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Introduction: Maintaining a better physical and mental health status is an important issue for older adults in their later life. Thus, the study's purpose was to evaluate the association between body mass index (BMI) and mental health status in older adults aged 65 years old or above residing in communities of Taipei City, Taiwan. Methods: We carried out secondary data analysis with data from a volunteer-based health examination project for older adults >65 years old residing in Taipei City from 2006 to 2010 with a retrospective study design. BMI, calculated by standardized measuring procedures for height and weight, and mental health status, evaluated by 5-item Brief Symptom Rating Scale (BSRS-5), were collected at their first visits of health examination. A BSRS-5 score ≥6 was considered an inferior mental health status for the outcome. In statistical analysis, univariable and multivariable logistic regressions were adopted to estimate the relative risk of inferior mental health status, treating BMI as the major exposure of interest. Results: A total of 90,576 subjects were involved, with a mean age of 73.38 years old (SD = 6.64 years) and 49.21% females. With confounders controlled, compared to normal or overweight (23 ≤ BMI <30), an adjusted OR of 1.23 (95% CI: 1.18, 1.29) on inferior mental health status was detected for the underweight group (BMI <23) significantly. Adjusted OR for those obese (BMI ≧30) was 0.87 (95% CI: 0.79, 0.96). Significantly elevated ORs of underweight were found for both genders, but the significantly protective effect of obese was only detected for females. Conclusion: Keeping an appropriate weight or even being overweighted might be beneficial for older adults dwelling in the community, especially for males. [ABSTRACT FROM AUTHOR]

Objective To evaluate the elderly mortality and all population emergency room visits (ERV) associated with exposing to particulate matter (PM) ≤ 10 μm in aerodynamic diameter (PM 10 ), PM 2.5 , and PM constituents in Taipei, Taiwan. Methods This study used a distributed lag nonlinear model with Poisson distribution to estimate cumulative 6-day (lags 0–5) relative risks (RRs) and confidence intervals (CIs) of mortality and ERV of all causes, circulatory diseases, and respiratory diseases associated with daily concentrations of PM 10 , PM 2.5 and PM constituents (organic carbon (OC), elemental carbon (EC), nitrate and sulfate). Results Mortality and ERVs were associated with PM concentrations and its constituents. The elderly all-cause mortality was significantly associated with nitrate concentrations (RR = 1.12 (95% CI: 1.02, 1.23) at 1 μg/m 3 ) and OC higher than 15 μg/m 3 ; and mortality from circulatory diseases was significantly associated with PM 10 (RR = 1.13 (95% CI: 1.02, 1.25) at 50 μg/m 3 ), PM 2.5 (RR = 1.16 (95% CI: 1.01, 1.34) at 30 μg/m 3 ), nitrate higher than 8 μg/m 3 , and sulfate (RR = 1.31 (95% CI: 1.12, 1.54) at 7 μg/m 3 ). An increase in PM 2.5 from 5 μg/m 3 to 30 μg/m 3 was associated with increased ERV risk of all causes and respiratory diseases with cumulative 6-day RRs of 1.12 (95% CI: 1.06, 1.18) and 1.27 (95% CI: 1.10, 1.46), respectively. All-cause ERV was significantly associated with concentrations of OC (RR = 1.03 (95% CI: 1.00, 1.06) at 4 μg/m 3 ), EC (RR = 1.08 (95% CI: 1.05, 1.12) at 2 μg/m 3 ), nitrate higher than 6 μg/m 3 , and sulfate higher than 8 μg/m 3 . Conclusions Ambient air quality management should regularly evaluate PM constituents and related health effects. [ABSTRACT FROM AUTHOR]

