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Background: In this study, we explored the relationship between social isolation, loneliness, and functional impairment in 50-year-old participants, by sex., Methods: Using longitudinal data from the China Health and Retirement Longitudinal Study (2018 and 2020), 6,524 participants meeting the inclusion criteria were analyzed. A cross-lag model was established to explore the associations between social isolation, loneliness, activities of daily living (ADL), and instrumental ADL (IADL) disability over time, with results stratified by sex., Results: Social isolation was not significantly associated with ADL and IADL disability, but loneliness was. Autoregressive associations indicated that social isolation, loneliness, and functional disability in 2018 predicted their exacerbations in 2020 (p < 0.001). Cross-lag analysis showed that the time-lagged effect of loneliness on ADL disability was greater in women (β = 0.27) than in men (β = 0.06); the time-lagged effect of ADL disability on loneliness was greater in men (β = 0.16) than in women (β = 0.05). The bidirectional time-lagged effects of loneliness and IADL disability showed opposite patterns between the sexes., Conclusion: Functional disability in China was significantly associated with loneliness but not with social isolation. Sex differences were observed in the time-lagged effect of loneliness on functional disability. These findings extend our understanding of the association between social relationships and functional disability in non-Western populations., Competing Interests: Declarations Ethics approval and consent to participate All participants provided informed consent, and the protocol was approved by the Ethical Review Board of Peking University (approval number: IRB00001052-11,015). Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Objectives: Allostatic load (AL) is an index that manifests as cumulative wear and tear on multiple physiological systems resulting from repeated adaptation to stressors throughout the life course. Higher AL was found to be associated with increased risk of adverse health outcomes, but studies on functional disability among large Chinese older population were limited. We aimed to investigate the associations of AL with functional disability among Chinese older adults., Research Design and Methods: This prospective cohort study included 5880 older adults who were at least 50 years old and participated in the CHARLS at baseline (2011 wave), with 3 follow-ups (2013, 2015 and 2018 waves). We selected 11 biomarkers from 4 physiological systems to construct AL. AL score was classified into three categories based on tertiles: 0-1 (low burden), 2-3 (medium burden) and 4-11 (high burden). Functional disability was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Multivariable logistic regression models examined the association between baseline AL, transitions of AL burden and incidence of functional disability., Results: In cross-sectional analyses, medium and high AL burden were associated with an increased prevalence of ADL disability, while association was only significant between high AL burden and IADL disability. During the 7-year follow-up, 1102 and 1777 participants incident ADL disability and IADL disability, respectively. Those with medium and high AL burden had an increased risk of new-onset ADL disability than those with low AL burden ("medium": OR = 1.25, 95%CI = 1.01, 1.55; "high": OR = 1.69, 95%CI = 1.32, 2.18). As for IADL disability, association was only significant in "high" group (OR = 1.50, 95% CI = 1.24, 1.83). We also found keep medium/high AL burden in 2011 and 2015 was associated with new-onset ADL (OR = 2.27, 95%CI = 1.50, 3.44) and IADL disability (OR = 1.51, 95%CI = 1.11, 2.05) in 2018., Conclusion: These results show that higher AL predicts functional disability among Chinese older adults. Monitoring AL and paying close attention to those with medium/high AL burden may aid prevention of adverse health outcomes, thus giving a healthier ageing experience to a large proportion of the population., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Objective: The limitation of activities of daily living (ADL) affects the mental health of older adults. We distinguished activities of daily living into basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and aimed to explore the relationship between the two limitations and depressive symptoms among Chinese older adults by using nationally representative cross-sectional data., Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS, wave 4) were used, and 9,789 older adults aged 60 years and above were screened. The 10-item Center for Epidemiologic Studies Depression (CES-D-10) scale was used to measure the depressive symptoms of older adults, and a 12-item scale for ADL was used to estimate functional limitations. Generalized linear mixed-effect models were employed to examine the relationship between BADL/IADL and depressive symptoms among older adults., Results: The prevalence of high-risk depression among older adults was 43.5%, and the rates of limitation in BADL and IADL were 19.02 and 25.29%, respectively. The prevalence of high-risk depression significantly differed among subgroups of smoking, drinking, chronic diseases, duration of sleep, having social activities or not, and the type of medical insurance. Older adults with limited BADL or IADL were at a higher risk of depression than those without limitations of BADL or IADL; BADL (OR -adjusted  = 2.71; 95% CI: 2.40-3.06) and IADL (OR -adjusted  = 2.68; 95% CI: 2.41-2.98) had various influences on the risk of depression in older adults., Conclusion: ADL was a related factor in the risk of depression among older adults in China. BADL and IADL had different effects on the risk of depression, suggesting that older adults with physical function limitations might be more likely to suffer from depression., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Liu, Ma, Lin, Sun, Li and Jiang.)

