Change in Healthy Lifestyle and Subsequent Risk of Cognitive Impairment Among Chinese Older Adults: A National Community-Based Cohort Study.

BACKGROUND: The association between change in lifestyle and cognitive impairment remains uncertain. OBJECTIVES: To investigate the association of change in lifestyle with cognitive impairment. METHODS: In this study, 4 938 participants aged 65 or older were involved from the Chinese Longitudinal Healthy Longevity Survey for years 2008-2018. A weighted healthy lifestyle score was derived from 4 lifestyle factors (smoking, alcohol consumption, physical activity, and diet). Multivariable Cox proportional hazards regression models were applied to investigate the associations between 3-year changes in healthy lifestyle (2008-2011) and cognitive impairment (2011-2018). RESULTS: Researchers documented 833 new-onset of cognitive impairments more than 20 097 person-years of follow up. Compared with those in the persistently unhealthy group, those in the improved and persistently healthy groups had a lower risk of cognitive impairment, with the multivariate-adjusted hazard ratios (HRs) of 0.67 (95% confidence interval (CI): 0.55, 0.83) and 0.53 (95% CI: 0.40, 0.71), respectively. Furthermore, a significant interaction was observed between change in lifestyle and sex (p-interaction = .032); the HRs were 0.48 (95% CI, 0.34, 0.69) for the improved group and 0.41 (95% CI: 0.26, 0.64) for persistently healthy group among male vs 0.81 (95% CI, 0.63, 1.04) and 0.64 (95% CI, 0.44, 0.92) among female, respectively. CONCLUSIONS: This study suggests that improving or maintaining a healthy lifestyle can significantly mitigate the risk of cognitive impairment in Chinese older adults. Additionally, researcher's findings emphasize the significance of maintaining a healthy lifestyle and highlights the potential positive impact of improving previous unhealthy habits, especially for older women.

Classified status of smoking and quitting has different associations with dyslipidemia in residents in northeast China.

BACKGROUND: Various smoking status and high prevalence of dyslipidemia in residents exist in northeast China. However, associations of dyslipidemia with smoking status remain unclear. METHODS: A total of 17,114 participants selected by a multistage stratified cluster random sampling design were enrolled from a cross-sectional study conducted in northeast China. Associations of dyslipidemia with smoking/quitting status (smoking amount, smoking duration, and quitting duration) were investigated using multiple logistic regression. RESULTS: Prevalence (39.2%) of dyslipidemia existed in residents in northeast China. Smoking amount was associated with dyslipidemia (1-10 cigarettes daily: OR = 1.19, 95% CI: 1.08-1.32; 11-20 cigarettes daily: OR = 1.29, 95% CI: 1.16-1.42; and over 20 cigarettes daily: OR = 1.51, 95% CI: 1.25-1.83). Smoking duration was associated with dyslipidemia risk (6-10 years: OR = 1.75, 95% CI: 1.51-2.03; 11-15 years: OR = 1.85, 95% CI: 1.51-2.26; and ≥15 years: OR = 1.12, 95% CI: 1.02-1.23). Quitting duration (1-5 years) was associated with dyslipidemia (OR = 1.26, 95% CI: 1.07-1.48); however, we found no statistically significant associations between dyslipidemia and quitting duration (over 6 years). CONCLUSIONS: Dyslipidemia risk is positively associated with smoking/quitting status. Smoking amount and smoking duration may co-determine dyslipidemia risk, and quitting duration (>6 years) is necessary for reducing dyslipidemia risk.

PREVALENCE AND RISK FACTORS OF IMPAIRED FASTING GLUCOSE AMONG ADULTS IN NORTHEAST CHINA: A CROSS-SECTIONAL STUDY.

OBJECTIVE: To investigate the prevalence and risk factors of impaired fasting glucose (IFG) among adults in northeast China. METHODS: A cross-sectional study was conducted in Jilin Province in 2012. Questionnaires were used to collect information about demographic characteristics, lifestyle factors, and health status from 15,540 residents. Fasting blood glucose (FBG) was measured in the morning after at least 12 hours of fasting, and χ2 tests were performed to compare differences between subjects with and without IFG. Logistic regression was carried out to identify factors influencing IFG occurrence. RESULTS: There were significant differences in demographic characteristics (age, sex, education, and marriage status), lifestyle factors (smoking, drinking, physical activity, and average sleep duration), and health status (hyperlipidemia, hypertension, and BMI category) between subjects with IFG and without IFG ( P<.05). IFG risk was significantly associated with sex, age, education (senior high school and college), marriage status (single), drinking, hyperlipidemia, hypertension, and BMI category (all P<.05). CONCLUSION: In adults in northeast China, risk factors of IFG are sex, age, education (senior high school and college), drinking, hyperlipidemia, hypertension, and BMI category; however, the protective factor of IFG is marriage status (single). ABBREVIATIONS: BMI = body mass index; CI = confidence interval; FBG = fasting blood glucose; IFG = impaired fasting glucose; OR = odds ratio; T2DM = type 2 diabetes.

