Centenarians In Hainan Research Articles

Sleep status of centenarians and its association with death in the China Hainan Centenarian Cohort Study

ObjectiveThis study investigated the associations of sleep status (duration and quality) with all-cause death among centenarians, using data from the China Hainan Centenarians Cohort Study. MethodThe epidemiological distribution of sleep duration and sleep quality (estimated using the Pittsburgh Sleep Quality Index) was described based on the data from the China Hainan Centenarians Cohort Study. Cox regression was used to analyze the association between sleep status and all-cause mortality. ResultsA total of 994 centenarians, with an average age of 102.77 ± 2.75years, were included. The median (Q1, Q3) daytime sleep duration was 1.00 (0.50, 1.50) hour, while nighttime sleep duration and total sleep duration were 8.00 (7.00, 9.00) hours and 9.00 (8.00, 10.50) hours, respectively. By the end of the follow-up period, 517 centenarians had died, with a median follow-up time of 4.2 (1.3-5.0) years. A noteworthy finding emerged: male centenarians with a daytime sleep duration of at least 2 hours had a 97% greater risk of all-cause mortality (HR=1.97, 95%CI: 1.07-3.62, P = .039) than those who got less daytime sleep, after adjusting for potential confounders. ConclusionThe sleep duration patterns of centenarians in Hainan were comparable to those in other provinces of China. Centenarians who sleep longer had a higher risk of all-cause mortality. This risk plateaued after more than 9 hours of sleep, with no gender differences observed. Furthermore, the duration of daytime sleep was significantly associated with all-cause mortality among male centenarians.

Analysis of Related Factors Influencing Hypertension Classification among Centenarians in Hainan, China.

As a population ages, blood pressure levels gradually increase, leading to a higher incidence of hypertension and increased cardiovascular diseases risk. This study examines factors affecting hypertension grading among centenarians in the Hainan Province. Data from 2014 to 2016 were accessed from the cross-sectional database "Hypertension Levels and Epidemiological Characteristics of the Elderly and Centenarians in Hainan province of China". This study included 690 centenarians with hypertension. Hypertension grading was the dependent variable, analyzed against independent variables including demographic information (sex, age, ethnicity, education level, marital status, cohabitation, and regional distribution), lifestyle factors (smoking, alcohol consumption, and physical activity), body mass index (BMI), and comorbid conditions (diabetes and hyperlipidemia). Logistic regression models, adjusted for these factors, were used to assess the determinants of hypertension grading among the participants. Multivariate regression analysis, after adjusting for other variables, revealed significant associations between BMI, low-density lipoprotein (LDL) levels, and hypertension grades. Individuals with BMI below 18.5 had a 0.614-fold lower risk of developing grade III hypertension (odds ratio [OR]: 0.614, 95% confidence interval [CI]: 0.390-0.966, p = 0.0350) and a 0.586-fold lower risk for grade II hypertension (OR: 0.586, 95% CI: 0.402-0.852, p = 0.0052). Furthermore, individuals with elevated LDL levels had a 6.087-fold greater risk of progressing from grade I to grade III hypertension (OR: 6.087, 95% CI: 1.635-22.660, p = 0.0071) and a 4.356-fold greater risk of progressing from grade II to grade III hypertension (OR: 4.356, 95% CI: 1.052-18.033, p = 0.0423). Additionally, individuals of Li ethnicity had 1.823-fold greater risk of progressing from grade I to grade II hypertension compared to those of Han ethnicity (OR: 1.823, 95% CI: 1.033-3.218, p = 0.0383). A BMI below 18.5 , elevated LDL, and ethnicity emerged the primary factors associated with hypertension grading in centenarians. To reduce the risk of hypertension, it is crucial for centenarians to maintain a healthy weight, normal LDL levels, and adopt dietary habits including a low-cholesterol and low-fat diet.

