Network analysis of the relationships between depressive symptoms and social participation activities among Chinese older adults and its implications for nursing

Objective:Network analysis was used to explore the complex inter-relationships between social participation activities and depressive symptoms among the Chinese older population,and the differences in network structures among different genders,age groups,and urban-rural residency would be compared.Methods:Based on the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),12,043 people aged 65 to 105 were included.The 10-item Center for Epidemiologic Studies Depression(CESD)Scale was used to assess depressive symptoms and 10 types of social participation activities were collected,including housework,tai-chi,square dancing,visiting and interacting with friends,garden work,reading newspapers or books,raising domestic animals,playing cards or mahjong,watching TV or listening to radio,and organized social activities.R 4.2.1 software was used to estimate the network model and calculate strength and bridge strength.Results:21.60%(2,601/12,043)of the participants had depressive symptoms.The total social participation score was negatively associated with depressive symptoms after adjusting for sociodemographic factors.The network of social participation and depressive symptoms showed that“D9(Inability to get going)”and“S9(Watching TV and/or listening to the radio)”had the highest strength within depressive symptoms and social participation communities,respectively,and“S1(Housework)”,“S9(Watching TV and/or listening to the radio)”,and“D5(Hopelessness)”were the most prominent bridging nodes between the two communities.Most edges linking the two communities were negative.“S5(Graden work)-D5(Hopelessness)”and“S6(Reading newspapers/books)-D4(Everything was an effort)”were the top 2 strongest negative edges.Older females had significantly denser network structures than older males.Compared to older people aged 65e80,the age group 81e105 showed higher network global strength.Conclusions:This study provides novel insights into the complex relationships between social participation and depressive symptoms.Except for doing housework,other social participation activities were found to be protective for depression levels.Different nursing strategies should be taken to prevent and alleviate depressive symptoms for different genders and older people of different ages.

Exploration of home care models for disabled older adults in China:Challenges and choices

This study explores the challenges and strategies of home care models for older adults with disabilities in China.The following challenges have been identified:limited policy support and lack of effective connections between different systems,pressure on caregivers,underestimation of caregivers’value,and inadequate service capacity of community institutions.Evidence-based suggestions to promote the development of home care models for older adults with disabilities include establishing a family caregiver compensation mechanism and psychological support system,strengthening community health centers from quantity to service capabilities for aging-in-place services,and promoting the integration of pension,disability,and health insurance systems.

Gut microbiota changes associated with frailty in older adults:A systematic review of observational studies

BACKGROUND Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes,including falls,disability,incapacity and death.While an increasing number of studies suggest that the gut microbiota may play a key role in the pathophy-siology of frailty,direct evaluation of the association between gut microbiome alterations and frailty in older adults remains limited.AIM Seven electronic databases(China National Knowledge Infrastructure,VIP,SinoMed,Wanfang,PubMed,Web of Science and EMBASE)were searched for articles published before October 31,2023 to identify observational studies that compared the microbiomes of older adults with and without frailty.The diversity and composition of the gut microbiota were the main outcomes used to analyze the associations of changes in the gut microbiota with frailty in older adults.The quality of the included studies was assessed via the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality.RESULTS Eleven observational studies with 912 older adults were included in this review.Consistent results revealed a significant difference in the gut microbiota composition between frail and non-frail older adults,with a significant decrease inαdiversity and a significant increase inβdiversity in frail older adults.The pooled results revealed that at the phylum level,four microbiota(Actinobacteria,Proteo-bacteria,Verrucomicrobia and Synergistetes)were significantly enriched,and two microbiota(Firmicutes and Fusobacteria)were significantly depleted in frail older adults.At the family level,the results consistently revealed that the abundances of 6 families,most of which belong to the Actinobacteria or Proteo-bacteria phylum,were greater in frail than in non-frail older adults.At the genus or species level,consistent results from more than two studies revealed that the abundances of the genera Prevotella,Faecalibacterium,and Roseburia were significantly lower in frail older adults;individual studies revealed that the abundances of some genera or species(e.g.,Megamonas,Blautia,and Megasphaera)were significantly lower,whereas those of other genera or species(e.g.,Bifidobacterium,Oscillospira,Ruminococcus and Pyramidobacter)were significantly greater in frail older adults.CONCLUSION This systematic review suggests that changes in the gut microbiota are associated with frailty in older adults,which is commonly reflected by a reduction in beneficial species and an increase in pathogenic species.However,further studies are needed to confirm these findings.

