Objective To investigate the current status and distribution characteristics of chronic constipation,sleep disturbances and olfactory disorders in Chinese elderly.Methods In 2010,the 3rd Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces and Xinjiang Production & Construction Corps.42 668 Chinese aged over 60 years in 98 548 households were randomly selected from 162 National Disease Surveillance Points (DSPs) by a stratified multistage cluster sampling.All subjects received a set of standardized questionnaire and interview.After a complex weighing,the differences in the prevalence of constipation,sleep disturbances and olfactory disorders were investigated among the residents with different genders,ages,urban or rural areas and regions.Results In all subjects aged over 60 years,the general prevalence of self-reported constipation was 5.06 ％,which increased with age.The general prevalence of self-reported constipation was higher in females than in males (5.80％ vs.4.27％,x2 =21.78,P＜0.05),higher in urban areas than in the rural areas (6.04％ vs.4.58％,x2 =5.66,P＜0.05),and there were no significant differences among residents in eastern,central,and western regions.The general prevalence of self-reported sleep disturbances was 14.19％,which increased with age.The general prevalence of self-reported sleep disturbances was higher in females than in males (17.27％ vs.10.94％,x2 =165.53,P＜0.05),and there were no significant differences among residents in urban and rural areas or in different regions.The general prevalence of self-reported olfactory disorders was 8.49％,which increased with age.The general prevalence of self-reported olfactory disorders was higher in females than in males (9.36％ vs.7.58％,x2 =22.32,P＜0.05).There were significant differences in the prevalence of self-reported olfactory disorders among residents in eastern,central and western regions (6.98％,8.28％ and 11.00％,x2 =6.66,all P＜0.05 respectively),and no significant difference was found between residents in urban and rural areas.Conclusions The prevalences of self-reported constipation,sleep disturbances and olfactory disorders are increased with age and significantly more common among women in Chinese elderly residents.

Objective: To investigate the disability status and its epidemiological characteristics in the elderly in urban and rural communities in China. Methods: The participants were from the project of Prevention and Intervention on Neurodegenerative Disease for Elderly in China conducted in 2015. A total of 23 803 urban and rural residents aged over 60 years were selected through stratified multi-stage cluster sampling in 6 provinces for a set of standardized questionnaire interview and physical examinations. Activities of daily living (ADL) scale was used to assess the disability status of the elderly. χ² test was used to analyze the difference in basic activities of daily living (BADL) and instrumental activities of daily living (IADL) disabilities in different elderly populations. Multivariate logistic regression model was used to analyze the influence factors for disability. Results: Taking bath had the highest impairment rate (1.7%) while eating had the lowest impairment rate (0.6%) in BADL. Making phone call had the highest impairment rate (16.6%), followed by taking bus (5.5%) and taking medicine (1.8%) in IADL. The BADL and IADL disability rates in community seniors were 2.1% and 19.1%, respectively. BADL disability rate was higher in females, the widowed, illiterate, the elderly with low body weight or obesity (P<0.05). IADL disability rate was higher in females, rural residents, the widowed, the elderly with lower educational level or lower body weight (P<0.05). Multivariate analysis showed that risk for BADL disability increased with age and abnormal BMI, and decreased with the increase of education level. The risk factors for IADL disability included being female, age, rural residence, being widowed and low BMI. The risk for IADL disability was lower in those with higher education level and overweight or obesity. Conclusion The present study showed that the disability rate was high in the elderly in China, which was influenced by the aging and multi demographic characteristics of the elderly. It is important to strengthen the prevention of BADL and IADL disabilities and intervention in the elderly.

