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Background: Pulmonary infection (PI) and urinary tract infection (UTI) have been the most common cause of hospitalization and most frequent infection respectively in older people with disability (OPWD). Long‐term care insurance (LTCI) policy, intending to provide services to reduce the disease burden of OPWD, it remains unclear whether LTCI could reduce PI‐, and UTI‐related hospitalizations. This quasi‐experimental study aimed to assess the influences of LTCI on all‐cause, especially PI‐ and UTI‐related hospitalizations among OPWD and the variation across sociodemographic characteristics. Methods: 32,120 participants in the Chengdu Long‐term Care Insurance cohort were considered the intervention group, and 2,704 not covered by the LTCI were in the control group. A total of 3,134,160 hospitalization records were collected between January 2014 and June 2021. A doubly robust difference‐in‐differences (DID) method was used to estimate the average treatment effect on the treated (ATT), indicating the average effect of LTCI on intervention group. Results: The average monthly all‐cause, PI‐, and UTI‐related hospitalization rates were 16.3%, 4.0% and 0.5% in the intervention group, respectively, and were 19.3%, 3.9% and 0.5% in the control group, respectively. Under LTCI, all‐cause (ATT [95% CI]: 7.15% [6.41%, 7.88%]), PI‐ (3.25% [2.76%, 3.74%]), and UTI‐related hospitalizations (0.46% [0.28%, 0.64%]) were decreased. The influences of LTCI became significant after 5 months since the LTCI implementation and remained stable over time. The impact was more pronounced among those with longer coverage. The overall reduction was stronger in those who were not married, lived alone, and resided in institutions. Conclusions: LTCI may reduce the occurrence of all‐cause, PI‐, and UTI‐related hospitalizations in OPWD, with stronger influences observed over an extended period of implementation. The implementation of LTCI can play a role in reducing the burden of infectious diseases in OPWD and the care burden of families and society. [ABSTRACT FROM AUTHOR]

Mental disorders are associated with dysregulated metabolism, but comprehensive investigations of their metabolic similarities and differences and their clinical relevance are few. Here, based on the plasma metabolome and lipidome of subcohort1, comprising 100 healthy participants, 55 cases with anxiety, 52 persons with depression, and 41 individuals with comorbidity, which are from WCHAT, a perspective cohort study of community‐dwelling older adults aged over 50, multiple metabolites as potential risk factors of mental disorders were identified. Furthermore, participants with mental illnesses were classified into three subtypes (S1, S2, and S3) by unsupervised classification with lipidomic data. Among them, S1 showed higher triacylglycerol and lower sphingomyelin, while S2 displayed opposite features. The metabolic profile of S3 was like that of the normal group. Compared with S3, individuals in S1 and S2 had worse quality of life, and suffered more from sleep and cognitive disorders. Notably, an assessment of 6,467 individuals from the WCHAT showed an age‐related increase in the incidence of depression. Seventeen depression‐related metabolites were significantly correlated with age, which were validated in an independent subcohort2. Collectively, this work highlights the clinical relevance of metabolic perturbation in mental disorders, and age‐related metabolic disturbances may be a bridge‐linking aging and depressive. [ABSTRACT FROM AUTHOR]

Based on the expert consensus on parenteral and enteral nutrition support for geriatric patients in China in 2013, domestic multidisciplinary experts were gathered to summarize the new evidence in the field of elderly nutritional support at home and abroad. The 2013 consensus was comprehensively updated and upgraded to a guideline by referring to the World Health Organization (WHO) guidelines for the Grading of Recommendations Assessment, Development, and Evaluation system for grading evidence. These guidelines were divided into two parts: general conditions and common diseases. After discussion by all members of the academic group and consultation with relevant experts, 60 recommendations were ultimately established as standardized nutritional support in the field of geriatrics in China. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence and factors associated with sarcopenia in a sample of older inpatients. Methods: A cross‐sectional study was conducted in three acute geriatric wards in 2012. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia. Results: We included 407 patients aged 81.0 ± 8.0 years. The prevalence of sarcopenia was 31% in the whole study population. Multiple logistic regression showed that being a female (odds ratio (OR) 4.75, 95% confidence interval (CI) 2.45–9.20), smoking (OR 2.94, 95% CI 1.26–6.69), cognitive impairment (OR 2.08, 95% CI 1.10–3.95), polypharmacy (OR 2.36, 95% CI 1.28–4.34) and body mass index (OR 0.75, 95% CI 0.68–0.83) were independently associated with sarcopenia. Conclusion: Sarcopenia was highly prevalent in older inpatients. In addition to factors previously reported to be associated with sarcopenia, we found that polypharmacy was associated with sarcopenia. As the direction of causality remains uncertain, these relationships deserve further study. [ABSTRACT FROM AUTHOR]

