Healthy Life Expectancy Research Articles

Towards a National Profile of Loneliness in Old-Age China: Prevalence and Lonely Life Expectancy.

Loneliness presents a significant challenge for many older adults in China. Understanding the national scale and patterns of loneliness is critical to inform and guide policy interventions. This study builds a national profile of loneliness among Chinese adults aged 55 and above, illustrating the prevalence of loneliness and the average years expected to feel lonely, and examining how these measures vary by urban/rural residence and gender. I use the China Health and Retirement Longitudinal Study (2011-2018, N=25,563) to estimate the loneliness prevalence across different gender and urban/rural residences. Drawing on Sullivan's method for calculating Healthy Life Expectancy, I estimate the Lonely Life Expectancy (LLE), which quantifies the expected years an individual will live with loneliness. Approximately 30% of older Chinese aged 55 and above reported experiencing loneliness during 2011-2018. At age 55, Chinese adults anticipate spending about seven to ten years feeling lonely, representing over one-third of their remaining lifespan. By age 75, this proportion may increase to more than half. Estimates of prevalence and LLE exhibit marked disparities with respect to gender and urban/rural residency. Rural women emerged as the most disadvantaged, facing the highest prevalence and largest proportion of remaining lifetime feeling lonely. Older adults in China spend a significant proportion of their remaining lives feeling lonely. Marked disparities in LLEs underscore the potential role of loneliness in perpetuating health inequalities across different gender and urban/rural residences. These results highlight the urgent need for targeted interventions to mitigate the consequences of prolonged loneliness.

Aging Well? Exploring Self-Reported Quality of Life in the Older Austrian Population Based on Repeated Cross-Sectional Data

ABSTRACT Increase in life expectancy around the world puts aging societies with all their challenges on the Global Public Health agenda. In Austria, additional years of life gained are not spent in good health, as healthy life expectancy is far below the European average. Using repeated cross-sectional data from three waves of the Austrian Health Interview Survey (2006, 2014 and 2019), including a total of 10,056 participants aged 65 years and above, this study examined the change in self-reported quality-of-life (QoL) over time and explored associated factors. QoL, estimated by domain scores of the WHOQOL-BREF questionnaire, increased over time but decreased with age in all survey waves. Observed mean scores were significantly higher in males than in females in all QoL domains except the social domain but sex differences disappeared in most domains in the multivariable regression analyses. Instead, factors associated with significantly higher QoL scores included younger age, higher socioeconomic status, living in Western Austria and having no chronic conditions. Statistically significant observed sex differences in QoL in the older-aged Austrian population disappeared when adjusting for income and education. Strategies and measures to increase financial capabilities may have a significant impact on QoL and well-being in this age group.

Holding Health Seminars at Acute Care Hospitals and Fitness Clubs to Prevent Heart Failure.

Ehime Prefecture has the highest heart failure mortality rate among men and women in Japan. Healthy life expectancy is low nationwide, which may be related to sarcopenia and frailty. Uwajima City contains a progresses aging of the population in the Ehime Prefecture. Therefore, preventing heart failure requires treatment and patient education not only for the underlying disease, but also for the complications associated with aging, such as sarcopenia and frailty. In 2020, we began working with the fitness club LocomoK.O to focus on prevention after the onset of disease and prevention before onset. We have commenced surveys of healthy older adults living in the community in Uwajima City, including the Short Physical Performance Battery, physical functions such as handgrip strength, and body composition assessment using in-body tests. The data showed that the rate of sarcopenia was extremely high, at 70% in patients with acute heart failure and 39% in the healthy older group, and that 24% of patients with acute heart failure had severe sarcopenia. Based on the collected data, we started health seminars in 2023 to educate citizens about the disease to prevent the onset and recurrence of heart disease, which is in line with the current situation in Uwajima City. We hope that our activities will help those struggling with local medical care.