Objective: To explore the influencing factors affecting the cognitive impairment of the elderly population in China. Methods: A stratified multi-stage cluster sampling was used in 6 provinces (autonomous administrative regions and municipalities) to select the sample. A total 24 000 urban and rural residents aged 60 years and above received a set of standardized questionnaire interview, physical examinations, laboratory test of lipid and glucose levels of blood and apolipoprotein E (APOE) genotype. The primary screening of cognitive function was assessed by using the Chinese Version of Ascertain Dementia 8, and then suspicious cognitive impairment cases with more than two abnormal results would receive the further cognitive function assessment by using the Mini-Mental State Examination (MMSE). 1 300 cases with cognitive impairment and 2 600 controls without cognitive impairment were recruited and matched according to their age, gender and resident area in a 1∶2 case-control study. The conditional logistic regression model was used to analyze the association between relevant factors and cognitive impairment. Results: Factors negatively associated with cognitive impairment and their OR (95%CI) values were primary or middle school as 0.63 (0.51-0.77), high school and above as 0.59 (0.39-0.88), daily neighborhood communication as 0.61 (0.50-0.75), weekly participating in social activities 0.59 (0.44-0.79), daily tea drinking as 0.71 (0.58-0.88) and doing regular exercise as 0.71 (0.57-0.88), reading newspaper (occasional: 0.50 (0.37-0.67); frequent: 0.40 (0.28-0.57)), playing majiang or cards (occasional: 0.51 (0.34-0.74); frequent: 0.50 (0.36-0.68)) respectively. Factors positively associated with cognitive impairment and their OR (95%CI) values were APOE-ε4 heterozygote as 1.31 (1.08-1.58), homozygote as 2.74 (1.52-5.00), diabetes onset before 50 years of age and after as 9.03 (3.07-33.60) and 4.40 (3.18-6.17), stroke as 1.90 (1.35-2.69), asthma as 1.95 (1.11-3.42) respectively. Conclusion APOE-ε4 alleles, lower educational level, stroke, asthma, diabetes are risk factors of cognitive impairment in the elderly. Keeping a healthy lifestyle and preventing chronic diseases in the whole life course could significantly reduce the incidence of cognitive impairment in the elderly.

Objective To investigate the epidemiological characteristics of obesity and its relationships to five common chronic diseases among the Chinese elderly population.Methods In 2013,The 4th Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces.A multistage cluster sampling method was used at 298 National Disease Surveillance Points(DSPs).A total of 51778 adults aged 60 and over received a standardized questionnaire,physical examinations,and laboratory tests for blood lipid & glucose levels.The body mass index(BMI)was used for obesity measurement and waist circumference(WC)for central obesity measurement.After weighting adjustment of the sample,the prevalence of obesity and central obesity was compared between different genders,among different age groups,and among different regions.The unconditional Logistic regression model was applied to analyze the relationships of five selected chronic diseases with BMI and WC.Population attributable fractions (AFP)were also calculated.Results Among the elderly,the prevalence of obesity and central obesity was 13.2 ％ and 55.4 ％,respectively.Both were higher in women(16.3％ and 64.4％)than in men(9.9％ and 46.0％)and higher in the urban areas (15.6％ and 62.0％) than in the rural areas (12.0％ and 52.1％) (all P ＜ 0.05).The increased prevalence of five common chronic diseases was correlated with increased BMI and WC(all P＜0.05).After adjustment for confounders,obesity was associated with increased prevalence of hypertension,diabetes,dyslipidemia,and stroke (ORs:1.43-2.68,AFP s:0.05-0.18);central obesity was associated with increased prevalence of the five chronic diseases (ORs:1.35-1.88,AFPs:0.16-0.33)Conclusions High prevalence of obesity and central obesity can be seen in aged women and the urban elderly population.Obesity and central obesity are both related to hypertension,diabetes,dyslipidemia,and stroke.Besides,central obesity is also associated with myocardial infarction.

Objective:To investigate the prevalence of hearing loss among community-dwelling older people aged 60 and over, and also to compare the discrepancies between self-reported hearing loss and hearing loss diagnosed via audiometry.Methods:Subjects were from the Prevention and Intervention on Neurodegenerative Disease for the Elderly in China(PINDEC)project.By using the stratified multi-stage cluster random sampling method, a total of 10 347 residents aged 60 years and over were selected from 12 counties and districts in Liaoning, Henan and Guangdong Provinces and hearing function assessment was performed in 2020 through otoscopy, pure-tone audiometry and questionnaires.Hearing loss(HL)was defined by the World Health Organization criteria.Self-reported hearing loss was assessed by asking participants whether they had difficulty in hearing.The χ2 and Cochran-Armitage trend tests were used to analyze the differences in HL between different groups.The multivariate Logistic regression model was applied to assess factors influencing HL. Results:In 2020, the prevalence of HL among the elderly aged 60 and older in Liaoning, Henan and Guangdong Provinces was 69.8%(95% CI: 68.9%-70.7%). The prevalence of HL in men was higher than that in women, and increased gradually with age.The prevalence of mild HL was 47.2%, and the prevalence of moderate, severe and profound HL were 18.0%, 3.6% and 0.9%, respectively.Multivariate Logistic regression analysis showed that factors positively correlated with HL were aging, male sex, living in rural areas and working in manual labor.Education level was negatively correlated with HL.Of the 7223 participants who were found to have HL, 5106(70.7%)self-reported having good hearing.Those of a younger age, with a higher educational achievement, having a spouse, or with mild HL were more likely to report having good hearing(all P<0.05). Conclusions:Hearing loss is quite prevalent among community-dwelling older people, and there is a large discrepancy in prevalence between self-reported HL and HL diagnosed via audiometry.Screening and comprehensive intervention for hearing loss for the elderly should be strengthened.

