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Objective: To systematically evaluate the effect of low intensity resistance training with blood flow restriction on fall resistance in middle-aged and older adults., Methods: PubMed, The Cochrane Library, Web of Science, Embase, EBSCO host, CNKI Database, VIP, Wanfang Database and CBMdisc were searched, and the retrieval period was from the beginning of each database to 25 July 2022. Randomized controlled trials were collected concerning the intervention of low intensity resistance training with blood flow restriction on lower limb muscle strength, muscle mass, muscle function, balance, walking and other fall resistance indicators in middle-aged and older adults. Cochrane Risk of Bias Tool was used for methodological quality assessment of the included literature. Statistical analysis was performed using RevMan 5.4 software and Stata 15.1., Results: A total of 14 randomized controlled trials (419 participants in total) were included in the study. Meta-analysis results revealed that low intensity resistance training with blood flow restriction significantly improved lower limb muscle strength (SMD = 0.51, 95%CI: [0.28, 0.74], p < 0.0001), lower limb muscle mass (MD = 1.99, 95%CI: [0.77, 3.22], p = 0.001) and walking ability (SMD = -0.89, 95% CI. [-1.71, -0.06], p = 0.03), while there was no apparent intervention effect on lower limb muscle function (SMD = 0.25, 95%CI: [-0.23, 0.73], p = 0.31) and balance (SMD = 0.22, 95%CI: [-0.08, 0.52], p = 0.15). The results of subgroup analysis showed that the intervention effect of low intensity resistance training with blood flow restriction on lower limb muscle strength was more significant in subjects aged 55-64 years, with exercise cycles of 4-8 weeks, exercise frequency of three times per week, exercise intensity of 20-30% 1RM, and vascular flow blocking pressure ≥ 120 mmHg., Conclusion: Low intensity resistance training with blood flow restriction can effectively improve lower limb muscle strength, muscle mass and walking ability in middle-aged and older adults, and can serve as an important form of fall resistance training for the older adults.

Background: A growing body of research suggests that financial difficulties could weaken the protective effects of socioeconomic status (SES) indicators, including education and income, on the health status of marginalized communities, such as African Americans., Aim: We investigated the separate and joint effects of education, income, and financial difficulties on mental, physical, and oral self-rated health (SRH) outcomes in African American middle-aged and older adults., Methods: This cross-sectional study enrolled 150 middle-aged and older African Americans residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics (education, income, and financial difficulties), and self-rated health (mental, physical, and oral health) were collected. Three linear regression models were used to analyze the data., Results: Higher education and income were associated with a lower level of financial strain in a bivariate analysis. However, according to multivariable models, only financial difficulties were associated with poor mental, physical, and oral health. As similar patterns emerged for all three health outcomes, the risk associated with financial difficulties seems robust., Conclusions: According to our multivariable models, financial strain is a more salient social determinant of health within African American communities than education and income in economically constrained urban environments such as South Los Angeles. While education and income lose some protective effects, financial strain continues to deteriorate the health of African American communities across domains.

Background: In an aging and digital society, Internet use is significantly associated with residents' physical exercise. This study aimed to explore the association between Internet use and physical exercise among Chinese middle-aged and older adults in two respects: Internet use and the purpose of Internet use., Methods: The data used in this study were obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS) conducted by Peking University. The logit model and the ordered probit model were used to analyze the association between Internet use and physical exercise, and the substitution variable method was used to examine the robustness of the results., Results: (1) Internet use and the frequency of Internet use significantly increased the probability and frequency of middle-aged and older adults' participation in physical exercise ( p < 0.001). (2) "Watching news", "chatting" and "watching videos" via the Internet were positively associated with physical exercise, while "playing games" had no impact. (3) Internet use had a greater impact on physical exercise participation among middle-aged adults and those living in urban areas than among older adults and those living in rural areas., Conclusions: This study suggests that Internet use among middle-aged and older adults is positively associated with their participation in physical exercise; the government should try to increase the popularity of Internet use to encourage their participation in physical exercise.

