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Background Evidence of the trend of the incidence of activities of daily living (ADL) disability among Chinese older people is limited. We aimed to investigate the time trends and potential risk factors for the incidence of ADL disability among Chinese older people (≥65 years). Methods We established two consecutive and nonoverlapping cohorts (6,857 participants in the 2002 cohort and 5,589 participants in the 2008 cohort) from the Chinese Longitudinal Healthy Longevity Survey. ADL disability was defined as the need for assistance with at least one essential activity (dressing, bathing, toileting, eating, indoor activities, and continence). Cox proportional hazards models were used to identify factors associated with the trend in the incidence of ADL disability from 2002 to 2014. Results The incidence (per 1,000 person-years) of ADL disability decreased significantly from 64.2 in the 2002 cohort to 46.6 in the 2008 cohort (p < .001), and decreasing trends in the incidence of ADL disability were observed for all sex, age, and residence subgroups (all p < .001), even after adjusting for multiple potential confounding factors. Moreover, we found that adjustment for sociodemographic, lifestyle information, and cardiovascular risk factors (hypertension, diabetes, heart disease, and stroke) explained less of the decline in ADL disability during the period from 2002 to 2014. Conclusion The incidence of ADL disability among the older adults in China appears to have decreased during the study period, and this finding cannot be explained by existing sociodemographic and lifestyle information and cardiovascular risk factors.

BACKGROUND: High concentrations of plasma 25-hydroxyvitamin D [25(OH)D], a marker of circulating vitamin D, have been associated with a lower risk of mortality in epidemiologic studies of multiple populations, but the association for Chinese adults aged ≥80 y (oldest old) remains unclear. OBJECTIVE: We investigated the association between plasma [25(OH)D] concentration and all-cause mortality among Chinese adults aged ≥80 y. DESIGN: The present study is a prospective cohort study of 2185 Chinese older adults (median age: 93 y). Prospective all-cause mortality data were analyzed for survival in relation to plasma 25(OH)D using Cox proportional hazards regression models, with adjustments for potential sociodemographic and lifestyle confounders and biomarkers. The associations were measured with HR and 95% CIs. RESULTS: The median plasma 25(OH)D concentration was 34.4 nmol/L at baseline. Over the 5466 person-year follow-up period, 1100 deaths were identified. Men and women were analyzed together as no effect modification by sex was found. After adjusting for multiple potential confounders, the risk of all-cause mortality decreased as the plasma 25(OH)D concentration increased (P-trend

Background: Little is known about the role of specific leisure activities in affecting cognitive functions. We aim to examine the associations of specific leisure activities with the risk of cognitive impairment among oldest-old people in China. Methods: This community-based prospective cohort study included 10,741 cognitively normal Chinese individuals aged 80 years or older (median age 88 years) from the Chinese Longitudinal Healthy Longevity Survey. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Cox proportional hazards models were utilized to estimate the effects of specific leisure activities on cognitive impairment outcome. Results: During a median follow-up time of 3.4 years (41,760 person-years), 2,894 participants developed cognitive impairment. Compared to those who “never” engaged in watching TV or listening to radio, reading books or newspapers, and playing cards or mah-jong, those who engaged in such activities “almost every day” reduced their risk of cognitive impairment, the fully-adjusted hazard ratios were 0.56 (0.51–0.61), 0.64 (0.53–0.78), and 0.70 (0.56–0.86), respectively. The association between the risk of cognitive impairment and watching TV and listening to the radio, playing cards or mah-jong, and reading books or newspapers were stronger among those who had two or more years of education. Moreover, the association between risk of cognitive impairment and watching TV and listening to radio was stronger in men than in women. Conclusions: In conclusion, a greater frequency of TV watching or radio listening, reading books or newspapers, and playing cards or mah-jong may decrease the risk of cognitive impairment among the oldest-old.

Evidence regarding alcohol consumption and cognitive impairment is controversial. Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown. This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment.This study included 15,758 participants age 65 years or older, selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that covered 23 provinces in China. Current alcohol use status, duration of alcohol cessation, and alcohol consumption before abstinence were self-reported by participants; cognitive function was evaluated using Mini-mental State Examination (MMSE). Cause-specific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment.Among the 15,758 participants, mean (± SD) age was 82.8 years (± 11.9 years), and 7,199 (45.7%) were males. During a mean of 3.9 years of follow-up, 3,404 cases were identified as cognitive impairment. Compared with current drinkers, alcohol cessation of five to nine years [adjustedA longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE. Alcohol cessation is never late for older adults to prevent cognitive impairment.

