| 1. |
- Arokiasamy, Perianayagam, et al.
(författare)
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Chronic Noncommunicable Diseases in 6 Low-and Middle-Income Countries : Findings From Wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (SAGE)
- 2017
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 185:6, s. 414-428
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older adults aged >= 50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low-and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local health-care systems.
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| 2. |
- Fu, Li, et al.
(författare)
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Effects of long-term exposure to ambient fine particulate matter and its specific components on blood pressure and hypertension incidence
- 2024
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Ingår i: Environment International. - 0160-4120 .- 1873-6750. ; 184
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Tidskriftsartikel (refereegranskat)abstract
- Background: Epidemiological evidence on the association of PM2.5 (particulate matter with aerodynamic diameter ≤ 2.5 μm) and its specific components with hypertension and blood pressure is limited. Methods: We applied information of participants from the World Health Organization's (WHO) Study on Global Ageing and Adult Health (SAGE) to estimate the associations of long-term PM2.5 mass and its chemical components exposure with blood pressure (BP) and hypertension incidence in Chinese adults ≥ 50 years during 2007–2018. Generalized linear mixed model and Cox proportional hazard model were applied to investigate the effects of PM2.5 mass and its chemical components on the incidence of hypertension and BP, respectively. Results: Each interquartile range (IQR = 16.80 μg/m3) increase in the one-year average of PM2.5 mass concentration was associated with a 17 % increase in the risk of hypertension (HR = 1.17, 95 % CI: 1.10, 1.24), and the population attributable fraction (PAF) was 23.44 % (95 % CI: 14.69 %, 31.55 %). Each IQR μg/m3 increase in PM2.5 exposure was also related to increases of systolic blood pressure (SBP) by 2.54 mmHg (95 % CI:1.99, 3.10), and of diastolic blood pressure (DBP) by 1.36 mmHg (95 % CI: 1.04, 1.68). Additionally, the chemical components of SO42−, NO3−, NH4+, OM, and BC were also positively associated with an increased risk of hypertension incidence and elevated blood pressure. Conclusions: These results indicate that long-term exposure to PM2.5 mass and its specific components may be major drivers of escalation in hypertension diseases.
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| 3. |
- Gildner, Theresa E., et al.
(författare)
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Ideal Cardiovascular Health and Cognitive Test Performance : Testing a Modified Index of Life's Simple 7 Among Older Chinese Adults
- 2018
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Evidence suggests that cognitive decline in older adults is influenced by cardiovascular health (CVH), with metabolic and vascular mechanisms hypothesized to underlie the etiology of cognitive impairment. Research in high-income nations suggests that improved CVH is linked with decreased cognitive impairment risk, but it is unclear if this pattern is evident in low-income countries. Nationally-representative data collected in China were drawn from the World Health Organization's Study on global AGing and adult health Wave 1 (2007-2010; n = 11,295). Seven CVH factors were classified as "ideal" or "not ideal": smoking and drinking frequency, body mass index, physical activity level, blood pressure, diet, and self-reported anxiety. Additionally, scores from five cognitive performance tests (immediate and delayed verbal recall, forward and backward digit span, verbal fluency) were used to create a composite cognitive function variable. Linear regression analyses tested whether ideal CVH measures were associated with higher composite cognitive performance, controlling for sociodemographic factors. As hypothesized, ideal CVH was generally associated with higher cognitive performance. Low anxiety levels and reliable access to sufficient food (including produce) were particularly associated with higher cognitive function. These results suggest early detection and controlling modifiable CVH risks may protect aging individuals in China from cognitive decline.
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| 4. |
- Guo, Yanfei, 1984, et al.
(författare)
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Frailty Risk in Older Adults Associated With Long-Term Exposure to Ambient PM2.5 in 6 Middle-Income Countries
- 2022
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Ingår i: Journals of Gerontology Series a-Biological Sciences and Medical Sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 77:5
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Tidskriftsartikel (refereegranskat)abstract
- Background A series of studies have explored the health effects of long-term exposure to ambient PM2.5 among older adults. However, few studies have investigated the adverse effect of long-term exposure to ambient PM2.5 on frailty, and the results are inconclusive. This study sought to investigate the associations between long-term exposure to ambient PM2.5 and frailty in 6 low- and middle-income countries. Methods We included an analytical sample of 34 138 individuals aged 50 and older from the Study on global AGEing and adult health Wave 1 (2007/2010). Air pollution estimates were generated using a standard methodology derived from Moderate Resolution Imaging Spectroradiometer observations and Multiangle Imaging Spectroradiometer instruments from the Terra satellite, along with simulations from the GEOS-Chem chemical transport model. A 3-level hierarchical logistic model was used to evaluate the association between frailty index and long-term PM2.5 exposure at 3 levels (individual, province, and country). Results In rural areas, each 10 mu g/m(3) increase in ambient PM2.5 was associated with a 30% increase in the odds of frailty (OR = 1.30, 95% CI: 1.21-1.39) after adjusting for various potential confounding factors. The gender-stratified analysis showed that the association seemed to be slightly stronger in men (OR = 1.31, 95% CI: 1.18-1.46) than in women (OR = 1.21, 95% CI: 1.07-1.36) in rural areas. Conclusion In a large sample of community-based older adults from 6 middle-income countries, we found evidence that long-term PM2.5 exposure was associated with frailty in rural areas.
