In 2019,China had over 13.14 million dementia cases,with incidence rates of(56.47-207.08)/100,000[1].Early cognitive impairment—a key dementia symptom—reduces quality of life,increases care dependence,and lowers survival in older adults[2].A decline in physical function can also be observed in older adults with increasing age.Grip strength has been shown to be a marker of overall physiological function in older adults.

Background We aimed to investigate the associations of long‐term exposure to ambient formaldehyde with hypertension and angina pectoris symptoms in Chinese adults. Methods and Results Participants' information was obtained from the WHO SAGE (World Health Organization Study on Global Aging and Adult Health) study. The Cox proportional hazards regression model was applied to estimate the associations of formaldehyde with hypertension and angina pectoris symptoms. Mediating effect analysis was used to investigate the mediating effect of hypertension between formaldehyde exposure and angina pectoris symptoms. Long‐term exposure to formaldehyde was positively associated with the risk of angina pectoris symptoms (hazard ratio [HR], 1.66 [95% CI, 1.29–2.13], per interquartile range [IQR], 3.33, 10 15 molecules/cm 2 ) and hypertension (HR, 1.17 [95% CI, 1.02–1.34], per IQR, 3.34, 10 15 molecules/cm 2 ). The associations between formaldehyde and angina pectoris symptoms were greater in participants aged ≥65 years (HR, 1.90 [95% CI, 1.29–2.80]) and in rural areas (HR, 2.71 [95% CI, 1.54–4.77]), whereas the associations of formaldehyde with hypertension were stronger in men (HR, 1.27 [95% CI, 1.02–1.58]), rural areas (HR, 1.22 [95% CI, 0.94–1.59]), and in ever smokers (HR, 1.33 [95% CI, 1.02–1.72]). The mediation effect analysis indicated that 18.44% (95% CI, 2.17–37.65) of the association between formaldehyde exposure and angina pectoris symptoms was mediated by hypertension. Conclusions Long‐term exposure to ambient formaldehyde was positively associated with hypertension and angina pectoris symptoms. The effects of formaldehyde may be modified by age, sex, urbanicity, and smoking status. Hypertension might play a mediating effect in formaldehyde‐induced angina pectoris symptoms.

Studies examining the effects of social participation on activities of daily living (ADL) disability are still scarce. To assess the reciprocal relationship between ADL disability trajectories and social participation among older Chinese people aged ≥ 60 years. This study included 2976 participants aged ≥ 60 years in six waves of a community-based survey from 2015 to 2022. Basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were used to assess the ADL disability in each survey. Social participation was assessed by involvement in four social activities and an extensive social participation score. Group-based trajectory modeling was used to identify potential heterogeneity in longitudinal changes over 7 years and explore associations between baseline predictors of group membership and these trajectories. Two BADL disability trajectories were identified: stable (94.8

Background: Previous trials have indicated that multimodal training could improve cognitive functions and moods in individuals with mild cognitive impairment (MCI). However, evidence was mainly obtained from studies in high-income countries. Objective: This trial aims to investigate the efficacy, safety, and potential mechanism of a multimodal intervention on cognitive function in individuals with MCI living in a community. Methods: In this single-blind, randomized controlled trial, 120 participants with MCI were randomly assigned to either the intervention group or the control group. The intervention group received the multimodal intervention, while the control group received regular health education. Neuropsychological tests and magnetic resonance imaging (MRI) were conducted at baseline and after the 12-week intervention. Results: Fifty-nine and fifty-seven participants respectively in the intervention and control groups completed the trial. The intervention group shown improvements in primary outcome, Mini-Mental State Exam (MMSE) total score (mean difference –0.96, 95% CI [–1.58, –0.34], p = 0.003), and secondary outcomes: MMSE recall (–0.39, 95% CI [–0.71, –0.07], p = 0.019), MMSE language (–0.26, 95% CI [–0.44, –0.07], p = 0.007), Auditory Verbal Learning Test instantaneous memory (–3.30, 95% CI [–5.70, –0.89], p = 0.008), Digit Symbol Substitution Test total score (–2.91, 95% CI [–5.67, –0.15], p = 0.039), digit span forwards (–1.25, 95% CI [–1.93, –0.56], p < 0.001), and Digit Span Test (–1.33, 95% CI [–2.33, –0.34], p = 0.009) compared to the control group. Improvements were observed in structural and functional connectivity related to language, concentration, executive function, memory, and recall functioning via MRI in the intervention group. Conclusions: The multimodal intervention improved cognitive function in individuals with MCI in cognitive performance and neuroimaging.