Objectives Currently, most treatment guidelines suggest lowering hypertriglyceridemia of any severity, even in elderly individuals. However associations of serum triglycerides (TGs) with adverse health and mortality risk decrease with age, it remains unclear among the oldest old (aged 80 years and older). The study was to investigate the relationship of serum TG concentrations with cognitive function, activities of daily living (ADLs), frailty, and mortality among the oldest old in a prospective cohort study. Design Longitudinal prospective cohort study. Setting Community-based setting in longevity areas in China. Participants A total of 930 (mean age = 94.0 years) Chinese oldest old. Measurements The TG concentrations were measured at baseline survey in 2009. Cognitive function, ADLs, frailty, and mortality were determined over 5 years of follow-up. Cox proportional hazards models and competing risk models were performed to explore the association, adjusting for potential confounders. Results Each 1-mmol/L increase in TGs was associated with a nearly 20% lower risk of cognitive decline, ADL decline, and frailty aggravation during the 5 years of follow-up. Consistently, higher TGs (each 1 mmol/L) was associated with lower 5-year all-cause mortality after fully adjustment (hazard ratio [HR] = 0.79; 95% confidence interval [CI] = 0.69-0.89). Nonelevated TG concentrations (less than 2.26 mmol/L) were associated with higher mortality risk (HR = 1.72; 95% CI = 1.22-2.44), relative to TGs of 2.26 mmol/L or more. We observed similar results regarding TG concentrations and mortality in 1-year lag analysis and when excluding participants with identified chronic disease. Conclusion In the oldest old, a higher concentration of TGs was associated with a lower risk of cognitive decline, ADL decline, frailty aggravation, and mortality. This paradox suggests the clinical importance of revisiting the concept of "the lower the better" for the oldest old. J Am Geriatr Soc 67:741-748, 2019.

Additional file 4: Table S3. Sensitivity analysis for the association of the number of natural teeth or denture use with mortality

Additional file 1: Figure S1. Flowchart of participant enrollment

Additional file 2: Table S1. Combined effects of tooth loss and denture use on mortality

Additional file 3: Table S2. Subgroup analysis for the associations between the number of natural teeth or denture use with mortality

Background: Higher C-reactive protein (CRP) levels have been proposed as a predictor of all-cause mortality in many existing studies from multiple populations, but the association for the oldest old adults (aged 80 and older) remains unclear. Objective: To examine the association between CRP and all-cause mortality among the oldest old Chinese adults. Design: This is a prospective, community-based longitudinal cohort study with 2206 adults aged 80 years old and older with available CRP test results. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidential intervals (95% CIs) for all-cause mortality according to CRP quartiles, adjusting for potential confounders. Results: The median age of the participants was 93 years old, and the median CRP concentration was 1.13 mg/L at baseline. During a median follow-up period of 36.7 months, 1106 deaths were verified. After full adjustment for potential confounders, a high CRP concentration was positively associated with an increased risk of all-cause mortality. Compared with the lowest quartile, the fully adjusted HRs of the second, third, and fourth quartiles were 1.17 (95% CI: 0.94, 1.46), 1.28 (95% CI: 1.01, 1.61), and 1.50 (95% CI: 1.20, 1.87), respectively. The association of CRP with all-cause mortality was likely modified by smoking status (P = 0.011). Conclusions: Our study indicated that a high CRP concentration was likely to be a prospective factor predicting death among the oldest old adults. Future studies investigating additional factors of disease and aging processes are needed to obtain a better understanding of the mechanisms.

This study aimed to assess the association of waist circumference (WC) with all-cause mortality among Chinese adults.The baseline data were from Shanxi Province of 2002 China Nutrition and Health Survey. The death investigation and follow-up visit were conducted from December 2015 to March 2016. The visits covered up to 5,360 of 7,007 participants, representing a response rate of 76.5%. The Cox regression model and floating absolute risk were used to estimate hazard ratio and 95% floatingThis study followed 67,129 person-years for 12.5 years on average, including 615 deaths. The mortality density was 916 per 100,000 person-years. Low WC was associated with all-cause mortality among men. Multifactor-adjusted hazard ratios (WC was an important predictor of death independent of body mass index (BMI). WC should be used as a simple rapid screening and predictive indicator of the risk of death.