Impact of Exercise on Depression in Older Adults:Potential Benefits,Risks,and Appropriate Application Strategies

As the global elderly population increases,depression within this group has become a significant public health concern.Although exercise has been recognized for its potential to improve depression in the elderly,the benefits,risks,and implementation strategies remain contentious.This review attempts to examine the impact of exercise on depression in older adults,including potential benefits,risks,and suggestions for application.Our analysis highlights the benefits of aerobic and resistance training,which can significantly alleviate depressive symptoms and enhance overall quality of life.Despite these benefits,the review acknowledges the complexity of the exercise-depression interaction in the elderly,necessitating personalized exercise regimens.Potential risks,such as muscle and joint pain,are pointed out,emphasizing the importance of tailored,supervised exercise programs.The review calls for future research to focus on identifying the most effective types of exercise and regimens for this population,considering factors such as age,gender,and existing health conditions.Lastly,it advocates for the inclusion of exercise in comprehensive treatment plans for depression in older adults,viewing it as a promising step toward achieving holistic mental health care in a growing demographic.

Adverse Side Effects of COVID-19 Vaccines in Older Adults: A Comprehensive Review of Current Research

The purpose of this research review was to examine current scientific literature on COVID-19 vaccine-induced side effects in older adults. We reviewed studies focusing on side effects categorized into cardiologic, immunologic, neurologic, and ocular groups. Cardiologic side effects included myocarditis, pericarditis, and myocardial infarction. Immunologic conditions examined were anaphylaxis and vaccine-induced immune thrombotic thrombocytopenia. Neurologic side effects included Guillain-Barré syndrome and Bell’s Palsy. Ocular side effects covered ocular swelling, submacular hemorrhage, and corneal graft rejection after keratoplasty and Descemet membrane endothelial keratoplasty. Additionally, less common side effects in older adults were reviewed but found to be statistically rare. Overall, COVID-19 vaccine-induced side effects in elderly populations were rare. We concluded that the vaccine’s efficacy in preventing excess deaths due to COVID-19 is significant, and the risk of these rare side effects does not justify foregoing vaccination in at-risk individuals. Patients at higher risk for these side effects should be informed, and additional considerations should be made by their treating physician. This review aims to increase awareness of rare vaccine-induced side effects to encourage further studies, enhancing understanding of their etiology and prevalence in at-risk older adult populations.

Associations between residence and cognitive function among Chinese older adults: the mediating role of leisure activity

Background:Cognitive function is a current research hotspot,residence may be related to differences in cognitive function,and the mediating role of leisure activities are limited in Chinese research.This study used leisure activities as a mediating variable to investigate the mediating role of leisure activity between place of residence(city-town-rural)and cognitive function among Chinese older,this is where the innovation of the article comes in.Methods:Using cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey,Pearson correlation analyses were employed to examine the relationships among various indicators.Mediation analyses were conducted using the SPSS PROCESS macro program,version 3.5,written by Hayes,to explore the mediating effects of leisure activity between place of residence and cognitive function in older adults.Results:A total of 10955 older adults were included in this study,with a mean age of(84.23±11.57)years.Among them,2739(24.8%)lived in the city,3627(33.1%)in town,and 4615(42.1%)in rural areas;their leisure activity score was(5.34±3.77),and their cognitive function score was(24.69±6.65).Place of residence,leisure activities,and cognitive function were significantly correlated(P<0.01).Using city as a reference,place of residence is negatively associated with cognitive function,and place of residence not only had a direct effect on cognitive function in older adults:town-cognitive function(effect=–0.399;95%confidence interval(CI)=(–0.685,–0.113));rural-cognitive function(effect=–0.42;95%CI=(–0.698,–0.141)).There were also indirect effects on cognitive function through the pathway of leisure activity:town-leisure activity-cognitive function(effect=–0.17;95%CI=(–0.246,–0.1)),rural-leisure activity-cognitive function(effect=–0.199;95%CI=(–0.272,–0.13)).Conclusion:Leisure activities play a partially mediating role between the impact of place of residence and cognitive function in Chinese older adults,and it is vital to pay attention to the impact of place of residence on the cognitive function of older adults in various aspects,and to increase the participation rate of older adults in leisure activities,which is beneficial to the prevention of cognitive decline and the protection of older adult’s physical and mental health.

