Physical activity dynamically moderates the impact of multimorbidity on the trajectory of healthy aging over sixteen years.

BACKGROUND: Research examining the healthy aging trajectory of retired older adults with multimorbidity is limited, leaving uncertainties regarding the optimal physical activity (PA) intensity and frequency necessary to sustain healthy aging during retirement. METHODS: Our study investigated the moderating effects of PA on the healthy aging trajectories of retired older adults living with multimorbidity in the United States (US). We utilized data from 1,238 retired individuals aged 50 to 102 who contributed 11,142 observations over 16 years from the Health and Retirement Study (HRS). We employed mixed effects modeling to assess the impact of various classes of multimorbidity on this group and examine how different PA, PA intensities, and PA frequencies influence the disability, physical, and cognitive functioning domains of healthy aging. RESULTS: The results reveal that while outcomes differed significantly, retired older adults in the US attained healthy aging at baseline. However, their ability to maintain healthy aging declined over time, with multimorbidity, especially musculoskeletal and neurological conditions, accelerating this decline. Fortunately, PA, especially light to moderate intensities, is associated with improving healthy aging and moderating the impact of multimorbidity on the disability and cognitive functioning domains of healthy aging. However, the specific moderating effects of PA depend on its frequency, intensity, and chronic conditions. CONCLUSIONS: The significant variability in healthy aging attainment among retired older adults underlies the need to consider these differences when addressing healthy aging issues in the US. Accounting for these variations would aid in evaluating the potential impact of future interventions and contribute to achieving health equity. Fortunately, our dynamic findings facilitate this objective by identifying specific frequencies and intensities of PA tailored to different aspects of multimorbidity and healthy aging. This highlights PA, especially light-to-moderate intensity, as an essential, cost-effective, and amenable strategy for alleviating the impact of multimorbidity on healthy aging.

Digital health care service reform and health inequity for older people: a quasi-natural experiment in China.

Objective: Addressing health inequity (HI) for older people is a pivotal global public health concern, as it impedes the process of healthy ageing. The digital health care service reform (DHSR) emerges as a progressive public health approach to enhance the health and well-being of older adults by providing comprehensive and equitable medical services. This study elucidates the association between DHSR and HI for older individuals to augment comprehension of DHSR implementation. Methods: The initiation of the action plan for smart health and eldercare (SHE) in 2017 serves as a quasi-natural experiment. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018, a propensity score matching (PSM) method was used to select samples, and a difference-in-differences (DID) regression was used to ascertain the net effect of DHSR on HI for older individuals in China. This methodology mitigates selection bias and segregates the DHSR effect from temporal shifts or other occurrences. Results: The PSM-DID analysis reveals that DHSR reduced the HI index for older individuals by 0.301 (p < 0.01). Heterogeneity analyses indicate that the effect of DHSR was more pronounced in older males (-0.333, p < 0.01) than females (-0.251, p < 0.05). The impact of DHSR was notably higher for older population in the western (-0.557, p < 0.01) and central regions (-0.318, p < 0.05) compared to the eastern region, where the relationship was statistically non-significant. Conclusion: The results demonstrate that DHSR plays a vital role in diminishing HI, fostering inclusive growth in public health. The study underscores the imperative of sustained DHSR endeavours and allocating resources to key older demographics to substantially mitigate HI.

Understanding Aging Policies in China: A Bibliometric Analysis of Policy Documents, 1978-2019.

Aging poses a big challenge in all aspects of social governance in China. A coherent and focused aging policy response that spans multiple sectors of government has been undertaken to achieve the goal of "Healthy Aging". From an historical perspective, this paper uses a bibliometric analysis method to probe into the evolution of Chinese aging policies from 1978 to 2019, and the roles of core government agencies in policy-making. We obtained 226 Chinese aging policies from the PKULaw Database and the websites of the government departments. Co-word analyses and network analyses were applied in mapping the topics of aging policies and collaboration among the agencies. Gephi software was used to visualize the most frequently used keywords and their network graphs. Findings are as follows. Firstly, the development of the aging policy system in China has undergone two phases, from focusing on basic security to emphasizing the rights and health of the elderly. Secondly, the network structure of aging policy-making departments presents a distinct edge-core layer. More and more government agencies have become involved in the formulation of aging policies. But collaboration among the agencies is insufficient. Thirdly, pilot promotion is the main tool for implementing aging policies.

Public Pension, Labor Force Participation, and Depressive Symptoms across Gender among Older Adults in Rural China: A Moderated Mediation Analysis.

Due to insufficient financial support and unceasing work, the rural elderly in China experience a range of mental disorders, and the most common one is depression. This study aims to investigate the association between public pension, labor force participation (LFP), and depressive symptoms for older men and women in rural China. A moderated mediation analysis is conducted using data in the 2015 wave extracted from the China Health and Retirement Longitudinal Study (CHARLS), a continuous national social survey. A total of 2709 available surveys were obtained in our analysis. Using PROCESS, results revealed that the income from China's New Rural Pension Scheme (NRPS) was directly negatively related to depressive symptoms. However, LFP did not mediate the link between pension income (PI) and depressive symptoms in the total study population. The results of moderated mediation estimates indicated that gender significantly moderated the relationship between LFP and depressive symptoms. Specifically, for older women, the indirect effect of PI on depressive symptoms via LFP was significant, but not for the opposite sex. In order to improve the mental health of older adults in rural China, the policy makers and mental health therapists need to pay attention to the aforementioned factors.