Figure S1. Kaplanâ Meier plot showing the all-cause mortality by quintiles of superoxide dismutase in women (PDF 159 kb)

Figure S3. Kaplanâ Meier plot showing the all-cause mortality by quintiles of malondialdehyde (PDF 159 kb)

Importance Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging. Objective To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older. Design, Setting, and Participants Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014. Main Outcomes and Measures Disability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence. Results Among the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P, This cohort study uses data from the Chinese Longitudinal Healthy Longevity Study to examine whether body mass index (BMI) is associated with subsequent disability in activities of daily living in Chinese adults 80 years of age or older., Key Points Question Is higher body mass index or overweight or obesity associated with higher risk of subsequent disability in activities of daily living in Chinese adults 80 years of age or older? Findings In this cohort study of 16 022 Chinese adults aged 80 years or older, body mass index was linearly and inversely associated with disability in activities of daily living. When body mass index was categorized by quintiles or categorized by Chinese guidelines, higher body mass index, including being overweight or obese, showed significantly decreased risk of disability in activities of daily living. Meaning The finding suggests that current recommendations for body mass index may need to be revisited; more attention should be paid to underweight rather than overweight or obesity for the prevention of disability in activities of daily living in adults 80 years of age or older.

OBJECTIVES: To investigate the association between late-life blood pressure and the incidence of cognitive impairment in older adults. DESIGN: Prospective cohort study. SETTING: Community-living older adults from 22 provinces in China. PARTICIPANTS: We included 12,281 cognitively normal (Mini-Mental State Examination [MMSE] ≥ 24) older adults (median age: 81 years) from the Chinese Longitudinal Healthy Longevity Survey. Eligible participants must have baseline blood pressure data and have one or more follow-up cognitive assessments. MEASUREMENTS: Baseline systolic (SBP) and diastolic blood pressure (DBP) were measured by trained internists. Cognitive function was evaluated by MMSE. We considered mild/moderate/severe cognitive impairment (MMSE < 24, and MMSE decline ≥ 3) as the primary outcome. RESULTS: The participants with hypertension had a significantly higher risk of mild/moderate/severe cognitive impairment (HR 1.17, 95% CI 1.10 to 1.24). Overall the associations with cognitive impairment seem to be hockey stick-shaped for SBP and linear for DBP, though the estimated effects for low SBP/DBP were less precise. High SBP was associated with a gradual increase in the risk of mild/moderate/severe cognitive impairment (P-trend < 0.001). Compared with SBP 120–129 mmHg, the adjusted HR was 1.17 (95% CI 1.07 to 1.29) for SBP 130–139 mmHg, increased to 1.54(95% CI 1.35 to 1.75) for SBP≥180 mmHg. Analyses for high DBP showed the same increasing pattern, with an adjusted HR of 1.09 (95% CI 1.01 to 1.18) for DBP 90–99 mmHg and 1.19 (95% CI 1.02 to 1.38) for DBP ≥110 mmHg, as compared with DBP 70–79 mmHg. CONCLUSION: Late-life high blood pressure was independently associated with cognitive impairment in cognitively normal Chinese older adults. Prevention and management of high blood pressure may have substantial benefits for cognition among older adults in view of the high prevalence of hypertension in this rapidly growing population.

Objective To examine the associations of blood pressure with all cause mortality and cause specific mortality at three years among oldest old people in China. Design Community based, longitudinal prospective study. Setting 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, conducted in 22 Chinese provinces. Participants 4658 oldest old individuals (mean age 92.1 years). Main outcome measures All cause mortality and cause specific mortality assessed at three year follow-up. Results 1997 deaths were recorded at three year follow-up. U shaped associations of mortality with systolic blood pressure, mean arterial pressure, and pulse pressure were identified; values of 143.5 mm Hg, 101 mm Hg, and 66 mm Hg conferred the minimum mortality risk, respectively. After adjustment for covariates, the U shaped association remained only for systolic blood pressure (minimum mortality risk at 129 mm Hg). Compared with a systolic blood pressure value of 129 mm Hg, risk of all cause mortality decreased for values lower than 107 mm Hg (from 1.47 (95% confidence interval 1.01 to 2.17) to 1.08 (1.01 to 1.17)), and increased for values greater than 154 mm Hg (from 1.08 (1.01 to 1.17) to 1.27 (1.02 to 1.58)). In the cause specific analysis, compared with a middle range of systolic blood pressure (107-154 mm Hg), higher values (>154 mm Hg) were associated with a higher risk of cardiovascular mortality (adjusted hazard ratio 1.51 (95% confidence interval 1.12 to 2.02)); lower values (

