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Objective@#To investigate the trends in prevalence of depression symptoms among middle-aged and elderly residents at ages of 45 years and older in China from 2011 to 2018, so as to provide insights into depression prevention and control among middle-aged and elderly residents. @*Methods@#Demographic features and evaluation data of depressive symptoms were collected from middle-aged and elderly residents at ages of 45 years and older recorded during four follow-ups in the China Health and Retirement Longitudinal Study (CHARLS), and the depressive symptoms were screened using the Center for Epidemiological Studies Depression Scale (CES-D). Following sampling weights, non-response weights, and post-stratification weighting, the detection of depressive symptoms was analyzed among the middle-aged and elderly residents with different demographics, and the trends in prevalence of depressive symptoms were identified using annual percent change (APC). @*Results@#A total of 48 223 middle-aged and elderly residents were enrolled, including 12 624, 10 427, 12 144, and 13 028 residents in 2011, 2013, 2015 and 2018, with mean ages of (58.8±9.4), (58.9±9.2), (59.0±9.2), and (61.1±9.2) years, respectively. The prevalence of depressive symptoms was 34.5% (95%CI: 33.3%-35.8%), 29.6% (95%CI: 28.5%- 30.8%), 30.6% (95%CI: 29.4%-31.8%), and 35.0% (95%CI: 33.6%-36.4%) among middle-aged and elderly residents in 2011, 2013, 2015 and 2018, respectively, with no remarkable changing trends seen (APC=0.4%, t=0.188, P=0.868). Higher detection was seen among residents at advanced ages, among women than among men, among rural residents than among urban residents, among residents with lower educational levels, among widowed and unmarried residents than among married residents, among unemployed residents than among employees, and among residents that had lower per capita personal consumption expenditures than mean expenditures than among residents that had higher per capita personal consumption expenditures than mean expenditures (all P<0.05). @*Conclusions@#There were no obvious trends in prevalence of depressive symptoms among middle-aged and elderly residents in China from 2011 to 2018, and individuals with advanced ages, women, urban residents and those with low educational and economic levels should be given a high priority for depression control.
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Objective:To analyze and compare the association between different obesity-related indices and vitamin D deficiency in middle-aged and elderly population dwelled in Lanzhou city.Methods:From May, 2011 to September, 2012, middle-aged and elderly individuals with complete baseline data were included via randomly cluster sampling from 3 communities in Lanzhou. The subjects were divided into 4 subgroups by vitamin D levels and various obesity-related indices were compared across subgroups with the same gender. The relationship between the obesity-related indices and the severity of vitamin D deficiency was analyzed using Spearman correlation analysis, and the effects of different obesity-related indices on the severity of vitamin D deficiency was analyzed using multivariate logistic regression analysis.Results:A total of 9 437 residents were included. The overall prevalence of vitamin D deficiency was 97.7%. Compared with the group with lower vitamin D level, participants in the group with higher vitamin D level showed evidently lower body mass index (BMI), waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride/ high density lipoprotein cholesterol (TG/HDL-C) ratio in the total population and females, while only WC, LAP, VAI and TG/HDL-C in the males (all P<0.05). Spearman correlation analysis showed that BMI, WC, LAP, VAI and TG/HDL-C were positively correlated with the severity of vitamin D deficiency in the total population and the females, while only LAP, VAI and TG/HDL-C in the males (all P<0.05) . Multivariate logistic regression analysis showed that higher levels of these obesity related indices were correlated with more severe vitamin D deficiency in the total population and the females, while only higher LAP, VAI and TG/HDL-C in the males (all P<0.05). The effects of higher LAP was the most prominant in the total population ,the females and the males. Conclusion:Various obesity phenotypes are closely related to vitamin D deficiency in middle-aged and elderly women, while only visceral obesity and abnormal lipid metabolism are related to vitamin D deficiency in middle-aged and elderly men, with LAP being the most important influencing factor.