China has the world's largest elderly population, and the oldest‐old population, with a current disability rate greater than 50%, will triple in the next 35 years. The field of geriatrics is young, because almost all geriatric departments were established after 2000, and so faces many challenges. Management of diseases and hospital care is the focus. Senior physicians were trained in other subspecialties, such as pulmonary or cardiology, and junior physicians entered geriatrics departments as masters or doctorate students after medical school. The inadequacy of post‐acute and long‐term care facilities has caused long hospital stays. There are no national systematic geriatric training programs, national board examinations, or qualifications in geriatrics. These challenges were used as a framework for guiding changes in the Department of Geriatrics at West China Hospital, Sichuan University. These changes have included international experiences and collaboration for physicians and nurses, revision of departmental conferences, and special training for a unique group of caregivers called hugong (untrained caregivers hired by families to be at the bedside of hospitalized individuals). The most significant yet challenging part of the transformation has been to develop and modify Western‐based geriatric models of care (e.g., Acute Care of the Elderly unit, delirium prevention and management models, palliative care). Lastly, the department established Tianxia (in the sky) Doctors, an internet‐based platform to connect the department's interdisciplinary team to other hospitals, nursing institutions, home‐based care service stations, community health service centers, and pharmacies throughout the region. [ABSTRACT FROM AUTHOR]

Aim Aim The aim of the present study was to examine the association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese people aged 60 years and older. Methods This study was carried out on 836 community-dwelling Chinese individuals aged ≥60 years to evaluate sarcopenia using the Asian Working Group for Sarcopenia criteria. Sociodemographic characteristics and lifestyle habits were collected using a general questionnaire. Nutritional status was assessed using the Mini Nutritional Assessment and biochemical parameters, whereas physical activity was assessed using the long form of the International Physical Activity Questionnaire. In addition, univariate and multivariate analysis was used to analyze the association between sarcopenia with nutritional status and physical activity. Results The total prevalence rate of sarcopenia was 10.5%, 47 (11.3%) men and 41 (9.7%) women who were classified as sarcopenia. The prevalence of sarcopenia was significantly lower among the participants of normal nutrition status. Compared with the participants with sarcopenia, those without sarcopenia had higher levels of prealbumin ( P < 0.05) and hemoglobin ( P < 0.05) for both sexes. In the multivariate model, after adjustment for all covariates, the Mini Nutritional Assessment score (adjusted OR 0.769, 95% CI 0.689-0.859, P < 0.05) was statistically significantly associated with sarcopenia, but the relationship between physical activity and sarcopenia was not significant. Conclusions The prevalence of sarcopenia in the Chinese community-dwelling population aged 60 years and older was high. There was a significant association between sarcopenia and nutritional status, but not with physical activity, based on a questionnaire. Further studies should evaluate whether maintaining a good nutritional status might be effective in lowering the risk of sarcopenia. Geriatr Gerontol Int 2017; 17: 1959-1966. [ABSTRACT FROM AUTHOR]

