BackgroundMultidrug-resistant organism (MDRO) infections are a major global health threat. The COVID-19 pandemic and related containment policies may have altered hospital infection epidemiology and the distribution of MDROs.MethodsIn this retrospective cohort study, clinical and microbiological data from 2,669 adult inpatients with culture-confirmed hospital-acquired infections between 2013 and 2023 were analyzed. MDROs were defined per CLSI guidelines. The study period was stratified into pre-pandemic, strict containment, and post-adjustment phases. Multivariate logistic regression was used to identified factors associated with specific MDRO infections.ResultsThe overall MDRO detection rate increased from 36.9% to 56.4% during the strict containment. CRAB, which had previously been the dominant resistant pathogen, was progressively overtaken by CRE, while Klebsiella pneumoniae became the predominant species in 2022 (40.0%).Bloodstream infections increased from a pre-pandemic peak of 24% to 32% during the strict containment phase. Male sex, age≥60 years, and prolonged hospitalization (>14 days) were associated with distinct distribution patterns of CRAB and CRE infection. In multivariable analyses, mechanical ventilation was associated with increased odds of CRAB infection (aOR=2.07, 95% CI: 1.36-3.16), while urinary catheter use was associated with increased odds of CRE infection (aOR=1.49, 95% CI: 1.06-2.09) but lower odds of CRAB infection (aOR=0.64, 95% CI: 0.46-0.89). Endotracheal intubation was associated with increased odds of VRE infection (aOR = 5.84, 95% CI: 1.10-30.9).ConclusionsHospital MDRO epidemiology shifted substantially across the COVID-19 policy phases, with CRE emerging as the dominant resistant pathogen. Specific invasive procedures showed pathogen-specific associations, supporting risk stratification and more targeted infection prevention strategies in high-risk hospitalized patients.

Purpose To compare differences in inpatient costs between endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the treatment of patients with colorectal neoplastic lesions (including precancerous lesions and early-stage cancer), analyze the associated influencing factors, and conduct short-term and long-term cost-effectiveness evaluations, so as to provide a basis for clinical procedure selection and optimization of healthcare resource allocation. Methods Clinical data were retrospectively collected from 144 patients treated with ESD and 95 patients treated with EMR. Univariate analyses were performed using the Mann-Whitney U test and the Kruskal-Wallis H test. Multivariate linear regression and quantile regression models were further used to explore the influencing factors across different levels of cost distribution. Results Both univariate and multivariate linear regression analyses indicated that occupation, lesion site, maximum tumor diameter, and length of hospital stay were independent factors influencing hospitalization costs for ESD procedures ( P < 0.05); pathological findings, maximum tumor diameter, number of adenomas, and length of hospital stay were independent factors influencing hospitalization costs for EMR procedures ( P < 0.05). Quantile regression results showed that in the ESD group, hospitalization costs for patients who were specialized technical personnel decreased significantly at the 50th quantile ( P = 0.044), while unemployed patients exhibited a negative effect on costs at the 25th and 90th quantiles ( P = 0.05). Compared to lesions located in the right half of the colon, costs for lesions in the left half of the colon were significantly lower at the 25th percentile, and costs for rectal lesions were significantly lower at the 50th percentile ( P < 0.05). A maximum tumor diameter ≥ 2 cm significantly increased hospitalization costs at the 50th percentile ( P = 0.007); a hospital stay of ≥ 11 days had a positive effect on costs at the 10th, 25th, 50th, and 75th percentiles ( P < 0.05). Quantile regression analysis in the EMR group showed that a pathological diagnosis of early-stage cancer significantly increased hospitalization costs at all cost percentiles ( P < 0.01); a maximum tumor diameter ≥ 2 cm significantly increased costs at the 10th to 75th percentiles ( P < 0.05); 3 or more adenomas significantly increased costs only at the 25th percentile ( P = 0.032); a length of hospital stay ≥ 11 days had a significant positive effect on hospitalization costs at the 25th, 50th, and 75th percentiles ( P < 0.05). Conclusion Hospitalization costs for ESD and EMR treatments of colorectal lesions are influenced by multiple factors, and these factors exhibit heterogeneity across different cost quantiles. Length of hospital stay is the most robust positive cost driver for both surgical procedures, with a particularly pronounced effect in the mid-cost range. This suggests that in clinical practice, developing individualized treatment plans based on tumor size, lesion location, and patient occupational background, and shortening hospital stays through Enhanced Recovery After Surgery (ERAS) strategies, are key to achieving optimal allocation of healthcare resources.