Background: Differences in activity limitations between stroke survivors and people with other chronic conditions and how their levels of activity limitation vary by sociodemographic characteristics have not been well quantified., Objective: To quantify activity limitations experienced by Chinese older adult stroke survivors and explore stroke effects in specific subgroups., Methods: We used Chinese Longitudinal Healthy Longevity Survey 2017-2018 data (N = 11,743) to produce population-weighted estimates of activity limitations using the Activities of Daily Living (ADL) and the Instrumental ADL (IADL) scales for older adults (age 65 and older) stroke survivors compared to those with non-stroke chronic conditions and those without chronic conditions. Multinomial logistic regressions were run with outcomes "no activity limitation," "IADL only limitation," and "ADL limitation.", Results: The weighted marginal prevalence of ADL limitation was higher in the stroke group (14.8%) than in those with non-stroke chronic condition (4.8%) or no chronic conditions (3.6%) (p < 0.01). The corresponding prevalence of IADL limitation for the three groups was 36.0%, 31.4%, and 22.2%, respectively (p < 0.01). Stroke survivors aged ≥ 80 years had a higher prevalence of ADL/IADL limitation than those aged 65-79 years (p < 0.01). Formal education was associated with a lower prevalence of ADL/IADL limitation in each chronic condition group (p < 0.01)., Conclusions: Prevalence and severity of activity limitation among Chinese older adult stroke survivors were several times higher than those without chronic conditions and those with non-stroke chronic conditions. Stroke survivors, particularly those aged ≥80 years and those without formal education, might be predisposed to more severe activity limitation and require more support to compensate., Competing Interests: Conflicts of interest The authors have no conflicts of interest to report for this study., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The association between the instrumental activities of daily living (IADL) score and the risk of initial cognitive function impairment is inconclusive. We aimed to identify distinctive IADL trajectories and examine their relationship with the onset of mild cognitive impairment (MCI) among Chinese older people., Methods: The study used six-wave longitudinal data from the Chinese Longitudinal Healthy Longevity Survey conducted between 2002 and 2018. It included a total of 11,044 Chinese people aged 65 years or older. A group-based trajectory model was used to identify distinctive trajectories of the IADL score, and the Cox proportional hazards model was used to explore the hazard ratio of various trajectories at the onset of MCI. Interaction analysis was used to analyze individual modification between the IADL trajectories and the onset of MCI. Finally, we adopted four types of sensitivity analysis to verify the robustness of the results., Results: During a median follow-up of 16 years, the incidence of MCI was 6.29 cases per 1,000 person-years (95% confidence interval [CI] 5.92-6.68). Three distinct IADL trajectory groups were identified: a low-risk IADL group (41.4%), an IADL group with increasing risk (28.5%), and a high-risk IADL group (30.4%). Using the Cox proportional hazards model after adjusting for covariates, we found that compared with the low risk IADL group, the hazard ratio of the IADL group with increasing risk was 4.49 (95% CI = 3.82-5.28), whereas that of the high-risk IADL group was 2.52 (95% CI 2.08-3.05). Treating the IADL group with increasing risk as the reference, the hazard ratio for the high-risk IADL group was 0.56 (95% CI 0.48-0.66). Interaction analyses showed that age and residence were significant moderators ( P for interaction <0.05)., Conclusion: A group-based trajectory model was developed to classify older people into three distinct trajectory groups of the IADL score. The IADL group with increasing risk had a greater risk of MCI than the high-risk IADL group. In the IADL group with increasing risk, city residents of ≥80 years were the most likely to develop MCI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yang, Zhang, Shen, Yu, Yang, Zhao, Xiong, Su, Wang and Lei.)

Population aging has become a major challenge for the Chinese government. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018, this study adopts the propensity score matching (PSM) method to assess the effect of community home-based elderly care services (CHECS) on the life satisfaction of the elderly in China. The results demonstrate that CHECS can improve their life satisfaction. Compared with life care services (LCS) and medical care services (MCS), the positive effect of spiritual and cultural services (SCS) and reconciliation and legal services (RLS) is more obvious. Moreover, the heterogeneity test demonstrates that the effect is more significant for the elderly who live with their families, whose activities of daily living are unrestricted, and whose depression levels are lower. The results obtained indicate that CHECS need precise policies for different elderly groups, attention to the positive impact of SCS and RLS on the life satisfaction of the elderly, and the substantive effectiveness of LCS and MCS.

