INTRODUCTION:The rapidly expanding population of ageing and older adults with disability has been a continuing public health priority in recent decades. The first step towards solving this issue is to assess disability accurately and identify high-risk factors and individuals for early prevention. We aim to establish a prospective cohort, the Beijing Longitudinal Disability Survey in Community Elderly (BLINDSCE), using multidimensional disability assessments and to develop multifactorial models for disability prediction among community-dwelling older adults. METHODS AND ANALYSIS:The BLINDSCE is a prospective cohort study that includes community-dwelling older adults aged ≥65 years with or without disability from urban and rural areas in Beijing. Participants complete structured questionnaires and undergo assessments of disability, cognition and disability-related factors and outcomes. Disability is assessed using the WHO's Disability Assessment Schedule 2.0, activities of daily living, the Barthel index, locomotor function and physical function. Based on baseline cross-sectional information, the relationships between multiple factors and disability can be initially screened using logistic regression. Every 1-1.5 years, participants will receive a follow-up survey to remeasure disability, cognitive function and other disability-related factors and outcomes. At least three follow-ups are scheduled. The primary outcome of this study is disability. The secondary outcomes include cognition and many disability-related conditions, such as falls, pain, poor health, decreased intrinsic capacity, frailty, sarcopenia, hospitalisation and death. Cox proportional hazards or logistic regression will be used to analyse follow-up data and construct prediction models, which will be validated internally and externally. ETHICS AND DISSEMINATION:The Ethics Committee of Xuanwu Hospital, Capital Medical University, approved this study (No: [2023]129). The results will be published in peer-reviewed journals focusing on geriatric medicine and presented at related scientific conferences. TRIALS REGISTRATION NUMBER:NCT06863727. Stage of study: recruiting.

To determine how the WHODAS 2.0 performs to detect disability against standard ADL scales in a community-dwelling geriatric population and to explore the score conversion between these two measures. WHODAS 2.0 is an applicable, sensitive, and comprehensive tool for detecting disability in community-dwelling older adults. The conversion between WHODAS 2.0 and ADL scores was built with precision. Integrating WHODAS 2.0 into routine comprehensive geriatric assessment in community practice is necessary. To compare the performance of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) with activities of daily living (ADL) scales for disability assessment and to explore the score conversion between these two measures in a community-dwelling geriatric population. Data were drawn from the observational cohort study, the Beijing Longitudinal Disability Survey in Community Elderly, including 2170 community-dwelling adults aged ≥ 65 years. The 12-item WHODAS 2.0, ADL scales, and other corresponding measurements (mobility, cognition, depression, pain, nutrition, frailty, and sarcopenia) were evaluated face-to-face by well-trained assessors. Receiver operating characteristic (ROC) curve analysis was used to assess the accuracy of discriminating participants with ADL disability. Spearman’s correlation coefficients were calculated to evaluate the associations between WHODAS 2.0, ADL scales, and other geriatric assessment tools. Equipercentile equating was performed to develop a conversion table between the WHODAS 2.0 and ADL scales. Among 2170 community-dwelling older adults, the mean (SD) age was 74.1 (7.2) years, and 867 (40.0

Objective To develop the crosswalk between the Montreal Cognitive Assessment-Basic (MoCA-B) and Mini-Mental Status Examination (MMSE) based on a community-dwelling older population to facilitate data synthesis and comparison. Design A cross-sectional study. Setting and Participants We used baseline data of 2170 subjects with total MoCA-B and MMSE scores from an ongoing prospective cohort study, the Beijing Longitudinal Disability Survey in Community Elderly (BLINDSCE). Methods The MoCA-B and MMSE were administered by trained assessors. Equipercentile equating was used to develop the conversion table between MoCA-B and MMSE scores in the total sample and subgroups by age, sex, residency, and education level. The mean absolute error (MAE), intraclass correlation coefficient (ICC), and Bland-Altman plot were used to evaluate the linking performance. Results MoCA-B and MMSE scores converted bi-directionally for the overall sample and subgroups, with small standardized MAE (SMAE) and high ICC. The linking results between MoCA-B and MMSE scores were consistent across the total sample and the age and sex subgroups, while a 2-score difference was observed within the residency and education subgroups. Conclusions and Implications This study provides easy-to-use crosswalks between measures of MoCA-B and MMSE with precision among community-dwelling older adults. Our results help to compare and pool data across studies using either of the 2 cognitive screening tests and provide a useful reference to clinicians for better evidence-based practice in patients evaluated using different cognitive tests.

