scholarly journals Trends in disability of instrumental activities of daily living among older Chinese adults, 1997-2006: population based study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016996 ◽  
Author(s):  
Yajun Liang ◽  
Anna-Karin Welmer ◽  
Jette Möller ◽  
Chengxuan Qiu

BackgroundData on trends for disability in instrumental activity of daily living (IADL) are sparse in older Chinese adults.ObjectivesTo assess trends in prevalence and incidence of IADL disability among older Chinese adults and to explore contributing factors.DesignPopulation based study.Setting15 provinces and municipalities in China.SubjectsParticipants (age ≥60) were from four waves of the China Health and Nutrition Survey, conducted in 1997 (n=1533), 2000 (n=1581), 2004 (n=2028) and 2006 (n=2256), and from two cohorts constructed within the national survey: cohort 1997–2004 (n=712) and cohort 2000–2006 (n=823).MeasurementsIADL disability was defined as inability to perform one or more of the following: shopping, cooking, using transportation, financing and telephoning. Data were analysed with logistic regression and generalised estimating equation models.ResultsThe prevalence of IADL disability significantly decreased from 1997 to 2006 in the total sample and in all of the subgroups by age, sex, living region and IADL items (all ptrend<0.05). The incidence of IADL disability remained stable from cohort 1997-2004 to cohort 2000-2006 in the total sample and in all of the subgroups (all p>0.10). The recovery rate from IADL disability significantly increased over time in those aged 60–69 years (p=0.03). Living in a rural area or access to local clinics for healthcare was less disabling over time (ptrend<0.02).ConclusionsThe prevalence of IADL disability decreased among older Chinese adults during 1997–2006, whereas the incidence remained stable. The declining prevalence of IADL disability might be partly due to the decreased duration of IADL disability, and to improvements in living conditions and healthcare facilities over time.

2021 ◽  
Vol 8 ◽  
Author(s):  
Xingqi Cao ◽  
Guanglai Yang ◽  
Xurui Jin ◽  
Liu He ◽  
Xueqin Li ◽  
...  

Objective: Biological age (BA) has been accepted as a more accurate proxy of aging than chronological age (CA). This study aimed to use machine learning (ML) algorithms to estimate BA in the Chinese population.Materials and methods: We used data from 9,771 middle-aged and older Chinese adults (≥45 years) in the 2011/2012 wave of the China Health and Retirement Longitudinal Study and followed until 2018. We used several ML algorithms (e.g., Gradient Boosting Regressor, Random Forest, CatBoost Regressor, and Support Vector Machine) to develop new measures of biological aging (ML-BAs) based on physiological biomarkers. R-squared value and mean absolute error (MAE) were used to determine the optimal performance of these ML-BAs. We used logistic regression models to examine the associations of the best ML-BA and a conventional aging measure—Klemera and Doubal method-BA (KDM-BA) we previously developed—with physical disability and mortality, respectively.Results: The Gradient Boosting Regression model performed the best, resulting in an ML-BA with an R-squared value of 0.270 and an MAE of 6.519. This ML-BA was significantly associated with disability in basic activities of daily living, instrumental activities of daily living, lower extremity mobility, and upper extremity mobility, and mortality, with odds ratios ranging from 1 to 7% (per 1-year increment in ML-BA, all P &lt; 0.001), independent of CA. These associations were generally comparable to that of KDM-BA.Conclusion: This study provides a valid ML-based measure of biological aging for middle-aged and older Chinese adults. These findings support the application of ML in geroscience research and may help facilitate preventive and geroprotector intervention studies.


2021 ◽  
Author(s):  
Xingqi Cao ◽  
Guanglai Yang ◽  
Xurui Jin ◽  
Liu He ◽  
Xueqin Li ◽  
...  

