Developing a nomogram for predicting the depression of senior citizens living alone while focusing on perceived social support

BACKGROUND Although the number of senior citizens living alone is increasing,only a few studies have identified factors related to the depression characteristics of senior citizens living alone by using epidemiological survey data that can represent a population group.AIM To evaluate prediction performance by building models for predicting the depression of senior citizens living alone that included subjective social isolation and perceived social support as well as personal characteristics such as age and drinking.METHODS This study analyzed 1558 senior citizens(695 males and 863 females)who were 60 years or older and completed an epidemiological survey representing the South Korean population.Depression,an outcome variable,was measured using the short form of the Korean version CES-D(short form of CES-D).RESULTS The prevalence of depression among the senior citizens living alone was 7.7%.The results of multiple logistic regression analysis showed that the experience of suicidal urge over the past year,subjective satisfaction with help from neighbors,subjective loneliness,age,and self-esteem were significantly related to the depression of senior citizens living alone(P<0.05).The results of 10-fold cross validation showed that the area under the curve of the nomogram was 0.96,and the F1 score of it was 0.97.CONCLUSION It is necessary to strengthen the social network of senior citizens living alone with friends and neighbors based on the results of this study to protect them from depression.

Investigation on the Characteristics of the Senior Citizens' Activities in the Parks and Greenbelts——A Case Study of Nanjing City

From the perspective of senior citizens,questionnaire survey and field investigation were carried on and analyzed in three parks in Nanjing City.The results showed that outdoor activities are the principal ways for the senior citizens to spend their time,the parks near home is their prior choice,and the radiation range of the park and greenbelt mostly is no more than 2 km;most of the senior citizens come to parks on foot and the parks are always within 30 minutes walking distance;the senior citizens always have fixed partners and groups for their exercise-dominant activities.

Status of and Suggestions for Senior Citizens＇ Participation in Ethnic Tourism： A Case Study of Wolong National Nature Reserve in Sichuan

The participation of ethnic minority communities in the development of local tourism is usual y based on the family unit. Senior citizens can not only provide labor services within their reach, but inherit and defend local culture and landscape, playing an important social role. Their living conditions are tied to the rest of the family, and affect the sustainability of the entire community. Through field visits to ethnic minority communities in Wolong National Nature Reserve in Sichuan, authors of the paper summarized the status and problems of elderly people's participation in tourism development, and put forward specific suggestions.

Building a Community for the Senior Citizens Using the Idea of Vertical Farms

Global population growth and urbanization have posed increasing threats to the ecological environment. In an aging society, high-density living spaces have resulted in intensifying housing concerns for urban senior citizens. Among the rapid urban development, addressing the demands of senior citizens for suitable living environments and enabling senior city dwellers to engage in diversified social interactions are concerns that necessitate public attention. This study introduced the idea of the “vertical farm” to the living environments of senior citizens. By integrating vegetation appreciation and physical labor, vertical farming allows senior citizens to experience joy and a sense of accomplishment. In addition, these farms can change the monotonous and gloomy exteriors of concrete buildings. By conducting in-depth interviews with 12 senior citizens residing in the Happiness Community in Taipei City, by building vertical farms, senior citizens can experience joy and a sense of achievement at the psychological level and communicate with families, friends and neighbors in the community at a social level. At the environmental level, comprehensive ecological communities can be achieved. We explored how promoting vertical farms in a living environment can affect senior citizens at the psychological, social and environmental levels. The results can be used to build vertical farms that accommodate the needs of senior citizen living environments.

China Has Over 110 Million Senior Citizens

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Epidemiologic survey and analysis of mild cognitive impairment amongst community senior citizens of Changsha City