Few studies have assessed the impact of home and community-based services (HCBSs) provision on cognitive function among older adults over time. This study examined the longitudinal association between HCBSs provision and cognitive function in Chinese older adults. The study included 5,134 participants aged 65 years and older in the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014. The Mini-Mental State Examination (MMSE) was used to evaluate cognitive function over the same time period. Participants were asked what kind of HCBSs were provided in his or her community. However, they were not asked whether services were utilised. The study used the number of HCBSs provided each wave to represent the strength of HCBSs, and used the MMSE score of each wave to represent the older adults' cognitive function status. A latent growth model was used to explore the relationship between HCBSs provision and cognitive function of older adults. The number of HCBSs provided was positively associated with older adults' cognitive function (2008: β = 0.03, p = 0.031; 2011: β = 0.06, p < 0.001; 2014: β = 0.06, p < 0.001) after controlling for gender, age, residence, education, income, medical insurance, activities of daily living disability, instrumental activities of daily living disability, serious illness, living arrangement and marital status. Results provided longitudinal evidence that an increase in HCBSs provision at a national level can result in better cognitive function in Chinese older adults., (© 2021 John Wiley & Sons Ltd.)

Objectives: A few studies of Western populations have found inconsistent results regarding the associations between vitamin D status and physical function. We explored the association between circulating vitamin D status [plasma 25-hydroxyvitamin D, 25(OH)D] and incident activities of daily living (ADL) disability among Chinese older adults., Design: Community-based longitudinal cohort study., Setting and Participants: A total of 2453 men and women (median age 84.0 years) in 7 Chinese longevity areas were included., Measures: Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident ADL, with adjustments for potential sociodemographic, and lifestyle confounders and biomarkers. Because there was a statistically significant interaction between plasma 25(OH)D and sex in relation to incident ADL, men and women were analyzed separately., Results: The median concentrations of plasma 25(OH)D were 46.6 nmol/L and 36.4 nmol/L for men and women, respectively. Compared with the lowest quartile in the fully adjusted model, the HR for incident ADL disability for the highest quartile was 0.55 (95% CI 0.36-0.85) for women; for men, a null association was indicated (HR highest vs lowest 0.61, 95% CI 0.37-1.00). However, when using the recommended circulating 25(OH)D thresholds by the US Institute of Medicine, those with vitamin D sufficiency (≥50 nmol/L) had better ADL disability prognoses than those with vitamin D deficiency (<30 nmol/L) in both sexes (men HR 0.45, 95% CI 0.28-0.72; women HR 0.58, 95% CI 0.37-0.90)., Conclusions and Implications: The relationship between plasma 25(OH)D concentration and incident ADL disability was sex-specific among Chinese older adults. However, participants with recommended vitamin D sufficiency may have better disability prognoses in both sexes, suggesting that the recommended 25(OH)D concentration for bone health may extend to functional outcomes such as ADL disability in Chinese older adults., (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: This study investigated whether loneliness or social isolation is associated with the onset of functional disability over 4 years among Chinese older populations., Setting and Subjects: This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Analyses were conducted with data from two waves (2011 and 2015) and were restricted to those respondents aged 50 and older and free of functional disability at baseline [n = 5,154, mean age (SD) = 60.72 (7.51); male, 52.3%]., Method: Social isolation, loneliness and covariates were measured at baseline. Follow-up measures of new-onset ADL and IADL disability were obtained 4 years later. We stratified the sample by gender, and then used binary logistic regressions to evaluate the associations between baseline isolation, loneliness and new-onset ADL and IADL disability., Results: For women, baseline social isolation was significantly associated with new-onset ADL (OR = 1.18, 95% CI = 1.07-1.30) and IADL (OR = 1.11, 95% CI = 1.01-1.21) disability; no significant association between loneliness and ADL or IADL disability was found. For men, neither social isolation nor loneliness was found to be significantly associated with ADL or IADL disability., Conclusion: This longitudinal study found that social isolation, rather than loneliness, was significantly associated with functional disability over 4 years among women (but not men) in China. These findings expand our knowledge about the association between social relationships and functional status among non-Western populations., (© Crown copyright 2020.)