BACKGROUND:China's rapid aging has exposed gaps in understanding life-course modifiable mortality risk factors, especially in the oldest-old. METHODS:This pooled cohort study analyzed 11 modifiable risk factors across age groups (30-49, 50-59, 60-79, 80-99, ≥100 years) using data from the China Kadoorie Biobank, China Hainan Centenarian Cohort Study, and Guangzhou Biobank Cohort Study. A modifiable risk factor score summed present factors. Cox models adjusted for age, sex, and other factors estimated age-stratified associations; hazard ratios (HRs) and population attributable fractions (PAFs) were calculated for all-cause mortality. RESULTS:Among 61,045 participants followed for mean 3.79-13.20 years, mortality rates were 6.45-169.52 per 1,000 person-years. A higher modifiable risk factor score was associated with increased mortality from middle age to centenarians (HR 1.11 [1.01-1.21] to 1.31 [1.21-1.36]). Metabolic risk factors attenuated with age: HR 1.43 (1.14-1.80) in middle-aged adults to 1.07 (0.99-1.17) in centenarians; diabetes and hypertension dominated this cluster. Hypertension-attributable mortality peaked at 16.2% (8.3-22.6%) in presenium, declining to 0.6% and 0.1% in advanced longevity groups. Conversely, low educational attainment showed increasing mortality impact with age (HR 1.55 [1.13-2.14] to 1.74 [1.01-3.01]; PAF 6.4%-30.8%); physical inactivity contributed significantly in both middle-aged adults and centenarians. CONCLUSIONS:Life-course stratification reveals dynamic transitions: metabolic burdens diminish while socio-behavioral risks intensify with longevity, supporting age-specific prevention strategies to optimize healthy aging.

Sleep disorders represent major public health concerns with significant health consequences. While diet shows promise as a modifiable intervention, the differential effects of established dietary patterns on specific sleep phenotypes and the contributions of specific food groups remains unclear. Therefore, this study investigated how three established dietary patterns relate to distinct sleep outcomes, and further explored the contributions of specific food components. We combined four decades of data and analyzed 9040 US adults from NHANES with sampling weights. Five sleep outcomes were examined in relation to dietary pattern adherence, quantified through averaged 24-h recall data from two consecutive days: including self-reported sleep duration, sufficiency, OSA, daytime sleepiness, and stop breathing. For international validation, we used the Global Dietary Database (62 countries) linked to country-level sleep apnea prevalence (191 countries). Cohort analysis employed the Chinese Longitudinal Healthy Longevity Survey (n = 6885). Causal associations between dietary components and sleep phenotypes were investigated using two-sample Mendelian randomization with genome-wide association summary statistics. Our results demonstrated that greater the Mediterranean Diet (MED) adherence was associated with longer sleep duration (β = 0.06, 95% CI: 0.03-0.10, p < 0.001) and sufficient sleep (OR = 1.10, 95% CI: 1.04-1.15, p < 0.001). Notably, dietary Approaches to Stop Hypertension (DASH) adherence offered the strongest protection against daytime sleepiness (OR = 0.89, 95% CI: 0.85-0.93, p < 0.001) and breathing cessation episodes (OR = 0.91, 95% CI: 0.85-0.96, p = 0.001). The Alternative Healthy Eating Index (AHEI) demonstrated balanced associations with improved sleep sufficiency (OR = 1.006, p < 0.05), reduced daytime sleepiness (OR = 0.995, p < 0.05), and fewer breathing episodes (OR = 0.989, p < 0.01). Furthermore, food-component-level analyses revealed consistent protective associations from legumes, nuts, and whole grains, while vegetables, fruits, meats, and SSBs showed variable effects-findings supported by both multi-database analyses and Mendelian randomization. Importantly, MR further demonstrated specific causal associations for fruits and vegetables: pears and strong vegetable preferences protected against short sleep, while cabbage, grapefruit, and melon causally increased sleep disorder risk. Additionally, processed meats causally increased OSA and snoring risk, with food processing degree emerging as a critical causal determinant. In conclusion, this study makes three main contributions. First, we provide a direct comparison of multiple dietary patterns (MED, DASH, AHE) across diverse sleep phenotypes. Second, we identify specific protective food components, with genetic causal evidence supporting their effects on sleep. Third, we integrate multi-national datasets to validate findings across diverse populations, substantially enhancing generalizability. Collectively, these findings support evidence-based dietary interventions for sleep health improvement.

