Prevalence of Poor Quality of Sleep among the Elderly Population: A Community-based Cross-sectional Study

Background: The spike in cases of sleep?related issues and its ill effects among the geriatric population has been highly noted these days. The drop in sleep quality has been seen to be associated with various day-to-day factors. The study has been conducted to mark the quality of sleep and the factors associated with it in the elderly population. Materials and Methods: A cross-sectional study was conducted among the elderly population. A face-to-face interview of 89 individuals over 60 years of age was conducted. The study tool for assessment of the quality of sleep was Pittsburgh Sleep Quality Index (PSQI). Chi?square test was done to find out the association between various factors and quality of sleep. Results: The prevalence of poor sleep quality was 58.43%. About 35.95% of the population had bad subjective sleep quality, 12.36% population had sleep latency of 31–60 min, while 22.47% population had sleep duration of <5 h. Eight percent of the population reported the use of sleep medication, and 23.6% of population reported sleep disturbance of more than thrice a week. Thirty?five (67.3%) females reported poor quality of sleep which was found to be statistically significant. Conclusion: The prevalence of poor sleep quality was found to be high among the elderly population. Educating the population about sleep health and methods to combat the situation by health-care workers can result in significant improvement of the conditions.

Protocolo de validación del instrumento Examen Dental Preventivo del Adulto Mayor / Validation protocol for the Preventive Dental Examination of the Elderly instrument

Los desafíos del envejecimiento de la población y la acumulación de daño oral nos obligan a desarrollar herramientas diagnosticas validas y confiables que nos permitan caracterizar a la población, evaluar sus necesidades terapéuticas, planificar intervenciones significativas y realizar seguimiento de su condición. Con este propósito realizamos una revisión sistemática de la literatura relevante para establecer una metódica secuencial para la validación de la herramienta diagnostica Examen Dental Preventivo del Adulto Mayor. Seleccionamos 48 artículos relevantes, cuya heterogeneidad impidió la realización de un metaanálisis. Sin embargo, los artículos seleccionados fueron sometidos a una síntesis cuantitativa analítica, que nos permitió identificar los dominios y estrategias relevantes para la validación y proponer un protocolo de cinco fases secuenciales que presentamos en extenso en el presente artículo.

The challenges of population aging and the accumulation of oral damage force us to develop valid and reliable diagnostic tools to characterize the population, evaluate their therapeutic needs, plan significant interventions, and monitor their condition post treatment. We carried out a systematic review of the relevant literature to establish a sequential method for the validation of the Preventive Dental Examination of the Elderly diagnostic tool. We selected 48 relevant articles, whose heterogeneity prevented us from performing a meta-analysis. However, the selected articles were subjected to an analytical quantitative synthesis, which allowed us to identify the relevant domains and strategies for validation and then propose a protocol of five sequential phases that we present in detail in this article.

Study on the Oral Health Status in Middle-aged and Elderly Population in Wuhan / 华中科技大学学报(医学版)

Objective To analyze the current oral health status of middle-aged and elderly people in Wuhan,and to provide clinical evidence for preventing and promoting oral health among middle-aged and elderly people.Methods The data was col-lected from the annual health examination data system of Wuhan,which included 1994 patients aged 45～95.According to the World Health Organization(WHO)"Basic Methods of Oral Health Survey"(5 th edition),the data of caries,periodontal disease,dentition defect,dentition loss and denture restoration was mainly studied.Statistical methods such as Chi-square test and vari-ance analysis were used for data analysis.Results Among the 1994 subjects,1613 people(80.89％)were male and 218 people(10.93％)were older than 75 years old.The average numbers of caries and teeth loss were 2.68 and 2.03,respectively.The mean number of caries and tooth loss increased with age.The mean numbers of caries and tooth loss in 45～,55～,65～,75～,and 85～95 years old groups were 0.98 and 0.54,1.82 and 1.39,3.21 and 2.48,7.65 and 6.04,12.65 and 9.91,respective-ly.The difference among different age groups was statistically significant(P＜0.01).The proportion of restoration of teeth loss was also elevated with the increase of age(P＜0.01),and the difference of community periodontal index(CPI)among different age groups was also statistically significant(P＜0.01).The proportion of people in CPI1 group(shallow periodontal pocket)was decreased with the increase of age,while the proportion of people in CPI2 group(deep periodontal pocket)was increased with the increase of age(P＜0.01).Conclusion The overall oral health examination results of middle-aged and elderly people in Wuhan shows that the oral health status is slightly better when compared with the result of urban area in the 4th National Oral Health Examination.But caries,periodontal disease,tooth loss and unrepaired dentures are still serious in the elderly population.It is necessary to improve the prevention awareness of oral diseases in the elderly through regular oral examination,timely detection and treatment.At the same time,attention should be paid to dental restoration in the elderly population to improve the quality of life.