Effect of birth parity on life expectancy and healthy life expectancy among rural women

Objective: To analyze the effect of birth parity on life expectancy (LE) and healthy life expectancy (HLE) among rural women. Method: A total of 15 304 women aged 40 to 79 years who participated in baseline and follow-up surveys were selected from a rural cohort in Henan province. The LE and HLE of women with different birth parity were calculated by using multi-state life table. Results: There were 1 195 (7.8%), 7 782 (50.8%), 3 867 (25.3%) and 2 460 (16.1%) women with 1, 2, 3 and 4 birth parities, respectively, and the M (Q1 and Q3) of age were 50.3 (47.3, 53.4) and 53.3 (48.8, 60.7), 62.6 (55.4, 66.9) and 69.5 (64.7, 73.4) years old, respectively. LE at 40 years old was 44.5, 44.8, 45.1 and 45.4 years old, and HLE was 17.7, 18.3, 18.8 and 19.3 years old, respectively. LE at age 40 increased by 0.3, 0.6, and 0.9 years in women with 2, 3, and 4 birth parities or more and HLE increased by 0.5, 1.1, and 1.6 years, respectively, compared with women with 1 birth parity. For women with higher and lower socioeconomic status who had 4 birth parities or more, the LE at age 40 was 47.1 and 43.9 years, respectively, an increase of 0.2 and 0.1 years over women with 1 birth parity, respectively; and the HLE was 20.4 and 18.7 years, respectively, an increase of 1.4 and 1.3 years over women with 1 birth parity, respectively. Conclusion: LE and HLE show an upward trend with the increase of birth parity among rural women.

Association of laughter and social communication with oral frailty among residents in Fukushima: a cross-sectional study.

Oral frailty (OF) is a form of frailty. Laughter and social communication such as talking and participating in community activities, contribute to extending healthy life expectancy by reducing stress and increasing physical activity. However, limited research exists on the association between laughter and social communication and OF. This cross-sectional study aimed to explore the association of laughter and social communication with the risk of developing OF using the eight-item OF Index among Fukushima residents. In 2020-2021, 916 residents aged 60-79 were surveyed regarding OF and psychosocial factors. Binomial logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for psychosocial factors associated with the OF prevalence. The OF prevalence was 41.5%. The sex- and age-adjusted ORs (95% CIs) for psychosocial factors associated with OF prevalence were 0.38 (0.26-0.57) for daily laughter, 0.51 (0.35-0.76) for laughter 1-5 times/week, 0.42 (0.20-0.89) for daily talking, 0.40 (0.22-0.72) for participating in community activities more than once/week, and 0.29 (0.20-0.43) for no depressive symptoms. After multivariate adjustment, only daily laughter and no depressive symptoms were associated with OF. As a public health strategy, increasing laughter and social communication frequencies, along with reducing depressive symptoms, may enhance healthy life expectancy through improved frailty.

Frailty transition and burden on mortality risk in middle-aged and older population: a prospective cohort study

The effect of frailty transition and burden on the risk of all-cause mortality in South Korea remains unclear. This study aimed to investigate the risk of all-cause mortality using the most recent frailty index (FI), changes in FI, and frailty burden. We analyzed data from the Korean Genome and Epidemiology Study (2013–2020). A total of 3,134 participants aged 53–87 years with a computable FI based on the osteoporotic fracture index during their initial visit. The FI was updated biennially during re-examinations and changes between the initial and last visits were categorized into four groups: (1) improved or maintained to non-frail, (2) worsened to pre-frail, (3) improved or maintained to pre-frail, and (4) worsened or maintained to frail. We used the Cox proportional hazards model, adjusted for age, sex, education, lifestyle factors, and diseases. During the follow-up, 218 participants died. Compared to those who were robust at the last visit, pre-frailty and frailty were associated with an increased risk of all-cause death. Of those who visited > 2 times, 62.3% improved or remained robust, and had a decreased risk of all-cause death. Those with > 63% of pre-frailty or frailty burden significantly higher risk of death, with > 60% increase compared to their non-frail counterparts. Maintaining or achieving robustness is associated with a decreased risk of mortality. To prevent premature death and extend healthy life expectancy, identifying biological aging through surrogate measures and implementing interventions to maintain or achieve a robust health status are needed.

Inequalities in healthy life expectancy and risk factors for poor health in small geographic areas