Association analysis between sex hormone levels and all-cause mortality in Hainan female centenarians

Objective: To investigate the distribution characteristics of sex hormones and their relationship with all-cause mortality in Hainan female centenarians. Methods: All the subjects were from China Hainan Centenarian Cohort Study. A total of 717 female centenarians were included in the final analysis. Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard regression was used to analyze the relationship between sex hormones and survival time. Results: The M(Q1, Q3) of estradiol and progesterone among female centenarians was 32.60 (18.40, 58.70) pmol/L and 0.62 (0.32, 1.01) nmol/L. The estradiol (pmol/L) and progesterone (nmol/L) in the survival and death groups were 26.65 vs.37.80, 0.54 vs.0.69, respectively, with statistical differences (P<0.05). Cox multivariate analysis showed that estradiol and progesterone were significantly associated with death (P<0.05), the hazard ratio (HR) of estradiol Q4 was 1.58 (95%CI: 1.17-2.15), and the HR of progesterone Q3 was 1.53 (95%CI: 1.10-2.12), HR for Q4 was 1.63 (95%CI: 1.15-2.32). Subgroup and cross-analysis showed that estradiol was statistically significant with hypertension, diabetes, and low high-density lipoprotein cholesterol (P<0.05), and progesterone interacted with diabetes (P=0.016), while testosterone interacted with low high-density lipoprotein cholesterol (P=0.034). Conclusion: It is suggested that the estrogen levels of female centenarians in Hainan were associated with a higher mortality risk and an increased risk of cardiovascular metabolic disease (such as diabetes, hypertension, and abnormal lipid metabolism).

Thyroid nodules and its association with vitamin D in centenarians

Thyroid Nodules (TNs) and hypovitaminosis D are common conditions in old people. Our objective was to determine the prevalence of benign and malignant thyroid nodules in centenarians and to examine their associations with serum vitamin D levels. A population-based survey of 875 centenarians in Hainan, China was conducted. The thyroid glands and neck areas were scanned by board-certified sonographers using standard procedures. The prevalence of thyroid nodules (TN) was 74.2%, with 58.9% in group of possibly benign thyroid nodules (TIRADS 2, 3) and 15.5% in group of possibly malignant thyroid nodules (TIRADS 4A, 4B, 4C, 5). An analysis of logistic regression revealed that serum vitamin D levels were independently associated with increased thyroid nodule prevalence. We observed an inverse dose-effect relationship between TNs and serum vitamin D status with full adjustments (P for trend=0.025%). For the severely vitamin D deficient group, the deficient group, and the insufficient group, respectively, odds ratios and 95% confidence intervals (OR: CI) for possibly malignant TNs were 3.46 (1.26-9.51), 2.15 (1.08-4.28), and 1.41 (0.72-2.75), compared to the optimal vitamin D status group. The multivariable OR with a 5ng/mL decrease in serum vitamin D levels was 1.16 (95% CI: 1.01-1.33), for possibly malignant TNs in centenarians. Nearly three-quarters of centenarians were found to have thyroid nodules. Most of these nodules were benign and did not possess any suspicious ultrasound findings. Vitamin D deficiency was associated with thyroid nodules as suggestive characteristics of malignancy in this population.

Cross-sectional analysis of gonadal hormone expression and relevant factors in female centenarians in Hainan, China.

Gonadal hormone is essential for the health of postmenopausal women, however, few studies have focused on the epidemiological distribution of gonadal hormones in postmenopausal women in very late postmenopausal women. This study aims to investigate and analyze the differences of serum gonadal hormone content and its influential factors among female centenarians in Hainan, China. The questionnaire and physical examination data of 741 female centenarians and 401 elderly females in Hainan Province were collected, and venous blood samples were taken to detect the indexes of lipid metabolism, bone metabolism, and gonadal hormone. The differences of gonadal hormones and relavant factors in female centenarians were analyzed and compared. The serum levels of estradiol and progesterone of female centenarians were significantly higher than those of the elderly females (both P<0.001). The serum levels of estradiol and testosterone of ethnic minority centenarians were higher than those in Han nationality (P<0.001), and the serum estradiol and testosterone concentrations were relatively higher when the daily activities were more than 10 min (both P<0.05). Serum estradiol concentration was negatively correlated with apolipoprotein A-I, high density lipoprotein, triglyceride and bone formation markers such as calcium, inorganic phosphorus and vitamin D3, and was positively correlated with the special sequence of β-collagen (markers of bone resorption) (all P<0.01). For the extremely late postmenopausal women (such as centenarians), there may be characteristic expressions of gonadal hormones, especially estradiol. There is an unprotective correlation of serum estradiol with lipid metabolism index and bone metabolism index in female centenarians, so it is necessary to evaluate the estrogen content and the use of estrogen therapy in postmenopausal women.

