scholarly journals Attitudes towards Advance Care Planning and Healthcare Autonomy among Community-Dwelling Older Adults in Beijing, China

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Ning Zhang ◽  
Xiao-hong Ning ◽  
Ming-lei Zhu ◽  
Xiao-hong Liu ◽  
Jing-bing Li ◽  
...  

Objectives. To investigate the preferences of ACP and healthcare autonomy in community-dwelling older Chinese adults.Methods. A community-based cross-sectional study was conducted with older adults living in the residential estate of Chaoyang District, Beijing.Results. 900 residents were enrolled. 80.9% of them wanted to hear the truth regarding their own condition from the physician; 52.4% preferred to make their own healthcare decisions. Only 8.9% of them preferred to endure life-prolonging interventions when faced with irreversible conditions. 78.3% of the respondents had not heard of an ACP; only 39.4% preferred to document in an ACP. Respondents with higher education had significantly higher proportion of having heard of an ACP, as well as preferring to document in an ACP, compared to those with lower education. Those aged <70 years had higher proportion of having heard of an ACP, as well as refusing life-prolonging interventions when faced with irreversible conditions, compared to those aged ≥70 years.Conclusions. Although the majority of community-dwelling older Chinese adults appeared to have healthcare autonomy and refuse life-prolonging interventions in terms of end-of-life care, a low level of “Planning ahead” awareness and preference was apparent. Age and education level may be the influential factors.

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029929 ◽  
Author(s):  
Yaohua Gu ◽  
Wenwen Wu ◽  
Jinbing Bai ◽  
Xuyu Chen ◽  
Xiaoli Chen ◽  
...  

ObjectivesTo explore the association between the number of teeth and frailty among older Chinese adults using a nationally representative sample.DesignCross-sectional analysis was carried out using the 2014 wave data from the Chinese Longitudinal Healthy Longevity Survey, which used a targeted random-sampling design.SettingThis research was conducted in communities from nearly half of the counties and cities in 22 out of 31 provinces throughout China.ParticipantsOf the 6934 interviewees aged ≥65 years, the final analysis included 3635 older adults who had completed the 2014 wave survey on the variables included in the study.Primary and secondary outcome measuresOutcome variables included frailty, measured by the Frailty Index, and number of teeth. Covariates included demographic characteristics (ie, age, sex, co-residence, marital status, years of education and financial support), body mass index (BMI) and health behaviours (ie, smoking, drinking and exercise). A univariate logistic regression was used to test the factors associated with frailty. A multiple logistic regression model was used, using the frailty score as the dependent variable and the number of teeth together with significant covariates as the independent variables.ResultsThe prevalence of frailty was 27.68%. The mean number of teeth present was 9.23 (SD=10.03). The multiple logistic regression showed that older adults’ demographic variables, health behaviours, BMI, tooth number and chewing pain were significantly associated with frailty. After adjusting for the covariates, older adults with fewer teeth had significantly higher odds of frailty than those with 20 or more teeth (no teeth: OR=2.07, 95% CI 1.53 to 2.80; 1 to 10 teeth: OR=1.77, 95% CI 1.31 to 2.38), except for older adults with 11 to 20 teeth (OR=1.30, 95% CI 0.93 to 1.82).ConclusionsThe presence of fewer teeth is significantly associated with frailty status among older Chinese adults. Future studies are needed to explain the specific mechanisms underlying how oral health status is associated with frailty.


2018 ◽  
Vol 30 (2) ◽  
pp. 107-117 ◽  
Author(s):  
Junmin Wei ◽  
Linlin Fan ◽  
Yuhui Zhang ◽  
Shirley Li ◽  
Jamie Partridge ◽  
...  

Malnutrition and depression are of important concern among older adults. We investigated the association between malnutrition and depression among community-dwelling older Chinese adults and how both affect health care costs. Data from 4916 older adults (age ≥60 years) collected as part of 2013-Wave II China Health and Retirement Longitudinal Study (CHARLS) survey were analyzed. Measures of body mass index and weight loss were used as indicators of malnutrition. Malnourished subjects were 31% more likely to be depressed than their non-malnourished counterparts (odds ratio = 1.311, P < .1). Health care–related cost was ¥591.8 higher for malnourished older adult per year compared to a non-malnourished counterpart ( P < .1), thus confirming that incidence of depression coupled with malnutrition significantly increases health care–related costs. These results highlight the importance of malnutrition and depression screening and treatment for older Chinese community-dwelling adults, and the importance of community-based nutrition-specific programs that could address the needs of the affected populations.


2020 ◽  
Author(s):  
Jing-Hong Liu ◽  
Qing-Hua Ma ◽  
Yong Xu ◽  
Xing Chen ◽  
Chen-Wei Pan

Abstract Background There was a lack of studies focusing on older adults about the longitudinal association between metabolic syndrome (MetS) and hyperuricemia (HUA). We aimed to assess the association of baseline MetS and incident HUA among older Chinese adults, with a special focus on the associations between different combinations of MetS components and HUA. Methods Data of 3,247 Chinese adults aged 60 years or older included in a community-based longitudinal cohort study were analyzed. Anthropometric examinations and collection of blood sample were conducted both at baseline and follow-up. HUA was defined as 7 mg/dl or above for men and 6 mg/dl or greater for women. MetS was assessed based on the National Cholesterol Education Program-Adult Treatment Panel Ⅲ, and older adults with presence of at least three of MetS components were considered as having MetS. Results MetS and its components including high blood pressure (BP), high body mass index, diabetes mellitus and high triglycerides were significantly related to incident HUA. The association between high BP and incident HUA is strongest among the five MetS components. Among all combinations of MetS components, the group consisting of diabetes mellitus, high BP and high triglycerides had the highest odds for incident HUA (OR = 13.07, 95%CI = 4.95–34.54). Conclusions MetS and its components except for low high-density lipoprotein cholesterol could increase the risk of HUA among community-dwelling older adults and high BP may be the most important determinant.


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.


2012 ◽  
Vol 20 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Mark W. Swanson ◽  
Eric Bodner ◽  
Patricia Sawyer ◽  
Richard M. Allman

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations while controlling for potential confounders. In multivariate analyses, each lower step in visual acuity below 20/50 was significantly associated with reduced odds of having a higher level of physical activity, OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults.


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