Metabolic Disorders Increase the Risk to Incident Cardiovascular Disease in Middle-aged and Elderly Chinese

Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.

Public Square Dancing Intervention on Subjective Well-Being of Middle-Aged and Elderly People:A Meta-Analysis

Objective:To understand the influence of public square dancing on the subjective well-being of middle-aged and elderly people.Methods:According to the principle of Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,we search Chinese databases,such as CNKI,Wanfang Data,and VIP,and English databases,such as Proquest,Web of Science,Pubmed,Cochrane,and ScienceDirect,and collect relevant articles at home and abroad from 2006 to December 2019 for meta-analysis in January 2020.Result:A total of 10 articles were included.The meta-analysis results showed that the well-being of middle-aged and elderly people in the public square dancing intervention group was significantly higher than that of the other exercise group and control group(both P<0.01).The results of the subgroup analysis showed the following:Different durations of intervention significantly influence the intervention effect(P<0.01).No difference was found between the effect of the mixed-gender intervention and the individual female intervention(P>0.05).No significant difference was found between the groups with weekly intervention frequency(P>0.05).Conclusion:Public square dancing intervention is effective for middle-aged and elderly people’s subjective well-being.Neither mixed intervention nor the times of weekly intervention have an impact on the intervention effect.However,the length of duration of intervention influences the intervention effect.

Relationship between platelet-lymphocyte ratio and carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus

Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2018 to September 2020 and were examined by ultrasound were selected as the subjects.The carotid artery intima-media thickness(CIMT)was examined by color Doppler ultrasonography,including normal CIMT group(n=111),CIMT thickening group(n=103)and CAS plaque group(n=206).The differences of serum PLR levels among the three groups were compared.Multivariate Logistic regression was used to analyze the relationship between PLR and CAS plaque formation.The receiver operating curve(ROC)was used to evaluate the value of multivariate Logistic regression model(Logit P)in the diagnosis of CAS lesions.Results:The mean value of PLR in CAS plaque group(127.86±48.54)was significantly higher than that in CIMT normal group(109.15±48.35).Multivariate Logistic regression analysis showed that after adjusting for other confounding factors,the increase of PLR was an independent risk factor for the occurrence of CAS plaque.ROC showed that the efficacy of multivariate Logit P model in the diagnosis of CAS plaque was(AUC=0.807,95%CI=0.759-0.858).Conclusions:PLR is one of the important risk factors for the occurrence of CAS lesions.At the same time,the multivariate Logistic regression model established in this study has clinical reference value in predicting CAS lesions in middle-aged and elderly patients with T2DM.

Associations of short-term ambient temperature exposure with lung function in middle-aged and elderly people:A longitudinal study in China

The short-term associations of ambient temperature exposure with lung function in middle-aged and elderly Chinese remain obscure.The study included 19,128 participants from the Dongfeng-Tongji cohort's first(2013)and second(2018)follow-ups.The lung function for each subject was determined between April and December 2013 and re-assessed in 2018,with three parameters(forced vital capacity[FVC],forced expiratory volume in 1 s[FEV1],and peak expiratory flow[PEF])selected.The China Meteorological Data Sharing Service Center provided temperature data during the study period.In the two follow-ups,a total of 25,511 records(average age:first,64.57;second,65.80)were evaluated,including 10,604 males(41.57%).The inversely J-shaped associations between moving average temperatures(lag01–lag07)and FVC,FEV1,and PEF were observed,and the optimum temperatures at lag04 were 16.5C,18.7C,and 16.2C,respectively.At lag04,every 1C increase in temperature was associated with 14.07 mL,9.78 mL,and 62.72 mL/s increase in FVC,FEV1,and PEF in the lowtemperature zone(<the optimum temperatures),whereas 5.72 mL,2.01 mL,and 11.64 mL/s decrease in the high-temperature zone(the optimum temperatures),respectively(all P<0.05).We observed significant effect modifications of gender,age,body mass index,body surface area,smoking status,drinking status,and physical activity on the associations(all Pmodification<0.05).Non-optimal temperatures may cause lung function decline.Several individual characters and lifestyles have effect modification on the temperature effects.

