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.

The power of informal institutions:The impact of clan culture on the depression of the elderly in rural China

Exploration of ways to improve the subjective welfare of residents is an important area of current academic research.Using data from the China Family Panel Studies survey conducted in 2010,this paper investigated the impact of clan culture on the mental health of elderly people in rural China.The results demonstrated that clan culture can significantly decrease the depression score of the rural elderly.Further,there was no gender difference with respect to the impact of clan culture on the depression score of the elderly.At the same time,the positive effects of clan culture on the depression score of the elderly have gradually weakened with economic development.Exploration of the mechanisms involved indicated that in areas with stronger clan culture,older people receive more social support.This study enriches our understanding of the impact of informal institutions on the welfare of rural residents.At the same time,it can also provide a certain decisionmaking reference for the government to formulate relative poverty relief strategies in a new stage of poverty alleviation.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

Investigation and Countermeasures on the Health-Promoting Lifestyle of the Disabled Elderly in a Rural Area

Objective： To investigate the level of health-promoting lifestyle in the disabled elderly in a rural area and to provide useful countermeasures for health care workers and the government to improve the elderly＇ s lifestyle behaviors. Methods： A total of 446 disabled elderly people were recruited and examined using the General Questionnaire and Health-Promoting Lifestyle Profile II. Results： The mean score of the health-promoting lifestyle was 109.73（ SD = 16.80）, in which 90.6 percent of the disabled elderly demonstrated unhealthy lifestyle behaviors. The average score for each of the subscales includedthe following： interpersonal relations, stress management, nutrition, self-actualization, health responsibility, and sports activity. Conclusions： The health-promoting lifestyle of the disabled elderly needs to be improved; health care workers and the government should pay more attention to the countermeasures that can improve the lifestyle behaviors and promote the health of the disabled elderly.

An Analysis of the Demand for Education for the Elderly in Rural Areas:A Caso Study of the Suburbs of Hangzhou

The education for the elderly is the last link of life-long education and an important part of spiritually providing for the aged.In the context of rural revitalization,this paper chooses the elderly in the suburbs of Hangzhou,an eastern developed city,as the survey object.Through the methods of questionnaire survey and quantitative statistics,this paper analyzes and introduces the basic situation of rural education for the elderly,the demand for participating in education for the elderly,the learning evaluation of education for the elderly and the problems existing in the education for the elderly in rural areas.On this basis,some brief conclusions and discussions are put forward.

Factors associated with active aging in Chinese elderly in rural areas of Xiangtan County,China

Objectives:To explore the level of active aging and correlates among rural elderly in Xiangtan County,China.Methods:A cross-sectional survey was conducted from July to November 2019.A total of 945 rural elderly from 3 towns in Xiangtan County,China,were investigated by using the positive aging evaluation questionnaire(PAEQ),the activity of daily living scale(ADL),and the depression in old-age scale(DIA-S).Results:The average score in the PAEQ among the rural elderly of Xiangtan County was 72.81(range=21-105).A moderate negative correlation was found between the score in the PAEQ and those in the ADL(r=−0.361)and DIA-S(r=−0.495).Symptoms of depression(β:−0.321,P=0.001),number of chronic diseases(β:−0.281,P=0.001),subjective economic status(β:0.239,P=0.001),ADL(β:−0.196,P=0.001),education(β:0.126,P=0.001),number of children(β:0.097,P=0.001),and marital status(β:−0.060,P=0.001)were significantly associated with levels of active aging in rural elderly,whereas gender and age were not independently related to active aging.Conclusions:The level of active aging is at a moderately high level in the Chinese elderly in rural areas in Xiangtan County.The focus group of active aging in rural areas should be elderly people suffering from chronic diseases,physical decline,poor education and economic conditions,childlessness,and those without partners.

Relationship between the Self-Efficacy and Mental Health of Elderly Patients with Coronary Heart Disease in Rural Hebei Province