Objective:The purpose of the current study was to conduct a mild cognitive impairment(MCI)prevalence survey among the community senior citizens of Changsha City and analyze possible relevant factors so as to perform early screening and intervention for MCI patients,and delay or prevent MCI from developing into Alzheimer’s disease(AD).Methods:Between April and September 2012,a total of 1764 community senior citizens in Changsha City were selected through multi-stage and random cluster sampling as study subjects.The following tables were used during the investigation to perform preliminary MCI screening for the subjects of this study:a general information survey;Mini-Mental State examination(MMSe);Montreal Cognitive Assessment(MoCA);Beijing version;global Deteriorate Scale(gDS);Clinical Dementia Rating(CDR)scale;and Activities of Daily Living(ADL)scale.Then,neurology specialists made diagnoses according to the actual status of subjects,survey findings,and clinical MCI diagnostic standards.The prevalence of MCI was calculated and the rates concerning senior citizens with different demographic characteristics were compared.Logistic regression analysis was used to analyze relevant factors that led to MCI,and comparing findings with those of other cities was conducted.Results:The MCI prevalence among senior citizens in Changsha City was 16.27%(287/1764).The MCI prevalence increased with age[for the 60,70,and 80 age groups,the prevalence was 9.79%(84/858),20.14%(149/740),and 32.53%(54/166),respectively,P<0.05].The more education received,the less the likelihood of developing MCI[the prevalence of illiteracy,those who went to pri-mary school,junior high school,senior high school,or technical secondary school,college,and un-dergraduates and above was 32.10%(26/81),18.40%(90/489),13.97%(70/501),15.29%(61/399),14.39%(19/132),and 12.96%(21/162),respectively,P<0.05].Bluecollar workers’chances of developing MCI was higher than white-collar workers[19.12%(187/978)and 12.72%(100/786),respectively,P<0.05].Living alone increased the likelihood of developing MCI than not living alone[21.59%(65/301)and 15.17%(222/1463),P<0.05].The logistic regression analysis showed that age,educational background,and marital status were in the regression(P<0.05).The MCI prevalence of Changsha did not differ from that Portugal,Singapore,Beijing,and Urumchi(P>0.05),but lower than Shanghai[35.78%(161/450)]and higher than Chengdu[2.35%(92/3910)](P<0.05).Conclusion:The prevalence of MCI among the community senior citizens of Changsha City is highly related to factors like age,educational background,and marital status.Prevention against these highrisk factors shall be carried out to delay cognitive decline for senior citizens.

Higher intakes of lysine,threonine and valine are inversely associated with non-alcoholic fatty liver disease risk:a community-based case-control study in the Chinese elderly

The associations of individual amino acid with non-alcoholic fatty liver disease(NAFLD)risk remained unclear.The present study aimed to investigate the associations between the two in the Chinese elderly.Methods:A community-based health check-up program was conducted in Qingdao,China.NAFLD was diagnosed by ultrasonography accompanied by epidemiological investigation.The dietary intakes of amino acids were investigated with 3-day,24-h dietary records and calculated by Nutrition Calculator software.Restricted cubic spline model was used to evaluate a nonlinear relationship between amino acid intake and NAFLD risk.Results:400 NAFLD subjects were identified,and 400 participants were randomly selected as controls and matched by gender and age(±3 years)Dose-response analysis showed that 1000 mg increment of aromatic amino acids(AAAs)was associated with reduced 16%risk of NAFLD.Dietary increments of 750 mg/d threonine,950 mg/d valine,or 1700 mg/d lysine were associated with a 20%reduction in the NAFLD risk(all P for linearity<0.05).Conclusion:The present study demonstrated that the dietary increases in milk,eggs and deep-sea fish,which are rich in the amino acids,might contribute to protecting against NAFLD in the elderly.

我国老年群体数字素养影响因素与提升路径

文章采用扎根理论,通过半结构化访谈收集20名老人数据,利用Nvivo11三级编码技术构建老年群体数字素养影响因素理论模型,分析各项主范畴对老年群体数字素养的内在关联和作用路径。研究发现:老年群体数字素养受主观意识、使用经验、社会交往、统计学特征、数字化支持和数字生态等因素影响;可以通过数字知识技能和数字态度共同作用,从内生驱动和外部推拉两个维度提升老年群体数字素养。

山地城市老旧社区公共空间老年人社交活动特征与可持续更新思路:基于社会网络分析

在人民城市理念背景下,针对山地城市人口老龄化趋势与老旧社区公共空间适老化更新的现实困境,需要更加长期、动态、准确地理解社区老人的社交需求与活动特征,进而结合地方自然、经济和人文特征,提出长效的可持续更新思路。运用社会网络理论和方法,选取山地城市老旧社区特征显著且老龄化严重的重庆市渝中区凉亭子社区为研究区域,以居住在该社区的老年人为研究对象,通过长期实地观察、访谈和对调研数据的分析,厘清各类社群关系下老年人的活动空间分布及活动类型特征,剖析老年社群—社交空间—社交活动的整体关系,进而明确社区公共空间适老化更新的问题与目标,提出因地制宜的可持续社区更新思路。对于突破山地城市老旧社区适老化更新的社区资产认知、持续改善和提升社区公共空间品质、整体构建和谐的社区社群关系具有参考意义。

