While many studies have focused on the hospitalization costs of hypertensive patients, few have examined avoidable hospitalization in hypertensive patients using big data.

This study aims to assess the prevalence of avoidable hospitalization among elderly hypertensive patients in Guangdong Province, providing insights for the integration and optimization of healthcare resources in the province's medical communities.

Health data for elderly individuals in Guangdong and hospitalization records from 2022 were integrated using the Guangdong Province Primary Healthcare Information Management System, the Guangdong Province Universal Health Information Platform, and inpatient case data. Influencing factors such as the number of general practitioners (GPs) per 10 000 population and the number of visits to primary healthcare institutions were obtained from the 2022 Guangdong Provincial Health Statistics Yearbook. A Logistic regression model was used to analyze the factors contributing to avoidable hospitalization.

The rate of avoidable hospitalization among elderly hypertensive patients in Guangdong Province was 8.76%. The likelihood of avoidable hospitalization was significantly higher in females [OR (95%CI) =1.231 (1.217-1.246) ] compared to males. Using 90 years and older as a reference, hypertensive patients aged 65-69, 70-74, 75-79, and 80-84 years were 2.044 [OR (95%CI) =2.044 (1.981-2.109) ], and 1.640 times more likely to avoid the occurrence of hospitalization than older hypertensive patients aged 90 years and older, respectively [OR (95%CI) =1.640 (1.590-1.693) ], 1.288 times [OR (95%CI) =1.288 (1.248-1.329) ], and 1.110 times [OR (95%CI) =1.110 (1.073-1.147) ]. Using a GDP per capita of less than 100 000 yuan as a reference, hypertensive patients with a GDP per capita of 100 000 yuan and above were 1.314 times more likely to have an avoidable incidence of hospitalization than those with a GDP per capita of less than 100 000 yuan [OR (95%CI) =1.314 (1.278-1.350) ]. When the number of GPs was ≥4 per 10 000 population, hypertensive patients were 1.039 times more likely to have avoidable hospitalization compared to those in areas with fewer than 4 GPs per 10 000 population [OR (95%CI) =1.039 (1.105-1.063) ]. The probability of avoidable hospitalization decreased by 40.60% when the number of secondary and tertiary hospitals per 10 000 population was less than 0.20 [OR (95%CI) =0.594 (0.570-0.619) ]. Finally, compared to areas with fewer than 3 visits per capita to secondary and tertiary hospitals or grassroots institutions, those with ≥3 visits per capita had a 1.047 times higher probability of avoidable hospitalization in secondary and tertiary hospitals [OR (95%CI) =1.047 (1.021-1.074) ], and a 1.229 times higher probability in grassroots institutions [OR (95%CI) =1.229 (1.191-1.268) ] .

Gender and age are significant factors influencing avoidable hospitalization in elderly hypertensive patients. Higher GDP per capita, greater visit frequency, and more GPs were associated with increased likelihood of avoidable hospitalization, while the number of secondary and tertiary hospitals did not contribute to this risk.

Diabetes and depression are global public health issues. There is a significant correlation between diabetes and depression. Therefore, monitoring and intervening in diabetes, depression, and their comorbidity among middle-aged and elderly people is crucial.

To explores the prevalence of diabetes and depression, as well as their comorbidity, among the elderly population, and the impact of sleep, exercise, and social activities on these conditions.

Based on the 2018 China Health and Retirement Longitudinal Study, 11 177 participants who met the research criteria were included as subjects. A multifactorial Logistic regression analysis model was employed to investigate the association between sleep, exercise, and social activities with the comorbidity of diabetes and depression. Subsequently, the product of nap duration and nighttime sleep duration was incorporated into the regression model for interaction analysis.

A total of 11 177 subjects were included in the study, with a prevalence of diabetes of 13.95% (1 559/11 177), a prevalence of depressive status of 24.85% (2 777/11 177), and a comorbidity prevalence of both diabetes and depressive status of 14.64% (1 636/11 177). The results of the multinomial Logistic regression analysis indicated that a nighttime sleep duration of 7 to 9 hours (OR=0.337, 95%CI=0.296-0.384), a nighttime sleep duration greater than 9 hours (OR=0.509, 95%CI=0.374-0.692), and a nap duration greater than 90 minutes (OR=0.792, 95%CI=0.666-0.941) were all protective factors for the comorbidity of diabetes and depressive status. High levels of social interaction were also found to reduce the risk of comorbidity (OR=0.778, 95%CI=0.686-0.882, P<0.05). The interaction analysis results showed that maintaining a nighttime sleep duration of 7 to 9 hours, regardless of nap duration, was effective in preventing the comorbidity of diabetes and depressive status (P<0.001). If the nighttime sleep duration is less than 7 hours, a nap duration of 60 to 90 minutes can also reduce the risk of comorbidity (OR=0.740, 95%CI=0.577-0.950, P<0.05). In the case of a nighttime sleep duration greater than 9 hours, not taking a nap (OR=0.270, 95%CI=0.125-0.581) or maintaining a nap duration of 60 to 90 minutes (OR=0.165, 95%CI=0.040-0.674) can also reduce the risk of comorbidity.

The comorbidity prevalence of diabetes and depressive status among middle-aged and elderly people in China is relatively high (14.64%). Nighttime sleep duration of more than 7 hours, nap duration of more than 90 minutes, and a high level of social interaction can all effectively reduce the risk of comorbidity of diabetes and depressive status. Moderate levels of physical activity can reduce the risks of diabetes and depressive status respectively. Napping serves as a compensatory mechanism, helping to make up for insufficient nighttime sleep. If nighttime sleep is less than 7 hours, controlling the nap duration to 60 to 90 minutes can also reduce the risk of comorbidity of diabetes and depressive status.

Existing studies have extensively explored the association between the triglyceride-glucose index (TyG) and cardiometabolic diseases (CMD), while the relationship between TyG and the occurrence of cardiometabolic multimorbidity (CMM) in the elderly population has been overlooked.

This study aims to investigate the association between TyG and the incidence of CMM in the elderly population.

A prospective cohort study was conducted using the Cheeloo Lifetime Electronic Health Database (Cheeloo LEAD), selecting elderly individuals aged ≥60 years in 2016. Using 2016 as the baseline, the study endpoints were defined as the occurrence of CMM or death, with the follow-up period lasting until December 31, 2022. Participants were divided into four groups based on the quartiles of the baseline TyG: Q1 (5.88≤TyG<8.22), Q2 (8.22≤TyG<8.53), Q3 (8.53≤TyG<8.90), and Q4 (8.90≤TyG<11.33). Kaplan-Meier survival curves were plotted, and Cox proportional hazards models were used to assess the impact of TyG on the risk of incident CMM. Subgroup and sensitivity analyses were also conducted. Restrictive cubic splines (RCS) were applied to explore the relationship between TyG and CMM.

A total of 15 258 participants were included in the analysis, with 3 875 in the Q1 group, 3 776 in the Q2 group, 3 840 in the Q3 group, and 3 767 in the Q4 group. The average follow-up time was 5.63 years, totaling 85 862.48 person-years of follow-up. There were 1 328 new cases of CMM (8.70%). The cumulative incidence rates of new CMM in the Q1-Q4 groups were 5.81%, 7.65%, 9.27%, and 12.16%, respectively. The comparison of CMM incidence rates among the four groups showed statistically significant differences (χ²=104.300, P<0.001). The results of the fully adjusted Cox proportional hazards model showed that, compared to the Q1 group, the risk of incident CMM in the Q2, Q3, and Q4 groups increased by 25.4% (HR=1.254, 95%CI=1.052-1.494, P<0.05), 42.0% (HR=1.420, 95%CI=1.196-1.686, P<0.001), and 83.6% (HR=1.836, 95%CI=1.535-2.195, P<0.001), respectively. The trend test in the Cox model indicated a dose-response relationship between TyG and the risk of incident CMM. This association was consistent in subgroup analyses based on sex and BMI, as well as in sensitivity analyses (P<0.05). RCS analysis showed a dose-response relationship between TyG and the risk of new CMM (P<0.001, P_{non-linearity}=0.175) .

TyG is an independent risk factor for incident CMM in the elderly population, with a dose-response relationship between the two. As TyG levels increase, the risk of incident CMM rises, and high TyG levels significantly elevate the risk of CMM, particularly in males and individuals with higher BMI. Controlling TyG levels plays an important role in disease prevention among the elderly population.

Frailty and metabolic syndrome (MetS) are both common geriatric conditions and may have potentially important links in terms of risk factors, body composition and metabolic mechanisms, which could jointly affect the prognosis of older patients with gastric cancer. Clearly distinguishing the characteristics of the two syndromes and elucidating their intrinsic relationship can help to develop precise and targeted preoperative management strategies.

To compare the characteristics of preoperative frailty and MetS in older patients with gastric cancer, focusing on general information, blood indicators and body compositions, then analyze their correlation.

A total of 286 patients aged 60 to 80 years who were admitted to the Gastrosurgery Department of the Jiangsu Province Hospital for gastric malignancy from August 2021 to August 2022 were included and divided into the four groups: the frailty group (n=45), the MetS group (n=58), the frailty+MetS group (n=12) and the normal group (n=171) based on the presence of frailty and MetS, and the clinical indicators of these groups were compared. With frailty as the dependent variable, Logistic regression analysis was conducted to investigate the correlation of MetS and the diagnostic indicators with preoperative frailty.

Statistically significant differences were observed among the four groups in terms of age, comorbidities, Nutritional Risk Screening 2002 (NRS2002) scores>3, fasting blood glucose, triglyceride, high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), hemoglobin, albumin, height, body mass, waist circumference, BMI, fat content, fat mass index, body fat percentage, visceral fat area, skeletal muscle content, skeletal muscle mass index, limb skeletal muscle mass index, muscle percentage, fat to muscle ratio and muscle to fat ratio (P<0.05). Multivariate Logistic regression analysis showed that age (OR=1.115, 95%CI=1.046-1.190), history of smoking (OR=2.156, 95%CI=1.134-4.096), NRS2002 score>3 (OR=2.359, 95%CI=1.159-4.802), CRP (OR=1.038, 95%CI=1.003-1.073) and central obesity (OR=0.405, 95%CI=0.183-0.896) were the risk factors for frailty in older patients with gastric cancer (P<0.05) .

The frailty group showed advanced age, elevated levels of inflammation and increased nutritional risk, along with an overall decline in fat and muscle composition. The MetS group showed increased comorbidities, elevated inflammation and albumin levels, abnormal markers of glycolipid metabolism, and overall increased fat and muscle composition. The frailty+MetS group had increased comorbidities, abnormal fasting blood glucose and HDL-C levels with increases only in fat-related components but no significant changes in muscle components. Thus, frailty was not significantly associated with MetS in this study.

With the global population aging at an accelerating rate, the rapid growth of the elderly population in China presents a series of health challenges, particularly in the management of chronic conditions such as hypertension, diabetes, and dyslipidemia. Residents of original residential communities, a unique social unit within the urbanization process, experience a higher prevalence of comorbidities related to these conditions. This underscores the urgent need for effective and comprehensive management strategies. Family function plays a critical role in the management of chronic diseases. For patients with the hypertension, diabetes, and dyslipidemia, family support is not only crucial for improving treatment outcomes but also a key factor in enhancing overall quality of life.

This study aims to investigate the prevalence of comorbidities and family function among older people of original residential communities of Guangzhou with hypertension, diabetes, and dyslipidemia.

