Middle-aged Population Research Articles

Cumulative blood pressure predicts risk of cardiovascular outcomes in middle-aged and older population

Background Cardiovascular disease (CVD) remains a major health concern globally, contributing to a considerable disease burden. However, few studies have considered long-term cumulative blood pressure (cBP) exposure in middle-aged and older population in China. The aim of this study was to investigate whether long-term cBP was associated with subsequent cardiovascular outcomes among participants without CVD at baseline in Chinese over 45 years old. Methods 6435 participants in China of the CHARLS (The China Health and Retirement Longitudinal Study) were included. Cumulative BP was calculated as the area under the curve using measurements from wave 1 (2011) to wave 2 (2013). Outcomes included CVD, heart disease and stroke. Results During a median follow-up period of 5 years, 1101 CVD events, 826 heart disease, and 351 stroke were recorded. Each 1-SD increase in cumulative systolic blood pressure (cSBP), cumulative diastolic blood pressure (cDBP), and cumulative mean arterial pressure (cMAP) was associated with increased risk of CVD (HR, 1.12; 95%, 1.05–1.20, HR, 1.14; 95%, 1.07–1.22, HR, 1.14; 95%, 1.07–1.22), heart disease (HR, 1.05; 95%, 0.97–1.13, HR, 1.09; 95%, 1.01–1.17, HR, 1.08; 95%, 1.00–1.16) and stroke (HR, 1.35; 95%, 1.21–1.51, HR, 1.31; 95%, 1.17–1.46, HR, 1.36; 95%, 1.22–1.51). The relationship between cBP and CVD has only been found in people younger than 60 years of age. A significant association was observed for cumulative pulse pressure (cPP) with stroke (HR, 1.23; 95%, 1.10–1.38). None nonlinear relationships were identified (p-nonlinear > .05). For the prediction of cardiovascular outcomes, cBP load outperformed baseline BP in terms of C statistics (p < .001). Conclusions Long-term cSBP, cDBP and cMAP were associated with subsequent CVD and only found in people younger than 60 years of age, whereas cPP was associated with stroke only across all ages. Cumulative BP may provide a better prediction of cardiovascular outcomes compared with single BP measurement. Efforts are required to control long-term BP in assessing cardiovascular risks.

Illicit Drug Use and Cerebral Microbleeds in Patients with Acute Ischemic Stroke and Transient Ischemic Attack.

Cerebral microbleeds (CMB) signal cerebral small vessel disease and are associated with ischemic stroke. While illicit drug use (IDU) is linked to cerebral vasculopathy, the association between CMB and IDU is poorly characterized. Our primary aim was to explore the relationship between IDU and CMB and delineate differences in vascular risk factors between those with and without CMB. We included 1746 (1614 unique patients) acute ischemic stroke and transient ischemic accident patient admissions from 2009 to 2018 with a readable T2*gradient-echo sequence brain MRI. We retrospectively obtained patient characteristics and IDU data (by history and/or urine toxicology). MRIs were reviewed for CMB and classified topographically as lobar, deep or infratentorial. Univariate analysis was used to assess differences in patient characteristics between those with and without CMB, as well as variation in CMB location by drug category subgrouping. Coprimary multivariate logistic/Poisson regression was used to characterize the association between drug category subgrouping and CMB. We observed IDU in 13.8% (n=241) and CMB presence in 32.9% (n=575) in our predominantly black, middle-aged population. 53.8% of CMB were lobar, 27.3% were deep and 18.8% were infratentorial. Within the IDU group, those with at least one CMB (compared to those without CMB) were older (56.9±11.5 vs. 53.6±10.5, p=0.036), had a lower BMI (26.6±4.4 vs. 28.1±5.9, p=0.039), and were more likely to have CKD (9.5% vs. 3.0%, p=0.033) or have had a previous IS/TIA (41.9% vs. 25.1%, p=0.009). On coprimary analysis, cocaine use was associated with increased CMB number by 0.24 (95% CI: 0.09, 0.38; p=0.001) and opioid use was associated with increased CMB number by 0.31 (95% CI: 0.08, 0.52; p<0.001) controlling for age, sex, hypertension status, and prior ischemic stroke or transient ischemic accident. CMB in the opioid use group were more likely to be deep (40.4% vs. 27.3%, p=0.023) compared to those without opioid use. Our findings support an association between CMB, an early marker of cerebral vasculopathy, and cocaine and opioid use. These results highlight the need for further research into the pathophysiological mechanisms linking illicit drug use to cerebrovascular injury and underscore the importance of targeted interventions in this population.