Objective:To investigate the self-efficacy and mental health of elderly patients with coronary heart disease(CHD)in rural Hebei Province as well as to analyze the relationship between them.Methods:From June 2021 to December 2021,480 elderly patients with CHD from rural areas,who had been discharged by the Department of Cardiology from three tertiary hospitals in three cities with different economic levels in Hebei Province for more than a year,were selected as the research subjects.The general self-efficacy scale(GSES)and symptom self-rating scale(SCL-90)were used to investigate the self-efficacy and mental health of these patients.SPSS 25.0 was used for data analysis.Results:The total mean self-efficacy score of elderly patients with CHD in rural Hebei Province was 17.18±4.68,which is lower than the international norm(t=-32.067,P=0.000)and the national norm(t=-28.783,P=0.000);the total average SCL-90 score was 148.64±55.13,which is higher than the national norm for adults and the reference norm for ordinary elderly people;except for hostility and psychosis,the other dimensions were significantly higher than the national norm for adults(P<0.05);except for psychosis,the other dimensions were significantly higher than the reference norm for ordinary elderly people(P<0.05);the self-efficacy score was found to be negatively correlated with the total SCL-90 score and the score for each dimension(P<0.05).Conclusion:Elderly CHD patients with higher self-efficacy in rural Hebei Province have higher mental health level.It is suggested that the mental health of elderly patients with CHD in rural areas can be improved by improving their self-efficacy.

Factors associated with financial support in old age for young and middle-aged rural residents in China

This study examined the factors associated with financial support in old age from three primary mechanisms-personal savings,family support,and social insurance-to explore the implications for the future development of China's rural social welfare system.Cross-sectional surveys of 1392 young and middle-aged rural residents were conducted in July and August2012.The results showed that while social insurance was increasingly acceptable,personal savings and family support still had fundamental value.Combining the three mechanisms,the rural old-age welfare system presented nontraditional features.China's new rural endowment insurance is discussed as a means to address the need for financial support among the rural aging population.

Reform and Reconstruction of the Rural Elderly Care Service System in the New Era

With decades of hard work,socialism with Chinese characteristics has crossed the threshold into a new era.The transformation of the principal contradiction in the new era has imposed new and higher requirements on the rural elderly care service system.However,the current service system based on welfare-multiplex and urban community environment is often difficult to operate in the rural areas of central and western China.And the urban home care service for the aged is inappropriate to the rural reality;community service for the aged faces difficulties in practice;institution care for the aged develops slowly;the synergy among different elderly care service models is poor.Through observing the rural areas of central and western China in the field for a long time,this paper proposes to build the rural elderly care service system based on family supporting,supported by community mutual assistance care,supplemented by institution care for the aged,combined with medical care,and localized with diversified forms for targeted groups according to different realities.And the system should follow the fundamental guidance of development-oriented family policy,adhere to the governance mode of multiple subjects with one core and respect rural reality,which could provide a feasible way for the reform and reconstruction of the rural elderly care service system.

Dilemma and Path for Rural Mutual Aid Elderly Care Model in Underdeveloped Areas——A Case Study of Dazhou City in Sichuan Province

Rural mutual aid elderly care,as an emerging elderly care model,has become an exploration and attempt to rebuild rural communities in the process of rural social transformation.At present,in the vast underdeveloped rural areas,the rural mutual aid elderly care model is faced with such problems as imperfect policies and regulations,insufficient funds,single service items,lack of professional services,and limited functions of civil organizations.It is necessary to strengthen the formulation and improvement of laws and regulations,and to ensure the stable source of funds,enhance the level of specialization,and give full play to the functions of social organizations in the rural mutual aid elderly care model,so as to promote the sustainable development of the rural mutual aid elderly care model.

Childcare,Elderly Caring and Off-farm Employment of Rural Couples in China

Based on the representative sample survey data of more than 1 000 farmers in 101 villages of 25 counties of 5 provinces in China,within the framework of family collective decision-making,this paper studied the effects and heterogeneity of childcare and elderly caring on the off-farm employment mode of rural couples. It found that caring the children younger than 3 years old significantly reduces the possibility of offfarm employment of rural couples;conversely,if there is 60-80 years old member in the family,it will significantly increase the possibility of off-farm employment of rural couples or the wives. Caring the children above 12 years old or the elderly older than 80 years old reduces the possibility of off-farm employment of the husbands. Whether there is preschool education service facility in the village has no effect on the off-farm employment of the couples.

Low selenium and reduced cognitive function in a cohort elderly study

Cognitive function in the elderly is affected by various environmental,social,and individual factors.Studies show that chemical trace elements are closely related to cognitive function.As a protective factor,selenium promotes cognition in the elderly.However,study results into the effects of selenium on cognition have varied.By eliminating unstable environmental and other related factors,the present study selected elderly individuals from rural areas of the Shandong province to verify whether low selenium exposure is a risk factor for decreased cognitive function.Results demonstrated that age,sex,education,occupation,hypertension,stroke,and body selenium levels were factors affecting cognitive function in the elderly,and that selenium was an important protective factor.Moreover,results supported the hypothesis that a lifelong low selenium level is associated with low cognitive function.