OBJECTIVE: Current international and national guidelines for body mass index (BMI) and waist circumference (WC) have been recommended to all adults. However, whether recommendations applied to the oldest old (aged 80+) were poorly known. The study objective was to investigate the relationship of BMI and WC with 3-year all-cause mortality among the oldest old. DESIGN, SETTING, AND PARTICIPANTS: A total of 4361 Chinese oldest old (mean age 91.8) participated in this community-based prospective cohort study. MEASUREMENTS: BMI and WC were measured at baseline in 2011, and were used as continuous variables and as categorized variables by recommendations or by tertiles. Adjusted, sex-stratified Cox models with penalized splines and Cox models were constructed to explore the association. RESULTS: Greater BMI and WC were linearly associated with lower mortality risk in both genders. The mortality risk was the lowest in overweight or obese participants (BMI≥24.0 kg/m(2)); and was lower in participants with abdominal obesity. Compared to the upper tertile, those in middle and lower tertile of BMI had higher risk of mortality for men (hazard ratio [HR]:1.23[1.02–1.48] and 1.53[1.28–1.82]) and for women [HR: 1.21(1.03–1.41) and 1.35(1.15–1.58)]; it was also found in participants in middle and lower tertile of WC for men (HR: 1.21[1.01–1.46] and 1.41[1.18–1.69]) and for women (HR:1.35[1.15–1.58] and 1.55[1.32–1.81]) (all the p-values for trend

Background: In vitro and in vivo studies have suggested that some biomarkers of oxidative stress, such as superoxide dismutase(SOD), may protect against oxidative damage. This study aimed to evaluate the associations between biomarkers of oxidative stress, including plasma SOD activity and malondialdehyde(MDA), with all-cause mortality in older adults. Methods: This is a community-based cohort study of 2,224 participants(women:1227, median age: 86 years). We included individuals aged 65 or above and with plasma SOD activity and/or MDA tests at baseline. We evaluated the hazard ratios(HRs) and 95% confidence intervals(CIs) by multivariable Cox models Findings: We documented 858 deaths during six years of follow-up. There was a significant interaction effect of sex with the association between SOD activity and mortality(P

This study aims to assess the status of successful aging (SA) in longevity areas in China and explore multiple factors associated with SA among the young-old and oldest-old.A total of 2296 elderly people aged 65 and older were interviewed in the longevity areas sub-sample of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2012. Baseline assessments included a researcher-administered questionnaire, physical examination, and laboratory testing. A logistic regression model was used to identify factors associated with SA.The prevalence of SA was 38.81% in the CLHLS in 2012. There were significant differences between ages groups, with SA compromising 56.85% among ⋝65 years group and 20.31% among ⋝100 years group (χ2trend=126.73, P0.01). The prevalence of SA among females was 33.59%, which was significantly lower than that among males (45.58%) (χ2gender=33.65, P0.05). In the regression analysis, having anemia (OR=0.744, 95% CI: 0.609-0.910), poor lifestyle (OR=0.697, 95% CI: 0.568-0.854), poor sleep quality (OR=0.558, 95% CI: 0.456-0.682), and central obesity (OR=0.684, 95% CI: 0.556-0.841) were the main factors associated with SA. The promoting SA rate decreased as age increased, and the group of 65-79 years had higher odds than the other age group.Preventing central obesity, improving sleep quality and promoting healthy lifestyle may contribute to achieve SA among the elderly.

To explore the relationship between anemia and cognitive function among senior female aged 90 years old and above in longevity regions in China.383 senior female in 5 longevity areas from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008 - 2009 were included in the study. The cognitive function was assessed by mini mental state examination (MMSE) scale. All subjects were administered the physical examinations and biochemical testing of blood, including the hemoglobin. The difference of cognitive function between those with and without anemia was analyzed. Logistic regression was used to analyze the relationship between anemia and cognitive function.The 383 subjects were divided into two groups, 141 in anemia group and 242 in group without anemia. The total score of cognitive function was 9.65 ± 9.32 in anemia group, and 13.06 ± 10.25 in group without anemia (χ(2) = 5.59, P0.05). The percentage of cognition impairment was 84.4% (119/141) in anemia group, and 72.3% (175/242) in group without anemia (χ(2) = 8.08, P0.05). In the multivariable logistic regressions, after adjustment for age, education, marital status, smoking and alcohol drinking, the risk for cognition impairment in anemia group was about twice of that in group without anemia (OR = 2.016, 95%CI: 1.185 - 3.431, P = 0.010).Anemia increases the risk of cognition impairment among senior female in Chinese longevity areas.