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| 5. |
- Guo, Yanfei, 1984, et al.
(författare)
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Frailty Trajectories in Chinese Older Adults : Evidence From the China Health and Retirement Longitudinal Study
- 2024
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Ingår i: Innovation in Aging. - : Oxford University Press. - 2399-5300. ; 8:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives The individual heterogeneity in the progression of frailty has not been fully disclosed. Studies on frailty trajectories in Chinese older adults are rare and lack evidence suggesting that the frailty trajectories follow similar patterns to those in other countries. This study aims to identify distinct frailty trajectories in a nationwide cohort of community-dwelling older adults in China and explore the relationship between demographic, socioeconomic, and behavioral factors, and frailty trajectories.Research Design and Methods We included an analytical sample of 8,993 individuals aged 50 and older from the China Health and Retirement Longitudinal Study. We used group-based trajectory models to identify patterns of frailty trajectories over time. Multinomial logistic regression was used to estimate the relationship between demographic, socioeconomic, and behavioral factors, and group membership.Results Three frailty trajectories were identified: "Low and stable trajectory" (56.8% of the respondents), "Moderate and increasing trajectory" (34.4%), and "High and increasing trajectory" (8.8%). Older age (odds ratio [OR] = 7.37, 95% confidence interval [CI]: 5.90-9.20), being female (OR = 1.79, 95% CI: 1.42-2.27), no formal education (OR = 4.91, 95% CI: 2.33-10.36), living in rural areas (OR = 1.22, 95% CI: 1.01-1.47), low level of physical activity (OR = 2.65, 95% CI: 1.94-3.62), and residing in Northeast China (OR = 3.53, 95% CI: 2.56-4.88) were associated with the rapid progression of frailty, whereas moderate alcohol consumption appears to be associated with low and stable frailty trajectory (OR = 0.45, 95% CI: 0.35-0.58).Discussion and Implications The findings of the study emphasize a significant number of older adults with moderate and increasing as well as high and increasing frailty trajectories in China, which is cause for concern.
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| 6. |
- Guo, Yanfei, 1984, et al.
(författare)
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Frailty trajectories in people aged 50 years and above in China
- 2022
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Ingår i: Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi. - 0254-6450. ; 43:11, s. 1711-1716
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Tidskriftsartikel (refereegranskat)abstract
- 目的： 识别中国≥50岁人群的衰弱轨迹，并探索相关影响因素。 方法： 采用WHO“全球老龄化与成人健康研究”（SAGE）中国项目第一至第三轮纵向数据，由32种变量计算衰弱指数得分，并在此基础上在组基轨迹模型中采用删失正态模型确定随时间变化的衰弱轨迹模式，采用多项式logistic回归模型研究社会经济地位和行为影响因素对衰弱轨迹的影响。 结果： 共纳入4 303名≥50岁且拥有3轮完整数据的调查对象进入分析，本研究识别出3条衰弱轨迹：低水平稳定轨迹（LT）、中度增加轨迹（MT）和高度增加轨迹（HT），分别占所有调查对象的75.9%，19.1%和5.0%。多项式logistic回归分析的结果显示，与LT组相比，HT组更倾向是女性（OR=1.88，95%CI：1.22~2.92）和农村居民（OR=1.87，95%CI：1.29~2.70）。在家庭人均财富方面，OR值有一个明显的梯度，较低的家庭财富更有可能归为HT组。 结论： 本研究识别出了3种我国≥50岁人群衰弱轨迹的进展模式，并强调了干预措施应尽可能地以那些衰弱进展快速的脆弱人群为目标。. Objective: To identify distinct frailty trajectories in a cohort of nationwide community adults aged 50 years and above, and explore the relationship between frailty trajectories and their socioeconomic characteristics and behavioral factors at baseline survey. Methods: Data were from the three waves of "Global Ageing and Adult Health Research" (SAGE) by World Health Organization in China. The frailty index is generated from 32 items. Group-based trajectory modeling using a censored normal model was conducted to identify the patterns in frailty progression over time. Multinomial logistic regression model was used to examine the effect of socioeconomic status and behavioral factors on the frailty trajectories. Results: A total of 4 303 adults aged 50 years and above with complete data from all three rounds of project were included in the final analysis. Three frailty trajectories were identified: low and stable trajectory (LT) (56.8%), moderately increased trajectory (MT) (34.4%) and highly increased trajectory (HT) (8.8%). The results of the multinomial logistic regression analysis showed that the HT group was more likely to be women (OR=1.88, 95%CI:1.22-2.92) and rural residents (OR=1.87, 95%CI:1.29-2.70) compared with the LT group. In terms of household wealth per capita, there was a clear gradient in ORs, the people with lower household wealth were more likely to be classified in the HT group. Conclusion: This study identified three patterns of progression of frailty trajectories in population aged 50 years and above in China and highlighted that interventions should target those vulnerable populations with rapid progression of frailty.