Abstract Background Reducing inequality in healthy life expectancy (HLE) is a UK government ambition and requires more detailed knowledge of interrelated morbidity and mortality risks at smaller areas than is routinely available. We assessed HLE and risk factors in small areas. Methods We used publicly available data to estimate HLE in 2011 and 2021 at birth and age 65 for males and females for 128 Middle layer Super Output Areas (MSOA) in Norfolk and Waveney, described the distribution using geospatial mapping, and analysed associations with risk factors using linear regression. Results Mean HLE at birth was 66.5 years (standard deviation 4.3; range 52.0 to 73.0) for men and 67.5 (3.9; 56.0 to 74.0) for women, and at age 65 was 10.9 years (1.8; 6.0 to 16.0) and 12.2 (1.9; 5.0 to 15.0) respectively in 2021. The range in HLE increased between 2011 and 2021 by 2.8 years for men and 1.6 years for women. HLE was usually lower and risks higher in urban and coastal areas. Lower HLE at area level was associated with lower weekly income, physical inactivity, air pollution, alcohol admissions, living alone as an older person and diet not meeting ‘5 a Day’. HLE at age 65 in 2021 increased by: 0.2 (95% CI 0.1,0.2) years for men and 0.2 (0.2,0.3) for women for each £10 rise in weekly net income after housing expenditure; 0.1 (0.1,0.2) years for men for each 10 fewer alcohol attributable hospital admissions per 100,000 admissions; 0.66 (0.31,1.00) years for men and 0.53 (0.15,0.91) years for women per 1 μg/m3 less 2.5 mm particulate matter concentration in air pollution; 0.6 (0.2,1.0) years for men and 0.6 (0.1,1.0) years for women for each 10% fewer people being physically inactive (multiple regression). Conclusions This innovative approach can be used to monitor risks and inform targeted public health interventions at a local level more relevant to local policy makers. Stronger public health surveillance systems are needed to accurately monitor a wider variety of local data on risks. Key messages • Healthy life expectancy at age 65 varies by over 10 years for men and women between different small geographic areas in an English county, alongside local variation in risk factors for poor health. • Lower HLE at area level was associated with lower weekly income, physical inactivity, air pollution, alcohol admissions, living alone as an older person and diet not meeting ‘5 a Day’.

The Health-Employment-Longevity Nexus: Implications for Retirement Age Policies in European Countries

Abstract Background Advances in medical knowledge and technology have led to increased general and healthy life expectancy in Europe. Combined with declining fertility rates, these trends have resulted in an aging population. Many European countries have been reluctant to adjust the retirement age, putting pension funds and Pay-As-You-Go social insurance systems at risk. Linking entitlement age to life expectancy could mitigate this risk and extend working life, but such policies are politically unpopular. This study investigates the empirical relationship among self-perceived health, employment, job quality, and life expectancy in the European context. Methods The study analyzes the determinants of self-rated health using the SHARE database, combined with general and healthy life-expectancy data from EUROSTAT and, where missing, the WHO, focusing on European countries. Results In Europe, both past and present employment improve self-rated health. Job quality has a detrimental effect on self-rated health for women and a positive effect on men. Life expectancy and healthy life expectancy raise self-rated health, while poverty rates negatively affect it. Job quality is widespread among European women, and its negative effect on health rises with age. For European men, job quality has a positive effect, peaking around age 56. The effects of employment and job quality on self-rated health are simultaneous. In European countries with an elasticity >1, healthy life expectancy rises faster than general life expectancy at higher ages, suggesting an improved ability to work at older ages. This finding indicates that adjusting the retirement age could be a powerful tool for improving the sustainability of social insurance systems in Europe. Conclusions For younger European women, it may be rational to set higher retirement-age increments and put them on a declining course as they age, considering the gender-specific age dynamics and job quality effects on health. Key messages • In Europe, employment and job quality significantly influence self-rated health, with gender-specific effects that vary with age and impact retirement age policies. • Adjusting retirement age in line with healthy life expectancy could improve the sustainability of European social insurance systems, considering health-employment dynamics.

A comparative analysis of national dementia plans: preventive strategies in five European countries

Abstract Background About 8.5% of people aged +65 live with dementia in Europe. Preventive measures can avert up to 40% of cases. The aim of the study is to analyse National Dementia Plans (NDP) in Europe, to elicit how much dementia prevention is considered a priority and whether policies are evidence-based. Methods A qualitative comparative analysis was performed between NDPs of countries with the best healthy life expectancy in the elderly in Europe. The NDPs of France, Ireland, Italy, Spain, and Sweden were included. The consensus on actions and elements of prevention policies was evaluated, according to the WHO recommendations and to Cheung’s framework designed for evaluating chronic diseases policies. Results All the NDPs prioritised early diagnosis, public awareness, and community engagement for dementia risk reduction. They fostered the development of information system for data collection and established committees for progress monitoring. However, not all NDPs defined timelines for policy implementation and most of them expired years ago. NDPs included prevention research agenda, but their preventive actions did not address alcohol consumption, traumatic brain injury, and air pollution, representing 3 well-known risk factors attributable for the 15% of preventable cases. Neither integration of dementia with other chronic disease preventive strategies was present and a clear allocation of funds for NDPs always missed. Conclusions NDPs partially address risk factors of preventable cases. All countries need to update their NDPs, integrating new scientific evidence and allocating clear financial funds. This can potentially prevent millions of new cases, decreasing the burden of disease and improving the sustainability of health systems. Key messages • NDPs do not target adequately dementia in Europe. • New evidence-based preventive policies, including most recent identified risk factors, would have a clear impact on burden of disease and health systems’ sustainability.