Objective: This study examined the effects of a multicomponent intervention program on cognitive function in community-dwelling older adults with mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Methods: This was a 2-arm, randomized controlled trial in which a multicomponent intervention was applied. Participants were recruited from June 2020 to August 2020, randomization and intervention began in August 2020, and the entire program ended in January 2021. It included cognitive training (mnemonic strategy training) and lifestyle guidance (diet, sleep, and exercise guidance) for 7 weeks. A total of 123 Chinese community-dwelling older adults experiencing MCI or SCD were randomly divided into a multicomponent intervention group (n =62) and a health education group (n = 61 ). The global cognitive function was measured using the Mini-Mental State Examination (MMSE). The cognitive domains outcomes included memory functions measured using the immediate and delayed tests of the Auditory Verbal Learning Test (AVLT) and Logical Memory Test (LMT), and executive function and attention measured using the Digital Symbol Substitution Test (DSST) and Digit Span Test (DST). Data were collected at baseline and postintervention. Results: For cognitive outcome, the results of linear mixed-effect model showed significant time x group effects in the MMSE (Cohen d = 0.63 [95% CI, 0.27 to 1.00], F = 10.25, P = .002). This study found significant time x group effects in AVLT-immediate (Cohen d = 0.47 [95% CI, 0.11 to 0.83], F = 8.18, P = .005), AVLT delayed (Cohen d = 0.45 [95% CI, 0.10 to 0.81], F = 4.59, P = .034), LMT-delayed (Cohen d = 0.71 [95% CI, 0.34 to 1.07], F = 4.59, P = .034), DSST (Cohen d = 0.27 [95% CI, -0.08 to 0.63], F = 4.83, P = .030), and DST (Cohen d = 0.69 [95% CI, 0.33 to 1.05], F = 8.58, P = .004). Conclusions and Implications: The results support the feasibility and effectiveness of the multicomponent intervention program in improving cognitive function in community- dwelling older adults at risk of dementia. The high adherence of this program shows its potential for promotion in the community and supports a larger and longer trial. Trial Registration: Chinese Clinical Trial Registry (ChiCTR2200061420).

INTRODUCTION:Studies using cross-sectional data or with a short follow-up period fail to distinguish whether the associations between sleep duration and physical activity with cognitive function result from reverse causation. METHODS:The longitudinal study examined the individual and joint associations, with specific temporality, between sleep duration and physical activity with cognitive function, using time-lagged linear mixed models and generalized additive mixed models. RESULTS:A total of 14,694 participants aged ≥ 50 years were included, with an average lagged time of 4.5 (standard deviation 1.3) years. Long sleep duration was independently associated with cognitive decline, while short sleep duration and physical activity were not. The analysis of joint effects showed that increased physical activity slowed the rate of cognitive decline among participants reporting long sleep duration, consistent with the results of the stratified analyses. DISCUSSION:Interventions on improving sleep should consider concurrent physical activity to maximize benefits for slowing cognitive decline. HIGHLIGHTS:Long sleep duration was independently associated with worse cognitive function, while short sleep duration was not. Elevated levels of physical activity were not independently associated with better cognitive function. Increased physical activity appeared to mitigate the negative impact of long sleep duration on cognitive function.