To investigate the levels and differences of plasma selenium, manganese, iron, copper, zinc among oldest elderly in longevity areas in China.446 oldest elderly including 208 centenarians, 238 aged 90 and over, who lived in Xiayi county of Henan province (110 persons), Zhongxiang city of Hubei province (111 persons), Mayang county of Hunan province (60 persons), Sanshui district of Guangdong province (113 persons), Yongfu county of Guangxi Zhuang autonomous region (52 persons) in China, were selected. The contents of plasma selenium, manganese, iron, copper, zinc were detected and compared among these elderly who were classified into different genders, different regions and different age groups.In oldest elderly, the median (inter-quartile range) of content of plasma selenium was 1.44 (0.91) micromol/L, content of manganese was 0.54 (0.94) micromol/L, content of iron was 69.17 (102.85) micromol/L, content of copper was 20.19 (8.73) micromol/L, content of zinc was 31.66 (32.51) micromol/L. Contents of plasma selenium of oldest elderly in Xiayi, Zhongxiang, Mayang, Sanshui, Yongfu region were 1.46 (0.66), 1.30 (0.80), 1.06 (0.51), 2.39 (1.53) and 1.35(0.55) micromol/L; contents of plasma manganese were 0.56 (0.51), 1.40 (1.11), 0.35 (0.71), 0.44 (0.55) and 0.15 (0.21) micromol/L; contents of plasma iron were 86.77 (86.87), 141.42 (101.83), 38.88 (36.28), 31.38 (46.19) and 79.64 (75.34) micromol/L; contents of plasma copper were 22.16 (8.11), 19.46 (9.26), 21.36 (12.38), 18.12 (6.74) and 21.47 (7.85) micromol/L; contents of plasma zinc were 36.85 (26.18), 36.59 (35.94), 39.98 (56.91), 25.05 (24.92) and 16.74 (16.81) micromol/L. Contents of plasma trace elements among oldest elderly in different longevity areas were significantly different (F values were 29.76, 38.75, 47.18, 11.51 and 13.47, P values were all less than 0.05). Contents of plasma trace elements in different gender groups (contents of plasma selenium were 1.38 (0.83) micromol/L in male and 1.45 (0.91) micromol/L in female; contents of plasma manganese were 0.52 (0.95) and 0.54 (0.91) micromol/L; contents of plasma iron were 69.23 (104.06) and 69.11 (101.05) micromol/L; contents of plasma copper were 20.28 (8.72) and 20.06 (8.76) micromol/L; contents of plasma zinc were 28.39 (32.58) and 31.85 (34.26) micromol/L) were not significantly different (t(Se) = -1.82, P = 0.07; t(Mn) = 0.64, P = 0.52; t(Fe) = 0.65, P = 0.52; t(Cu) = -1.90, P = 0.06; t(Zn) = -0.96, P = 0.34). The contents of plasma selenium, iron, copper in centenarians were higher than those aged 90 and over (contents of plasma selenium were 1.63 (0.94) micromol/L and 1.30 (0.82) micromol/L, contents of plasma iron were 112.63 (119.78) and 60.13 (58.43) micromol/L, contents of plasma copper were 21.07 (9.03) and 18.81 (8.86) micromol/L, F value were 41.99, 27.32, 24.45, P values were less than 0.01). Content of plasma manganese in centenarians was lower than those aged 90 and over (0.44 (0.76) and 0.64 (0.93) micromol/L, F = 10.76, P0.01). No significant differences were detected in plasma zinc between concentration and those aged 90 and over (31.78 (34.06) and 31.11 (33.85) micromol/L; F = 1.32, P = 0.25).The concentrations of plasma selenium, manganese, iron, copper and zinc were high in oldest elderly in the longevity areas. The contents of plasma selenium, iron, copper increased with age.