Predictive value of systemic immunity index for sepsis in low-medium risk community-acquired pneumonia

Objective:To assess the predictive value of systemic immune inflammation index(SII)for sepsis in low-and medium-risk community-acquired pneumonia.Methods:A total of 589 elderly patients with low-and medium-risk community-acquired pneumonia admitted to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University from January 2020 to January 2023 were included as the research subjects,and the general information and laboratory test results of the patients were collected,and the optimal cut-off value of continuous variables for predicting sepsis in elderly patients with low-and medium-risk community-acquired pneumonia was determined by plotting the receiver work characteristic(ROC)curve,which was converted into dichotomous variables and univariate and multivariate logistic Regression analysis of the influencing factors of sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.Based on this,a nomogram model is constructed to predict the risk of sepsis.The differentiation,consistency and accuracy of the model were verified by calibration curve and subject operating characteristic(ROC)curve,and the clinical utility of the model was determined by decision curve analysis.Results:A total of 589 elderly patients with low-and intermediate-risk community-acquired pneumonia were included in this study,of which 96(16.30%)developed sepsis.There were significant differences in age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,PCT,SII and other indexes between sepsis and non-sepsis groups(P<0.05).Logistics regression analysis showed that age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,and SII were independent risk factors for sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.The nomogram prediction model was used to verify the results,and the AUC was 0.826(95%CI:0.780-0.872),and the calibration curve tended to the ideal curve with good accuracy.The decision curve shows that when the threshold of the model is between 0.10~0.78,the model has the advantage of clinical benefit.Conclusion:The nomogram prediction model constructed based on SII to predict sepsis in elderly patients with low-and medium-risk community-acquired pneumonia has good accuracy,which can predict the occurrence of sepsis early,help early identification of high-risk groups and timely intervention,and thus improve the prognosis of patients.

技术焦虑会阻碍老年人IT使用吗?

在老年人IT使用意愿影响因素的实证研究中,技术焦虑对IT使用相关变量的作用不尽一致,研究结果分歧不利于指导实践。为消除这种分歧,文章采用Meta分析法,对收集的45项研究的相关系数进行整合,并对调节效应进行分析以探究结果异质性的来源。研究发现:老年人技术焦虑与感知易用性、感知有用性、使用意愿呈较弱的负相关关系,被试特征(学历、技术使用经验)、社会背景(地理区域、经济发展水平、信息通信技术发展水平、文化背景)与技术类型是不同研究结果异质性的影响因素。

技术接受模型下老年人心电血压监测仪设计探究

从老年心血管疾病人群需求出发,从技术接受模型的角度以产品设计来优化老年心血管疾病患者的心率血压监测过程。通过分析老年人的心理以及生理特点,总结出针对老年心电血压监测仪的设计趋势,以此搭建技术接受模型,并进行问卷设计及数据分析处理。由数据处理结果得出服务系统性、情感补偿性、移动便携性3个因素对老年人接受家用心电血压监测仪具有正向影响。并据此对心电血压监测仪造型、色彩、交互界面、使用流程以及系统性功能重新设计。通过提升用户的功能及情感方面的使用体验,可以进一步加强对老年人心血管疾病的预防把控,从而降低因病致死率。

双向社会支持和家庭关怀度对社区老年人总体幸福感的影响

目的探讨社区老年人双向社会支持、家庭关怀度和总体幸福感的关系,分析家庭关怀度在社区老年人双向社会支持和总体幸福感中的中介效应。方法2022年2-7月采用便利抽样法,选取浙江省6个城市的383名社区老年人为研究对象,运用一般人口学问卷、简版双向社会支持量表、总体幸福感量表和家庭关怀度指数问卷对其进行调查,通过结构方程模型构建家庭关怀度在老年人双向社会支持对总体幸福感影响的中介效应模型。结果双向社会支持中的接受社会支持和提供社会支持与家庭关怀度、总体幸福感均呈正相关(均P<0.05);接受社会支持可通过给予社会支持的中介作用以及给予社会支持和家庭关怀度的链式中介对总体幸福感产生间接效应,中介效应分别占总效应的45.6%和29.1%。结论接受社会支持可通过给予社会支持和家庭关怀度对老年人的总体幸福感产生间接影响,提示政府和有关部门可构建促进老年人双向社会支持和家庭关怀度的相关措施,以提升其幸福感。

