scholarly journals Gender Specificity of Spousal Concordance in the Development of Chronic Disease Among Middle-Aged and Older Chinese Couples:  A Prospective Dyadic Analysis

2020 ◽  
Author(s):  
Jing Liao ◽  
Jing Zhang ◽  
Jinzhao Xie ◽  
Jing Gu

Abstract Background This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Methods Data of 3420 couples (husbands: mean age, 57.5 years, SD = 8.5; wives: mean age, 55.6 years, SD = 8.0) were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was used to analyze the incidence of chronic disease development over 4 years, conditional on the spousal baseline chronic disease status; and stepwise adjusting for the couples’ sociodemographic characteristics (i.e. age, education, retirement status and household income), and their individual lifestyle (i.e. smoking, drinking, exercise, social participation and (pre-)obesity) all measured at baseline. Results The incidence of chronic diseases after 4 years of follow-up was 34.5% in the husbands (727/2110) and 37.2% in the wives (882/2371). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had a chronic disease at baseline showed an increased risk of developing a chronic disease over 4 years (ORadjusted=1.37, 95% CI:1.14,1.63), but this risk was not statistically-significant for wives (ORadjusted=1.16, 95%CI:0.97,1.40). Conclusions Our study identified gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older- Chinese couples. This finding may contribute to the design of couple-based intervention for disease prevention and management for community-dwelling older adults.

Author(s):  
Jing Liao ◽  
Jing Zhang ◽  
Jinzhao Xie ◽  
Jing Gu

This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Data of 3420 couples were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was used to analyze the incidence of chronic disease development over 4 years, conditional on the spousal baseline chronic disease status; and stepwise adjusting for the couples’ sociodemographic characteristics (i.e., age, education, retirement status and household income), and their individual lifestyle (i.e., smoking, drinking, exercise, social participation and BMI) all measured at baseline. The incidence of chronic diseases after 4 years of follow-up was 22.95% in the husbands (605/2636) and 24.71% in the wives (623/2521). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had chronic diseases at baseline showed an increased risk of developing chronic diseases over 4 years (ORadjusted = 1.24, 95%CI: 1.02, 1.51), but this risk was not statistically-significant for wives (ORadjusted = 0.88, 95%CI: 0.71, 1.08). Our study identified gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. This finding may contribute to the design of couple-based intervention for disease prevention and management for community-dwelling older adults.


2017 ◽  
Vol 8 (5) ◽  
pp. 513-519 ◽  
Author(s):  
T. Bianco-Miotto ◽  
J. M. Craig ◽  
Y. P. Gasser ◽  
S. J. van Dijk ◽  
S. E. Ozanne

Developmental origins of health and disease (DOHaD) is the study of how the early life environment can impact the risk of chronic diseases from childhood to adulthood and the mechanisms involved. Epigenetic modifications such as DNA methylation, histone modifications and non-coding RNAs are involved in mediating how early life environment impacts later health. This review is a summary of the Epigenetics and DOHaD workshop held at the 2016 DOHaD Society of Australia and New Zealand Conference. Our extensive knowledge of how the early life environment impacts later risk for chronic disease would not have been possible without animal models. In this review we highlight some animal model examples that demonstrate how an adverse early life exposure results in epigenetic and gene expression changes that may contribute to increased risk of chronic disease later in life. Type 2 diabetes and cardiovascular disease are chronic diseases with an increasing incidence due to the increased number of children and adults that are obese. Epigenetic changes such as DNA methylation have been shown to be associated with metabolic health measures and potentially predict future metabolic health status. Although more difficult to elucidate in humans, recent studies suggest that DNA methylation may be one of the epigenetic mechanisms that mediates the effects of early life exposures on later life risk of obesity and obesity related diseases. Finally, we discuss the role of the microbiome and how it is a new player in developmental programming and mediating early life exposures on later risk of chronic disease.


2018 ◽  
Vol 9 (4) ◽  
pp. 711-719 ◽  
Author(s):  
Huiying Liu ◽  
Vivian W Q Lou

Abstract Although ecological momentary assessment (EMA) has been used in youth and adult populations, very few of the studies provided evidence of the feasibility and utility of smartphone-based EMA protocols to collect biopsychosocial data from aging populations. This study aimed to describe the design and implementation of a smartphone-based EMA protocol, and to evaluate the feasibility and utility of this EMA protocol among community-dwelling late-middle-aged and older Chinese. A sample of 78 community-dwelling Chinese aged between 50 and 70 years was trained to participate in a 1-week EMA data collection, during which each participant carried an Android smartphone loaded with a researcher-developed EMA application and a smartphone-based electrocardiogram (ECG) monitor to provide psychosocial (e.g., daily activities, social interaction, affect) data and ECG recordings six times daily. Adherence was demonstrated with a total response rate of 91.5% of all scheduled assessments (n = 3,822) and a moderately high level of perceived feasibility. Female participants reported higher compliance to the study and rated the overall experience as more pleasant and interesting than male participants. Our study provided the first evidence of the feasibility and utility of smartphone-based EMA protocols among late-middle-aged and older Chinese. Key areas for improvement in future design and implementation of mobile-based EMA include the incorporation of usable technology, adequate and training, and timely assistance.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254956
Author(s):  
Elizabeth R. Ralston ◽  
Priscilla Smith ◽  
Joseph Chilcot ◽  
Sergio A. Silverio ◽  
Kate Bramham

