Association between physical activity levels and intrinsic capacity impairment among Chinese older adults: A cross-sectional study based on CHARLS.

Objective: This study aims to examine the association between the frailty index (FI) and stroke risk among Chinese adults, describe the burden of stroke in China, and explore the causal role of FI in ischemic stroke through Mendelian randomization. Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS) included 13,473 participants aged 45 years and older without a history of stroke. Cox models, restricted cubic splines, and sensitivity analyses were employed to assess the association between the modified frailty index (mFI) and incident stroke. Additionally, data from the Global Burden of Disease (GBD) 2021 data report were utilized to describe stroke trends in China from 1990 to 2021. Two-sample Mendelian randomization was conducted to evaluate the causal effects of FI on ischemic stroke subtypes. Results: During a median follow-up period of approximately 7 years, 811 incident strokes were recorded. Each 0.1-point increase in mFI was associated with a 16% increase in stroke risk (HR = 1.16, 95% CI: 1.06–1.27), demonstrating a linear dose–response relationship. From 1990 to 2021, the proportion of ischemic stroke rose from 46.9% to 63.2%. Mendelian randomization analysis provided genetic evidence supporting a causal association between FI and ischemic stroke (OR = 1.191, 95% CI: 1.046–1.357), particularly driven by large-artery atherosclerotic (OR = 1.852) and small-vessel stroke (OR = 1.415), but not by cardioembolic stroke. Conclusions: A higher FI is associated with an increased risk of stroke among Chinese adults, with genetic evidence supporting a causal role in ischemic stroke. Therefore, FI may serve as a valuable addition to existing risk assessment tools.

The nocturnal chronotypes may be associated with an increased susceptibility to depression. Furthermore, the chronotype shows long-term stability and is not easily changed. Considering that sleep quality is related to chronotype and depressive symptoms, assessing the role of sleep quality in the relationship between chronotype and depressive symptoms could help to identify intervention targets. This study analyzed the network structure of sleep quality, chronotype, and depressive symptoms. Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR), a national, multi-cohort, comprehensive cross-sectional survey conducted in China. We used data from 2023 and included 28,312 individuals in our analysis. Identified central symptoms by expected influence value and bridge symptoms by bridge expected influence value. Among all the samples, 5327 (18.82%) reported experiencing depressive symptoms (PHQ-9 total scores≥10), and 7183 (25.37%) reported poor sleep quality (B-PSQI total scores >5). Network analysis demonstrated that "Sleep problem" had the highest expected influence centrality, followed by "Moving change", "Difficulty with concentrating", "Hopelessness" and "Sleep disturbance". Four bridge symptoms were identified: "Sleep problem", "Sleep disturbance", "Sleep efficiency", and "Suicidality". This exploratory study explored the inter-relationships between sleep quality, chronotype and depressive symptoms in Chinese adults. As central and bridge symptoms, sleep problems and sleep disturbance may represent potential intervention targets for addressing the depressive symptoms associated with chronotype.

Internet use, social adaptation and subjective well-being in Chinese older adults: a cross-lagged study.

Aim: Many studies have demonstrated that physical inactivity and reduced renal function are associated with an increased risk of all-cause mortality. However, most of this evidence is derived from non-Chinese populations. This study aimed to investigate the association of physical activity (PA) with the risk of all-cause mortality among Chinese adults with and without impaired kidney function. Materials & methods: We conducted a prospective cohort study among a population in Jiangsu Province, China. Cox proportional hazards regression models were used to explore the associations of estimated glomerular filtration rate (eGFR) and PA with all-cause mortality, as well as to test for potential interactions between eGFR and PA. Results: A total of 6266 participants with complete data were included in the analysis, with a median age of 52years and 44% being male. Of these participants, 1034 (16.5%) had an eGFR <60ml/min/1.73m2. During a median follow-up 9.1years (interquartile range [IQR]: 7.7-9.9), 196(3.1%) participants died. Participants with eGFR <60ml/min/1.73m2 had a significantly higher risk of death (hazard ratio [HR]=1.93; 95% confidence interval [CI]:1.39-2.68) compared with eGFR ≥60ml/min/1.73m2. A significant interaction was observed between PA and eGFR in relation to all-cause mortality risk (p for interaction=0.004). Notably, participant with eGFR <60ml/min/1.73m2 and low PA had a highest risk of all-cause mortality, compared with those with eGFR ≥60ml/min/1.73m2 and high PA (HR: 4.06; 95% CI: 2.34-7.03). Conclusion: PA, a key lifestyle factor, is a potentially modifiable risk factor for both individuals with normal renal function and those with impaired kidney function. Consistent with existing literature, participants with decreased renal function exhibited a significantly higher risk of all-cause mortality. Notably, our analysis further revealed that the risk of all-cause mortality was the highest among participants with impaired renal function and low PA.

