Health impacts of lifestyle and ambient air pollution patterns on all-cause mortality: a UK Biobank cohort study.

BACKGROUND: Extensive evidence indicates that both lifestyle factors and air pollution are strongly associated with all-cause mortality. However, little studies in this field have integrated these two factors in order to examine their relationship with mortality and explore potential interactions. METHODS: A cohort of 271,075 participants from the UK Biobank underwent analysis. Lifestyles in terms of five modifiable factors, namely smoking, alcohol consumption, physical activity, diet, and sleep quality, were classified as unhealthy (0-1 score), general (2-3 score), and healthy (4-5 score). Air pollution, including particle matter with a diameter ≤ 2.5 µm (PM2.5), particulate matter with a diameter ≤ 10 µm (PM10), particulate matter with a diameter 2.5-10 µm (PM2.5-10), nitrogen dioxide (NO2), and nitrogen oxides (NOx), was divided into three levels (high, moderate, and low) using Latent Profile Analysis (LPA). Cox proportional hazard regression analysis was performed to examine the links between lifestyle, air pollution, and all-cause mortality before and after adjustment for potential confounders. Restricted cubic spline curves featuring three knots were incorporated to determine nonlinear relationships. The robustness of the findings was assessed via subgroup and sensitivity analyses. RESULTS: With unhealthy lifestyles have a significantly enhanced risk of death compared to people with general lifestyles (HR = 1.315, 95% CI, 1.277-1.355), while people with healthy lifestyles have a significantly lower risk of death (HR = 0.821, 95% CI, 0.785-0.858). Notably, the difference in risk between moderate air pollution and mortality risk remained insignificant (HR = 0.993, 95% CI, 0.945-1.044). High air pollution, on the other hand, was independently linked to increased mortality risk as compared to low air pollution (HR = 1.162, 95% CI, 1.124-1.201). The relationship between NOx, PM10, and PM2.5-10 and all-cause mortality was found to be nonlinear (p for nonlinearity < 0.05). Furthermore, no significant interaction was identified between lifestyle and air pollution with respect to all-cause mortality. CONCLUSIONS: Exposure to ambient air pollution elevated the likelihood of mortality from any cause, which was impacted by individual lifestyles. To alleviate this hazard, it is crucial for authorities to escalate environmental interventions, while individuals should proactively embrace and sustain healthy lifestyles.

Association of living arrangements with all-cause mortality among older adults: a propensity score-matched cohort study.

BACKGROUND: Many studies exist on the living arrangements and health status of older adults, but the findings have been inconsistent. Therefore, we examined the relationship between living arrangements and all-cause mortality in older adults. METHODS: This perspective study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018. We used a sample aged 65 years and over included in the study in 2011. Propensity score matching was performed to minimize bias and Cox proportional hazards regression models were conducted. RESULTS: A total of 7,963 participants were included. Of these, 1,383 were living alone, 6,424 were living with families, and 156 were living in nursing homes. In the propensity score-matched cohort, older adults living alone had a significantly lower risk of all-cause mortality than those living with families (hazard ratio 0.85; 95% confidence intervals 0.76 to 0.95). Living alone was prominently associated with a decline in mortality compared with living in nursing homes (hazard ratio 0.61; 95% confidence intervals 0.44 to 0.84). There was no significant difference in mortality between living in nursing homes and living with families (hazard ratio 1.19; 95% confidence intervals 0.89 to 1.60). Subgroup analyses indicated that there was no significant interaction with age, sex, education, or residence. CONCLUSIONS: The risk of all-cause mortality was significantly lower in older adults living alone than in those living with families or living in nursing homes. This article's findings suggest the need to adopt multiple approaches to meet the needs of senior care services.

Effects of common plastic products heat exposure on cognition: Mediated by gut microbiota.

Considering plastic exposure patterns in modern society, the effects of exposure to leachate from boiled-water treated plastic products on cognitive function was probed in mice through changes in gut microbiota diversity. In this study, Institute for Cancer Research (ICR) mice were used to establish drinking water exposure models of three popular kinds of plastic products, including non-woven tea bags, food-grade plastic bags and disposable paper cups. 16S rRNA was used to detect changes in the gut microbiota of mice. Behavioral, histopathology, biochemistry, and molecular biology experiments were used to evaluate cognitive function in mice. Our results showed that the diversity and composition of gut microbiota changed at genus level compared to control group. Nonwoven tea bags-treated mice were proved an increase in Lachnospiraceae and a decreased in Muribaculaceae in gut. Alistipes was increased under the intervention of food grade plastic bags. Muribaculaceae decreased and Clostridium increased in disposable paper cups group. The new object recognition index of mice in the non-woven tea bag and disposable paper cup groups decreased, and amyloid ß-protein (Aß) and tau phosphorylation (P-tau) protein deposition. Cell damage and neuroinflammation were observed in the three intervention groups. Totally speaking, oral exposure to leachate from boiled-water treated plastic results in cognitive decline and neuroinflammation in mammals, which is likely related to MGBA and changes in gut microbiota.