Factors affecting balance ability among middle-aged and elderly peoplewith depressive symptoms / 预防医学

Objective@#To explore the factors affecting balance ability among middle-aged and elderly people with depressive symptoms, so as to provide the evidence for improving balance ability and prevention of falls.@*Methods@#Based on the 2015 database of China Health and Retirement Longitudinal Study (CHARLS), demographic information, lifestyle and health status were collected from people aged 45 years and older who scored 10 and more on the Self-rating Depression Scale or took antidepressants. The balance ability was assessed by semi-tandem and full-tandem stand tests, which was defined as meeting the standard when both tests were completed. Factors affecting the balance ability among middle-aged and elderly people with depressive symptoms were identified using a multivariable logistic regression model.@*Results@#Data were collected from 4 263 participants with an mean age of (60.73±8.53) years, including 1 748 males (41.00%) and 2 515 females (59.00%). There were 1 241 people failed to meet the standard of balance ability test, accounting for 29.11%. Multivariable logistic regression analysis showed that participants who were at ages of 65 years and older (OR=1.234, 95%CI: 1.071-1.421), were female (OR=1.422, 95%CI: 1.161-1.741), were physically disabled (OR=1.309, 95%CI: 1.127-1.521) and had physical pain (OR=1.170, 95%CI: 1.023-1.340) had higher risks of failing to meet the standard of balance ability test, while participants who took naps (OR=0.856, 95%CI: 0.748-0.980), never smoked (OR=0.641, 95%CI: 0.517-0.793) and had social activities (OR=0.864, 95%CI: 0.755-0.988) had lower risks of failing to meet the standard of balance ability test.@*Conclusion@#The balance ability among middle-aged and elderly people with depressive symptoms was associated with age, gender, napping, smoking, social activities, physical disability and physical pain.

Correlation between urinary protein levels and the incidence of chronic obstructive pulmonary disease in middle-aged and elderly population / 公共卫生与预防医学

Objective To explore the relationship between baseline urinary protein levels and the onset of chronic obstructive pulmonary disease (COPD). Methods A questionnaire survey, blood and urine sample collection, physical examination, and pulmonary function test were conducted among permanent residents over 40 years old in Pudong New Area, Shanghai. The subjects were divided into four groups based on the baseline urine albumin-to-creatinine ratio (ACR) quartiles (0~1.65 mg/g, 1.65~4.89 mg/g, 4.89~10.78 mg/g, and ≥10.78 mg/g). Cox regression analysis was used to explore the relationship between ACR levels and the incidence of COPD in middle-aged and elderly people. Results Among the 3 105 subjects, the median follow-up time was 3.212 years (P25~P75：3.102~3.473). 116 new cases of COPD were observed, with an incidence density of 10.423 per 1000 person-years. The incidence densities for COPD at four ACR levels were 7.922 per 1 000 person-years, 8.300 per 1 000 person-years , 11.419 per 1 000 person-years, and 13.843 per 1 000 person-years, respectively. Cox regression analysis revealed that as the ACR level increased, there was a rising trend in the incidence rate of COPD (χ2=4.396, P=0.036). After adjusting for gender, age, education level, occupational exposure to dust, history of childhood pneumonia, smoking, family history of COPD, central obesity, and hypertension, the risk of developing COPD was 2.499 times higher (95% CI: 1.460~4.276) for ACR levels ≥10.78 mg/g compared to the reference group with a baseline ACR level of 0~1.65 mg/g. Conclusion Elevated ACR levels in middle-aged and elderly population may increase the risk of COPD, and early monitoring of urine protein levels is beneficial for COPD prevention.

