The impact of pension on the health behavior of elderly rural residents: evidence from China.

BACKGROUND: Unhealthy behavior is an important factor threatening the health of older rural residents in China. We examine the effects of receiving pension on elderly rural residents' health behavior (namely conscious control of sugar, salt, and edible oil intake, as well as learning health or wellness knowledge), also including effect heterogeneity by income level and gender. METHODS: Using China Rural Revitalization Survey (CRRS) in 2020, we used the policy rule of the China's New Rural Pension Scheme that only those people who are over 60 years old can have access to pension as the natural experiment, and explore the causal effect of receiving pensions on the health behaviors by using regression discontinuity design method. RESULTS: Having access to pension can improve the health behavior of rural elderly residents, including increasing the probability of rural residents' conscious control of sugar (p < 0.1) and conscious control of salt intake (p < 0.1), which is still valid after a series of robustness tests. Heterogeneity analysis finds that access to pensions is more likely to improve the health behavior of low-income families and male rural elderly residents. CONCLUSIONS: The research has expanded the discussion on the correlation between the pension and the health of rural elderly residents, and the conclusion provides important policy implications for optimizing the rural elderly insurance system and leveraging pension to improve the health behavior of rural elderly residents.

Air particulate pollution exposure associated with impaired cognition via microbiota gut-brain axis: an evidence from rural elderly female in northwest China.

This study aimed to reveal harm of exposure to indoor air pollution to cognitive function through "gut-brain-axis" among rural elderly residents. There were 120 participants recruited in rural villages of northwest China from December 2021 to February 2022. The cognitive level was assessed by eight-item ascertain dementia (AD) questionnaire, and indoor air pollution exposure was measured by air quality sensor. Inflammatory cytokines and oxidative stress-related index were detected in blood serum. Fecal samples were collected for gut microbiota analysis. The 120 participants were divided into impaired cognition (AD8) (81/67.5%) and cognition normal (NG) (39/32.5%). And there had more female in AD8 (FAD) (55/67.9%) than NG (FNG) (18/46.2%) (P = 0.003). Exposure of air pollution in FAD was higher than FNG (PM1, PM2.5, PM10, P < 0.001; NO2, P < 0.001; CO, P = 0.014; O3, P = 0.002). The risk of cognitive impairment increases 6.8%, 3.6%, 2.6%, 11%, and 2.4% in female for every 1 µg/m3 increased in exposure of PM1, PM2.5, PM10, NO2, and O3, separately. And GSH-Px and T-SOD in FAD were significantly lower than the FNG group (P = 0.011, P = 0.019). Gut microbiota in FAD is disordered with lower richness and diversity. Relative abundance of core bacteria Faecalibacterium (top 1 genus) in FAD was reduced (13.65% vs 19.81%, P = 0.0235), while Escherichia_Shigella and Akkermansia was increased. Correlation analysis showed Faecalibacterium was negatively correlated with age, and exposure of O3, PM1, PM2.5, and PM10; Akkermansia and Monoglobus were positively correlated with exposure of PM1, PM2.5 and PM10; Escherichia_Shigella was significantly positively correlated with NO2. Indoor air pollution exposure impaired cognitive function in elderly people, especially female, which may cause systemic inflammation, dysbiosis of the gut microbiota, and ultimately leading to early cognitive impairment through the gut-brain axis.

Humoral and Cellular Immune Response Elicited by the BNT162b2 COVID-19 Vaccine Booster in Elderly.