Background Although previous studies have suggested that left ventricular ejection fraction (LVEF) adjusted by left ventricular mass (LVM) might improve prognostic risk stratification of cardiac events, few prospective cohort studies have examined its clinical implications. We assessed the predictive ability of LVEF indexed to LVM, body surface area (BSA), and body mass index for the cardiac event risk. Methods We conducted a 5.52‐year cohort study on the association between LVEF indexed to LVM and cardiac events among 4266 participants with mildly reduced or preserved LVEF. Multivariable Cox regression analysis incorporating restricted cubic spline functions evaluated the predictive ability of LVEF, LVEF/LVM, and other indexed measures. Results After multivariable Cox regression adjustment, LVEF/LVM, LVEF/LVM/BSA, and LVEF/LVM/body mass index remained significantly associated with cardiac events (all P<0.05), whereas LVEF alone was not (P=0.569). Restricted cubic spline analysis identified a nonlinear approximately U‐shaped relationship for both LVEF/LVM and LVEF/LVM/BSA (both P for nonlinearity<0.001). Compared with the middle reference group, participants in the low LVEF/LVM (hazard ratio [HR], 2.00 [95% CI, 1.08–3.71]) and low LVEF/LVM/BSA (HR, 2.13 [95% CI, 1.11–4.07]) groups had significantly higher risks. While the high groups showed nonsignificant differences (LVEF/LVM: HR, 1.41 [95% CI, 0.68–2.95]; LVEF/LVM/BSA: HR, 1.39 [95% CI, 0.65–2.99]), the observed risk pattern indicated that values outside the ranges of 4.72 to 5.53/kg (LVEF/LVM) and 19.7 to 24.3 m2/kg2 (LVEF/LVM/BSA) suggested a higher cardiac event risk. Conclusions LVEF indexed to LVM provides better cardiac event risk stratification than LVEF alone in individuals with mildly reduced or preserved ejection fraction.

Abstract The associations of blood pressure components with cardiovascular risks and death remain unclear, and the definition of wide pulse pressure (PP) is still controversial. Using data from 1257 participants without a history of cardiovascular disease, who were followed for 4.84 years, we performed multivariable Cox regression analyses to assess how systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP contribute to risks of cardiovascular events and all‐cause death. Among all participants, SBP and PP were significantly associated with the risks of cardiovascular events and all‐cause death (all p < .05). DBP was not significantly associated with the risk of all‐cause death; rather, it was only associated with a marginally significant 1% increased risk for cardiovascular events (p = 0.051). In participants aged < 65 years, DBP was significantly associated with a 3% increased risk for cardiovascular events (hazard ratio [HR]: 1.03, 95% confidence interval [95% CI]: 1.01–1.06). The association between PP and cardiovascular events appeared to be J‐shaped in comparison to participants with the lowest‐risk PP (50–60 mmHg), with adjusted HRs of 1.71 (95% CI: 1.03–2.85), 1.63 (95% CI: 1.00–2.68), and 2.13 (95% CI: 1.32–3.43) in the <50, 60.0–72.5, and ≥72.5 mmHg subgroups, respectively. The optimal cutoff points of a wide PP for predicting the risks of cardiovascular events and all‐cause death were 70.25 and 76.25 mmHg, respectively. SBP and PP had a greater effect on cardiovascular risk, whereas DBP independently influenced cardiovascular events in middle‐aged participants. Considerable PP alterations should be avoided in antihypertensive treatment.

