Association between physical activity level and diabetes incidence among Chinese middle-aged and older adults: a cross-sectional study from the China health and retirement longitudinal study
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SUBMITTER: Zhang Y
PROVIDER: S-EPMC11341424 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Objective: Biological age (BA) has been accepted as a more accurate proxy of aging than chronological age (CA). This study aimed to use machine learning (ML) algorithms to estimate BA in the Chinese population. Materials and methods: We used data from 9,771 middle-aged and older Chinese adults (≥45 years) in the 2011/2012 wave of the China Health and Retirement Longitudinal Study and followed until 2018. We used several ML algorithms (e.g., Gradient Boosting Regressor, Random Forest, CatBoost Regressor, and Support Vector Machine) to develop new measures of biological aging (ML-BAs) based on physiological biomarkers. R-squared value and mean absolute error (MAE) were used to determine the optimal performance of these ML-BAs. We used logistic regression models to examine the associations of the best ML-BA and a conventional aging measure-Klemera and Doubal method-BA (KDM-BA) we previously developed-with physical disability and mortality, respectively. Results: The Gradient Boosting Regression model performed the best, resulting in an ML-BA with an R-squared value of 0.270 and an MAE of 6.519. This ML-BA was significantly associated with disability in basic activities of daily living, instrumental activities of daily living, lower extremity mobility, and upper extremity mobility, and mortality, with odds ratios ranging from 1 to 7% (per 1-year increment in ML-BA, all P < 0.001), independent of CA. These associations were generally comparable to that of KDM-BA. Conclusion: This study provides a valid ML-based measure of biological aging for middle-aged and older Chinese adults. These findings support the application of ML in geroscience research and may help facilitate preventive and geroprotector intervention studies.
| S-EPMC8671693 | biostudies-literature
Project description:BackgroundHousehold solid fuel have been associated with changes of handgrip strength (HGS). However, no study has explored the longitudinal associations between household solid fuel use and HGS. Thus, the aim of our cohort study was to investigate the longitudinal associations between household fuel use and HGS.MethodsThe study was based on the China Health and Retirement Longitudinal Study. A handheld dynamometer was used to measure HGS. Household fuel use statuses were collected using questionnaires. Analyses of covariance were performed to examine the associations between household fuel use and HGS.ResultsThe study included 9,382 participants during a 4-year follow-up. The participants who used solid fuel for cooking had more decreases of HGS than those who used clean fuel (P < 0.0001). The least square means (95% CIs) of changes of HGS for participants who used solid fuel and those who used clean fuel for cooking were -1.67 (-2.15, -1.19) and-2.27 (-2.75, -1.79), respectively. The association between fuel use for heating and HGS was non-significant (P = 0.63). The interaction terms of sex to cooking fuel (P = 0.04) and smoking to cooking fuel (P < 0.001) were significant; men and participants who had ever smoked had higher decreases in HGS.ConclusionUsing household solid fuel for cooking but not heating was associated with more decreases in HGS. Proper ventilation and clean fuel should be promoted for public health.
| S-EPMC9280178 | biostudies-literature
Project description:BackgroundAlthough numerous studies focused on the relationship between area socioeconomic status (SES) and health, only a few of them investigated how community-level SES was linked to late-life cognitive function as well as the potential pathways underlying this association, and very few of them focused on the context of China. This study examined how community-level SES was linked to cognitive function and the potential pathways underlying this association among middle-aged and older adults in China.MethodsData was drawn from the waves 1-4 of China Health and Retirement Longitudinal Study. We measured cognitive function with the components of the Telephone Interview of Cognitive Status battery. Community-level SES was derived from a sum of z scores of the percentage of the illiterate and the per-capita net income status within communities. We adopted two-level hierarchical linear regression models to explore the associations between community-level SES and cognitive function. A multilevel mediation analysis with structural equation modeling was undertaken to disaggregate the direct and indirect pathways of the associations.ResultsHigher community-level SES was associated with better cognitive function (β = 0.562, 95% CI = 0.390, 0.734), and this significant association was only present in rural participants, not in urban participants. Furthermore, we discovered the mediating effects of outdoor exercise facilities within communities (β = 0.023, 95% CI = 0.000, 0.056) and individual-level SES (β = 0.108, 95% CI = 0.057, 0.156) to explain the relationship between community SES and cognitive function.ConclusionsThese findings highlight the importance of community environmental interventions in maintaining individuals' cognitive health in China, especially for older adults. Our results provided solid empirical evidence for reducing mental health inequalities in China, and suggested that developing an aging-friendly environment and properly distributing community resources are important to improve cognitive function of older adults.