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Objective@#To examine the correlation between frailty and lifestyle factors among middle-aged and elderly populations, so as to provide insights into the management of frailty among middle-aged and elderly populations.@*Methods @#Middle-aged and elderly residents at ages of 45 ot 69 years were recruited using the convenient sampling method from seven townships in Changxing County of Zhejiang Province from 2019 to 2020. The demographic characteristics and lifestyle factors were collected using questionnaires, and the frailty was measured using the Chinese version of Tilburg Frailty Indicator ( TFI ). Factors affecting frailty were identified among middle-aged and elderly populations using the multivariable logistic regression model.@*Results@#A total of 7 170 residents were surveyed, including 2 780 males ( 38.77% ) and 4 390 females ( 61.23% ), which had a median age of 56 (interquartile range, 10) years. The median frailty score was 2 (interquartile range, 3 ) among the study subjects, and the median frailty score was 2 ( interquartile range, 2 ) among residents at ages of 45 to 59 years, and 2 (interquartile range, 3) among residents at ages of 60 to 69 years. The overall detection of frailty was 16.07%, and the detection of frailty was 13.52% among subjects at ages of 45 to 59 years and 21.01% among subjects at ages of 60 to 69 years. Multivariable logistic regression analysis identified physical activity ( OR=0.826, 95%CI: 0.719-0.949 ) and sleep quality ( OR: 3.376-11.493, 95%CI: 2.907-15.808 ) as factors affecting frailty among middle-aged and elderly residents. Following age stratification, physical activity ( OR=0.817, 95%CI: 0.681-0.981 ) and sleep quality ( OR: 3.076-11.566, 95%CI: 2.518-18.216 ) as factors affecting frailty among subjects at ages of 45 to 59 years, while sleep quality ( OR: 3.777-11.827, 95%CI: 3.002-18.547 ) significantly correlated with frailty among residents at ages of 60 to 69 years.@*Conclusion@#Physical activity and sleep quality are associated with the risk of frailty among middle-aged and elderly populations.
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Objective @#To investigate the spatial distribution and the influencing factors of hypertensive patients aged 45 years and above,and to provide evidence for the prevention and control of hypertension among middle-aged and elderly population.@*Methods @#Multi-stage stratified random sampling method was used to collect 150 counties（cities or districts）from 30 provinces（municipalities or autonomous regions）from CHARLS database in 2015 according to the per capita GDP in different areas. Then the probability proportionate to size sampling method was used to select three villages（neighborhood committees）,80 families were randomly selected from each village（neighborhood committees）,and residents aged 45 years and above were interviewed. Spatial analysis was based on the vector map of China's provincial boundaries,Geoda and ArcGIS 10.2 software were used to analyze the prevalence and influencing factors of hypertension at provincial levels.@*Results @#The health data of 14 880 people aged 45 years and above in 28 provinces（municipalities or autonomous regions）were obtained,including 4 203 patients with hypertension（28.25%）and 5 408 people with pre-hypertension（36.34%）. The results of local spatial analysis showed that the clustering regions of hypertension patients were in northeast and eastern parts of China. The results of spatial regression analysis showed that males,age of 80 years and above and overweight were the main risk factors for hypertension（all P<0.05）,which had greater influence on the middle part of China,north and northeast of China,and the east and north of China,respectively.@*Conclusion @#Males,age of 80 years and above and overweight were the main risk factors for hypertension in middle-aged and elderly population in China. The main prevention and control areas of hypertension were eastern and northeast China.
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Objective To investigate the association between people who were under lack of care in childhood and the development of cognitive impairment in their middle-aged and elderly life spans.Methods Based on the baseline survey data of the third phase of "Guangzhou Biobank Cohort study" conducted from January 2007 to January 2008,9 223 residents aged ≥50 years with records on Mini Mental State Examination (MMSE) were included in a retrospective survey on received childhood carc of their early lives.Questions would include:feelings of care and support from their close relatives during childhood,the status of separation from their mothers for ≥ 1 year,and the current status of their parents.Linear regression,unconditional and multinomial logistic regression models were used to analyze the associations between the received childhood care and cognitive function (i.e.,MMSE scores and cognitive impairment) in middle and old age,of this population under study.Results After adjusting for age,gender,education,place of residence,marital status,physical activity,smoking,drinking,occupation,personal income,childhood socioeconomic position and depressive symptoms etc.,factors as feeling lack of concern and support from close relatives (LC),status of separation from the mother for ≥ 1 year (SM),and the current status of their parents etc.,were all negatively associated with the MMSE score when in middle and old age,with partial regression coefficient β (95％CI) as-0.44 (-0.65--0.23),-0.26 (-0.38--0.14) and-0.61 (-0.96--0.27),respectively.The presence ofLC,SM or PD were associated with the increased risks of cognitive impairment,and the adjusted odds ratio OR (95％CI) appeared as 1.43 (1.15-1.78),1.26 (1.08-1.47) and 1.64 (1.16-2.31)respectively in all the participants,but 1.27 (1.01-1.62),1.29 (1.09-1.55) and 1.75 (1.19-2.55) respectively,in those with education level of primary school or below.In those with secondary school education or above,only the presence of item A was associated with an increased risk of cognitive impairment (OR=2.26,95％CI:1.41-3.50).Conclusion We noticed that ‘lack of care'in childhood was associated with cognitive impairment during middle and old age,mainly in those population with lower education.