BACKGROUNDIncreased homocysteine levels are associated with the risk of cardiovascular disease (CVD) and death. However, their prevention has not been effective in decreasing CVD risk. This study investigated the individual and combined associations of hyperhomocysteinemia and hypertension with incident CVD events and all-cause death in the Chinese elderly population without a history of CVD.METHODSThis prospective study was conducted among 1,257 elderly participants (mean age: 69 years). A questionnaire survey, physical examinations, and laboratory tests were conducted to collect baseline data. Hyperhomocysteinemia was defined as homocysteine level ≥ 15 µmol/L. H-type hypertension was defined as concomitant hypertension and hyperhomocysteinemia. Multivariate Cox regression analysis was used to evaluate individual and combined associations of hyperhomocysteinemia and hypertension with the risks of incident CVD events and all-cause death.RESULTSOver a median of 4.84-year follow-up, hyperhomocysteinemia was independently associated with incident CVD events and all-cause death. The hazard ratios (HRs) were 1.45 (95% CI: 1.01−2.08) for incident CVD events and 1.55 (95% CI: 1.04−2.30) for all-cause death. After adjustment for confounding factors, H-type hypertension had the highest HRs for incident CVD events and all-cause death. The fully adjusted HRs were 2.44 for incident CVD events (95% CI: 1.28−4.65), 2.07 for stroke events (95% CI: 1.01−4.29), 8.33 for coronary events (95% CI: 1.10−63.11), and 2.31 for all-cause death (95% CI: 1.15−4.62).CONCLUSIONSHyperhomocysteinemia was an independent risk factor, and when accompanied by hypertension, it contributed to incident CVD events and all-cause death in the Chinese elderly population without a history of CVD.

Objective: To explore the association of depression, as well as untreated hypertension or diabetes with all-cause death in community-based postmenopausal women in Beijing.Methods: A cohort of 863 community-based postmenopausal women with no history of cardiovascular heart disease (CHD), stroke, cancer, or dementia was investigated on 20 July-28 September 2009 at baseline. Depression was diagnosed using the 30-item Center for Epidemiologic Studies Depression (CES-D) scale with CES-D >= 11. Meanwhile, data on health behavior, physical comorbidity, and social support at baseline were collected. These individuals were followed up from 20 July to 30 August 2014. All-cause mortality and cause of death were surveyed.Results: After a median follow-up of 4.97 years, 120 subjects died of all-cause. Twenty-four died of stroke, 19 died of myocardial infarction, 21 died of cancer. The others died of aging, infection, and accident. Depression and untreated HP were significantly associated with all-cause mortality in Cox models after full adjustment for all of the potential confounders (Depression HR: 2.16, 95%CI: 1.35-3.46; Untreated hypertension HR: 1.84, 95%CI: 1.12-3.02). However, negative correlation of untreated diabetes on all-cause mortality was observed in this population (HR: 1.36, 95%CI: 0.75-2.49). When depression was co-existing with hypertension/diabetes, the HR for mortality elevated significantly (Depression co-existing with hypertension HR = 3.87, 95% CI: 2.07-7.23; Depression co-existing with diabetes HR = 5.02, 95% CI: 1.5-16.79).Conclusions: It is suggested we should take sufficient care of postmenopausal females with depression and control blood pressure and glucose more effectively.

Background/objectives: Functional disability (FD) is common after stroke and associated with the occurrence of future adverse events; however, whether FD is as strong a risk factor as comorbid vascular risk factors for cardiovascular events and death is unclear. Methods: Consecutive patients 3-6 months after index ischemic stroke were assessed at baseline and followed up for documented new cardiovascular events (recurrent stroke, acute myocardial infarction, and sudden death) and death within 5 years. Comorbidity of vascular risk factors was stratified as low or intermediate-to-high risk according to the Stroke Prognostic Instrument II. Four mutually exclusive cohorts were identified (1) intermediate-to-high risk only, n = 505, (2) FD only, n = 78, (3) both intermediate-to-high risk and FD, n = 264, and (4) low risk and no FD, n = 240. Results: The incidence of cardiovascular events was lowest in patients free of FD with low risk, followed by patients with FD alone, intermediate-to-high risk alone, and both. Compared with intermediate-to-high risk only, patients free of FD with low risk had a significantly lower adjusted hazard ratio (HR) (HR: 0.56, 95% confidence interval [CI]: 0.33-0.94), patients with FD only had a similar HR (HR: 0.47, 95% CI: 0.19 -1.18), and patients with both FD and intermediate-to-high risk had a significantly higher HR (HR: 2.13, 95% CI: 1.53-2.98) of cardiovascular events. A similar trend but a larger HR was noted for all-cause death. Conclusion: FD 3-6 months after ischemic stroke is a risk equivalent to comorbidity of conventional vascular risk factors for the incidence of cardiovascular events and mortality of all-cause death.