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| 7. |
- Li, Suyang, et al.
(författare)
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Association between social capital and oral health among adults aged 50 years and over in China: a cross-sectional study
- 2022
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Social capital has a potential effect in protecting oral health among population. However, no study has explored the association between social capital and oral health in the Chinese context. Due to the unique culture, political, social context in China, it is important to understand their association in the Chinese context. The study aims to investigate the association between cognitive and structural dimensions of social capital with edentulism among adults aged 50 years and over in China. Method The study used data from the WHO SAGE (Study on Global AGEing and Adult Health) wave 1 China component. Structural social capital was operationalized as social participation. Cognitive social capital was operationalized as perceived community trust and perceived community safety. Community-level social capital was measured by aggregating individual-level social capital into community level. Oral health was measured using a final marker of oral health status, self-reported edentulism. A 2-level multilevel logistic regression was used to evaluate the association between different dimensions of social capital and oral health. Results In total, 12,856 individuals were included in the study, the overall prevalence of edentulism was 9.1% (95% CI 8.3-10.0). Multilevel logistic analysis revealed that individual-level social capital and community-level social capital are independently associated with edentulism. Individuals with low structural social capital and living in areas with low structural social capital have, respectively, 1.54 (95% CI 1.18-2.01) and 2.14 (95% CI 1.47-3.12) times higher odds for edentulism, after adjustment for potential confounders (age, sex, marital status, residence locality, wealth, education level, chronic conditions) and a potential mediator(smoking). Conclusions Living in a community with lower structural social capital and individual with low structural social capital is associated with higher risk for edentulism among adults aged 50 years and over in China.
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| 8. |
- Li, X., et al.
(författare)
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The association of cooking fuels with cataract among adults aged 50 years and older in low- and middle-income countries: Results from the WHO Study on global AGEing and adult health (SAGE)
- 2021
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697. ; 790
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Tidskriftsartikel (refereegranskat)abstract
- Reducing household air pollution and protecting eye health are essential to achieve the Sustainable Development Goals (SDGs). There is contradictory evidence about the association between cooking fuels and cataract among adults aged 50 years and older. WHO Study on global AGEing and adult health (SAGE) was conducted in six low- and middle-income countries (LMICs). We used propensity-score method (inverse probability of weighting) and logistic regression to examine the association between cooking fuels and self-reported cataract. Odds ratio (OR) estimates and 95% confidence intervals (CIs) were calculated. Overall, use of unclean fuels was associated with an adjusted OR of cataract of 1.42 (95%CIs, 1.29–1.56). In subgroup analysis, unclean cooking fuels increased 1.71 (95%CI, 1.46–2.01) and 1.53 (95%CI, 1.30–1.79) times the risk of cataract in India and China, respectively, whereas no association was found in other countries. In gender-stratified analyses, unclean fuel use was associated with a 1.27 (95%CI, 1.13–1.44) times risk for males and 1.67 (95%CI, 1.44–1.94) times risk for females. Higher cataract risk attributed to unclean fuels was observed among those aged over 60 (1.45; 95%CI, 1.28–1.64) than people aged under 60 (1.39; 95%CI, 1.20–1.62). OR was higher in rural area (1.74; 95%CI, 1.51–2.00) than urban area (1.24; 95%CI, 1.09–1.41). Our results indicate that unclean fuels may be associated with self-reported cataract, but it varied among different LMICs. Higher risk was found in females, people older than 60 years old and those who live in rural areas. The result of this study provides useful information to support transition to clean household energy and eye health promotion in LMICs. Greater efforts should be taken to protect vulnerable populations. © 2021 Elsevier B.V.