Research progress on fall risk and prevention in elderly population / 公共卫生与预防医学

Fall is an important cause of serious injury and even death in the elderly. With the increasing proportion of the elderly in China, fall in the elderly has become a major public problem in society. There are many causes of fall in the elderly, and age, gender, chronic diseases, physical function and living environment are closely related to the fall risk in the elderly. Therefore, it is of great significance to understand and analyze the risk factors of fall in the elderly in detail, formulate targeted and rational preventive interventions and reduce the incidence rate of fall in the elderly, so as to relieve the personal and family burdens, save the social resources and enhance the quality of life of the elderly.

Association between dietary inflammatory index and gallstone disease among middle-aged and elderly population / 预防医学

Objective@#To analyze the association between dietary inflammatory index (DII) and gallstone disease among middle-aged and elderly population, so as to provide the evidence for the prevention and control of gallstone disease.@*Methods@#Baseline survey data were collected from the Shanghai Women's Health Study (SWHS) and Shanghai Men's Health Study (SMHS), including demographic information, gallstone disease prevalence and dietary habits. DII was calculated using 29 kinds of food parameters associated with common inflammatory biomarkers and food intake data of residents. A multivariable logistic regression model was used to analyze the association between dietary inflammatory index and gallstone disease.@*Results@#A total of 132 312 individuals were included in the analysis. There were 59 627 males and 72 685 females. Among males, the median age was 53.07 (interquartile range, 9.73) years, 41 544 cases (69.67%) had an educational level of middle school, 4 463 cases (7.48%) had gallstone disease, and DII was -6.46 to 5.59. Among females, the median age was 50.27 (interquartile range, 9.05) years, 47 380 cases (65.19%) had an educational level of middle school, 8 090 cases (11.13%) had gallstone disease, and DII was -6.44 to 4.93. Multivariable logistic regression analysis showed that after adjusting for age, educational level, income level, smoking, alcohol consumption, tea consumption, physical activity and menopausal status (only for females), DII (OR=1.095, 95%CI: 1.002-1.196) was associated with an increased risk of gallston disease among males, but no statistically association was found among females (P>0.05).@*Conclusion@#DII might be associated with an increased risk of gallstone disease among middle-aged and elderly population.

Provincial distribution differences and influencing factors of self-assessed health among elderly population in China / 环境与职业医学

Background Regional differences in economic development, natural environment, health care level, and social structure may lead to differences in the provincial distribution of the health status of the elderly population. Objective To explore the provincial distribution characteristics, regional differences, and influencing factors of the self-assessed health of the elderly population, with the aim of providing a policy basis for improving the health of the elderly population and promoting healthy aging according to local conditions. Methods Using 31 provinces (municipalities and autonomous regions) in China as the basicstudy unit and based on the method of Wagstaff, the self-rated health data of the elderly population (aged 60 years and above) in each province from the 2010 and 2020 national censuses and the 2015 1% National Population Sample Survey were converted into ill-health scores as a measure of self-assessed health, and higher scores represented worse health status perception. Global Moran's I was used to evaluate spatial autocorrelation, range [−1, 1], with a value of 1 as a perfect clustered pattern. Local Moran's I was used to evaluate the tendency of local autocorrelation, and high-high aggregation/low-low aggregation indicated that both target province and its neighboring provinces showed higher/lower ill-health scores. Spatial econometric models were selected by Lagrange multiplier test and Hausman test to explore influencing factors of the self-assessed health of the elderly population. Results In 2010, 2015, and 2020, the national ill-health scores of the elderly population were 1.831, 1.873, and 1.547, respectively, and the corresponding Global Moran's I statistics were 0.347, 0.482, and 0.511, respectively (P<0.01), indicating that the ill-health scores of the elderly population showed a significant spatial positive autocorrelation, and the degree of spatial aggregation was increasing gradually. From 2010 to 2020, the high-high aggregation of ill-health scores among the elderly population was concentrated in the inland northwest, while the low-low aggregation was concentrated in the southeast coast, gradually showing a "southeast-central-northwest" stepped incremental pattern of differentiation. The Lagrange multiplier test and Hausman test suggested that the fixed-effects spatial lagged model was a better choice, and the regression model showed a spatial autocorrelation in the ill-health scores of the elderly population, with an autocorrelation coefficient of 0.3969 (P<0.001); the ill-health scores of the elderly population were negatively correlated with the natural logarithms of gross regional product per capita, and the number of beds in health care facilities per 1000 population, with regression coefficients of −0.8297 and −0.0454 (P<0.05) respectively, and positively correlated with the annual average concentration of PM2.5, illiteracy rate, and the number of health technicians per 1000 population, with regression coefficients of 0.0033, 0.0297, and 0.0765 (P<0.05), respectively. Conclusion From 2010 to 2020, the overall self-assessed health level of China's elderly population showed an upward trend and a spatial positive autocorrelation, with better self-assessed health in the southeast coast and poorer ratings in the northwestern inland. Additionally, there was a gradual decline in self-assessed health of the elderly population from the southeast to the central regions and further to the northwest in terms of spatial distribution. Economic development level, environmental pollution, health resource allocation, and education level are important factors influencing the self-assessed health of the elderly population.