Help-seeking among destitute adults has not been adequately investigated. Therefore, this study clarifies the mechanisms that suppress help-seeking in middle-aged and older adults living alone. Data were collected from 1274 individuals (aged 50-79 years) who were living alone, using a survey that measured future time perspective, barriers to help-seeking, help-seeking intentions, and current and childhood economic statuses. Men living alone experienced lower help-seeking intention than women, were more likely to try to solve problems by themselves, and experienced greater distrust in others. No sex differences were observed in "future anxiety" and "resignation to the future." Poor economic status was associated with high "resignation to the future," "future anxiety," and "distrust of others" for both sexes. "Resignation to the future" was particularly higher among men with a poorer current economic status, which suppressed help-seeking. Abandoning hope for the future, which is characteristic of middle-aged and older men living alone, may inhibit help-seeking behavior.

Some population groups could be especially vulnerable to the effects of population ageing. The Global Activity Limitation Indicator (GALI) has been proposed as a measure of disability, but it has not been used in minority groups. The aim of this study is to estimate the prevalence of disability using the GALI and to analyse its determinants in immigrant and Roma populations. Data from the Spanish National Health Survey 2017 and the National Health Survey of the Roma Population 2014 were used, including adults aged 50 and above. Prevalence of disability was estimated, and odds ratios were calculated using logistic regression models to assess the association between disability and demographic, socioeconomic, and health variables. The prevalence of disability was estimated at 39.4%, 30.6%, and 58.7% in the native, immigrant, and Roma populations, respectively. Gender was a common determinant for the native and Roma populations. On the other hand, among immigrants, the risk of disability increased over the time residing in Spain. There were significant interactions with age and gender in the native population. Disability has different determinants in the three population groups. Public health measures to protect the Roma population and immigrants' health should be considered.

Background : Given the documented importance of employment for middle-aged and older adults' mental health, studies of the association between their number of work hours and depressive symptoms are needed. Objectives : To examine the association between the number of work hours and depressive symptoms in Korean aged 45 and over. Methods : We used data from the first wave to fourth wave of the Korea Longitudinal Study of Aging. Using the first wave at baseline, data included 9845 individuals. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression scale. We performed a longitudinal analysis to estimate the prevalence of depressive symptoms by work hours. Results : Both unemployed males and females aged 45-65 years were associated with higher depressive symptoms (β = 0.59, p < 0.001; β = 0.32, p < 0.001). Females working ≥ 69 h were associated with higher depressive symptoms compared to those working 41-68 h (β = 0.25, p = 0.013). Among those both middle-aged and older adults, both males and females unemployed were associated with higher depressive symptoms. Those middle-aged female working ≥69 h were associated with higher depressive symptoms. Conclusions : An increase in depressive symptoms was associated with unemployed males and females working ≥69 h compared to those working 41-68 h. Although this association was found among middle-aged individuals, a decrease in depressive symptoms in both sexes was associated with working 1-40 h. Depressive symptoms should decrease by implementing employment policies and social services to encourage employers to support middle-aged and older adults in the workforce considering their sex and age differences.

Poor sleep quality and frailty are common problems among aged people. However, the association between sleep quality and frailty in middle-aged and older people is seldom discussed in Asia, especially in Taiwan. This study investigated this association hopefully to provide pertinent knowledge for the prevention of frailty. We conducted a cross-sectional study and enrolled 828 subjects, 237 male and 591 female, aged 50-85 years old, from a community in Northern Taiwan. Poor sleep quality was defined as the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) > 5. Prefrailty and frailty were defined as fulfillment of one or two and three, respectively, of five phenotypic criteria: exhaustion, weakness, slowness, weight loss, and low physical activity. Our univariate analysis showed that the incidence of prefrailty/frailty in the group of poor sleep quality was higher than that in the group of CPSQI ≤ 5 ( p < 0.001). Further multiple logistic regression analysis revealed that poor sleep quality was an independent factor for prefrailty and frailty status (odds ratio = 1.95, 95% confidence interval = 1.38-2.77), after adjustment for confounding factors. We concluded that poor sleep quality is independently associated with prefrailty and frailty status in our study population.