Background The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long-term mortality and readmission in a population of elderly inpatients in acute care wards. Methods We conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Handgrip strength was measured with a handheld dynamometer, and physical performance was measured via a 4 m walking test. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The survival status and readmission information were obtained via telephone interviews at 12, 24, and 36 months during the 3 year follow-up period following the baseline investigation. Results Two hundred and eighty-eight participants (mean age: 81.1 ± 6.6 years) were included. Forty-nine participants (17.0%) were identified as having sarcopenia. This condition was similar in men and women (16.9% vs. 17.5%, respectively, P = 0.915). During the 3 year follow-up period, 49 men (22.7%) and 9 women (16.4%) died ( P = 0.307). The mortality of sarcopenic participants was significantly increased compared with non-sarcopenic participants (40.8% vs. 17.1%, respectively, P < 0.001). After adjusting for age, sex and other confounders, sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25-4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17-2.80). Conclusions Sarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long-term mortality in elderly patients in acute care wards. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship between waist circumference (WC) and activities of daily living (ADL)/ instrumental activities of daily living (IADL) disability among nonagenarians and centenarians. Methods: We analyzed data obtained from a cross-sectional study carried out in 870 older Chinese adults aged 90 years and older in Dujiangyan, a town in West China. The participants were divided into four groups according to their sex and WC quartile. The ADL and IADL disabilities were measured using the physical self-maintenance scale and Lawton and Brody's IADL scale, respectively. Results: We included 233 men and 505 women in this statistical analysis. The prevalence of ADL or IADL disability was 53.6% in men and 71.3% in women. Participants in the highest WC quartile group (WC ≥83.0 cm for men or WC ≥82.0 cm for women) had higher prevalence of ADL or IADL disability compared with those in the lowest WC quartile group (WC <73.0 cm for men or WC <70.5 cm for women). Adjusting for relevant confounders, the highest quartile group showed significantly increased odds ratios for either ADL (1.7 for men and 2.1 for women) or IADL disability (odds ratios 3.3 for men and 2.0 for women) compared with the lowest quartile group. Conclusion: Among Chinese older adults aged 90 years and older, both men and women in the highest quartile of WC were at higher risk of ADL or IADL disability compared with those in the lowest quartile of WC. [ABSTRACT FROM AUTHOR]

Aim We explored the association between family functioning and cognitive impairment in the very elderly aged 90-108 years. Methods The present study comprised data from subjects included in the 2005 Project of Longevity and Aging in Dujiangyan, China. Sociodemographic and family functioning data were collected, and cognitive function was assessed in all subjects using the Mini- Mental State Examination. Results Data from 699 Chinese nonagenarians and centenarians were included. The prevalence of cognitive impairment was 62.8%. The prevalence of family dysfunction was 52.2%, including 8.6% severe and 43.6% moderate dysfunction. There were significant differences among individuals with different family functioning level with regard to cognitive function scores ( P = 0.005) or cognitive impairment prevalence ( P = 0.012). Subjects with cognitive impairment had lower family functioning scores than those without cognitive impairment ( P = 0.004). Pearson's correlation analysis showed that family functioning scores were correlated with Mini- Mental State Examination scores ( r = 0.13, P = 0.001). Multiple logistic regressions showed that severe family dysfunction was a risk factor for cognitive impairment. The effect remained after adjusting for sociodemographic status, life habits and metabolic indicators. Conclusions Family functioning was related to cognitive impairment among Chinese nonagenarians and centenarians. We found that the higher the family functioning scores, the higher the Mini- Mental State Examination scores. Severe family dysfunction was associated with increased risk of cognitive impairment. Geriatr Gerontol Int 2015; 15: 1135-1142. [ABSTRACT FROM AUTHOR]