Although the safety and efficacy of COVID-19 vaccines in older people are critical to their success, little is known about their immunogenicity among elderly residents of long-term care facilities (LTCFs). A single-center prospective cohort study was conducted: a total IgG antibody titer, neutralizing antibodies against Wild-type, Delta Plus, and Omicron BA.2 variants and T cell response, were measured eight months after the second dose of BNT162b2 vaccine (T0) and at least 15 days after the booster (T1). Forty-nine LTCF residents, with a median age of 84.8 ± 10.6 years, were enrolled. Previous COVID-19 infection was documented in 42.9% of the subjects one year before T0. At T1, the IgG titers increased up to 10-fold. This ratio was lower in the subjects with previous COVID-19 infection. At T1, IgG levels were similar in both groups. The neutralizing activity against Omicron BA.2 was significantly lower (65%) than that measured against Wild-type and Delta Plus (90%). A significant increase of T cell-specific immune response was observed after the booster. Frailty, older age, sex, cognitive impairment, and comorbidities did not affect antibody titers or T cell response. In the elderly sample analyzed, the BNT162b2 mRNA COVID-19 vaccine produced immunogenicity regardless of frailty.

A knowledge-driven decision support system for remote medical management.

Residential medical digital technology is an emerging discipline combining computer network technology and medical research. Based on the idea of knowledge discovery, this study was designed to construct a decision support system for remote medical management, analyze the need for utilization rate calculations and obtain relevant modeling elements for system design. Specifically, the model constructs a design method for a decision support system for the healthcare management of elderly residents through the use of a utilization rate modeling method based on digital information extraction. In the simulation process, the utilization rate modeling and system design intent analysis are combined to obtain the relevant functions and morphological characteristics that are essential to the system. Using regular usage slices, a higher-precision non-uniform rational B-spline (NURBS) usage rate can be fitted and a surface model with better continuity can be constructed. The experimental results show that the deviation of the NURBS usage rate generated by the boundary division from the original data model can reach test accuracies of 83, 87 and 89%, respectively. It is shown that the method can effectively reduce the modeling error caused by the irregular feature model in the process of modeling the utilization rate of digital information, and that it can ensure the accuracy of the model.

The impact of prolonged exposure to air pollution on the incidence of chronic non-communicable disease based on a cohort in Tianjin.

Evidence on the associations of prolonged ambient pollutants exposure with chronic non-communicable diseases among middle-aged and elderly residents is still limited. This prospective cohort study intends to investigate the long-term effects of ambient pollution on hypertension and diabetes incidence among relatively older residents in China. Individual particulate matter exposure levels were estimated by satellite-based model. Individual gaseous pollutants exposure levels were estimated by Inverse Distance Weighted model. A Cox regression model was employed to assess the risks of hypertension and diabetes morbidity linked to air pollutants exposures. The cross-product term of ambient pollutants exposure and covariates was further added into the regression model to test whether covariates would modify these air pollution-morbidity associations. During the period from 2014 to 2018, a total of 97,982 subjects completed follow-up. 12,371 incidents of hypertension and 2034 of diabetes occurred. In the multi-covariates model, the hazard ratios (HR) and 95% confidence interval (CI) were 1.49 (1.45-1.52), 1.28 (1.26-1.30), 1.17 (1.15-1.18), 1.21 (1.17-1.25) and 1.33 (1.31-1.35) for hypertension morbidity per 10 µg/m3 increment in PM1, PM2.5, PM10, NO2 and SO2, respectively. For diabetes onsets, the HR (95% CI) were 1.17 (1.11-1.23), 1.09 (1.04-1.13), 1.06 (1.02-1.09), 1.02 (0.95-1.10), and 1.24 (1.19-1.29), respectively. In addition, for hypertension analyses, the effect estimates were more pronounced in the participants with age <60 years old, BMI ≥24 kg/m2, and frequent alcohol drinking. These findings provided the evidence on elevated risks of morbidity of hypertension and diabetes associated with prolonged ambient pollutants exposure at relatively high levels.

Effects of Social Participation by Middle-Aged and Elderly Residents on the Utilization of Medical Services: Evidence From China.