BACKGROUND:Guidelines and consensus statements lack consistent management targets and ranges for low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) in older adults. OBJECTIVES:The objectives of the study were to investigate the relationships of LDL-C and HDL-C with cardiovascular disease (CVD) risk in older adults and to identify optimal target ranges for their management. METHODS:This study included 217,442 U.K. Biobank participants aged ≥60 years, free of CVD and cancer at baseline. Multivariable Cox regression models and restricted cubic splines were employed to estimate HRs and 95% CIs for the associations of LDL-C and HDL-C levels with CVD outcome. RESULTS:During follow-up, 26,756 CVDs and 2,726 CVD deaths occurred. LDL-C exhibited U-shaped relationships with both incident CVD and CVD mortality (minimal risk: 3.600-4.204 mmol/L). HDL-C showed an L-shaped association with incident CVD but a U-shaped association with CVD mortality (minimal risk: 1.421-1.699 mmol/L). Compared with the reference LDL-C group, the Q1 group had a 39% higher incident CVD risk (HR: 1.39; 95% CI: 1.32-1.47) and 27% higher CVD mortality risk (HR: 1.27; 95% CI: 1.08-1.48). Conversely, compared with the reference HDL-C group, the Q6 group was associated with a lower incident CVD (HR: 0.90; 95% CI: 0.84-0.97) and higher CVD mortality risk (HR: 1.24; 95% CI: 1.01-1.51). Notably, the CVD risk rose progressively with joint LDL-C and HDL-C risk tiers. CONCLUSIONS:U/L-shaped associations of LDL-C and HDL-C with CVD risk in older adults underscore the importance of maintaining lipids within an optimal range. This distinct "Goldilocks zone" is associated with minimized risk and highlights current guideline limitations.

BACKGROUND:Obesity and handgrip strength are independently associated with mortality risk; however, research evidence regarding their effects on premature mortality risk, either individually or in combination, remains limited. Concurrently, the European Association for the Study of Obesity (EASO) has introduced a novel obesity classification framework offering more refined criteria for weight status categorisation. Research re-evaluating the relationship between obesity and mortality risk based on this new framework is urgently required. OBJECTIVE:To investigate the association between weight status (WS), handgrip strength (HGS), their combined effect, and premature mortality risk. METHOD:This study utilised data from the UK Biobank (2006-2010) to construct a dynamic cohort of older adults (aged ≥60.0 years). Multivariable Cox proportional hazards models were employed to analyse the independent associations of body weight status and HGS, as well as their combined effects, with the risk of premature mortality. Heterogeneity was explored by stratifying for age, sex, and age at death. RESULTS:The study ultimately included 200,405 older adults. During a median follow-up of 5311.0 days, 28,094 all-cause mortality and 5172 premature mortality (2.6%) occurred. Obesity prevalence was significantly higher (62.5%) when defined by the new EASO framework compared to BMI-based obesity (24.9%). After adjusting for confounding factors, both weight category and muscular function were independently associated with premature mortality under the new classification. Compared to individuals with normal weight, underweight individuals (HR = 2.40, 95% CI: 1.79-3.23) and obese individuals (HR = 1.07, 95% CI: 1.00-1.14) exhibited significantly elevated premature mortality risks. Conversely, overweight individuals demonstrated a significantly reduced risk of premature mortality (HR = 0.78, 95% CI: 0.69-0.89). Compared with normal grip strength, abnormal grip strength increased premature mortality risk (HR = 1.46, 95% CI: 1.35-1.57). In the combined analysis of weight categories and grip strength, the underweight with abnormal grip strength (UW/A-HGS) group exhibited the most pronounced increase in premature mortality risk relative to the normal weight with normal grip strength group (HR = 4.96, 95% CI: 3.07-8.01). Conversely, a significantly decreased risk was observed in the overweight with normal grip strength group (HR = 0.79, 95% CI: 0.69-0.91). Stratified analysis revealed notable gender- and age-specific differences in outcomes. CONCLUSIONS:This study demonstrates that: 1) The new obesity criteria significantly enhance obesity detection rates and improve mortality risk prediction sensitivity; 2) Both weight status and grip strength independently and synergistically influence premature mortality risk; 3) Combined assessment of WS and HGS significantly optimises premature mortality risk stratification in older adults, with effects exhibiting gender and age heterogeneity. Integrating the EASO obesity criteria with grip strength into geriatric health assessment systems enables more precise identification of high-risk populations, providing critical scientific evidence for early intervention and personalised health management.