The correlation between TyG-BMI and the risk of osteoporosis in middle-aged and elderly patients with type 2 diabetes mellitus

Background and objectivesOsteoporosis (OP) has emerged as one of the most rapidly escalating complications associated with diabetes mellitus. However, the potential risk factors contributing to OP in patients with type 2 diabetes mellitus (T2DM) remain controversial. The aim of this study was to explore the relationship between triglyceride glucose-body mass index (TyG-BMI), a marker of insulin resistance calculated as Ln [triglyceride (TG, mg/dL) × fasting plasma glucose (mg/dL)/2] × BMI, and the risk of OP in T2DM patients.MethodsThis retrospective cross-sectional study enrolled 386 inpatients with T2DM, comprising both male and postmenopausal female participants aged 40 years or older. Individuals with significant medical histories or medications known to influence bone mineral density were excluded. Machine learning algorithms were employed to rank factors affecting OP risk. Logistic regression analysis was performed to identify independent influencing factors for OP, while subgroup analysis was conducted to evaluate the impact of TyG-BMI on OP across different subgroups. Restricted cubic spline (RCS) analysis was used to explore the dose-response relationship between TyG-BMI and OP. Additionally, the receiver operating characteristic (ROC) curve was utilized to assess the predictive efficiency of TyG-BMI for OP.ResultsMachine learning analysis identified TyG-BMI as the strongest predictor for type 2 diabetic osteoporosis in middle-aged and elderly patients. After adjusting for confounding factors, multivariate logistic regression analysis revealed that age, osteocalcin, and uric acid were independent influencing factors for OP. Notably, TyG-BMI also emerged as an independent risk factor for OP (95%CI 1.031–1.054, P &amp;lt; 0.01). Subgroup analysis demonstrated a consistent increase in OP risk with higher TyG-BMI levels across all subgroups. RCS analysis indicated a threshold effect, with the risk of OP gradually increasing when TyG-BMI exceeded 191.52. Gender-specific analysis showed increasing the risk of OP when TyG-BMI surpassed 186.21 in males and 198.46 in females, with a more pronounced trend observed in females. ROC suggested that TyG-BMI index has significant discriminative power for type 2 diabetic osteoporosis.ConclusionTyG-BMI has been identified as a robust predictive biomarker for assessing OP risk in middle-aged and elderly populations with T2DM.

Assessment of the Relationship Between Internet Addiction, Psychological Well-Being, and Sleep Quality: A Cross-Sectional Study Involving Adult Population

Internet addiction is an emerging public health concern among adults, potentially affecting psychological well-being and sleep quality. Although a substantial body of research has focused on adolescents and younger adults, less is known about middle-aged and older adult populations. This study investigated the relationships between Internet addiction, sleep quality, and psychological well-being in 629 adults (aged 30–60 years) and examined the socio-demographic predictors of Internet addiction. Participants completed online questionnaires assessing Internet addiction, psychological well-being, and sleep quality (Pittsburgh Sleep Quality Index). The final sample had a mean age of 39.4 (SD = 7.8), with 53.4% female participants. Most were employed (77.9%), and nearly half held an undergraduate degree (49.1%). The mean Internet addiction score was 38.1 ± 13.6. Poor sleep quality was prevalent (67.2%), and Internet addiction was positively correlated with total PSQI scores (r = 0.593; p &lt; 0.001). Higher psychological well-being was inversely associated with both Internet addiction (r = −0.417; p &lt; 0.001) and poor sleep quality (r = −0.490; p &lt; 0.001). Younger age, female gender, regular employment, and higher income predicted greater Internet addiction, whereas having an undergraduate degree was associated with lower scores. Taken together, the findings of this study emphasize the importance of addressing sleep quality and psychological well-being to mitigate excessive Internet use in mid-life and older populations, particularly among those at higher risk.