DYNAMO-HIA: A health impact assessment tool fit for quantifying tobacco control policy

Abstract DYNAMO-HIA is a generic, publicly-available and easy to use software tool for health impact assessments of changes in health risk-factors such as obesity, air pollution, processed meat consumption, physical activity, alcohol taxation, or smoking. The tool uses a graphic use interface, does not require programming skills, and has comparatively modest data requirements. Health outcomes that can be investigated are mortality, life expectancy, healthy-life expectancy, disability and prevalence of various chronic disease such as chronic obstructive pulmonary disease (COPD), cancer, or coronary heart diseases. DYNAMO-HIA can in principle be used for any tobacco control policy or ordinance-e.g. price increases or pictorial health warning labels-that target changes in smoking prevalence or smoking initiation/quitting rates. Past applications of DYNAMO-HIA for tobacco control policy included country studies for Belgium, Mongolia, or Korea and several comparative country studies. In this presentation we will give a general overview into the use of DYNAMO-HIA and show-case a recently published study. This study quantified the reduction in COPD burden that would occur in Italy, England and Sweden over 40 years if tobacco prices were increased by 5%, 10% and 20% over current local prices.

Public Health Challenges for 2050 in the Netherlands

Abstract Every 4 years, the National Institute for Public Health and the Environment (RIVM) carries out the Dutch Public Health Foresight Study, commissioned by the Ministry of Health. The ninth edition (PHFS-2024) compiles an outlook on future public health and the health care system in the Netherlands. It combines a business-as-usual Trend Scenario with literature study and a range of qualitative and mixed-methods approaches. The Trend Scenario comprises projections up to 2050 for a broad range of epidemiological indicators. Such as (healthy) life expectancy, disease burden, life style factors. The qualitative and mixed methods approaches supported an incremental intersubjective process. Methods were a focus groups study, stakeholder sessions and workshops. An important innovation in this study was the Citizen Council and Panel. The outcomes show that demographic development, in particular growth of the group people at high age with multimorbidity, will lead to high pressure on the formal and informal health care system but also on e.g. mental health. A life course approach applied shows that decreasing mental health of youth will have long term consequences. Also, overweight will deeply impact older people’s health in the future. Lastly, climate change in combination with e.g. energy transition will deeply affect our society and living environment. Next to these challenges, there will also be opportunities to improve health. Building a climate-proof living environment that also stimulates healthy life styles and social interaction is one of them. However, improving health has linkages with policy areas outside the traditional public health domain as well and requires, firstly, a Health in/for All Policies approach. Secondly a whole-of-society approach in which companies and civil organizations take action is needed. All these efforts can only be effective if people and communities are put at the core of all health policies.

10.N. Scientific session: Gender and parenthood: short and long-term income, career, and health inequities

Abstract Despite the last decades’ changes in the distribution of household and child-rearing tasks, its main responsibility tends to fall on women. As such, parenting may remain an important determinant of gender inequalities in income, careers, and health and well-being. In 2022, on average, European women’s gross income was 12.7% below men’s. This income gap is, in part, explained by inequalities in full-time employment: in the EU, 31.5% of women with children worked part-time, which contrasts with 20.2% of women without children, with 4.9% of men with children, and 7.2% of men without children. These income and career impacts may occur due to the persistence of some traditional conceptions of the division of paid and nonpaid labor. These conceptions, and the subsequent inequalities in career progression and income, may be reflected in women’s living conditions, work-family conflict, chronic strain, well-being, and health. Yet, it can also be posited that men, experiencing the pressure to remain the main provider in the family and the most recent expectations to comply with childrearing roles, may also see their well-being and health affected. However, countries with higher gender equity have shown better results in life expectancy and healthy life expectancy for women and men. It can be argued that women and men, especially those who have children, benefit from countries with more progressive parental policies, such as longer and more equally divided parental leaves, accessible childcare, or flexible working schemes. It could, thus, be expected that these countries present higher gender equity in paid and nonpaid work division, career progression, and income, with a higher couple balance, and healthier family environments, with health gains for women and men who are parents and their children. This workshop aims to present and open to discussion recent research outcomes on the role of parenthood on income, career, and health inequalities across European countries. It will show results from quantitative and qualitative studies that focus on analyzing these impacts in the short- and long-term. By discussing these results, researchers and public health professionals may grasp parental, labor market, or social policies or health programs to foster gender equality in access to better living conditions and health, especially during and after parenthood. Key messages • Parenthood may widen gender inequities regarding income and career progression, contributing to the gender gap in health and well-being. • By understanding the magnitude of gender inequities and their distribution across countries, public health researchers and professionals may identify policies that effectively address the gender gap.