A stroke prediction model based on the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project was developed. We compared its predictive ability with the revised Framingham Stroke Risk Score (R-FSRS) for 5-year stroke incidence in a community cohort of Chinese adults, namely the Beijing Longitudinal Study of Aging (BLSA). Calibration, discrimination, and recalibration were used to compare the predictive ability between the two prediction models. Category-less net reclassification improvement (NRI) and integrated discrimination improvement (IDI) values were also assessed. During a mean follow-up duration of 5.1 years, 106 incidents of fatal or non-fatal strokes occurred among 1,203 participants aged 55–84 years. The R-FSRS applied to our cohort underestimated the 5-year risk for stroke in men and women. China-PAR performed better than the R-FSRS in terms of calibration (men, R-FSRS: χ2-value 144.2 [P < 0.001], China-PAR: 10.4 [P = 0.238]; women, R-FSRS: 280.1 [P < 0.001], China-PAR: 12.5 [P = 0.129]). In terms of discrimination, R-FSRS and China-PAR models performed modestly in our cohort (C-statistic 0.603 [95% CI: 0.560–0.644] for men using China-PAR and 0.568 [95% CI: 0.524–0.610] using the R-FSRS; the corresponding numbers for women were 0.602 [95% CI: 0.564–0.639] and 0.575 [95% CI: 0.537–0.613). The recalibrated China-PAR model significantly improved the discrimination in C statistics and produced higher category-less NRI and IDI for stroke incidence than the R-FSRS. Although China-PAR fairly estimated stroke risk in our cohort, it did not sufficiently identify adults at high risk of stroke. Caution would be exercised by practitioners in applying the original China-PAR to Chinese older adults. Further studies are needed to develop an adequate prediction model based on the recalibrated China-PAR or to find new risk markers which could upgrade this model.

Aim: To evaluate the association between kidney dysfunction and cardiovascular disease (CVD) events in a middle-aged and elderly population in China. Materials and methods: In July 2009, a baseline survey of health status was performed in adults aged 55 years and older from Beijing, China. Occurrence of CVD events and mortality in subjects free of CVD at baseline was recorded in a 5-year follow-up period until December 2014. The association of mild (eGFR(CKD-EPI) 45 - 59 mL/min/1.73m(2)) and moderate to severe (eGFR(CKD-EPI) < 45 mL/min/1.73m(2)) kidney dysfunction with adverse outcomes were analyzed with Cox regression analysis. Results: A total of 1,257 subjects were included in the final analysis. The risk of CVD events in those with mild kidney dysfunction increased by 65% (HR: 1.65, 95% CI: 1.04 - 2.62) as compared to those with normal kidney function. Subjects with both hypertension and CKD experienced more significantly increased risk of CVD events (adjusted HR = 1.87, 95% CI 1.17 - 2.97) and stroke (adjusted HR = 2.24, 95% CI 1.24 - 4.04). Pulse pressure (PP) >= 60 mmHg was the strongest risk factor for stroke in patients with CKD, with the adjusted HR value of 1.98 (95% CI 1.08 - 3.64). Conclusion: Moderate to severe kidney dysfunction was an independent risk predictor of CVD events. Among subjects with hypertension or poorly controlled blood pressure level, the presence of CKD significantly increased the risks of CVD events and stroke.