Dietary behaviors and patterns of centenarians in Hainan: A cross-sectional study

ObjectivesThe aim of this study was to understand the diet-related behaviors of Hainan centenarians and to analyze dietary factors that affect their nutritional status. MethodsData were collected from the China Hainan Centenarian Cohort Study, a full sample survey including questionnaires, physical examinations, and physiologic indices of the centenarian population. The study included 1002 centenarians. The diet-related behaviors were assessed using the food frequency questionnaire; nutritional status was determined according to the Mini Nutritional Assessment – short form scale scores. We used logistic regression models to analyze the main dietary risk factors of malnutrition. ResultsOf all the centenarians, 94.6% maintained regular meals, 80.4% had three meals a day, 53.4% ate each meal until 80% full, 88.7% ate vegetables daily, and 70% drank one to two cups of water daily. Centenarians ate rice-based staple foods; eggs, dairy, legumes, nuts, and poultry were not popular. The main sources of meat were red meat and seafood. None liked fried food, and 19.3% preferred sweet flavors. People with normal nutritional status accounted for 12.3% of the population, whereas those with malnutrition comprised 20.8%. Dietary factors that affected nutritional status included three meals a day (odds ratio [OR], 0.366; 95% confidence interval [CI], 0.173–0.778), tea drinking (OR, 0.236; 95% CI, 0.087–0.641), and the frequency of poultry (OR, 0.261; 95% CI, 0.088–0.771), seafood (OR, 0.247; 95% CI, 0.110–0.554), nuts (OR, 0.381; 95% CI, 0.150–0.965), and pastry (OR, 0.219; 95% CI, 0.080–0.600) consumption. ConclusionThis was the first study on the dietary behaviors and nutritional status of centenarians using survey data. We highlighted the factors affecting nutritional status and provided scientific support for dietary strategies that may improve the nutritional status of the elderly population.

Distribution characteristics of blood lipid profile in Hainan centenarians

Objective: To explore the prevalence of lipid profile and the influencing factors of dyslipidemia in centenarians in Hainan province, and provide basic data for the study of the lipid profile in centenarians. Methods: The data of this study were from the baseline data of China Hainan Centenarian Cohort Study from June 2014 to December 2016. A total of 1 002 centenarians were recruited. According to the guidelines for the prevention and treatment of dyslipidemia in Chinese adults in 2016, the prevalence of lipid profile were described and the prevalence of dyslipidemia with different clinical classifications were compared, and the main influencing factors were analyzed. Results: The median levels of TC, TG, LDL-C and HDL-C were 4.60 mmol/L, 1.05 mmol/L, 2.77 mmol/L and 1.41 mmol/L, respectively, in centenarians in Hainan. Blood lipid profile level was higher in females than in males. With the increase of BMI, TC, TG and LDL-C increased significantly, while HDL-C decreased significantly. The total prevalence of dyslipidemia was 19.1%. Smoking, BMI and area distribution were the main influencing factors of dyslipidemia. Conclusion: The prevalence of dyslipidemia in centenarians in Hainan was at a low level compared with other countries, and the blood lipid profile level was higher in females than in males.