COVID-19 drives medical education reform to promote "healthy China 2030" action plan.

In June 2019, the Chinese government proposed the Healthy China Action Plan (2019-2030) development strategy, which focuses on disease prevention and health promotion. It is expected that by 2030, the national health literacy level will be significantly improved, premature mortality caused by major chronic diseases will be significantly reduced, the average healthy life expectancy will be greatly improved, and the main health indicators of residents will enter the ranks of high-income countries. Unfortunately, at the end of 2019, COVID-19 began to break out in Wuhan, China, which had a huge impact on China's economy and people's health. A series of problems in China's health care and medical education were exposed in the prevention and treatment of the epidemic. How to reform medical education and build a medical talent training system with Chinese characteristics is the key to achieving China's Health 2030 strategy. This article will explore the direction of medical education reform in China under the background of the "Healthy China 2030" strategy and the post pandemic era.

Evolving trends, regional differences, determinants, and disease sources of provincial-level health inequalities in china 1990–2019: a temporal convergence and novel triple decomposition analysis

BackgroundPromoting health equity has been a worldwide goal, but serious challenges remain globally and within China. Multiple decomposition of the sources and determinants of health inequalities has significant implications for narrowing health inequalities and improve health equity.MethodsLife expectancy (LE), healthy life expectancy (HALE), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-year (DALY) rates in 31 provinces of mainland China were selected as health status indicators, obtained from the Global Burden of Disease (GBD) database. Temporal convergence analysis was used to test the evolving trends of health status. Dagum’s Gini coefficient decomposition was used to decompose the overall Gini coefficient based on intraregional and interregional differences. Oaxaca-Blinder decomposition was used to calculate contributions of determinants to interregional differences. The factor-decomposed Gini coefficient was used to analyze the absolute and marginal contribution of each component to overall Gini coefficients.ResultsFrom 1990-2019, China witnessed notable improvements in health status measured by LE, HALE, ASMR and age-standardized DALY rates.Nevertheless, the three regions (East, Central and West) exhibited significant inter-regional differences in health status, with the differences between the East and West being the largest. The adjusted short-term conditional β-convergence model indicated that the inter-provincial differences in LE, HALE, ASMR, and age-standardized DALY rates significantly converged at annual rates of 0.31%, 0.35%, 0.19%, and 0.28% over 30 years. The overall Gini coefficients of LE, HALE, and age-standardized DALY rates decreased, while the ASMR exhibited an opposite trend. Inter-regional and intra-regional differences accounted for >70% and<30% of overall Gini coefficients, respectively. Attribution analysis showed that socioeconomic determinants explained 85.77% to 91.93% of the eastern-western differences between 2010-2019, followed by health system determinants explaining 7.79% to 11.61%. The source-analysis of Gini coefficients of ASMR and age-standardized DALY rates revealed that noncommunicable diseases (NCDs) made the largest and increasing absolute contribution, while communicable, maternal, neonatal, and nutritional diseases (CMNNDs) had a diminishing and lower impact. However, NCDs exerted a negative marginal effect on the Gini coefficient, whereas CMNNDs exhibited a positive marginal effect, indicating that controlling CMNNDs may be more effective in reducing health inequities.ConclusionsRegional differences are a major source of health inequities in China. Prioritizing prevention and control of CMNNDs, rather than NCDs, may yield more pronounced impacts on reducing health inequalities from the perspective of marginal effect, although NCDs remain the largest absolute contributor to health inequalities.