Coping review of dementia fear studies among middle-aged and elderly people in the community

This study used Arksey and O’Malley’s scoping review methodology as a framework and searched the following databases:PubMed,Embase,EBSCO,CINAHL,Web of Science,Cochrane Library,Scopus,CNKI,Wanfang,VIP,and the Chinese Biomedical Literature Database.The database is open to December 20,2023,and documents related to the fear of dementia among the elderly in the community are described and analyzed to provide a reference for future research in this field.At the same time,we screened,extracted,and summarized relevant information from 21 included documents(16 in English and 5 in Chinese),which consisted of 16 cross-sectional studies,2 quasi-experimental studies,2 randomized controlled studies,and 1 longitudinal study.Sixteen of the included documents mentioned the incidence or level of dementia fear among the elderly in the community,2 addressed the adverse effects of dementia fear,and 4 reported prevention and intervention measures for dementia fear.In total,there are 8 assessment tools,and the influencing factors are categorized into sociodemographic characteristics,psychological and behavioral characteristics,sociocultural background factors,and health and dementia-related factors.The final conclusion is that the fear of dementia is common among the elderly in the community.In the future,the application of research tools should be expanded among middle-aged individuals,with considerations for other types of dementia in mind.It is recommended to conduct large-scale,multi-center randomized controlled trials while confirming the intervention’s effect on different types of middle-aged and elderly individuals,focusing on the long-term impact of these intervention measures to promote healthy aging.

Post-stroke seizures in consecutive elderly stroke patients

This prospective study sought to investigate the clinical, radiological and electroencephalographic （EEG） characteristics of seizures in elderly stroke patients, and their outcomes. Over a 2-year study period, 158 consecutive elderly patients with stroke were examined and followed up. Of these patients, 32 （20%） developed seizures, primarily related to stroke, within a follow up period between 5 months and 2 years. Of these 32 cases, 20 experienced infarctions, and 12 experienced hemorrhages. Involvement of cortical regions was detected in most of the patients exhibiting seizures. In these patients, 44% of the lesions involved cortical areas exclusively or in addition to subcortical areas observed on computed tomography （CT） images. Twenty-five patients （78%） developed early seizures （within 2 weeks after stroke）, and half exhibited immediate post-stroke seizures. None of the patients exhibiting early onset seizures developed recurrent seizures or epilepsy, while 57% of late onset seizures （four cases） developed epilepsy. No specific EEG pattems were apparent in those who later developed epilepsy. Overall, early onset seizures after stroke were found to be relatively common, and did not affect outcome. Late onset seizures were less common, but were associated with chronic epilepsy.

Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China

In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone （TT） and sex hormone-binding globulin （SHBG） were performed, and the aging male symptoms （AMS） questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms （decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido） were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l^-1 for a decreased ability/frequency to perform sex, 12.55 nmol l^-1 for decreased frequency of morning erections, and 14.35 nmol l^-1 for decreased sexual desire. The calculated free testosterone （CFT） thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l^-1, respectively. TT 〈13.21 nmol l^-1 （OR =1.4, 95%Ch 1.0-1.9, P= 0.037） or CFT 〈268.89 pmol l^-1 （OR - 1.5, 95%Ch 1.1-20, P=0.020） was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels 〈13.21 nmol l^-1 and CFT levels 〈268.89 pmol l^-1. Our results may improve the diagnostic accuracy of LOH in older men.

Prevalence and influence factors of self-medication in Chinese middle-aged and elderly people: evidence from 2011, 2013 and 2015 CHARLS panel data

Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health.In this study,we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people,and explored the influence factors.The data from China Health and Retirement Longitudinal Study(CHARLS)in 2011,2013 and 2015 were used.Self-medication prevalence was calculated as the number of whole people divided by the number of people taking self-medication.The influence factors of self-medication were analyzed by panel data random effect model.We excluded observations with missing values in our analysis,leaving 16 962,17 876 and 19 572 observations in 2011,2013 and 2015,respectively.The average 3-year self-medication prevalence was 45.52%.Moreover,11.70%of respondents practiced self-medication with prescription medicine in 2011,2013 and 2015.Respondents living in non-rural areas(P=0.009)and western region(P=0.000)took more self-medication.Self-medication was a common phenomenon among middle-aged and elderly population in China.The government should strengthen the guidance for the middle-aged and elderly people who took more self-medication,such as those living in urban and western region.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China:results from a national survey

This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.

Prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes

Background Stroke is now the most prevalent and debilitating disease affecting diabetic population in China. The study aimed to investigate the prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes. Methods A total of 4 629 subjects with type 2 diabetes （males： 1 917; females： 2 712） aged ≥ 40 years from Shijingshan district, Beijing, China from November 2011 to August 2012 were included in the study. Data on demographic information, lifestyle, history of diabetes mellitus, stroke, coronary heart disease, hypertension, and dyslipidemia were collected. The oral glucose tolerance test or a standard meal test was performed. Non-fatal stroke was reported by the subjects. The 2-tailed test was used, and P 〈0.05 was regarded as statistically significant. Results Prevalence of stroke in the subjects with type 2 diabetes was 5.5%. The prevalence of smoking, overweight or obesity, hypertension, and dyslipidemia was 41.0%, 65.8%, 67.4%, and 52.0% in males, and 2.2%, 65.5%, 69.5%, and 57.6% in females. Multivariate Logistic regression analysis showed that increased age, hypertension, diabetic duration, and overweight or obesity were positively correlated with stroke in the population with type 2 diabetes, whereas high- density lipoprotein cholesterol level was negatively correlated with stroke. After adjustment for age and gender, the odds ratio values of stroke in subjects having 1,2 or ≥3 of 4 risk factors, including smoking, overweight or obesity, hypertension and dyslipidemia, were 2.302 （95% CI： 0.789-6.712）, 4.089 （95% CI： 1.470-11.373）, 6.023 （95% CI： 2.176-16.666）, compared with subjects without any of the above 4 risk factors. Conclusions The prevalence of stroke was higher in middle-aged and eldedy Chinese with type 2 diabetes than that in the general population. With the aggregation of risk factors, the prevalence of stroke increased.

The Association between Interpersonal Relationship and Erectile Dysfunction of Middle-Aged and Elderly Men in a Rural Area of Zhejiang,China

Objective:To explore the association between interpersonal relationship and erectile dysfunction(ED)of middle-aged and elderly men.Methods:A population-based cross-sectional research was conducted in the rural area of Jiashan County,Zhejiang Province,in 2016.Middle-aged and elderly men(aged 40-80)were selected as study participants.The face-to-face questionnaire was collected,including basic information,lifestyles,interpersonal relationship,and sexual function.The interpersonal relationship was evaluated based on marital relationship,neighborhood relationship,and relatives/friends relationship.According to the International index of erectile function,the study participants were divided into ED group(mild ED,moderate-to-severe ED),and non-ED group.Correlations were evaluated between interpersonal relationship indices and the prevalence or the severity of ED.Potential confounders were adjusted by the logistical regression model.Results:There were 674 study participants with average age of 60.4±8.5 years,and 489 ED patients with prevalence of 72.6%.With age increasing,the prevalence and the severity of ED increased significantly.The men who could get help from spouse when an emergency occurred or who were more cared about by their neighbors had lower ED risk,and odds ratios(ORs)(95%confidence intervals[CIs])were 0.23(0.13-0.42)and 0.58(0.46-0.75),respectively.After the adjustment of the covariates(age,education degree,household income,smoking,and drinking),the ORs(95%CIs)were 0.29(0.14-0.60)and 0.54(0.39-0.74),respectively.Good marital relationship and good neighborhood relationship were associated with a less severity of ED.