Background: Biological age (BA) has been accepted as a more accurate proxy of aging than chronological age (CA). This study aimed to use machine learning (ML) algorithms to estimate BA in the Chinese population. Methods: We used data from 9,771 middle-aged and older (≥45 years) Chinese adults in the China Health and Retirement Longitudinal Study. We used several ML algorithms (e.g., Gradient Boosting Regressor, Random Forest, CatBoost Regressor, and Support Vector Machine) to develop new measures of biological aging (ML-BAs) based on physiological biomarkers. R-squared value and mean absolute error (MAE) were used to determine the optimal performance of these ML-BAs. We used logistic regression models to examine the associations of the best ML-BA and a conventional aging measure - Klemera and Doubal method -biological age (KDM-BA) we previously developed - with physical disability and mortality, respectively. Results: The Gradient Boosting Regression model performed best, resulting in a ML-BA with R-squared value of 0.270 and MAE of 6.519. This ML-BA was significantly associated with disability in basic activities of daily living, instrumental activities of daily living, lower extremity mobility, and upper extremity mobility, and mortality, with odds ratios ranging from 1% to 7% (per one-year increment in ML-BA, all P <0.001), independent of CA. These associations were generally comparable to that of KDM-BA. Conclusion: This study provides a valid ML-based measure of biological aging for middle-aged and older Chinese adults. These findings support the application of ML in geroscience research and help facilitate the understanding of the aging process.


Author(s):  
Qian Song ◽  
Haowei Wang ◽  
Jeffery A Burr

Abstract Objectives We investigated whether there was a “high outmigration penalty” for psychological health among older adults in rural China by assessing 2 potential community stressors associated with major sociodemographic changes in the community—increased outmigration and older adult density. We also investigated whether disparities in community economic conditions moderated the association between community stressors and depressive symptoms. Methods We employed 3 waves of data from the China Health and Retirement Longitudinal Study (2011–2015), using multilevel negative binomial models to address our research questions. Results Our results supported the “high outmigration penalty” hypothesis. Older adults living in low-income rural communities may experience an aggravated mental health penalty compared to those living in high-income rural communities. Higher older adult density was also associated with more depressive symptoms but only in less wealthy communities. Community differences in economic conditions were key factors buffering the high outmigration disadvantage associated with the psychological health of older Chinese adults. Discussion Rural outmigration may have deepened existing intercommunity health disparities among older adults. Policies should be developed to address community-level factors negatively associated with the well-being of older Chinese adults living in high outmigration and less wealthy rural communities.


Author(s):  
Mona Elbarbary ◽  
Artem Oganesyan ◽  
Trenton Honda ◽  
Geoffrey Morgan ◽  
Yuming Guo ◽  
...  

There is an established association between air pollution and cardiovascular disease (CVD), which is likely to be mediated by systemic inflammation. The present study evaluated links between long-term exposure to ambient air pollution and high-sensitivity C reactive protein (hs-CRP) in an older Chinese adult cohort (n = 7915) enrolled in the World Health Organization (WHO) study on global aging and adult health (SAGE) China Wave 1 in 2008–2010. Multilevel linear and logistic regression models were used to assess the associations of particulate matter (PM) and nitrogen dioxide (NO2) on log-transformed hs-CRP levels and odds ratios of CVD risk derived from CRP levels adjusted for confounders. A satellite-based spatial statistical model was applied to estimate the average community exposure to outdoor air pollutants (PM with an aerodynamic diameter of 10 μm or less (PM10), 2.5 μm or less (PM2.5), and 1 μm or less (PM1) and NO2) for each participant of the study. hs-CRP levels were drawn from dried blood spots of each participant. Each 10 μg/m3 increment in PM10, PM2.5, PM1, and NO2 was associated with 12.8% (95% confidence interval; (CI): 9.1, 16.6), 15.7% (95% CI: 10.9, 20.8), 10.2% (95% CI: 7.3, 13.2), and 11.8% (95% CI: 7.9, 15.8) higher serum levels of hs-CRP, respectively. Our findings suggest that air pollution may be an important factor in increasing systemic inflammation in older Chinese adults.


Sign in / Sign up

Export Citation Format

Share Document