Objective To investigate the occurrence and risk factors of mild cognitive impairment (MCI) and the conversion rates to dementia in Chinese people over 80 years of age. Methods Two hundred and two participants (>80 years old) without dementia were assessed clinically using neuropsychological tests; they were re-assessed at 1, 2, and 3 years. Results The results revealed that 30.2% of the study population was classified as having MCI at baseline. Multivariate linear regression analysis showed that coronary heart disease, hypertension, and stroke were risk factors of MCI. During the 3 years follow-up, the occurrence of MCI increased, and 21.8% of the participants with MCI progressed to dementia. Conclusions These results suggest that in the older elderly, prevention and early treatment of cardiovascular and cerebrovascular diseases may be effective in lowering the risk of MCI. MCI is a high risk factor for dementia. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives To examine evidence of the efficacy of antipsychotics in the treatment of delirium in older hospitalized adults. Design Systematic literature review. Setting Hospital. Participants Older adults with delirium. Measurements The MEDLINE (January 1980-December 2010) and Cochrane Databases were searched using the keywords 'delirium' and 'antipsychotics.' References of review articles were reviewed to identify additional studies. Study selection criteria included prospective design, more than 10 participants (in treatment arms), mean age 60 and older, standardized criteria for diagnosing delirium, and validated delirium rating scales for reporting outcomes. Results Thirteen articles met selection criteria: six single-agent and seven comparison studies. Of these, eight (62%) had fewer than 25 participants in treatment arms, 10 (77%) recruited participants from psychiatry referrals, and eight (62%) did not clearly describe their screening methods. All single-agent studies were open-label studies. Of the comparison studies, five (71%) used randomization, but only one of these (a placebo-controlled study) used adequate allocation concealment methods, and only one other study (comparing two antipsychotics) described a double-blind method in detail. In the only placebo-controlled study (which was stopped early), no statistically significant differences in mean delirium severity scores were found at individual time points (Days 2, 3, 4, 7, 10). The other 12 studies reported improvements in delirium severity or resolution of delirium based on cutoff scores of the scales, but it is not clear from any of these studies what the natural course of delirium would have been without use of antipsychotics. Conclusion Because of severe methodological limitations, the studies in this review do not support the use of antipsychotics in the treatment of delirium in older hospitalized adults. Additional well-designed randomized placebo-controlled trials are needed. [ABSTRACT FROM AUTHOR]

Objective Previous research has suggested that social support and functional status influence the subjective well-being of the elderly. However, few studies have investigated whether these associations influence well-being in the very old. Methods In this population-based, cross-sectional study, 1401 persons aged 90 years or over were located in Du Jiang Yan city, Sichuan, China. Among them 732 were willing to participate and provided data on a battery of standardized questionnaire inventories. The 23-item Philadelphia Geriatric Center Morale Scale (PGCMS) was examined as an index of subjective well-being. Functional status was assessed using the physical self-maintenance scale (PSMS) and the instrumental activities of daily living (IADL) scales. The mini-mental state examination (MMSE) was used to measure cognitive function. Social support was assessed using the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) scale and the social support requirement scale (SSRS). Results The mean age was 93.7 ± 3.4 years for the participants, of whom 68% were female. PGCMS total scores were significantly correlated with the Family APGAR and Objective Support subscale of the SSRS, as well as with scores on the MMSE and PSMS scales. However, in a multiple regression analysis, only MMSE and Family APGAR scores were independent predictors of PGCMS scores. Conclusion Both social support from family members and cognitive function appear to be key factors associated with quality of life among the very old in China. Further research is needed among very old populations to confirm the importance of these variables and to examine potential cross-cultural differences. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the occurrence of potentially inappropriate medications (PIM) in older patients in China. Researchers evaluated 1,796 patients. They found that there were high rates of PIM and that the most comon PIMs were benzodiazepines, drugs with strong anticholinergic properties and megestrol, and that there were several others.

Objective Methods Results Conclusion To investigate the associations between parity (the number of offspring a female has borne) and cognitive function, depression, and chronic comorbidity in Western China.A total of 846 women aged 50–55 years were included in the current analysis. Cognitive status was measured using a 10‐item short portable mental status questionnaire (SPMSQ). Depressive symptoms were assessed using the 15‐item geriatric depression scale (GDS‐15). Other characteristics were self‐reported. The associations between parity and cognitive decline, depression, and chronic comorbidity were analyzed using univariable and multivariable models. Multivariable models were adjusted for age, ethnic group, occupation, marital status, educational level, lifestyle factors, and sleeping time.Among the enrolled women, 26.71% were either childless or had one child, 47.40% had two children, 18.32% had three children, and 7.57% had ≥4 children. Compared to women with low parity, women with two or more children exhibited a higher risk of cognitive decline. Moreover, having four or more children was significantly associated with depression and chronic comorbidity. After adjusting covariates, women with three or more children exhibited a higher risk of cognitive decline than those with low parity. However, high parity was not significantly associated with depression or chronic comorbidity after adjustment for covariates.Our study showed that ≥3 children was associated with cognitive decline in women. Longitudinal studies are needed to evaluate this conclusion and to investigate the mechanisms involved. More importantly, families and societies should pay more attention to women's long‐term health outcomes related to fertility. [ABSTRACT FROM AUTHOR]