Background Data on which frailty scales are most suitable for estimating risk in Chinese community populations remain limited. Herein we examined and compared four commonly used frailty scales in predicting adverse outcomes in a large population-based cohort of Chinese older adults. Methods A total of 5402 subjects (mean age 66.3 ± 9.6 years, 46.6% male) from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Frailty was measured using a 35-item frailty index (FI), the frailty phenotype (FP), FRAIL, and Tilburg Frailty Indicator (TFI). Multivariate logistic regression models were performed to evaluate the independent association between frailty and outcomes including 4-year disability, hospitalization, and 4- and 7-year all-cause mortality. The accuracy for predicting these outcomes was determined by evaluating the area under the curve (AUC). The prevalence of frailty, sensitivity, and specificity were calculated using our proposed cut-off points and other different values. Results Prevalence of frailty ranged from 4.2% (FRAIL) to 16.9% (FI). FI, FRAIL and TFI were comparably associated with 4-year hospitalization, and 4- and 7-year mortality (adjusted odds ratios [aORs] 1.44–1.69, 1.91–2.22 and 1.85–2.88, respectively). FRAIL conferred the greatest risk of 4-year disability, followed by FI and TFI (aOR 5.55, 3.50, and 1.91, respectively). FP only independently predicted 4- and 7-year mortality (aOR 1.57 and 2.21, respectively). AUC comparisons showed that FI, followed by TFI and FRAIL, exhibited acceptable predictive accuracy for 4-year disability, 4- and 7-year mortality (AUCs 0.76–0.78, 0.71–0.71, 0.65–0.72, respectively), whereas all scales poorly predicted 4-year hospitalization (AUCs 0.53–0.57). For each scale, while specificity estimates (85.3–97.3%) were high and similar across all outcomes, their sensitivity estimates (6.3–56.8%) were not sufficient yet. Prevalence of frailty, sensitivity, and specificity varied considerably when different cut-off points were used. Conclusion Frailty defined using any of the four scales was associated with an increased risk of adverse outcomes. Although FI, FRAIL and TFI exhibited fair-to-moderate predictive accuracy and high specificity estimates, their sensitivity estimates were not sufficient yet. Overall, FI performed best in estimating risk, while TFI and FRAIL were additionally useful, the latter perhaps being more applicable to Chinese community-dwelling older adults.

目的 探讨50岁及以上人群卫生保健服务满意度和生活质量之间的关系.方法 利用世界卫生组织(World Health Organization,WHO)全球老龄化与成人健康研究中国项目基线调查资料,选取我国8个省/直辖市15050名50岁及以上的中老年人,使用全球老龄化与成人健康研究问卷和WHO生活质量量表8项简化版评估卫生保健服务满意度和生活质量,并获取社会人口学及慢性病患病情况等信息,使用多元线性回归模型分析两者之间的关系并按居住地、性别和年龄组进行分层分析.结果 研究共纳入研究对象13408人,平均年龄为(63.86±10.24)岁,对本市(区)提供的卫生保健服务感到非常满意的占4.16％,感到满意的占58.90％,感到一般的占30.81％,感到不满意的占5.69％,感到非常不满意的占0.44％.研究对象生活质量得分为(40.25±15.56)分,多元线性回归分析显示研究对象的卫生保健服务满意度越高,生活质量越好(P<0.001).在分层分析中,该关联在不同居住地区、不同性别以及不同年龄组中均有统计学意义(P<0.001).结论 50岁及以上的人群中,较高的卫生保健服务满意度和较高的生活质量相关.

Objective This study examined the moderating effect of overall social support and the different types of social support on cognitive functioning in depressed older adults. We also investigated whether the moderating effect varied according to age. Methods A total of 2,500 older adults (≥60 years old) from Shanghai, China were enrolled using a multistage cluster sampling method. Weighted linear regression and multiple linear regression was utilized to analyze the moderating effect of social support on the relationship between depressive symptoms and cognitive function and to explore its differences in those aged 60–69, 70–79, and 80 years and above. Results After adjusting for covariates, the results indicated that overall social support (β = 0.091, p = 0.043) and support utilization (β = 0.213, p < 0.001) moderated the relationship between depressive symptoms and cognitive function. Support utilization reduced the possibility of the cognitive decline in depressed older adults aged 60–69 years (β = 0.310, p < 0.001) and 80 years and above (β = 0.199, p < 0.001), while objective support increased the possibility of cognitive decline in depressed older people aged 70–79 years (β = −0.189, p < 0.001). Conclusion Our findings highlight the buffering effects of support utilization on cognitive decline in depressed older adults. We suggest that age-specific measures should be taken when providing social support to depressed older adults in order to reduce the deterioration of cognitive function.