The Waist-adjusted Weight Index (WWI) is a novel anthropometric marker, its association with dyslipidemia in Asian populations remains unclear. This study examines the relationship between WWI and dyslipidemia in Japanese adults. Grounded in adipose tissue dysfunction and metabolic syndrome mechanisms, WWI, an index of central adiposity independent of body weight, serves as a biologically plausible predictor of dyslipidemia. We retrospectively analyzed 15,453 adults, undergoing health examination from Gifu Murakami Memorial Hospital (1994-2016). Logistic regression and fitted smooth curve analysis assessed WWI and dyslipidemia associations. Stratified analyses were performed based on sex, age, exercise, alcohol consumption, and smoking. WWI was positively associated with dyslipidemia (Adjusted OR = 1.30, 95% CI: 1.21-1.39). Risk increased across quartiles: Q2 (OR = 1.20), Q3 (OR = 1.36), Q4 (OR = 1.44). Smooth curve analysis indicated a nonlinear, accelerating increase. Associations were stronger in men, adults >60, smokers, drinkers, and those with insufficient exercise (P < 0.05). The findings support mechanistic links proposed by the adipose tissue disease theory and metabolic syndrome model, highlighting WWI as a simple, effective early screening tool for dyslipidemia. Prospective studies are needed to validate its predictive value in clinical and public health practice.

While Life's Essential 8 (LE8) provides a comprehensive measure of cardiovascular health (CVH), its association with mortality among the oldest-old, including centenarians, remains unclear. This study evaluated the relationship between LE8-defined CVH and all-cause mortality across adulthood using data from the China Kadoorie Biobank (Hainan cohort) and the China Hainan Centenarian Cohort Study, including 31,473 individuals aged 30-116. Participants were categorized by life stage and CVH score (low, moderate, high). Higher CVH scores were associated with significantly reduced mortality risk at all life stages, including among centenarians, who experienced a 54.8% lower risk with high CVH. A near-linear dose-response relationship was observed. Population-attributable fractions for mortality reached 36.8% in centenarians. Physical activity and body mass were particularly important in reducing mortality among centenarians. These findings challenge therapeutic nihilism in the oldest-old while underscoring the need for age-specific strategies tailored to distinct physiological profiles is crucial for extending healthy lifespan across the adult life course.

In this prospective cohort study of 1545 participants aged 80 years and older from the China Hainan Centenarian Cohort Study, we investigated the independent and joint associations of modifiable risk factors and genetic predisposition with life expectancy. A weighted modifiable risk factor score (MRFS) based on 11 factors and a polygenic risk score (PRS) for longevity were constructed. A favorable modifiable risk factor profile (low MRFS) was associated with a 40.7% lower death risk (HR 0.593, 95%CI 0.505-0.696) compared with high MRFS. Genetic predisposition to longer lifespan (high PRS) conferred a 13.0% lower risk (HR 0.870, 95%CI 0.768-0.986). Participants with both low MRFS and high PRS had the lowest mortality (HR 0.544, 95%CI 0.432-0.686), with a borderline significant multiplicative interaction (P = 0.040). Life expectancy gains from a low MRFS were more pronounced in those with high PRS (6.92 years at age 80) than low PRS (5.35 years). Among the oldest-old Han Chinese, favorable modifiable risk profiles and genetic predisposition independently and jointly contribute to substantially longer life expectancy. Importantly, an unfavorable modifiable profile may largely negate genetic longevity benefits, emphasizing the critical role of managing these factors even in advanced age and irrespective of genetic inheritance.