The survey was based on the annual health examination services for patients with hypertension and type 2 diabetes, in accordance with the National Basic Public Health Service Standards (Third Edition). Stratified random sampling was used to conduct a questionnaire survey with the APGAR scale among patients of comorbidities of hypertension, diabetes, and dyslipidemia over 60 years old in Panyu District, Guangzhou, between January and June 2023. To explore the multimorbidity and family functioning status of original residential communities of Guangzhou and its associated factors.

A total of 2 507 patients were surveyed. Among them, 202 patients (8.1%) had only one condition, 1 712 patients (68.3%) had two conditions, and 593 patients (23.7%) had all three conditions. Statistically significant differences (P<0.05) were observed in the types of conditions present based on variables such as gender, place of residence, number of household members with hypertension, diabetes, and dyslipidemia, BMI, exercise habits, fasting blood glucose levels, lipid profiles, and family function score. The prevalence ratio for hypertension, dyslipidemia, and diadetes was 2.4∶2.4∶1. Among the comorbidity patterns, hypertension combined with diadetes was the most common (1 404 cases, 56.0%), followed by patients with all three conditions (593 cases, 23.7%). No statistically significant differences (P>0.05) were found in the distribution of different comorbidity patterns between genders or across age groups. The mean total family function score was (7.63±1.83). Significant differences (P<0.05) were found in the partnership, affection, and resolve sub-scores, as well as in the total family function scores, among patients with different disease patterns. Multivariate linear regression analysis identified gender (female: β=-0.148, t=-2.275, P=0.023), place of residence (apartment complex: β=-0.155, t=-2.402, P=0.016), and fasting blood glucose levels (abnormal glucose: β=-0.045, t=-2.465, P=0.014) as risk factors for lower total family function scores. On the other hand, the number of family members with hypertension, diabetes, and dyslipidemia (two or more: β=0.174, t=2.356, P=0.026) and the type of disease patterns ("comorbidity of two conditions": β=0.193, t=2.586, P=0.010; "comorbidity of all three conditions": β=0.342, t=3.248, P=0.001) were identified as protective factors for higher total family function scores.

Elderly patients with the hypertension, diabetes, and dyslipidemia in original residential community of Guangzhou metropolitan predominantly exhibit "a comorbidity of two conditions" pattern with generally good family function. Gender, place of residence, the number of family members with hypertension, diabetes, and dyslipidemia, type of diseases and fasting blood glucose are key influencing factors of family function.

With the acceleration of population aging, chronic disease comorbidities have become a major public health problem threatening the health of the elderly. There is a close correlation between chronic disease comorbidity and activity of daily living (ADL). However, there are few studies on the influence of chronic disease comorbidity and comorbidity pattern on ADL.

To understand the impact of chronic disease comorbidity on ADL, to provide a reference for improving the quality of life of the elderly.

From June to July 2022, a multi-stage stratified random cluster sampling method was used to conduct a face-to-face household survey among 20 821 residents in 4 counties of Ningxia Hui Autonomous Region, including demographic characteristics, chronic diseases, and ADL impairment. In this study, 4 362 elderly people (≥60 years) were included as subjects. Potential category analysis was used to determine comorbidity patterns, and Logistic regression was used to analyze the effects of chronic disease comorbidity and different comorbidity patterns on activities of daily living.

The prevalence of chronic diseases among the elderly included was 62.52% (2 727/4 362), the prevalence of comorbidities was 23.75% (1 036/4 362), the ADL damage rate was 18.36% (801/4 362). Five comorbidity patterns were identified based on the latent category analysis, namely the coronary heart disease comorbidity group, the rheumatoid arthritis comorbidity group, the diabetes comorbidity group, the hypertension comorbidity group, and the multisystem disease comorbidity group. Adjusting for factors such as gender, age, educational level, marital status, occupation, annual per capita household income, smoking, alcohol consumption, exercise status, and self-rated health status, elderly people with comorbidity had 1.909 times (95%CI=1.581-2.305, P<0.05) risk of impaired ADL than those without comorbidity, older adults in the rheumatoid arthritis comorbidity group had a higher risk of impaired ADL than those in the coronary heart disease comorbidity group [OR (95%CI) =1.834 (1.245-2.701), P<0.05] .

Older adults with chronic comorbidities have a higher risk of ADL impairment than older adults without chronic comorbidities. There are differences in the risk of ADL impairment among the elderly with different comorbidity patterns of chronic diseases. The risk of ADL impairment in the elderly in the comorbidity group of rheumatoid arthritis is higher than that in the comorbidity group of coronary heart disease. Therefore, there is an urgent need to pay more attention to elderly people with chronic disease comorbidities, appropriate measures should be taken to improve their health and improve their quality of life.

Elderly hypertension combined with cognitive impairment has been one of the global public health problems. A systematic evaluation of the prevalence of mild cognitive impairment (MCI) in elderly hypertension patients in China helps provide data support for the prevention and treatment of cognitive impairment in elderly hypertension patients.

To analyze the prevalence rate of MCI in elderly hypertensive patients in China by meta-analysis, and further explore the development trend of the prevalence rate.

Chinese and English databases including CNKI, Wanfang Data, VIP, CBM, PubMed, Cochrane Library, Embase and Web of Science were systematically searched from self-built database to February 22, 2024. NoteExpress software was used for literature management and screening, and the American Institute for Agency for Healthcare Research and Quality (AHRQ) cross-section research evaluation criteria was used for literature quality evaluation. Meta-analysis and subgroup analysis were performed by StataMP 14.0 software.

Twenty-seven cross-sectional studies from 2008 to 2023 were systematically analyzed, involving 57 461 elderly patients with hypertension and 11 812 patients with the disease. A random effects model was used for meta-analysis, and the overall prevalence was 21.3% (95%CI=18.4%-24.2%, P<0.001). A total of 11 provinces/cities/autonomous regions were included in the study, and the prevalence rate varied greatly among provinces/cities/autonomous regions and among geographical regions. The overall prevalence rate showed a fluctuating trend with time from 2008 to 2023. Subgroup analysis showed that the prevalence of MCI was 33.6% (95%CI=6.4%-60.7%, P<0.001) in rural and 21.8% (95%CI=18.1%-25.4%, P<0.001) in urban elderly patients with hypertension. The prevalence in North China (14.0%, 95%CI=9.3%-18.7%, P<0.001) was lower than that in other regions. The prevalence of MMSE+MoCA combined application was 25.9% (95%CI=15.8%-36.0%), and the prevalence of MoCA alone was 21.4% (95%CI=18.5%-24.4%) and MMSE alone was 17.9% (95%CI=13.9%-21.9%) .

The overall prevalence rate of MCI in elderly hypertensive patients in China is high, and there are great differences between different provinces and cities, urban and rural prevalence rate, and the trend of dynamic change with time. The detection rate of MCI varies greatly among different assessment tools, which is affected by the quantity and heterogeneity of literature studies. The conclusion needs to be confirmed by further high-quality studies.

Type 2 diabetes mellitus (T2DM) among the elderly has become a significant public health problem both globally and in China, affecting population health. It is extremely urgent to clarify the related disease burden.

To assess the disease burden of T2DM among the elderly population globally and in China from 1990 to 2021, project future trends, and offer insights to inform public health and medical decision-makings.

Data on incidence and mortality burdens of individuals aged 60 years and above with T2DM in China and around the world were extracted from the global Burden of Disease (GBD) 2021 database. Age-standardized incidence and mortality rates were estimated based on the GBD 2021 standard population. Joinpoint regression was utilized to calculate the average annual percentage change (AAPC) for assessing disease burden trends. Subgroup analyses were performed based on age and sex, and decomposition analysis was performed to examine how aging, population growth, and epidemiological changes impacted disease burden. Bayesian models were employed to forecast prevalence and mortality between 2022 and 2035.

In 2021, the global incidence of T2DM stood at 6 047 049, while in China, it reached 800 764, representing increases of 178.68% and 220.28%, respectively, compared to the incidence in 1990. Over the period from 1990 to 2021, the global age-standardized incidence rate exhibited a significant overall upward trend (AAPC=1.21%, P<0.001), whereas the trend in China was not statistically significant (AAPC=0.29%, P=0.189). The number of deaths among elderly T2DM patients in 2021 in the global and Chinese populations was 1 304 150 and 149 972, respectively, marking increases of 164.68% and 197.98% compared to the number of deaths in 1990. Throughout the same period, the global age-standardized mortality rate displayed a consistent upward trend (AAPC=0.32%, P<0.001), while the trend in China remained relatively stable (AAPC=0.01%, P=0.922). Notably, the number of incidence and mortality for female in 1990 and 2021, globally and in China, exceeded those of males. Meanwhile, the 60-64 age group had the highest proportion of incidences in 2021, while the 70-74 age group had the highest proportion of deaths. Population growth emerged as the primary influencer driving the rise in incidence and mortality in elderly T2DM patients in both global and Chinese populations, as revealed by decomposition analysis. The projection indicates a continued increase in the incidence and mortality of elderly T2DM patients worldwide and in China from 2022 to 2035.

The persistent heavy burden of incidence and mortality among elderly individuals with T2DM in both global and Chinese populations necessitates urgent reinforcement and formulation of more effective public health policies and clinical prevention and control strategies to alleviate the fundamental burden associated with this demographic.

Cognitive impairment is one of the serious risk factors affecting the quality of life in the elderly. Some studies have found an association between frailty and cognitive function, but research on mediating and moderating effects between the two is relatively scarce.

To explore the influence of frailty on cognitive function, and to investigate the mediating role of activities of daily living and depressive symptoms between frailty and cognitive function. Additionally, the moderating effect of social participation will be analysed.

Using data from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS), 8 173 individuals aged 65 and older were selected to obtain relevant information on frailty, cognitive function, activities of daily living, depressive symptoms, social participation, and demographic data among the elderly. The differences in cognitive function among elderly individuals with different characteristics were analyzed. Pearson correlation analysis was employed to investigate the interrelationships between the variables. Stratified regression was utilised to examine the impact of frailty on cognitive function. The Process macro programme was used to test the chain mediating role of activities of daily living and depressive symptoms between frailty and cognitive function, and the moderating effect of social participation within it.

Of the 8 173 participants, 1 769 (21.6%) had cognitive impairment and all variables were correlated. Stratified regression analyses showed frailty negatively predicts cognitive function (B=-2.862, P<0.001). The results of the chain-mediated effects analysis showed that the activities of daily living (B=-1.713, 95%CI=-1.944 to -1.498) and depressive symptoms (B=-0.435, 95%CI=-0.531 to -0.345) mediated the link between cognitive function and frailty to some extent. The interaction term between frailty and social participation (B=1.140, 95%CI=0.822 to 1.457) as well as the interaction term between depression and social participation (B=0.113, 95%CI=0.015 to 0.211) both significantly and positively predicted cognitive function, while the interaction term between activities of daily living and social participation was negatively correlated with cognitive function (B=-0.413, 95%CI=-0.560 to -0.266) .

Social participation moderated the direct and indirect effects of activities of daily living and depressive symptoms on the relationship between frailty and cognitive function. The findings indicate that interventions targeting older people's mental health and enhancing the quality of social relationships may facilitate the dissolution of the correlation between frailty and cognitive impairment.

