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ObjectiveTo analyze the effect of frailty status on the risk of mortality in a community-based population aged 45 years and above in Shanghai with different characteristics， and to provide further basis for population-based interventions for frailty and prevention of adverse outcomes. MethodsData were derived from baseline data from the Shanghai prospective study on AGEing and adult health （2009-2010） and cohort follow-up of causes of death up to October 30， 2021. Frailty index （FI） scores were constructed from 40 variables. Those with frailty index FI≥0.2 were judged to be in a frail state， and a multifactorial Cox regression model was used to calculate the hazard ratio （HR） to evaluate the effect of frailty status on the risk of death in different age groups by gender. Socioeconomic characteristics （age， residence， marital status， education and family economic level， etc.） and health-related behaviors （smoking， alcohol consumption， fruit and vegetable intake， social participation， etc.） were included as control variables. ResultsThe study included 7 978 subjects， 777 （9.7%） of whom were in a frail state. After （11.3±1.8） years of follow-up， 1 043 （13.1%） individuals were dead， including 214 （27.5%） who were frail. The results of the multifactorial Cox regression analysis showed that the effect of frailty on the risk of death in each subgroup was in descending order of men in the middle-aged group （45‒ years） （HR=2.92， 95%CI： 1.38-6.19）， women in the low-aged elderly group （60‒ years） （HR=1.68， 95% CI： 1.08-2.60）， and women in the old-aged elderly group （≥75 years and older） （HR=1.59， 95%CI： 1.22‒2.06）. ConclusionFrailty is associated with the risk of death， and we should focus on the frailty status of men aged 45~59 years and women aged 60 years and above. Early screening and assessment of frailty status and taking appropriate preventive interventions may reduce the occurrence of adverse outcomes and premature death.
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Objective@#To investigate the association between daily sedentary time and frailty among people aged 50 years and over.@*Methods@#Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China. A two-level (individual level and community level) logistic model was performed to identify the association between daily sedentary time and frailty. The dose-response relationship between them was analyzed by restrictive cubic spline curve.@*Results@#A total of 13 175 individuals aged 50 years and over were included for analysis. A positive association between daily sedentary time and frailty was noticed, both in urban (OR=1.22, 95%CI: 1.17-1.27) or rural areas (OR=1.11, 95%CI: 1.05-1.18) under study. The dose-response curve showed that daily sedentary time and frailty might present an approximate linear relationship.@*Conclusion@#Results from this study showed significant association exsited between daily sedentary time and frailty, approximately with a linear dose-response relationship.
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Objective@#To investigate the association between sleep duration and frailty among people aged 50 years and over.@*Methods@#Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China. Frailty index was constructed on the proportion of deficits, out of the 40 variables. A two-level (individual level and community level) linear model was performed to identify the related factors on frailty. All the models were stratified by age, gender, residence (urban/rural). Restricted cubic spline was performed to graphically evaluate the dose-response association between self-reported sleep duration and frailty.@*Results@#A total of 13 175 individuals aged 50 years and over participated in this study. Without adjusting on any confounding factors, shorter or longer sleep duration significantly increased the risk of weakness compared with normal sleep time (OR=2.05, 95%CI: 1.71-2.44; OR=1.35, 95%CI: 1.12-1.63). After adjusting for confounding factors such as gender, age, residence, education, family assets, vegetable, smoking, drinking and physical activity, a positive association between short sleep duration and frailty was noticed compared with normal sleep time (aOR=1.60, 95%CI: 1.27-2.01). The results of stratified analysis on sex, age and urban and rural areas showed that, after adjusting for gender, age, residence, education level, family assets, intake of vegetables and fruits, smoking, drinking and physical activity, only shorter sleep duration was positively correlated with the risk of weakness. In addition, among people aged 65 years and over, adjusted for confounding factors, the risk of weakness increased by 91%, compared with normal sleep time (aOR=1.91, 95%CI: 1.46-2.49). The dose-response curve also showed that the sleep duration and frailty present an approximate "U" shaped relationship.@*Conclusion@#Short sleep duration might be associated with frailty.
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Objective@#To explore the relationship between physical activity level and quality of life among people aged 50 years and over.@*Methods@#From October 2009 to June 2010, 8 872 middle-aged and elderly people aged 50 years and over, were selected from five districts of Shanghai, by multi-stage random cluster sampling method. Both Global Physical Activity Questionnaireand World Health Organization Quality of Life Scale (WHOQoL-8) were used to assess the physical activity, level and quality of life. A two-level (individual level and community level) linear model was used to analyze the relationship between physical activity level and quality of life in different age groups.@*Results@#A total of 8 454 individuals aged (63.16±9.74) years were included in this study. 59.95% of the people in this study were with low physical activity level, while 28.00% and 12.05% of them were with medium or high levels of physical activities. The WHOQoL-8 score appeared as 43.91±0.69. The higher the level of physical activity, the lower the WHOQoL-8 score was, referring to a better quality of life (P=0.00). After controlling the confounding factors of socio-economic factors, health status and social participation, the increase of physical activity level showed significant effect in improving the quality of life for the middle-aged and under 80 elderly (P<0.05). However, compared with the low-level, middle and high-level physical activities did not improve the quality of life among the people aged 80 years and over. The P values were 0.06 and 0.47, respectively.@*Conclusion@#Higher level of physical activity appeared its relations to a better quality of life among people aged between 50 and 80, in Shanghai.