The dose-response analysis between BMI and common chronic diseases in northeast China.

High body mass index (BMI) predisposes to several chronic diseases, but a large-scale systematic and detailed study of dose-response relationship between BMI and chronic diseases has not been reported previously. In this study, we aimed to investigate the relationship between BMI and 3 chronic diseases (hypertension, dyslipidemia and MetS) in northeast China. A sample of 16412 participants aged 18~79 years old were included in Jilin province in 2012. The lambda-mu-sigma (LMS) method was applied to examine the trend of BMI by age, and the restricted cubic splines were used to investigate the non-linear associations (dose-response curve) between BMI and chronic diseases. It was pointed out that BMI increased rapidly when young, then kept steady in middle age, and finally declined slowly in old age, and accordingly age was divided into 3 segments, which were different by gender. The odds ratios (ORs) of BMI for the chronic diseases increased relatively slowly when young, then increased dramatically in middle-age and old population, especially for men. Further, the ORs of BMI among non-smokers were lower than those among smokers, and the same trend was shown to be more apparent among drinkers and non-drinkers. The risk of BMI for common chronic diseases increased dramatically in middle-aged, especially for men with drinking and smoking habits.

Socioeconomic status and prevalence of chronic non-communicable diseases in Chinese women: a structural equation modelling approach.

OBJECTIVE: To investigate the role of socioeconomic status (SES) in chronic non-communicable diseases (NCDs) and offer theoretical evidence for the prevention and control of NCDs. DESIGN: Cross-sectional survey and structural equation modelling. SETTING: Nationwide, China. PARTICIPANTS: Female participants in the 2008 National Health Services Survey in China who were 15 years and older. RESULTS: SES factors were associated with the increased risk of NCDs in Chinese women. Education was identified as the most important factor with a protective role (factor loading=-0.115) for NCDs. Income mainly affected NCDs directly, whereas occupation mainly affected NCDs indirectly. The effects of SES on NCDs were more significant than that of smoking. Medical insurance, smoking and self-reported health played a mediating role in the correlations between those SES factors and NCDs. CONCLUSIONS: In China, socioeconomic disparities associated with the prevalence of NCDs exist among women. Educational and social interventions are needed to mitigate their negative consequences on health outcomes in Chinese women.

Gender differences in general mental health, smoking, drinking and chronic diseases in older adults in Jilin province, China.

There is little information on gender differences in general mental health, smoking, drinking and chronic diseases in Chinese elderly. We examined the gender differences in general mental health, smoking, drinking and a number of chronic diseases in a large Chinese old population. Multistage stratified cluster sampling was used in this cross-sectional study. A total of 4115 people (2198 women; 1917 men) aged between 60 and 79 years were included and their general mental health, smoking, drinking and chronic diseases were recorded with standardized assessment tools. Multivariate analyses revealed that women were less likely to be current smokers and frequent drinkers, but had higher prevalence of poor mental health compared with their male counterparts. In addition, the prevalence rate of chronic diseases and multi-morbidities were higher in women than that in men (both p values <0.05). Health professionals and policy makers need to pay special attention to the common chronic diseases and poor mental health in older women and higher prevalence of smoking and drinking in men.

Risk Factors for Cardiovascular Disease and Their Clustering among Adults in Jilin (China).