Relationship between obesity related anthropometric indicators and depression risk in Hainan centenarians

Objective: To analyze the association of waist circumference, BMI, waist-hip ratio, waist-height ratio, calf circumference and waist-calf circumference ratio (WCR) with depression risk in centenarians in Hainan province. Methods: A total of 1 002 centenarians in Hainan were selected by cluster sampling. GDS-15 was used to investigate the depression. Multivariate linear regression and logistic regression analyses were conducted to evaluate the correlation between anthropometric indicators and depression risk. Restricted cubic spline was used to analyze and visualize the linear relationship. Results: After adjusting demographic characteristics (gender, age, ethnic group, marital status, educational level and type of residence) and lifestyle (smoking and drinking), the standard β of BMI, WC, WHR, WHtR, calf circumference and WCR associated with GDS-15 were -0.069, -0.032,0.009, -0.009, -0.099 and 0.060, respectively, and the P values of BMI and calf circumference were <0.05. With the increase of calf circumference, the risk of depression decreased, OR value was 0.94 (95% CI:0.90-0.98), and after adjustment, the results were still significant. Classified variable analysis indicated with the decrease of calf circumference and the increase of WCR, the risk of depression increased gradually, the trend P values were 0.038 and 0.042, respectively. Conclusion: Central obesity (waist circumference and WCR) and periphery obesity (calf circumference) have differed effects on depression in centenarians, and increased calf circumference is a protective factor for depression in female centenarians, attention should be paid to the mental health of the elderly women with lower calf circumference.

Prevalence of diabetes and associated factors in Hainan centenarians

Objective: To investigate basic characteristics of diabetes prevalence and associated factors in centenarians in Hainan province of China. Methods: All the subjects were from China Hainan Centenarian Cohort Study. A total of 1 002 centenarians were included in the final analysis, who were divided into three groups: diabetes group, impaired fasting glucose (IFG) group, and normal glucose group according to the guideline. Results: The average age of centenarians was (102.77±2.55) years, and the proportion of females was 82.0%. There were 95 centenarians who suffered from diabetes, and the prevalence rate was 9.5%. There were 81 centenarians who had IFG, and the prevalence rate was 8.1%. The mean fasting plasma glucose (FPG) level of centenarians was (5.12±1.44) mmol/L, while 43.5% of centenarians had FPG levels ranging from 4.00 to 5.00 mmol/L and 22.1% of centenarians had the FPG levels ranging from 5.00 to 6.00 mmol/L. Increased triglyceride level and abdominal obesity might be associated with the risk for diabetes. Conclusion: The glycometabolism in centenarians in Hainan was better than that in other age groups, and no gender specific difference was observed.

Association between serum albumin level and health-related quality of life in Hainan centenarians: a cross-sectional study

Objective: To investigate the association between serum albumin levels and health-related quality of life in centenarians in Hainan province, China. Methods: We conducted a full sample centenarian cohort study in a community population in Hainan from 2014 to 2016, which included 1 002 centenarians for questionnaire surveys, physical examinations and biological tests. The EQ-5D-VAS scale was used to evaluate health-related quality of life, and multiple linear regression and multiple logistic regression analyses were used to analyze the association between serum albumin levels and health-related quality of life. Results: There was a positive linear relationship between serum albumin levels and EQ-5D/VAS score. The normalized β values in the fully adjusted model was 0.156 (P<0.001). In the multivariate logistic regression analysis, after fully adjusting the covariates, the risk of health related life quality impairment in the lower albumin group was 2.369 times(95%CI: 1.424-3.939) than that in the higher albumin group. Gender stratified analyses showed that the OR was 4.406 (95%CI: 1.537-12.631) in male centenarians and 2.035 (95%CI: 1.125-3.680) in female centenarians. Conclusion: Lower serum albumin level was associated with impaired health-related quality of life in centenarians in Hainan.