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Objective@#To examine the association between long-term exposure to ambient PM2.5 combined with indoor air pollution and handgrip strength among people aged 50 and over.@*Methods@#Data were from the first wave of World Health Organization Study on global AGEing and adult health in China. Ambient annual concentration of PM2.5 was estimated by using the satellite data we also investigated the use of fuels and chimneys as indoor air pollution. A two-level (individual level and community level) linear model was applied to examine the association between long-term exposure to ambient PM2.5 combined with indoor air pollution and the handgrip strength.@*Results@#A total of 13 175 individuals aged 50 years and over were included for analysis. The handgrip strength was (26.67±0.54) kg. Ambient PM2.5 was found to be significantly associated with the risk of decreased handgrip strength. Outdoor PM2.5 concentration was negatively correlated with handgrip strength (β=-0.23, 95%CI: -0.31 - -0.14) decrease in handgrip strength after adjusting for gender, age, residence, education, household assets, intake of vegetables and fruits, smoking and drinking, physical activity. In rural area, compared to those who used solid fuel, use of clean fuel increased (β=1.41, 95%CI: 0.36-2.46) handgrip strength. But in urban area, we did not find any statistically significant association between the use of clean fuel and handgrip strength (β=0.19, 95%CI: -0.95-1.32).@*Conclusion@#This study found that long-term exposure to ambient PM2.5 combined with indoor air pollution was significantly associated with low handgrip strength among people aged 50 years and over, this suggested that ambient PM2.5 might serve as one of the risk factors for low physical function seen in the people aged 50 years and over.
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Objective@#To investigate the association between edentulism and cognition in people aged 50 and over in China.@*Methods@#Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China, among people aged 50 and over in China. A comprehensive cognitive test was used to assess cognitive functions, including verbal recall (VR), verbal fluency (VF), forward digit span (FDS) and backward digit span (BDS) among the subjects. Association between edentulism and cognition was examined by a two-level (individual level and community level) linear model.@*Results@#A total of 12 843 individuals aged 50 years and over were included for analysis, with an average age of (63.0±9.3) years. The overall prevalence of edentulism was 11.0%. The edentulous adults had lower mean scores of VR (4.55), VF (10.88), FDS (6.25), BDS (2.96) and overall cognition (49.15) (P<0.001). Edentulism was negatively associated with VR (β=-0.216, 95%CI: -0.370 - -0.062), FDS (β=-0.186, 95%CI: -0.293 - -0.078) and overall cognition (β=-1.703, 95%CI: -3.025 - -0.381) after adjusted for age, sex, residence, education level, marital status, household income, co-morbidity of chronic conditions, BMI, smoking and drinking alcohol.@*Conclusion@#Edentulism was related with lower cognition level in people aged 50 and over in China.
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Objective To evaluate the subjective well-being feelings of people aged ≥50 years in Shanghai by using the Day Reconstruction Method (DRM) and explore the related factors.Methods A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai.DRM was used to assess participants' subjective well-being by net effect and U-index.Univariate and multivariate linear regression models were used to explore the related factors.Results A total of 8 075 participants were included,with average age of 63.1 years.The mean net effect value was 1.24 (95％CI:1.15-1.33),and the mean U-index was 1.55％ (95％ CI:1.10％-1.99％).After adjusted for demographic factors,univariate liner regression model indicated that age,education level,marital status,family wealth,residence,self-rated health status,WHODAS score and prevalence of chronic disease were associated with subjective well-being,and multivariate liner regression model indicated that higher WHODAS score was associated with lower net effect value (P＜0.05).Conclusion The subjective well-being feelings of people aged ≥50 years in Shanghai might be associated with age,education level,marital status,family wealth,residence,self-rated health status and WHODAS score.Enhanced social support and appropriate social security system might facilitate the improvement of the subjective well-being of the elderly.
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Objective To investigate the associations of obesity and physical activity with cognition in the elderly.Methods A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai.The subjects' body weight,body height,waist circumference and hip circumference were measured to calculate body mass index (BMI) and waist-hip ratio (WHR),and the data on self-reported physical activity level were collected through questionnaire survey.A comprehensive battery of cognitive tests was conducted to assess subjects' cognitive functions,including verbal recall,forward digit span (FDS),backward digit span (BDS),and verbal fluency (VF).General linear model was used to examine the associations of BMI,WHR and physical activity with cognition.Results A total of 7 913 participants were included,with a median age of 60 years.Age,sex,education level,income level,BMI,WHR and physical activity level were significantly associated with cognitive scores in univariate analysis.After adjusted for age,sex,education level and income level,BMI was no longer significantly associated with cognitive scores in all cognitive functions (all P＞0.01).WHR was significantly associated with VF score (P＜0.01).Abdominally obese participants had lower VF score than non-abdominally obese participants (P＜0.01).Physical activity level was significantly associated with all cognitive functions (P＜0.01).Compared with participants with moderate physical activity level,participants with low physical activity level had lower scores in all cognitive functions (P＜0.01).Conclusion Abdominal obesity and low physical activity level were negatively associated with cognition level in the elderly,suggesting that waist circumference control and physical activity might help maintain cognition in the elderly.