BACKGROUND: Clustering of cardiovascular disease (CVD) risk factors constitutes a major public health challenge. Although a number of researchers have investigated the CVD risk factor clusters in China, little is known about the related prevalence and clustering associated with demographics in Jilin Province in China; this study aims to reveal that relationship. METHODS: A cross-sectional survey based on a sample of 16,834 adults aged 18 to 79 years was conducted in Jilin in 2012. The prevalence and clustering of CVD risk factors were analysed through complex weighted computation. Quantitative variables were compared by the t test, and categorical variables were compared by the Rao-Scott-χ² test. Finally, multivariable logistic regression analysis was used to evaluate the CVD risk factor clusters associated with demographics. RESULTS: The prevalences of hypertension, diabetes, dyslipidemia, overweight and smoking were 37.3%, 8.2%, 36.8%, 47.3%, and 31.0%, respectively, and these risk factors were associated with gender, education level, age, occupation and family income (p < 0.05). Overall, compared with females, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors clusters in males were 3.70 (95%CI 3.26 to 4.20), 4.66 (95%CI 4.09 to 5.31), and 5.76 (95%CI 5.01 to 6.63), respectively. In particular, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors increased with age. CONCLUSIONS: CVD risk factor clusters are common among adults in northeast China, and they constitute a major public health challenge. More effective attention and interventions should be directed toward the elderly and toward persons with lower incomes and low levels of education.

Prevalence and Associated Factors of Passive Smoking among Women in Jilin Province, China: A Cross-Sectional Study.

BACKGROUND: The present study aimed to investigate the prevalence and associated socio-demographic factors of passive smoking among women in Jilin Province, China. METHODS: A cross-sectional study was conducted in 2012, using a self-reported questionnaire interview. A representative sample of 9788 non-smoking women aged 18-79 years was collected in Jilin Province of China by a multistage stratified random cluster sampling design. Descriptive data analysis and 95% confidence intervals (CI) of prevalence/frequency were conducted. Multivariable logistic regressions were used to examine the associated socio-demographic factors of passive smoking. RESULTS: The overall prevalence of passive smoking among non-smoking women in Jilin Province was 60.6% (95% CI: 59.3-61.8), 58.3% (95% CI: 56.7-59.9) from urban areas, and 63.4% (95% CI: 61.6-65.3) from rural areas. Twenty-six percent (95% CI: 24.9-27.1) of the non-smoking women reported daily passive smoking, of which 42.9% (95% CI: 41.6-44.1) reported passive smoking at home, and 5.1% (95% CI: 4.5-5.7) reported passive smoking in restaurants. Women in urban areas were less likely to be passive smokers than those in rural ones (OR-Odds Ratio: 0.825, 95% CI: 0.729-0.935), elderly women were less likely to be passive smokers than younger women (55-64 years OR: 0.481, 95% CI: 0.342-0.674; 65-79 years OR: 0.351, 95% CI: 0.241-0.511). Seperated/divorced women were less likely to be passive smokers (OR: 0.701, 95% CI: 0.500-0.982), and widowed women (OR: 0.564, 95%CI: 0.440-0.722), as the married were the reference group. Retired women second-hand smoked due to environmental causes significantly less than manual workers (OR: 0.810, 95% CI: 0.708-0.928). Women with a monthly family income of more than 5000 RMB were less likely to be passive smokers than those with an income less than 500 RMB (OR: 0.615, 95% CI: 0.432-0.876). CONCLUSIONS: The prevalence of passive smoking is lower than that reported in 2010 Global Adult Tobacco Survey (GATS) China, but passive smoking is still prevalent and has been an acute public health problem among non-smoking women in Jilin Province, China. Our findings suggest an urgent need for tobacco control and the efforts of public health should be both comprehensive and focus on high-risk populations in Jilin Province, China.

[Risk factors for cardiovascular disease and their clustering among middle aged and old people in Jilin province].

OBJECTIVE: To understand the risk factors for cardiovascular disease (CVD) and their clustering among middle aged and old people in Jilin province and provide evidence for the development of effective intervention measures. METHODS: A total of 13 914 people aged 35-79 years were selected from 32 counties (district) in 9 prefectures (municipality) of Jilin province through multi-stage stratified cluster sampling to conduct a face to face questionnaire survey and health examination. Complex weighted computation was conducted to analyze the survey results. RESULTS: The prevalence of hypertension, diabetes, dyslipidemia, smoking and overweight were 41.3%, 11.5%, 42.8%, 31.5% and 53.5%, respectively. Only 16.2% of the subjects surveyed were free of the 5 risk factors. ≥ 1 risk factor and ≥ 3 risk factors were found to clustering in 83.8% and 29.9% of the middle aged and old people. Compared with females, the odds ratios of ≥ 1, ≥ 2 and ≥ 3 risk factors clustering in males were 3.18, 4.28 and 5.58 times higher, respectively. Compared with urban residents, the odds ratios of ≥ 1, ≥ 2 risk factors clustering in rural residents were 1.22 and 1.20 times higher. In addition, the odds ratios of ≥ 1, ≥ 2 and ≥ 3 risk factors clustering increased with age (all P < 0.001). CONCLUSION: High prevalence of major cardiovascular disease risk factors and their clustering were found in middle aged and old people in Jilin province. More attention and intervention should be given to the old males in rural areas.