Objective:To study the correlation between hypertension label and self-rated health (SRH) in adults aged ≥18 years in China.Methods:Data were from 2013 Chronic Non-communicable Disease and Risk Factor Surveillance Project. The project collected the information through multi stage stratified cluster sampling, face-to-face questionnaire survey and on-site body measurement. The SRH status of the adults was inquired according to the recommendation of Behavioral Risk Factor Surveillance System (BRFSS) in the United States. Blood pressure measurement was performed by using OMRON HBP-1300 electronic sphygmomanometer. Surveymeans and surveyfreq processes were used to describe the general characteristics of the sample population. The cumulative odds logit model was implemented by the processes of surveylogistic to analyze the association between hypertension label and self-rated health in adults in China.Results:A total of 173 008 subjects were included in this study. Hypertension was associated with poorer SRH ( OR=1.29, 95 %CI: 1.22-1.35, P<0.001), but this association was eliminated by adjustment for hypertension label ( P=0.670). Hypertension label was associated with poorer SRH ( OR=2.09, 95 %CI: 1.96-2.23, P<0.001) and the association was still significant even after adjusting for actual hypertension status ( OR=2.08, 95 %CI: 1.94-2.23, P<0.001). In hypertension group, those with hypertension label had poorer SRH than those without hypertension label ( OR=2.18, 95 %CI: 2.02-2.36, P<0.001). In normal blood pressure group, those with hypertension label had poorer SRH than those without hypertension label ( OR=1.89, 95 %CI: 1.64-2.18, P<0.001). Men’s SRH was more sensitive to hypertension label, especially in hypertension group ( OR=2.20, 95 %CI: 1.98-2.45, P<0.001). The results were all adjusted for demographic factors, smoking status, alcohol consumption, physical activity and chronic diseases. Conclusions:Hypertension label is associated with self-rated health independently in adults in China. The diagnosis of hypertension should strictly follow the latest guidelines.

Objective:To investigate the association of apolipoprotein E (ApoE) genotype, sleep problem, olfaction problems, chronic constipation and their interactions on cognitive impairment in the elderly aged 60 and above.Methods:A stratified multi-stage cluster sampling was used in 6 provinces (autonomous administrative regions and municipalities) to select the sample. 1 300 cases with cognitive impairment and 2 600 controls without cognitive impairment were recruited and matched according to their age, gender and resident area in a 1∶2 case-control study. A total of 3 501 people were included after data cleaning. Chi-square test and conditional logistic regression model were used for univariate analysis, multivariate analysis and interaction analysis.Results:ApoE carrying ε4 genotypes, sleep problems, smell disorders, constipation is independent risk factors of cognitive impairment in the elderly ( OR=1.44, 1.65, 2.26, 2.13, P<0.001). The additive interaction between ApoE genotype and olfaction change was statistically significant [ AP=0.45(95% CI: 0.13- 0.77), S=2.37 (95% CI: 1.08-5.24)]. The interaction between other factors with cognitive impairment was not found to be statistically significant. The above results were adjusted for occupation, tea drinking, neighborhood interaction, social activities, physical exercise, reading books and newspapers, playing cards and mahjong, memory changes and hypertension, diabetes, stroke. Conclusions:ApoE genotype, sleep problems, olfaction problems, and chronic constipation are risk factors for cognitive impairment in people 60 and older. There is a synergistic interaction effect between ApoE genotype and olfaction problems on cognitive impairment in the elderly over 60 years old.

Stroke has high disability rate and high mortality rate, resulting in huge disease burden to society and individuals. In the context of highly informationization of global health system, countries have built and improved various public health information platform to provide support for health decision-making through public health information collection, classification, extraction, analysis and sharing in the research of disease burden of stroke. Based on the retrieval of domestic and foreign literatures, this paper summarizes the research methods of stroke-caused disease burden and its public health information sources in China, evaluates the significance of public health as well as the limitations of each research method of disease burden and describes the application and development of stroke-caused disease burden big data platform in the world, and provide suggestions for establishing a more modern and information-based stroke-caused disease burden evaluation system in China by analyzing the limitations of the existing stroke-caused disease burden evaluation system.