To investigate the association between chronic pain and cognitive function in community-dwelling cancer survivors. Using five waves of data from the China Health and Retirement Longitudinal Study (CHARLS), a cohort of community-based cancer survivors was established. Baseline chronic pain status was used to classify exposure groups, and the occurrence of cognitive dysfunction was defined as the endpoint. We employed Cox proportional hazards regression models to evaluate the association between chronic pain and cognitive dysfunction. The study included 640 participants, with a chronic pain prevalence of 38.3

Background Muscle mass (MM) was important because of its strong correlation with all-cause mortality. However, its assessment was complex, nonportable and expensive. Serum creatine kinase (CK) was proposed to counteract this problem. However, its correlation with all-cause mortality was unknown. Objectives The aim of this study was to investigate the associations between serum CK levels and all-cause mortality risk in Chinese centenarians. Methods A prospective cohort study of centenarians was conducted to classify serum CK levels according to all-cause mortality via restricted cubic spline (RCS) analysis, Cox regression analysis and Kaplan‒Meier analysis. Results We included 949 participants with a median follow-up of 29.4 months (interquartile range (IQR) 14.5, 51.7). A total of 92.9% of the subjects died. The RCS analysis revealed an inverse J-shaped relationship between the serum CK level and the risk of death. The mortality rate of centenarians with serum CK levels ranging from 8–66 U/L (Q1–Q2) was 34.3% higher than that of those with serum CK levels ranging from 66–192 U/L (Q3–Q4) (multivariable analysis hazard ratio (HR), 1.343; 95% confidence interval (CI), 1.173–1.538; P < 0.001). Kaplan–Meier analyses revealed that centenarians with lower serum CK levels had significantly shorter median survival time (Q1‒Q2 versus Q3‒Q4: 26 months versus 36 months, log-rank P < 0.001). Conclusions Serum CK levels were negatively associated with centenarian mortality, indicating that they may predict mortality risk in centenarians. CK could be utilized as an independent predictor of mortality in centenarians. Clinical Trial Registry number and website where it was obtained. Not applicable. Registry and registry number for systematic reviews or meta-analyses. Not applicable.

BACKGROUND:This study quantified age-, sex-, and geography-stratified trends in fatal and nonfatal burdens of early-onset pancreatic cancer (EOPC) across global populations, sociodemographic index (SDI) regions, and high-burden Asian countries from 1990 to 2021. METHODS:We analyzed Global Burden of Disease (GBD) 2021 data to quantify trends in EOPC burden using three epidemiological measures: mortality, incidence, and disability-adjusted life years (DALYs). Joinpoint regression subsequently calculated average annual percentage changes in EOPC burden trajectories. RESULTS:Globally in 2021, EOPC accounted for 31 531 new cases and 26 996 deaths. Analyses revealed a concerning upward trajectory in EOPC burden, with persistently high disease burden observed in high-SDI regions. Asia bore the highest global EOPC burden (2021), predominantly driven by East Asia where developing nations - particularly China and India - disproportionately contributed. Crucially, while global pancreatic cancer data identified high fasting plasma glucose (FPG) as the primary risk factor (surpassing smoking), this metabolic shift was not observed in EOPC. Moreover, EOPC risk escalates with advancing age and disproportionately affects older males, corresponding to significantly elevated disease burden in this demographic. CONCLUSIONS:Over recent decades, the burden of EOPC has escalated steadily, revealing striking demographic gradients, geographic disparities, and evolving risk profiles. These findings underscore an urgent imperative for precision public health interventions targeting high-risk populations. Timely implementation is critical to mitigate EOPC's disproportionate burden across Asia and developing nations, ultimately reversing its global trajectory.

