The data is taken from Chinese Longitudinal Healthy Longevity Survey(CLHLS)between 2005 and 2008 to study health insurance’s impact on Chinese rural elders’ health demand. It found that health insurance significantly increased Chinese rural elders’ total health expenditure by 19%; however, it could neither significantly lengthen life expectancy nor decrease the risk of death. Chinese rural elders’ excessive demand induced by health insurance is probably inefficient. Therefore, to insure Chinese rural elders’ diseases could be treated, the government should improve medical security and control unreasonable increases in health service price.

Objective:To systematically review the characteristics of sleep patterns in the elderly with subjective cognitive decline (SCD) and the relationship between subjective cognitive decline and sleep disorders.Methods:Observational studies on sleep patterns in the elderly with SCD were retrieved by computer in Chinese and English databases such as PubMed, Embase, Web of Science, ScienceDirect, China National Knowledge Infrastructure (CNKI) , WanFang Data and VIP, and the retrieval time was from the establishment of the database to March 31, 2020. Two researchers independently conducted article screening, data extraction and quality evaluation according to the standard. The random-effects model was used for Meta-synthesis of studies with data that could be pooled, and descriptive analysis for studies that could not be pooled.Results:A total of 12 articles were included, with a total sample size of 67 474 cases. The prevalence of SCD in the elderly was 25.9% (95% CI: 6.4%-52.5%) . The sleep patterns of the elderly with SCD were characterized by decreased total sleep time, prolonged wake-time after sleep onset, and frequent awakenings at night. Compared with the normal elderly, the elderly with SCD had a higher risk of poor sleep quality, insomnia and excessive daytime sleepiness ( OR=2.1, 1.15, 2.6) , and excessive daytime sleepiness (ESD) increased the risk of SCD in the elderly ( OR=6.06) . Conclusions:Compared with the normal elderly, the overall sleep quality of the elderly with SCD is poor, and sleep disorders can increase the risk of SCD in the elderly. Existing studies have differences in the diagnostic criteria of SCD, and future studies need to further confirm the causal relationship between SCD and sleep disorders in the elderly.