Objectives: To examine whether and how early-life experiences such as years of schooling affect late-life cognitive function through a pathway of activity engagement., Design: Prospective., Setting: We used data from 2 waves of the Population Study of Chinese Elderly in Chicago (PINE)., Participants: PINE is the largest population-based epidemiological study of Chinese-American adults aged 60 and older in the greater Chicago area. Wave 1 data were collected for 2 years, from July 2011 to June 2013, and Wave 2 data were collected from 2013 to 2015; total sample size was 2,713., Measurements: Education was measured in years of schooling. Activity engagement was assessed using 15 items grouped into two clusters: cognitive activity and social activity. Cognitive function was evaluated using five instruments to assess general mental status (Chinese Mini-Mental State Examination (C-MMSE)), episodic memory, perceptual speed, working memory, global cognition score., Results: Adjusting for sociodemographic and health-related control variables, education measured at Wave 1 was associated with better global cognition (b = 0.025, p < .001), C-MMSE (b = .037, p < .001), episodic memory (b = .026, p < .001), Symbol Digit Modalities Test perceptual speed (b = .036, p < .001), and Digit Span Backward working memory (b = .047, p < .001) at Wave 2. Activity engagement, cognitive activity in particular, significantly mediates the effect of education on all cognitive tests, with the size of the mediating effect ranging from 16% to approximately 24%., Conclusion: Amount of schooling early in life is significantly related to late-life cognitive function in virtually all domains, and cognitive activity is one of many links between the two. J Am Geriatr Soc 67:S525-S531, 2019., (© 2019, Copyright the Authors Journal compilation © 2019, The American Geriatrics Society.)

Background: Existing studies in developed countries show that social participation has beneficial effects on the functional ability of older adults, but research on Chinese older people is limited. This study examined the effects of participating in different types of social activities on the onset of functional disability and the underlying behavioral and psychosocial mechanisms among older adults aged 65 and older in China., Methods: The 2005, 2008, and 2011 waves of the Chinese Longitudinal Health Longevity Study were used. Life table analysis and discrete time hazard models were adopted to examine the relationship between social participation and functional disability. Social participation was defined as the frequencies of engaging in group leisure-time activities (i.e., playing cards/mahjong) and organized social activities, involving in informal social interactions (i.e., number of siblings frequently visited), and participating in paid jobs. Extensive social participation was measured by a composite index by adding up the four types of social activities that an older person was engaged in., Results: After controlling for the effect of socio-demographic characteristics, health status, and health behavioral factors, extensive social participation is associated with a significant reduced risk for the onset of functional disability (hazard ratio [HR] = 0.92, p < 0.001). Different types of social participation affect the risk of functional decline through different mechanisms. Frequent playing of cards/mahjong is a protective factor for functional decline (HR = 0.78, p < 0.001), and the relationship is partially mediated by cognitive ability and positive emotions (accounting for 18.9% and 7.0% of the association, respectively). Frequent participation in organized social activities is significantly related to a reduced risk of functional decline (HR = 0.78, p < 0.001), and the association is mediated by physical exercises and cognitive ability (accounting for 25.7% and 17.7% of the association, respectively). Frequent visits from siblings has a strong inverse relationship with functional decline (HR = 0.75, p < 0.001). However, no significant association between paid job and functional decline is observed., Conclusion: Extensive social participation, regular engagement in group leisure-time activities, organized social activities, and informal social interactions in particular may have beneficial effects on the functional health of older adults through behavioral and psychosocial pathways. The findings shed light for the importance of promoting social participation among older adults.

