Temporal and spatial characterization of myopia in China.

Purpose: The aim of this study was to characterize the temporal and spatial distribution of myopia among students aged 7-18 years, by analyzing the aggregation area and providing the basis for the prevention and control of myopia in China. Methods: A database for the spatial analysis of myopia in China during 1995-2014 was established using ArcGIS10.0 software as a platform for data management and presentation. A spatial autocorrelation analysis of myopia was undertaken, and a temporal and spatial scan analysis was performed using SaTScan9.5 software. Results: Our data demonstrated that the prevalence of myopia in China in 1995, 2000, 2005, 2010, and 2014 was 35.9, 41.5, 48.7, 57.3, and 57.1%, respectively, thus indicating a gradual upward trend. The prevalence of myopia was analyzed in various provinces (municipalities and autonomous regions), and the highest was found in Jiangsu Province, with an average Moran's I index of 0.244295 in China (P ≤ 0.05). According to the local Moran's I autocorrelation analysis, there was a spatial aggregation of myopia prevalence among students in the entire country, with Shandong, Jiangsu, Anhui, and Shanghai being classified as high-high aggregation areas, while Hainan and Guangxi were classified as low-low aggregation areas. In addition, the Getis-Ord General G results of the global hotspot analysis showed a countrywide myopia prevalence index of 0.035020 and a Z score of 1.7959 (P = 0.07251). Because the myopia prevalence correlation difference was not statistically significant, there were no "positive hotspots" or "negative hotspots." The local hotspot analysis shows that Shandong and Jiangsu belong to high-value aggregation areas, while Hainan and Guizhou belong to low-value aggregation areas. Further analysis using time-space scanning showed 15 aggregation regions in five stages, with four aggregation regions having statistically significant differences (P ≤ 0.05). However, the aggregation range has changed over time. Overall, from 1995 to 2014, the aggregation areas for the myopia prevalence in Chinese students have shifted from the northwest, north, and northeast regions to the southeast regions. Conclusion: Our data demonstrate that, from 1995 to 2014, the prevalence of myopia increased in students aged 7-18 years in China. In addition, the prevalence of myopia is randomly distributed in various provinces (municipalities and autonomous regions) and exhibits spatial aggregation. Also, the gathering area is gradually shifting to the southeast, with the existence of high-risk areas. It is, therefore, necessary to focus on this area and undertake targeted prevention and control measures.

Negative life events and self-harm among the elderly: Result from a survey of 7070 people aged≥60 in China.

PURPOSES: Negative life events have been reported as a risk factor for elderly self-harm. The aim of this study was to examine the relationship between negative life events and self-harm in a large sample of people aged 60 and older, and explore the role of some previously identified influential factors in this relationship. METHODS: Multi-stage stratified sampling method was used to select the elderly people over 60 years old in Shandong, China. Information were collected through face-to-face interviews. Univariate and multivariable logistic regression were used for initial analysis. Karlson-Holm-Breen (KHB) method was used for mediating effect analysis. RESULTS: A total of 7070 participants were included in the study, 160 reported they had a history of self-harm (2.3%), 756 reported they had negative life event experience (10.7%). After model adjustment, the association between negative life events, loneliness, economic status and self-harm was still statistically significant. Mediation analysis showed that the association is explained by loneliness (proportion of mediation 48.86%), self-rated economic status (16.13%). CONCLUSIONS: Negative life events, loneliness and economic status were associated with self-harm among the older adults. Loneliness and economic status may play an intermediary role in the relationship between negative life events and self-harm, especially loneliness. More psychological and social functions intervention strategies and prevention measures on the self-harm of the elderly should be provided for the elderly who have experienced negative life events.

Association between Overweight, Obesity and the Prevalence of Multimorbidity among the Elderly: Evidence from a Cross-Sectional Analysis in Shandong, China.