The objective of this study was to estimate the joint effects of cognitive impairment and depressive symptoms on health-related quality of life (HRQoL) and to explore the mediating role of disability among Chinese community-dwelling older adults. A cross-sectional study was conducted with 2525 community-dwelling older adults aged ≥60 years and living in Shanghai, China in 2019. Participants were divided into four groups: (1) non-depressed without dementia, (2) non-depressed with probable MCI, (3) depressed without dementia and (4) depressed with probable mild cognitive impairment (MCI). HRQoL was assessed using the 36-Item Short-Form Health Survey. Cognitive impairment and depressive symptoms were evaluated with the AD8 and the Geriatric Depression Scale respectively. Activities of daily living (ADL) and instrumental activities of daily living (IADL) disability and other sociodemographic variables were also assessed. The results of this study showed that controlling for sociodemographic characteristics, significant differences in a physical component score (PCS) and a mental component score (MCS) of HRQoL were found across the four groups. Compared to those who were non-depressed without dementia, older adults who were depressed with probable MCI reported the lowest level of PCS and MCS, followed by older adults who were depressed without dementia. Both ADL and IADL disabilities played mediating roles in the relationship between cognitive impairment and depressive symptoms and PCS. Based on this study, we suggest that the early detection and adequate management of depressive symptoms and cognitive status-as well as efforts to improve individuals' ability to manage their ADLs and IADLs-may help to maintain or improve their HRQoL.

目的 评估上海市静安区死因监测数据质量,为进一步提高数据质量提供依据.方法 2015-2019年死亡数据来源于上海市静安区疾病预防控制中心死因监测系统.通过死因监测数据基本信息填写完整性评价、死因可靠性评价(可靠诊断单位率和可靠诊断依据率)、死因链填报丰富程度评价(多死因链填报比例)和根本死因编码质量评价(根本死因垃圾编码率)进行数据质量评价.结果 2015-2019年上海市静安区死因监测数据基本信息填写完整性较高,死亡病例身份证号码填写率为99.98％,最高诊断单位不详仅9例,诊断依据不详仅1例,其他基本信息均无不详.上海市静安区可靠诊断单位率为95.97％,可靠诊断依据率为98.14％.多死因链填报比例为57.25％.根本死因垃圾编码率为2.73％.结论 上海市静安区死因监测数据质量较高.今后需继续加强培训和质控,提高死因监测数据质量.

Abstract BACKGROUND: Frailty is related to numerous adverse outcomes and can be operationalized in a variety of ways. However, data on which frailty scales are most suitable for estimating risk remain limited. Herein we examined and compared four validated frailty scales in predicting adverse outcomes in a large population-based cohort of older adults.METHODS: A total of 5402 subjects aged 50 and older from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Frailty was measured using a 35-item frailty index (FI), the frailty phenotype (FP), FRAIL, and Tilburg Frailty Indicator (TFI). Logistic regression models were performed unadjusted/adjusted to evaluate the association between frailty and outcomes including 4-year disability, hospitalization, and 4- and 7-year all-cause mortality. The accuracy for predicting these outcomes was determined by assessing the area under the curve (AUC) as well as sensitivity and specificity.RESULTS: Prevalence of frailty ranged from 4.2% (FRAIL) to 16.9% (FI). Frailty, however defined, was associated with an increased risk of any outcome. The aforementioned associations, except for those of FP with disability and hospitalization, remained significant after controlling for potential covariates. FI, followed by TFI and FRAIL, showed acceptable predictive ability for disability and mortality (AUC: 0.65-0.78). While specificity estimates (85.3-97.3%) for each scale were higher and similar across all outcomes, sensitivity estimates (6.3-56.8%) varied considerably within a lower range.CONCLUSIONS: All four scales did have the potential to identify Chinese older adults at high risk of adverse outcomes; however, their predictive accuracy varied.

