Screening for frailty and its association with activities of daily living, cognitive impairment, and falls among community-dwelling older adults in China.

OBJECTIVES: Frailty is a prevalent geriatric condition that significantly impacts the health of older adults. This study aimed to examine the prevalence of frailty among older Chinese adults aged ≥ 65 years and to assess its association with adverse geriatric outcomes. METHOD: This study included 20,724 older adults aged ≥ 65 years in Jiangsu Province, China, utilizing a random, stratified, multistage cluster sampling approach. Frailty was assessed using the 5-item FRAIL scale. Geriatric outcomes, such as independence in activities of daily living (ADL), cognitive impairment, and frequent fall events (occurring four or more times in the preceding year), were evaluated. Logistic regression models were employed to evaluate the association between frailty and geriatric outcomes, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The mean age of the participants was 73.4 ± 6.4 years. The standardized prevalence of prefrailty and frailty was 35.2% and 10.3%, respectively. Individuals identified as prefrail or frail tended to live in rural areas, have lower educational levels, be widowed, have lower incomes, and engage in less physical activity. Prefrailty and frailty were associated with an increased risk of limitations in BADL (OR: 9.62, 95% CI: 7.43-12.46; and OR: 29.25, 95% CI: 22.42-38.17, respectively) and IADL (OR: 2.54, 95% CI 2.35-2.74; and OR: 5.19, 95% CI 4.66-5.78, respectively), positive cognitive impairment screening (OR: 1.23, 95% CI: 1.16-1.31; and OR: 1.72, 95% CI: 1.56-1.91, respectively), and frequent falls (occurring four or more times in the preceding year) (OR: 3.38, 95% CI: 2.50-4.56; and OR: 8.37, 95% CI: 6.01-11.65). The association between frailty and both limitations in BADL and falls was notably more pronounced among the younger age groups (p for interaction < 0.001). CONCLUSIONS: According to the 5-item FRAIL scale, frailty was associated with limitations in BADLs and IADLs, positive cognitive impairment screening, and recent falls among older adults living in the community. Screening for frailty in younger age groups has the potential to prevent declines in physical function and falls.

The association between functional disability and depressive symptoms among older adults: Findings from the China Health and Retirement Longitudinal Study (CHARLS).

BACKGROUND: Previous research has shown that depressive symptoms in older adults was associated with functional disability, including basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). However, little is known about the impact of different patterns of functional disability and new-onset functional disability on subsequent depressive symptoms. OBJECTIVE: To determine the effect of various patterns of functional disability and new-onset functional disability on depressive symptoms among Chinese older adults aged 60 years and above. METHOD: The study included 3242 older adults from the China Health and Retirement Longitudinal Study (CHARLS), which was conducted from 2011 to 2018. Cox proportional hazards models were used to investigate the associations between patterns of functional disability and depressive symptoms. The associations were also examined in the population with new-onset functional disability. RESULT: During 15,321 person-years of follow-up, 946 depressive symptoms occurred. The hazard ratios (HRs) of depressive symptoms were 1.29 (95 % confidence intervals [CI]: 1.05-1.58) for IADLs disability, 1.22 (95 % CI: 0.75-1.55) for BADLs disability, and 1.78 (95 % CI: 1.41-2.22) for both IADLs and BADLs disabilities. In the analysis of new-onset functional disability, the HRs were 1.50 (95 % CI: 1.06-2.13) for onset IADLs disability, 1.28 (95 % CI: 0.85-1.91) for onset BADLs disability, and 1.69 (95 % CI: 1.03-2.76) for both onset BADLs and IADLs disabilities. LIMITATIONS: Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale, which has limitations in diagnosing clinical depression. CONCLUSION: Functional disability increases the risk of depressive symptoms, particularly impaired IADLs function. Psychological care for older adults with functional disability should be strengthened.

Association of multiple anthropometric indices with in 944,760 elderly Chinese people.

OBJECTIVES: The aims of this study were to update the latest data on the prevalence of hypertension (HTN) in the elderly Chinese population and to assess relationships between new anthropometric indices and HTN. METHODS: Data were obtained from the Basic Public Health Service (BPHS) survey for Jiangsu Province, China. A total of 944,760 people aged 65 years and older were included in this study. Blood pressure was measured by trained investigators. Body weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), conicity index (COI), body roundness index (BRI), and a body shape index (ABSI) were included in the analysis as anthropometric indices. Logistic regression analysis and restricted cubic splines were used to evaluate the association of anthropometric indices with HTN. RESULTS: The prevalence of HTN among elderly residents of Jiangsu Province was 64.7% (95% confidence interval, 64.6 to 64.8). After adjusting for multiple covariates, all anthropometric indices except ABSI showed significant non-linear positive dose-response associations with HTN across sex (pnonlinear<0.001). Among participants with BMI <28 kg/m2, abnormal weight, WC, WtHR, BRI, COI, and ABSI were positively associated with HTN. CONCLUSIONS: The prevalence of HTN in the elderly in Jiangsu Province is gradually increasing. It is necessary to consider the combination of ABSI and COI with BMI for screening elderly individuals for HTN in follow-up prospective studies.

Association of sleep duration and sleep quality with the risk of metabolic syndrome in adults: a systematic review and meta-analysis.