村域社会资本与农村老人的社区治理参与

基于对全国11个省份1137位农村老人的问卷调查,从村域社会网络、村域信任和村域规范3个维度考察了村域社会资本对农村老人社区治理参与的影响。结果表明,村域社会网络、村域信任和村域规范均显著正向影响农村老人的社区治理参与,且这一结果具有稳健性。村域社会网络、村域信任和村域规范对农村老人社区治理参与的影响存在着性别、年龄和政治身份的群体差异,特别是村域社会资本的各个维度仅显著影响了非党员群体的社区治理参与,而对党员群体的影响不显著。研究进一步发现,村域社会资本主要通过公平感提升和支持获得状况改善影响农村老人的社区治理参与。要发挥村域社会资本的作用,须打造社区参与平台及空间,为积累村域社会资本提供土壤;还须通过培育参与意识和公共精神,促进村域社会资本的积累,延续村域社会资本的生命力。

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.

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.

空巢老人失能状况及影响因素的城乡差异——基于2018 CLHLS数据的实证分析

[目的]分析我国空巢老人失能状况及影响因素的城乡差异,为预防老年人失能及完善老龄社会政策提供参考。[方法]基于2018年中国老年健康调查数据(CLHLS),选取≥65岁的空巢老人为研究对象,利用Katz指数量表及二分类Logistic回归模型对4488名空巢老人失能状况及影响因素进行分析。[结果]空巢老人总体失能率为13.4%,城市空巢老人失能率(14.6%)高于农村空巢老人(12.2%),轻度失能者占比最高(9.9%),洗澡困难是失能老人最易遇到的自理难题。高龄、自评健康差、患多种慢性病、参与社交活动频率低是城乡空巢老人失能的共同危险因素(P<0.05)。吸烟、过去从事体力劳动、未每年体检是农村空巢老人失能特有危险因素,受教育水平高则是其失能的保护因素(P<0.05)。[结论]与一般老年群体相比,我国空巢老人失能率较高,且失能状况存在显著城乡差异。应制定针对性预防和社会救助措施,完善老年照护服务支持体系,协同保障空巢老年人身心健康。

农村二孩家庭男孩偏好对长姐体质健康的影响研究

基于资源分配理论,选用中国家庭追踪调查(CFPS)2010-2018年数据,考察了农村二孩家庭中男孩偏好对长姐体质健康的影响及内在机制。研究发现:男孩偏好对长姐体质健康具有显著负向影响,相比有妹妹,有弟弟的长姐身高Z评分将降低0.254个单位,表现出发育迟缓和消瘦的概率比正常组将分别提高5%和2%,但与肥胖不存在显著关联。性别平等感知在男孩偏好与长姐体质健康关系中发挥调节效应,父母感知到的社会性别平等越弱,男孩偏好对长姐体质健康的不利影响越强。男孩偏好对长姐体质健康的影响存在异质性,长姐处于学龄期、二孩处于学龄前和父亲出生队列较早时,男孩偏好对长姐体质健康将产生更不利的影响。未来应结合我国农村地区重男轻女的社会环境,在保证儿童福利有效供给的基础上,发展以家庭为核心的福利政策,全面构建普惠型儿童福利支持体系。

Study on the challenge and influence of the built thermal environment on elderly health in rural areas:Evidence from Shandong,China

Elderly health is increasingly recognized as a worldwide challenge with the continuous social aging trend.This study aimed to investigate the thermal conditions of the elderly in rural areas of Shandong,China.The thermal sensation and physiological response performances of elderly participants were examined in their own houses.Results show a clear seasonal pattern in cardiovascular disease mortality,cold stress increases the cardiovascular disease risk.The coal-based stoves serve as the main source of home heating and their limited coverage of the room area gave rise to poor quality of thermal comfort.The analysis of skin temperature for those under 65 and above did not reveal any significant difference in response to different indoor temperatures.The regression results confirm that a colder home leads to a rising value of the elderly’s systolic blood pressure,rising by more than 1 mmHg for every 1℃decrease in indoor temperature and thus posing a greater risk of cardiovascular diseases.The systolic blood pressure value of older subjects rise more when they are exposed to decreasing indoor temperatures,possibly due to an age-related decline in their ability to maintain stability of blood pressure.It is noteworthy that the average blood velocity of older subjects reduces less in response to decreasing indoor temperatures,indicating a weakened capacity to resist cold stress and its associated high risk of hypertension.This investigation provides evidence in favor of improving the thermal environment of the elderly and reducing their risk of cardiovascular diseases.