| S-EPMC8941774 | biostudies-literature
Project description:ObjectiveThe complicated association of daytime napping, biological aging and cognitive function remains inconclusive. We aimed to evaluate the cross-sectional and longitudinal associations of daytime napping and two aging measures with cognition and to examine whether napping affects cognition through a more advanced state of aging.MethodsData was collected from the China Health and Retirement Longitudinal Study. Napping was self-reported. We calculated two published biological aging measures: Klemera and Doubal biological age (KDM-BA) and physiological dysregulation (PD), which derived information from clinical biomarkers. Cognitive z-scores were calculated at each wave. Linear mixed models were used to explore the longitudinal association between napping, two aging measures, and cognitive decline. Mediation analyses were performed to assess the mediating effects of biological age acceleration on the association between napping and cognition.ResultsParticipants aged over 45 years were included in the analyses. Non-nappers had greater KDM-BA and PD [LS means (LSM) = 0.255, p = 0.007; LSM = 0.085, p = 0.011] and faster cognitive decline (LSM = -0.061, p = 0.005)compared to moderate nappers (30-90 min/nap). KDM-BA (β = -0.007, p = 0.018) and PD (β = -0.034, p < 0.001) showed a negative association with overall cognitive z scores. KDM-BA and PD partially mediated the effect of napping on cognition.ConclusionIn middle-aged and older Chinese, compared to moderate nappers, non-nappers seem to experience a more advanced state of aging and increased rates of cognitive decline. The aging status possibly mediates the association between napping and cognition. Moderate napping shows promise in promoting healthy aging and reducing the burden of cognitive decline in Chinese middle-aged and older adults.
| S-EPMC10693455 | biostudies-literature
Project description:Background and aimsObesity and insulin resistance are well-known important risk factors for hypertension. This study aimed to investigate the mediating effect of the triglyceride-glucose index (TyG) in the association between Chinese visceral obesity index (CVAI) and hypertension among Chinese middle-aged and older adults.MethodsA total of 10,322 participants aged 45 years and older from CHARLS (2011-2018) were included. Baseline data were collected in 2011 and hypertension incidence data were gathered during follow-up in 2013, 2015 and 2018. Multivariate logistic regression models were constructed to investigate the association of CVAI and TyG with the incidence of hypertension. Additionally, mediation analyses were conducted to evaluate the mediating role of the TyG index in the relationship between CVAI and hypertension. Subgroup analysis was also performed.ResultsA total of 2,802 participants developed hypertension during the follow-up period. CVAI and TyG index were independently and significantly associated with hypertension incidence. Increasing quartiles of CVAI and TyG index were associated with high hypertension incidence in middle-aged and older adults. The TyG index was identified as a mediator in the relationship between CVAI and hypertension incidence, with a mediation effect (95% confidence interval) was 12.38% (6.75, 31.81%).ConclusionOur study found that CVAI and TyG were independently associated with hypertension incidence. TyG played a partial mediating effect in the positive association between CVAI and hypertension incidence.
| S-EPMC10898648 | biostudies-literature
Project description:BackgroundPopulation aging is a major global trend with significant social, economic, and health implications. In China, the increasing aging population presents challenges, including increased chronic diseases and disabilities. Social capital has emerged as vital in determining health outcomes for middle-aged and older adults. This study seeks to examine the impact of social capital and educational attainment on physical functioning in middle-aged and older adults, with particular emphasis on the moderating effect of education within this relationship.MethodsThis study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) from 2018 to 2020, involving 9,497 participants aged 45 and older. Physical function was assessed using the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Social capital was measured in four dimensions: social trust, social support, social participation, and reciprocity. Educational attainment was categorized into four levels: below primary school, primary school, middle school, and high school or above. Cox proportional hazards regression and moderating effect models were used for data analysis, adjusting for demographic and health-related variables.ResultsOur findings highlight the significant roles of social participation (aHR = 0.856, 95%CI: 0.675-0.809) and reciprocity (aHR = 0.700, 95%CI: 0.626-0.784) in improving physical function. Education enhanced the positive effects of social participation (aHR = 0.923, 95%CI: 0.840-0.980). Subgroup analyses showed that social support was a protective factor for females (aHR = 0.857, 95% CI: 0.737-0.998), while social trust negatively affected urban residents (aHR = 1.330, 95%CI: 1.135-1.560).ConclusionThe findings underscore the importance of social participation, reciprocity, and education in enhancing physical function among middle-aged and older adults. Tailored interventions addressing gender and residential differences are essential to meet the unique needs of various subgroups. Understanding the relationship between social capital, education, and health can inform strategies to improve this population's well-being.
