p0.05; βSDMT=0.2742, p