Smoking Prevalence and Associated Factors as well as Attitudes and Perceptions towards Tobacco Control in Northeast China.

OBJECTIVES: The present study aimed to investigate the prevalence of smoking and environmental tobacco smoke (ETS), the associated factors of current smoking among adults, and their attitudes and perceptions towards tobacco control. METHODS: A population-based cross-sectional survey was conducted in 2012 using a self-reported questionnaire. A representative sample of adults aged 18-79 years was collected in the Jilin Province of Northeast China by a multistage stratified random cluster sampling design. Descriptive data analysis was conducted, and 95% confidence intervals (CI) of prevalence/frequency were calculated to enable comparisons between the alleged differences and similarities. Multivariable logistic regressions were used to examine the risk factors associated with current smoking. RESULTS: 21,435 adults responded to the survey (response rate: 84.9%). The overall prevalence of ever smoking, current smoking, and former smoking or smoking cessation was 39.1% (95% CI: 38.3-39.9), 31.8% (95% CI 31.1-32.6), and 7.3% (95% CI: 6.9-7.7), respectively. The proportion of ETS exposure among adult non-smokers in Jilin Province was 61.1% (95% CI: 60.1-62.1), and 23.1% (95% CI: 22.3-24.0) of the non-smokers reported daily ETS exposure. The proportion of ETS exposure at home was 33.4% (95% CI: 32.5-34.4), but the proportion of ETS exposure at restaurants was lower (6.5%) (95% CI: 6.0-7.1). More than 90% of the participants had positive attitudes and perceptions towards tobacco control, but 23.2% (95% CI: 22.5-24.0) of them did not agree with the perception of "smoking is fully quit in public places", and almost half of the adults (49.5%) (95% CI: 48.7-50.3) did not agree with the perception of "hazards of low-tar cigarettes are equal to general cigarettes". CONCLUSIONS: Smoking and exposure to ETS are prevalent among adults from the Jilin Province of Northeast China. Our findings suggest that tobacco control should be advocated in Northeast China. Anti-smoking campaigns and legislation should be built into the public health curriculum and government policy.

Infantile Hemangioma: Clinical Characteristics and Efficacy of Treatment with the Long-Pulsed 1,064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser in 794 Chinese Patients.

OBJECTIVE: This study aimed to evaluate the clinical characteristics of infantile hemangiomas (IHs) and the safety and efficacy of the long-pulse 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for definitive treatment of IHs in 794 Chinese patients. METHODS: Infants with hemangiomas who had received long-pulse 1,064-nm Nd:YAG laser treatment in our department in the last 5 years were recruited. Demographic and clinical characteristics were recorded and outcomes of long-pulse 1,064-nm Nd:YAG laser treatment were assessed. Statistical analyses were performed to identify factors that affected the efficacy of treatment. RESULTS: The efficacy of long-pulse 1,064-nm Nd:YAG laser for the treatment of IHs in all patients in our study was 87.57%. Efficacy did not depend on sex or the location of the lesion. Older age and superficial hemangioma were the primary factors contributing to greater efficacy of long-pulse 1,064-nm Nd:YAG laser treatment for IHs. The most common side effects were pigment changes, skin atrophy, and wrinkled redundant skin, which usually resolved spontaneously within 1 to 3 years. CONCLUSIONS: Long-pulse 1,064-nm Nd:YAG laser is a safe and efficacious treatment for IHs.

Rural-urban differences in the prevalence of chronic disease in northeast China.

Rural-urban differences in the prevalence of chronic diseases in the adult population of northeast China are examined. The Jilin Provincial Chronic Disease Survey used personal interviews and physical measures to research the presence of a range of chronic diseases among a large sample of rural and urban provincial residents aged 18 to 79 years (N = 21 435). Logistic regression analyses were used. After adjusting for age and gender, rural residents had higher prevalence of hypertension, chronic ischemic heart disease, cerebrovascular disease, chronic low back pain, arthritis, chronic gastroenteritis/peptic ulcer, chronic cholecystitis/gallstones, and chronic lower respiratory disease. Low education, low income, and smoking increased the risk of chronic diseases in rural areas. Reducing rural-urban differences in chronic disease presents a formidable public health challenge for China. The solution requires focusing attention on issues endemic to rural areas such as poverty, lack of chronic disease knowledge, and the inequality in access to primary care.