Objectives: Aim to evaluate the effect of social participation on utilization of medical services among middle-aged and elderly residents in China. Methods: We used data from the 2018 wave of the China Health and Retirement Longitudinal Study. Social participation is classified into three types. Furthermore, to control for confounding factors, our study computed propensity score matching (PSM) to evaluate the effect of social participation on the utilization of medical services. Result: The result of PSM indicates that social participation significantly positively affects the utilization of outpatient services, the average treatment effect on the treated (ATT = 0.038***) and the utilization of inpatient services (ATT = 0.015**) by middle-aged and elderly residents. Furthermore, the utilization of outpatient health care services was significantly positively associated with leisure activities (ATT = 0.035***), social activities to help others (ATT = 0.031***), and learning activities to gain new knowledge (ATT = 0.034***) among middle-aged and elderly residents. The utilization of inpatient health care was significantly positively associated with leisure activities (ATT = 0.015***) but had no significant association with social deeds that help others and increased new knowledge among middle-aged and elderly residents. Conclusion: Thus, social participation significantly positively affects healthcare utilization by middle-aged and elderly residents. Hence, the government and society should provide more conveniences and promote social participation among middle-aged and elderly residents.

Associations among quality of life, activities, and participation in elderly residents with joint contractures in long-term care facilities: a cross-sectional study.

BACKGROUND: Joint contractures and degenerative osteoarthritis are the most common joint diseases in the elderly population, can lead to limited mobility in elderly individuals, can exacerbate symptoms such as pain, stiffness, and disability, and can interfere with social participation and quality of life, thus affecting mental health. However, relevant studies on this topic are very limited. This study describes the associations of joint contracture categories and sites in elderly residents in long-term care facilities with their quality of life, activities, and participation. METHODS: Elderly individuals with joint contractures who were residents in long-term care facilities were recruited. The World Health Organization (WHO) Quality of Life and the WHO Disability Assessment Schedule 2.0 were used to survey the participants. Correlations, multiple linear regressions, and multiple analyses of variance, with joint contractures as the response variable, were used in the statistical analysis. RESULTS: The final statistical analysis included 232 participants. The explanatory power of contracture sites on activities and participation had a moderate strength of association (η2 = .113). Compared with elderly residents with joint contractures and osteoarthritis isolated to the upper limbs, those with joint contractures and osteoarthritis in both the upper and lower limbs had significantly worse activity and participation limitations. No significant differences in activity and participation were found between elderly residents with joint contractures affecting only the upper limbs and those with joint contractures affecting only the lower limbs (F1,226 = 2.604 and F1,226 = 0.674, nonsignificant). Osteoarthritis had the greatest impact on activity limitations and participation restrictions among elderly residents with joint contractures affecting both the upper and lower limbs (F1,226 = 6.251, p = .014). CONCLUSIONS: Elderly residents in long-term care facilities belonging to minority groups, with a history of stroke, and with osteoarthritis are at a high risk of developing activity limitations and participation restrictions. Moreover, compared with other contraction sites, regardless of osteoarthritis, joint contractures affecting both the upper and lower limbs were associated with the greatest activity limitations and participation restrictions. TRIAL REGISTRATION: This study has been registered in the Chinese Clinical Trial Registry, registration number and date: ChiCTR2000039889 (13/11/2020).

Factors Affecting Dietary Improvements in Elderly Residents of Long-Term Care Institutions Receiving Domiciliary Dental Care.

Background: Oral disabilities occur due to tooth loss. This study aimed to investigate oral and systemic factors related to diet in elderly residents receiving domiciliary dental care. Methods: The subjects were 74 consenting residents. Survey items included whether subjects could eat independently and diet type. Subjects were examined by the dentist for the number of teeth, occlusal support index, and wearing dentures. Contingency table analysis was performed to determine what levels of decline in general and oral functions led to difficulties eating a normal diet. Results: There was a significant difference in the mean number of activities of daily living (ADL) requiring assistance evident between subjects eating a normal diet and those eating fluid boiled rice (p < 0.01). A comparison of occlusal support and diet type showed that most subjects who ate a soft diet or gruel had no occlusal support. Almost all subjects who ate a normal diet wore dentures. However, only 38% of subjects eating a soft diet and 40% of those eating gruel did wear dentures; both group differences were significant (p < 0.01). Conclusions: Future studies need to further investigate oral factors related to the type of diet and their relationships to domiciliary dental care in older adults.