Relationship between cumulative exposure to pesticides and sleep disorders among greenhouse vegetable farmers.

BACKGROUND: In the northern region of China, many greenhouse vegetable farmers are exposed to high cumulative levels of pesticides due to long-term work in greenhouses that impacts their health. The aim of the current study was to identify the relationship between cumulative pesticide exposure and sleep disorders among farmers in Yinchuan, Northwest China. METHODS: A cross-sectional study was conducted for 3 consecutive years in 2015, 2016 and 2017. Using a random sampling to select the resident teams, 1366 participants were enrolled, and information was collected via face-to-face interviews by trained investigators. Ordinal logistic, multinomial logistic and poisson logistic regression models were used to identify the associations between cumulative exposure intensity (CEI) and sleep disorders. RESULTS: High CEI (OR = 1.56, 95% CI: 1.02-3.38) was associated with short sleep duration when compared with low CEI in the Full Model. CEI was not associated with long sleep duration. Self-rated sleep quality was associated with medium (OR = 1.46, 95% CI: 1.10-2.00) and high (OR = 2.50, 95% CI: 1.83-3.40) CEI. Similarly, having difficulty sleeping was associated with medium (OR = 1.52, 95% CI: 1.02-2.24) and high (OR = 1.74, 95% CI: 1.16-2.62) CEI. Differences in the associations by gender were also noted. CONCLUSION: CEI was associated with sleep disorders, and gender differences were observed. Efforts should be made by local governments to address sleep problems that result from cumulative pesticide exposure in farmers, and gender differences should be considered.

Mitochondrial-related gene expression profiles suggest an important role of PGC-1alpha in the compensatory mechanism of endemic dilated cardiomyopathy.

Keshan disease (KD) is an endemic dilated cardiomyopathy with unclear etiology. In this study, we compared mitochondrial-related gene expression profiles of peripheral blood mononuclear cells (PBMCs) derived from 16 KD patients and 16 normal controls in KD areas. Total RNA was isolated, amplified, labeled and hybridized to Agilent human 4 × 44k whole genome microarrays. Mitochondrial-related genes were screened out by the Third-Generation Human Mitochondria-Focused cDNA Microarray (hMitChip3). Quantitative real-time PCR, immunohistochemical and biochemical parameters related mitochondrial metabolism were conducted to validate our microarray results. In KD samples, 34 up-regulated genes (ratios ≥ 2.0) were detected by significance analysis of microarrays and ingenuity systems pathway analysis (IPA). The highest ranked molecular and cellular functions of the differentially regulated genes were closely related to amino acid metabolism, free radical scavenging, carbohydrate metabolism, and energy production. Using IPA, 40 significant pathways and four significant networks, involved mainly in apoptosis, mitochondrion dysfunction, and nuclear receptor signaling were identified. Based on our results, we suggest that PGC-1alpha regulated energy metabolism and anti-apoptosis might play an important role in the compensatory mechanism of KD. Our results may lead to the identification of potential diagnostic biomarkers for KD in PBMCs, and may help to understand the pathogenesis of KD.

Association between coffee and tea consumption and the risk of dementia in individuals with hypertension: a prospective cohort study.

Many studies have shown that drinking coffee and tea may be associated with the risk of hypertension and dementia. Limited research exists on their impact on dementia risk in hypertensive patients. This study aimed to determine the association between coffee and tea consumption and the risk of dementia development in hypertensive population by utilizing Cox proportional risk modeling with 453,913 participants from a UK biobank. Our findings reveal a J-shaped and U-shaped association between the risk of all-cause dementia and the consumption of coffee and tea respectively in hypertensive people. The hypertensive patients who drink 0.5-1 cup of coffee or 4-5 cups of tea per day have the lowest risk of dementia. A U-shaped relationship was observed between daily caffeine consumption and the risk of developing all-cause dementia and vascular dementia in the hypertensive population. Furthermore, the significant association between the amount of coffee and tea consumed and the risk of all-cause and vascular dementia were more likely to be found in hypertensive patients than in the non-hypertensive population.

Association of Plastic Exposure with Cognitive Function Among Chinese Older Adults.