The elderly population in our country is large and growing rapidly, and depression is a common emotional disorder and mental health problem among the elderly population. The mental health of the female elderly population is increasingly becoming a focus of social concern.

To explore the influencing factors of depression symptoms in the female elderly population from a multi-level and comprehensive perspective of health ecology, and provide theoretical basis for identifying and intervening in depression symptoms in the elderly female population in China.

In January 2024, we extracted for the 2020 survey data from the China Health and Retirement Longitudinal Survey (CHARLS), and a group of female elderly adults aged 60 years and above were selected for the study (n=4 594). Based on the health ecology model, the influencing factors were divided into five levels: personal characteristics layer, behavioural characteristics layer, interpersonal network layer, living and working conditions layer, and policy environment layer. The χ² test and binary Logistic regression model were used to explore the influencing factors of depression symptoms and to establish a health ecology model of depression symptoms in the Chinese female elderly population.

The detection rate of depression symptoms in the Chinese female elderly population was 48.06% (2 208/4 595). Logistic regression analysis showed that age of ≥80 years (OR=0.601, 95%CI=0.449-0.804), sleep duration of≥6 h (OR=0.561, 95%CI=0.493-0.639), satisfaction with life (OR=0.256, 95%CI=0.199-0.330), better self-rated physical health (OR=0.459, 95%CI=0.395-0.533), urban household registration (OR=0.717, 95%CI=0.603-0.853), satisfaction with children (OR=0.666, 95%CI=0.472-0.940), education level of junior high school and above (OR=0.712, 95%CI=0.582-0.871), family income >50 000 yuan (OR=0.822, 95%CI=0.704-0.959) and the per capita GDP of the city is 50 000 to 100 000 yuan (OR=0.841, 95%CI=0.730-0.970) were the protective factors for the development of depression symptoms in the Chinese female elderly population (P<0.05). Having become disabled (OR=1.786, 95%CI=1.556-2.050), suffering from chronic diseases (OR=1.159, 95%CI=1.014-1.324), central region (OR=1.298, 95%CI=1.107-1.522) and western region (OR=1.407, 95%CI=1.183-1.675) were the risk factors for depression symptoms in the Chinese female elderly population (P<0.05) .

The detection rate of depression symptoms in the Chinese female elderly population is relatively high, and there are many influencing factors, including: age in the personal characteristics layer; sleep time, satisfaction with life, self-related of physical health, disability, and chronic disease in the behavioral characteristics layer; household registration type, satisfaction with children, and geographical distribution in the interpersonal network layer; education and family income in the living and working conditions layer; the per capita GDP of the city in the policy environment layer. Effective intervention measures should be taken at all layers, targeting key populations, in order to reduce the incidence of depression symptoms among the Chinese elderly women.

The aging of Chinese society has intensified, and the health of the elderly is a matter of great concern. As a densely populated and economically active area, the health of the elderly population in Huangpu District, Guangzhou City, is particularly important to the social and economic development of the local community. Therefore, regular monitoring and assessment of the health of the elderly population in Huangpu District can help identify potential health problems, prevent and control chronic diseases, and improve health literacy and self-care ability.

This study collects data on health checkups of the elderly population in Huangpu District and establishes a retrospective cohort to gain an in-depth understanding of the health status of the elderly population in the district, the influencing factors of diseases, and to provide reasonable suggestions for the development of targeted health interventions to improve the quality of life of the elderly.

Physical examination data were collected from 2019-2021 from Huangpu District, Guangzhou City, who participated in community health checkups and were≥65 years old, and the study involved basic information, history of living habits, auxiliary examinations, laboratory tests, and history of previous illnesses of the study subjects. Logistic regression analysis was performed on the influencing factors of the diseases.

A total of 17 412 study subjects were included in the analysis of this study. In the "baseline-follow-up" cohort, there were statistically significant differences (P<0.05) in the prevalence of exercise, smoking, alcohol consumption, diastolic blood pressure, BMI, waist circumference, fasting blood glucose, blood creatinine, glomerular filtration rate, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-Ｃ), hypertension, diabetes mellitus, dyslipidemia, and chronic kidney disease (CKD). Differences in terms of were statistically significant (P<0.05). The proportion of developing hypertension, diabetes mellitus, dyslipidemia, or CKD at follow-up in the cohort population was 3.07%, 7.25%, 21.92%, and 6.00%, respectively. In participants with new-onset chronic disease at follow-up, 45.63% had comorbidities. Multifactorial logistic regression analysis: Risk factors for the prevalence of hypertension included age, pulse rate, and BMI; glomerular filtration rate and HDL-C were protective factors. Risk factors for the development of diabetes mellitus included age, systolic blood pressure, and BMI; and HDL-C was the main protective factor (P<0.05). Risk factors for dyslipidemia include systolic blood pressure. Risk factors for the development of CKD include age, systolic blood pressure, fasting blood glucose, and triglycerides (P<0.05) ; HDL-C was a protective factor (P<0.05) .

The prevalence of dyslipidemia was higher among the study population in the present study, followed by diabetes mellitus and CKD. Multiple chronic diseases predominantly suffer from both diseases. Age, systolic blood pressure, and BMI were the main risk factors for the development of chronic diseases among the elderly people who participated in the physical examination in this study. In response to the analysis, it is recommended to make full use of the health records based on the optimization of information technology, implementation of targeted interventions, leveraging community strengths as well as strengthening health education and health promotion to improve the health of the elderly.

There are a large number of middle-aged and elderly patients with chronic diseases. However, there is currently limited research on the depression status and influencing factors of middle-aged and elderly patients with chronic diseases nationwide.

By exploring the depression status and influencing factors of middle-aged and elderly patients with chronic diseases in China, to provide a reference for improving their mental health status.

According to the fifth round of national survey data conducted by the China Health and Retirement Longitudinal Study (CHARLS) in 2020, a total of 12 551 middle-aged and elderly patients with chronic diseases were selected as the study objects. The depression status of the study objects was measured using the Center for Epidemiologic Studies Depression Scale (CES-D), and the main factors affecting the depression status of middle-aged and elderly patients with chronic diseases were analyzed using the chi-square test and multivariate Logistic regression.

Among middle-aged and elderly patients with chronic diseases, the proportion of those with depressive symptoms was 40.7% (5 111/12 551). The results of multivariate Logistic regression analysis showed that: gender (male: OR=0.613, 95%CI=0.553-0.680), age (65-<75 years old: OR=0.862, 95%CI=0.769-0.965; ≥75 years old: OR=0.604, 95%CI=0.510-0.716), presence of spouse/partner living together or not (have OR=0.730, 95%CI=0.648-0.822), places of residence (rural: OR=1.515, 95%CI=1.387-1.654), educational levels (junior high school: OR=0.727, 95%CI=0.657-0.805; senior high school and above: OR=0.561, 95%CI=0.488-0.646), social status (1 item: OR=0.870, 95%CI=0.793-0.956; ≥ 2 items: OR=0.866, 95%CI=0.779-0.963), satisfaction with child relationships (satisfaction: OR=0.266, 95%CI=0.218-0.324), smoking (OR=1.131, 95%CI=1.014-1.263), alcohol consumption (OR=0.873, 95%CI=0.795-0.959), nighttime sleep duration (6-<8 h: OR=0.539, 95%CI=0.493-0.590; ≥8 h: OR=0.443, 95%CI=0.396-0.495), BADL (damaged: OR=1.875, 95%CI=1.692-2.077), IADL (damaged: OR=2.251, 95%CI=2.030-2.496), number of chronic diseases (2 types: OR=1.202, 95%CI=1.076-1.342; 3 types: OR=1.452, 95%CI=1.289-1.636; ≥ 4 types: OR=1.954, 95%CI=1.749-2.183) were the influencing factors of depression symptoms in middle-aged and elderly patients with chronic diseases (P<0.05) .

The incidence of depressive symptoms in middle-aged and elderly patients with chronic diseases is 40.7%, and the situation is not optimistic. Their depression is influenced by various factors. Healthcare institutions and policymakers should pay attention to their mental health and take targeted measures from personal, family, community, and other aspects to improve.

Intra-abdominal infection is a common etiology of sepsis, and older patients with intra-abdominal sepsis have a high mortality rate. Therefore, it is significant to evaluate the prognosis accurately. Currently, the measurement of skeletal muscle mass derived from computed tomography (CT) has become a research hotspot. Whereas the prognostic value of skeletal muscle mass in older patients with abdominal sepsis is rarely reported.

To investigate the prognostic value of the skeletal muscle index (SMI) at the midpoint of the third lumbar vertebra (L3) along with Sequential Organ Failure Assessment (SOFA) score or Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score in older patients diagnosed with intra-abdominal sepsis.

This study was conducted at the Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University from January 1 to July 31, 2022. A total of 335 older patients with intra-abdominal sepsis were recruited. The participants were divided into survival group (250 cases) and non-survival group (85 cases) based on their survival status during hospitalization. Clinical characteristics and L3 SMI derived from abdominal CT were compared between survival and non-survival groups. Multivariable Logistic regression analysis was used to identify the risk factors of in-hospital mortality in older patients with intra-abdominal sepsis. The receiver operating characteristic (ROC) curves of L3 SMI, SOFA score, APACHEⅡ score, and combined variables for predicting in-hospital mortality were drawn, and the area under the curve (AUC) were calculated and subsequently compared.

335 older patients with intra-abdominal sepsis were included, of whom 85 (25.4%) died. There were statistically significant differences in age, BMI, albumin, creatinine, procalcitonin, L3 SMI, Nutritional Risk Screening 2002 (NRS2002), sepsis shock proportion, SOFA score, APACHE Ⅱ score between the two groups (P<0.05). Multivariable Logistic regression analysis revealed that decreased L3 SMI (OR=0.924, 95%CI=0.886-0.964, P<0.001), increased NRS2002 score (OR=1.312, 95%CI=1.086-1.585, P=0.005), increased SOFA score (OR=1.170, 95%CI=1.053-1.300, P=0.004), and increased APACHEⅡ score (OR=1.052, 95%CI=1.003-1.103, P=0.038) were independent risk factors for in-hospital mortality in older patients with intra-abdominal sepsis. The AUCs of L3 SMI, SOFA score, and APACHEⅡ score for predicting the risk of in-hospital mortality were 0.711, 0.740, and 0.742, respectively. L3 SMI combined with SOFA score, or APACHEⅡ score could improve their predictive ability, with AUCs of 0.795 and 0.792, respectively.

Decreased L3 SMI was an independent risk factor for in-hospital mortality in older patients with intra-abdominal sepsis, The skeletal muscle mass based on abdominal CT combined with critical illness scoring systems could effectively evaluate the prognosis of these patients.

With the accelerated population aging, the number of elderly patients with chronic diseases is growingly elevated. Adherence to medication regimens is pivotal for the health outcomes of chronic diseases. Existing research mainly analyzed influencing factors for medication adherence and the outcome of medication adherence by interventions. A single analysis of medication adherence from the aspect of medication experience is one-sided.

To understand the current situations of medication experience and medication adherence in elderly patients with chronic diseases, and to explore the influence of medication experience at multiple dimensions on medication adherence, thus proposing countermeasures to improve medication adherence in elderly patients with chronic diseases.

