scholarly journals Association between primary caregiver type and mortality among Chinese older adults with disability: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yangyujin Liu ◽  
Haoxue Li ◽  
Bei Wu ◽  
Xiaoting Liu ◽  
Honglin Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Cox Regression ◽  
Family Care ◽  
Primary Caregiver ◽  
Community Dwelling ◽  
Care Needs ◽  
Chinese Older Adults ◽  
Demographic Transitions ◽  
Healthy Longevity

Abstract Background Socio-demographic transitions have dramatically changed the traditional family care settings in China, caused unmet care needs among older adults. However, whether different primary caregiver types have different influences on disabled older adults’ health outcomes remain poorly understood. We aimed to examine the association between the type of primary caregiver (e.g., spouse and children) and death among community-dwelling Chinese older adults disabled in activities of daily living. Methods We used data from Chinese Longitudinal Healthy Longevity Survey. The analytic sample comprised 4278 eligible adults aged ≥ 80 years. We classified primary caregiver type into five categories: spouse, son/daughter-in-law, daughter/son-in-law, grandchildren, and domestic helper. We used Cox regression model to examine the association between primary caregiver type and all-cause mortality. Covariates included age, sex, residence, years of education, co-residence status, financial independence, whether living with children, number of ADL disability, number of chronic conditions, and self-reported health, cognitive impairment, and caregiving quality. Results Married older adults whose primary caregivers were son/daughter-in-law had a 38% higher hazard of death than those who had spouse as the primary caregiver. Married men who received care primarily from son/daughter-in-law or daughter/son-in-law had a 64 and 68% higher hazard of death, respectively, than those whose primary caregiver was spouse. The association between primary caregiver type and mortality among widowed older adults differed between urban and rural areas. Urban residents who had domestic helpers as the primary caregiver had an 16% lower hazard of death, while those living in rural areas had a 50% higher hazard of death, than those having son/daughter-in-law as the primary caregiver. Conclusions The quality of care of the primary caregiver may be a risk factor for mortality of disabled older adults in China. Interventions are necessary for reducing unmet needs and managing care burden.

Regional and Geographical Disparities in Body Mass Index (BMI) Among Chinese Older Adults: The Chinese Longitudinal Healthy Longevity Survey

2020 ◽  
pp. 073346482093096
Author(s):  
Yen-Han Lee ◽  
Ching-Ti Liu ◽  
Mack Shelley ◽  
Yen-Chang Chang
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Body Mass ◽  
Weight Change ◽  
Rural Areas ◽  
Cox Regression ◽  
Chinese Older Adults ◽  
Healthy Longevity ◽  
Urban And Rural Areas ◽  
Older Males

This study examined the regional and geographical disparities in body mass index (BMI) among Chinese older adults. Using panel data from the Chinese Longitudinal Healthy Longevity Survey, participants included 3,740 older adults (age ≥ 65 years) who answered all three waves of the survey (2009–2014). Sex-stratified and multistate Cox regression was used to examine the disparities in BMI change. Results showed that both older males and older females who resided in the central-south had lower rates of weight change from nonobese to obese, compared with those from the east. Older females from urban regions had higher rate of weight change from nonobese to obese, compared with rural participants (hazard ratio [HR]: 1.35, 95% confidence interval [CI] = [1.13, 1.60]; p < .01). However, there were no disparities between urban and rural areas among older males ( p > .05). These results provided practical implications for regional and geographical disparities in BMI among Chinese older adults.

scholarly journals Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal Analysis in China

2021 ◽  
Vol 8 ◽  
Author(s):  
Xurui Jin ◽  
Shangzhi Xiong ◽  
Changzheng Yuan ◽  
Enying Gong ◽  
Xian Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Apolipoprotein E ◽  
Cox Regression ◽  
Population Based ◽  
Fish Intake ◽  
Chinese Older Adults ◽  
Healthy Longevity ◽  
All Cause Mortality ◽  
Diet Pattern ◽  
Interactive Relationship