Psychometric validation of the Chinese version of the PaArticular Scales among elderly residents in long-term care facilities with joint contractures.

BACKGROUND: Joint contractures, which affect activity, participation, and quality of life, are common complications of neurological conditions among elderly residents in long-term care facilities. This study examined the reliability and validity of the Chinese version of the PaArticular Scales in a population with joint contractures. METHODS: A cross-sectional study design was used. The sample included elderly residents older than 64 years with joint contractures in an important joint who had lived at one of 12 long-term care facilities in Taiwan for more than 6 months (N = 243). The Chinese version of the PaArticular Scales for joint contractures was generated from the English version through five stages: translation, review, back-translation, review by a panel of specialists, and a pretest. Test-retest reliability, internal consistency reliability, construct validity, and criterion validity were evaluated, and the results were compared with those for the World Health Organization Quality of Life scale and the World Health Organization Disability Assessment Schedule. RESULTS: The Chinese version of the PaArticular Scales had excellent reliability, with a Cronbach α coefficient of 0.975 (mean score, 28.98; standard deviation, 17.34). An exploratory factor analysis showed three factors and one factor with an eigenvalue > 1 that explained 75.176 and 62.83 % of the total variance in the Activity subscale and Participation subscale, respectively. The subscale-to-total scale correlation analysis showed Pearson correlation coefficients of 0.881 for the Activity subscale and 0.843 for the Participation subscale. Pearson's product-moment correlation revealed that the correlation coefficient (r) between the Chinese version of the PaArticular Scales and the World Health Organization Disability Assessment Schedule was 0.770, whereas that for the World Health Organization Quality of Life scale was - 0.553; these values were interpreted as large coefficients. CONCLUSIONS: The underlying theoretical model of the Chinese version of the PaArticular Scales functions well in Taiwan and has acceptable levels of reliability and validity. However, the Chinese version must be further tested for applicability and generalizability in future studies, preferably with a larger sample and in different clinical domains.

[Vitamin A nutrition status and influencing factors of Chinese rural elderly in 2015].

OBJECTIVE: To analyze the level of vitamin A and its influencing factors of Chinese rural elderly. METHODS: The serum samples of the rural elderly were selected by random sampling method from the biological sample bank of Chinese Adults Nutrition and Chronic Diseases Surveillance in 2015(CANCDS2015). The basic information of the subjects was collected by questionnaire survey. High performance liquid chromatography(HPLC) method was used to determine the vitamin A nutritional status of the population according to the standard recommended by WHO. Multiple logistic regression analysis was explored the relationship between vitamin A status with the potential relevant factors. RESULTS: A total of 3134 elderly from Chinese rural were included in this study. The serum vitamin A concentration(M(P25, P75))was 1. 92(1. 50, 2. 45)µmoL/L. The prevalence of vitamin A deficiency was 0. 99%(95%CI 0. 64%-1. 34%), and the prevalence of vitamin A marginal deficiency was 4. 38%(95%CI 3. 65%-5. 10%). The prevalence of vitamin A marginal deficiency was significantly higher in elderly lived in western region than that lived in eastern and central regions of China. The serum vitamin A adequacy rate of rural elderly who were 80 years old and above or thin was relatively low(P<0. 05). Married elderly had significant lower vitamin A deficiency rate. The result from multivariate logistic regression model analysis showed that gender, age and body mass index had significant effects on vitamin A nutritional status of Chinese urban elderly(P<0. 05). CONCLUSION: The nutritional status of vitamin A in rural elderly in China was better, and the deficiency rate was lower.

The Role of Bedroom Privacy in Social Interaction among Elderly Residents in Nursing Homes: An Exploratory Case Study of Hong Kong.