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Objective To investigate the association between people who were under lack of care in childhood and the development of cognitive impairment in their middle-aged and elderly life spans.Methods Based on the baseline survey data of the third phase of "Guangzhou Biobank Cohort study" conducted from January 2007 to January 2008,9 223 residents aged ≥50 years with records on Mini Mental State Examination (MMSE) were included in a retrospective survey on received childhood carc of their early lives.Questions would include:feelings of care and support from their close relatives during childhood,the status of separation from their mothers for ≥ 1 year,and the current status of their parents.Linear regression,unconditional and multinomial logistic regression models were used to analyze the associations between the received childhood care and cognitive function (i.e.,MMSE scores and cognitive impairment) in middle and old age,of this population under study.Results After adjusting for age,gender,education,place of residence,marital status,physical activity,smoking,drinking,occupation,personal income,childhood socioeconomic position and depressive symptoms etc.,factors as feeling lack of concern and support from close relatives (LC),status of separation from the mother for ≥ 1 year (SM),and the current status of their parents etc.,were all negatively associated with the MMSE score when in middle and old age,with partial regression coefficient β (95％CI) as-0.44 (-0.65--0.23),-0.26 (-0.38--0.14) and-0.61 (-0.96--0.27),respectively.The presence ofLC,SM or PD were associated with the increased risks of cognitive impairment,and the adjusted odds ratio OR (95％CI) appeared as 1.43 (1.15-1.78),1.26 (1.08-1.47) and 1.64 (1.16-2.31)respectively in all the participants,but 1.27 (1.01-1.62),1.29 (1.09-1.55) and 1.75 (1.19-2.55) respectively,in those with education level of primary school or below.In those with secondary school education or above,only the presence of item A was associated with an increased risk of cognitive impairment (OR=2.26,95％CI:1.41-3.50).Conclusion We noticed that ‘lack of care'in childhood was associated with cognitive impairment during middle and old age,mainly in those population with lower education.
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Objective·To investigate the relationship between obesity and chronic kidney disease (CKD) in a community-based study among a middle-aged and elderly Chinese population. Methods·A survey of 10375 inhabitants aged 40 years or older in Jiading District of Shanghai was performed using cluster sampling. All the subjects were recruited to undergo questionnaire interview, anthropometric measurements, and biochemical measurements. Blood and urine samples were collected to measure biochemical features, including plasma glucose, lipid profiles, liver and renal function, as well as urinary albumin and creatinine. Obesity status was diagnosed according to the World Health Organization (WHO) criteria. According to body mass index (BMI) levels, the subjects were divided into normal weight group (BMI<25 kg/m2), overweight group (25 kg/m2 ≤ BMI<30 kg/m2) and obesity group (BMI ≥ 30 kg/m2). The estimated glomerular filtration rate (eGFR) was calculated based on American Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation. Logistic regression analysis was used to analyze the risk of CKD among people with different BMI levels. Results·Increased BMI levels were associated with more unfavorable metabolic profiles. After a variety of factors were adjusted,each 1 kg/m2 increment of BMI was associated with a 9% higher risk of prevalent CKD, and the odds ratio (OR) was 1.09 (95% CI:1.07-1.12). Results from multivariate Logistic regression analysis showed that in the total population, compared with individuals in the normal weight group, those in the overweight and obesity groups had 51% (OR=1.51, 95% CI: 1.27-1.78) and 181% (OR=2.81, 95% CI: 2.20-3.61) higher risk of prevalent CKD. Conclusion·In the middle-aged and elderly community population in China, overweight and obesity are associated with an increased risk of prevalent CKD.
