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.

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.

Volunteering and Depression among Older Adults: An Empirical Analysis Based on CLASS 2018

Introduction:Older adults are prone to high levels of depression due to their deteriorating physical functions and shrinking social networks after retirement.Volunteering as an important social activity is essential for alleviating depression by building social network.This paper aims to examine the effect of volunteering on depression among older adults by using China Longitudinal Aging Social Survey(CLASS 2018)data.Methods:This study uses descriptive analysis and chi-square tests to show differences in demographic factors of older adults’volun-teerism participation,followed by bivariate correlation analysis to examine the correlation between the vital vari-ables.Afterward,stratified linear regression analysis is used to research the significant level and impact between volunteering and degree of expertise,frequency,and variety of participation.Results:8,459 older adults are included in study.The research reveals that older adults who are younger,live in urban areas,are married,or have a higher degree of education tend to have fewer depressive symptoms.Meanwhile,participation in volun-teering(OR=0.90,95%CI:0.8,1.1,p<0.001),as well as that demands specialized skills(OR=0.51,95%CI:0.30,0.2,p<0.001),more frequency of participation(OR=1.85,95%CI:1.53,2.18,p<0.001),and a wider variety of activities(OR=0.21,95%CI:0.12,0.29,p<0.001),all have a positive influence on depression levels.Discussion/Conclusion:Older adults who participate in voluntary services have lower depression symptoms and should be encouraged to use their professional skills and increase participation frequency and variety in this process.This article suggests that governments should help older adults participate in voluntary services by time bank which will further strengthen social ties,rebuild social networks and alleviate depression symptoms of older adults.

A Model for Predicting the Psychological WellBeing of Older Adults in South Korea

This study examined factors related to the psychological well-being of older adults and built and verified a model for predictingpsychological well-being. The participants were 350 older adults aged over 60 years who lived in South Korea and were active in thelocal community. The model proposed in this study was found to be suitable. Depression, self-efficacy, and social support had adirect effect on the psychological well-being of older adults, while depression, activities of daily living (ADLs), and self-efficacy hadan indirect effect. Self-efficacy and social support mediated the relationship between depression and psychological well-being, andself-efficacy mediated the relationship between ADLs and psychological well-being. It is necessary to develop and implement aprogram that can help alleviate depression and improve self-efficacy and social support among older adults in order toenhance their psychological well-being. Additionally, to establish a model that predicts the psychological well-being of olderadults, a study is needed to verify the model not only in Korea but also in other countries.

Meaning in Life and Mental Health Issues in Older Adults:A Meta-Analysis

This study aims to be the first to use meta-analysis to explore the relationship between meaning in life(MIL)and mental health issues among older adults.A meta-analysis was conducted using six databases,resulting in 16 studies with 5,074 participants in total.The“metacor”and“forestplot”packages in R-Studio were used for data analysis.The total effect was calculated using a random-effects model,with I2=86%in the heterogeneity test.The results showed a moderate negative correlation between MIL and mental health issues among older adults,with an average effect of−0.37.Five potential moderating variables were examined:the conceptualization of MIL(value vs.purpose),region(Asian vs.Western countries),residence status(community vs.nursing home vs.hospital),types of mental health issues,and evaluation methods(clinical vs.non-clinical).The first four had no significant moderating effect.The mean correlation coefficients between mental health issues and value/purpose were−0.49/−0.33;the mean correlation coefficients in Asian countries and Western countries were−0.48 and−0.34;the mean correlation coefficients among participants living in community/nursing home/mixed status were−0.33/−0.40/−0.40;the mean correlation coefficients between MIL and depression/others were−0.37/−0.35;however,the negative relationship between MIL and mental health issues was stronger when non-clinical evaluations(self-report only)were used.Specifically,the mean correlation coefficient for non-clinical evaluations was−0.42 and for clinical evaluations was−0.29.This study is the first meta-analysis to identify the negative correlation between older adults’MIL and mental health issues.Significant moderating effects of evaluation methods were found.

The quality of older adults'involvement in clinical communication with general practitioners:evidence from rural towns in Australia

Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.