Study on Prevention and Treatment of Kidney Deficiency and Bone Mineral Loss in Middle-Aged and Elderly Female Diabetes Patients

In this study, 48 cases of middle-aged and elderly female diabetes patients were dividedrandomly into two groups, and treated separately by western medicine alone ( glibenclamide) in group A, andby traditional Chinese medicine (herbs that replenish the Kidney and activate blood circulation ) and gliben-clamide in group B. Before treatment, the patients of both groups had elevated glycosylated hemoglobin(HbAlc) and fast blood glucose (FBG) levels, decreased serum estradiol (E2 ) and testosterone/estradiol(E2/T) ratio, and the loss of bone mineral (elevated urinary calcium,phosphorus levels) . Most ot the pa-tients in the two groups had the symptoms of soreness and weakness of the loins and knees, general weak-ness ,dizziness,decreased sexual libido , palpitation and frequent urination , etc. These symptoms in traditionalChinese medicine belong to the deficiency of the Kidney. After treatment in both groups. the patients' serumHbAlc, FBG, and urinary Beta-2-microglobulin (B2M) got reduced, the concentration of serum sex hormone(E2 , E2/T ratio) elevated, and the elimination of urinary calcium, phosphorus levels cut down. But , the ther-apeutic effect in group B is apparently better than that in group A. The symptoms of deficiency of the Kidneywas apparently improved in group B. So, The authors think the medicinal herbs(reinforcing Kidney and acti-vating blood circulation) have an important role in the prevention and treatment of the 'Kidney deficiency'and bone mineral loss in middle-aged and elderly female diabetes patients.

Effect of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia

Objective To evaluate effects of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2diabetes and combined hyperlipidemia.Methods Totally80 elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia were treated with Atorvastatin(10 mg/d)for 12 weeks.Fasting plasma levels

The study of the correlation between serum uric acid and insulin resistance in middle-aged and elderly hospitalized patients with type 2 diabetes

Objective To study the relationship between serum uric acid and insulin resistance in type 2 diabetic patients.Methods A total of 728 middle-aged and elderly type 2 diabetic patients were recruited and the anthropometric,clinical and biochemical parameters and

Analysis of the impact of exercise education interventions on middle-aged and elderly people in Central-western rural China

This study aims to analyze the impact of health education effort that promote exercise activities have had on middle-aged and older people in central-western rural China.The Project for Family Health Care(PFHC)of the population in central and western China used questionnaires completed anonymously to survey 4217 randomly selected respondents in the baseline year of 2011,and 4529 in the end-line year of 2015.We used bivariate and multivariate analyses to examine the associations between several factors and regular exercise activities.The 2011 baseline year sample indicated that 90.5%of respondents knew the functions of regular exercise,but that only 45.4%participated in regular exercise activities.In the baseline multivariate model,a number of factors were positively associated with the prevalence of participation in regular exercise activities.Respondents who were women,older,retired,lived with children,had chronic diseases,and self-reported better health were more likely to participate in regular exercise.The proportion of those participating in regular exercise increased to 75.9%among the end-line year respondents after health education.This study revealed that health education interventions effectively encouraged rural middle-aged and elderly people to participate in regular exercise activities.Health education efforts of this sort for rural middle-aged and older adults should be further strengthened,and more public facilities for exercise should be provided.

METABONOMICS CHARACTERISTICS OF MIDDLE-AGED AND ELDERLY CHINESE PEOPLE WITH QI-INSUFFICIENCY CONSTITUTION

The aim of the work was to investigate the metabonomic characteristics of qi-insufficiency constitution among middle-aged and elderly healthy Chinese people.All healthy Chinese participants were screened from 2012annual health check-up for middle-aged and elderly community residents(=50 years old)at Chajiao community,

20.5.Epilepsy

920390 Clinical analysis of 36 cases ofepilepsy in the elderly with cerebrovasculardiseases.SHI Shangjin (石尚金),et al.DeptNeurol,General Hosp,Guangzhou Milit Com-mand.Chin J Geriatr 1991;10(4):206-208.

