Obesity is positively Associated with Depression in Older Adults:Role of Systemic Inflammation

Objective We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.Methods Adults≥65 years old(n=1,973)were interviewed at baseline in 2018 and 1,459 were followed up in 2021.General and abdominal obesity were assessed,and serum C-reactive protein(CRP)levels were measured at baseline.Depression status was assessed at baseline and at follow-up.Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms,as well as the relationship between obesity and CRP levels.The associations of CRP levels with the geriatric depression scale,as well as with its three dimensions,were investigated using multiple linear regressions.Results General obesity was associated with worsening depression symptoms and incident depression,with an odds ratio(OR)[95%confidence interval(CI)]of 1.53(1.13-2.12)and 1.80(1.23-2.63),especially among old male subjects,with OR(95%CI)of 2.12(1.25-3.58)and 2.24(1.22-4.11),respectively;however,no significant relationship was observed between abdominal obesity and depression.In addition,general obesity was associated with high levels of CRP,with OR(95%CI)of 2.58(1.75-3.81),especially in subjects free of depression at baseline,with OR(95%CI)of 3.15(1.97-5.04),and CRP levels were positively correlated with a score of specific dimension(life satisfaction)of depression,P<0.05.Conclusion General obesity,rather than abdominal obesity,was associated with worsening depressive symptoms and incident depression,which can be partly explained by the systemic inflammatory response,and the impact of obesity on depression should be taken more seriously in the older male population.

The Status and Associated Factors of Successful Aging among Older Adults Residing in Longevity Areas in China

Objective 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. Methods 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. Results 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 （X2trend=126.73, P〈O.01）. The prevalence of SA among females was 33.59%, which was significantly lower than that among males （45.58%） （X2gender=33.65, P〈0.05）. 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. Conclusion Preventing central obesity, improving sleep quality and promoting healthy lifestyle may contribute to achieve SA among the elderly.

Abdominal Obesity and Its Attribution to All-cause Mortality in the General Population with 14 Years Follow-up:Findings from Shanxi Cohort in China

Objective This study aimed to assess the association of waist circumference(WC)with all-cause mortality among Chinese adults.Methods 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%floating CI of death by gender and age groups(≥60 and<60 years old).Sensitivity analysis was performed by excluding current smokers;participants with stroke,hypertension,and diabetes;participants who accidentally died;and participants who died during the first 2 years of follow-up.Results This 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(HR)were 1.60(1.35–1.90)for WC<75.0 cm and 1.40(1.11–1.76)for WC ranging from 75.0 cm to 79.9 cm.Low WC(<70.0 cm and 70.0–74.9 cm)and high WC(≥95.0 cm)groups had a high risk of mortality among women.The adjusted HRs of death were 1.43(1.11–1.83),1.39(1.05–1.84),and 1.91(1.13–3.22).Conclusion 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.

Alcohol Cessation in Late Life is Associated with Lower Risk of Cognitive Impairment among the Older Adults in China

Objective 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.Methods 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).Causespecific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment.Results 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[adjusted HR,0.79(95%CI:0.66-0.96)]and more than nine years[adjusted HR,0.82(95%CI:0.69-0.98)]were associated with lower risk of cognitive impairment.Conclusion A 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.

High Sensitivity C-Reactive Protein Associated with Different Health Predictors in Middle-Aged and oldest old Chinese

Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.