Pandemia e velhices: práticas de saúde e produções de conhecimento / The pandemic and elderly people: health practives and the produtction of knowledge / Pandemia y vejez: práticas de salud y producciones de conocimiento

Visto que a população idosa compõe o grupo de risco para Covid-19, o artigo teve como objetivo mapear a produção científica, nas bases de dados Scielo, Lilacs e Pepsic, bem como em instituições de saúde, que articulam envelhecimento e Covid-19, no âmbito das políticas públicas de saúde da pessoa idosa. Foi uma revisão integrativa que, reunindo 26 trabalhos, analisou quatro campos: 1) pesquisa de aproximação entre pandemias; 2) determinantes sociais de saúde; 3) protocolos de tratamento e ações; e 4) reflexões instauradas pela pandemia. Reconhecemos a presença da articulação entre existências e determinantes sociais de saúde e marcadores sociais em muitos trabalhos, porém observamos essa lacuna em outros. Este trabalho agrupa materiais para a assistência à população velha com protocolos, diretrizes e possibilidades, propondo a prática profissional atrelada às políticas públicas de saúde.(AU)

The elderly population belongs to COVID-19's risk group. Taking that in consideration, this article aimed to outline the scientific production in the following databases: Scielo, Lilacs, and Pepsic; considering, also, health institutions which worked with COVID-19 and the elderly population, in public health policies related to this population. This is literature review, made in a integrative manner. In this study, 26 publications were found. There were four analysis categories: 1) reasearches connecting different pandemics; 2) social determinants of health; 3) treatment protocols and actios; 4) discussions brought up by the pandemic. We acknowledge the presence of a relation between existences, social determinants of health and social indicators in a lot of studies, but we observed gaps in some of the other works. This study gathers materials which aim to assist the elderly population with protocols, guidelines, and possibilities, offering a professional practice that works with synergy with the public health policies.(AU)

Teniendo a la vista que la población anciana compone el grupo de riesgo para la Covid19, el artículo tuvo como objetivo mapear la producción científica, en las bases de datos Scielo, Lilacs y Pepsic, así como en instituciones de salud, que consideran el envejecimiento y la Covid-19, en el ámbito de las políticas públicas de salud de los adultos mayores. Fue una revisión integradora que, reuniendo 26 trabajos, analizó cuatro campos: 1) investigación de aproximación entre pandemias; 2) determinantes sociales de la salud; 3) protocolos de tratamientos y acciones; y 4) reflexiones establecidas por la pandemia. Encontramos la presencia de la relación entre existencias y determinantes sociales de salud y marcadores sociales en muchos trabajos estudiados, por otra parte, se observó esta laguna en otros. Este trabajo agrupa materiales para la asistencia a la población mayor con protocolos, lineamientos y posibilidades, proponiendo la práctica profesional aliada a las políticas públicas de salud.(AU)

A Systematic Review on Comparison between Otago Exercise Program and Balance Exercise in Balance and Fall Risk among elderly with Knee Osteoarthritis