Self-portrait of young and middle-aged aged care -- Based on the investigation of young and middle-aged aged care willingness and influencing factors in Bengbu

With the advent of an aging society in China, the issue of elderly care has become increasingly severe. Particularly in the next 10 to 20 years, the current mid-dle-aged and young population aged 30–50 will enter old age. The trend of smaller family sizes and fewer children has challenged the traditional family-based elder-ly care model. This study focuses on the middle-aged and young population in Bengbu, exploring their willingness and influencing factors regarding elderly care through questionnaire surveys and data analysis. The research finds that the aver-age elderly care demand level among Bengbu's middle-aged and young population is 0.626, indicating a moderately high level of willingness and demand. Key in-fluencing factors include physical health, education level, and marital status. Those with poorer health, higher education, or who are unmarried or living alone express greater concerns about their future elderly care. The study suggests that the government should improve basic elderly care systems and policies, while so-ciety should establish a diversified elderly care security system, strengthen com-munity-based elderly care institutions, and promote a complementary relationship between family-based and socialized elderly care to address future elderly care challenges

Association between the ratio of serum uric acid to high density lipoprotein cholesterol and depressive symptoms in middle-aged and elderly Chinese.

Previous studies have reported that metabolic syndrome is associated with depression. In recent years, the ratio of uric acid to high-density lipoprotein cholesterol (UHR) has been considered as a new effective marker of metabolic syndrome. The purpose of this study was to investigate the association between UHR and depression in people aged 45 years and older in China using the China Health and Retirement Longitudinal Study(CHARLS) database. A total of 10,396 subjects aged 45 years and above were included in this cross-sectional study. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to facilitate rapid screening and assessment of depression. A CESD-10 score of ≥ 10 was considered the critical value of depression. UHR was calculated from the ratio of serum uric acid (mg/dL) to high-density lipoprotein cholesterol (mg/dL). Linear regression and logistic regression were used to explore the relationship between UHR and depression, respectively. In addition, subgroup analysis and interaction tests were performed. The study found that UHR was negatively associated with depression. In the fully adjusted model, every 1-unit increase in UHR was associated with a 14% lower odds of developing depression (OR = 0.14, 95% CI: 0.05-0.37). Participants in the highest quartile of UHR were 24% less likely to develop depression compared with participants in the lowest quartile (OR = 0.76, 95% CI: 0.67-0.87). The interaction analysis indicates that this negative correlation is more pronounced in the subgroup aged 60 years and above. UHR was significantly negatively correlated with depressive symptoms in the middle-aged and elderly Chinese population. However, further prospective studies are needed to accurately elucidate the causal relationship between increased UHR levels and the risk of depression. Therefore, larger cohort studies are needed to support these findings.

Association between physical activity and frailty transitions in middle-aged and older adults: a nationwide longitudinal study

BackgroundFrailty has become an important health problem in the middle-aged and older people population. Physical activity (PA) is a key intervention for frailty prevention and management. However, studies of the association between COVID-19 pre-pandemic PA and the worsening or improvement of frailty during the pandemic remain unclear.MethodsThis longitudinal cohort study used data from the English Longitudinal Study of Ageing (ELSA), including participants aged 50 and over. Three intensities of PA (vigorous, moderate, and mild) were categorized as less than once per week and at least once per week, respectively, based on participant self-report. The frailty index (FI) assessed the frailty status, defining frailty as FI ≥ 25. Logistic regression was applied to examine the association between PA and frailty, estimating odds ratios (OR) and 95% confidence intervals (95% CI).ResultsOf the 4379 non-frail participants at baseline (median age 67, 54.9% female), 8.1% developed frailty during a mean follow-up of 3.5 years. Among 564 frail participants at baseline (median age 71, 66.5% female), 17.9% regained health. Compared to those engaging in PA less than once per week, participants who engaged in vigorous (OR: 0.47 [95% CI: 0.35–0.62]), moderate (OR: 0.37 [95% CI: 0.29–0.48]), or mild (OR: 0.38 [95% CI: 0.26–0.56]) PA at least once a week had a lower risk of frailty worsening. Additionally, participants who engaged in moderate (OR: 2.04 [95% CI: 1.29–3.21]) or mild (OR: 2.93 [95% CI: 1.54–5.58]) PA at least once a week had a higher likelihood of frailty improvement. Sensitivity analyses based on comprehensive PA levels confirmed these findings. Participants who maintained at least one PA per week had lower frailty worsening (Vigorous, OR: 0.20 [95%CI: 0.12–0.33]; Moderate, OR: 0.13 [95%CI: 0.09–0.19]; Mild, OR: 0.20 [95%CI: 0.11–0.38]) and higher frailty improvement rates (Moderate, OR: 3.43 [95%CI: 1.93–6.11]; Mild, OR: 4.65 [95%CI: 1.90-11.42]). In addition, individuals (Vigorous, OR: 0.35 [95%CI: 0.20–0.60]; Moderate, OR: 0.36 [95%CI: 0.22–0.56]) who transitioned from inactive to active also exhibited a lower risk of frailty.ConclusionsThis study emphasized the critical role of PA in preventing and improving frailty in middle-aged and older people, especially during the COVID-19 pandemic. Our study also highlighted the importance of maintaining PA habits to reduce frailty risk and promote its improvement. Also, the study indicated that individuals who transitioned from inactive to active had a lower risk of frailty. These findings enriched the understanding of the association between PA and frailty and provided valuable insights for addressing the health impact of future pandemics on middle-aged and older people.