The triglyceride–glucose (TyG) index and triglyceride–glucose/body mass index (TyG–BMI) have been shown to be associated with cardiovascular and cerebrovascular disorders and the risk of death. The aim of this study was to explore the relationships of the TyG index and TyG–BMI with all-cause mortality among Chinese centenarians. Data from the China Hainan Centenarian Cohort Study (CHCCS) were analyzed. Eligible centenarians were divided into quartiles on the basis of their TyG and TyG–BMI indices. Kaplan‒Meier analysis was used to compare survival times across groups. The associations of the TyG index and TyG–BMI with all-cause mortality were investigated using restricted cubic splines (RCSs) and Cox proportional hazards regression models. Moreover, the concordance of the associations of the TyG index and TyG–BMI with all-cause mortality in different subgroups was further explored by subgroup analysis. A total of 921 centenarian participants were included in this study. During a median follow-up of 29.70 months, 852 (92.5

Abstract Background We investigated the associations between IgM, IgG, IgA, and IgE levels and all-cause mortality risk in Chinese centenarians. Methods All participants were from the China Hainan Centenarian Cohort Study. Eligible participants were divided into quartiles based on their IgM, IgG, IgA, and IgE levels. We used restricted cubic spline analyses, Cox regression analyses, and Kaplan–Meier survival curves to analyze associations between IgM, IgG, IgA, and IgE and all-cause mortality risk. Results A total of 906 centenarian participants were included in this study (81.2% female; median age, 102 years). During a median follow-up of 30.1 months, 838 (92.5%) participants died. Restricted cubic spline analysis revealed a nonlinear relationship (“L” type) between serum IgM level and all-cause mortality. Compared with the higher three quartiles of serum IgM level, the lowest quartile was associated with a higher risk of death (Q1 versus Q2-Q4: HR, 1.365; 95% CI, 1.166–1.598; P < 0.001). Among individuals for whom IgM < 0.708 g/L (Q1), the risk of all-cause mortality was 36.5% higher. Kaplan–Meier analyses showed that centenarians with lower serum IgM levels had significantly shorter median survival time (Q1 versus Q2-Q4: 26 months versus 32 months, log-rank P = 0.001). Conclusion Serum IgM levels in centenarians significantly correlated with the risk of death, suggesting that they are suitable for predicting the overall risk of death in centenarians and can be used as an independent predictor of death.

Objectives:To conduct a comprehensive analysis in Hainan centenarians on the link between sleep status and their blood pressure status. Furthermore, the study also aims to explore how inflammatory indicators may mediate the relationship. Methods:The China Hainan Centenarians Cohort Study (CHCCS) collected baseline data on sleep status, inflammatory indicators, and blood pressure data. The study used a mediation model to investigate how inflammatory indicators mediate the relationship between sleep status and blood pressure status. Result:In this study, a total of 967 centenarians were included. The prevalence of hypertension among the centenarians was 71.4%. The analysis showed that centenarians with poor sleep quality had a 43% higher risk of hypertension compared to those with normal sleep quality (OR = 1.43, 95% CI: 1.03-1.97). Additionally, centenarians with nighttime sleep durations of ≤ 6 h or > 9 h had higher proportions of high pulse pressure (PP), with OR values of 1.76 (95% CI: 1.18-2.63) and 2.07 (95% CI: 1.34-3.19), respectively. Mediation analysis illustrated that complement C3 played a mediating role in the relationship between sleep quality and hypertension, with an effect ratio of 2.4%. Similarly, lymphocyte count, the neutrophil-to-lymphocyte ratio (NLR), and the systemic immune-inflammation index (SII) were identified as mediating factors in the association between nighttime sleep duration and high PP, with effect ratios of 91.22%, 36.93%, and 0.20%, respectively. Conclusion:In centenarians, poor sleep quality raises the risk of hypertension, with complement C3 as a mediator. Additionally, nighttime sleep durations of ≤ 6 h or > 9 h increases the risk of high PP, mediated by lymphocyte count, NLR, and SII.