Background: Patients with knee osteoarthritis have balance issues and an increased fall risk; nevertheless, it is unclear whether the Otago exercise programme (OEP) or balance exercise will improve balance and reduce fall risk among individuals with knee osteoarthritis. Therefore, there is a need to compare the effectiveness of these exercises in treating knee osteoarthritis. This review aims to investigate the effects of an OEP and balance exercise programme to improve balance and reduce fall risk among the elderly population with knee osteoarthritis (OA).Methodology: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to conduct this systematic review. Four databases (PubMed, Cochrane central register of controlled trails (CENTRAL), Physiotherapy Evidence Database (PEDro), and Science Direct) were searched until September 2022 using predefined terms by two independent reviewers. The methodological quality of the studies was assessed using PEDro. All literature published from each source was selected according to the inclusion and exclusion criteria, and data extraction was performed independently with the outcomes of the Berg balance scale (BBS), time up and go test (TUG), chair stand test (CST), and short falls efficacy scale (SFES I).RESULT: The literature review studied seven full-text articles that met the selection criteria and PRISMA guidelines. Those articles were reviewed by grouping them into five different sub-groups based on the interventions. The quality of studies ranged from good (5 studies) to fair (2 studies). The improvement in balance and fall risk prevention following OEP and balance training showed mixed results, and the findings from this review may form the basis for a future systematic research program. CONCLUSION: It is difficult to conclude clear evidence-based recommendations for Otago exercise programmes and balance exercises in improving balance and reducing fall risk among the elderly population with knee OA due to limited availability and weak evidence.

Health profiling of elderly in Gujarat: evidences from longitudinal ageing study in India

Background: Considering the burden of different health related disorders amongst the elderly, the present study aims to examine the health profile and the factors associated with various health issues among the elderly in Gujarat. Methods: The current study has used the Longitudinal Ageing Study in India (LASI) Wave-1 data. The chi-square test and logistic regression model have been used to establish the association between the study variables and factors associated with the chronic diseases among elderly in Gujarat. Results: The prevalence of chronic diseases among elderly in Gujarat is 51.3 percent. Hypertension was the highest prevalent disease suffered by nearly one-fourth (24.3%) of the elderly people covered under the study followed by prevalence of chronic bone/joint diseases (15.7%) and diabetes (12.4%). The present study showed that the risk of occurrence of chronic diseases increases along with the age. Consumption of alcohol increases the risk of chronic morbidities. On the other hand, education, work status and physical activity play significant role in reducing the prevalence of chronic diseases. Conclusions: The study highlights the prevalence of different health related disorders amongst the elderly in Gujarat. In addition to this, the study tries to identify the critical factors associated with health issues of elderly. The findings from the study can also help in strengthening the scope of National level preventive and health care programme for the elderly population in Gujarat.

Adverse events with COVID-19 vaccination (precaution dose) among the elderly population aged 60 years and above in South India

Background: India started administering the precaution dose or the Booster dose of COVID vaccine from 10 January 2022 to comorbid people aged 60 and above. To identify the adverse events with COVID-19 vaccination (precaution dose) among the elderly population aged 60 years and above. To determine the association between adverse reactions and sociodemographic factors, morbidity profile and previous history of COVID 19. Methods: This cross-sectional study was undertaken at COVID- 19 vaccination centre, of SVIMS, Tirupati. AP from January 2022 to July 2022. Data was collected by interviewing the study subjects. Study respondents who received COVID-19 vaccine were observed for a period of 30 minutes and after 48 hours, study participants were contacted through telephone to find out any vaccine related adverse effects. Results: Overall, 676 of 60 years or older received their precaution dose. Majority of the respondents were in 60-70 years age group (60.8%) males (n=397, 58.7%) were higher than females (n=279,41.3%). Out of 676, 34 (5.0 %) participants reported adverse effects after 1st or 2nd dose. With regard to precaution dose, only 43 (6.4%) reported adverse events within the 30 minutes of receiving COVID-19 vaccine. While 54 (8.0%) reported adverse events in last 48 hours after receiving COVID-19 vaccine (precaution dose). Spectrum of symptoms reported were fever, anxiety, dizziness/giddiness, body pains, headache, nausea, pain at injection site, pain in abdomen, swelling at injection site, rash. Conclusions: Only 43 (6.4%) reported adverse events within the 30 minutes of receiving COVID-19 vaccine while 54 (8.0%) reported adverse events in last 48 hours after receiving COVID-19 vaccine(precaution dose).There were no reports of serious adverse effects.