Is marrying up better for mental health? Educational assortative mating, marital well-being, subjective socioeconomic status, and depressive symptoms among Chinese adults: Evidence from cross-lagged panel networks.

Associations between adverse childhood experiences and eating disorder psychopathology and intuitive eating in Chinese adult men and women: Variable-centered and person-centered approaches.

Are emotion regulation strategies changing over time? A preregistered cross-temporal meta-analysis in Chinese adults (2005–2023)

A multicenter, randomized, double-blind, imipenem/cilastatin-controlled clinical study of cefiderocol for the treatment of complicated urinary tract infections caused by gram-negative pathogens in chinese adults.

Long-term safety, tolerance, and population-specific effects of innovatively fermented D-allulose are lacking in the Chinese population. This study aimed to address these gaps and support its application as a novel food ingredient in China. A 30-day randomized, double-blind, parallel-group design with pre-post comparison trial was conducted, enrolling 50 healthy Chinese adults (high-dose group: 36 g/day, 0.6 g/kg body weight, n = 26; low-dose group: 24 g/day, 0.4 g/kg body weight, n = 24). Gastrointestinal tolerance was monitored via daily questionnaires; systemic safety was evaluated using hematological tests, serum biochemical tests, urinalysis, fecal analysis, and body composition measurements. The incidence of gastrointestinal symptoms was 48.0%, which were mild, transient, and most frequent on Days 1-3, with no significant intergroup differences. All statistically significant changes in safety indicators remained within normal clinical reference ranges. Compared with baseline, the 30-day intervention resulted in reduced red blood cell count, hematocrit, and platelet count, as well as elevated mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration in both groups. For serum biochemical parameters, levels of alkaline phosphatase, gamma-glutamyl transferase, uric acid, total cholesterol, and high-density lipoprotein cholesterol decreased in both groups, while fasting blood glucose was reduced only in high-dose group. Notably, high-dose D-allulose intervention decreased bone mineral density T-scores in participants aged 35 years and older. All statistically significant alterations in the measured indicators remained within normal clinical ranges and were clinically insignificant. This study provides critical safety data to support the planned approval of D-allulose as a novel food ingredient in China in 2025. Its modulation of hematological and serum biochemical parameters suggests effects on hematopoiesis and glycolipid metabolism. Given the limitations of the 30-day intervention duration, relatively modest sample size, and restriction to healthy normal-BMI adults, a provisional safe intake limit of 0.4 g/kg body weight per day is proposed for Chinese adult population, requiring validation in longer-term and larger-scale studies.

Development of an interpretable machine learning model-based online tool for risk identification of anxiety symptoms in Chinese older adults.