To explore the level and effect factors of superoxide dismutase (SOD) and malondialchelyche (MDA) of the people aged 90 years old and above in longevity regions in China.From Xiayi county (Henan province), Zhongxiang county (Hubei province), Mayang county (Hunan province), Foshan county Sanshui district (Guangdong province) and Yongfu county (Guangxi province), the people of hundred-year were selected and numbered. The old people aged 90 - 99 according to the age and sex were appointed by the centenarians' code and 496 people were selected in total. Questionnaire investigation was conducted on nationality, education, nutrition, smoking, alcohol drinking, tea drinking and physical activities.436 blood sampling (4 ml Per sampling) were conducted and the level of triglyceride (TG), SOD, MDA, Ca, Mg, and some microelements were determined. Non-conditional logistic regression analysis was conducted to explore the effect factors of SOD and MDA in plasma.Analysis showed that the activity of plasma SOD was (31.19 +/- 5.51) U/ml, and the content of MDA was (4.68 +/- 1.98) micromol/L. The SOD level of minority people of 90 years old and over was (27.55 +/- 4.97) U/ml, lower than that of Han nationality ((31.73 +/- 5.39) U/ml; t = 5.85, P0.01); the MDA level of minority people of 90 years old and over was (5.58 +/- 1.95) micromol/L, higher than that of Han nationality ((4.54 +/- 1.95) micromol/L; t = -3.94, P0.01). logistic regression showed, comparing with the Han nationality, the minority had lower level of SOD (OR = 0.493), and higher level of MDA (OR = 5.412, P0.05). Beside nationality, the factors significantly affecting the activity of SOD included the intake frequency of meat, intake frequency of eggs and plasma concentration of Se (OR values were 0.388, 2.260 and 1.906, P0.05). The factors significantly affecting the level of MDA included the intake frequency of milk, physical activity and the level of TG (OR values were 0.435, 1.850 and 1.647, P0.05).The level of SOD of the oldest-old people aged 90 years old and over is relatively higher than the younger ones, and the level of MDA is relatively lower in longevity region, China. The effect factors of SOD are nationality, meat intake frequency, eggs intake frequency and the level of Se in plasma. The effect factors of MDA are nationality, milk intake frequency, physical activity and the level of TG in plasma.

To describe the epidemiological characteristics of anemia among elderly people aged 80 years old and above in longevity areas in China and to analyze its relevant factors to the health effects.The data used in this study came from the Chinese Longitudinal Healthy Longevity Survey, including all centenarians in 7 longevity areas, as well as randomly selected population aged 40-, 60-, 80- and 90- in the same 7 areas. A total of 1980 subjects enrolled in the study. The data of general information, eating habits and diseases history was collected by questionnaire survey. Hemoglobin, plasma macro and trace elements were gained by biochemical test. Logistic regression was used to analyze the anemia and its relevant factors.The prevalence of anemia of elderly people aged 40-, 60-, 80-, 90-, 100- were 16.1% (75/465), 19.1% (82/429), 41.1% (141/343), 46.2% (171/370) and 57.1% (213/373) in 7 longevity areas, which kept on a rise with the increasing of age (z = 14.7, P0.05). The prevalence of anemia of male aged 100 years old and above was 66.7% (38/57), which was the highest one among all elderly. Plasma Ca (2.96 mmol/L), Fe (58.22 micromol/L), Zn (28.84 micromol/L) and Cu (19.56 micromol/L) of the elderly people aged 90 years old and above in anemia group, and in control group they were 3.30 mmol/L, 78.26 micromol/L, 33.66 micromol/L, 20.62 micromol/L, respectively. The significant differences were observed between the two groups (z values were -2.95, -3.07, -2.23 and -2.16, P0.05). The main risk factors related to anemia were age (OR = 1.675, 95%CI: 1.554 - 1.807), followed by frequency of beans and their products intake (OR = 0.545, 95%CI: 0.435 - 0.682), waist circumference (OR = 0.567, 95%CI: 0.456 - 0.705) and frequency of meat intake (OR = 1.608, 95%CI: 1.303 - 1.983).The anemia status of oldest old people in longevity areas was severe. Higher frequency of beans and their products intake and maintaining well nutritional condition benefit for the prevention of anemia.