桂林中老年群体智慧医疗服务使用意愿调查:基于技术采纳与应用整合理论模型

目的对中老年群体智慧医疗服务使用情况及其影响因素进行调查分析,为医疗机构优化智慧医疗服务、推动中老年群体数字鸿沟治理提供参考。方法在广西壮族自治区桂林市采用线下问卷调查、访谈等方法收集数据,结合技术采纳与应用整合理论模型,使用SPSS 26.0和AMOS 24.0进行不同变量描述统计、单因素分析、不同维度相关分析和结构方程模型路径分析,研究中老年群体在使用智慧医疗服务过程中的影响因素。结果桂林市中老年群体对智慧医疗服务的使用意愿得分为(3.14±0.76)分,除了性别,不同变量对中老年群体的使用意愿差异分别有统计学意义(P<0.05)。中老年群体的绩效期望、社群影响、配合情况对中老年群体使用智慧医疗服务意愿有正向影响,努力期望对于使用意愿的影响不明显。结论桂林市中老年群体智慧医疗服务使用意愿还有很大的提升空间,要从各维度入手提高中老年群体的使用意愿,多方共同努力推进智慧医疗服务的使用。

Clinical characteristics and impactof comorbidities on the prognosis of senileepilepsy in Southwest China:a retrospectivecohort study

Background Senile epilepsy and its comorbidities pose a tremendous burden on patients and the society.Thisstudy was aimed to investigate the clinical characteristics and comorbidities of senile epilepsy,as well as the impactof comorbidities on the prognosis of senile epilepsy.Methods Information of patients with senile epilepsy was retrospectively collected from three tertiary hospitalsin Southwest China between December 2014 and December 2022.A total of 154 patients met the inclusion criteriaand were divided into two groups based on the presence or absence of comorbidities.The prevalence,type,charac-teristics,and impacts of the comorbidities were investigated.The characteristics of patients with and without comor-bidities were also compared.Results Eighty-one percent of patients with senile epilepsy had at least one comorbidity,and 36%had three or morecomorbidities.Eighteen different types of comorbidities were identified.The most common comorbidities were neu-rological(61%),followed by cardiovascular(45%)and psychiatric(26%)comorbidities.More than one-third of patientshad bidirectional comorbidities,whereas more than half of the patients had additional causal comorbidities.Amongall types of comorbidities,neurological and psychiatric comorbidities were found to be associated with an increasedrisk of recurrent seizures.Compared to patients without bidirectional comorbidities,those with at least one bidirec-tional comorbidity had a lower rate of achieving seizure freedom.The higher the number of bidirectional comor-bidities,the lower the seizure-free rate.Survival analysis revealed that patients with neurological comorbidities hada higher risk of death.Conclusions This study revealed a high comorbidity rate and a low seizure-freedom rate among patients with senileepilepsy.In particular,neuropsychiatric comorbidities can increase the risk of seizures and affect the survival rateof patients with senile epilepsy.Therefore,preventing and managing these comorbidities may improve seizure out-comes and reduce mortality in this special population.

New-Onset Geriatric Epilepsy in China:A Single-Center Study

Background:Few studies have been published on new-onset geriatric epilepsy especially in older Chinese people.This study was to have a comprehensive understanding of new-onset geriatric epilepsy and find a more reasonable diagnosis and management of epilepsy in older people. Methods:One hundred and three patients with onset age 60 years and older were admitted between January 2008 and December 2016. Electronic medical records were reviewed to collect information. Results:There were 103 older patients with new-onset epilepsy.The mean age of the patients was 68.5±6.4 years (range:60-89 years), and there were 67 (65%)men and 36 (35%)women.The mean onset age was 67.9 ±6.2 years (range:60-89 years).The most common identifiable etiology of symptomatic seizures was autoimmune epilepsy in 43 (41.7%)patients.The second most common etiology was stroke in 15 (14.6%)patients.Seven (6.8%)older patients with acute seizures present with status epilepticus and 26 (25.2%)patients experienced clustered seizures (more than three events in 24 h)at seizure onset.Focal seizures (96.1%)were more common than generalized seizures (3.9%).Fifty-three (51.5%)patients had an abnormal brain magnetic resonance imaging (MRI)scan.Among them, video-electroencephalogram findings in 31 (30.1%)patients correlated with MRI abnormalities.Levetiracetam was the most used drugs before admission,in hospital,and during follow-up. Conclusions:Autoimmune encephalitis is becoming an increasing risk factor of subsequent epilepsy in older people.Older patients with new epilepsy are more likely to respond to antiepileptic drugs,and drug-resistant epilepsy is uncommon.