The Beijing Healthy Aging Cohort Study (BHACS) was established to supplement the limited data of a large representative cohort of older people based on the general population and was designed to evaluate the prevalence, incidence, and natural history of cognitive decline, functional disability, and conventional vascular risk factors. The aim was to determine the evolution of these conditions by estimating the rates and determinants of progression and regression to adverse outcomes, including dementia, cardiovascular events, cancer, and all-cause death. It can therefore provide evidence to help policy makers develop better policies to promote healthy aging in China. BHACS consisted of three cohorts (BLSA, CCHS-Beijing, and BECHCS) in Beijing with a total population of 11 235 (6281 in urban and 4954 in rural areas) and an age range of 55 years or older (55–101 years) with a mean age of 70.35 ± 7.71 years (70.69 ± 7.62 years in urban and 69.92 ± 7.80 years in rural areas). BHACS-BLSA conducted the baseline survey in 2009 with a multistage stratification-random clustering procedure for people aged 55 years or older; BHACS-CCHS-Beijing conducted the baseline survey in 2013–2015 with a stratified multistage cluster random sampling method for people aged 55 years or older; and BHACS-BECHCS conducted the baseline survey in 2010–2014 with two-stage cluster random sampling method for people aged 60 years or older. Data were collected through questionnaires, physical measurements, and laboratory analyses. Topics covered by BHACS include a wide range of physical and mental health indicators, lifestyles and personal, family, and socio-economic determinants of health. There are no immediate plans to make the cohort data freely available to the public, but specific proposals for further collaboration are welcome. For further information and collaboration, please contact the corresponding author Yao He (e-mail: yhe301@x263.net).

Objective This 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. Method The 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. Results A 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. Conclusion The 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.

ObjectivesThis study aimed to examine the relationship between anemia and all-cause mortality in Chinese centenarians.DesignProspective cohort study.Setting and participantsWe included 1002 Chinese centenarians from the China Hainan Centenarian Cohort Study (CHCCS)MeasurementsStandard procedures were followed to perform blood analysis, home interviews, and physical examinations. Anemia was defined as a hemoglobin level of less than 130 g/L for men and less than 120 g/L for women.ResultsDuring the 9-year follow-up period, a total of 929 (92.7%) deaths were identified. Cox proportional hazards regression models revealed that anemia (hazard ratio [HR] 1.289, 95% confidence interval [CI]: 1.117–1.489) was significantly associated with all-cause mortality. There was an apparent dose-response relationship between anemia and all-cause mortality. Centenarians with severe anemia had approximately 1.6 times higher likelihood of all-cause mortality than those without anemia (HR 1.662; 95% CI: 1.154–2.394).ConclusionAnemia is associated with an increased risk of all-cause mortality in Chinese centenarians. Further research will be needed to collect more comprehensive data on the etiology of anemia and causes of death in centenarians.

The association between smoking cessation and decreased mortality existed among former smokers has been well documented. However, evidence is limited for smokers with long-term exposure. This study aims to quantify the association between smoking cessation and mortality by years since quitting in older adults with long-term smoking history. Data from Beijing Healthy Aging Cohort Study (BHACS), conducted among communities aged over 55 years old at recruitment, were collected via questionnaire between July 2009 and September 2015 and followed up for all-cause and cancer mortality until March 2021. Self-reported smoking status and years since quitting were collected at baseline. Cox proportional hazards models were used to examine the association between smoking cessation and all-cause and cancer mortality. A total of 11 235 participants (43.9 What is already known on this topic. Accumulating evidence has shown an association between smoking cessation and decreased mortality among former smokers in general or older populations. However, little evidence exists for smoker with long-term exposure. What this study adds. This study demonstrates significant relative benefits of smoking cessation among older populations, even those with long-term smoking exposure. Notably, participants who quit over 20 years ago showed a reduction in excess risk of all-cause mortality to levels comparable with never smokers. How this study might affect research, practice or policy. These findings highlight the substantial benefit of smoking cessation in reducing mortality risk, even after long-term exposure. Public health efforts in China should focus on encouraging smokers to quit as early as possible to mitigate the hazard of smoking. This research may inform smoking cessation policies and interventions targeting older long-term smokers.