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Background: there is little evidence to suggest that older people today are living in better health than their predecessors did at the same age. Only a few studies have evaluated whether there are birth cohort effects on frailty, an indicator of health in older people, encompassing physical, functional and mental health dimensions. Objectives: this study examined longitudinal trajectories of frailty among Chinese older people in Hong Kong. Methods: this study utilised data from the 18 Elderly Health Centres of the Department of Health comprising a total of 417,949 observations from 94,550 community-dwelling Chinese people aged ≥65 years in one early birth cohort (1901-23) and four later birth cohorts (1924-29, 1930-35, 1936-41, 1942-47) collected between 2001 and 2012, to examine trajectories of the frailty index and how birth cohorts may have contributed to the trends using an age-period-cohort analysis. Results: more recent cohorts had higher levels of frailty than did earlier cohorts at the same age, controlling for period, gender, marital status, educational levels, socioeconomic status, lifestyle and social factors. Older age, being female, widow-hood, lower education and smoking were associated with higher levels of frailty. Conclusion: more recent cohorts had higher levels of frailty than did earlier cohorts. Frailty interventions, coupled with early detection, should be developed to combat the increasing rates of frailty in Hong Kong Chinese. [ABSTRACT FROM AUTHOR]

Throughout Hong Kong’s colonial history, court proceedings have relied on English as the primary medium of communications. Given that the majority of the population is Chinese and possesses varying degrees of mastery over English, court proceedings have tended to be systematized and detached. With the development of legal bilingualism in Hong Kong, there is a proliferation of the use of Chinese (orally Cantonese) in the courtroom, particularly in the lower courts. Drawing on courtroom observations of the magistrates’ courts, I observe that the use of Chinese criminal proceedings has allowed the courts to engage in a moral discourse towards defendants and, by extension, towards the public, more directly. Magistrates chastise defendants on their unlawful behaviours and lecture them on what is right and wrong. The moral lecturing eclipses the formal law by criticizing defendants harshly but imposing relatively lenient sentences. By directly communicating to defendants in Chinese, magistrates’ opinions are expressed more forcefully than the formal law. [ABSTRACT FROM AUTHOR]

Background. In Asia, the role of primary care physicians (PCPs) in mental health delivery is not clearly defined and what happens to patients following a depressive episode remains poorly understood. Objective. To examine the 12-month naturalistic outcomes of depression in primary care and the impact of PCP identification. Methods. A cohort study was conducted. A total of 10 179 adults were consecutively recruited from the waiting rooms of 59 PCPs across Hong Kong to complete a survey which screened for depression. Blinded doctors provided data on their diagnosis and management; 539 screenedpositive and 3819 screened-negative subjects consented to telephone follow-up at 3, 6 and 12 months. Study instruments included Patient Health Questionnaire-9, Centre for Epidemiologic Studies Depression Scale 20 and Short-Form Health Survey Version 2.0 (SF-12v2) and self-reported mental health and primary care service use. Results. 12-month remission rate was 60.31%. PCP detection had no association with remission. Identified patients had poorer health-related quality of life (HRQOL) at baseline but a faster rate of recovery in SF-12v2 mental component scores. PCP detection was associated with greater mental health service use at 12, 26 and 52 weeks, while GP consultation rates were only increased at 12 weeks. Conclusions. Over 1 year, ~60% of depressed patients experience symptom resolution, while 40% continue to suffer a chronic or remitting course of illness. Identification of depression by a PCP does not appear to affect remission of mood symptoms at 12 months, but is associated with a faster rate of recovery of HRQOL. PCP detection raises GP consultation rates temporarily however appears to enable more patients to access mental health services over 12 months. [ABSTRACT FROM AUTHOR]

Background: although social engagement and depressive symptoms are important concerns for long-term care facility residents, the dynamic relationship between them has not been adequately studied.Objective: this study examines the relationship between social engagement and depressive symptoms and changes in social engagement and depressive symptoms among Chinese residents of long-term care facilities over 6 years.Design and methods: a latent growth model was used to analyse six waves of data collected using the Resident Assessment Instrument Minimum Data Set 2.0 in the Hong Kong Longitudinal Study on Long-Term Care Facility Residents. Ten residential facilities with a total of 1,184 eligible older adults at baseline were included in the study.Results: after controlling for demographic variables at baseline, a higher level of social engagement was associated with fewer depressive symptoms. Trajectories of social engagement were significantly related to trajectories of depressive symptoms. Participants who recorded positive social engagement growth reported reduction in depressive symptoms.Conclusion: the findings of our study extend previous research by showing that increased social engagement is associated with decreased depressive symptoms over time. In long-term residential care settings, it is important for services to engage residents in meaningful social activities in order to reduce depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Smoking cessation programs are well established in the West, but reports on smoking cessation clinics (SCCs) from China are lacking. On the basis of the Hong Kong experience and with strong support from Guangzhou Health Bureau, we established the first SCC in Guangzhou, China. The objective was to describe the characteristics of smokers, measure quit rates and examine predictors of successful quitting. [ABSTRACT FROM PUBLISHER]

Objectives. This study examined financial transfers from adult children to elderly parents in Hong Kong and tested three hypotheses about the motives for such transfers. We address previous research, suggesting that family financial support for retirees will decline in the coming decades as a consequence of the reduction in the fertility rate; we also examine whether financial transfers are a function of the number of adult children in the family. Methods. We used multiple regression models based on data from a representative sample of parents aged 60 years and older to identify the correlates of the amount of transfers from adult children to their elderly parents. Results. We found evidence for the hypothesis that upstream transfers to elderly parents are their way of withdrawing savings from a “support bank” in which they made contribution for their children’s education earlier in life and that transfers are altruistic in nature, but our results provide only moderate support to the old age security hypothesis that perceives family as a source of capital. Discussion. The number of children has a ceiling effect on transfers, which calls into question common assumptions about the extent to which the decline in fertility will pose a severe threat to the extent of familial support of older persons over the coming decades. [ABSTRACT FROM PUBLISHER]