The Association Between Daily Physical Activity and Risk of Hypertension in Middle-Aged and Older Adults:A Nationwide Cohort Study in China

Physical activity (PA) plays a key role in the treatment of hypertension, and moderate to vigorous PA has been documented to lower the risk of developing hypertension. However, dose-response relationships between PA and hypertension are not consistent, and little is known about this relationship within the Chinese middle-aged and older people. We investigated the relationship between PA and hypertension within this population using China Health and Nutrition Survey 1991-2015 data. Physical activity was expressed in terms of the metabolic equivalent task (MET) and participants were divided into groups according to quartiles, namely, Q1 (< 32.97 METs-h/w), Q2 (32.97-60.38 METs-h/ w), Q3 (60.38-98.95 METs-h/w), and Q4 (> 98.95 METs-h/w). Compared with the Q1 group, the odds ratio of risk with hypertension (95% CIs) after adjusting for confounding factors were 0.63 (0.35, 1.12), 0.49 (0.28, 0.86), and 0.62 (0.35, 1.09) for those in Q2, Q3, and Q4, respectively. Restricted cubic spline functions were used and a U-shaped relationship between physical activity and hypertension risk was found, indicative of an optimal level of physical activity, which was found to be 112 METs-h/w. Our data suggest maintenance of optimal levels of total daily physical activity may be important for preventing hypertension in Chinese adults over the age of 40.

Development of the Making the Connection Intervention to Address Loneliness and Isolation in Older Adults

Fifty percent of individuals aged over 60 are reported at risk of social isolation and one-third will experience some degree of loneliness later in life. Isolation and loneliness have been reported as having negative consequences for mental and physical health and mortality. Existing supportive interventions, even when successful are not widely adopted or utilized. A developmental, mixed methods approach was taken to building and testing the components and delivery of an intervention, Making the Connection (MTC) in preparation for mounting a larger, systematic test. Method: The approach relied upon the six steps of 6sQuID for the development of public health interventions: 1) Define and understand the problem and its causes. 2) Clarify which causal or contextual factors are malleable. 3) Identify how to bring about change. 4) Identify how to deliver the change mechanism. 5) Test and refine on small scale. 6) Collect sufficient evidence of effectiveness to justify rigorous evaluation/implementation. Depressive symptoms, how often people felt lonely, and size of social networks were quantitatively measured and analyzed. Qualitative measures were also used. Findings: All six steps in the 6sQuiD model were followed in building the intervention for potential testing. In an initial test within CCRC facilities, five loneliness-related areas were examined qualitatively and identified as potentially modifiable. Testing of a subsequent 10-session gamified intervention established trends for reduced reports of symptoms of depression, and increases in social connections. Pre and post-test found there was a statistically significant reduction in reports of loneliness in the past week. Discussion: Making the Connection manualized intervention appears both feasible and viable, a necessary first step to prepare for more systematic evaluation in a randomized control trial.

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.

The impact of perceived social support, loneliness, and physical activity on quality of life in South Korean older adults

Purpose: The purpose of this study was to propose and test a conceptual model that explains the interrelationships among perceived social support, loneliness, physical activity(PA), and quality of life(QoL) among active older adults in South Korea.Methods: Data were collected from 332 individuals over the age of 65 using a systematic stratified convenience sampling method. Survey data were collected and analyzed using a structural equation model(SEM).Results: Perceived social support had a significantly positive effect on PA(b = 0.14, p < 0.01) and QoL(b = 0.28, p < 0.001) while decreasing loneliness(b = —0.55, p < 0.001). PA had a significant positive effect on QoL(b = 0.12, p < 0.01), and loneliness had a negative effect on QoL(b = —0.37, p < 0.001). Loneliness mediated the relationship between perceived social support and QoL.Conclusion: The SEM results of the current study support the proposed model that explained the interrelationships among perceived social support, loneliness, PA, and QoL among active older adults in South Korea. These findings suggest the importance of incorporating social support mechanisms for PA interventions in order to enhance QoL. The findings of this study can help create more effective health and physical education programs for the older generations in South Korea to enhance their QoL.