Association between Support and Satisfaction with Life among Older Adults in Ekiti, Nigeria: Findings and Implications

Many developing countries like Nigeria lack policy for the care of the older adults and this creates major challenges for the elderly population. The traditional family institution and community support that used to be safety nest are being adversely affected by westernization. This development might have adverse effect on life satisfaction among the older adults. This hospital based cross-sectional study was designed to determine the association between support and life satisfaction among older adults. A total of 128 subjects participated in the study out of which 28.9% were satisfied with life. Expectation of support was mainly from the family, less from the community and very low from the government. The level of support received from all sources generally fell short of expectations. Marital status and source of livelihood were significantly associated with life satisfaction. There is inadequate social support from the government and support from family and community fell below expectations. Expectations of support were the most strongly correlated with life satisfaction. Support for older adults must be addressed in order to meet their expectations and improve their level of satisfaction with life.

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.

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.

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.

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.

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.

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.

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.

Affective responses to supervised 10-week programs of resistance exercise in older adults

Background:Resistance exercise has numerous,well-documented benefits on the health and functional performance of older adults.However,little information exists on the affective responses to resistance exercise in this population.As affective responses can predict continued exercise behavior,examining if and how they differ between resistance exercise intensities and frequencies in older adults may provide important data to improve resistance exercise prescription.Methods:We monitored the affective responses of older adults when performing high-velocity,low-load(HVLL)or low-velocity,high-load(LVHL)resistance exercise once or twice weekly.A total of 40 moderately to highly active,but resistance-exercise naïve,older adults(60-79 years)completed 1 of 4 randomly assigned progressive resistance exercise conditions:HVLL once weekly(HVLL1:n=10),HVLL twice weekly(HVLL2:n=10),LVHL once weekly(LVHL1:n=10),or LVHL twice weekly(LVHL2:n=10).The Physical Activity Affect Scale,Felt Arousal Scale,Feeling Scale,rating of perceived exertion,Visual Analog Scale,and the Physical Activity Enjoyment Scale were used to assess enjoyment and affective responses.Results:The results from Physical Activity Enjoyment Scale(out of 35)suggest that all exercise conditions were largely and similarly enjoyable to older adults(HVLL1:30.9±2.4;LVHL1:31.9±3.6;HVLL2:30.9±3.5;LVHL2:30.2±3.7)despite greater fatigue(p=0.033;ηp^2p=0.22)and perceived workload(p=0.042;ηp^2=0.20)in LVHL(results from Visual Analog Scale).Conclusion:Moderately to highly physically active older adults may tolerate higher intensities of resistance exercise performed once or twice weekly without experiencing a negative impact on enjoyment.However,the role that supervision and social interaction played in shaping the participants’responses is unclear.

Atherosclerosis,its risk factors,and cognitive impairment in older adults

Objective To examine the association of atherosclerotic cardiovascular disease(ASCVD)and its risk factors with cognitive impairment in older adults.Methods Six hundred and fourteen subjects,aged≥65 years,from one center(2016–2018)underwent clinical,laboratory assessments and the Montreal Cognitive Assessment(Mo CA).Using regression analysis,the relationship between ASCVD and its risk factors was evaluated in subjects with and without cognitive impairment(MoCA score<26).Results Older age(b=-1.3 per 5 years,95%CI:-1.7 to-0.9,P<0.001),history of stroke(b=-1.6,95%CI:-3.0 to-0.3,P=0.01),and myocardial infarction(MI;b=-2.2,95%CI:-3.6 to-0.8,P=0.003)were independently associated with lower MoCA scores,whereas more education(b=1.5 per 3 years,95%CI:1.1 to 1.9,P<0.001),higher body mass index(BMI;b=0.5 per 3 kg/m^2,95%CI:0.0 to 1.0,P=0.04),higher estimated glomerular filtration rate(eGFR;b=0.8 per 15 U,95%CI:0.1 to 1.4,P=0.03),left ventricular ejection fraction(LVEF;b=0.4 per 5%,95%CI:0 to 0.8,P=0.04)and statin use(b=1.3,95%CI:0.3 to 2.3,P=0.01)were associated with a higher MoCA score.Cognitive impairment was independently associated with older age(OR=1.51 per 5 yrs,95%CI:1.28 to 1.79,P<0.001),less education(OR=0.55 per 3 years,95%CI:0.45 to 0.68,P<0.001),lower BMI(OR=0.78 per 3 kg/m^2,95%CI:0.62 to 0.98,P=0.03)and higher levels of high sensitivity c-reactive protein(hsCRP;OR=1.08 per 1 mg/L,95%CI:1.02 to 1.15,P=0.01).Conclusions Beyond age,cognitive impairment was associated with prior MI/stroke,higher hsCRP,statin use,less education,lower eGFR,BMI and LVEF.