From September 2023 to December 2023, a total of 2 432 residents of three cities in Shandong Province were selected by stratified random sampling according to the economic level and social development. Elderly patients (>60 years of age) with chronic diseases and long-term medications were screened according to the inclusion and exclusion criteria. A self-designed Medication Experience Scale, consisting of 7 dimensions and 28 items was used to investigate the medication experience. A Chinese version of 4-item Medication Adherence Scale was used to investigate the medication adherence. Current status of patients' medication experience and medication adherence were described. Multiple linear regression was performed to analyze the dimensions of medication experience that greatly influenced medication adherence.

A total of 2 432 questionnaires were distributed in this survey, and 2 415 were retrieved. After excluding samples with missing data on the main variables, a total of 1 544 samples were included in this study. The mean score of medication experience of elderly patients with chronic diseases was (4.31±0.39) point, with the highest score in the dimension of life influenced by medication (4.72±0.58) points, and lowest in the dimension of convenience (3.86±0.49) points. The mean score of medication adherence in elderly patients with chronic diseases was (3.48±0.62) points. A total of 698 (45.2%) patients were identified as a poor adherence. The most common cause for non-adherence was 'forgetting to take medication' (77.1%, 538/698). Medication adherence scores were significantly lower in female elderly, or elderly patients with two or more chronic diseases than those of counterparts (P<0.05). The results of multivariate linear regression showed that medication adherence was worse in female elderly patients (β=-0.056) and elderly patients with two or more chronic diseases (β=-0.053) (P<0.05). Among the dimensions of the Medication Experience Scale, the dimensions of effectiveness (β=0.083), and affordability (β=0.135) positively predicted patients' medication adherence (P<0.05) .

The proportion of elderly patients with poor medication adherence to chronic diseases in Shandong Province is 45.2%, among whom, female patients and elderly patients with two or more chronic diseases have a worse medication adherence. The effectiveness and affordability dimensions of the medication experience are positive predictors of medication adherence. Relevant departments should focus on continuously reducing the price of chronic disease medicines, and doctors should strengthen the pharmacy guidance service provided to female patients and elderly patients with two or more chronic diseases.

Subjective symptoms are the main reason for visiting and readmissions in elderly patients, and symptoms of elderly patients are closely related to ageing. At present, few studies have focused on the age-related changes of symptoms in elderly patients, thus reducing the targete, dynamic and prospective management of symptoms in elderly patients.

To analyze the characteristics of hospitalization, incidence of high-frequency symptoms and age-related changes for pre-elderly and elderly inpatients in recent 10 years, and to provide reference and direction for symptoms management, functional improvement in pre-elderly and elderly inpatients.

We conducted a retrospective study. Pre-elderly and elderly inpatients of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from 2014 to 2023 were included. The medical data retrieval and application platform of the hospital "IDu Cloud" was used for retrieval, and statistical data of the departments receiving treatment, the top 5 patients diagnosed with diseases and the symptoms of patients were extracted through the platform result analysis interface. The frequency of symptoms was defined as ≥5%. The high frequency symptoms of elderly hospitalized patients were divided into 6 categories: common, respiratory system, digestive system, nervous system, circulatory system, urinary system symptoms. Cases (%) were used to describe the distribution of hospitalization departments, disease diagnoses, and symptoms of elderly inpatients. To analyze the differences in high frequency symptoms among inpatients aged 50-<60 years (pre-elderly), 60-<70 years (younger elderly), 70-<80 years (middle-senior elderly), and≥80 years (senior elderly). Origin was used to plot scatter plots and graphs to describe the pattern of change in the incidence of inpatient symptoms with age.

A total of 1 214 387 pre-elderly and elderly inpatients were included in the study, including 465 488 (38.33%) pre-elderly inpatients, 422 935 (34.83%) younger elderly inpatients, 235 364 (19.38%) middle-senior elderly inpatients, and 90 600 (7.46%) senior elderly inpatients. The first inpatient department was cardiovascular medicine, the first disease diagnosis was malignant tumor chemotherapy in presenium, hypertension in the young and middle aged elderly, and coronary heart disease in advanced age. There were 12, 14, 19 and 23 kinds of high frequency symptoms in 50-<60 years old, 60-<70 years old, 70-<80 years old, and≥80 years old inpatients, respectively. The most prominent symptoms were physical decline, weight loss, cough, chest tightness, and poor appetite. Respiratory symptoms showed a "high increase" trend with aging, the age-related changes of digestive symptoms showed heterogeneity, and neurological, circulatory and urinary symptoms showed a relatively "low increase" trend with aging.

The incidence of symptoms in pre-elderly and elderly inpatients shows an overall increasing trend with age, and the rate of age-related changes varies for different symptoms. The diagnosis, the number and incidence of high-frequency symptoms in elderly inpatients after 70 years old changed significantly compared with those of the younger elderly, and the role of age-related changes became prominent. The age of 70 years may become an important turning point in the decline of the overall condition of elderly inpatients.

First aid in mountainous areas is the key and difficult point in the construction of the basic emergency rescue network in China. As the main resident population in mountainous areas, the elderly in mountainous rural areas have a high mortality and disability rate of cardiovascular and cerebrovascular emergencies and understanding the real experience of this group when witnessing acute cardiovascular and cerebrovascular diseases is an important supplement to the relevant research on mountain first aid literacy.

To analyze the real experience of elderly people in rural areas under the witness situation of acute cardiovascular and cerebrovascular events to deeply understand the first-aid literacy level of elderly people in rural areas and to provide practical reference for the management of cardiovascular and cerebrovascular diseases in mountainous areas for grass-roots public health service personnel.

From January to February 2024, purpose sampling was used to select rural elderly people in Zunyi Mountain area of Guizhou Province as the research objects for face-to-face and semi-structured in-depth interviews. The directed content analysis method was used to analyze the data based on the knowledge-attitude-practice (KAP) theory.

Three themes and eight sub-themes were summarized: (1) Personal first aid knowledge and skills: serious lack of first aid knowledge, weak ability of information screening, information support needs exist. (2) Beliefs and attitudes towards rescue in emergency situations: negative response to life first aid, lack of confidence in the role of rescue, more rescue concerns. (3) Specific behavior in emergent situations: poor response to illness, wrong rescue behavior.

The problems of low first aid literacy, poor treatment level, and insufficient rescue initiative among elderly people in mountainous rural areas who witness acute cardiovascular and cerebrovascular events have become prominent. Grassroots health service organizations should focus on improving the relevant work of this group's ability to treat acute cardiovascular and cerebrovascular diseases.

The concept landscape of frailty has evolved from a single dimension which emphasising predominantly physical frailty into a multidimensional concept encompassing physical, psychological and social frailty. Conducting researches on multidimensional frailty armong community-dwelling older adults is an important way to address the current fragmentation of community-based elderly care services and enhance the comprehensive health of this population. In this paper, firstly, we review the evolution of the concept of multidimensional frailty; secondly, classify and describe the multidi. mensional frailty assessment tools that can be applied to community-dwelling older adults; thirdly, analysis the influencing factors of multidimensional frailty in community-dwelling older adults as well as the interactions between the dimensions of frailty, finally, assess the predictive value of multidimensional frailty in community-dwelling older adults in relation to health outcomes. Existing evidences suggest that the multidimensional frailty is found to be the result of a combination of physiological, psychological, and social factors, and that assessing multidimensional frailty in community-dwelling older adults can predict a variety of health outcomes such as disability, disease risk, and mortality, and that the different dimensions of frailty are correlated and interact with each others. However, there is no a standardized tool for evaluating multidimensional frailty in the community-dwelling older adults, and the underlying mechanisms of its occurrence and development have not been clarified. So, the follow-up studies could explore the developmental trajectory of multidimensional debility based on large prospective cohort studies, in order to provide a referable basis for the development of intervention strategies to reverse or delay the frail process in community-dwelling older adults.

With the acceleration of population aging in my country, the multiple chronic conditions in the elderly has become increasingly common. This not only seriously affects the quality of life of the elderly, but also places a heavy burden on families and society. Gansu is a province with a relatively high aging population in the northwest region, and it is urgent to pay attention to the multiple chronic conditions among the elderly.

In order to understand the current status and influencing factors of multiple chronic conditions among the elderly in Gansu Province, and provide a reference basis for the prevention, treatment and management of multiple chronic conditions in Gansu Province.

From 2023-07-15 to 2023-08-10, a multi-stage stratified random cluster sampling method was used to select 20 000 elderly people aged ≥60 years old in Gansu Province for a questionnaire survey. The questionnaire was designed by the research team itself and mainly investigated the prevalence of 15 common chronic diseases among the elderly, as well as their demographic characteristics and family circumstances. In the end, 19 038 valid questionnaires were collected, and the effective questionnaire recovery rate was 95.19%.

The prevalence rate of chronic diseases among the elderly in Gansu Province was 74.78% (14 236/19 038), and the incidence rate of multiple chronic conditions was 38.97% (7 419/19 038). The top six chronic diseases with the highest prevalence were hypertension[9 693 (50.91%) ], arthritis or rheumatism[3 648 (19.16%) ], and heart disease[3 418 (17.95%) ], diabetes or elevated blood sugar[3 033 (15.93%) ], chronic lung disease[1 645 (8.64%) ], stroke[1 548 (8.13%) ]. Common comorbidity combination patterns are all related to hypertension. The top-ranked binary comorbidity pattern is hypertension + diabetes or elevated blood sugar[2 112 (11.09%) ], and the top-ranked ternary comorbidity pattern is hypertension + diabetes or elevated blood sugar + heart disease[532 (2.79%) ]. The results of multi-factor Logistic regression analysis showed that gender, age, ethnicity, pre-retirement occupation, spouse, number of children, relationship with children, self-rated health status, self-rated life satisfaction, and loneliness are influencing factors for the occurrence of multiple chronic conditions in the elderly (P<0.05) .

The incidence of multiple chronic conditions among the elderly in Gansu Province is lower than the national average. Multiple chronic conditions occurs among the elderly who are female, elderly, Tibetan, have a job before retirement, have a normal relationship with their children, have average/poor self-rated health, and have average self-rated life satisfaction. The risk of chronic disease is higher, and the risk of multiple chronic conditions is lower for the elderly who have a spouse, fewer children, and do not feel lonely. Relevant departments should focus on the prevention, treatment and management of common multiple chronic conditions in the elderly, promptly intervene in variable risk factors, strengthen the elderly's awareness of self-health management, and improve the multiple chronic conditions management system in primary medical and health institutions.

Cognitive frailty is a prevalent clinical syndrome in the elderly, with subtypes of reversible and potentially reversible cognitive frailty. It is associated with adverse health outcomes such as falls, disability, and mortality. However, there is limited research on the current prevalence of cognitive frailty subtypes and their influencing factors in the elderly population.

To investigate the current status of cognitive frailty (CF) among community elderly in Beichen District in Tianjin, and to explore the influencing factors of different subtypes of cognitive frailty, so as to provide references for the early identification and intervention of reversible cognitive frailty (RCF) .

From June to August 2023, totally 3 916 community residents in Beichen District, Tianjin were recruited with convenience sampling, and a face-to-face questionnaire survey was conducted using the demography questionnaire, FRAIL Frailty Scale, the Brief Mental Status Examination Scale (MMSE), and the Subjective Cognitive Decline Questionnaire (SCD-Q9) to assess the incidence of different types of cognitive frailty and analyze the influencing factors among older people using a multivariate Logistic regression model.