65岁及以上老年人群中基于脂肪组织过多引起的慢性疾病患病情况及影响因素分析

背景美国临床内分泌学家协会和美国内分泌学会提出基于脂肪组织过多引起的慢性疾病(ABCD)模型来评价肥胖,目前国内针对ABCD的研究极少,应用效能也尚不清楚。目的运用ABCD这一新的肥胖评价指标,了解中国65岁及以上老年人群中ABCD的患病情况及其影响因素。方法选择2021年1—12月参加广东省深圳市坪山区28家社区健康服务中心体检的65岁及以上老年人5562名,通过问卷调查、体格检查、实验室检测获取研究对象基本特征,根据ABCD模型的诊断标准对样本人群进行ABCD分期,计算ABCD及各个分期的患病率,采用多因素Logistic回归分析探究ABCD分期与不同心脏代谢危险因素风险的关系。结果本研究中ABCD患病率为71.0%,0期、1期、2期患病率分别为4.8%(267/5562)、32.5%(1808/5562)、33.7%(1874/5562)。多因素Logistic回归分析结果显示,以ABCD正常为参照组,除高总胆固醇与饮酒外,糖尿病、高血压、三酰甘油升高、高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高、吸烟与ABCD分期存在关联(P<0.05);ABCD 1期发生高血压、三酰甘油升高、高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高的风险分别是正常人群的2.393倍、1.515倍、1.940倍、1.688倍、1.376倍;ABCD 2期发生糖尿病、高血压、三酰甘油升高、高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高的风险分别是正常人群的2.918倍、4.231倍、9.282倍、4.128倍、2.970倍、1.672倍。吸烟是ABCD1期和2期的保护因素,OR(95%CI)分别为0.577(0.480~0.693)、0.752(0.633~0.893)。结论本研究中65岁及以上老年人ABCD患病情况存在男女差异,患病率与高血压、糖尿病、吸烟等心脏代谢危险因素存在关联,ABCD模型在中国老年人群中应用效果良好。

全身免疫炎症指数对低中危社区获得性肺炎发生脓毒症的预测价值

目的:评估全身免疫炎症指数(systemic immune inflammation index,SII)对低中危社区获得性肺炎发生脓毒症的预测价值。方法:纳入2020年1月~2023年1月海南医学院第二附属医院急诊科收治的589例低中危社区获得性肺炎老年患者为研究对象,收集患者一般资料、实验室检测结果,通过绘制受试者工作特征(ROC)曲线确定连续变量预测低中危社区获得性肺炎老年患者并发脓毒症的最佳界值,转化为二分类变量,采用单因素和多因素Logistic回归分析低中危社区获得性肺炎老年患者发生脓毒症的影响因素。并以此构建预测脓毒症发生风险的列线图模型。分别通过校准曲线和ROC曲线验证模型的区分度、一致性和准确性,并采用决策曲线分析法确定模型的临床实用性。结果:本研究共纳入589例低中危社区获得性肺炎老年患者,其中发生脓毒症者96例(16.30%)。脓毒症组和非脓毒症组的年龄、合并糖尿病及慢性阻塞性肺疾病、Lac、PCT、SII等指标的差异有统计学意义(P<0.05)。Logistics回归分析显示:年龄、合并糖尿病及慢性阻塞性肺疾病、Lac、SII为低中危社区获得性肺炎老年患者发生脓毒症的独立危险因素。使用列线图预测模型进行验证,结果显示AUC为0.826(95%CI:0.780~0.872),校准曲线趋于理想曲线,具有较好的准确性。决策曲线表明,该模型的阈值在0.10~0.78之间时,该模型有临床获益优势。结论:基于SII构建的预测低中危社区获得性肺炎老年患者发生脓毒症的列线图预测模型具有较好的准确性,可以早期预测脓毒症的发生,有助于早期识别高危人群和及时干预,从而改善患者预后。