This study evaluates mortality risks from all causes, circulatory diseases, and respiratory diseases associated with particulate matter (PM 10 and PM 2.5 ) concentrations and Asian dust storms (ADS) from 2000 to 2008 in Metropolitan Taipei. This study uses a distributed lag non-linear model with Poisson distribution to estimate the cumulative 5-day (lags 0–4) relative risks (RRs) and confidence intervals (CIs) of cause-specific mortality associated with daily PM 10 and PM 2.5 concentrations, as well as ADS, for total (all ages) and elderly (≥65 years) populations based on study periods (ADS frequently inflicted period: 2000–2004; and less inflicted period: 2005–2008). Risks associated with ADS characteristics, including inflicted season (winter and spring), strength (the ratio of stations with Pollutant Standard Index >100 is <0.5 or ≥0.5), and duration (ADS persisted for 1–3 or ≥4 days), were also evaluated. Nonlinear models showed that an increase in PM 10 from 10 μg/m 3 to 50 μg/m 3 was associated with increased all-cause mortality risk with cumulative 5-day RR of 1.10 (95% CI: 1.04, 1.17) for the total population and 1.10 (95% CI: 1.02, 1.18) for elders. Mortality from circulatory diseases for the elderly was related to increased PM 2.5 from 5 μg/m 3 to 30 μg/m 3 , with cumulative 5-day RR of 1.21 (95% CI: 1.02, 1.44) from 2005 to 2008. Compared with normal days, the mortality from all causes and circulatory diseases for the elderly population was associated with winter ADS with RRs of 1.05 (95% CI: 1.01, 1.08) and 1.08 (95% CI: 1.01, 1.15), respectively. Moreover, all-cause mortality was associated with shorter and less area-affected ADS with an RR of 1.04 for total and elderly populations from 2000 to 2004. Population health risk differed not only with PM concentration but also with ADS characteristics. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated risks of the emergency room visits (ERV) for cerebrovascular diseases, heart diseases, ischemic heart disease, hypertensive diseases, chronic renal failure (CRF), diabetes mellitus (DM), asthma, chronic airway obstruction not elsewhere classified (CAO), and accidents associated with the ambient temperature from 2000 to 2009 in metropolitan Taipei. Methods: The distributed lag non-linear model was used to estimate the cumulative relative risk (RR) and confidence interval (CI) of cause-specific ERV associated with daily temperature from lag 0 to lag 3 after controlling for potential confounders. Results: This study identified that temperatures related to the lowest risk of ERV was 26 °C for cerebrovascular diseases, 18 °C for CRF, DM, and accidents, and 30 °C for hypertensive diseases, asthma, and CAO. These temperatures were used as the reference temperatures to measure RR for the corresponding diseases. A low temperature (14°C) increased the ERV risk for cerebrovascular diseases, hypertensive diseases, and asthma, with respective cumulative 4-day RRs of 1.56 (95% CI: 1.23, 1.97), 1.78 (95% CI: 1.37, 2.34), and 2.93 (95% CI: 1.26, 6.79). The effects were greater on, or after, lag one. At 32°C, the cumulative 4-day RR for ERV was significant for CRF (RR = 2.36; 95% CI: 1.33, 4.19) and accidents (RR = 1.23; 95% CI: 1.14, 1.33) and the highest RR was seen on lag 0 for CRF (RR = 1.69; 95% CI: 1.01, 3.58), DM (RR = 1.69; 95% CI: 1.09, 2.61), and accidents (RR = 1.19; 95% CI: 1.11, 1.27). Conclusions: Higher temperatures are associated with the increased ERV risks for CRF, DM, and accidents and lower temperatures with the increased ERV risks for cerebrovascular diseases, hypertensive diseases, and asthma in the subtropical metropolitan. [ABSTRACT FROM AUTHOR]

This study reported cumulative 6-day (lag 0–5 days) relative risks (RR) and confidence intervals (CI) of daily outpatient visits for total respiratory disease (RD), asthma, and chronic airway obstruction not otherwise classified (CAO) associated with three ozone metrics (daily 1-h maximum (O3, 1 h max), 8-h average maximum (O3, 8 h max), 24-h average (O3, 24 h avg)), and an alternative oxidant indicator (Ox) in Taipei Metropolitan, using distributed lag non-linear models after controlling for potential confounders. The Ox showed the strongest association with outpatient visits for total RD (RR = 1.10, 95% CI: 1.10, 1.11) and asthma (RR = 1.18, 95% CI: 1.00, 1.39) in the cold season. The O3, 24 h avg appeared to be the optimal ozone metric associating with total RD than O3, 1 h max and O3, 8 h max based on model selection. In conclusion, outpatient visits for total RD associated with ozone vary with ozone metrics, disease and season. [Copyright &y& Elsevier]

Abstract: Objective: This study investigated whether outpatient visits of acute upper respiratory infections for children aged less than 15 years are associated with temperature, air pollutants and circulating respiratory viruses in Taipei, Taiwan, from 2003 to 2007. Methods: Outpatient records for acute upper respiratory infections (ICD9 CM codes: 460, 462, 463,464, 465.9 and 487) in a randomly selected sample (n=39,766 children in 2005) was used to estimate the cumulative relative risks (RR) associated with average temperature lasting for 8 days (lag 0–7 days), air pollutants (NO2, O3 and PM2.5) lasting for 6 days (lag 0–5 days), and virus-specific positive isolation rate lasting for 11 days (lag 0–10 days) using distributed lag non-linear models after controlling for relative humidity, wind speed, day of week, holiday effects and long-term trend. Results: Average temperature of 33°C was associated with the lowest risk for outpatient visits of acute upper respiratory infections. Relative to 33°C, cumulative 8-day RR was highest at 15°C of ambient average temperature [RR=1.94; 95% confidence interval (CI): 1.78, 2.11]. With the first quartile as reference, cumulative 6-day RRs were 1.25 (95% CI: 1.21, 1.29) for NO2, 1.04 (95% CI: 1.01, 1.06) for O3, and 1.00 (95% CI: 0.98, 1.03) for PM2.5 at the 95th percentile. Per-standard deviation (SD) increase of virus-specific isolation rate for influenza type A (SD=13.2%), type B (SD=8.76%), and adenoviruses (SD=5.25%) revealed statistical significance for overall 11-day RRs of 1.02 (95% CI: 1.01, 1.03), 1.05 (95% CI: 1.03, 1.06) and 1.04 (95% CI: 1.03, 1.05), respectively. Conclusions: Current study suggested a positive association between outpatient visits for acute upper respiratory infections and ambient environment factors, including average temperature, air pollutants, and circulating respiratory viruses. [Copyright &y& Elsevier]