Sleep quality index among the elderly population in selected areas of Delhi: a community-based cross-sectional study

Background: Studies have shown that effects of low sleep quality can include cognitive decline, sleepiness during the day, and decreased quality of life. Problems with sleep have also been associated with an increased risk of hospitalization and increased mortality. Therefore, the present study was envisaged to assess the sleep quality index and the factors associated with it among the elderly. Methods: This cross-sectional study was conducted in rural and urban setting of Delhi. We selected 115 participants in each area using systematic random sampling. We used a semi structured questionnaire and validated sleep quality index to collect the data. Results: In the present study, only 41 (17.8%) out of 230 individuals were having normal sleep quality and 189 out of 230 individuals were having poor sleep quality. 105 (55.5%) in the rural area (Fatehpur Beri), and 84 (44.5%) in the urban area (Aliganj) were having poor sleep quality respectively. In the rural area, taking sleeping pills and depression were significantly associated with higher scores of sleep quality index. Conclusions: Poor sleep quality was found in 82.2% of elderly participants which was associated with a rural locality, depression, and not taking sleep pills. There is a need to start a sleep hygiene program for the elderly population, particularly in rural area.

Three years of COVID-19 pandemic: comparative analysis of incidence, lethality and mortality among the States of the south region of Brazil / Três anos de pandemia da COVID-19: análise comparativa da incidência, letalidade e mortalidade entre os Estados da região sul do Brasi

Introduction: the first COVID-19 case in Brazil was confirmed on February 26, 2020. As of March 17, 2023, the Ministry of Health reported 699,634 deaths from COVID-19, with a case fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil extends to socioeconomic and healthcare systems, reflecting significant regional disparities. Objective: To analyze mortality, incidence, and case fatality rates for COVID-19 in the states of Paraná and Santa Catarina, in the southern region of Brazil. Methods: This is an ecological time-series study using official Brazilian secondary data for COVID-19 cases and deaths. Data were extracted from the dashboard of the State Health Department of Santa Catarina and Paraná. Temporal series were developed for trend analysis using the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: In the analysis of rates over the entire period, trends for mortality, case fatality, and incidence in the state of Santa Catarina are decreasing, decreasing, and stationary, respectively. In Paraná, rates over the entire period showed a stationary trend for mortality, decreasing for case fatality, and increasing for incidence. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states experienced the progression of the COVID-19 pandemic, with higher case fatality and mortality rates observed in Paraná, while Santa Catarina had a higher incidence rate over the three years of the COVID-19 pandemic.

Stress perception among the elderly and its effect on some muscle strength parameters

Background: With improvement in living conditions in the population and the availability of treatments for various communicable and non-communicable diseases, the life expectancy and consequently the elderly population have increased. Stress leads to mental and physical problems. Aim and Objective: The aim of this study was to assess the effect of stress on muscle functions in the elderly. Materials and Methods: One hundred apparently healthy persons (50 males and 50 females) took part in the study. Perceived stress scale was used to measure their level of stress. Maximum voluntary contraction (MVC) and endurance time were measured with the help of a handgrip dynamometer. Results: The elderly population sample in our study showed a moderate level of stress, but there was no significant difference between the three age groups under study. Conclusion: A significant positive correlation between MVC and stress level was observed in our study subjects.

Review on exposure characteristics and health effects of per- and poly-fluoroalkyl substances / 环境与职业医学

Per- and poly-fluoroalkyl substances (PFAS) are a new type of persistent organic pollutants that have received extensive attention in recent years. This article reviewed the population characteristics of environmental exposure to PFAS, as well as the potential health effects. Previous studies have verified that people are exposed to PFAS mainly through ingestion, and food and water are the dominant contributors. In terms of exposure characteristics, geographical, gender, age, and occupational differences have an impact on the level of PFAS exposure in the corresponding populations by influencing their behavioral characteristics and metabolic levels, with occupational exposure receiving more attention, especially in the exploration of novel PFAS. PFAS associate with a variety of adverse health effects caused by hepatorenal toxicity, immunotoxicity, reproductive toxicity, neurotoxicity, and carcinogenicity. However, some of the conclusions are not completely consistent, and the published epidemiological studies have focused on children and young people, lacking relevant data of the elderly. Future research can pay more attention to the elderly population and carry out validation exploration on controversial conclusions.