Estimated Pulse Wave Velocity and Stroke Among Middle-Aged and Older Population: Insights From 3 Prospective Cohorts.

Arterial stiffness is recognized as a new risk factor for stroke. However, the association between estimated pulse wave velocity (ePWV), a well-established indirect measure of arterial stiffness and stroke among older adults, remains incompletely investigated. This study utilized data from 3 prospective, nationally representative cohorts: the Health and Retirement Study in the United States, the English Longitudinal Study of Aging in the United Kingdom, and the China Health and Retirement Longitudinal Study in China. ePWV was calculated based on age and mean arterial pressure. Cox proportional hazard models were used to compute hazard ratios and 95% CIs. The final analysis included 6458 participants from the Health and Retirement Study (mean age: 66.99 years; 40.4% men), 6458 from the English Longitudinal Study of Aging (mean age: 66.32; 44.4% men), and 12 415 from the China Health and Retirement Longitudinal Study (mean age: 58.60; 46.2% men). Over follow-up periods of 10.28 years in the Health and Retirement Study, 9.95 years in the English Longitudinal Study of Aging, and 6.30 years in the China Health and Retirement Longitudinal Study, 624 (9.7%), 374 (5.8%), and 656 (5.3%) participants developed stroke, respectively. Fully adjusted Cox regression analysis revealed a significant association between ePWV and incident stroke across all cohorts (Health and Retirement Study: hazard ratio, 1.29 [95% CI, 1.24-1.35]; English Longitudinal Study of Aging: hazard ratio, 1.37 [95% CI, 1.28-1.46]; China Health and Retirement Longitudinal Study: hazard ratio, 1.20 [95% CI, 1.15-1.25]). This study demonstrated that higher levels of ePWV were associated with increased risks of incident stroke among middle-aged and older populations. Arterial stiffness assessment through ePWV could potentially improve primary prevention and treatment strategies for stroke.

Distribution and association of depression with tobacco consumption among middle-aged and elderly Indian population: nested multilevel modelling analysis of nationally representative cross-sectional survey