Privacy is often overlooked in Hong Kong nursing homes with the majority of elderly residents living in shared bedrooms of three to five people. Only a few studies have used Bluetooth low energy indoor positioning systems to explore the relationship between privacy and social interaction among elderly residents. The study investigates the social behavioural patterns of elderly residents living in three-bed, four-bed, and five-bed rooms in a nursing home. Location data of 50 residents were used for the identification of mobility and social interaction patterns in relation to different degrees of privacy and tested for statistical significance. Privacy is found to have a weak negative correlation with mobility patterns and social behaviour, implying that the more privacy there is, the less mobility and more formal interaction is found. Residents who had more privacy did not spend more time in social space. Residents living in bedrooms that opened directly onto social space had higher social withdrawal tendencies, indicating the importance of transitional spaces between private and public areas. Friends' rooms were used extensively by residents who had little privacy, however, the concept of friends' rooms have rarely been discussed in nursing homes. There is evidence supporting the importance of privacy for social interaction. Future study directions include considering how other design factors, such as configuration and social space diversity, work with privacy to influence social interaction.

Developing and Evaluating an Educational Program for Respiratory Infection Prevention among Rural Elderly Residents in South Korea.

Based on social cognitive theory (SCT), an educational program was developed to prevent rural elderly residents from respiratory infections in South Korea. The effectiveness of the program was investigated in terms of knowledge, attitudes, and practices about respiratory infection prevention, as well as social capital. A pretest-posttest nonequivalent control group quasi-experimental design was used to test the short-term effect of this program. In addition, 1- and 6-month follow-up surveys were administered to evaluate the long-term effects. A total of 69 subjects (37 in the experimental group and 32 in the control group) participated in the experiment. The results showed that knowledge about respiratory infection prevention, respiratory infection prevention practices, and social capital were enhanced among the elderly residents who participated in the educational program. The educational effects differed significantly across time periods (pretest, posttest, 1- and 6-month follow up) in all the above variables. In particular, the program remained effective 1 month after the intervention, but a reinforcement session extended the program's effects up to 6 months later. This educational program would be used as an effective intervention to help rural elderly residents prevent respiratory infections.

[The Study of the Relationship Between Community Social Capital and Quality of Life among the Middle-aged and Elderly Rural-to-Urban Residents].

OBJECTIVE: To analyze the relationship between community social capital and quality of life among the middle-aged and elderly rural-to-urban residents, and to provide the policy reference for improving the health status. METHODS: A multi-stage random sampling method was used to select the research objects. Univariate analysis and logistic regression model were used to explore the effect of social capital on quality of life among the middle-aged and elderly rural-to-urban urbanized residents. RESULTS: The scores of self-rated physical health and mental health in the rural-to-urban residents were lower than those of urban residents ( P<0.05). The total score of community social capital, community participation and community cohesion in the rural-to-urban residents were lower than those of urban residents ( P<0.05). The result of multivariate analysis showed that community attachment and community cohesion were the protective factors of physical health ( P<0.05), and community cohesion was the protective factor of mental health ( P<0.05). CONCLUSION: There is a correlation between community belonging, community cohesion and quality of life among the elderly rural-to-urban residents. Attention should be paid to the promotion of community social capital so as to improve the health status of middle-aged and elderly rural-to-urban residents.

Factors related to perceived caring among older people residing in long-term care facilities: a cross-sectional study.

BACKGROUND: Healthcare providers who exhibit caring behaviours promote quality of care. Theoretical and empirical models have promoted a three-dimensional paradigm of care perception. However, the perception of elderly residents in long-term care facilities related to caring has not been investigated. OBJECTIVES: This study explored factors related to the elderly's perception of healthcare providers' caring in long-term care facilities. METHODS: A cross-sectional survey was conducted among 461 elderly residents living in 57 long-term care facilities in southern Taiwan. A structured questionnaire included demographic information, facility characteristics and the 12-item Caring Scale for Institutionalized Elders. Hierarchical regression analysis was used to determine significant factors related to the elderly residents' caring perceptions. FINDINGS: A hierarchical regression model showed 49.9% of the variance in elderly's perception of caring. Significant related factors included resident's age, number of comorbidities, need for caring, time spent being cared for, bed-to-nurse staffing ratios and accreditation status. CONCLUSIONS: Improved Registered Nurse staffing ratios with a higher level of accreditation status yield better perceptions of caring among residential elderly. Those with comorbid diseases and fewer caring needs have a higher perception of healthcare provider caring. IMPLICATIONS: The related factors of elderly's perceived caring provide long-term care managers and nursing staff with beneficial information to develop strategies that can manage residents with high expected-care needs. Policies to improve the accreditation standards of long-term care facilities are needed.