INTRODUCTION: The association between sleep duration and metabolic syndrome (MetS) remains controversial, and few have considered the effects of sleep quality. We performed a meta-analysis to clarify the relationship of sleep duration and sleep quality with the risk of MetS. MATERIAL AND METHODS: We conducted a systematic and comprehensive literature search of electronic databases from inception to 17 February 2022. The effect sizes of covariates from each study were pooled using a random or fixed model, and a restricted cubic spline random-effects meta-analysis was performed to examine the dose-response relationship between sleep duration and MetS. RESULTS: A total of 62 studies were included in this meta-analysis. Compared to normal sleep duration, short sleep duration [odds ratio (OR) = 1.14, 95% confidence interval (CI): 1.10-1.19] and long sleep duration (OR = 1.15, 95% CI: 1.09-1.23) were associated with an increased risk of MetS. The restricted cubic spline analysis indicated that sleep durations of 8.5 h (OR = 0.95, 95% CI: 0.92-0.97) and 11 h (OR = 1.58, 95% CI: 1.31-1.91) were significantly associated with the risk of MetS. The pooled results showed that poor sleep quality (OR = 1.46, 95% CI: 1.03-2.06) and sleep complaints had significant positive associations with MetS. CONCLUSION: Our results demonstrated that short sleep duration increased the risk of developing MetS. Long sleep duration was also associated with MetS, especially for 11 h. 8.5 h can be considered the recommended sleep duration for MetS. Poor sleep quality and sleep complaints were also associated with MetS.

Effect of Metabolic Health and Obesity Phenotype on Risk of Diabetes Mellitus: A Population-Based Longitudinal Study.

BACKGROUND: Epidemiologic evidence on body mass index (BMI)-metabolic status phenotypes and diabetes risk remains controversial, especially for metabolically healthy obesity (MHO). We aimed to examine the effect of metabolic health and obesity phenotype on diabetes risk in the Chinese population. METHODS: A population-based cohort study was carried out. The baseline survey was conducted in 2017, with two follow-up visits in 2018 and 2020. Diabetes was defined based on the criteria of the World Health Organization. Robust generalized estimating equation models with a binary distribution using a log link and exchange structure were applied for the pooled analysis sample. RESULTS: A total sample of 9623 observations was pooled for the longitudinal data analysis. The average follow-up time was 1.64 years per person and the overall incidence density of diabetes was 6.94% person-years. Decreased diabetes risk was found in metabolically healthy overweight phenotype (RR = 0.65; 95% CI = 0.47-0.90) and no significant associations were detected for the MHO individuals (RR = 0.99; 95% CI = 0.63-1.53) compared with those of metabolically healthy normal weight, in contrast to metabolically unhealthy normal weight (MU-NW) (RR = 1.81; 95% CI = 1.28-2.55), metabolically unhealthy overweight (MU-OW) (RR = 2.02; 95% CI = 1.57-2.61) and metabolically unhealthy obesity (MUO) (RR = 2.48; 95% CI = 1.89-3.26) phenotypes. Significant associations between BMI-metabolic status phenotypes and diabetes were found in both males and females. CONCLUSION: The MUO phenotype needs to be accorded much more importance. MU-NW and MU-OW are also important component for targeted prevention. Our findings can be targeted for optimizing preventive strategies to mitigate the obviously increased prevalence of diabetes.

A genetic analysis identifies haplotype at adiponectin locus: Association with the metabolic health and obesity phenotypes.

BACKGROUND: Obesity and metabolic syndrome frequently co-exist and define obese individuals into different obesity phenotypes, such as metabolically healthy obese (MHO), metabolically unhealthy obese (MUO) and metabolically unhealthy normal weight (MUNW). Growing evidence suggests that genetic predisposition and environmental factors can explain the heterogeneity among these phenotypes. METHODS: We conducted a case-control study including 130 MHO, 251 MUNW, 208 MUO and 336 health controls by genotyping 2 SNPs (rs2241766, rs1501299) in ADIPOQ to investigate possible associations between SNPs in the ADIPOQ gene with susceptibility to three obese phenotypes respectively in Chinese Han population. Unconditional logistic regressions were used to detect the association between ADIPOQ SNPs and MHO/MUNW/MUO risks. RESULTS: Variant G allele of rs2241766 was associated with a reduced odds of MUO (additive model: Adjusted OR = 0.55; 95% CI = 0.40-0.75; P < 0.001) and no evidence of any significant association between rs2241766 and MHO phenotype (additive model: Adjusted OR = 0.84; 95% CI = 0.61-1.16; P = 0.306) or MUNW phenotype (additive model: Adjusted OR = 0.95; 95% CI = 0.73-1.24; P = 0.720) was found. Minor allele T of rs1501299 were significantly associated with decreased risk of MHO (Adjusted OR = 0.53; 95% CI = 0.37-0.76; P < 0.001) and MUNW (Adjusted OR = 0.63; 95% CI = 0.48-0.83; P = 0.001) in additive genetic model after correction for multiple testing. CONCLUSIONS: The variant G allele of rs2241766 was negatively associated with risk of MUO and variant T allele of rs1501299 exhibited reduced odds for MHO and MUNW. Beyond that, future studies are warranted to validate and extend our findings.