(1) Background: Multimorbidity, defined as the occurrence of two or more chronic diseases, is a global public health problem which has a significant negative impact on individuals, families and the society. The aim of this study was to evaluate the association between overweight, obesity and the prevalence of multimorbidity among male and female older adults; (2) Methods: Cross-sectional data of the 7070 participants from China, aged 60 years and above included in 2017 the Shandong Elderly Family Health Service Survey were analyzed. Multivariate logistic regression analysis was used to examine the relationship between overweight, obesity and the prevalence of multimorbidity in males and females; (3) Results: Among the 7070 participants, of which 40.25% were males and 59.75% were females, the average age of all participants was (69.81 ± 6.45) years old. The prevalence of multimorbidity in older adults was 34.71%, and the overweight and obesity rates were 39.25% and 16.89%. Among the male elderly, the likelihood of multimorbidity was more than two times higher among the obese than the normal BMI population (OR: 2.14; 95%CI: 1.63-2.82). A less strong association was found in the overweight male older population (OR: 1.43; 95%CI: 1.18-1.74). In the females, compared with individuals with normal BMI, the risks for incident multimorbidity were high in the overweight and obese groups, with odds ratios of 1.42 (95%CI: 1.21-1.65) and 1.81 (95%CI: 1.51-2.17), respectively. (4) Conclusions: In this study, overweight and obesity had the strongest association with the prevalence of multimorbidity among Chinese older adults, and the associations were different between the male and female elderly. The prevalence of multimorbidity might be effectively prevented by controlling body mass index. Encouraging the elderly to eat the recommended amount of vegetables and fruits, walk at least 30 min a day and have enough sleep to maintain a healthy weight.

Prevalence and Associated Factors of Self-Treatment among the Elderly-A Comparative Study between Empty and Non-Empty Nesters in Shandong, China.

(1) Objectives: With an aging society in China, self-treatment now plays an important role in health care among older adults, but it can be problematic. This study aims to explore and compare the self-treatment behavior among empty and non-empty nesters. (2) Methods: Using a multi-stage stratified random cluster sampling method, a total of 4366 elderly people aged 60 and above from Shandong Province, China, were enrolled in this study. Data were collected through a structured questionnaire. Binary logistic regression was used to analyze the associated factors of self-treatment. (3) Results: The prevalence of self-treatment in empty nesters was significantly lower than that in non-empty ones (74.0% vs. 83.3%). Binary logistic regression analysis showed that higher educational level and poorer self-rated economic status were negatively associated with self-treatment in empty nesters, while unemployed and urban and rural residents' basic medical insurance were positively associated with self-treatment in non-empty ones. (4) Conclusions: The study indicated that empty nesters had lower likelihood of self-treatment than non-empty ones. Empty nesters with better socioeconomic status were more likely to use self-treatment; by contrast, non-empty nesters with relatively poorer socioeconomic status were more inclined to self-treatment. Targeted interventions should be developed to maximize the effectiveness of self-treatment and reduce health risks.

The Relationship between Self-Rated Economic Status and Falls among the Elderly in Shandong Province, China.

(1) Background: Older people are more vulnerable and likely to have falls and the consequences of these falls place a heavy burden on individuals, families and society. Many factors directly or indirectly affect the prevalence of falls. The aims of this study were to understand the prevalence and risk factors of falls among the elderly in Shandong, China; the relationship between economic level and falls was also preliminary explored. (2) Methods: Using a multi-stage stratified sampling method, 7070 elderly people aged 60 and over were selected in Shandong Province, China. General characteristics and a self-rated economic status were collected through face to face interviews. Chi-square tests, rank sum tests and two logistic regression models were performed as the main statistical methods. (3) Results: 8.59% of participants reported that they had experienced at least one fall in the past half year. There was a significant difference in experienced falls regarding gender, residence, marital status, educational level, smoking, drinking, hypertension, diabetes, coronary disease, and self-reported hearing. The worse the self-rated economic status, the higher the risk of falling, (poor and worried about livelihood, OR = 3.60, 95%; CI = 1.76-7.35). (4) Conclusions: Women, hypertension, diabetes and self-reported hearing loss were identified as the risk factors of falls in the elderly. The difference of economic level affects the falls of the elderly in rural and urban areas. More fall prevention measures should be provided for the elderly in poverty.