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Objective·To investigate the association between mid-upper arm circumference (MUAC) and non-alcoholic fatty liver disease (NAFLD) or insulin resistance in middle-aged and elderly Chinese community population. Methods·A cross-sectional study was conducted in 6570 residents aged 40 years or older in Jiading District of Shanghai in 2014. All participants received standard questionnaire, anthropometric measurements, biochemical evaluation and ultrasonic examination. NAFLD was defined by hepatic ultrasonography, after excluding subjects with excess alcohol consumption and medical history of liver diseases. Participants were divided into 4 groups according to the quartiles of MUAC, then association between MUAC and NAFLD or insulin resistance was analyzed. Results·With the increase of MUAC level, body mass index (BMI), waist circumference, systolic blood pressure, diastolic blood pressure, triacylglycerol, fasting insulin, HOMA-IR levels, low-density lipoprotein-cholesterol, alanine aminotransferase,γ-glutamyl transpeptidase, and aspartic transaminase levels were increased significantly (all P<0.01), as well as the prevalence of NAFLD, hypertension,dyslipidemia, and insulin resistance (all P<0.01). A fully adjusted multivariate Logistic regression analysis revealed that with the increase of MUAC level, the risk of having NAFLD and insulin resistance were increased among women. However, among men, there was no correlation between MUAC and NAFLD or insulin resistance. Conclusion·MUAC is significantly associated with NAFLD and insulin resistance in middle-aged and elderly female Chinese community population.
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Objective·To investigate the relationship between obesity and chronic kidney disease (CKD) in a community-based study among a middle-aged and elderly Chinese population. Methods·A survey of 10375 inhabitants aged 40 years or older in Jiading District of Shanghai was performed using cluster sampling. All the subjects were recruited to undergo questionnaire interview, anthropometric measurements, and biochemical measurements. Blood and urine samples were collected to measure biochemical features, including plasma glucose, lipid profiles, liver and renal function, as well as urinary albumin and creatinine. Obesity status was diagnosed according to the World Health Organization (WHO) criteria. According to body mass index (BMI) levels, the subjects were divided into normal weight group (BMI<25 kg/m2), overweight group (25 kg/m2 ≤ BMI<30 kg/m2) and obesity group (BMI ≥ 30 kg/m2). The estimated glomerular filtration rate (eGFR) was calculated based on American Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation. Logistic regression analysis was used to analyze the risk of CKD among people with different BMI levels. Results·Increased BMI levels were associated with more unfavorable metabolic profiles. After a variety of factors were adjusted,each 1 kg/m2 increment of BMI was associated with a 9% higher risk of prevalent CKD, and the odds ratio (OR) was 1.09 (95% CI:1.07-1.12). Results from multivariate Logistic regression analysis showed that in the total population, compared with individuals in the normal weight group, those in the overweight and obesity groups had 51% (OR=1.51, 95% CI: 1.27-1.78) and 181% (OR=2.81, 95% CI: 2.20-3.61) higher risk of prevalent CKD. Conclusion·In the middle-aged and elderly community population in China, overweight and obesity are associated with an increased risk of prevalent CKD.
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Objective·To investigate the association between mid-upper arm circumference (MUAC) and non-alcoholic fatty liver disease (NAFLD) or insulin resistance in middle-aged and elderly Chinese community population. Methods·A cross-sectional study was conducted in 6570 residents aged 40 years or older in Jiading District of Shanghai in 2014. All participants received standard questionnaire, anthropometric measurements, biochemical evaluation and ultrasonic examination. NAFLD was defined by hepatic ultrasonography, after excluding subjects with excess alcohol consumption and medical history of liver diseases. Participants were divided into 4 groups according to the quartiles of MUAC, then association between MUAC and NAFLD or insulin resistance was analyzed. Results·With the increase of MUAC level, body mass index (BMI), waist circumference, systolic blood pressure, diastolic blood pressure, triacylglycerol, fasting insulin, HOMA-IR levels, low-density lipoprotein-cholesterol, alanine aminotransferase,γ-glutamyl transpeptidase, and aspartic transaminase levels were increased significantly (all P<0.01), as well as the prevalence of NAFLD, hypertension,dyslipidemia, and insulin resistance (all P<0.01). A fully adjusted multivariate Logistic regression analysis revealed that with the increase of MUAC level, the risk of having NAFLD and insulin resistance were increased among women. However, among men, there was no correlation between MUAC and NAFLD or insulin resistance. Conclusion·MUAC is significantly associated with NAFLD and insulin resistance in middle-aged and elderly female Chinese community population.