Background Women with chronic disease are at increased risk of adverse pregnancy outcomes. Pregnancies which pose higher risk, often require increased medical supervision and intervention. How women perceive their pregnancy risk and its impact on health behaviour is poorly understood. The aim of this systematic review of qualitative literature is to evaluate risk perceptions of pregnancy in women with chronic disease. Methods Eleven electronic databases including grey literature were systematically searched for qualitative studies published in English which reported on pregnancy, risk perception and chronic disease. Full texts were reviewed by two researchers, independently. Quality was assessed using the Critical Appraisal Skills Programme Qualitative checklist and data were synthesised using a thematic synthesis approach. The analysis used all text under the findings or results section from each included paper as data. The protocol was registered with PROSPERO. Results Eight studies were included in the review. Three themes with sub-themes were constructed from the analysis including: Information Synthesis (Sub-themes: Risk to Self and Risk to Baby), Psychosocial Factors (Sub-themes: Emotional Response, Self-efficacy, Healthcare Relationship), and Impact on Behaviour (Sub-themes: Perceived Risk and Objective Risk). Themes fitted within an overarching concept of Balancing Act. The themes together inter-relate to understand how women with chronic disease perceive their risk in pregnancy. Conclusions Women’s pregnancy-related behaviour and engagement with healthcare services appear to be influenced by their perception of pregnancy risk. Women with chronic disease have risk perceptions which are highly individualised. Assessment and communication of women’s pregnancy risk should consider their own understanding and perception of risk. Different chronic diseases introduce diverse pregnancy risks and further research is needed to understand women’s risk perceptions in specific chronic diseases.


2008 ◽  
Vol 23 (2) ◽  
pp. 185-194 ◽  
Author(s):  
Andrew C. Miller ◽  
Bonnie Arquilla

AbstractBackground:Inadequately controlled chronic diseases may present a threat to life and well-being during the emergency response phase of disasters. Chronic disease exacerbations (CDE) account for one of the largest patient populations during disasters, and patients are at increased risk for adverse outcomes.Objective:The objective of this study was to assess the burden of chronic renal failure, diabetes, and cardiovascular disease during disasters due to natural hazards, identify impediments to care, and propose solutions to improve the disaster preparation and management of CDE.Methods:A thorough search of the PubMed, Ovid, and Medline databases was performed. Dr. Miller's personal international experiences treating CDE after disasters due to natural hazards, such as the 2005 Kashmir earthquake, are included.Discussion:Chronic disease exacerbations comprise a sizable disease burden during disasters related to natural hazards. Surveys estimate that 25–40% of those living in the regions affected by hurricanes Katrina and Rita lived with at least one chronic disease. Chronic illness accounted for 33% of visits, peaking 10 days after hurricane landfall. The international nephrology community has responded to dialysis needs by forming a well-organized and effective organization called the Renal Disaster Relief Task Force (RDRTF). The response to the needs of diabetic and cardiac patients has been less vigorous.Patients must be familiar with emergency diet and renal fluid restriction plans, possible modification of dialysis schedules and methods, and rescue treatments such as the administration of kayexalate. Facilities may consider investing in water-independent extracorporeal dialysis techniques as a rescue treatment. In addition to patient databases and medical alert identification, diabetics should maintain an emergency medical kit. Diabetic patients must be taught and practice the carbohydrate counting technique. In addition to improved planning, responding agencies and organizations must bring adequate supplies and medications to care for diabetic, cardiac, and renal patients during relief efforts.Conclusions:By recognizing and addressing impediments to the care of chronic disease exacerbations after natural disasters, the quality, delivery, and effectiveness of the care provided to diabetic patients during relief efforts can be improved.


2019 ◽  
Vol 25 (2) ◽  
pp. 163 ◽  
Author(s):  
Thi Thu Le Pham ◽  
Sarah Callinan ◽  
Michael Livingston

Risky alcohol use places those with existing chronic conditions at increased risk of medical complications. Yet, there is little research assessing the alcohol consumption among this group. The aim of this study is to assess the prevalence of risky drinking among people with a range of chronic diseases. As part of the 2013 National Drug Strategy Household Survey (NDSHS), 22684 Australians aged ≥18 years answered questions about their experience of chronic diseases and their drinking patterns. Nearly 18% (CI: 17.2–19.3) of people with chronic disease reported drinking at a long-term risky level, roughly the same rate as those without chronic disease (19.3%, (CI: 18.6–20.2)). Nearly one-quarter, 24% (CI: 23.0–25.3), of people with chronic diseases drank at levels of increased short-term risk, significantly less than the rest of the sample. Respondents with mental illness were more likely to drink at risky levels than the rest of the sample, while the reverse was true of those with diabetes. Overall, those with chronic diseases have similar drinking patterns to the rest of the population, despite increased risks associated with this consumption. Regular screening and subsequent brief interventions for those with chronic disease, particularly mental illness and cancer, are recommended.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S829-S830
Author(s):  
Min Li ◽  
Fang-Yi Huang