Reference intervals for anemia-related routine blood test indicators in Hainan oldest-old and Hainan centenarians

Objective: To investigate reference intervals for anemia-related routine blood test indicators in Hainan oldest-old and Hainan centenarians. Methods: A cross-sectional data set of China Hainan Centenarians Cohort Study (CHCCS) was used. Household interview, physical examinations, and blood sample analysis were conducted in accordance with standardized procedures. The hemoglobin level, red blood cell count, and hematocrit were analyzed with automatic biochemical analyzer and the reference intervals were determined following CLSI C28-A3 guidelines using a non-parametric method. Results: A total of 715 centenarians, including 137 males (19.2%), and 767 long-lived individuals aged ≥80 years, including 312 males (40.7%), were surveyed. The reference interval of hemoglobin level was 89.1-173.5 g/L in males and 94.4-146.0 g/L in females, respectively, in long-lived individual group. The reference interval of hemoglobin level was 68.4-145.6 g/L in males and 81.0-140.0 g/L in females, respectively, in centenarian group. Conclusion: The reference intervals of hemoglobin level, red blood cell count, and hematocrit were set for the first time for the oldest-old and centenarians in Hainan, which was lower than that currently used in adults.

Canonical Correlation Analysis on the Association Between Sleep Quality and Nutritional Status Among Centenarians in Hainan.

Objective: To analyze the correlation between nutritional status and sleep quality among centenarians.Methods: A total of 1,002 centenarians in Hainan were included in the full sample survey. The Mini Nutritional Assessment-Short Form (MNA-SF) was used for nutritional risk assessment and the Pittsburgh Sleep Quality Index Scale (PSQI) was used for evaluating sleep quality. Canonical correlation analysis was conducted to analyze their correlation.Results: Two statistically significant (p < 0.05) canonical coefficients were found, with the first canonical correlation coefficient having a value of 0.247, eigenvalue of 0.065, and contribution rate of 89.0%. The linear combination of nutrition variable V1, mainly determined by MNA1 (appetite loss), MNA5 (dementia/depression), and MNA2 (weight loss), indicates an association with sleep quality; the linear combination of sleep quality W1, mainly determined by PSQI1 (subjective sleep quality), PSQI7 (daytime dysfunction), and PSQI2 (sleep latency), indicates an association with nutritional status. Appetite loss, dementia/depression, and weight loss have negative correlations with subjective sleep quality and daytime dysfunction.Conclusion: Among centenarians, the relationship between nutritional status and sleep quality is bidirectional. Furthermore, appetite loss, dementia/depression, weight loss, subjective sleep quality, and daytime dysfunction are the main relevant factors.

Serum albumin and activities of daily living in Chinese centenarians: a cross-sectional study

BackgroundObjective deterioration in activities of daily living (ADLs) exists among older population, and particularly worsens with age. Considering the criterion standard of positive aging and longevity, little information focusing on centenarians is available. This study set out to explore the relationship between serum albumin and ADLs among centenarians in long-lived areas.MethodsThis population-based cross-sectional study investigated a full sample of Chinese centenarians in Hainan, the longest-lived area of China (n = 1002). We assessed serum albumin levels and basic and instrumental activities of daily living (BADLs and IADLs).ResultsOf 1002 participants included in the analysis, 287 (28.64%) had BADL disabilities and 648 (64.67%) had IADL disabilities. The median level of serum albumin was 38.5 g/L (interquartile range, 36.2–41.3). The multivariable analyses controlling for socio-demographic characteristics, lifestyle, morbidities, and other influential factors showed that albumin level was associated with the total score of BADL (standard β = 0.335, P < 0.001) and IADL (standard β = 0.206, P < 0.001). With the increasing of albumin level, the risk of ADLs disability decreased (BADL: odds ratios [OR] = 0.835, 95% Confidence interval [CI]: 0.797–0.876; IADL: OR = 0.863, 95%CI: 0.824–0.905). In the stratified analyses, similar results were found in both sex, but were more prominent in women.ConclusionsHigher levels of serum albumin was a protective factor for the decline of ADLs in centenarians. This association can be observed in both genders and is more pronounced in women.

Waist-Calf Circumference Ratio Is an Independent Risk Factor of HRQoL in Centenarians.