Among 3 916 participants, 679 (17.34%) with RCF and 440 (11.24%) with PRCF. There were significantly differences in CF prevalence among the elderly with different genders, ages, educational backgrounds, sleep disorders, the prevalence of various types of chronic illnesses, exercise, smoking histories, drinking histories, the number of medications used for chronic illnesses, and hemoglobin levels (P<0.05). Multifactorial Logistic regression analysis showed that with no cognitive frailty as a control, being female (OR=2.186, 95%CI=1.713-2.791), age≥70 years (OR=3.056, 95%CI=2.519-3.708), smoking (OR=1.753, 95%CI=1.431-2.146), having a sleep disorder (OR=1.275, 95%CI=1.046-1.555), low hemoglobin levels (OR=1.531, 95%CI=1.026-2.284), and≥3 medications for a chronic condition (OR=2.168, 95%CI=1.490-3.156) were associated with a higher risk of RCF, and exercise (OR=0.459, 95%CI=0.382-0.551) was associated with a lower risk of RCF (P<0.05) ; being female (OR=1.941, 95%CI=1.465-2.573), age≥70 years (OR=1.830, 95%CI=1.460-2.292), drinking (OR=2.270, 95%CI=1.734-2.970), having a sleep disorder (OR=1.996, 95%CI=1.557-2.560), stroke (OR=2.114, 95%CI=1.026-4.355), low hemoglobin levels (OR=1.991, 95%CI=1.288-3.078), and ≥3 medications for a chronic condition (OR=1.626, 95%CI=1.050-2.518) were associated with a higher risk of PRCF, and exercise (OR=0.522, 95%CI=0.423-0.644) was associated with a lower risk of PRCF in the aged (P<0.05) .

The prevalence of reversible and potentially reversible cognitive frailty is high among the elderly in the community of Beichen District in Tianjin. It is recommended to add the assessment of CF into community physical examinations and implement multidimensional effective strategies to delay the onset and progression of CF.

The cognitive function of older people relocated for poverty alleviation varies. It is of great significance to focus on the cognitive function of older adults relocated for poverty alleviation and identify the influencing factors, thus improving their cognitive function.

To illustrate the cognitive function of older adults relocated for poverty alleviation in Shanxi Province, and to identify the influencing factors, thus providing a scientific basis for developing targeted intervention strategies.

A multi-stage stratified sampling method was used to survey the relocated older people in 24 resettlement sites of 8 counties in Taiyuan, Xinzhou, Lyuliang and Linfen of Shanxi Province from June to August 2023. A total of 1 882 questionnaires were collected. The cognitive function of the relocated older adults was assessed using the Chinese version of the Mini-mental State Examination (CMMSE). Based on the education level, older adults with primary school or below and CMMSE above 22 points, and those with secondary school/technical secondary school or above and CMMSE above 26 points were considered without cognitive impairment. The hierarchical linear regression model and multivariate Logistic regression analysis model were used to analyze the influencing factors of cognitive impairment from four dimensions, including social demographic characteristics, health-related behaviors, health status, and society and environment.

A total of 1 848 older adults relocated for poverty alleviation in Shanxi Province were recruited, with the CMMSE score of (24.40±5.84) points. Hierarchical linear regression indicated that age (B=-2.355), education level (primary school and below: B=-2.189), marital status (B=-0.987), physical exercise (B=-0.792), body mass index (BMI, overweight: B=1.034), activity of daily living (ADL, B=0.900), depression (B=-0.089), and social capital (B=0.125) were influencing factors of cognitive function of relocated older adults of Shanxi Province (P<0.05). There were 428 (23.2%) relocated older adults with cognitive impairment. Multivariate Logistic regression showed that age (OR=1.894, 95%CI=1.398-2.566), individual monthly income (≤500 yuan: OR=0.598, 95%CI=0.380-0.943), marital status (OR=1.507, 95%CI=1.078-2.106), physical exercise (OR=1.673, 95%CI=1.276-2.193), BMI (overweight: OR=0.543, 95%CI=0.368-0.804), ADL (OR=0.805, 95%CI=0.823-0.895), and social capital (OR=0.958, 95%CI=0.934-0.983) were influencing factors of cognitive impairment of relocated older adults of Shanxi Province (P<0.05) .

The detection rate of cognitive impairment in older adults relocated for poverty alleviation in Shanxi Province is 23.2%. Age, education level, marital status, physical exercise, ADL, depression, BMI and social capital are important factors affecting the cognitive function of the relocated older adults in Shanxi Province. More effective interventions targeted at these factors should be taken to prevent cognitive decline among them.

The incidence of frailty among the elderly in China increases with age, investigating the mechanisms by which central obesity and vitamin D levels contribute to the development of frailty is essential for effective management strategies.

A cross-lagged model was employed to investigate the longitudinal mediating role of vitamin D levels in the relationship between central obesity and frailty among the elderly, thereby offering a theoretical framework for the management of frailty in this population.

The study subjects were 1 364 elderly individuals selected from the Chinese Longitudinal Healthy Longevity Study (CLHLS) in 2011-2012 (T1) and 2014 (T2). The vitamin D levels of the study subjects were measured, and abdominal obesity was assessed using the weight-adjusted-waist index (WWI), while frailty was measured using the frailty index (FI). A cross-lagged model was implemented to analyze the causal temporal relationship and underlying mechanisms between central obesity, vitamin D levels, and frailty among the elderly.

The detection rate of frailty in the elderly was 21.8% (298/1 364) at T1 and 31.2% (425/1 364) at T2. At two time points, WWI was negatively correlated with vitamin D levels (P<0.05) and positively correlated with FI (P<0.05) ; vitamin D levels were negatively correlated with FI (P<0.05). Cross-lagged model results showed that WWI at T1 could predict FI at T2 (β=1.124, P<0.05), and FI at T1 could predict WWI at T2 (β=0.125, P<0.05). Longitudinal mediation effect analysis showed that T1 WWI could not only directly predict T2 FI (β=0.040, P<0.05), but also predict T2 FI through the mediating effect of T2 vitamin D level (β=-0.131, P<0.05) .

Abdominal obesity can not only directly predict frailty in the elderly, but also indirectly affect frailty in the elderly through the longitudinal mediating effect of vitamin D levels. Elderly people should regularly monitor abdominal obesity and vitamin D levels, to prevent or delay the onset of debilitation.

In the context of an aging society, the number of elderly Alzheimer's disease and related dementia (ADRD) patients in China has been increasing year by year, placing a heavy caregiving burden on their primary family caregivers and garnering extensive attention both domestically and internationally.

This study aims to analyze the burden of ADRD among Chinese elderly individuals, explore the influence of age, period, and cohort factors on its incidence and prevalence, and predict its incidence post-2021, providing a basis for the development of preventive and curative measures by relevant authorities.

Using ADRD data from the Global Burden of Disease Study 2021 (GBD 2021), we extracted the crude incidence rate, crude prevalence rate, crude mortality rate, and crude DALY rate of ADRD among Chinese elderly individuals from 1992 to 2021. After age standardization, we analyzed trends using the Joinpoint regression model and calculated the annual percentage change (APC) and average annual percentage change (AAPC). Age-period-cohort models were used to analyze the effects of age, period, and cohort factors on the incidence and prevalence of ADRD, while Bayesian age-period-cohort models were employed to predict incidence rates from 2022 to 2030.

The age-standardized incidence and prevalence of ADRD among China's elderly population from 1992 to 2021 showed an overall increasing trend (incidence: AAPC=0.57%, 95%CI=0.41%-0.72%; prevalence: AAPC=0.64%, 95%CI=0.60%-0.68%). The growth rate of standardized incidence was higher in men than in women (AAPC: 0.63% vs. 0.60%), while the growth in standardized prevalence was higher in women than in men (AAPC: 0.68% vs. 0.66%). The standardized mortality rate decreased across three intervals (1992-2019: APC of -0.11%, -0.41%, and -0.08%) but increased from 2019 to 2021 (APC=1.96%, 95%CI=0.78%-3.15%). The effects of age, period, and cohort factors on ADRD incidence and prevalence were significant. Specifically, the risk of incidence and prevalence increased with age in both men and women over 60 years old, with individuals aged 95 years and older having 13.24 and 13.53 times higher risk of incidence in men and women, respectively, compared to the 60-64 age group. The corresponding prevalence risks were 13.55 and 16.05 times higher. Over time, the risk increased, peaking during 2017-2021. In contrast, cohort effects revealed a progressive decrease in risk with later birth cohorts. By 2030, the standardized incidence rate is projected to increase by approximately 43.62% in women (from 1 267.77 to 1 820.80 per 100 000) and by 36.52% in men (from 920.22 to 1 256.30 per 100 000). Additionally, the number of ADRD cases among men and women was expected to rise significantly, with increases of 89.74% and 105.06%, respectively, between 2021 and 2030.

The increasing burden of ADRD in China's elderly population highlights the need for effective measures, particularly to protect elderly women.

Since China officially entered into an aging society in 1999, the issue of population aging has escalated significantly, leading to institutional care becoming a popular option for older people. However, falls among residents are a recurring problem, and the current assessment tools have shown limited effectiveness.

To construct a comprehensive fall risk assessment tool for older people in elderly care institutions and verify its reliability and validity.

From March to December 2021, the initial item pool of the tool was developed through a literature review, semi-structured interviews and 2 rounds of expert consultation and pre-investigation. Older people and nursing assistants in elderly care facilities were randomly selected to make a survey. SPSS 26.0 and AMOS 26.0 software were used to analyze and evaluate the reliability and validity of the assessment tool. The correlation coefficient method, critical ration, internal consistency test and exploratory factor analysis were used for item analysis and screening. The intrinsic reliability, split-half reliability, scores reliability and inter-item consistency reliability were used to examine the reliability; face validity, content validity, criterion-related validity, contract validity and discriminant validity were used to examine the validity.

The assessment tools included three sub-instruments: (i) Fall risk assessment scale for older people; (ii) Fall record form for older people; (iii) Daily fall risk checklist for older people. The total Cronbach's alpha coefficient for sub-instrument (i) was 0.73 and the scorer reliability coefficient was 0.85; the exploratory factor analysis extracted three common factors with a cumulative variance contribution of 57.95%; the fit indices of the confirmatory factor model: Chi-square degrees of freedom ratio (χ²/df), Goodness of fit index (GFI), adjusted goodness of fit index (AGFI), standardized moderate index (NFI), comparative fit index (CFI), Tucker-Lewis coefficient (TLI), approximation error (RMSEA) were 2.43, 0.95, 0.91, 0.89, 0.93, 0.91, and 0.07, and discriminant validity is statistically significant (P<0.001). The results of the predictive ability analysis showed an area under the test work characteristic curve (AUC) of 0.87 for Morse Fall Scale (MFS) ≥55 and 0.84 for MFS≤25. Sub-instrument (ii) and (iii) were evaluated by a combination of experts and nursing assistants to form the final version.

This study has developed a comprehensive fall risk assessment tool for elderly people in elderly care institutions, which contains three sub-instruments that complement each other to improve the whole pathway from assessment to prevention, with good reliability, validity and predictive ability, and can provide a reference for fall prevention and management in the future.

Health management based on family doctors' contract service is an essential approach for promoting healthy aging for rural older adults in China, yet its implementation is influenced by various factors.

To summarize influencing factors of health management for older adults contracted by rural family doctors in China, providing the basis of reference for the accessibility and effectiveness.