Background: Physical function (PF) impairment and elder mistreatment (EM) are alarming public health issues facing by many older adults. Prior studies have not generated uniform findings on the associations between PF and EM. This study aimed to address the research gap of this association among U.S. Chinese aging population., Methods: Three thousand one hundred fifty-eight community-dwelling Chinese older adults in the Greater Chicago Area were surveyed. Independent variables included both self-reported and performance-based PF measurements. Dependent variable was EM, assessed by a 10-item instrument that has been widely used in social studies., Results: The mean age of study participants was 76.3 years (SD ± 8.4) and 58.0% were female. After adjusting for potential covariates, higher scores of activities of daily living (odds ratio [OR] = 0.85, 95% confidence interval [CI] = 0.73-0.98), instrumental activities of daily living (OR = 0.87, 0.82-0.92), and Rosow-Breslau reversely coded (OR = 0.85, 0.75-0.96) were associated with lower risk of EM. Also, lower scores of observed PF performance measurements, including tandem stand (OR = 0.78, 0.70-0.88), measured walk (OR = 0.84, 0.77-0.91), and the overall measurement (OR = 0.93, 0.89-0.97) have significant associations with lower risk of EM., Conclusions: Findings from this study suggested that greater levels of PF impairment were associated with lower risk of EM among U.S. Chinese older adults in the Greater Chicago Area. Longitudinal studies are needed to obtain a more comprehensive understanding of the pathways between PF and EM and its subtypes among Chinese aging populations., (© The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: The study aimed to investigate the independent associations of dietary factors with cognitive impairment (CI) and physical frailty (PF) among Chinese older adults. Methods: This study included 10,734 participants (mean age = 78.7 years) free of CI and PF at baseline from the Chinese Longitudinal Health Longevity Survey. Dietary intake was collected using a simplified food frequency questionnaire every 3–4 years. The Chinese version Mini-Mental State Examination was used to assess cognition function, participants with a score below 18 were defined as CI. PF was defined using the activities of daily living, instrumental activities of daily living, and functional limitation-related questions. The outcome was defined as the first onset of either CI or PF. Competing risk models were used to estimate the corresponding hazard ratios (HRs) and the 95% confidence intervals (95% CIs). Results: During the study follow-up (mean = 8.1 years), a total of 1220 CI cases and 1451 PF cases were newly identified. Higher frequency of fruits intake was associated with a lower hazard of CI (HR = 0.75, 95% CI 0.58–0.97), whereas higher intake of preserved vegetables demonstrated an opposite association (HR = 1.23, 95% CI 1.07–1.42). In terms of PF, we observed a lower risk associated with higher meat and poultry intake (HR = 0.72, 95% CI 0.61–0.88). In particular, a significant protective association of fish and aquatic products intake with PF was observed among participants with ≥ 28 natural teeth (HR = 0.52, 95% CI 0.27–0.99). Conclusion: Our findings suggest divergent roles of major dietary factors in the development of CI and PF among Chinese older adults. [ABSTRACT FROM AUTHOR]

ObjectiveThe limitation of activities of daily living (ADL) affects the mental health of older adults. We distinguished activities of daily living into basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and aimed to explore the relationship between the two limitations and depressive symptoms among Chinese older adults by using nationally representative cross-sectional data.MethodsData from the China Health and Retirement Longitudinal Study (CHARLS, wave 4) were used, and 9,789 older adults aged 60 years and above were screened. The 10-item Center for Epidemiologic Studies Depression (CES-D-10) scale was used to measure the depressive symptoms of older adults, and a 12-item scale for ADL was used to estimate functional limitations. Generalized linear mixed-effect models were employed to examine the relationship between BADL/IADL and depressive symptoms among older adults.ResultsThe prevalence of high-risk depression among older adults was 43.5%, and the rates of limitation in BADL and IADL were 19.02 and 25.29%, respectively. The prevalence of high-risk depression significantly differed among subgroups of smoking, drinking, chronic diseases, duration of sleep, having social activities or not, and the type of medical insurance. Older adults with limited BADL or IADL were at a higher risk of depression than those without limitations of BADL or IADL; BADL (OR-adjusted = 2.71; 95% CI: 2.40–3.06) and IADL (OR-adjusted = 2.68; 95% CI: 2.41–2.98) had various influences on the risk of depression in older adults.ConclusionADL was a related factor in the risk of depression among older adults in China. BADL and IADL had different effects on the risk of depression, suggesting that older adults with physical function limitations might be more likely to suffer from depression.

Background: Falls are major health care concerns for older adults. Pain is associated with increased falls in older adults. However, the impact of pain on functional disability and how this might predispose Chinese older adults to fall is unclear. Aim: The aim of the current study was to examine whether functional disability mediates the association of any pain, back and/or shoulder pain (B–S pain) and leg and/or knees pain (L–K pain) with falls and serious falls. Methods: The study included 7619 community-dwelling older adults aged 60 years and above from the China Health and Retirement Longitudinal Study. Baseline data were from Wave 3 and fall outcomes were from Wave 4. Functional disability was measured by the ADLs and IADLs scales. We used a logistic regression model to investigate associations between pain and fall outcomes and KHB method to estimate the mediating effects of ADL/IADL disability on pain–fall relationship. Results: After fully adjusting for covariates, the three pain measures (any pain, back and/or shoulder pain, leg and/or knees pain) were significantly associated with fall outcomes. When body pain was compared with no body pain, the proportion mediated by the ADL disability was 28.43% for falls, while the proportion mediated by IADL disability was 17.96% for falls. For associations between specific parts of body pain and falls, the proportions mediated by the ADL disability were 34.18% and 35.89% in back and/or shoulder pain and leg and/or knees pain, respectively, but the proportions reduced to 21.98% and 20.82% when mediated by the IADL disability. However, there were no significant contributions of ADL/IADL disability for the association between specific part of body pain and serious falls. Conclusions: Pain in general and pain in specific body sites were significantly associated with an increased risk of fall among older adults living in community in China. Functional disability partially mediated the relationship of pain with falls. [ABSTRACT FROM AUTHOR]