PurposeTo analyze the associations between waist circumference (WC), body mass index (BMI), waist–hip ratio (WHR), waist–height ratio (WHtR), calf circumference, waist-calf circumference ratio (WCR), and quality of life in Hainan centenarians.Patients and MethodsA total of 1002 centenarians in Hainan were selected by a full sample survey. The EQ-5D visual analogue scale (EQ-5D-VAS) was used to investigate the quality of life. Restricted cubic splines were used to analyze and visualize the linear relationships.ResultsAfter adjustment, the standard β values for BMI, WC, WHR, WHtR, calf circumference, and WCR associated with EQ-5D score were 0.101, 0.126, −0.018, 0.100, 0.302, and −0.219, respectively; all associations except for WHR were significant (P < 0.01). With increasing BMI, WC, and calf circumference, the risk of EQ-5D score <1 decreased (odds ratios [ORs] 0.91 [95% confidence interval (CI): 0.86–0.97), 0.97 [95% CI: 0.95–0.99], and 0.87 [95% CI: 0.82–0.92] after adjustment, respectively). With increasing WCR, the risk also increased (OR 2.70 [95% CI: 1.54–4.75]).ConclusionAfter excluding nutritional and muscle retention factors, fat central distribution negatively impacted the health-related quality of life of the oldest old population.

Characteristics of centenarians’ lifestyles and their contribution to life satisfaction: A case study conducted on Hainan Island

BackgroundCentenarians represent an intriguing model for healthy aging. They appear to have adapted well to their lives and are likely to be influenced by previous lifestyle habits, and their life satisfaction is influenced by mental and psychological health. ObjectiveThe aim of this study is to explore centenarians’ lifestyles by sex and their potential contribution to life satisfaction. MethodIn order to examine the common characteristics of centenarians in Hainan and the potential differences between men and women, a cross-sectional survey was conducted with 223 cognitively-intact Chinese centenarians. We also explored the association between life satisfaction and other physical factors using binary logistic regression and principal component analysis. ResultsThe results provided supplementary evidence indicating that women tended to live longer than men. However, the difference in life satisfaction observed between the sexes was not obvious (p = 0.659). The proportion of physical factors between each sex showed a similar trend in distribution. Most centenarians’ lifestyles were similar, in that they followed a light diet and did not smoke or drink alcohol. Centenarians in better physical condition and with higher self-assessment, as well as those with “alcohol and tobacco habits,” were more satisfied with their life. Of the factors examined in the binary logistic regression, sleep satisfaction was the only factor significantly positively correlated with life satisfaction (p < .01). ConclusionThe research findings elucidated physiological and psychological health in centenarians and provided a model of healthy aging strategies for reference purposes.

Relationship between thyroid nodules and lifestyle characteristics in Chinese centenarians

Objective To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan. Methods The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure. Results Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05). Conclusions The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age. Key words: Ultrasonography; Thyroid nodules; Centenarians; Lifestyle characteristics

Association between anthropometric measures and cardiovascular disease (CVD) risk factors in Hainan centenarians: investigation based on the Centenarian\u2019s health study

BackgroundCentenarians refer to a special group who have outlived most of their fellows. Body shape and abdominal obesity have been identified as cardiovascular disease (CVD) risk factors. Our study aimed to evaluate the relationship between body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) and CVD risk factors among male and female centenarians in Hainan province.MethodsFive hundred thirty-seven centenarians aged between 100 and 115 (Mage = 107 years old) years participated in this study. Each participant received a standardized questionnaire and physical examination. We measured anthropometric variables (BMI, WC, WHR, WHtR, SBP and DBP) and serum lipid (TC, TG, HDL-C and LDL-C).Results76.9% (n = 413) of the study subjects were female. TC, TG, LDL-C and HDL-C were significantly higher in female group than that of male group. BMI, WC and WHtR were well-correlated with the CVD risk factors. The anthropometric measures were negatively related with HDL-C levels and positively related with the other CVD risk factors.ConclusionsHainan centenarians were short in stature and underweight. Moreover, female centenarians were often pear-shaped, while male centenarians were often apple-shaped. Further, BMI, WC and WHtR were well-correlated with the serum lipid, and TC, TG, LDL-C and HDL-C were significantly higher in females than males. Also, BMI, WC and WHtR were closely related to the incidence of dyslipidemia in females, including high TG, high LDL-C and low HDL-C.