Nicotinamide Adenine Dinucleotide (NAD)-Dependent Protein Deacetylase, Sirtuin, as a Biomarker of Healthy Life Expectancy: A Mini-Review.

Although a variety of disease-specific biomarkers have been identified for common lifestyle- or aging-related diseases, there are currently no indices available to measure general health or the existence of pre-symptomatic conditions in various types of tissue and organ damage. A rising body of research suggests that sirtuins may have the potential to be used as an index to assess overall health status and the existence of pre-symptomatic illness states. Sirtuins (SIRTs) are nicotinamide adenine dinucleotide (NAD)-dependent deacetylases expressed in a variety of human somatic cells both in health and disease conditions. The activity and expression of SIRTs affect important metabolic pathways, such as cell survival, senescence, proliferation, energy production, stress tolerance, DNA repair, and apoptosis, thereby closely linked to aging and longevity. Given the broad significance of SIRTs in physiological function maintenance, their activity in somatic cells may reflect the early cross-sectional status of tissue damage caused by aging or systemic inflammatory responses that are too early to be detected by disease-specific biomarkers. In this mini-review, we discuss the utility of SIRTs as a surrogate clinical biomarker for health status to evaluate and monitor health life expectancy and the presence of pre-symptomatic illness states.

Data resource profile: Exploring freely accessible data describing wider determinants of health in England

IntroductionIn England, life expectancy has stalled and significant decreases observed in certain geographical areas and populations. The cause of this involves complex dynamics between an individual's health, characteristics, lifestyle, and their wider environment known as the wider determinants of health which are key to good life expectancy, healthy life expectancy, and prevention of long-term medical conditions. Knowing the availability, breadth, features, and linkage potential of datasets relevant to wider determinants of health is important for exploring trends and associations for policy and public health planning. MethodsA systematic mapping of internet content identified accessible datasets relevant to wider determinants of health in England with town level geographical granularity or lower. Search terms were used in search engines and chatbots to identify weblinks subsequently examined for eligible datasets. Results105 potential weblinks to datasets were identified. Of these, twenty-one weblinks were explored further after exclusion of those: not accessible or currently live (n = 13); duplicated across search engines (n = 17); providing information only (i.e. no raw data, n = 14); did not provide freely accessible data (n 3); were not relevant to wider determinants of health (n = 17); lacked geographical granularity (n = 26). Eighty-nine datasets of interest were compiled with sub-town level data aggregation. Approximately half (n = 47, 52%) were from the England and Wales census 2021, with the remaining sources including government bodies, public services, and research datasets. Datasets covered many valuable categories of wider determinants of health. Key data gaps included food consumption, social care data and community/voluntary services. ConclusionIn England, access to data relevant to wider determinants of health is good and available at relatively small geographical resolution. Accessible datasets were identified and compiled within multiple categories of wider determinants of health as a useful data resource to explore wider determinants of health at place if linked to relevant health data or population studies. Key Features This data resource profile describes a systematic mapping of freely accessible population data on wider determinants of health in England. To the authors knowledge this is the first comprehensive compilation of freely accessible data resources of this kind. This data resource profile was created to support research into the mechanisms and impact of wider determinants on the health of populations in England but is applicable to research and populations studies wider than this. Eighty-nine datasets were identified that may be of use to researchers in health and other population data fields. Datasets are held separately but many have the potential to be linked through common geographical area codes to other relevant datasets such as health data. The datasets originate from multiple sources including government bodies, public services, and research datasets. They cover many key categories of wider determinants of health including socioeconomics, employment, housing, support services, and the environment. Key data gaps included food consumption, social care data and community/voluntary services. The data resource profile in this article links directly to freely accessible datasets at the time of publication in the tables provided. The authors welcome contact from researchers for collaboration on exploring wider determinants of health through data use. Please contact Dr Melanie Rees-Roberts m.rees-roberts@kent.ac.uk

SPECIFICITY OF SELF-PRESERVATION BEHAVIOR OF THE POPULATION OF THE CAPITAL REGION

Based on data from official statistics and the "Selective Observation of Population Health" implemented by Rosstat, the article analyzes the dynamics of life expectancy and healthy life expectancy in the regions of Russia in the period from 2019 to 2023, with special attention paid to the position of Moscow in the structure under study.

Aerobic exercise effects on systolic blood pressure and endothelial inflammation in obese and non-obese elderly women with isolated systolic hypertension.