Introduction: The interactions between apolipoprotein E (APOE) genotype and diet pattern changes were found significant in several trials, implying that APOE gene may modify the effect of animal protein-rich food on health outcomes. We aim to study the interaction of APOE genotype with the effect of meat, fish and egg intake on mortality.Methods: This population-based study enrolled 8,506 older adults (mean age: 81.7 years, 52.3% female) from the Chinese Longitudinal Healthy Longevity Study. The intake frequency of meat, fish and egg was assessed by 3-point questions at baseline. Cox regression was conducted to calculate the hazard ratios for all-cause mortality of intake levels of meat, fish and egg. The analyses were stratified by APOE genotype and sex. The analyses were performed in 2020.Results: In the multivariable-adjusted models, meat and fish intake was associated with all-cause mortality (high vs. low intake: meat: HR: 1.14, 95% CI: 1.01, 1.28; fish: HR: 0.83, 95% CI: 0.73, 0.95). APOE genotype have significant interactions with meat and fish intake (Ps &lt; 0.05). Compared with low fish intake, high fish intake was associated with lower risk of mortality (HR: 0.74, 95% CI: 0.56–0.98) only among the APOE ε4 carriers. High meat intake was significantly associated with higher risks of mortality (HR: 1.13, 95% CI: 1.04–1.25) only among the APOE ε4 non-carriers. The interactive relationship was restricted among the male. No significant findings were observed between egg and mortality among carriers or non-carriers.Conclusions: Among Chinese older adults, the significance of associations of mortality with reported meat or fish intake depended on APOE-E4 carriage status. If validated by other studies, our findings provide evidence for gene-based “precision” lifestyle recommendations.

Predictors of Physical Functioning Trajectories among Chinese Oldest Old Adults: Rural and Urban Differences

2009 ◽  
Vol 69 (3) ◽  
pp. 181-199 ◽  
Author(s):  
Fei Sun ◽  
Nan Sook Park ◽  
David L. Klemmack ◽  
Lucinda L. Roff ◽  
Zhihong Li
Keyword(s):  
Older Adults ◽  
Hierarchical Linear Modeling ◽  
Rural Areas ◽  
Oldest Old ◽  
Community Dwelling ◽  
Linear Modeling ◽  
Healthy Longevity ◽  
Rural And Urban ◽  
Rural Sample ◽  
Community Dwelling Older Adults

This article examined the differences between rural/urban older adults in their trajectories of activities of daily living (ADL) over a 4-year period. The sample included 2,490 community dwelling older adults who completed three waves (1998, 2000, and 2002) of the Chinese Longitudinal Healthy Longevity Survey. Among them, 63.5% were from rural areas. Hierarchical linear modeling (HLM) was run for the whole sample and separately for rural and urban samples. For both rural and urban samples, older age and involvement in fewer activities predicted increases in ADL difficulties over time. In addition, being female and routinely smoking predicted increases in ADL difficulties for the rural sample. Implications for interventions to slow down ADL decline were discussed.

scholarly journals PLANNING FOR AGING IN PLACE IN RURAL AREAS: PERCEPTIONS AND NEEDS OF OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S252-S252
Author(s):  
Raven H Weaver ◽  
Cory Bolkan
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Rural Areas ◽  
Chronic Conditions ◽  
Family Care ◽  
Computer Assisted ◽  
Service Access ◽  
Community Resources ◽  
Care Needs ◽  
Age In Place