Patients diagnosed with cancer are more prone to depressive symptoms and cognitive dysfunction. This study aimed to explore the dynamic relationship between depressive symptoms and cognitive function in middle-aged and older adults before and after a cancer diagnosis. The data were derived from Waves 1 to 5 of the China Health and Retirement Longitudinal Study (CHARLS). The cognitive functioning and depressive symptoms were measured using the validated Chinese version of the Mini-Mental State Examination (MMSE) and the Center for Epidemiologic Studies Depression Scale-10 (CESD-10), respectively. Cross-sectional network analysis was utilized for constructing the contemporaneous network, and cross-lagged panel network analysis was subsequently employed for longitudinal analysis. In the temporal network, greater "Hope" before cancer diagnosis was associated with improved "Recall" after diagnosis (β = 0.112) between cognitive function and depressive symptoms. "Attention" (predictability = 0.797) exhibited the highest in-prediction values among all nodes. In contrast, "Drawing" (influence = 1.333) exerted the strongest out-prediction on other symptoms in the cross-lagged network. This study utilized the CHARLS database and employed cross-lagged network analysis to elucidate the dynamic mechanisms of influence between depressive symptoms and cognitive function before and after a cancer diagnosis. This study identified the strongest predictive edges in the temporal network, providing new targets for clinical interventions regarding depressive symptoms and cognitive function before and after a cancer diagnosis. Furthermore, we identified the node with the strongest out-prediction in the temporal network spanning from pre-diagnosis to post-diagnosis, which is critical for developing targeted intervention strategies.

The 1-hour plasma glucose as a specific marker for early-phase insulin secretory defects in young adults with obesity.

Disruption and restoration of the self are theorized to be central to bereavement adjustment, yet previous interventions rarely address self-disruption directly. This study examined whether an online expressive writing intervention targeting self-disruption could alleviate grief symptoms in bereaved adults. In a two-arm randomized controlled trial, 66 bereaved participants were randomly assigned to an intervention group (n = 35) or a waitlist control group (n = 31). The intervention consisted of six sessions (one psychoeducational session and five structured expressive writing sessions) over three weeks, focusing on four aspects of self-disruption, namely: Loss of Self-Direction, Self-Derailment, Self-Devaluation, and Disconnection of Relational-Self. Grief severity was assessed using the PG-13-R at baseline and post-intervention, with a six-month follow-up for the intervention group. Compared with the waitlist control group, the intervention group showed a significantly greater reduction in grief severity (Cohen's d = - 0.93). Within the intervention group, the improvement remained stable at the six-month follow-up. Online expressive writing targeting self-disruption in bereaved adults may provide an effective, low-cost, and scalable intervention for grief. However, in the absence of a validated measure of self-disruption, whether the intervention exerts its effects through changes in the self remains untested. This trial was retrospectively registered with the Chinese Clinical Trial Registry (Registration Number ChiCTR2600120661, Date 18.03.2026).

Association of depression severity and transition patterns of cardiometabolic multimorbidity.

The 'conflict thesis' between scientific and supernatural beliefs has attracted considerable intellectual interest. However, empirical studies examining its impact on health behaviours are scarce. To address this gap, drawing on the Health Locus of Control (HLOC) theory, we developed an integrated dual-pathway cognitive model to explore how these conflicting attitudes compete and how they influence health behaviours differently. In an online survey conducted with 673 middle-aged and older Chinese adults, we found that supernatural beliefs did not directly conflict with scientific attitudes. Instead, they competed in predicting cancer-prevention behaviours through their associated sub-beliefs - specifically, cancer fatalism and cancer controllability. Our findings do not support a root-level 'conflict thesis' but instead support a downstream-level 'conflict thesis'. This finding adds to the literature on the 'conflict thesis' and enhances our understanding of how conflict manifests in the cancer-prevention setting. The cultural specificity and generalizability of this study are discussed.

Smartphone function preference patterns and cognitive function in middle-aged and older Chinese adults: A cluster analysis study.

The long-term health impacts of dietary nitrate may depend on its food source, since coingested components differ between plant-based (eg, polyphenols) and animal-based (eg, heme iron) foods, likely directing nitrate toward distinct metabolic pathways and divergent vascular effects. We investigated whether plant- and animal-sourced nitrate intake showed different associations with 5-year blood pressure (BP) changes and whether these associations were modified by key coingested nutrients. In a cohort of 2942 Chinese adults, dietary intake was assessed using a validated food frequency questionnaire. Systolic BP and diastolic BP were measured at baseline and after 5 years. Brachial-ankle pulse wave velocity was assessed at follow-up to define arterial stiffness. Linear and logistic regression models were used to estimate β-coefficients and odds ratios, respectively. Higher plant-sourced nitrate was associated with a greater 5-year SBP decline (β, -3.51 [95% CI, -5.89 to -1.13]) and lower arterial stiffness (odds ratio, 0.59 [95% CI, 0.35-0.98]). Conversely, higher animal-sourced nitrate was associated with diastolic BP increase (β, 1.95 [95% CI, 0.54-3.37]). In joint analyses using a 2×2 approach based on median intakes of each component, high intakes of both plant-sourced nitrate and polyphenols or vitamin C showed the strongest inverse associations with systolic BP change, whereas high intakes of both animal-sourced nitrate and heme iron showed the strongest positive associations with DBP change. The association between dietary nitrate and BP is determined by its food source and might be affected by accompanying nutrients, highlighting the importance of considering the complete dietary context in nutritional epidemiology.