Real-world evidence on adjuvant chemotherapy in older adults with stage II/III colon cancer

Colon cancer represents one of the most common cancers diagnosed in older adults worldwide.The standard of care in resected stage II and stage III colon cancer continues to evolve.While there is unequivocal evidence to suggest both disease free and overall survival benefits with the use of combination chemotherapy in patients with stage III colon cancer,data regarding its use in patients with stage II colon cancer are less clear.Further,although colon cancer is a disease that affects older adults,there is considerable debate on the value of adjuvant chemotherapy in the aging population.In particular,many older patients are undertreated when compared to their younger counterparts.In this review,we will describe the clinical trials that contributed to the current adjuvant chemotherapy approach in colon cancer,discuss representation of older adults in trials and the specific challenges associated with the management of this subpopulation,and highlight the role of comprehensive geriatric assessments.We will also review how real-world evidence complements the data gaps from clinical trials of early stage colon cancer.

Public library services to older adults in China:An empirical study based on content analysis

Purpose:The research is undertaken to help the Chinese public libraries answer the growing needs for library services to the elderly.Based on an investigation of the current situation of the services to older adults in China and a comparative analysis of the services in the U.S.,we attempt to explore what improvements the Chinese public libraries can make to better serve the needs of older adults.Design/methodology/approach:We empirically analyzed the older adults services of 271public libraries in China from 2002 to 2011 via content analysis of both the print materials such as the regulations and policies released by these libraries and the related information on the libraries' websites and the Internet Web pages.Findings:Great strides have been made in the Chinese public libraries' services to older adults in constructing service systems,providing facilities and equipment,exploring cooperative programming,and planning diversified and regularly scheduled activities.Compared with American counterparts,however,the Chinese public libraries need to catch up in understanding the elderly people as library users,planning customized services,formulating service guidelines and evaluation systems,and working with other local agencies for cooperative programming for seniors in communities.Research limitations:It is hard to collect more data covering more geographical areas and longer periods of time.The content analysis of libraries' policies and regulations is a very rough approximation of the libraries' 'real' services.The study should be extended to visits to public libraries in the future.Practical implications:This study provides useful information for the Chinese library policymakers to formulate regulations and policies to provide services to older adults.Originality/value:To the best of our knowledge,the comprehensive survey reported in this paper is the first in-depth investigation of the current situation of public library services to older adults in China,providing the analysis framework for more in-depth surveys in the future.

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.

Acceptable noise level as a deciding factor for prescribing hearing aids for older adults with cochlear hearing loss-A scoping review

Older adults often find it difficult to perceive speech, especially in noisy conditions. Though hearing aid is one of the rehabilitative devices available to older adults to alleviate hearing loss, some of them may experience annoyance through hearing aid and hence reject it, may be due to circuitry noise and/or background noise. Acceptable noise level is a direct behavioural measure to estimate the extent of how much a person is able to put up with noise while simultaneously listening to speech. Acceptable noise level is a central auditory measure and it is not influenced by age, gender, presentation level or speaker. Using this measure, we can quantify the annoyance level experienced by an individual. This in-formation is of utmost importance and caution should be paid before setting the parameters in hearing aid, especially for those who are unable to accept noise. In this review article, an attempt has been made to document how to optimize the hearing aid program by setting parameters such as noise reduction circuit, microphone sensitivity and gain. These adjustments of parameters might help to reduce rejection rate of hearing aids, especially in those individuals who are annoyed by background noise. Copyright ? 2015 The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of Otolaryngology Head and Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).