IntroductionDementia has become a public health priority and is irreversible. Mild cognitive impairment (MCI), an intermediate state between normal cognition and dementia, is the prime time for early diagnosis and intervention. The activities of daily living of dementia patients are usually insufficient. Therefore, continuing to explore the risk factors of MCI, especially the influence of physical activity on MCI and its mechanism can enrich the relevant research fields in China.Materials and methodsFor this cross-sectional study, 2,518 adults aged 60 years or older in Xinzhuang, Minhang District, Shanghai were recruited between July 2019 and April 2019, using a multistage, cluster-sampling method. A binary unconditional logistic regression model was used with MCI status as the dependent variable. Different types of physical activity were separately included in the multifactor model to test their correlations. Sensitivity analysis was performed using BADL as a stratification factor. The mediating effect of depression between physical activity and MCI was examined using the Bootstrap method.ResultsThis research includes 271 (10.8%) MCI. Old age (odds ratio 2.967 [95%CI 2.063∼4.269]), having diabetes (1.816 [1.302∼2.534]), and depression (3.012 [2.209∼4.108]) were possible risk factors for MCI. High education level (0.722 [0.523∼0.999]), medium level of physical activity (0.459 [0.326∼0.645]), and high level of physical activity (0.396 [0.270∼0.580]) were possible protective factors. Medium (0.548 [0.396∼0.757]) and high levels (0.557 [0.366∼0.846]) of physical exercise and medium (0.433 [0.318∼0.590]) and high levels (0.487 [0.296∼0.801]) of household chores are possible protective factors of MCI and their significance remained in the mutually adjusted model. Sensitivity analysis showed that physical activity and household chores were possible protective factors in all strata (P < 0.05). Physical exercise and work-related activities showed a protective effect in fully independent older adults, but the effect disappeared in those who cannot be fully independent. Depression played a partially mediating role with an indirect effect of 6.67%.DiscussionOverall, our results highlight that physical activity is a possible protective factor for MCI. Physical exercise and household chores have strong protective effects and future interventions could be targeted from this perspective. Depression plays a partially mediating role and more attention should be paid to the mental health of older adults.

Abstract Background A series of studies have explored the health effects of long-term exposure to ambient PM2.5 among older adults. However, few studies have investigated the adverse effect of long-term exposure to ambient PM2.5 on frailty, and the results are inconclusive. This study sought to investigate the associations between long-term exposure to ambient PM2.5 and frailty in 6 low- and middle-income countries. Methods We included an analytical sample of 34 138 individuals aged 50 and older from the Study on global AGEing and adult health Wave 1 (2007/2010). Air pollution estimates were generated using a standard methodology derived from Moderate Resolution Imaging Spectroradiometer observations and Multiangle Imaging Spectroradiometer instruments from the Terra satellite, along with simulations from the GEOS-Chem chemical transport model. A 3-level hierarchical logistic model was used to evaluate the association between frailty index and long-term PM2.5 exposure at 3 levels (individual, province, and country). Results In rural areas, each 10 μg/m3 increase in ambient PM2.5 was associated with a 30% increase in the odds of frailty (OR = 1.30, 95% CI: 1.21–1.39) after adjusting for various potential confounding factors. The gender-stratified analysis showed that the association seemed to be slightly stronger in men (OR = 1.31, 95% CI: 1.18–1.46) than in women (OR = 1.21, 95% CI: 1.07–1.36) in rural areas. Conclusion In a large sample of community-based older adults from 6 middle-income countries, we found evidence that long-term PM2.5 exposure was associated with frailty in rural areas.