Acute coronary syndrome in the older adults

Coronary heart disease remains the leading cause of death in the developed world. Advanced age is the single strongest risk factor for coronary artery disease （CAD） and independent predictor for poor outcomes following an acute coronary syndrome （ACS）. ACS refers to a spectrum of conditions compatible with acute myocardial ischemia and/or infarction due to various degrees of reduction in co- ronary blood flow as a result of plaque rupture/erosion and thrombosis formation or supply and demand mismatch.

Stable ischemic heart disease in the older adults

1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.

Predictors of health-promoting behaviour among older adults with hypertension in Indonesia

Objectives:This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City,Bengkulu,Indonesia.Methods:A cross-sectional study was conducted in 333 older adults with hypertension,who were selected using multistage sampling method.Data were obtained by face-to-face interview with structured questionnaires.The questionnaires used in this study included the Health-Promoting Lifestyle Profile II(HPLP II),Hypertension Knowledge-Level Scale(HK-LS),Self-Rated Abilities for Health Practices Scale(SRAHP),Barriers to Health-promoting Behaviour Scales(BAS),Benefits to Health-Promoting Behaviour Scales(BES),Multidimensional Scale of Perceived Social Support(MSPSS)and Situational Influences Questionnaire(SIQ).Data were analysed by using multiple linear regressions.Results:The mean and standard deviation(Mean±SD)of each questionnaire were as follows:HPLP II,2.55±0.19;HK-LS,11.83±3.00;SRAHP,2.00±5.87;BAS,27.89±2.70;BES,34.29±2.29;MSPSS,60.35±8.12;and SIQ,47.71±6.66.According to the multiple linear regression model,36.9% of the variation in health-promoting behaviour among older adults with hypertension can be explained by six variables,namely,education,knowledge,self-efficacy,perceived barriers,social support and situational influences(adjusted R^(2)=0.369).Conclusions:High and good-quality education will increase the level of health-promoting behaviour,whereas barriers,such as expense and time requirement,can decrease it.Situational influences and support from family and friends can also influence the older adult's attempts to change their health behaviour.Increased self-efficacy will clearly result in improved health-promoting behaviour of older adults with hypertension.

Association between Adiponectin and Metabolic Syndrome in Older Adults from Major Cities of China

Objective To investigate the association between adiponectin and metabolic syndrome （MetS） and related diseases in older adults from major cities of China. Methods A total of 2 049 adults at the age of 60-96 years from18 major cities of China were enrolled in the study. Plasma adiponectin and insulin concentrations were measured. Insulin resistance was assessed by homeostasis model assessment of insulin resistance （HOMA-IR）. The definitions proposed by International Diabetes Federation （IDF） and American Heart Association/National Heart, Lung, and Blood/nstitute （AHA/NLHBI） were used to identify MetS. Results The adiponectin concentration increased with the advance of age and was higher in women than in men. The sex specific adiponectin concentration was inversely correlated with body mass index （BMI）, waist circumference, diastolic blood pressure, triglycerides, glucose and fasting blood insulin, and positively correlated with HDL-C （P〈0.001）. The adiponectin concentration decreased with increasing MetS components. Compared with the 4th sex-specific adiponectin quartile, the odds ratio （OR） for prevalent MetS-IDF and MetS-AHA/NLHBI in subjects of the 1st quartile group was 3.25 （95% CI： 2.24, 4.71） and 3.21 （95% CI： 2.26, 4.55）, respectively. The association was independent of age, sex, life-style factors, medication, family history of chronic diseases, BMI, and HOMA-IR, The OR for MetS was much higher than those of MetS components and its related diseases. Conclusion Adiponectin is strongly associated with MetS independent of insulin resistance and obesity in older adults from major cities in China. The adiponectin concentration is a useful predictor for the risk of MetS.