BackgroundResearch on the distribution and association of depression with tobacco consumption among young population is commonly prioritised in India, while studies on tobacco use among middle-aged (45–59 years) and elderly (≥ 60 years) adults are noticeably lacking. Thus, we conducted this study with the objectives of estimating the prevalence, distribution and determining the association of depression and tobacco consumption among middle-aged and elderly Indian population; overall and stratified into age group, gender, and geographical location.MethodsUsing dataset from Longitudinal Aging Study in India (LASI), a bivariate analysis was conducted among middle-aged (45–59 years) and elderly (≥ 60 years) Indians to estimate the prevalence of depression and tobacco consumption. States and Union Territories were categorised as low, medium, and high as per prevalence of depression and tobacco consumption, and spatial distribution maps were created. To reduce the confounding effects of demographic & socioeconomic and health-related & behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was employed to explore the association between depression (outcome variable) and tobacco consumption (explanatory variable) using STATA version 17. The p value < 0.05 was considered statistically significant.ResultsOverall, 36.78% (36.03–37.55%) participants documented using any form of tobacco; with higher consumption of smokeless tobacco (SLT) (19.88%) than smoking (SM) (13.92%). The overall prevalence of depression was 7.62% irrespective of tobacco consumption, and 8.51% among participants consuming any form of tobacco. Mizoram had the highest consumption of tobacco in any form (78.21%), whereas Madhya Pradesh recorded the highest (14.62%) depression prevalence. Bihar, Uttar Pradesh, West Bengal, and Uttarakhand had both high prevalence of depression and any form of tobacco consumption. The average estimated treatment effect (ATE) indicated a positive association both between depression and any form of tobacco consumption (p value = 0.001) and with smokeless tobacco (p value = 0.001) consumption. Participants ever consuming any form of tobacco had 28% higher odds (aOR-1.28 (1.18–1.38). The odds of having depression were higher among females (aOR = 1.28 (1.17–1.41); richest (aOR-1.48 (1.32–1.65); living alone (aOR = 1.14 (1.01–1.33). Participants with comorbidity (aOR = 1.20 (1.10–1.30) and multimorbidity (aOR = 1.24 (1.13–1.36)) had higher odds of depression.ConclusionThe study has established significant positive association between depression and tobacco consumption stratified into gender and age group. Prioritisation of mental health disorders like depression and tobacco prevention and cessation programmes must be implemented with focusing on females and the middle-aged population with community awareness and intersectoral collaborative effort irrespective of subnational-variations.

Role of abdominal aortic calcification score in predicting cardiovascular risk in the general population.

Abdominal aortic calcification (AAC) is closely related to cardiovascular disease. Although its clinical significances have primarily been investigated in patients with chronic kidney disease, its association with cardio-cerebrovascular mortality in the general middle-aged and elderly population has not been sufficiently investigated. To study the association of AAC and cardio-cerebrovascular mortality in both the entire general middle-aged and elderly populations and age subgroups. Data of participants of the National Health and Nutrition Examination Survey (NHANES) 2013-2014 were analyzed. This study included middle-aged and elderly (≥ 40years old) individuals who underwent dual-energy X-ray absorptiometry.The severity of AAC was assessed by an AAC scoring system (AAC score) with a maximum possible value of 24. Participants were tracked for survival status and major cause of death till 31st December 2019. This study utilized AAC score = 6 as the optimal cut-off according to Harrell's c statistic. Based on AAC scores, participants were trichotomized (0, 0-6, and ≥ 6). Groupwisesurvival curves and cumulative incidence functionswere plotted to reveal the association of AACand cardio-cerebrovascular mortality. Given results under trichotomization, combination of participants with AAC scores 0 and 0-6 was conducted to reaffirm the association of AAC and adverse prognosis. Correlation between increased AAC score and poorer survival, higher cumulative incidence of events was revealed. Cox models identified AAC score ≥ 6 as an independent risk factor of cardio-cerebrovascular mortality (AAC score ≥ 6 vs. AAC score = 0: Hazard ratio: 2.38, P = 0.008) after adjusting for cardiovascular risk factors. Results remained significant after regrouping (AAC score ≥ 6 vs. AAC score < 6: Hazard ratio: 2.06, P = 0.016). Subgroup analysis provided no evidence of unparallel change in hazard for the same amount of increase in AAC score among middle-aged (40-65years old) and elderly (≥ 65years old) individuals. AAC score ≥ 6 independently indicate increased risk of cardio-cerebrovascular death and would be effective in risk stratification among the general middle-aged and elderly population in clinical practice.

The association of physical activity, physical fitness, dental caries, and erosive tooth wear in Northern Finland Birth Cohort 1966.