The association of short-term effects of air pollution and sleep disorders among elderly residents in China.

Sleep disorders, oftentimes co-occurring with other mental and neurological disorders in the elderly, have been previously linked to short-term exposures to air pollution. Here we assessed such associations among 395,651 elderly Chinese in Ningbo, China where air pollution exposures are high and the proportion of elderly in the population is growing. We utilized a regional health information database in China (2008-2017) that collected information on hospital visits for sleep disorders among the elderly (age 60+). Measures of daily air pollution concentrations including nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), inhalable particles (PM10), and ambient fine particulate matter (PM2.5) were generated from seven environmental air quality monitoring sites in the study area. We used a generalized additive model to evaluate the associations between hospital visits for sleep disorders and short-term air pollution exposures for up to 7 days prior to a hospital visit. Short-term exposure to multiple air pollutants was associated with hospital visits for sleep disorders in an elderly population; with the strongest associations during 2-3 days prior to a clinic visits for traffic-related pollutants including air quality index (AQI), PM2.5, PM10, and NO2 and for SO2 and O3 for 5 days prior to the visits. Our study based on large health care record system suggested that short-term air pollution exposures are associated with sleep disorders in the elderly. Considering the individual covariates that could not be adjusted in time-series analyses, future studies with individual level data and an ability to evaluate the severity of sleep disorders and their relation to mental and physical health in general and air pollution are needed. An aging population with increasing health problems and the frequency of high and very high air pollution events in China make our findings very health policy relevant.

Analysis on the characteristics and trend of injury death among the elderly aged 65 and above in Chongqing / 公共卫生与预防医学

Objective To analyze the characteristics and changing trend of injury death among elderly residents aged 65 and above in Chongqing from 2013 to 2017, and to provide a basis for formulating intervention strategies for elderly injuries. Methods Based on monitoring data of death causes of permanent residents in Chongqing from 2013 to 2017, the injury death cases of elderly residents aged 65 and above were extracted, and the mortality rate and sequence were calculated. The standard mortality rate was calculated based on the standard population composition of the sixth national population census in 2010. The Joinpoint Regression Program 4.2 software was used to analyze the death trend. Results From 2013 to 2017, the average annual crude injury mortality rate of Chongqing residents aged 65 and above was 140.89/100 000, and the standardized mortality rate was 12.57/100 000. The crude death rate of male elderly residents was higher than that of female residents in the same year (P <0.001), and the injury mortality rate increased with the age of the elderly (P <0.001). The injury mortality rate of female and all elderly residents, and elderly residents in the 75- and 85-year-old groups showed an upward trend (P<0.05). Falls, road traffic injuries, suicide, other accidental injuries and drowning were the top five causes of injury death in Chongqing, accounting for 93.16% of the total injury deaths. In the past five years, the fall mortality of elderly residents in Chongqing showed an upward trend (P < 0.05). Falling was the first cause of injury death for elderly aged 70 and above in Chongqing. The crude rate of death of elderly residents aged 85 and over was 313.52 /100 000. Conclusion The injury mortality and fall mortality of elderly residents aged 65 and above in Chongqing showed a rising trend in the past five years. It is urgent to take measures to prevent injury and falls for seniors in Chongqing.

[Intake of nuts among Chinese elderly residents in 15 provinces, 2015].