目的 总结大动脉炎合并脑梗死患者的临床特点,分析此类患者脑梗死复发的相关因素.方法 回顾性分析2010年1月-2020年6月随访超过3年的大动脉炎合并脑梗死患者的临床资料,对此类患者脑梗死复发的相关因素进行分析.结果 共纳入49例患者,首次脑梗死中位年龄30.0(22.0～45.0)岁,中位随访时间3.4(3.2～3.7)年.11例(22.4％)出现复发性脑梗死,两次脑梗死间隔中位时间8.0(5.0～88.0)个月.与脑梗死无复发患者相比,复发性脑梗死患者合并糖尿病比例(27.3％?vs?2.6％,P=0.031)以及首次脑梗死后随访期间平均TG水平(3.65±0.96?mmol/L?vs?1.14±0.54?mmol/L,P=0.001)升高.大动脉炎受累动脉以颈总动脉最为常见(48/49,98％),其次是椎动脉(40/49,81.6％),受累血管病变性质以狭窄(49/49,100％)和闭塞(36/49,73.5％)最常见.脑梗死复发组动脉闭塞比例(100％?vs?65.8％,P=0.024)和动脉血栓发生率(45.5％?vs?13.2％,P=0.033)均高于脑梗死无复发组.治疗方面,脑梗死复发组抗血小板治疗患者比例(63.6％?vs?97.4％,P=0.007)及接受血管重建术的患者比例(27.3％?vs?68.4％,P=0.033)均低于脑梗死无复发组.结论 大动脉炎合并脑梗死的患者,如合并糖尿病、血脂控制欠佳、主动脉弓分支动脉有闭塞、血栓形成者,脑梗死复发风险高.

Urinary Alzheimer-associated neuronal thread protein (AD7c-NTP) is elevated in early Alzheimer's disease (AD) and mild cognitive impairment, and is considered a biomarker for the early diagnosis of AD. However, it has not yet been investigated whether urinary AD7c-NTP is elevated with increases in blood biochemical indicators related to AD risk factors. We recruited 2180 participants, aged 35-93 years, from communities of four districts in Beijing. Blood biochemical indicators, including blood glucose, blood lipids, renal function, and highsensitivity C-reactive protein, were measured using routine methods. Urinary AD7c-NTP was detected using an enzyme-linked immunosorbent assay AD7c-NTP kit. In the general population, there were no significant differences in urinary AD7c-NTP levels in subjects with different Mini-Mental State Examination levels or C-reactive protein values. After adjusting for age and sex, there were significant differences in urinary AD7c-NTP levels between different education levels, marital statuses, blood glucose, blood lipids, and kidney function. There was a negative correlation between urinary AD7c-NTP levels and serum creatinine (r = -0.128). There was a positive correlation between urinary AD7c-NTP levels and HbA1c (r = 0.104), insulin (r = 0.101), and triglycerides (r = 0.093). Urinary AD7c-NTP might be useful as a potential indicator to predict AD risk.

BACKGROUND AND OBJECTIVES Previous studies on the importance of metabolic syndrome (MS) as a cardiovascular risk factor had not focused on older Chinese adults. The present study analyzed the association of MS with carotid atherosclerosis and the risk of cardiovascular events in Chinese adults. METHODS AND STUDY DESIGN Data of a representative cohort study with 5-year follow-up were used. Community-dwelling people (n=1257) aged ≥55 years without cardiovascular disease (CVD) at baseline were followed up from 2009 to 2014. MS was defined based on the Chinese Diabetes Society criteria under the Chinese Medical Association. Multiple regression analyses were performed to examine the associations of MS with atherosclerosis and CVD events, with adjustment for confounding factors. RESULTS In a multivariate logistic regression model with adjustment, MS was closely related to common carotid artery intima-media thickness (CCA-IMT) (1.62; 95% CI: 1.19-2.21) and carotid plaque presence (1.38; 95% CI: 1.01-1.89), but not with carotid artery stenosis. At the end of the 5-year follow- up, compared with subjects without MS, hazard ratios and 95% confidence intervals for the different risks in subjects with MS were 1.86 (1.02-3.29) for myocardial infarction (MI), 1.39 (1.01-2.05) for stroke, 1.52 (1.02- 2.37) for CVD death, and 1.13 (0.62-2.58) for total death, after adjusting for age, gender, smoking, drinking, physical activity, uric acid, high-sensitivity C-reactive protein, dietary factors and carotid atherosclerosis status. CONCLUSIONS MS was significantly associated with IMT and the presence of carotid plaque and with positively increased risks of MI, stroke, and CVD mortality independent of CVD risk factors in older Chinese adults.