ObjectiveTo analyze the effect of frailty status on the risk of mortality in a community-based population aged 45 years and above in Shanghai with different characteristics， and to provide further basis for population-based interventions for frailty and prevention of adverse outcomes.MethodsData were derived from baseline data from the Shanghai prospective study on AGEing and adult health （2009-2010） and cohort follow-up of causes of death up to October 30， 2021. Frailty index （FI） scores were constructed from 40 variables. Those with frailty index FI≥0.2 were judged to be in a frail state， and a multifactorial Cox regression model was used to calculate the hazard ratio （HR） to evaluate the effect of frailty status on the risk of death in different age groups by gender. Socioeconomic characteristics （age， residence， marital status， education and family economic level， etc.） and health-related behaviors （smoking， alcohol consumption， fruit and vegetable intake， social participation， etc.） were included as control variables.ResultsThe study included 7 978 subjects， 777 （9.7%） of whom were in a frail state. After （11.3±1.8） years of follow-up， 1 043 （13.1%） individuals were dead， including 214 （27.5%） who were frail. The results of the multifactorial Cox regression analysis showed that the effect of frailty on the risk of death in each subgroup was in descending order of men in the middle-aged group （45‒ years） （HR=2.92， 95%CI： 1.38-6.19）， women in the low-aged elderly group （60‒ years） （HR=1.68， 95% CI： 1.08-2.60）， and women in the old-aged elderly group （≥75 years and older） （HR=1.59， 95%CI： 1.22‒2.06）.ConclusionFrailty is associated with the risk of death， and we should focus on the frailty status of men aged 45~59 years and women aged 60 years and above. Early screening and assessment of frailty status and taking appropriate preventive interventions may reduce the occurrence of adverse outcomes and premature death.

目的 探讨我国≥50岁人群心脑血管疾病与认知功能的关联.方法 利用WHO全球老龄化与成人健康研究中国项目基线数据.认知功能测试包括即时、延时词语回忆、数字广度、语言流畅度.心脑血管疾病包括高血压、心绞痛和脑卒中.采用一般线性回归模型分析心脑血管疾病与认知功能的关联.结果 共纳入12 645名调查对象.一般线性回归分析显示,与不患心脑血管疾病者相比,只患心绞痛者即时、延时词语回忆和整体认知得分均更低(均有P＜0.05),共患高血压和心绞痛者每项认知得分均更低(均有P＜0.05),共患高血压和脑卒中者即时、延时词语回忆、数字广度测试和整体认知得分更低(均有P＜0.05),共患心绞痛和脑卒中者数字广度测试和整体认知得分均更低(均有P＜0.05),共患高血压、心绞痛和脑卒中者数字广度测试得分更低(P=0.019).心脑血管疾病患病数量与每项认知得分均呈负相关(均有P＜0.05).结论 与不患心脑血管疾病者相比,共患心脑血管疾病与更差的认知功能相关.

It is well established from previous cross-sectional studies that telomeres shorten with age. However, due to a considerable inter-individual variation in telomere length (TL), its relationship with biological aging is difficult to unpick. Longitudinal repeated assessments of TL changes within individuals should augment our understanding of TL dynamics in aging. This study disentangles within- and inter-individual effects of age on leukocyte telomere length (LTL) dynamics in a large population-based cohort of older adults. A total of 4053 subjects aged 50 and older from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Relative LTL (T/S ratio) was measured at baseline (2009–2010) and follow-up (2017–2018) by quantitative real-time polymerase chain reaction. We used linear random slope models to analyze LTL dynamics in relation to age and sex and within-subject centering method to distinguish within- versus between-subject effects. We observed LTL shortening in 66.32%, maintenance in 11.23%, and elongation in 22.45% of the study participants. LTL declined significantly with age both cross-sectionally and longitudinally. More importantly, the longitudinal decline in LTL was much greater than the cross-sectional decline (− 0.017 (p < 0.001) versus − 0.002 (p < 0.001) per year). Furthermore, women had a lower within-subject LTL shortening rate than men (− 0.014 versus − 0.020 per year, p < 0.001). The within-individual longitudinal decline in LTL was much greater than the inter-individual cross-sectional decline, indicating that chronological age might impose a greater impact on LTL shortening than other influencing factors combined. Moreover, women showed a lower within-individual LTL shortening rate than men.