To compare the isolation effects and yields of rat kidney cells by three different digestion methods (collagenase, trypsinase, and the two step digestion method), the yields, proliferation rate, and LDH leakage in two different media (MEM and RPMI1640 media) in rats in two different ages (suckling and adult) .The renal cortex from the suckling and the adult rat group was digested by three different methods, respectively, and the suspension was separately cultured in MEM and RPMI1640 media. After 48 hours, the cells were digested and counted to calculate the yields, and the proliferation rate between 24h and 48h was examined by MTT examination, and the leakage of LDH in the media was measured by biochemical analyzer every day for 7 days.The yields of kidney cells by collagenase and the two-step method were significantly higher than by trypsinase method (P0.01), the suckling group were significantly higher than the adult group. The isolation effect of the two-step method was better than the collagenase method. The yields, proliferation rate, and LDH leakage of cells in MEM and RPMI1640 media had no significant difference.The two-step digestion method was the most appropriate method for the preparation of kidney cells. Both MEM and RPMI1640 media were suitable for the culture of kidney cells. The suckling rat was proper than the adult for kidney cell preparation.

Objectives Increasingly more studies have shown that high sensitivity C-reactive protein (hs-CRP) is related to diabetes in adults; thus, hs-CRP is thought to be a new emerging risk factor for cardiovascular disease, and diabetes. In addition, there are studies suggesting that the predictive value of classic risk factors diminish with advancing age; these results are controversial, and to our knowledge, few studies have explored the association of hs-CRP and diabetes in the oldest old. This study aimed to address the knowledge gap through analysis of the association of traditional risk factors and hs-CRP with diabetes among a group of Chinese oldest old. Methods 1603 participants in the fifth wave of the Chinese Longitudinal Healthy Longevity Study (CLHLS) from five longevity areas were invited to participate in this sub-study; based on availability of hs-CRP and other related data, 522 subjects aged 80 and older were included in the sample. Information was collected related to demographics (age, sex, nationality, marriage, and education), lifestyle (smoking status, drinking status, and physical activity), and self-reported chronic diseases, including diabetes and hypertension. Measurements of waist circumstance, diastolic blood pressure and systolic blood pressure were performed. High sensitively C reactive protein (hs-CRP), total cholesterol (TC), triglycerides (TG) and fasting plasma glucose (FPG) were tested in a certified laboratory in Beijing. The subjects were classed into two groups according to the prevalence of diabetes (a positive self-report or a plasma glucose of above 7.0 mmol/l was considered to be diabetic). Student9s t-test was used to compare the basic characteristics and clinical biochemical indices. Logistic regression was used to analyse the association of hs-CRP and traditional risk factors of diabetes (including age, smoking status, drinking status, physical activity, central obesity, total cholesterol, triglycerides). Also multivariable linear regression was fit to explore the relation of hs-CRP and traditional risk factors with FPG. Results Compared with the non-diabetic group, plasma hs-CRP concentrations in the diabetic group were significantly higher (median value 1.95 mg/l, p 0.05) in the two groups. Logistic regression analysis showed that hs-CRP was significantly positively associated with diabetes (p Conclusions In contrast to traditional risk factors of diabetes except TG, hs-CRP is significantly and independently associated with diabetes in the Chinese oldest-old.

Table S3. Sensitivity analyses for the association between superoxide dismutase and all-cause mortality (DOCX 30 kb)

Table S4. Sensitivity analyses for the association between malondialdehyde and all-cause mortality (DOCX 29 kb)

Table S4. Sensitivity analyses for the association between malondialdehyde and all-cause mortality (DOCX 29 kb)

Table S2. Subgroup analyses for the hazard ratio of all-cause mortality for each 5â Îźmol/L increase in malondialdehyde (DOCX 27 kb)

Table S1. Subgroup analyses for the hazard ratio of all-cause mortality for each 10â U/mL increase in superoxide dismutase activity in men (DOCX 27 kb)

Figure S2. Kaplanâ Meier plot showing the all-cause mortality by quintiles of superoxide dismutase in men (PDF 153 kb)

Table S2. Subgroup analyses for the hazard ratio of all-cause mortality for each 5â Îźmol/L increase in malondialdehyde (DOCX 27 kb)

Table S3. Sensitivity analyses for the association between superoxide dismutase and all-cause mortality (DOCX 30 kb)

Table S1. Subgroup analyses for the hazard ratio of all-cause mortality for each 10â U/mL increase in superoxide dismutase activity in men (DOCX 27 kb)