Associations of Sarcopenia, Handgrip Strength and Calf Circumference with Cognitive Impairment among Chinese Older Adults

Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study.Cognitive impairment was assessed by the Chinese Mini-Mental State Examination.Handgrip strength was calculated from the means of the right and left hand values.Calf circumference was measured at the site of maximum circumference of the non-dominant leg.The formula developed by Ishii was used to define sarcopenia.Multiple logistic regression was performed to evaluate the associations of sarcopenia,handgrip strength,and calf circumference with cognitive impairment.Results The prevalence of cognitive impairment was 34.36%.The adjusted odds ratio(OR)for cognitive impairment in individuals with sarcopenia was 2.55[95% confidence interval(95%CI):1.86-3.50].Compared with individuals in the first quartile(Q1)of calf circumference,the adjusted ORs in the second,third,and fourth quartiles(Q_(2),Q_(3),and Q_(4))were 0.75(95% CI:0.58-0.96),0.59(95% CI:0.44-0.79),and 0.62(95% CI:0.45-0.8),respectively.Compared with individuals in Q1 of handgrip strength,the adjusted ORs for Q_(2),Q_(3),and Q_(4) were 0.49(95%CI:0.38-0.62),0.31(95% CI:0.23-0.41),and 0.30(95%CI:0.21-0.44),respectively.Conclusion Sarcopenia,identified by low handgrip strength and low calf circumference,was positively associated with cognitive impairment.

The association between Tai Chi exercise and safe driving performance among older adults： An observational study

Background: Age-related cognitive and physical decline can impair safe driving performance. Tai Chi exercise benefits cognitive and physical function and may influence safe driving performance in older adults. The primary aim of this observational study was to compare cognitive processes and physical function related to safe driving performance among older adult Tai Chi practitioners to normative reference values.Secondary aims were to examine relationships between Tai Chi exercise habits, cognitive processes, and physical function related to safe driving performance and to explore potential predictors of safe driving performance.Methods: The Driving Health Inventory, the Driving Scenes Test, other driving-related cognitive and physical measures, and self-reported measures including the Mindful Attention Awareness Scale(MAAS) and the Vitality Plus Scale(VPS) were collected from current Tai Chi practitioners(n = 58; age 72.9 ± 5.9 years, mean ± SD) with median >3 years Tai Chi practice.Results: Compared to normative reference values, participants performed better on numerous cognitive measures including the Driving Scenes Test(p < 0.001, d = 1.63), maze navigation(p = 0.017, d = 0.27), the Useful Field of View Test(p < 0.001, r = 0.15), and on physical measures including the Rapid Walk Test(p < 0.001, r = 0.20), and the Right Foot Tapping Test,(p < 0.001, r = 0.35). Participants scored higher than normative reference values on MAAS and VPS(p < 0.001, d = 0.75; p = 0.002, d = 0.38, respectively). Statistically significant correlations were found between several study measures. The digit span backward test was the strongest predictor of safe driving performance(β = 0.34,p = 0.009).Conclusion: Tai Chi exercise has the potential to impact cognitive processes and physical function related to safe driving performance. Further study using randomized controlled trials, structured Tai Chi exercise doses, and driving simulator or on-road driving performance as outcome measures are warranted.

Socio-economic and Psychosocial Determinants of Smoking and Passive Smoking in Older Adults

Objective To determine the associations of socio-economic and psychosocial factors with active and passive smoking in older adults. Methods Using a standard interview method, we examined random samples of 6071 people aged 〉 60 years in 5 provinces of China during 2007-2009. Results World age-standardised prevalence for current and former smoking in men was 45.6% and 20.5%, and in women 11.1% and 4.5%. Current smoking reduced with older age but increased with men, low socioeconomic status （SES）, alcohol drinking, being never-married, pessimistic and depressive syndromes. Former smoking was associated with men, secondary school education, a middle-high income, being a businessman, being widowed, less frequencies of visiting children/relatives and friends, and worrying about children. Among 3774 never-smokers, the prevalence of passive smoking was 31.5%, and the risk increased with women, low SES, alcohol drinking, being married, having a religious believe, and daily visiting children/relatives. There were sex differences in the associations, and an interaction effect of education and income on smoking and passive smoking. Conclusion Older Chinese had a higher level of smoking and passive smoking than those in high income countries, reflecting China＇s failures in controlling smoking. The associations with low SES and different psychosocial aspects and sex differences suggest preventative strategies for active and passive smoking.