Study on sleep quality and related determinants among centenarians in Hainan province

Objective: To investigate the sleep quality and related determinants among centenarians in Hainan. Methods: A cross-sectional study of centenarians from 16 cities/counties was carried out in Hainan province between June 2014 and June 2016. Data related to demography, chronic diseases and lifestyles of the centenarians were collected. Pittsburg sleep quality index (PSQI) was used to assess the quality of sleep while multivariable logistic Regression model was used to determine the risk factors on the quality of sleep. Results: Of the 730 centenarians in this study, 225 suffered from sleep disorders (30.8%). The average score of PSQI was (6.44±3.05), with the top three problems related to sleep as sleep inefficiency (48.5%), sleep latency (35.5%), and daytime dysfuntion (20.6%) among the centenarians. Results from the multivariate logistic analysis showed that incontinence, cardiovascular disease and chronic pain were risk factors, while habitual afternoon nap, and regular diet appeared as protective factors (P<0.05), related to sleep disorder. Conclusions: Quality of sleep had been a problem to the centenarians in Hainan. Intervention on risk factors of sleep disorder should be helpful on these centenarians.

Study on self-rated health and related factors in centenarians in Hainan province

Objective: To investigate the self-rated health and related factors in centenarians in Hainan province. Methods: A cross-sectional study in centenarians from 18 cities and counties was carried out in Hainan between June 2014 and December 2016. They data about their demographics, chronic diseases, ability of daily life, mental health and sleep quality were collected in a household interview. Self-rated health status was classified into 5 degrees according to the subjective assessment by centenarians. Results: Of 991 centenarians in this study, 157 (15.8%) were in good self-rated health and 228 (23.0%) were in poor self-rated health. Multivariate logistic regression analysis showed that chronic pain, visual impairment, depression, limited ability of daily life and poor sleep quality were the factors associated with poor self-rated health in centenarians in Hainan (P<0.05). Conclusion: The proportion of centenarians in good self-rated health was low in Hainan, the influencing factors included chronic pain, visual impairment, depression, poor sleep quality and limited ability of daily life. It is necessary to conduct targeted intervention in centenarians in Hainan.

Comparative study on home-based care effects of disabled centenarians

Objective To evaluate the effect of home-based care alongside with health promotion on Wechat towards disabled centenarians, to provide the basis for improving the home and community based care towards the oldest old. Methods A total of 158 indigious centenarians in Hainan were surveyed and 78 of them who were considered disabled by Barthel criteria were selected and then divided into intervention group (with health education on Wechat platform and nursing visit) and control group (with nursing care handbook) by the serial number of them. The living quality,incidence of adverse health events and positive feeling of family care givers of two group were evaluated and compared after 6 months intervention. Results After 6 months of home-care intervention, significant statistical differences in incidence of adverse health events were found between intervention group and control group, which compromise falls (2 cases vs. 13 cases, χ2= 8.91, P= 0.00), pain (1 case vs. 17 cases, χ2= 17.28, P= 0.00) and constipation (6 cases vs. 15 cases, χ2= 4.75, P= 0.03). When it came to positive feeling of care givers, the scores of intervention groupwere (33.44±3.72), (36.46±4.06) points, control groupwere (28.10±3.25), (28.15±3.15) points, significant differences were found at 3rd and 6th month′s follow-up between two groups, which t value represent 4.955 (P=0.00) and 10.142 (P=0.00), respectively. It also suggested that the differences in living quality of the elderly were statistical significant when refered to discomfortble or pain scored 1.58±0.50 and 2.37±0.63 (t=-6.154,P=0.00), and anxiety or depression scored1.73±0.64 and 2.32±0.70 (t=-3.889,P=0.00). Conclusions Health education on Wechat platform with nursing visit can enhance the effect of home-based care by improving the living quality, incidence of adverse health events of the elderly and positive feeling of family care givers. Key words: Disabled centenarians; Aged; Home care; Wechat; In-home interview