From January to April 2023, the PRISMA-ScR checklist was used. Studies on health management by family doctor contract service were searched from databases of Web of Science, PubMed, Embase, Medline, CINAHL, CNKI, Wanfang Data, VIP, and CBM from inception to December 2022, and enrolled according to the inclusion and exclusion criteria. Relevant data were extracted, collected, summarized and reported guided by the Social Ecological Model.

A total of 27 articles were included. We extracted 5 levels of influencing factors related to health management for older adults by family doctors contracted service in rural areas, including individual, interpersonal, organizational, community and policy.

The implementation of health management for older adults contracted by rural family doctors is influenced by multiple factors. To promote the development of health management for older adults in rural areas, it is necessary to comprehensively consider these influencing factors, clarify the rights and responsibilities of relevant departments and parties, and jointly promote the improvement of the quality and efficiency of health management services based on family doctor contract services.

The cerebellar vermis is closely related to emotional regulation and cognitive function. There have been few reports on whether repeated transcranial magnetic stimulation (rTMS) of the cerebellar vermis can improve clinical symptoms in elderly patients with chronic schizophrenia (CSZ) .

Observing the effects of cerebellar vermis rTMS with theta burst stimulation (TBS) paradigm on negative symptoms, cognitive function, and serum inflammatory cytokine levels in elderly CSZ patients.

This study was a single blind randomized controlled trial. Fifty elderly CSZ patients in stable condition admitted to Shenyang Mental Health Center were selected between October 2022 and August 2023 as the subjects. Using a random number table method, CSZ patients were divided into an observation group and a control group, with 25 cases in each group. The patients in observation group were treated with rTMS with TBS paradigm, the stimulation site was the vermis of the cerebellum. The treatment was conducted 5 days a week, once a day, for 4 consecutive weeks. The patients in control group were intervention with pseudo stimulation, and the treatment time and parameters were the same as those in the observation group. Use the Positive and Negative Symptom Scale (PANSS) to evaluate overall psychiatric symptoms, and use the SANS to evaluate negative symptoms. Evaluate cognitive function using the MATRICS Consensus Cognitive Battery (MCCB) . Detecting serum interleukin-1β (IL-1β) , Interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) .

Compared with the control group, the observation group had lower PANSS negative symptom scores [ (17.11±2.00) scores vs (19.21±2.76) scores], general psychopathological symptom scores [ (26.34±2.07) scores vs (29.33±4.27) scores], total scores after treatment [ (53.10±3.61) scores vs (58.99±5.53) scores], and lower SANS scale scores [ (54.00±3.78) scores vs (57.83±4.15) scores] (P<0.05) . Compared with the control group, the observation group had higher post-treatment information processing speed scores [ (39.78±2.45) scores vs (37.24±1.10) scores], attention alertness scores [ (47.07±4.27) scores vs (40.01±2.17) scores], working memory scores [ (45.12±3.20) scores vs (41.89±4.11) scores], and social cognitive scores [ (46.40±4.29) scores vs (41.42±7.45) scores] (P<0.05) . Compared with the control group, the observation group had lower levels of IL-1β [ (41.09±7.34) μg/L vs (47.03±12.45) μg/L], IL-6 [ (41.28±7.32) μg/L vs (47.03±9.45) μg/L], and TNF-α [ (53.28±14.15) μg/L vs (61.35±12.79) μg/L] after treatment (P<0.05) . During the rTMS treatment process, only 4 cases in the observation group experienced dizziness and headache symptoms during the first treatment, which gradually became tolerable with prolonged treatment time. All other patients have no complaints of discomfort.

The rTMS with TBS paradigm can improve negative symptoms, cognitive function, and serum inflammatory factor levels in elderly patients with CSZ.

As China enters a moderately aging society, the mental health problems of the elderly are increasing year by year, and lifestyle habits are closely related to the mental health of the elderly.

Exploring the relationship between nap time, nighttime sleep, and depressive symptoms among elderly people in China, and determining recommended sleep time based on lifestyle habits, providing scientific basis for early prevention and control of depression in the elderly.

Based on the publicly released fifth round (2020) of the China Health and Retirement Longitudinal Study (CHARLS) on November 16, 2023, 8 233 eligible individuals were included as research subjects. The Depression Rating Scale (CSE-D10) was used to assess depressive symptoms in elderly individuals, with nap duration divided into 5 levels: no nap, <30 min, 30-59 min, 60-89 min, ≥90 min. Nighttime sleep was divided into 5 levels: ≥8 h, 7-<8 h, 6-<7 h, 5-<6 h, <5 h. Multivariate Logistic regression analysis was used to explore the factors that affect the occurrence of depression symptoms in elderly people. Random forest model was used to analyze the importance of nap duration and nighttime sleep in the occurrence of depression symptoms in elderly people. Restrictive cubic spline curves were used to further explore the dose-response relationship between nap duration, nighttime sleep duration, and the risk of depression symptoms.

During the 2020 survey period, the incidence of depressive symptoms among elderly people in China was 24.84% (2 045/8 233) . The results of multivariate Logistic regression analysis showed that a nap duration of 30-59 minutes was a protective factor for depression symptoms in the elderly (OR=0.814, 95%CI=0.673-0.985, P=0.034) , and a nighttime sleep duration of less than 5 hours was a risk factor for depression symptoms in the elderly (OR=1.705, 95%CI=1.435-2.027, P<0.001) . Women, unmarried/separated/divorced/widowed, disabled, physically painful, physically active, self-rated health status decreased, life satisfaction decreased, stroke, and Parkinson's disease increased the risk of depression symptoms in the elderly (P<0.05) . The random forest model showed that the duration of nap time and nighttime sleep time had a significant impact on depressive symptoms. There was a non-linear relationship between the duration of nap time and the occurrence of depressive symptoms (P_nonlinear<0.05) . The risk of depression in elderly people continued to decrease with increasing time after nap time of 30 minutes, with the lowest level being about 50 minutes. The risk of depression symptoms increased after nap time exceeded 75 minutes. The risk of depression in elderly people decreased continuously with time after 6 hours of sleep at night, with a minimum level of about 7 hours. The risk of depression increased after more than 9 hours of sleep (P_overall<0.05) .

The incidence of depression (24.84%) is higher in the elderly population in China, and there is a J-shaped relationship between the duration of nap time and nighttime sleep and depression. It is recommended that elderly people nap for 30-75 minutes every day, and moderate nap time can effectively reduce the risk of depression symptoms in the elderly. At the same time, sleeping for 6-9 hours at night can reduce the risk of depression symptoms, which has certain significance for early prevention and control of depression in the elderly population.

The aging of our population is a growing problem, and depression is one of the more common psychiatric disorders in the elderly population, leading to a significantly increased risk of disability and death. The studies found a significant association between depression and cognitive disorders, and that this association may be influenced by sex. Sex differences in the associations between depression with cognitive functions and different cognitive domains are not clear in the elderly population.

Population ageing has become a common global phenomenon, and psychiatric problems associated with ageing are of great concern. This study investigated the status of depression and cognitive function in the urban elderly and examined the associations and sex differences between depression and cognitive function.

From September to October 2022, a stratified sampling method was used to select elderly residents aged 65 years and above in a community within the city of Hefei, Anhui province as the participants. General information was collected and depression and cognitive function status were assessed using the Geriatric Depression Scale (GDS) and the Brief Screening Scale for Dementia (BSSD), respectively. We explored the factors associated with depression in the elderly and analyzed the effects of depression, sex factors and their interactions on cognitive functioning.

A total of 328 older adults were included and the overall detection rate for depression was 14.9 %. Regression analyses showed that drinking (OR=0.362, 95%CI=0.155-0.847), and living with children (OR=2.445, 95%CI=1.021-5.853) were independently associated with depression (P<0.05). Factorial design analysis of variance showed that the total score of BSSD and scores of language (command) comprehension, attention and computation, orientation in place, orientation in time, and immediate memory factors were lower in the depressed group of the elderly than in the non-depressed group. Females had a lower total score of BSSD, lower scores of general knowledge and picture and orientation in place, and a higher score of language (command) comprehension than males (P<0.05). Depression and sex had significant interactions in general knowledge and picture, language (command) comprehension, and orientation in place (P<0.05) .

The urban elderly are at a higher risk of depression, and those with comorbid depression may have a certain degree of cognitive decline, with sex differences. Increased attention should be paid to psychiatric problems such as depression and dementia among the elderly, especially for the female geriatric population. It is necessary to develop individualised and comprehensive interventions to improve the mental health and quality of life of the elderly.

With the aging population, research on elderly care has increasingly become a focal point. Previous surveys on the demand rate for elderly care have shown significant variation (8.54% to 53.15%) and lack large-scale study evidence.

To understand the prevalence and influencing factors among community-dwelling older people in three provinces of China.

The study subjects were from the baseline survey of Prevention and Intervention on Neurodegenerative Disease for Elderly in China conducted in 2019. This survey employed a multi-stage stratified cluster random sampling method, selecting a total of 16 199 elderly individuals aged 60 and above from 16 districts and counties across Liaoning, Henan, and Guangdong provinces. The questionnaire covered basic demographic characteristics (gender, age, urban/rural residence, marital status, education level, occupation, weight, living situation), current care needs, chronic disease status, the Patient Health Questionnaire (PHQ-9), the Mini-Mental State Examination (MMSE), the Activities of Daily Living (ADL) scale, self-rated health status, daily exercise habits, and the number of falls. The PHQ-9 was used to assess the psychological health of the elderly, the MMSE was used to evaluate cognitive function, and the ADL scale or self-reported need for care was used to assess elderly care needs, defined as the presence of BADL or IADL disabilities, or a self-reported need for care. Logistic regression analysis was used to explore the influencing factors of elderly care needs.

The prevalence of care needs among community-dwelling older people in three provinces was 14.57% (95%CI=14.02%-15.11%), and the prevalence of care needs increased gradually with age, consistently higher among females than males in all age groups. The results of multifactorial analysis showed that the risk of care need increased 7% (OR=1.07, 95%CI=1.06-1.08) for each additional year of age. Compared with illiteracy, the ORs of care need for those with primary school, secondary school, high school and above were 0.33 (95%CI=0.29-0.37), 0.24 (95%CI=0.20-0.28), 0.17 (95%CI=0.12-0.22), respectively. Compared with daily exercise, the OR of care needs for those who did not exercise daily was 1.17 (95%CI=1.05-1.30) .Compared with those who did not suffer from chronic diseases, the ORs of care needs for those who suffered from 1-2 kinds and those 3 or more kinds of chronic diseases were 1.29 (95%CI=1.10-1.51) and 1.57 (95%CI=1.35-1.82). Compared with normal cognitive function, the OR of care need for those with abnormal cognitive function was 2.02 (95%CI=1.79-2.27). Compared with good self-assessed health status, the OR of care need for those with fair health status and those with poor health status were 1.29 (95%CI=1.14-1.46) and 2.68 (95%CI=2.27-3.16). Compared with those did not having fallen, ORs of care needs for those with 1-2 and 3 or more falls were 1.23 (95%CI=1.06-1.43) and 2.00 (95%CI=1.59-2.52). ORs of care needs for those with mild and moderately severe depression compared to those with a good mental status were 1.14 (95%CI=1.21-1.65) and 2.05 (95%CI=1.69-2.48) .

The demand for elderly care among community-dwelling older adults of China is notably high. This demand is particularly elevated among individuals who are older, have poorer physical and psychological health, and have experienced a higher frequency of falls.