Abstract Most individuals prefer to live independently in their homes, but will need support to age-in-place safely. Rural-dwelling individuals historically have worse health, limited income, and restricted access to adequate services/supports compared to their urban counterparts. Community-based aging services organizations (i.e., Area Agency on Aging; AAA) offer in-home health, social support, and information/referral to community resources that support older adults in both urban and rural communities. A representative sample of adults aged 60+ (N=253, mean age=74) were surveyed via computer-assisted-telephone interviews about their health status, needs, and service utilization. Over half (54%) lived in rural counties, which was significantly associated with receiving insufficient health care services (X2=9.227, p=.002). Insufficient service access was also associated with experiencing a fall (X2=7.315, p=.007). While 53% reported having chronic conditions, most individuals still reported good health and their top reported needs included: yard work, interior/exterior house repairs, and housework. Content analysis of open-ended survey responses regarding future care needs revealed participants anticipate help from family/friends or neighbors; reliance on physicians for referrals; and expect insurance to cover their needs. Participants had varying awareness levels of available community resources and identified concerns about adequacy of services (e.g., mental health; transportation) and health insurance barriers (e.g., reimbursement; vision/dental coverage). Preparing for future needs and anticipating changing functional capacity is critical, especially among rural-dwelling older adults with chronic conditions. To improve ability for adults with diverse needs to age-in-place, preventive services/supports that span the continuum of care needs and that complement informal family care are necessary.

scholarly journals Physical Work and Exercise Reduce the Risk of Cognitive Impairment in Rural Older Adults: A Population-based Longitudinal Study

2020 ◽  
Author(s):  
Fan He ◽  
Junfen Lin ◽  
Fudong Li ◽  
Yujia Zhai ◽  
Tao Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Rural Areas ◽  
Tai Chi ◽  
Cox Regression ◽  
Population Based ◽  
Physical Work ◽  
Protective Effects ◽  
Chinese Older Adults

Abstract Background: The effect of physical work on the risk of cognitive impairment in Chinese older adults living in rural areas remains to be elucidated. We investigated whether physical work and exercise can reduce the risk of cognitive impairment. Methods: We collected data from 7,000 individuals without cognitive impairment (age ≥60 years) over a follow-up period of 2 years. The Chinese version of the Mini-Mental State Examination was used to assess cognitive function, and the multivariable Cox regression model was used to identify associations between physical work/exercise and cognitive impairment. Results: Over a median follow-up period of 1.93 years, 1,224 (17.5%) of 7,000 participants developed cognitive impairment, with a total incidence of 97.69 per 1,000 person-years. Participation in physical work (hazard ratio [HR]: 0.66; 95% confidence interval [CI], 0.55-0.78) or exercise (HR: 0.76; 95% CI, 0.62-0.93) was associated with a reduced risk of cognitive impairment. Agricultural work (HR: 0.60; 95% CI, 0.49-0.73) and walking/tai chi (HR: 0.75; 95% CI, 0.60-0.93) exerted significant protective effects against cognitive impairment. Conclusions: Physical work and exercise can reduce the risk of cognitive impairment in older adults. Reasonable types and appropriate intensities of physical activity are recommended to prevent or delay the progression of cognitive impairment.

scholarly journals CAREGIVER TYPE AND ITS ASSOCIATION WITH MORTALITY AMONG OLDER ADULTS WITH DISABILITY IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S76-S77
Author(s):  
Chenkai Wu ◽  
Haoxue Li ◽  
Xiaoting liu ◽  
honglin chen
Keyword(s):  
Older Adults ◽  
Primary Caregiver ◽  
Community Dwelling ◽  
Mortality Data ◽  
Poor Survival ◽  
Chinese Older Adults ◽  
Adjusted Model ◽  
Community Dwelling Older Adults ◽  
Multivariable Adjusted Model

Abstract A large proportion of older adults in China needs assistance with activities of daily living (ADL). The quality of care for this population has gained growing attention. However, little is known about the patterns of their caregiver type or its association with mortality. We examined the patterns of primary caregiver type among community-dwelling older adults in China and to examine the association between caregiver type and mortality. Data were from the 2005, 2008, and 2011 waves of the China Longitudinal Health and Longevity Study. We included 437 married and 3,971 widowed participants. The average age was 96.7 years (SD=6.9) and 73.7% were female. For married persons, 55.1%, 25.2%, 12.1%, 2.3%, and 3.9% of the primary caregiver was spouse, son/daughter-in-law, daughter/son-in-law, grandchildren, and housekeeper. For widowed persons, 60.2%, 21.1%, 9.9%, and 5.9% of the primary caregiver was son/daughter-in-law, daughter/son-in-law, grandchildren, and housekeeper, respectively. Multivariable-adjusted model showed that, among married older adults, son/daughter-in-law and daughter/son-in-law as the primary caregiver was associated with 41% (95% confidence interval [CI]=6%-87%) and 67% (95%CI=10%-154%) higher mortality than spouse as the primary caregiver, respectively. For widowed persons, daughter/son-in-law and grandchildren as the primary caregiver was associated with 12% (95%CI=3%-20%) and 14% (95%CI=2%-24%) lower mortality than son/daughter-in-law as the primary caregiver, respectively. Majority of disabled older adults in China relied on their spouse and children to care for them. Type of primary caregiver was associated with death in both married and widowed persons. More resources need to be allocated to disabled Chinese older adults with poor survival outcomes.