Association analysis of various obesity-related indices and vitamin D deficiency in middle-aged and elderly population in Lanzhou / 中华临床营养杂志

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.

Epidemiological characteristics of infected patients aged 60 years and older during the outbreak of SARS-CoV-2 Omicron variant in Sanya, Hainan in 2022 / 中国热带医学

@# or older during the outbreak epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in Sanya City, Hainan Province, August-September 2022, and to provide scientific and effective basis for formulating strategies for the prevention and treatment of COVID-19 in the elderly in the future. Methods　The data of 1 785 COVID-19 cases aged ≥60 years reported from August 1 to September 8, 2022 in Sanya City, and 537 local COVID-19 inpatients aged ≥60 years treated in Sanya Central Hospital were collected and analyzed using WPS Office 2018 software for data cleaning, database assistance, and drawing, and SPSS 22.0 software was used to statistically describe and analyze the counting data. Results　A total of 1 785 local COVID-19 cases aged ≥60 years were reported in China's Disease Prevention and Control Information System, including 1 509 confirmed cases (84.54%) and 276 asymptomatic cases (15.46%). Of the confirmed cases, 1 448 were mild cases (95.96%), 40 were common cases (2.65%), 10 were severe cases (0.66%), and 11 were critical cases (0.73%), and no deaths were reported. The ratio of male to female was 0.88∶1. The youngest was 60 years old, the oldest age was 107 years old, with a median age of 67 years old. Most of them (1 559 cases, 87.34%) were non-social employed personnel. Among them, 952 (53.33%) were from Tianya District and 733 (41.06%) from Jiyang District. Among the 537 COVID-19 elderly infected patients hospitalized in Sanya Central Hospital, infected patients with underlying diseases accounted for 287 (53.45%) cases of hypertension, diabetes and other types of basic diseases (chronic kidney disease, hyperlipidemia, chronic gastritis, gastric ulcer, etc.), and there were serious infections. Conclusions　Most of the elderly infected with Omicron variants were mild cases with few symptoms, but the elderly infected with Omicron variants were difficult to recover or even worsen the condition due to old age and underlying diseases. Therefore, by analyzing the various aspects of elderly infected cases, scientific and effective basis can be provided to prevent and control the epidemic situation in the future, and reduce the occurrence of severe, critical and death cases of COVID-19 in the elderly.

Trends in prevalence of depression symptoms among middle-aged and elderly residents in China from 2011 to 2018 / 预防医学

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.

A multi-center analysis of thyroid-stimulating hormone level in apparently healthy elderly population in China / 南方医科大学学报

OBJECTIVE@#To investigate serum thyroid stimulating hormone (TSH) level and its changes with age in apparently healthy Chinese elderly population and analyze the differences between TSH levels detected using Roche and Snibe electrochemiluminescence immunoassay analyzers.@*METHODS@#General clinical data and frozen fasting serum samples were collected from 5451 apparently healthy Chinese elderly individuals (> 60 years) from 10 centers in different geographic regions in China. Thyroid function indexes including TSH level were detected using Roche and Snibe electrochemiluminescence immunoassay analyzer, and the median (2.5% and 97.5% quantiles) TSH level was calculated. The variations of TSH level among the participants with geographic regions, gender, and age (with an interval of 5 years) were analyzed to determine the influence of these factors on TSH level.@*RESULTS@#The reference ranges of serum TSH level established using Roche and Snibe electrochemiluminescence immunoassay analyzers were 0.42-9.47 mU/L and 0.36-7.98 mU/L, respectively, showing significant differences between the two methods (P < 0.001). The TSH levels measured at two centers in Western China were significantly higher than those at the other centers (P < 0.05). In elderly male population, serum TSH level tended to increase with age, which was not observed in elderly female population. At the age of 60-75 years, women generally had higher serum TSH level than men, but this difference was not observed in the population beyond 75 years.@*CONCLUSION@#In elderly population, serum TSH level can vary with geographic region, gender, and age, but there was no need for establishing specific reference ranges for these factors. The differences between different detection methods should be evaluated when interpreting the detection results of TSH level.