目的 评价北京地区中老年人群肾功能水平及不同肾功能水平时心血管疾病(CVD)及其危险因素的患病情况.方法 采用分层、分段、随机、整群的抽样方法,抽取北京市怀柔区、大兴区、宣武区55岁及以上人群作为调查对象,于2009年7～9月对2468名55岁以上中老年人进行调查,其中完成实验室检查1458人,以这部分人群作为研究对象进行分析.以慢性肾脏病流行病学合作组(CKD-EPI)提出的CKD-EPI公式估算肾小球滤过率(eGFR),根据2012年全球改善肾脏病预后委员会(KDIGO)指南规定的慢性肾脏病(CKD)诊断及分期标准,将研究对象分为3组:肾功能正常组[eGFR≥60 ml/(min·1.73m2)],肾功能轻至中度损伤组[eGFR45～59 ml/(min·1.73m2)],肾功能中至重度损伤组[eGFR<45 ml/(min·1.73m2)],比较各组研究对象特征及不同肾功能水平相关CVD及其危险因素的患病情况.结果 ①1458名中老年人群中,eGFR平均值为(56.45±13.46)ml/(min·1.73m2),且eGFR平均值随着年龄的增长而降低.随着肾功能的减低,3组之间女性所占比率逐渐升高.②肾功能水平越低,高血压病、血脂紊乱、肥胖患者所占比率越高,3组间比较差异均具有统计学意义(P<0.01).③高血压患者肾功能水平低于非高血压患者,在心肌梗死患者、血脂紊乱患者和肥胖患者中亦得出同样的结果(P<0.01).结论 ①中老年人群肾功能水平普遍降低,并且随着年龄的增长呈现逐渐下降的趋势.②中老年人群中,肾功能水平的降低与CVD及其危险因素密切相关,说明在C K D患者中C V D普遍存在.

目的 通过对北京市社区老年人抑郁症状筛查的检查情况进行流行病学调查,初步了解北京市社区老年人抑郁症状的流行现况,并探讨影响抑郁症状的因素,为早干预提供依据以改善老年人的生活质量,减轻家庭及社会负担.方法 2013～2014年,采取分层4阶段抽样的方法选取北京市4个区县3292例社区老年人进行问卷调查和体格检查.采用老年抑郁量表(GDS)和抑郁药物服用情况评估老年人的抑郁症状,其中0～10分者视为正常,11分以上和规律服用抗抑郁药物者为存在抑郁症状.实际完成抑郁量表评估者为3004例.患病率采用2010年全国第六次人口普查北京市标准人口数据进行加权,应用logistic回归模型探讨影响老年人抑郁症状发生的危险因素.结果 加权后2963例老年人中,男性占46.2％,平均年龄(73.3±6.1)岁.调查发现229人存在抑郁症状,检出率为7.7％.男性5.7％,女性为9.5％,女性明显高于男性,未见城乡差异,抑郁检出率随年龄增长呈上升趋势.单因素分析结果显示,高龄老人、女性、受教育程度低、没有配偶、独居、伴有慢性疾病(尿失禁、跌倒、心脏病、卒中、视力障碍、失眠等)、无法完成体能检测的老年人抑郁风险增加.非条件logistic回归显示,有视力障碍、女性、失眠、有跌倒史、吸烟和既往脑卒中及无法完成体能检测的老年人抑郁症状检出风险高,OR值分别为4.870(95％CI:2.755～8.610)、1.897(95％CI:1.221～2.947)、1.875(95％CI:1.338～2.627)、1.697(95％CI:1.136～2.534)、1.645(95％CI:1.083～2.497)、1.627(95％CI:1.108～2.389)、1.418(95％CI:1.122～1.793).结论 抑郁症状在社区老年人中检出率较高,尤其是女性、有视力障碍、易跌倒、失眠、有吸烟史或伴有慢性病的老年人,医务工作者特别是社区医生在临床工作中,除了解决患者躯体疾病外也应关注老年人的心理健康问题,及时发现患者存在的抑郁症状,采取心理疏导或药物干预,提高老年人的心理健康水平.