Introduction Research on the impact of physical activity and physical fitness on oral health has been limited in scope. The aim of this report is to assess the impact of physical activity and physical fitness as modifiable factors in dental caries and erosive tooth wear among middle-aged individuals in Finland. Methods Data was gathered from the North Finland Birth Cohort 1966 (NFBC1966) 46-year follow-up, which included dental clinical examinations conducted by seven calibrated dentists, physical fitness tests, measurements of physical activity (PA), and measurements of height and weight administered between 2012 and 2014. PA was measured over a two-week period with a wrist-worn accelerometer and reported as average daily duration of PA (min/day). Physical fitness was assessed by measuring cardiorespiratory fitness via heart rate recovery (HRR) in a step test using a heart rate monitor and chest belt, and by evaluating back strength with the Biering-Sorensen test. Of the whole cohort, 1,964 cohort members participated in the oral clinical examination, and the regression models were conducted with 1,590 participants. The prevalence of dental caries (ICDAS), DMFT score, and erosive tooth wear (BEWE), and the results of the PA test and physical fitness tests, were categorized and analyzed using cross-tabulations and multivariable logistic regression models. SPSS version 29.0.0.0 was used to calculate 95% confidence intervals [CI], Odds Ratios [OR], 𝜒2, and p-values. Results Poor (OR 1.60, 95% CI 1.15 - 2.23) and moderate (OR 1.48, 95% CI 1.14 - 1.93) cardiorespiratory fitness and low PA (OR 1.48 95% CI 1.07 - 2.05) were associated with dentine caries in the regression model. The same model indicated that tooth brushing frequency (OR 1.97, 95% CI 1.21 - 3.20), erosive tooth wear (ETW) (OR 1.30, 95% CI 1.12 - 1.49), and male gender (OR 1.22, 95% CI 1.05 - 1.43) were associated with increased dentine caries. No statistically significant association was found between PA or physical fitness and ETW. Conclusion In the middle-aged Finnish population, high physical activity and good physical fitness are associated with a lower prevalence of dentine caries. No association between physical activity or physical fitness and ETW were found. Further research is needed to explore the potential oral health benefits of physical activity and physical fitness as modifiable factors.

Protocol for the quantitative detection of mtDNA inthesupernatants of activated human naive CD8+ Tcells.

Protocol for the quantitative detection of mtDNA inthesupernatants of activated human naive CD8+ Tcells.

Incident type 2 diabetes and its risk factors in men and women aged 40-60 years from four sub-Saharan African countries: results from the AWI-Gen study.

Incident type 2 diabetes and its risk factors in men and women aged 40-60 years from four sub-Saharan African countries: results from the AWI-Gen study.

Non-linear associations between blood glucose, blood lipids and inflammatory markers and new-onset arthritis in the middle-aged and older population - a cohort study in Europe

ObjectiveThe arthritis burden increases with aging, while blood glucose, lipid profiles and inflammatory markers may affect the development of arthritis. This study aims to determine the associations between blood markers and rheumatoid arthritis (RA) and osteoarthritis (OA) for better arthritis management.MethodData from the 6th and 9th wave of the Survey of Health, Ageing, and Retirement in Europe (SHARE) were used. Logistic regression and Cox proportional hazards regression models were used to examine the associations between blood markers and arthritis. Generalized additive models and restricted cubic splines (RCS) were employed to assess non-linear associations.ResultsThis study included a total of 14,276 participants. The incidence was 5.80% for OA, and 13.92% for RA. The participants with new-onset OA and RA were more likely to be older, female, and with higher body mass index. The generalized additive model detected nonlinear associations between the incidence of OA and glycated hemoglobin A (HbA1c), and between the incidence of RA and high-density lipoprotein (HDL) and triglycerides (TRG). RCS curves (P-nonlinear < 0.05) showed an increased risk of new-onset OA for HbA1c levels between 4.75% and 5.91% in individuals aged ≤ 65. For those aged>65, HDL levels between 44.99 and 67.42 mg/dL and TRG levels between 265.37 and 1125.06 mg/dL were associated with an increased risks of new-onset RA. Furthermore, total cholesterol, HbA1c, HDL and TRG were associated with the prevalence of arthritis.ConclusionMonitoring lipid profiles and HbA1c levels in middle-aged and older adults may help to manage arthritis.

Osteoarthritis Incidence Trends Globally, Regionally, and Nationally, 1990-2019: An Age-Period-Cohort Analysis.