Objective:The survey learned about the current status of depression in community's elderly aged 60 years and older and explored its influencing factors.Methods:Respondents from the "Prevention and Intervention of Key Diseases in the Elderly" project used a multi-stage stratified cluster random sampling method to complete the depression screening of 14 335 ≥60-year-old elderly people in 16 counties and districts Liaoning, Henan, and Guangdong provinces in 2019. Through the questionnaire survey on the demographic characteristics of the subjects, whether they live with their families or interact with neighbors, daily exercise, cognitive function, and activity of daily living (ADL), the PHQ-9 depression screening scale was used to assess the depression status of the elderly in the last fortnight. Binary logistic regression was used to analyze the influencing factors of depression in the elderly.Results:The prevalence of depressive symptoms among the elderly in Liaoning province, Henan province, and Guangdong province was 15.45%, and those in the three provinces were 18.17%, 18.87% and 9.93%, respectively. There were differences between urban and rural areas in the detection rate of depressive symptoms among the elderly in different regions, among which Henan: 17.09% vs. 20.61%; Guangdong province: 7.99% vs. 11.03%, the differences were statistically significant ( P<0.05). The results of multivariate logistic regression analysis showed that the detection rate of depressive symptoms in older women was higher than that in men ( OR=1.76, 95% CI: 1.58-1.96), in those divorced or separated ( OR=2.08, 95% CI: 1.01-4.30), with cognitive dysfunction ( OR=1.78, 95% CI: 1.59-1.98) or impaired essential ability of daily living (BADL) ( OR=1.74, 95% CI: 1.23-2.46). The impaired instrumental ability of daily living (IADL) ( OR=2.23, 95% CI: 1.97-2.54) was a risk factor for depression in the elderly ( P<0.05), and the impact of IADL impairment on depression in the elderly was higher than that of BADL impairment (2.23 vs. 1.74). Results also showed that factors as: 80 years old and above ( OR=0.82, 95% CI: 0.68-0.99), living with family members ( OR=0.67, 95% CI: 0.57-0.80), interacting with neighbors ( OR=0.86, 95% CI: 0.76-0.98), exercise multiple times per week ( OR=0.82, 95% CI: 0.69-0.96), and exercise almost every day ( OR=0.63, 95% CI: 0.56-0.70) were protective for depression in the elderly ( P<0.05). Conclusions:The detection rate of depressive symptoms in the elderly aged 60 and above in the community is relatively high in China. Gender, marital status, social interaction, physical exercise, cognitive function, and ADL are all influencing factors of depression in the elderly. The elderly health care sector should carry out psychological prevention and intervention of critical populations.

Objective:To investigate the distribution characteristics of cognition-related lifestyles of elderly in communities and explore the integrated effects on early cognitive decline.Methods:The participants were from the Project of Prevention and Intervention of Neurodegenerative Disease for Elderly in China. A total of 2 537 older adults aged ≥60 years without dementia in the 2015 baseline survey and the 2017 follow-up survey were included. The information about their cognition-related lifestyles, including physical exercise, social interaction, leisure activity, sleep quality, smoking status, and alcohol consumption, were collected through questionnaire survey and the integrated scores were calculated. Multivariate logistic regression analysis was used to assess the association between integrated cognition-related lifestyle score and early cognitive decline.Results:In the 2 537 older adults surveyed, 28.7% had score of 5-6, while only 4.8% had high scores for all 6 healthy lifestyles. Significant differences in healthy lifestyle factor distributions were observed between men and women. Multivariate logistic regression model showed that the risks for early cognitive decline in the older adults who had lifestyle score of 4 and 5-6 were lower than that in those with lifestyle score of 0-3 ( OR=0.683, 95% CI: 0.457-1.019; OR=0.623, 95% CI: 0.398-0.976; trend P=0.030). In the women, the risks for early cognitive decline was lower in groups with score of 4 and 5-6 than in group with score of 0-3 ( OR=0.491, 95% CI: 0.297-0.812; OR=0.556, 95% CI: 0.332-0.929; trend P=0.024). Conclusion:Cognition-related healthy lifestyles are associated with significantly lower risk for early cognitive decline in the elderly, especially in women.