scholarly journals Incidence of frailty among community-dwelling older adults: a nationally representative profile in China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weihao Xu ◽  
Ya-Xi Li ◽  
Chenkai Wu
Keyword(s):  
Older Adults ◽  
Incidence Rate ◽  
Rural Areas ◽  
Geographic Region ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Chinese Older Adults ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Abstract Background Frailty is a clinically recognizable state of reduced resilience to stressors and increased vulnerability to adverse outcomes. The majority of studies have focused on the prevalence and risk factors of frailty, while the incidence of frailty has not been well documented, especially in less developed regions including China—a country that has the largest aging population in the world. We investigated the incidence of frailty among non-frail Chinese older adults by sociodemographic characteristics, disease burden, and geographic region. Methods Participants were 4939 adults aged ≥60 years from the China Health and Retirement Longitudinal Study, a cohort study of a nationally representative sample of middle-aged and older community-dwelling adults from 28 provinces in China. Frailty was assessed by an adapted version of the well-validated Fried’s physical frailty phenotype, in which five criteria were included: weakness, slowness, exhaustion, physical inactivity, and shrinking. Results Over an average of 2.1 years of follow-up (10,514.2 person-years), the weighted incidence rate of frailty was 60.6 per 1000 person-years; the incidence rate was 28.8 and 86.6 per 1000 person-years for those who were initially robust and prefrail, respectively. Participants who were older and widowed, had lower education and household income, lived in rural areas, and had higher burden of chronic conditions had higher frailty incidence. Frailty incidence ranged from 44.8 per 1000 person-years in the Southeast to 93.0 per 1000 person-years in the Northwest. Conclusions Incidence rate of frailty was 60.6 per 1000 person-years among community-living Chinese adults aged ≥ 60 years. Substantial sociodemographic and geographical disparities exist in frailty incidence.

scholarly journals Transition of Living Arrangement and Cognitive Impairment Status among Chinese Older Adults: Are They Associated?

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 961
Author(s):  
Yen-Han Lee ◽  
Chia-Hung Lin ◽  
Jia-Ren Chang ◽  
Ching-Ti Liu ◽  
Mack Shelley ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Filial Piety ◽  
Cox Regression ◽  
Living Arrangement ◽  
Living Alone ◽  
Chinese Older Adults ◽  
Healthy Longevity ◽  
Household Members

Background and Objectives: Living arrangement is a crucial factor for older adults’ health. It is even more critical for Chinese older adults due to the tradition of filial piety. With the aging of China’s population, the prevalence of cognitive impairment among older adults has increased. This study examines the association between living arrangement transition and cognitive function among Chinese older adults. Materials and Methods: Using three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2008–2009, 2011–2012, and 2014), we analyzed data for older adults (age ≥ 65) who lived with other household members and reported good cognitive function or mild cognitive impairment when they participated in the survey. Multistate Cox regression was employed to study changes in cognitive function. Results: Older adults who transitioned to living alone had lower risk of cognitive impairment (hazard ratio (HR) = 0.66, 95% CI: 0.52, 0.83; p < 0.01), compared with those who continued to live with other household members. Moving into an institution was also not associated with cognitive impairment. Conclusions: With older adults’ transition to living alone, public health practitioners or social workers might educate them on the benefits of such a living arrangement for cognitive function.

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