Osteoarthritis (OA) contributes substantially to global disability. We analysed global and national OA incidence trends and associated factors. Data obtained from the 2019 Global Burden of Disease Study were used to examine 30-year OA incidence patterns globally and for 204 countries/territories. An age-period-cohort (APC) model determined annual percent changes, age-specific changes, and period/cohort effects. From 1990 to 2019, global OA incidence rose by 21.3 million, with the highest cases in China, India, the United States, and Japan. Incidence was higher in women versus men and peaked at ages 20-24years, though shifting towards middle-aged adults. The annual increase was 0.225% (95% confidence interval [CI] 0.157, 0.293) and 0.158% (95% CI: 0.114, 0.201) in high and low socio-demographic index countries, respectively, with most countries showing increasing incidence. Disadvantageous incidence trends over time and birth cohorts occurred in all regions except middle-high index countries, which had the lowest increase and declining period effect after 2005. OA represents an escalating public health burden, predominantly affecting middle-aged and elderly populations, and more women than men. Obesity and ageing are major drivers of rising OA incidence. Swiftly implementing policies to prevent modifiable risks and ensure proper treatment access is imperative to mitigate the impact of OA.

Neighborhood environment and cognitive functioning in middle-aged and older population: A mediating role of physical activity.

Neighborhood environment and cognitive functioning in middle-aged and older population: A mediating role of physical activity.

Bidirectional association between sarcopenia and diabetes: A prospective cohort study in middle-aged and elderly adults.

Bidirectional association between sarcopenia and diabetes: A prospective cohort study in middle-aged and elderly adults.

The longitudinal relationship between night-time sleep duration, midday napping, and frailty among middle-aged and older people in China: a prospective analysis.

Frailty is an important issue presented by ageing. Night-time sleep and midday napping are important modifiable factors influencing health, but their impacts on frailty remain unclear. We used five waves of data from the China Health and Retirement Longitudinal Study (2011-20), with 15 333 participants in the baseline sample. We used fixed effects regression models to explore longitudinal relationships between night-time sleep duration, midday napping, and frailty index (FI). We added interaction terms of sleeping and napping to the regression model to explore their combined effects. We further used the Cox proportional regression model to quantify risks for frailty. Compared to sleeping seven to nine hours, sleeping <6 hours (FI = 0.016), six to seven hours (FI = 0.004), and >9 hours (FI = 0.005) were significantly associated with a mean increase in FI separately. Napping >90 minutes significantly increased FI by 0.003 compared to non-nappers. Effects of sleeping six to seven hours and >9 hours on frailty were separately enhanced by napping >90 minutes and any napping duration (except 60-90 minutes). Sleeping <6 hours and six to seven hours increased frailty risk by 44% (hazard ratio (HR) = 1.44) and 12% (HR = 1.12), respectively. Frailty risk was increased by napping >90 minutes by 14% (HR = 1.14) compared to non-nappers. Short (<7 hours) or long (>9 hours) sleep and prolonged midday napping (>90 minutes) were associated with frailty among the Chinese middle-aged and older population. The compensation effect of napping for short night-time sleep was not found in this study, and certain napping durations even increased risks of sleeping six to seven hours and >9 hours for frailty.

Glycoprotein acetyls response to a mixed meal is associated with increased insulin resistance and risk of type 2 diabetes in a middle-aged population.

Glycoprotein acetyls response to a mixed meal is associated with increased insulin resistance and risk of type 2 diabetes in a middle-aged population.

Exploring disparities in depressive symptoms between rural and urban middle-aged and elderly adults in China: evidence from CHARLS

ABSTRACT The study was to investigate the relevant factors that were associated with differences in depressive symptoms between urban and rural middle-aged and elderly population in China, measuring the contribution of related influencing factors. We constructed binary logistic regression models to investigate the primary factors influencing depressive symptoms and employed Fairlie models to examine these factors contributing to the differences in depressive symptoms between urban and rural middle-aged and elderly individuals. The proportion of depressive symptoms among middle-aged and older individuals in China was 38.16%, with findings indicating that rural areas exhibited higher rates (44.47%) of depressive symptoms compared to urban areas (31.85%). The Fairlie decomposition analysis demonstrated 53.51% of the disparities in depressive symptoms could be accounted for, which was mainly linked to differences in self-reported health status (19.16%), education level (14.45%), insurance (8.28%), instrumental activities of daily living dysfunction (6.16%), gender (−3.72%), sleep time (2.35%), falling history (2.31%), age (−2.17%), physical examination (2.03%), and chronic disease condition (−0.50%). The prevalence of depressive symptoms in rural middle-aged and elderly was greater than urban, linked to demographics, lifestyle, health status and social status. This study aided policymakers in reducing health disparities and designing targeted mental health interventions for vulnerable populations.