| S-EPMC11652280 | biostudies-literature
Project description:BackgroundIt has been demonstrated that receptive cultural engagement, such as visits to theaters and museums, can reduce depression in older adults. However, the association between hobby engagement and lower rates of depressive symptoms (DS) remains unclear. The objective of this study was to investigate the potential relationship between hobby engagement and depressive symptoms.MethodsThe data for this prospective cross-sectional study were collected from participants in the China Longitudinal Study of Health and Retirement (CHARLS) wave 2020. To assess DS, a score of 10 or more on the Center for Epidemiological Studies Depression Scale was used to indicate depression. Hobby engagement was gaged by trained staff through the administration of a battery of standardized questions. Logistic regression and inverse probability of treatment weighting (IPTW) using the propensity score analyses were employed to investigate the relationship between hobby engagement and DS.ResultsA total of 16,057 participants were included, with a mean age of 62.4 ± 9.2 years. Of these, 7,699 were male and 8,358 were female. The proportion of individuals exhibiting depressive symptoms was 31.57% (1,286 out of 4,073) among those with hobby engagement, while it was 39.67% (4,754 out of 11,984) among those without hobby engagement. After adjusting for covariates, the odds ratio was 0.89 (95% CI: 0.82-0.97, p = 0.0109). Propensity-score analyses also supported these findings, with the odds ratio being 0.91 (95% CI: 0.84-0.99, p = 0.0204). The finding was consistent with multiple sensitivity analyses.ConclusionOur study found hobby engagement was associated with a reduced risk of depressive symptoms in Chinese middle-aged and older adults. Our findings need to be confirmed in future studies.
| S-EPMC11466789 | biostudies-literature
Project description:BackgroundHip fracture (HF) is one of the most prevalent orthopedic conditions among the elderly, with falls being the primary risk factor for HF. With the surge of aged population, China is facing great challenges from HF and falls. However, a comprehensive long-term observation of risk factors affecting HF and falls and their association are little reported at a national level.MethodsThe longitudinal cohort was established using the China Health and Retirement Longitudinal Study (CHARLS) data from 2011 to 2018. The incidence density and multi-risk-stratified lifetime risk (up to 90 years of age) of falls and HF were studied at index ages of 50, 60, and 70, as well as the lifetime risk stratified by six regions in China, based on the modified Kaplan-Meier method with Statistical Analysis System (SAS).ResultsThis study identified 17 705 subjects aged 50-89. The incidence density of falls was 65.07 and 47.53 per 1000 person-years in women and men, respectively. The incidence density of HF was also higher in women at 5.58 per 1000 person-years than in men at 4.88. By age 50, the lifetime risk of experiencing a HF was 18.58 % for women and 13.72 % for men. Vision and hearing abilities were significantly related to the lifetime risk of both falls and HF. Obesity-related factors presented age-relevant relationships with lifelong risks. Lack of naps, poor lower limb strength, and physical capabilities were indicative of HF risk. The north-western region of China had the lowest lifetime risk of falls but highest risk of HF, while other regions showed a consistent trend between falls and HF.ConclusionThe aging population worldwide faces a considerable risk of falls and HF. Several risk factors were identified in this study using a Chinese population, relating to disease history, lifestyle habits, health status and physical function, and the risks differed among six regions in China. Future precautionary management programs, as well as patient self-awareness are necessary for improving the prevention of falls and HF to reduce their incidence in the aging population.The translational potential of this articleWith the greatest aged population worldwide, China faces the unparalleled challenge on public health. The study poses the lifetime risk of hip fracture and falls stratified by multiple risk factors in people from 45 to 90 in a national scale, which would shed a light on the early and continuous prevention of such injury.