Objectives: To assess the prevalence of metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) using different definitions. Methods: The data were taken from a nation-wide survey on hypertension in China conducted in 2013–2015. Population-based sample of 4757 adults (male 51.1%) aged 35 years and older in Beijing provided data on BMI and metabolic status. Obesity was defined as BMI ≥28 kg/m2, and definitions of metabolic abnormalities were from 5 sets of metabolic syndrome or cardiometabolic abnormalities including the Adult Treatment Panel III (ATP-III), Karelis, Wildman, Chinese Diabetes Society (CDS) and homeostasis model assessment (HOMA) index. Results: The prevalence of obese was 24.3% (1155/4757). The highest prevalence of MHO (13.6%, 95% CI 11.0–16.2) was obtained from the HOMA criteria, followed by CDS, ATP-III, and Wildman. The lowest were from Karelis criteria (4.2%, 95% CI 1.4–7.0). The prevalence of MUO from the highest to the lowest were ranged on the contrary to MHO, the highest was Karelis (20.1%, 95% CI 17.6–22.6) and the lowest was HOMA (10.6%, 95% CI 7.9–13.3). The prevalence of MHO in criteria of ATP-III, Wildman, CDS and HOMA increased with age and reached the peak at age 45 years, then declined and slightly rose after age 80 except for Wildman criteria. The age-specific prevalence of MUO increased with age before 60–64 years and then declined after age 65 regardless of which criteria used. After age 84, the prevalence defined by the criteria of ATP-III and CDS kept on declining continuously, while an increment was observed in the prevalence defined by Karelis, Wildman and HOMA. Conclusion: The variations in the prevalence of both MHO and MUO were magnitude, and this may due to the heterogeneity of the definitions of metabolic disorder. Large cohort studies are needed in the future.

BACKGROUND:Alzheimer-associated neuronal thread protein (AD7c-NTP) has been found to be a biomarker for Alzheimer's disease (AD).OBJECTIVE:The aim of the present study was to investigate the distribution of Alzheimer-associated neuronal thread protein and its relationship to common chronic diseases in the general population.METHODS:Urine samples of 1,805 participants were collected from four districts (Xi Cheng, Fang Shan, Tong Zhou, and Yan Qing) in Beijing. The assessment in this study included a questionnaire that captured participants' demographic information, use of medication and histories of disease, neurological examinations, psychometric evaluations, physical and clinical examinations, and laboratory tests.RESULTS:Urine AD7c-NTP level was increased among the population over 60 years old and females exhibited higher levels than males. These results controlled for other demographic factors such as education levels, employment status, body mass index and current residence. The urine AD7c-NTP levels exhibited no association with non-neurological diseases (0.3346±0.4482 ng/ml), such as hypertension (0.3445±0.4187), stroke (0.3652±0.4010), diabetes (0.3319±0.4371), dyslipidemia (0.3440±0.4314), renal insufficiency (0.3223±0.3909), cancer (0.5055±1.0006), chronic lung disease (0.2911±0.2852), chronic liver disease (0.5579±0.6726), severe depression symptoms (0.5186±0.7040), and mild depression symptoms (0.3669±0.3811).CONCLUSIONS:Cut-off values for urine AD7c-NTP levels for different age groups and genders should be established. AD7c-NTP levels proved relatively stable in the body and were not impacted by demographic factors or common chronic diseases.