The growing prevalence of short video platforms among middle-aged and older adults raises questions about their mental health implications. Using a national survey of 5,039 Chinese adults aged 50 years and above, this study examined how short video use relates to depressive symptoms through competing mechanisms using structural equation modeling. The results showed a dual-path pattern: Short video use was associated with fewer depressive symptoms via more positive attitudes toward aging, but also with increased symptoms via Internet addiction. Moderation analyses indicated that higher levels of Internet addiction were associated with a weaker protective cognitive pathway. Greater diversity in platform use was linked to higher addiction risk and reduced cognitive benefits, suggesting that fragmented engagement may correspond to less favorable psychosocial patterns. Urban-rural differences further indicated that these pathways are context-dependent. Overall, the findings highlight the importance of both behavioral patterns and usage structure in understanding the mental health effects of digital media in later life.

Arterial stiffness (AS) is a critical pathological basis for major cardiovascular diseases (CVD), with its progression closely associated with modifiable risk factors such as hypertension and dyslipidemia. Remnant cholesterol (RC), a key dyslipidemia indicator, is increasingly recognized for its cardiovascular risk predictive value independent of low-density lipoprotein cholesterol (LDL-C). This study explored the independent and additive interactive associations of hypertension and RC with AS in a Chinese middle-aged and elderly population, so as to provide evidence-based support for the prevention and management of cardiovascular diseases in this high-risk population. A retrospective cohort study was conducted on 6,886 middle-aged and elderly participants (≥ 45years) who underwent health examinations at the Health Management Center of Zigong Fourth People's Hospital from January to December 2023. All participants completed measurements of brachial-ankle pulse wave velocity (baPWV) for AS assessment, blood pressure, blood lipids, and other biochemical indicators. Participants were stratified into the AS group (baPWV ≥ 1800cm/s) and normal group (baPWV < 1800cm/s). Multiple analytical approaches were used to analyze the relationship between hypertension, RC and AS: multivariable logistic regression models (adjusted for age, gender, BMI, smoking history, drinking history, diabetes, and other confounding factors) were applied to evaluate their independent and joint effcets with AS; participants were further divided into four subgroups (low RC without hypertension, high RC without hypertension, low RC with hypertension, high RC with hypertension) to assess the interaction of the two factors on AS risk; additive interaction models were constructed to quantify their additive interaction; restricted cubic spline (RCS) models were used to explore the non-linear relationship between blood pressure and AS risk and to identify apparent inflection points within the study population. Of the 6,886 participants, 4,702 (68.3%) were identified with AS. Both hypertension and elevated RC were independently associated with an increased odds of AS (P < 0.001). Participants with both hypertension and high RC exhibited the highest risk of AS (OR = 3.50, 95% CI: 2.66-4.61) compared to the low RC without hypertension. A additive interaction between hypertension and elevated RC on AS was observed, with the relative excess risk due to interaction (RERI) = 1.21 (95% CI: 0.13-2.23). The RCS model identified apparent inflection points around 127mmHg for systolic blood pressure (SBP) and 84mmHg for diastolic blood pressure (DBP), where the risk of AS appeared to increase more rapidly within the study population. This study identified an additive interaction between hypertension and elevated RC in relation to AS among middle-aged and elderly Chinese adults. These findings suggest that the integrated assessment of hypertension and RC may provide complementary information for identifying individuals at increased risk of AS.