Background Few studies have explored patterns of physical activity (PA) and examined their relationship with depression among community-dwelling older adults. We aimed to identify the patterns of PA through a person-centered analytical approach and examine the association between quantity and patterns of PA, and depression among community-dwelling older adults. Methods We conducted a cross-sectional survey study in the Minhang district, Shanghai, China, in August 2019, and used a self-administered questionnaire to collect data through home visits. The total sample included 2525 older adults. This study used the Physical Activity Scale for the Elderly (PASE) to assess the quantity of PA in older adults. Depression was evaluated with the Geriatric Depression Scale (GDS). Latent class analysis (LCA) was used to identify subpopulations by shared item response patterns. Logistic regressions were performed to estimate the relationship between PASE score, patterns of PA, and depression. An exploratory analysis of joint levels and patterns of PA effects on depression was based on sample subgroups with combinations of levels and patterns of PA. Logistic regression was used to calculate the odds ratio for combined subgroups. Results Four latent classes were identified: “domestic types,” “athletic types,” “gardening/caring types,” and “walkers.” PASE scores and patterns of PA both were associated with depression. Older adults who were the most active (PASE quartile: 75–100%) and the athletic types had the strongest significant association with depression ( OR = 0.19, 95% CI: 0.06–0.65), followed by those who were the most active (PASE quartile: 75–100%) and the walkers ( OR = 0.28, 95% CI: 0.14–0.57) when compared with older adults with the least activity (PASE quartile: 0–25%) and domestic types. Conclusion This study suggests both the quantity and patterns of physical activity are associated with depressive symptoms among community-dwelling older adults. Population-level intervention should encourage community-dwelling older adults to increase their quantity of PA to reduce the risk of depression. Athletics and walkers are recommended. To develop individual-level tailored interventions, more attention should be paid to older adults who are highly engaged in gardening/caring for others.

《上海市防治慢性非传染性疾病中长期规划(2018—2030年)》于2018年8月正式发布,该文以公共卫生专业技术部门视角,从上海市慢性病流行现状、 应对及面临的挑战分析规划出台的背景,全面阐述由4大功能体系构建的慢性病综合防控体系,解读针对慢性病不同阶段实施的重点预防与控制措施,对照国家防治慢性病规划比较评价指标,更好理解未来10年上海市慢性病防治工作新蓝图.

To explore the separate and joint associations between frailty and long-term, all-cause mortality with health-related behaviors in older adults. We enrolled a total of 4050 community residents age ≥60 years from Songjiang District, Shanghai, China, and followed up with them every year from 2015 to 2018.Based on the standard procedure for creating an FI, we developed one containing 28 measured variables. Survival analyses were used to examine the risk ratios (RRs) between frailty and 4-year mortality; hazard ratios (HRs) were obtained and adjusted for gender and age. Over an average follow-up time of 1107.56 ± 144.43 days, 216 (5.4%) participants died. Of all participants, 71.7% were non-frail (FI = 0–0.1), 23.2% were pre-frail (FI = 0.1–0.2), and 5.1% were frail (FI ³0.2). Multivariate HRs (with 95% confidence intervals [CIs]) for all-cause mortality were 1.58 (1.06–2.34) and 2.63 (1.52 –4.55) for moderate (FI 0.1–0.2) and severe (FI >0.2) frailty, respectively, compared with mild frailty (<0.1). Risk of death for severely frail participants who were physically inactive (HR = 3.40; 95% CI, 1.78–6.50; P < 0.001) was 105%, much higher than for severely frail participants who performed physical exercise (HR = 2.34; 95% CI, 1.35–4.09; P < 0.01). Similarly, among severely frail participants, those who were socially inactive (HR = 5.77; 95% CI, 2.69–12.38; P < 0.01) were 344% more likely to die than those who regularly participated in social activities (HR = 2.33; 95% CI, 1.42–3.86; P < 0.01).