Cognitive Training in Older Adults with Mild Cognitive Impairment

Objective We investigated the feasibility and efficacy of cognitive training for older adults in rura settings and with low education levels, who have mild cognitive impairment （MCl）. Methods Forty-five older adults （ages 〉65 years） with MCI were assigned to treatment or control groups, at a 2：1 ratio. Cognitive training occurred in the treatment group for 2 months. The cognitive abilities of the participants were assessed at pre-training, metaphase, and post-training time points, using the Mini-Mental State Examination （MMSE）, Montreal Cognitive Assessment （MoCA）, Loewenstein Occupational Therapy Cognitive Assessment （LOTCA）, and Hamilton Depression Scale （HAM-D）. Results Following training, cognitive abilities improved in the treatment group, based on the total scores of all 4 measures, as well as specifically on the MoCA and LOTCA. There were differences in the main effects of group and time point on some subscales, but these differences had little, if any, effect on the overall analyses. Conclusion The present study demonstrated that cognitive training has beneficial effects on attention, language, orientation, visual perception, organization of visual movement, and logical questioning in patients with MCI. Furthermore, the observed effects are long-term changes.

Relationship between activities of daily living and depression among older adults and the quality of life of family caregivers

Objective： The purposes of this study were to explore the associations of activities of daily living （ADL） and depression among older adults with family caregivers1 quality of life and provide evidence for improving family caregivers＇ quality of life.Methods： Older adults （n=395） and their family caregivers （n=395） were selected as participants. The ADL scale and Geriatric Depression Scale were used to assess ADL and depression among older adults, and the 36-Item Short Form Health Questionnaire （SF-36） was used to assess family caregivers1 quality of life. Descriptive statistics and multiple linear regression were used to analyze the data.Resslts： The older adults’ ADL and depression scores were 21 ±7 and 11 ±6, respectively. Approximately 69.9% of older adults had declining or severely impaired ADL, and 47.1% had mild or moderate-to-severe depression. Family caregivers＂ mean quality of life score was 529±100. There was a negative correlation of older adults＇ ADL and depression with caregivers＇ quality of life. The correlation coefficient between ADL and the SF-36 mental component summary score was stronger than it was with the SF-36 physical component summary score.Conclusions： The ADL and depression of older adults influenced family caregivers＇ quality of life. Psychological health deserves closer attention, especially that of caregivers of disabled older adults.

Associations of accelerometer-determined physical activity and sedentary behavior with sarcopenia and incident falls over 12 months in community-dwelling Swedish older adults

Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls over 12 months.Methods:A total of 3334 Swedish 70-year-olds were assessed for sarcopenia,as defined by the revised definition of the European Working Group on Sarcopenia in Older People.Assessments were based on low scores for appendicular lean mass(dual-energy X-ray absorptiometry),hand grip strength,and the Timed Up and Go test.For 7 days after baseline,total time and total number of bouts(≥10 min of continuous activity at a given intensity)of activity performed at sedentary,LPA,and MVPA intensities were assessed by accelerometer.Incident falls were self-reported 6 months and 12 months after baseline.Results:Only 1.8%of participants had probable or confirmed sarcopenia.After multivariable adjustment for other levels of activity,only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass,low hand grip strength,and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria(all p<0.05),and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia(odds ratio=0.80,95%confidence interval:0.71-0.91 h/week).Similar associations were identified for total number of bouts,with no evidence of threshold effects for longer duration of bouts of MVPA.A total of 14%of participants reported-1 fall,but neither total time nor bouts of activity was associated with incident falls(all p>0.05).Conclusion:Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components,regardless of the length of bouts or amounts of sedentary behavior.