OBJECTIVE: To examine nuts consumption in a sample of Chinese elderly residents. METHODS: Samples from 2015 China Nutritional Transition Cohort Study were used. A total of 5071 participants aged 60 years old and above were included in the final analysis. Three consecutive 24 h recalls were used to collect dietary consumption data. Average daily nuts intake was calculated. Then compared with recommended intake level of Dietary Guidelines for Chinese Residents(2016). Logistic regression was applied to analyze key factors affecting the consumption of nuts intake. RESULTS: The overall prevalence of nuts consumption among elderly residents in 15 provinces was 17. 8%. The P90 nuts intake was 13. 6 g/d in the whole population and 16. 7 g/d in P50 in the consuming group. There were 81. 1% of the whole population achieved the recommendation of dietary guidelines. The Logistic analysis showed that the group of young age, high education level and urban residents had more nuts consumed. CONCLUSION: Nuts consumption rate was low among Chinese elderly residents. The intake was insufficient in the whole. Age, education level and area were key factors that influenced nuts consumption of the elderly.

Validity of One-Day Physical Activity Recall for Estimating Total Energy Expenditure in Elderly Residents at Long-Term Care Facilities: CLinical EValuation of Energy Requirements Study (CLEVER Study).

Malnutrition is a severe problem among elderly residents living in long-term care facilities. A simple and accurate estimation for total daily energy expenditure (TEE) is required in order to provide them with an adequate amount of food. The purpose of this study was to validate a physical activity assessment tool for estimating TEE among elderly residents. The data of 58 subjects aged 69-99 y were analyzed in this study. The one-day physical activity recall was filled out by facility staff for a typical day. TEE was measured by the doubly labeled water (DLW) method (TEEDLW), and predicted by one-day physical activity recall using the basal metabolic rate (pTEEBMR) and body weight (pTEEBW). The TEEDLW, pTEEBMR and pTEEBW were 1,129±196 kcal/d, 1,186±251 kcal/d and 1,326±236 kcal/d, respectively. In a regression model, body weight, movement means and sex explained 39.0% of the variance in the difference between pTEEBMR and TEEDLW (p<0.05). Percentage of fat mass, body weight, and Barthel Index except mobility explained 47.3% of the variance in the difference between pTEEBW and TEEDLW (p<0.05). The current results suggested that pTEEBW is not recommended to estimate TEE because the error depends on body size, and pTEEBMR was significantly correlated with TEEDLW but also included systematic errors in elderly residents. In order to improve the accuracy of the present assessment to estimate TEE, it is necessary to establish a new equation of basal metabolic rate for elderly residents and consider sex and movement means to estimate TEE.

[Analysis of influencing factors and causes of death in elderly residents with non-alcoholic fatty liver disease].