This study aimed to investigate the effects of a 16-week aerobic exercise program on systolic blood pressure, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1, and oxidized low-density lipoprotein of obese and nonobese elderly women with isolated systolic hypertension. Elderly women aged 70-85 years were recruited and grouped into the normal isolated systolic hypertension ( n = 12) and obese isolated systolic hypertension groups ( n = 13). The participants followed an aerobic exercise program, using a wireless heart rate monitor to maintain an appropriate heart rate reserve based on the American College of Sports Medicine exercise guidelines. The two-way repeated measures analysis of variance tested group × time interaction. Pearson's correlation and simple regression assessed the influence of each variable, which showed significant differences. An interaction effect for systolic blood pressure, intracellular cell adhesion molecule-1, and vascular cell adhesion molecule-1 ( P < 0.05) and a main time effect for oxidized low-density lipoprotein ( P < 0.05) were observed. A correlation between the rates of change in systolic blood pressure and vascular cell adhesion molecule-1 ( P < 0.05) with a 42.8% influence ( P < 0.001) and in intracellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 ( P < 0.05) with a 21.6% influence ( P < 0.05) was observed. These findings collectively showed that the 16-week aerobic exercise program effectively lowered blood pressure in patients with isolated systolic hypertension, particularly in the normal group compared to the obese group. Thus, regular aerobic exercise for 16 weeks or more enhances vascular health, potentially improving the healthy life expectancy of elderly women.

Differences in sarcopenia indices in elderly Japanese women and their relationships with obesity classified according to waist circumference, BMI, and body fat percentage

BackgroundSarcopenic obesity (SO) is defined as a decrease in lean body mass and an increase in body fat mass (BFM) due to aging. Detecting SO in elderly women is important from the perspective of extending healthy life expectancy. While various indices of SO are currently used, there is no global consensus regarding diagnostic criteria for SO. This study aimed to examine the relationship between obesity indices (waist circumference (WC), body mass index (BMI), and body fat percentage (BFP)) and sarcopenia indices (total body muscle mass (TBM), appendicular lean mass (ALM), skeletal mass index (SMI)), and physical function (gait speed (GS), handgrip strength (HGS)).MethodsSubjects were 170 community-dwelling healthy elderly women aged 65–79 years (mean: 72.7 ± 5.78 years) who underwent measurements for WC, BMI, and BFP. A WC of ≥ 90cm was defined as the obese group, BMI was determined as weight (kg) divided by height squared (m2) and a cutoff of ≥ 25 kg/m2 was used to define the obesity group. BFM was measured using the bioelectrical impedance analysis (BIA) method and BFP was calculated from body weight and a cutoff of ≥ 30% was used to define the obesity group. TBM and ALM (kg) were measured using the BIA method, ALM (kg) was corrected for height (m2) to obtain SMI (kg/m2). Physical function was assessed by GS and HGS, which were measured by the 5-m walk test and a digital grip strength meter, respectively.ResultsWhen obesity was assessed using BMI, WC and BFP, obese individuals had higher TBM, ALM and SMI, and lower GS among the sarcopenia indicators. HGS did not differ significantly between the non-obese and obese groups.ConclusionOur findings suggest HGS is thought to reflect muscle strength without being affected by obesity indices, suggesting that it may be useful in detecting possible sarcopenia in obese individuals.

Assessing the Relationships between Physical Activity, a Healthy Life, and Personal Happiness in European Union Countries.

Background: Maintaining a physically active lifestyle is a determinant factor of a healthy life and personal happiness. Meanwhile, physical inactivity remains a significant issue, resulting in negative consequences for public health. Objectives: This paper investigates the relationships between physical activity, physical inactivity, a healthy life, life expectancy, and personal happiness in European Union (EU) countries. Methods: This empirical study uses an artificial neural network and cluster analysis to analyze and interpret data from 27 EU countries. Artificial neural network analysis enables the assessment of the relationships between physical activity and inactivity, a healthy life, and personal happiness, while cluster analysis identifies groups of EU countries based on physical activity, healthy life, and personal happiness indicators. Results: The results show significant positive links between physical activity and improvements in healthy living and personal happiness. Conclusions: This study highlights considerable variations among EU countries regarding the levels of physical activity, healthy living, and personal happiness, emphasizing the importance of promoting physical activity to enhance public health and overall well-being. The findings suggest the need to develop customized policies that address country-specific factors and promote an active lifestyle.