We explored the associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and carotid atherosclerosis with all phenotypes and cardiovascular disease (CVD) events in Chinese older adults. A total of 1257 adults aged ≥55 years who were free of CVD were enrolled in this cohort study. Lipoprotein-associated phospholipase A2 level was evaluated in 3 categories: Lp-PLA2 < 175, 175≤ Lp-PLA2 < 223, and Lp-PLA2 ≥ 223 ng/mL. The highest level of Lp-PLA2 was independently associated with common carotid artery intima-media thickening (≥1.0 mm; odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.14-2.26) and carotid plaque (OR: 1.42, 95% CI: 1.01-1.99) in individuals without carotid artery stenosis. At the end of the 5-year follow-up, after adjustment for CVD risk factors and carotid atherosclerosis status, Lp-PLA2 had remained an independent predictor for myocardial infarction (MI; hazard ratio [HR]: 1.90, 95% CI: 1.02-3.55) and CVD death (HR: 1.78, 95% CI: 1.02-3.13). However, no association was found with stroke. Therefore, elevated Lp-PLA2 level in the older adults studied was associated with an increased risk of carotid atherosclerosis and MI and CVD mortality. Lipoprotein-associated phospholipase A2 assessment might be used for MI and CVD death risk prediction.

Objective To investigate the prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community. Methods A cross-sectional study by recruiting 1 458 middle-aged and elderly people from a cohort of the "Beijing Longitudinal Study of Aging" in 2009 was conducted. All participants were asked to complete a standardized questionnaire, physical examination and laboratory examinations. Hyperhomocysteinemia was defined as homocysteine (Hcy) > 15 μmol/L, and H- type hypertension was defined as having hypertension and hyperhomocysteinemia simultaneously. The prevalence of H-type hypertension was estimated by using the results of 2000 Beijing population census to weight the data. Multivariate Logistic regression analysis was preformed to estimate the associated factors of H-type hypertension. Results The age was (69.48 ± 8.09) years, and the distribution of Hcy was skewed with the median of 16.56 μmol/L. After weight, the prevalence of hyperhomocysteinemia was 57.20% (834/1 458), and the prevalence of H-type hypertension was 35.32% (515/1 458), accounting for 59.47% (515/866) in patients with hypertension. The ageing, male, hyperuricemia, estimated glomerular filtration rate (eGFR) and insufficiency of fishes/ shrimps were independent risk factors of H-type hypertension ( OR = 2.30, 1.04, 1.02, 0.95 and 0.67; 95% CI 1.54-3.44, 1.02-1.06, 1.04-1.06, 0.94-0.97 and 0.46-0.97; P＜0.01 or＜0.05). Conclusions The proportion of H-type hypertension is high in the middle-aged and elderly people in Beijing community. Lowering uric acid, protection of renal function and intake sufficient fishes and shrimps might prevent and control H-type hypertension.

Objective To discuss the relationship between food habits and hyperhomocysteinemia (HHcy), and provide dietary intervention basis for the aged in prevention and cure of HHcy. Methods Participants coming from the cohort of the Beijing Longitudinal Study of Aging in 2009, were asked to complete a food habits questionnaire and underwent laboratory examinations, including total homocysteine and blood biochemical item. According to effects of food on metabolism of Hcy, the commonly used foods were divided into three kinds: (1)Rich in VitB12 or folic acid or betaine:chicken or duck egg, pork or beef or lamb, bean products and vegetables.(2)Rich in VitB6: fish or shrimp, milk and chicken or duck. (3)Rich in antioxidant: fresh fruit, tea and coffee. According to the intake of frequency, each food was divided into"often eat"and"not often eat"or"not eating". HHcy was defined as>15μmol/L, Logistic regression analysis was used to analyze the association between dietary intake and HHcy, after adjusting confounding factors. Results The prevalence of HHcy was 61.9%(902/1458);accordi ng to the results, for the patients who do not often eat or not eat food rich in VitB12 or folic acid or betaine (chicken or duck egg, bean products and pork or beef or lamb) and VitB6 (fish or shrimp and milk), the risk of HHcy was significantly increased. After adjusting for multiple factors, the risk was still significantly increased, P<0.05. Conclusions Not often eating chicken or duck egg(less than once a day), bean products(less than once a week), fish or shrimp(less than twice a month) and not eating pork or beef or lamb or milk, were independtly associated with the increasing risk of HHcy in elderly people.