| S-EPMC11782876 | biostudies-literature
Project description:BackgroundObesity is a major global health issue, driving high morbidity and mortality rates. The body roundness index (BRI), which includes waist circumference, offers a more accurate measure of visceral and total body fat. However, despite evidence of BRI's effectiveness in predicting obesity-related diseases, national-level data, especially from non-Western populations like China, remain limited.MethodsThis study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a large, nationally representative cohort of Chinese adults, to examine the temporal trends of BRI, identify associated risk factors, and investigate the longitudinal associations between BRI and cardiovascular disease (CVD) outcomes. BRI was calculated using height and waist circumference measurements. Temporal trends and risk factors were analyzed cross-sectionally, while longitudinal associations were examined using Cox proportional hazards models adjusted for confounders. Mediation analyses were conducted to assess the role of intermediate factors such as hypertension and diabetes in the relationship between BRI and CVD.ResultsA total of 12,902 participants were included for risk factor analysis, 10,525 for longitudinal analysis, and 7,310 for cumulative analysis. BRI continued to rise slowly across survey cycles but was higher in women, older adults, and urban residents. Multivariable analysis identified age, alcohol consumption, elevated blood pressure, and diabetes as positive predictors of BRI, while male sex, rural residence, and smoking were negatively associated. Higher baseline BRI was significantly associated with increased CVD risk (HR: 1.44, 95% CI: 1.22-1.69), stroke (HR: 1.49, 95% CI: 1.12-1.98), and heart disease (HR: 1.47, 95% CI: 1.22-1.77). Cumulative BRI similarly predicted increased risks of CVD, stroke, and heart disease. Mediation analysis showed that hypertension accounted for 20.69% of the association between BRI and CVD risk.ConclusionsBRI is a robust predictor of CVD risk. Targeting hypertension and other metabolic conditions could mitigate the elevated CVD risk associated with high BRI in Chinese adults. These findings underscore the importance of incorporating BRI into public health strategies to better manage obesity-related health risks in China.
| S-EPMC11804525 | biostudies-literature
Project description:BackgroundThe effects of physical activity (PA) across different domains and intensities on depressive symptoms remain inconclusive. Incorporating the community-built environment (CBE) into longitudinal analyses of PA's impact on depressive symptoms is crucial.ObjectiveThis study aims to examine the effects of PA at different intensities-low-intensity PA (eg, walking activities) and moderate-to-vigorous-intensity PA (eg, activities requiring substantial effort and causing faster breathing or shortness of breath)-across leisure-time and occupational domains on depressive symptom trajectories among middle-aged and older adults. Additionally, it investigated how CBEs influence depressive symptoms and PA trajectories.MethodsThis longitudinal study included 6865 middle-aged and older adults from the China Health and Retirement Longitudinal Survey. A CBE variable system was developed using a community questionnaire to assess attributes of the physical built environment. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Latent growth curve modeling was applied to analyze 3 waves of the cohort data (2015, 2018, and 2020) to explore the differential effects of PA on depressive symptoms and the role of the CBE.ResultsIn the 2015 and 2018 waves, higher low-intensity leisure-time physical activity (LTPA) was associated with lower depressive symptoms (β=-.025, P=.01 and β=-.027, P=.005, respectively). Across all waves, moderate-to-vigorous-intensity LTPA showed no significant predictive effects (P=.21 in 2015, P=.57 in 2018, and P=.85 in 2020, respectively). However, higher occupational physical activity (OPA), particularly at moderate-to-vigorous intensities, was consistently associated with higher depressive symptoms. Parallel process latent growth curve modeling revealed that the initial level of total LTPA negatively predicted the initial level of depressive symptoms (β=-.076, P=.01). OPA exhibited dual effects, positively predicting the initial level of depressive symptoms (β=.108, P<.001) but negatively predicting their upward trajectory (β=-.136, P=.009). Among CBE variables, better infrastructure conditions (β=-.082, P<.001) and greater accessibility to public facilities (β=-.036, P=.045) negatively predicted the initial level of depressive symptoms. However, greater accessibility to public facilities positively predicted the upward trajectory of depressive symptoms (β=.083, P=.04). Better infrastructure conditions (β=.100, P=.002) and greater accessibility to public transport (β=.060, P=.01) positively predicted the initial level of total LTPA. Meanwhile, better infrastructure conditions (β=-.281, P<.001) and greater accessibility to public facilities (β=-.073, P<.001) negatively predicted the initial level of total OPA. Better infrastructure conditions positively predicted the declining trajectory of total OPA (β=.100, P=.004).ConclusionsThis study underscores the importance of considering the differential effects of PA across domains and intensities on depressive symptoms in public policies and guidelines. Given the influence of the environment on PA and depressive symptoms, targeted community measures should be implemented.
| S-EPMC11773281 | biostudies-literature