Multimorbidity pose challenges to older adults' health services. It is of great importance to explore its impact on health services utilization in the elderly. The Chinese Multimorbidity-Weighted Index (CMWI) has been developed to measure the burden of multimorbidity in Chinese middle-aged and elderly, but there is a lack of cohort studies on the association between CMWI and health service utilization.

To explore the association between burden of multimorbidity and utilization of health among older adults, which provides scientific evidence for improving the intervention and management of older adults' patients with multimorbidity.

From December 2021 to January 2024, taking Sihui City of Zhaoqing City, Guangdong Province as an example, the electronic health records of residents from 2017 to 2021 were collected from the city's national health information platform to establish a natural population cohort for health examination of the elderly. We used the time of the first health examination in this period as the baseline, the CMWI was used to measure individual's baseline burden of multimorbidity .We use the negative binomial regression to analyze the association between individual's CMWI respectively and the total number of outpatient visits, chronic disease-related outpatient visits, total number of hospitalizations and chronic disease-related hospitalizations during the follow-up period.

Among the total 39 989 participants, there were 14 991 (55.18%) cases of multimorbidity, and the CMWI was 1.3 (0, 2.3). During an average 1 268 days follow-up period, 26 141 people (65.37%) had used outpatient services, the number of total outpatient visits and chronic disease-related outpatient visits was 2 (0, 6) and1 (0, 4). In our study 7 332 (18.34%) had used hospitalization services, the number of total hospitalization and chronic disease-related hospitalization was 0 (0, 0) and 0 (0, 0). Age, genders, education levels and CMWI varied significantly by the utilization of health (P<0.05). The residential type varied significantly by the utilization of outpatient services (P<0.05) but no by utilization of inpatient services (P>0.05). After adjusting the covariates of age, gender, residence and education levels, negative binomial regression analysis showed that CMWI was a risk factor on the increase of health service utilization in the elderly (IRR>1). For each unit increase in CMWI, the total number of outpatient visits increased by 1.210 (95%CI=1.196-1.224), the number of chronic disease-related outpatient visits increased by 1.276 (95%CI=1.259-1.292), the total number of hospitalizations increased by 1.277 (95%CI=1.244-1.312), and the number of chronic disease-related hospitalizations increased by 1.286 (95%CI=1.252-1.321) .

CMWI is a risk factor for the increase of health service utilization in the elderly, and the number of health service utilization in the elderly increases with the increase of CMWI. More attention should be paid to the burden of multi-chronic diseases in the elderly, so as to provide scientific basis for improving the intervention and management of multi-chronic diseases in the elderly in China.

Hypertension is a growing public health problem in China. In recent years, more and more studies have begun to focus on the quality of life of hypertensive older adults, and explore the factors affecting their quality of life, which is of great significance for the development of effective health management programs for hypertension.

To measure the health state utility (HSU) of hypertensive older adults in Northwest China using the EQ-5D-5L scale and the 15D scale, evaluate the health-related quality of life (HRQoL) of them, and explore the main factors affecting HRQoL in the elderly.

A total of 2 000 older adults were randomly recruited in Lanzhou City, Gansu Province in 2021, the clinical data were collected through questionnaires, basic physical examination and laboratory tests, and HSU was measured using the EQ-5D-5L and 15D scales. Subgroup analysis, Tobit regression analysis and multiple linear regression analysis were used to evaluate the factors affecting HRQoL.

A total of 1 784 older adults participated in this study, 50.9% of them had normal blood pressure, 676 (37.9%) had stage 1 hypertension, 152 (8.5%) had stage 2 hypertension, 48 (2.7%) had stage 3 hypertension, the HSU of these older adults were 0.949, 0.942, 0.933, and 0.921 in the EQ-5D-5L, and 0.875, 0.863, 0.851, and 0.840 in the 15D scale, respectively. Tobit regression analysis showed that gender, age, years of education, occupational status, and annual income were associated with HSU in older adults in the EQ-5D-5L scale (P<0.05), multiple linear regression analysis showed that gender, age, years of education, hypertension, and alcohol consumption were associated with HSU in older adults in the 15D scale (P<0.05) .

The HSU of older adults in both EQ-5D-5L scale and 15D scale gradually decrease with the increase of blood pressure level, indicating a progressive impairment of HRQoL. Factors affecting HRQoL in older adults include gender, age, hypertension, years of education, marital status, occupational status, annual income and alcohol consumption.

As global population continues to age, disability has become one of the most prominent health problems in the aging population. Chinese older adults with chronic diseases often diagnosed with multi-morbidities resulting in increased risks for disability. However, previous evidence on disability rates in this population have been inconsistent.

To systematically evaluate the prevalence of disability in older adults with chronic diseases in China.

We searched databases including PubMed, Embase, Web of Science, Cochrane Library, Scopus, CNKI, Wanfang Data, VIP, CBM and China Medical Journal Full-text Database up until August 2023 for publications on disability prevalence in Chinese older adults with chronic diseases. Literature screening, quality appraisal and data extraction were performed independently by two researchers. Meta-analysis was conducted using Stata 16.0 software.

A total of 32 publications (34 studies) were included. Sample sizes ranged from 221 to 16 566 cases with a disability rate of 6.9%-82.8%. Meta-analysis showed that the prevalence of disability in Chinese older adults with chronic diseases was 43.2% (95%CI=32.9%-53.5%). Subgroup analyses showed: disability rate was higher in female (36.6%, 95%CI=27.0%-46.2%) than in male (33.9%, 95%CI=23.9%-43.9%) ; disability prevalence increased with age (60-69 years old: 24.2%, 95%CI=14.3%-34.0%; 70-79 years old: 34.9%, 95%CI=24.1%-45.7%; ≥80 years old: 47.7%, 95%CI=36.3%-59.1%) ; compared to other chronic diseases, individuals with dementia/Parkinson's disease (56.3%, 95%CI=40.9%-71.7%), mental illness (53.9%, 95%CI=46.0%-61.7%), and cerebrovascular disease (49.2%, 95%CI=33.5%-64.8%) had the highest prevalence of disability; and the prevalence of disability increased with the number of comorbidities (1 disease: 33.1%, 95%CI=20.8%-45.3%; 2 diseases: 36.3%, 95%CI=22.6%-50.0%; ≥3 diseases: 49.7%, 95%CI=31.3%-68.0%) .

The prevalence of disability among Chinese older adults with chronic diseases is high and can be impacted by both the type of chronic disease and the number of comorbidities. It is recommended to strengthen chronic disease monitoring and management efforts to prevent and eliminate disability and promote healthy aging in this population.

With the population aging, the number of patients with chronic diseases and disability is increasing, which brings a heavy burden on the medical system. While it is well established that comorbidity and disability are closely interconnected, there is a noticeable scarcity of studies addressing the relationship between different patterns of comorbidity and disability.

To explore the common comorbidity patterns and their associations with disability among the older adults in China taking Sichuan as an example.

A total of 501 older adults, aged 60 and above, were selected using quota sampling in Sichuan from August to Novermber 2022. Detailed data on chronic diseases, disability, and general demographics were collected. Comorbidity patterns among the older adults were identified using a two-step clustering method that combined self-organizing maps and K-Means. The association between patterns of comorbidity and disability was explored using a logistic regression model, employing the National Disability Assessment Scale for the Long-term Care issued by the National Healthcare Security Administration of China in 2021.

In this survey, The prevalence of comorbidity 62.3% (312/501) and the prevalence of disability was 74.3% (372/501). We identified six comorbidity patterns: Arthritis/Rheumatism and Hypertension diseases, Cardiovascular and Metabolic diseases, Kidney and Arthritis/Rheumatism diseases, Cancer and Arthritis/Rheumatism diseases, Asthma, Hypertension, and Gastrointestinal diseases, Emotional/Mental and Memory-related diseases. The results of binomial logistic regression showed that the risk of disability was 6.3 times higher when people suffering from two or more chronic diseases at the same time (OR=6.3, 95%CI=3.9-10.3, P<0.05). The results of multinomial logistic regression showed that the risk of disability was increased in all six comorbidity patterns (P<0.05). Compared to the population without comorbidities, the comorbid group with the emotional/mental and memory-related diseases pattern has a 10.7 times risk with more severe disability (OR=10.7, 95%CI=1.7-63.6), which had the greatest impact on disability. Next is the Cancer and Arthritis/Rheumatism pattern (OR=7.8, 95%CI=2.4-24.8) .

The incidence of comorbidity among the older adults in Sichuan is high, and there is a significant association between several comorbidity patterns and disability, especially for the Emotional/Mental and Memory-related diseases pattern and Cancer and Arthritis/Rheumatism pattern. The health care system should focus on the older adults with comorbidity, formulate accurate and effective long-term care policies and strategies based on different comorbidity patterns to prevent and reduce the occurrence of disability, improve the well-being of the older adults, and save social medical resources.

The incidence of falls among elderly inpatients with psychiatric disorders is on the rise. A lack of adequate physical activity and a sedentary lifestyle have become prevalent among hospitalized elderly patients. Balance training has been demonstrated to be efficacious in reducing the occurrence of falls, yet its application within psychiatric care remains limited.

To explore the effect of balance intensive training on balance ability of hospitalized elderly patients with schizophrenia.

Seventy-two elderly patients with schizophrenia from a tertiary psychiatric hospital in Jiangxi Province were selected as objects for this research in 2023. Participants were randomly assigned into experimental group (n=36) and control group (n=36). The control group received standard rehabilitation training, whereas the experimental group was provided with a balance-strengthening training program in addition to the standard regimen. The Berg Balance Scale (BBS), the Chinese version of the Barthel Index (BI), and the International Falls Effectiveness Scale (FES-I) were utilized to assess patients at baseline and after 4 and 12 weeks of intervention.

A total of 62 patients completed the study, with 30 in the experimental group and 32 in the control group. Two-factor repeated measurement ANOVA showed that there was interaction between group and time on BBS and BI scores (P<0.05), group had significant main effect on BBS scores (P<0.05), but had no significant effect on BI scores (P>0.05), and time had significant effect on BBS and BI scores (P<0.05). After 12 weeks of intervention, the BBS and BI scores of experimental group were higher than those of control group (P<0.05). Intra-group comparison showed that the BBS and BI scores of the experimental group were higher at 4 weeks of intervention than before intervention, and the BBS and BI scores after 12 weeks of intervention were higher than before intervention and 4 weeks of intervention, with statistical significance (P<0.05). Group and time had interaction effects on the total score of FES-I and indoor and outdoor activity scores (P<0.05). The main effect on FES-I indoor activity score was significant (P<0.05), but the main effect on FES-I total score and outdoor activity score was not significant (P>0.05). The main effects of time on the total score of FES-I and indoor and outdoor activity scores were significant (P<0.05). After 12 weeks of intervention, the total score of FES-I and indoor and outdoor activity scores of experimental groups were higher than those of control group (P<0.05). Intra-group comparison showed that the total score of FES-I and indoor and outdoor activity scores of experimental groups were higher than before intervention at 4 weeks (P<0.05) ; the total score of FES-I and indoor and outdoor activity scores at 12 weeks of intervention were higher than those before and after 4 weeks of intervention (P<0.05) .

Implementing a balance-strengthening training program among elderly inpatients with schizophrenia can lead to significant improvements in balance, self-care, and fall self-efficacy, thereby potentially reducing the risk of falls.