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| 9. |
- Li, X., et al.
(författare)
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The effect of polluting cooking fuels on depression among older adults in six low- and middle-income countries
- 2022
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697. ; 838
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about the association between polluting cooking fuel and depression among older adults living in low-and middle-income countries (LMICs).Objective: To evaluate the association between polluting cooking fuel and depression in older population of LMICs.Methods: We derived data from WHO Study on global AGEing and adult health (SAGE), which was conducted in six LMICs including China, India, Ghana, South Africa, Mexico and Russia. We applied logistic regression with the propensity score method to examine the relationship of polluting cooking fuel and depression among adults >= 50 years old.Results: Overall, the odds ratio (OR) of depression was 1.57 [95% confidence intervals (CIs), 1.26-1.93] for older adults relying on polluting cooking fuel in six LMICs. In India and China, polluting cooking fuel was associated with depression with ORs of 2.06 (95%CI, 1.44-2.94) and 1.59 (95%CI, 1.01-2.49), respectively. Positive OR of depression was identified for those polluting cooking fuel users aged over 65 years old (OR, 1.65; 95%CI,1.16-2.36) and those aged 50-65 (OR, 1.50; 95%CI,1.14-1.97). Polluting cooking fuel was associated with depression for females (OR, 1.80; 95%CI, 1.32-2.46), however we did not observe significant association for males. Positive effect of polluting cooking fuel was identified in both rural (OR, 1.72; 95%CI, 1.26-2.34) and urban areas (OR, 1.44; 95%CI, 1.07-1.95). For individuals relying on solid fuel, cooking in a room used for living/sleeping and using open stove/ fire was associated with depression with ORs of 1.30 (95%CI, 1.14-1.48) and 1.15 (95%CI, 1.01-1.31), respectively. However, no significant effect was identified for hood.Conclusion: Polluting cooking fuel was related to depressive symptoms among older adults in LMICs. In addition, cooking ventilation could be useful intervention to control health hazard of solid fuel.
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| 10. |
- Qin, F., et al.
(författare)
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Frailty and risk of adverse outcomes among community-dwelling older adults in China: a comparison of four different frailty scales
- 2023
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Ingår i: Frontiers In Public Health. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundData on which frailty scales are most suitable for estimating risk in Chinese community populations remain limited. Herein we examined and compared four commonly used frailty scales in predicting adverse outcomes in a large population-based cohort of Chinese older adults. MethodsA total of 5402 subjects (mean age 66.3 +/- 9.6 years, 46.6% male) from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Frailty was measured using a 35-item frailty index (FI), the frailty phenotype (FP), FRAIL, and Tilburg Frailty Indicator (TFI). Multivariate logistic regression models were performed to evaluate the independent association between frailty and outcomes including 4-year disability, hospitalization, and 4- and 7-year all-cause mortality. The accuracy for predicting these outcomes was determined by evaluating the area under the curve (AUC). The prevalence of frailty, sensitivity, and specificity were calculated using our proposed cut-off points and other different values. ResultsPrevalence of frailty ranged from 4.2% (FRAIL) to 16.9% (FI). FI, FRAIL and TFI were comparably associated with 4-year hospitalization, and 4- and 7-year mortality (adjusted odds ratios [aORs] 1.44-1.69, 1.91-2.22 and 1.85-2.88, respectively). FRAIL conferred the greatest risk of 4-year disability, followed by FI and TFI (aOR 5.55, 3.50, and 1.91, respectively). FP only independently predicted 4- and 7-year mortality (aOR 1.57 and 2.21, respectively). AUC comparisons showed that FI, followed by TFI and FRAIL, exhibited acceptable predictive accuracy for 4-year disability, 4- and 7-year mortality (AUCs 0.76-0.78, 0.71-0.71, 0.65-0.72, respectively), whereas all scales poorly predicted 4-year hospitalization (AUCs 0.53-0.57). For each scale, while specificity estimates (85.3-97.3%) were high and similar across all outcomes, their sensitivity estimates (6.3-56.8%) were not sufficient yet. Prevalence of frailty, sensitivity, and specificity varied considerably when different cut-off points were used. ConclusionFrailty defined using any of the four scales was associated with an increased risk of adverse outcomes. Although FI, FRAIL and TFI exhibited fair-to-moderate predictive accuracy and high specificity estimates, their sensitivity estimates were not sufficient yet. Overall, FI performed best in estimating risk, while TFI and FRAIL were additionally useful, the latter perhaps being more applicable to Chinese community-dwelling older adults.
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