Dyslipidemia awareness, treatment, control and influence factors among adults in the Jilin province in China: a cross-sectional study.

BACKGROUND: In China, even though the prevalence of dyslipidemia among adults increased yearly and dyslipidemia being an important risk factor for cardiovascular diseases among the Chinese population, however, the awareness, treatment and control of dyslipidemia are at low levels, and only limited studies on the influence factors associated with the awareness, treatment and control dyslipidemia in China have been carried out. METHODS: The analysis was based on a representative sample of 7138 adult subjects aged 18~79 years recruited from a cross-sectional study of chronic disease and risk factors among adults in the Jilin province in 2012. Chi-square test was used to compare the rates of dyslipidemia awareness, treatment and control between different characteristics of participants. Multiple logistic regression analyses were performed separately for each group to explore the associations between participants' characteristics and dyslipidemia awareness, treatment and control. RESULTS: Among participants with dyslipidemia, 11.6% were aware of the diagnosis, 8.4% were receiving treatment, and 34.8% had dyslipidemia controlled. Increase in age and BMI ≥ 24 kg/m2 were by far the strongest risk factors associated with better awareness and treatment of dyslipidemia. Retirees were more likely to be aware of their dyslipidemia condition (OR=1.255; 95% CI: 1.046, 1.506) and to be receiving treatment (OR=1.367; 95% CI: 1.114, 1.676) than manual workers. A family history of dyslipidemia increased the likelihood of awareness (OR=3.620; 95% CI: 2.816, 4.653) and treatment (OR=3.298; 95% CI: 2.488, 4.371) of dyslipidemia. Alcohol drinking and physical activity were associated with a lower level of awareness and treatment.Cigarette smokers (OR=0.501; 95% CI: 0.349, 0.719) and those with BMI ≥ 24 kg/m2 (OR=0.480; 95% CI: 0.326, 0.706) who received treatment were also associated with poor dyslipidemia control. CONCLUSION: Our study highlights low levels of awareness, poor treatment and control of dyslipidemia among adults aged 18~79 in the Jilin province. Promotion of healthy lifestyles and establishment of a comprehensive strategy of screening, treatment and control of dyslipidemia is needed to reduce or prevent the risk of cardiovascular disease in the Jilin province.

Awareness, treatment, control of diabetes mellitus and the risk factors: survey results from northeast China.

BACKGROUND: The awareness, treatment and control of diabetes mellitus (DM) can effectively reflect on the social status of diabetes conditions. Although several researchers have investigated the awareness, treatment and control rates of diabetes mellitus in China, little is known about their association with risk factors. This study aims to examine the relationship between risk factors and awareness, treatment and control of diabetes mellitus in northeast China. METHODS: A cross-sectional survey was conducted in 2012. Multistage stratified random cluster sampling design was used to select participants aged 18 to 79 years old. The analysis was based on a representative sample of 1,854 adult subjects. Multivariable logistic regression analysis was used to examine socio-demographic factors associated with the levels of awareness, treatment and control of diabetes mellitus. RESULTS: The awareness, treatment, and control rates of diabetes mellitus were 64.1%, 52.9% and 44.2%, respectively. In the multivariable logistic regression analysis, family history of diabetes was significantly positively associated with awareness (OR, 2.145; 95% CI, 1.600-2.875) and treatment (OR, 2.021; 95% CI, 1.559-2.619) of diabetes mellitus, while negatively associated with control (OR, 0.671; 95% CI, 0.529-0.951). Cigarette smokers and alcohol drinkers were less likely than non-smokers and non-drinkers to be aware of their blood glucose levels (OR, 0.895, 0.614; 95% CI, 0.659-1.216, 0.446-0.844, respectively). Participants who frequently exercise were more likely to be aware of their diabetic conditions than people who never or rarely exercise (OR, 2.003; 95% CI, 1.513-2.651). CONCLUSIONS: We found that the awareness and treatment of diabetes mellitus were positively associated with age and were high in participants with a family history of diabetes and those who exercise frequently, but low for cigarette smokers and alcohol drinkers. Participants with a family history of diabetes had their diabetic condition poorly controlled.