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Objective To estimate the incidence and distribution characteristics of fall related injury in people aged ≥50 years in 8 provinces in China and related physiological,psychological and social risk factors.Methods Cross-sectional data were collected from adults aged ≥50 years participating in the World Health Organization (WHO) study on global ageing and adult health (SAGE) round 1 in China.Two-level hierarchical logistic model was used to identify the related factors for fall-related injury.All the models were stratified by living area (urban/rural).Results Estimated incidence of fall related injury (road traffic injury was not included) was 3.2％.Ageing and multiple chronic conditions (OR=2.55,95％CI:1.41-4.64) was significantly associated with the incidence of fall related injury in urban area.In rural area,depression (OR=4.33,95％ CI:2.52-7.42) and multiple chronic conditions (OR=2.46,95％CI:1.37-4.41) were associated with the incidence of fall related injury.Conclusions This study estimated the incidence of fall related injury in adults aged ≥50 years in 8 provinces in China.A significant association between multiple chronic conditions and fall related injury were found in both urban and rural residents.Targeted measures should be taken for the prevention and control of chronic diseases in elderly population.
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Objective To evaluate the subjective well-being feelings of people aged ≥50 years in Shanghai by using the Day Reconstruction Method (DRM) and explore the related factors.Methods A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai.DRM was used to assess participants' subjective well-being by net effect and U-index.Univariate and multivariate linear regression models were used to explore the related factors.Results A total of 8 075 participants were included,with average age of 63.1 years.The mean net effect value was 1.24 (95％CI:1.15-1.33),and the mean U-index was 1.55％ (95％ CI:1.10％-1.99％).After adjusted for demographic factors,univariate liner regression model indicated that age,education level,marital status,family wealth,residence,self-rated health status,WHODAS score and prevalence of chronic disease were associated with subjective well-being,and multivariate liner regression model indicated that higher WHODAS score was associated with lower net effect value (P＜0.05).Conclusion The subjective well-being feelings of people aged ≥50 years in Shanghai might be associated with age,education level,marital status,family wealth,residence,self-rated health status and WHODAS score.Enhanced social support and appropriate social security system might facilitate the improvement of the subjective well-being of the elderly.
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Objective To investigate the associations of obesity and physical activity with cognition in the elderly.Methods A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai.The subjects' body weight,body height,waist circumference and hip circumference were measured to calculate body mass index (BMI) and waist-hip ratio (WHR),and the data on self-reported physical activity level were collected through questionnaire survey.A comprehensive battery of cognitive tests was conducted to assess subjects' cognitive functions,including verbal recall,forward digit span (FDS),backward digit span (BDS),and verbal fluency (VF).General linear model was used to examine the associations of BMI,WHR and physical activity with cognition.Results A total of 7 913 participants were included,with a median age of 60 years.Age,sex,education level,income level,BMI,WHR and physical activity level were significantly associated with cognitive scores in univariate analysis.After adjusted for age,sex,education level and income level,BMI was no longer significantly associated with cognitive scores in all cognitive functions (all P＞0.01).WHR was significantly associated with VF score (P＜0.01).Abdominally obese participants had lower VF score than non-abdominally obese participants (P＜0.01).Physical activity level was significantly associated with all cognitive functions (P＜0.01).Compared with participants with moderate physical activity level,participants with low physical activity level had lower scores in all cognitive functions (P＜0.01).Conclusion Abdominal obesity and low physical activity level were negatively associated with cognition level in the elderly,suggesting that waist circumference control and physical activity might help maintain cognition in the elderly.
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Objective To estimate the incidence and distribution characteristics of fall related injury in people aged ≥50 years in 8 provinces in China and related physiological,psychological and social risk factors.Methods Cross-sectional data were collected from adults aged ≥50 years participating in the World Health Organization (WHO) study on global ageing and adult health (SAGE) round 1 in China.Two-level hierarchical logistic model was used to identify the related factors for fall-related injury.All the models were stratified by living area (urban/rural).Results Estimated incidence of fall related injury (road traffic injury was not included) was 3.2％.Ageing and multiple chronic conditions (OR=2.55,95％CI:1.41-4.64) was significantly associated with the incidence of fall related injury in urban area.In rural area,depression (OR=4.33,95％ CI:2.52-7.42) and multiple chronic conditions (OR=2.46,95％CI:1.37-4.41) were associated with the incidence of fall related injury.Conclusions This study estimated the incidence of fall related injury in adults aged ≥50 years in 8 provinces in China.A significant association between multiple chronic conditions and fall related injury were found in both urban and rural residents.Targeted measures should be taken for the prevention and control of chronic diseases in elderly population.