Abstract Objectives. This study investigates how social participation of the aging population is associated with the community capacity, measured by the number of amenities and organizations within the community. Method. Using nationally representative survey data from the China Health and Retirement Longitudinal Study (2011), this study examines the availability of community amenities and organizations in rural and urban areas, and investigates the associations between community capacity and social participation among the middle aged and older Chinese using multilevel analysis. Results. The results of this study indicate that both community amenities and community organizations are positively associated with the social participation of the middle-aged and older Chinese. Additionally, the association between community organizations and the frequency of formal social participation is stronger among urban communities than rural ones, even after controlling for the individual-level socioeconomic status and health conditions. Conclusion. This study highlights the importance of building the community capacity by developing community-based grassroots organizations to promote the social engagement and participation of the aging population.


2022 ◽  
pp. 206-224
Author(s):  
Irina M. Matran ◽  
Tuan Quoc Le ◽  
Monica Tarcea

As living standards change with the development of modern industry and social encounters, people tend to change their lifestyle and environment exposure along with their psychophysiological factors, leading to an imbalance of homeostasis and increasing the risk for chronic diseases. In addition to ingredients, methods, and food conditions storage and processing, the use of additives and certain new foods have facilitated the increased occurrence of chronic diseases in children or adults. The interaction of some components of the food system with enzymes that metabolize different types of drugs can affect the body's clearance and therapeutic index.The objective of this chapter was to present the general principles of food development for special nutritional conditions, also the adjuvants used for chronic disease status improvement, under the condition of nutritional nutrivigilence and food safety standards, and specific to introduce an adjuvant food for atopic dermatitis management.


2020 ◽  
Vol 37 (6) ◽  
pp. 839-844
Author(s):  
Muhammad Danial Hadi ◽  
Yongxing Patrick Lin ◽  
Ee-Yuee Chan

Abstract Background Chronic diseases continue to be a significant cause of morbidity and mortality despite modifiable risk factors. This suggests that current primary healthcare provision needs to delve beyond patient education, to understand the motivators that drive patients to undertake chronic disease self-management. Understanding these motivations within the context of a multi-cultural community can facilitate tailored support for chronic disease self-management. Objectives To explore the motivations behind effective chronic disease self-management in community dwelling adults in Singapore. Methods A qualitative descriptive study was carried out in five clinics in a large medical centre. Twelve participants who were assessed to be optimally managing their chronic diseases were recruited using purposive sampling. Individual in-depth interviews were conducted until data saturation, with data thematically analysed. Results Three salient themes emerged from the data. Firstly, ‘Regaining self-control, avoiding complications’ describes the participants’ journey towards personal mastery in self-management, as well as a fear of debilitating complications resulting in their desire for good health. Secondly, ‘Preserving social identities and roles’ illustrates how participants yearn to maintain their pre-existing roles and functions through maintenance of their health. Finally, ‘Accessing proximal support systems’ highlights resources and supports surrounding the participants that encourage continued chronic disease self-management. Within each theme, specific motivators and challenges encountered by participants in their self-management journey were discussed. Conclusions Findings can prompt primary healthcare providers to leverage on the patients’ life goals and social roles in chronic disease self-management support. This may empower patients to engage in self-management and strengthen primary care provision.


F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 137
Author(s):  
Chuangzhou Xu ◽  
Christian A Gericke

Introduction: Chronic disease has become a major problem affecting the health of the Chinese population. In response to this situation, the New Rural Cooperative Medical Scheme (NRCMS) has begun to provide health cover for outpatients with chronic disease expenses, made possible by the increased risk pool of previous years. We compare the differences between Benefit Packages for Chronic Diseases Outpatients (BPCDO) in order to produce a reference for policy makers.Methods: Information on the various BPCDO was located by searching the official NRCMS website in Chinese, using certain criteria to select the ideal BPCDO. Population coverage, service coverage and cost of coverage were chosen to form the analytical framework for this paper. The diseases were classified according to the World Health Organisation's (WHO) International Classification of Diseases (ICD-10).Results: To avoid “moral hazard”, complex processes have been created. This has resulted in chronic disease patients finding it very difficult to become beneficiaries. Forty-one types of chronic diseases were listed in 32 different BPCDO. We found that different counties have different co-payment rates, deductible lines, ceilings, coverage of drugs and tests, appointed hospitals and reimbursement frequencies.Conclusion: High mortality diseases and diseases with a heavier cost burden should be the priority on the list of reimbursement. The BPCDO scheme should be introduced urgently at the national level. It should include twenty-one types of disease and eight essential factors.


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