scholarly journals Are there gender differences in the trajectories of self-rated health among chinese older adults? an analysis of the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shichen Cui ◽  
Yushan Yu ◽  
Weizhen Dong ◽  
Tingke Xu ◽  
Yunyun Huang ◽  
...  

Abstract Background Self-rated health (SRH) is a good predictor of morbidity and mortality. Extensive research has shown that females generally report poorer SRH than males but still tend to live longer. Previous studies used cross-sectional or pooled data for their analyses while ignoring the dynamic changes in males’ and females’ SRH statuses over time. Furthermore, longitudinal studies, especially those that focus on older adults, typically suffer from the incompleteness of data. As such, the effect of dropout data on the trajectories of SRH is still unknown. Our objective is to examine whether there are any gender differences in the trajectories of SRH statuses in Chinese older adults. Methods The trajectories of SRH were estimated using the pattern-mixture model (PMM), a special latent growth model, under non-ignorable dropout data assumption. We analyzed the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data of 15,613 older adults aged 65 years and above, collected from 2005 to 2014. Results The results demonstrated the effect of non-ignorable dropout data assumptions in this study. The previous SRH score was negatively associated with the likelihood of dropping out of the study at the next follow-up survey. Our results showed that both males and females in China perceive their SRH as decreasing over time. A significant gender difference was found in the average SRH score (female SRH was lower than male SRH) in this study. Nonetheless, based on the results obtained using the PMM, there are no gender differences in the trajectories of SRH at baseline as well as in the rate of decline among the total sample. The results also show that males and females respond to SRH predictors similarly, except that current drinking has a more pronounced positive effect on males and healthcare accessibility has a more pronounced positive effect on females. Conclusions Our results suggest that missing data have an impact on the trajectory of SRH among Chinese older adults. Under the non-ignorable dropout data assumptions, no gender differences were found in trajectories of SRH among Chinese older adults. Males and females respond to SRH predictors similarly, except for current drinking habit and healthcare accessibility.

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 208
Author(s):  
Yen-Han Lee ◽  
Yen-Chang Chang ◽  
Yun-Ting Wang ◽  
Mack Shelley

China launched a comprehensive health reform in 2009, as part of the central government’s plan to improve its healthcare system. This study investigates the associations of socioeconomic status with receiving adequate healthcare services among Chinese older adults following the 2009 health reform. Using the 6th and the 7th waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a repeated cross-sectional study design was adopted (n = 9305). Firth’s logistic regression models were used for statistical analysis. In the fully adjusted model, being non-married was negatively associated with adequate healthcare services (adjusted odds ratio (AOR) = 0.68, 95% confidence interval (CI): 0.54, 0.86). Higher levels of income were positively associated with adequate healthcare services (all ps < 0.05). Participants who relied on non-urban social insurance plans all had lower odds of receiving adequate healthcare services (all ps < 0.01), compared with older adults who used the urban employment basic medical insurance (UEBMI). However, disparities regarding education and urban-rural differences were not observed in the full model. As China is pushing for further reforms, vulnerable population groups, such as non-married or more impoverished older adults, should be assisted in receiving adequate healthcare services.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 31-31
Author(s):  
Weiyu Mao ◽  
Yaolin Pei ◽  
Huabin Luo

Abstract Oral health is a global public health concern. The four papers in this symposium capture various understudied risk and protective factors in oral health and dental care among older adults in China. The first paper examined the relationship between social isolation, loneliness, and tooth loss among Chinese older adults, using the Chinese Longitudinal Healthy Longevity Survey. The findings suggest that higher levels of social isolation, rather than loneliness, were associated with fewer remaining teeth and accelerated tooth loss over time. The second paper investigated urban-rural disparities in dental care utilization among Chinese adults aged 18 to 65 years old, using the 2019 New Era and Living Conditions in Megacities Survey. The findings demonstrate urban residents were more likely to visit dentists than rural residents. Besides socioeconomic status, health attitudes/behaviors, and oral health needs, health insurance coverage was considered an important enabling factor to promote dental care use in this population. The third paper examined the relationship between denture use and cognitive decline among Chinese older adults, using data from the Chinese Longitudinal Healthy Longevity Survey. The findings indicate that denture use is protective against cognitive decline over time in later life. The fourth paper examined the prevalence of self-reported orofacial pain symptoms and their correlates at the last year of life among Chinese older adults. Low socioeconomic status, smoking, chronic conditions, oral hygiene practice, and natural teeth condition were associated with such symptoms. This symposium offers valuable insights to improve oral health and dental care in older adults in China.


2020 ◽  
Author(s):  
Shaojie Li ◽  
Yongtian Yin ◽  
Lijun Chen ◽  
Guanghui Cui ◽  
Jiaqin Li ◽  
...  