The intima-media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and β-stiffness of the carotid artery (CA) are considered as independent risk factors for cardiovascular diseases (CVDs). Pre-hypertension (PHT) is also an independent CVD risk factor. This study investigated the association between CA damage (CAD) and PHT. A total of 544 adults participated; their blood pressures (BPs) and CA characteristics were measured using a mercury-free sphygmomanometer and ultrasound. Analysis of covariance (ANCOVA) was performed to assess the differences in the CA characteristics according to the BPs, multinomial logistic regression to evaluate the risk of CAD associated with PHT. In ANCOVA, the CA characteristics of PHT were significantly different from normotensive. The odds ratios (ORs) of IMTmax, LDmax, LDmin, peak-systolic FV (PFV), end-diastolic FV (EFV), PFV/LDmin, EFV/LDmax, compliance, and β-stiffness of PHT were 4.20, 2.70, 3.52, 2.41, 3.06, 3.55, 3.29, 2.02, and 1.84 times higher than those of the normotensive, respectively, in Model 2. In Model 3 adjusted for age, the ORs of LDmax, LDmin, EFV, PFV/LDmin, and EFV/LDmax of PHT were 2.10, 2.55, 1.96, 2.20, and 2.04 times higher than those of the normotensive, respectively. Therefore, the present study revealed that CAD is closely correlated with pre-hypertensive status in adults.

Partial or total non-adherence has been recognized as major issues in the long-term management of hypertension. This study aims to investigate the prevalence and associated factors of compliance behaviors among Chinese middle-aged and older hypertensive patients. A sample of 6308 hypertensive patients aged ≥45 years was obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS) data. Two compliance behaviors were involved including medication and blood pressure monitoring. Stratified binary logistic regression analysis was employed to examine the associated factors. 77.2% of the participants reported medication compliance, and 40.7% complied with blood pressure monitoring. Better medication compliance associated with older age, overweight or obesity, one or ≥3 complications, no drinking, living in urban areas, and health education. Better blood pressure monitoring compliance associated with older age, overweight or obesity, ≥3 complications, normal activities of daily living (ADL), no smoking, sleep duration of 6-8 h, better cognitive function, living in urban areas, education level of middle school or above, and health education. Chinese middle-aged and older hypertensive patients experienced unoptimistic compliance behaviors, especially for blood pressure monitoring. Special attention and targeted interventions are urgent for the high-risk population of poor compliance behaviors, such as rural individuals, low educational population, and younger hypertensive patients.

Changes in lifestyle behaviors may effectively maintain or improve the health status of individuals with chronic diseases. However, such health behaviors adopted by individuals are unlikely to demonstrate similar patterns. This study analyzed the relationship between the heterogeneous latent classes of health behavior and health statuses among middle-aged and older adults with hypertension, diabetes, or hyperlipidemia in Taiwan. After selecting 2103 individuals from the 2005 and 2009 Taiwan National Health Interview Survey (NHIS), we first identified heterogeneous groups of health behaviors through latent class analysis (LCA). We further explored the relationship between each latent class of health behavior and health status through ordered logit regression. We identified the following five distinct health behavior classes: the all-controlled, exercise and relaxation, healthy diet and reduced smoking or drinking, healthy diet, and least-controlled classes. Regression results indicated that individuals in classes other than the all-controlled class all reported poor health statuses. We also found great magnitude of the coefficient estimates for individuals who reported their health status to be poor or very poor for the least-controlled class. Therefore, health authorities and medical providers may develop targeted policies and interventions that address multiple modifiable health behaviors in each distinct latent class of health behavior., Competing Interests: The authors declare no conflict of interest.

With the rapid and widespread adoption of mobile devices, mobile phones offer an opportunity to deliver cardiovascular disease (CVD) interventions. This study evaluated the efficacy of a mobile phone-based lifestyle intervention aimed at reducing the overall CVD risk at a health management center in Guangzhou, China. We recruited 589 workers from eight work units. Based on a group-randomized design, work units were randomly assigned either to receive the mobile phone-based lifestyle interventions or usual care. The reduction in 10-year CVD risk at 1-year follow-up for the intervention group was not statistically significant (-1.05%, p = 0.096). However, the mean risk increased significantly by 1.77% (p = 0.047) for the control group. The difference of the changes between treatment arms in CVD risk was -2.83% (p = 0.001). In addition, there were statistically significant changes for the intervention group relative to the controls, from baseline to year 1, in systolic blood pressure (-5.55 vs. 6.89 mmHg; p < 0.001), diastolic blood pressure (-6.61 vs. 5.62 mmHg; p < 0.001), total cholesterol (-0.36 vs. -0.10 mmol/L; p = 0.005), fasting plasma glucose (-0.31 vs. 0.02 mmol/L; p < 0.001), BMI (-0.57 vs. 0.29 kg/m²; p < 0.001), and waist hip ratio (-0.02 vs. 0.01; p < 0.001). Mobile phone-based intervention may therefore be a potential solution for reducing CVD risk in China.