面向乐龄读者的公共图书馆阅读疗愈服务探析

公共图书馆作为我国公共文化服务体系的重要组成部分,开展面向乐龄读者的阅读疗愈服务,能够有效帮助乐龄读者缓解焦虑、孤寂等不良情绪,帮助乐龄读者走出心灵困境。通过分析阅读疗法的研究现状,总结公共图书馆开展面向乐龄读者的阅读疗愈服务的重要意义,并提出公共图书馆开展面向乐龄读者的阅读疗愈服务的4种途径,对阅读疗愈服务在公共图书馆的发展前景作出了初步展望。

糖化血红蛋白变异指数在评价老年2型糖尿病患者合并髋部骨折术后肺部感染的临床研究

目的探讨糖化血红蛋白变异指数(HGI)在评价老年2型糖尿病合并髋部骨折术后肺部感染的临床价值。方法收集2021年1月-2023年4月在同济大学附属上海市第四人民医院行手术治疗的142例老年2型糖尿病合并髋部骨折患者的临床资料,依据术后是否发生肺部感染分为肺部感染组和非肺部感染组,通过电子病历收集2组患者围术期临床资料并进行单因素分析,采用多因素Logistic回归分析术后肺部感染的相关因素。绘制受试者工作特征(Receiver operating characteristic,ROC)曲线分析HGI对术后肺部感染的预测价值。结果与非肺部感染组比较,肺部感染组吸烟史比例高,糖尿病病程和卧床时间长,血清白蛋白水平低,术中出血量多,空腹血糖、糖化血红蛋白(HbA1c)和HGI水平较高,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,糖尿病病程、卧床时间、空腹血糖、HbA1c和HGI是髋关节术后肺部感染的独立危险因素(P<0.05)。血清白蛋白是保护性因素(P<0.05)。ROC分析显示,HGI预测术后肺部感染的曲线下面积(Area Under the Curv,AUC)为0.912,明显高于空腹血糖、HbA1c的0.654和0.817(Z=4.289,P<0.05),最佳截断值为0.52%,灵敏度和特异度分别为87.21%和85.79%,提示具有良好的诊断效能。以最佳截断值为切入点将患者分为2组,高HGI组中肺部感染发生率(36.11%)显著高于低HGI组(12.86%),差异有统计学意义(P<0.05)。结论高HGI的老年2型糖尿病合并髋部骨折患者术后发生肺部感染的风险越大,其预测术后肺部感染的价值优于空腹血糖和HbA1c等传统血糖指标,临床应当密切监测HGI的变化,以更好的用于术后肺部感染的风险评估。

夏热冬冷地区养老院老年人冬季室外热舒适性探究

养老院室外空间是机构养老人群的主要室外活动场所,室外空间的热舒适性对老年人身心健康具有重要影响。为营造健康、舒适的室外热环境,文章以上海Q养老院为例,通过对养老院室外热环境实测和老年人室外热舒适问卷调查,分析老年人室外热舒适与热感觉关系,研究热环境因素对老年人冬季室外热舒适的影响,从热中性生理等效温度、热中性生理等效温度范围、满足90%热可接受率的生理等效温度范围和热偏好生理等效温度等4个方面,确定老年人冬季热舒适性评价基准;最后基于研究结果,从自然环境和建筑环境两方面提出养老院冬季室外热环境优化设计建议,为夏热冬冷地区养老院室外热环境改善提供参考。

基础型社区养老服务供给对老年人生活满意度的影响——自评健康变化的中介作用

基于2018年中国老年健康影响因素跟踪调查(CLHLS 2018)数据,运用多元线性回归、逐步回归、Bootstrap等研究方法分析基础型社区养老服务供给对老年人生活满意度的影响,并引入自评健康变化作为中介变量,探讨了其影响机制。研究发现:基础型社区养老服务供给对老年人生活满意度具有正向影响,且通过老年人自评健康变化对其生活满意度可以产生间接影响效应。在社区养老服务体系建设过程中,应重视基础型社区养老服务的作用,充分发挥政府购买公共服务的优势。

智慧化体医融合模式对社区老年人体质与健康的影响

选取社区老年人男性15名、女性21名,进行为期24周的线上线下结合的有氧运动和健康教育干预,干预前后进行体检和体质监测指标比较.结果表明,智能化体医融合模式在促进老年人体质与健康方面具有较好的效果,可以优化体脂和血脂水平,改善最大摄氧量、握力、体前屈、闭目单足站立、反应时,血糖和血压也呈现下降的趋势.