Objective: To understand and analyze the incidence rate, risk factors, independent risk factors and the causes of death in elderly population with non-alcoholic fatty liver disease (NAFLD). Furthermore, analyze the relationship between metabolic syndrome (MS) and mortality rate in patients with NAFLD to provide evidence for the prevention and control of NAFLD in the elderly population. Methods: A total of 7 619 elderly people aged over 60 years, and local household registered in Kunshan city, Jiangsu province in 2016 were included as subjects to analyze the incidence rate, influencing factors and causes of death in patients with NAFLD and the relationship between MS and mortality rate in patients with NAFLD. According to different data, using Kruskal-Wallis H test, analysis of variance, t-test, chi-square test or logistic regression analysis were performed. Results: The prevalence of NAFLD was14.10% (1 074/7 619) among the elderly over 60 years in Kunshan city, Jiangsu province in 2016, and the female prevalence rate was significantly higher than that of males (P < 0.05). When the body mass index (BMI) was < 32 (kg/m(2)), the prevalence of NAFLD increased with the increase of BMI index. When BMI was 18.5-23.9 kg/m2, 24-27.9 kg/m(2) and > 32 kg/m(2), the prevalence of NAFLD was significantly higher in females than males (P < 0.05). There was no significant difference in prevalence between males and females with BMI <18.5 kg/m(2) and 28~31.9 kg/m(2) (P > 0.05). BMI gradually decreased (P < 0.05) with the increase of age, and the incidence of NAFLD showed a downward trend (P < 0.05). An independent risk factors for NAFLD (P < 0.01) were gender (OR = 0.616), age (OR = 0.970), waist circumference (OR = 1.065), triglycerides (OR = 1.162), BMI (OR = 1.238), and diastolic blood pressure (OR = 1.012). The probability of NAFLD combined with three and four kinds of MS was significantly higher than control group (P < 0.05). Subjects' mortality rate during the follow-up period was 1.94%, 2.23% in the NAFLD group, and 1.89% in the control group. Average life expectancy was 75.58 years in NAFLD group and 78.68 years in the control group. All deaths in NAFLD groups were associated with MS, and 70.83% combined with three or more MS. The primary cause of death in NAFLD group was tumors (37.5%), followed by cardiovascular disease (16.67%) and three cases died directly from MS. Conclusion: The prevalence of NAFLD in the elderly population in Kunshan city, Jiangsu province is relatively low, which may be associated with local diet and high-intensity workouts. MS disorders represented by obesity and diabetes mellitus are closely associated to the onset of NAFLD. Obesity is the most important risk factor for the incidence of NAFLD in the local elderly population over 60 years old. However, the risk of NAFLD should not be neglected in people with normal BMI, especially in aged women, and the weight control should be the most important means to prevent and control NAFLD. NAFLD may increase mortality rate and reduce life expectancy in the elderly population. The main reason to cause death in the elderly with NAFLD is cardiovascular disease and malignant tumors. Simultaneously, multiple MS development may increase the death rate in elderly with NAFLD.

[Relationship of different dietary patterns with dyslipidemia and hypertension among middle-aged and elderly residents in Bengbu City in 2014-2015].

OBJECTIVE: To understand the dietary patterns of the middle-aged and elderly in Bengbu City and to analyze the associations of dietary patterns with dyslipidemia and hypertension. METHODS: During September of 2014 to September of 2015, the cluster random sampling method was used to select 860 residents aged ≥45 years old( 45-76 years old) from 6 communities of Bengbu City. They answered a well-designed questionnaire( age, gender, history of chronic disease), received physical examinations ( height, weight, waist circumference, hip circumference) and dietary survey, measured the blood lipids and blood pressure. Factor analysis was applied to determine major dietary patterns in order to analyze the associations between dyslipidemia and hypertension. RESULTS: ( 1) Four dietary patterns was identified, namely "rice and vegetables" pattern, "animal food" pattern, "fruits and milk" pattern, "drinking" pattern. ( 2) There were significant difference of BMI between the "rice and vegetables" pattern and "animal food" pattern( P < 0. 01). There were significant difference of WC between the "rice and vegetables"pattern, "animal food" pattern and "drinking" pattern( P < 0. 01). There were significant difference of SBP between the "rice and vegetables " pattern and "drinking" pattern( P < 0. 01). ( 3) The Q4 group of "rice and vegetables" pattern and "animal food" pattern had higher proportion of protein that contributed to total energy than the Q1 group( 17. 44% vs. 13. 63%, 20. 52% vs. 17. 55%, P < 0. 05). The Q4 group of "rice and vegetables" pattern had higher energy intake of 1. 75-fold than the Q1 group. ( 4) Whether or not controlling the confounding factors of gender, age, degree of education, physical activity and BMI, a positively association was found between "animal food" pattern, "drinking" pattern and dyslipidemia by logistic regression analysis between the Q4 group with the Q1 group( unadjustment OR = 2. 665, OR = 1. 926, P < 0. 01; after adjustment OR = 1. 835, OR = 1. 447, P < 0. 05). CONCLUSION: "Animal food" pattern and "drinking" pattern may be risk factors for dyslipidemia and hypertension, reducing the intake of meat, oil in our meals may play an important role in the prevention and control of chronic diseases.