Background: Physical function (PF) impairment and elder mistreatment (EM) are alarming public health issues facing by many older adults. Prior studies have not generated uniform findings on the associations between PF and EM. This study aimed to address the research gap of this association among U.S. Chinese aging population.Methods: Three thousand one hundred fifty-eight community-dwelling Chinese older adults in the Greater Chicago Area were surveyed. Independent variables included both self-reported and performance-based PF measurements. Dependent variable was EM, assessed by a 10-item instrument that has been widely used in social studies.Results: The mean age of study participants was 76.3 years (SD ± 8.4) and 58.0% were female. After adjusting for potential covariates, higher scores of activities of daily living (odds ratio [OR] = 0.85, 95% confidence interval [CI] = 0.73-0.98), instrumental activities of daily living (OR = 0.87, 0.82-0.92), and Rosow-Breslau reversely coded (OR = 0.85, 0.75-0.96) were associated with lower risk of EM. Also, lower scores of observed PF performance measurements, including tandem stand (OR = 0.78, 0.70-0.88), measured walk (OR = 0.84, 0.77-0.91), and the overall measurement (OR = 0.93, 0.89-0.97) have significant associations with lower risk of EM.Conclusions: Findings from this study suggested that greater levels of PF impairment were associated with lower risk of EM among U.S. Chinese older adults in the Greater Chicago Area. Longitudinal studies are needed to obtain a more comprehensive understanding of the pathways between PF and EM and its subtypes among Chinese aging populations. [ABSTRACT FROM AUTHOR]

Guided by Cantor's social care model, this study identified individual, family, and social support factors that influence urban older adults' need for home- and community-based services, including medical and rehabilitation, instrumental care and support, and psychosocial services. The data were extracted from the Sample Survey on Aged Population in Urban/Rural China conducted by the China Research Center on Aging in 2006. Results from multiple logistic regression show that older adults' need for medical and rehabilitation services is significantly related to instrumental activities of daily living, depression, not having filial children, friend support networks, and having a confidant. Older adults' need for instrumental care and support is related to their educational attainment, financial strain, instrumental activities of daily living, not living with children, and friend support networks. Finally, older adults' need for psychosocial services is significantly related to educational attainment, depression, not being married, friend support networks, and having a confidant. Implications for social service development are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the strength of association between impaired functional status and long-term (3-year) mortality in Chinese nursing home older adults. Design: A 3-year prospective multicenter cohort study. Setting: Nine nursing homes in Hong Kong. Participants: A total of 672 nursing home older adults (224 men; 448 women), mean age 85.0 ± 7.4. Measurements: Functional statuses of participants were assessed by Barthel Index (BI) and participants were stratified into different groups according to their BI score: BI score 100, BI score 75–95, BI score 45–70, BI score 15–40, and BI score 0–10. Other covariates included age, sex, comorbidities, score of abbreviated mental test, serum albumin, serum creatinine, serum hemoglobin, and hospitalization in the preceding year. The outcome measures were the 1-year, 2-year, and 3-year all-cause mortality. Results: Older adults with lower BI score had significantly higher all-cause mortality and this trend persisted in 1-year, 2-year, and 3-year mortality (P < .001). After multivariate analysis, there was a dose-response relationship in hazard ratio (HR) between BI score and 3-year all-cause mortality (compared with BI score 100; BI score 75–95: HR 1.38 [CI: 1.00–2.56; P < .05]; BI score 45–70: HR 1.80 [CI: 1.04–3.11; P < .001]; BI score 15–40: HR 2.12 [1.21–3.70; P < .001]; BI score 0–10: HR 3.13 [1.82–5.41; P < .001]; and trend test P < .05). Similar relationships were found in 1-year and 2-year mortality. Conclusion: Impaired functional status is associated with higher short-term and long-term mortality with a dose-response relationship in Chinese nursing home older adults. [Copyright &y& Elsevier]