BACKGROUND Older adults’ health literacy levels are crucial to improving health outcomes and health-related quality of life (HRQoL). However, the impact of eHealth literacy on HRQoL in older adults is unclear. OBJECTIVE The aim of this study was to examine the association between eHealth literacy and HRQoL of older adults and provide reference for the development of network intervention measures related to the health quality of life of the older adults. METHODS An anonymous cross-sectional survey was conducted among 1,201 adults aged 60 or older from Jinan, China. The eHealth Literacy Scale and Short-Form Health Survey (SF-12) were used to measure eHealth literacy and HRQoL. We used linear regression to test the adjusted association between eHealth literacy and HRQoL. RESULTS Most participants (88.9%) had inadequate eHealth literacy. Lower eHealth literacy was related to older age ( F=12.618, P<.001), female gender( t=3.303, P<.01), living in rural areas( F=11.356, P<.001), having less education( F=59.084, P<.001), being unmarried, divorced or widowed( t=4.416, P<.001), having a lower family income( F=38.017, P<.001), living with others(χ2=4.319, P<.05), and not having health insurance( F=12.713, P<.001). There were significant differences across physical functioning( t=-4.862, P<.001), role- physical( t=-2.485, P<.05), bodily pain( t=-3.470, P<.01), general health( t=-4.449, P<.001), vitality( t=-3.498, P<.001), role-emotional( t=-2.654, P<.01), mental health( t=-4.150, P<.001), physical component summary( t=-6.350, P<.001) and mental component summary( t=-4.483, P<.001) between adequate eHealth literacy and inadequate eHealth literacy. After controlling for age, gender, and other covariates, adequate eHealth literacy was positively related to physical component summary ( beta=7.6, P<.001) and mental component summary(beta=4.6, P=.001). CONCLUSIONS This study showed that Chinese older adults with higher eHealth literacy were more likely to contribute to higher HRQoL. Thus, Older adults’ eHealth literacy levels need to be taken into account when formulating health education and promotion programs for older adults, especially when the expected outcome is to improve HRQoL.


Author(s):  
Yee Mang Chan ◽  
Norhafizah Sahril ◽  
Ying Ying Chan ◽  
Nor’ Ain Ab Wahab ◽  
Norliza Shamsuddin ◽  
...  

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence.


Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1780 ◽  
Author(s):  
Alwerdt ◽  
Patterson ◽  
Sliwinski

Sex hormone changes in adults are known to play a part in aging, including cognitive aging. Dietary intake of phytoestrogens can mimic estrogenic effects on brain function. Since sex hormones differ between genders, it is important to examine gender differences in the phytoestrogen–cognition association. Therefore, the goal of this study is to examine the relationship between urinary phytoestrogens and speed of processing (SOP) and the variation of the association between genders in older adults. Participants were drawn from the 1999–2002 National Health and Nutrition Examination Survey and included 354 individuals aged 65–85 years old. General linear models (GLMs) were used to test for significant gender differences in the relationship between phytoestrogens and SOP. Results from the GLMs showed significant gender differences in the relationship between genistein and SOP. Higher levels of genistein were associated with better SOP in women. This relationship was reversed in men: higher genistein levels were associated with worse performance. Results indicate that there are distinct gender differences in the relationship between genistein and SOP. These results emphasize the importance of considering gender differences when devising dietary and pharmacologic interventions that target phytoestrogens to improve brain health.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Abhinav J Appukutty ◽  
Lesli E Skolarus ◽  
Mellanie V Springer ◽  
William J Meurer ◽  
James F Burke

Introduction: Stroke incidence is reportedly increasing in younger adults. While increasing vascular risk factor prevalence has been suggested as a cause, the reasons for rising stroke incidence in the young are not clear. We explored several alternate explanations: trends in neurologically-focused emergency department (ED) visits, differential diagnostic classification of stroke and TIA over time, and changes in the use of advanced imaging in young and older adults. Methods: We performed a retrospective, serial, cross-sectional study on a nationally representative sample of all ED visits in the United States to quantify changes in patterns of neurologically-focused ED visits, stroke and TIA diagnoses, and rates of MRI utilization for young (18 – 44 years) and older (65+ years) adults over a 17-year period (1995 – 2000; 2005 – 2015) using National Hospital Ambulatory Medical Care Survey (NHAMCS) data. Results: In young adults, 0.4% (95% CI 0.3% – 0.5%) of neurologically-focused ED visits resulted in a primary diagnosis of stroke vs. 6.8% (95% CI 6.2% – 7.5%) for older adults. In both populations, the incidence of neurologically-focused ED visits has increased over time (+111/100,000 population/year, 95% CI +94 – +130 in the young vs. +70/100,000 population/year, 95% CI +34 – +108 in older adults). There was no evidence of differential classification of TIA to stroke over time (OR 1.001 per year, 95% CI 0.926 – 1.083 in the young; OR 1.003 per year, 95% CI 0.982 – 1.026 in older adults) and no evidence of disproportionate rise in MRI utilization for neurologically-focused ED visits in the young (OR 1.057 per year, 95% CI 1.028 – 1.086 in the young; OR 1.095 per year, 95% CI 1.066 – 1.125 in older adults). Conclusions: If the specificity of stroke diagnosis amongst ED visits is similar amongst young and older populations, then the combination of data observed here, including (1) a lower prior probability of stroke diagnoses in the young and (2) an increasing trend in neurologically-focused ED visits in both age groups, suggests that false positive diagnoses will increase over time, with a faster rise in the young compared to older adults. These data suggest a potential explanation that may contribute to higher stroke incidence in the young and merits further scrutiny.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrew Yu

PurposeThis study examines the relationship between quality and quantity of open space in residential areas and the sense of community of Chinese older adults in Hong Kong.Design/methodology/approachA survey was conducted with 257 adults aged 55 and over in Kwun Tong, Hong Kong. The quality of open space was assessed from four dimensions: social and recreational facilities, entrance, location and environment. Geographic information system (GIS) was used to evaluate the quantity of open space in terms of size and amount.FindingsThe result shows that the environment has a strong influence on the sense of community, while the quantity of open space does not. The results provide urban planners with evidence for open space planning in the future. Urban planners should consider building more people-oriented environment; such as green areas instead of merely increasing the size, amount and facilities of open space. The Hong Kong Government also needs to review the current standardised planning guideline in order to maximise the social connection of older adults.Originality/valueThis cross-sectional study tried to understand the relationship between the quality and quantity of open spaces and sense of community in Chinese older adults in Hong Kong. It is one of the few studies to simultaneously examine both the quality and quantity of open spaces when studying its relationship with sense of community.


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