Given the increasing prevalence of the high incidence of bone and joint diseases in the elderly population, and significantly associated with higher mortality, more disability, decline in functional status and lower quality of life, this creates a large disease burden. There is currently no research on the prevalence and influencing factors of this disease in Henan Province.

To provide scientific basis for understanding the epidemic characteristics and influencing factors of bone and joint diseases in the elderly population in Henan Province and implementing precise prevention and control.

The multi-stage random cluster sampling method was used to obtain the demographic characteristics, past disease history, physical activity and physical indicators of permanent residents aged≥18 years old in Henan Province in 2018 through questionnaires, medical physical examination, laboratory testing and other methods. 1 055 people aged ≥60 years old were included in this study. Multivariate Logistic regression was used to analyze the characteristics and influencing factors of bone and joint diseases in the elderly population with different characteristics in Henan Province.

The incidence rate of bone and joint diseases among the elderly population in Henan Province in 2018 was 28.13% (95%CI=28.10%-28.15%). Among them, women, urban areas, those with overweight or obesity, central obesity, dyslipidemia or hyperlipidemia, snoring history, moderate intensity activity, and non-smoking history have higher incidence rates, and the differences are statistically significant (P<0.05). Multivariate Logistic regression analysis showed that males (OR=0.717, 95%CI=0.550~0.933, P=0.013) were protective factors for bone and joint diseases in the elderly population, while overweight or obesity (OR=1.329, 95%CI=1.050-1.684, P=0.018) and central obesity (OR=1.305, 95%CI=1.047-1.626, P=0.018) were risk factors for bone and joint diseases in the elderly population.

Bone and joint diseases in the elderly population in Henan Province are related to gender, BMI, and central obesity. Targeted health education and comprehensive intervention should be carried out for women, overweight or obese individuals, and central obesity in the elderly population.

The memory and self-care abilities of older adults with chronic diseases are gradually declining, and relying solely on their personal strength for disease self-management is difficult to achieve good results, requiring more help from others. When providing health education to older adults with chronic diseases, it is not only necessary to focus solely on the elderly, but also to fully utilize the patient's social network and involve social network members in the disease management of the patients, to more effectively improve their self-management ability.

To explore the impact of social network-based health education on the self-management ability of older adults with chronic diseases in community.

From March 2021 to June 2022, older adults with chronic diseases who visited Beijing Fangzhuang Community Health Service Center, Clinic of Tsinghua Changgeng Hospital and Endocrinology Clinic of Beijing Hospital, Hongliancun Community were recruited. Using a computer-generated random number table, the older adults were assigned numbers in the order of recruitment, with odd numbers being intervention group and even numbers being control group. They were randomly divided into an intervention group and a control group in a 1∶1 ratio. The older adults in the intervention group received health education with their social network members, while those in the control group received health education alone. The Chronic Disease Self-Management Study Scale (CDSMS) was used to evaluate the effectiveness of chronic disease self-management before intervention, at the 6th and 12th months of intervention, meanwhile the Lubben Social Network-6 (LSNS-6) was used to assess their social network level.

Eighty older adults with chronic diseases were enrolled, of which 1 patient (in control group) withdrew from the study due to two hospitalizations during the study period. Finally, 79 older adults completed the study: 40 older adults in the intervention group+40 members of their social network, and 39 older adults in the control group. The exercise dimension, cognitive symptom management dimension of self-management behavior subscale, and self-efficacy subscale of CDSMS had an interactive effect on time and grouping (F_{interation-values} were 7.174, 8.488, and 9.939, respectively, P<0.05) ; The main effect of time on the two subscales of CDSMS was significant (F_time-values were 13.527, 12.188, 7.576, 5.058, respectively, P<0.05) ; The main effects of grouping on three dimensions of CDSMS self-management behavior subscale were significant (F_group-values were 12.324, 7.383, 5.927, respectively, P<0.05). At the 6th month of intervention, the CDSMS exercise dimension score in the intervention group was higher than that in the control group (t=2.852, P=0.006), the difference was statistically significant. At the 12th month of intervention, the CDSMS exercise dimension score in the intervention group was higher than that in the control group (t=4.473, P<0.05), the score of cognitive symptom management dimension was higher than that in the control group (t=-2.780, P=0.005), the self-efficacy subscale score was higher than that in the control group (t=2.993, P=0.004), the differences were statistically significant.

A 12-month social network-based health education can improve some of the self-management behaviors and self-efficacy with chronic diseases.

Obstructive sleep apnea (OSA) is prevalent in the elderly population due to the weakened neuromuscular function of the upper airway and unstable respiratory regulation in the elderly. OSA is a risk factor for a variety of common chronic diseases, and affects cognitive function and multi-system organ function in the elderly. Therefore, it is essential to provide effective therapeutic interventions for OSA in the elderly. The Sleep Medicine Branch of the Chinese Geriatrics Society, as the initiator, organized domestic experts in related fields to repeatedly discuss the operation process, requirements, specific ways and methods of noninvasive positive pressure ventilation (NPPV) treatment for elderly OSA patients with reference to domestic and international clinical studies, and finally made this expert consensus, which is aimed at standardizing the treatment of NPPV in elderly OSA patients in China to provide a reference.

Empirical research and evidence on the relationship among the medical insurance system reform, health status and life satisfaction of the elderly are scant.

To analyze the effects of the integration of the urban and rural residents basic medical insurance (URRBMI) on the self-evaluation of health status and life satisfaction of the Chinese elderly.

Based on the follow-up data of China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2018, elderly people over 60 years old with complete information were included as the research subjects. The demographic information, health status and function, medical care and insurance were extracted from the CHARLS questionnaire. According to the integration of URRBMI or not, subjects were assigned into URRBMI integration group and non-integration group. Logistic regression model was used to analyze the effects of the integration of URRBMI on the self-evaluation of health status and life satisfaction of the elderly. In addition, a structural equation model was constructed to analyze the mediating effect with the URRBMI integration as an independent variable, self-evaluation of health status as a mediating variable, and life satisfaction as a dependent variable.

A total of 4 364 subjects were analyzed in this study, including 694 (15.90%) in the URRBMI integration group and 3 670 (84.10%) in the non-integration group. The self-evaluation of health status in the URRBMI integration group was significantly better than that of the non-integration group (20.74% vs 17.41%, P=0.038). The self-evaluation of health status in the URRBMI integration group was significantly superior (OR=1.281, 95%CI=1.038-1.581, P=0.021). The life satisfaction of the URRBMI integration group was significantly higher than that of the non-integration group (94.80% vs 91.87%, P=0.009). The life satisfaction was better in the URRBMI integration group (OR=1.378, 95%CI=1.037-1.831, P=0.027). There was a partial mediating effect of the self-evaluation of health status on the impact of URRBMI integration on the life satisfaction, with the mediating effect value of 0.050 (P=0.043), and the proportion of mediating effect in the total effect accounted for 46.66%.

The URRBMI integration is beneficial to improve the self-evaluation of the health status and life satisfaction of the elderly, which has a positive practical significance. In the future, further efforts should be made on strengthening the publicity of the URRBMI, constantly improving the medical insurance treatment level for urban and rural residents, establishing a more reasonable financing mechanism, promoting the quality of medical services in rural areas, and finally improving the health level of the elderly population.

The Screening Tool of Older Person's Potentially Inappropriate Prescriptions (STOPP) and the Screening Tool to Alert to Right Treatment (START) were initially developed by a panel of experts from Cork University Hospital, Ireland in 2008, and underwent a second update in 2015. Since their inception, these criteria have played a pivotal role in identifying potentially inappropriate medication use in the elderly, enhancing oversight of medication misuse in older individuals, and reducing adverse drug events among the elderly. In 2023, the third edition of the STOPP/START criteria was released, providing updated and more practical evidence-based guidance. Building upon the second edition, this iteration includes the addition, revision, and removal of certain criteria, resulting in a total of 190 new standards for potentially inappropriate medication use. This latest version incorporates the most recent research findings and clinical evidence related to appropriate medication use in older adults. We provide a detailed analysis of the STOPP/START criteria (version 3), offering valuable insights for the updating and refinement of potentially inappropriate medication criteria in our country. Furthermore, it presents recommendations for future research in this field.

In recent years, with the aging of the population, the incidence of coronary artery large vessel disease in elderly patients has significantly increased. Drug-coated balloons (DCB), as an emerging treatment method, have attracted considerable attention due to their ability to effectively reduce the rate of restenosis. However, existing studies have largely focused on small vessel lesions, with limited data on the effectiveness in de novo large vessel lesions.

To explore the effectiveness of DCBs in treating de novo large coronary artery vessel lesions in elderly patients.

A retrospective selection of 128 elderly patients (>60 years) with coronary heart disease (CHD) who underwent percutaneous coronary intervention (PCI) at the Affiliated Hospital of Inner Mongolia Medical University in 2022 was conducted. Preoperative examinations and laboratory tests were completed. The patients were divided into DCB group (n=30), Drug-eluting stent (DES) group (n=64), and bioresorbable vascular scaffold (BVS) group (n=34) according to the PCI treatment plan. Coronary angiography (CAG) was performed preoperatively, immediately postoperatively, and during the 1-year follow-up to observe the reference vessel diameter (RVD), minimum lumen diameter (MLD), and further calculate the preoperative diameter stenosis (DS), immediate postoperative lumen gain (AG), residual diameter stenosis (RDS) at immediate postoperative and 1-year follow-up, and late lumen loss (LLL). During the follow-up period, patients were regularly followed up in outpatient clinics or by telephone, recording major adverse cardiovascular events (MACE) within the hospital and within one year after discharge. LASSO regression analysis was used to screen relevant variables, followed by multifactorial Logistic regression analysis to explore the influencing factors of MACE. The Kaplan-Meier method was used to draw the survival curve of patients with MACE, and the comparison of survival curves was made using the Log-rank test.

There was no statistically significant difference in the baseline data of patients in the DCB, DES, and BVS groups (P>0.05). Immediately postoperatively, the MLD and AG in the BVS group were higher than those in the DCB and DES groups, and the RDS was lower than those in the DCB and DES groups (P<0.05). At 1-year postoperatively, the RDS in the DES group was lower than that in the DCB group (P<0.05). No MACE occurred in the hospital in all three groups. The median follow-up time was 478 (425, 538) days, with a total of 38 MACE. No myocardial infarction or cardiac death occurred during the follow-up period. Bleeding events: there were 0 cases in the DCB group, 3 cases in the DES group, and 3 cases in the BVS group, manifested as gum bleeding, assessed as mild bleeding. The Log-rank test showed no statistically significant difference in the survival rate of patients without MACE events among the three groups (P=0.580). LASSO regression analysis included low-density lipoprotein cholesterol (LDL-C) and history of interventional treatment in the analysis, and the results of multifactorial Logistic regression analysis showed that LDL-C (OR=12.204, 95%CI=3.403-43.768) and history of interventional treatment (OR=0.041, 95%CI=0.010-0.162) were influencing factors for the occurrence of MACE.

Compared with DES and BVS, there is no significant difference in the treatment of large vessel lesions in elderly CHD patients with DCB, and its effectiveness and safety are comparable to that of DES and BVS. DCB is a safe and effective method for treating large coronary artery vessel lesions in elderly patients, and increased LDL-C and a history of interventional treatment are influencing factors for the occurrence of MACE.