Background: The widespread exposure to plastic products and the increasing number of individuals with cognitive impairments have imposed a heavy burden on society. Objective: This study aims to investigate the relationship between plastic product exposure in daily life and cognitive function in older Chinese individuals. Methods: Data were obtained from the 2023 Ningxia Older Psychological Health Cohort, comprising 4045 participants aged 60 and above. Cognitive function was assessed using the Mini-Mental State Examination scale. A population-based plastic exposure questionnaire was used to calculate plastic exposure scores (PES). Binary logistic regression was employed to analyze the relationship between PES and cognitive function, while restricted cubic splines were used to examine the dose-response relationship between PES and cognitive function. Latent profile analysis (LPA) was employed to explore the potential patterns of plastic exposure, and logistic regression was used to investigate the relationship between different exposure patterns and cognitive function. A linear regression model was utilized to investigate the relationship between PES and different dimensions of cognitive function. Results: Among the 4045 participants, 1915 individuals were assessed with mild cognitive impairment (MCI). After adjusting for all covariates, PES (OR = 1.04, 95% CI 1.02-1.06) was significantly associated with the risk of MCI and exhibited a dose-response relationship. LPA identified two potential categories of plastic exposure, with a higher risk of MCI observed in the group using plastic utensils. Conclusions: This study indicates a positive correlation between plastic exposure levels and MCI risk, particularly among individuals who frequently use plastic tableware.

Antagonizing Effects of Chromium Against Iron-Decreased Glucose Uptake by Regulating ROS-Mediated PI3K/Akt/GLUT4 Signaling Pathway in C2C12.

To investigate the effect of chromium and iron on glucose metabolism via the PI3K/Akt/GLUT4 signaling pathway. Skeletal muscle gene microarray data in T2DM (GSE7014) was selected using Gene Expression Omnibus database. Element-gene interaction datasets of chromium and iron were extracted from comparative toxicogenomics database (CTD). Gene ontology (GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using DAVID online tool. Cell viability, insulin-stimulated glucose uptake, intracellular reactive oxygen species (ROS) level, and protein expression level were measured in C2C12 cells. The bioinformatics research indicated that PI3K/Akt signaling pathway participated in the effects of chromium and iron associated with T2DM. Insulin-stimulated glucose uptake level was significantly higher in chromium picolinate (Cr group) and lower in ammonium iron citrate (FA group) than that for the control group (P < 0.05); chromium picolinate + ammonium iron citrate (Cr + FA group) glucose uptake level was higher than that for the FA group (P < 0.05). Intracellular ROS level was significantly higher in the FAC group than that for the control group (P < 0.05), and that for the Cr + FA group was lower than that for the FA group (P < 0.05). p-PI3K/PI3K, p-Akt/Akt, and GLUT4 levels were significantly lower in the FA group than that for the control group (P < 0.05), and the Cr + FA group had higher levels than the FA group (P < 0.05). Chromium might have a protective effect on iron-induced glucose metabolism abnormalities through the ROS-mediated PI3K/Akt/GLUT4 signaling pathway.

Toxicity to the Male Reproductive System after Exposure to Polystyrene Nanoplastics: A Macrogenomic and Metabolomic Analysis.

Nanoplastics (NPs) cause serious contamination of drinking water and potential damage to human health. This study aimed to investigate the effects of NPs with different particle sizes and concentrations on the reproductive function of male mice. In this study, free drinking water exposure was used to expose male BALB/C mice to PS-NPs (20 nm, 200 nm, and 1000 nm) at 0.1 mg/L, 1 mg/L, and 5 mg/L for 4 months. The male reproductive function of the mice was assessed after NPs exposure, and fecal and blood samples were collected for macrogenomics and metabolomics. The results showed that PS-NPs resulted in mice with reduced testicular organ coefficients, decreased sperm quality, altered testicular tissue structure, disturbed sex hormone levels, and abnormal levels of inflammatory factors and oxidative stress. Furthermore, this study found that NP exposure affected the alteration of gut communities and metabolic pathways related to male reproduction, such as Clostridium and glutathione metabolism. Importantly, we found an effect of NP particle size on reproductive function. In the future, more attention should be paid to the smaller particle sizes of NPs.

[Screening of differentially expressed proteins in serum from subjects with Keshan disease by two-dimensional electrophoresis and mass and mass spectrometry].

OBJECTIVE: To screen differentially expressed proteins in serum in patients with Keshan disease (KD), peripheral blood protein expression spectrum between subjects with Keshan disease and health controls were compared. METHODS: Differentially expressed protein spots were screened by two-dimensional gel electrophoresis (2-DE) between Keshan disease and health control subjects, and constitutive protein were identified by matrix assisted laser adsorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). RESULTS: 9 differentially expressed protein spots were showed in 2-DE images and 8 differentially expressed proteins were identified by MALDI-TOF-MS. In them, 3 up-regulated proteins, mainly relatedd to lipid metabolism, apoptosis resistance, immunological regulation and 3 down-regulated proteins, involved to cellular iron ion homeostasis; 2 up-regulated proteins in serum in patients with KD versus controls from KD areas were detected, mainly associated with protease inhibition. CONCLUSIONS: Haptoglobin, serum albumin, alpha-l-antitrypsin, transferring and alpha2-heremans schmid glycoprotein may be considered as candidate biological indicators used for diagnosis or prognosis of KD.

Association study of selenium-related gene polymorphisms with geriatric depression in China.

Depression is a common mental health problem in older adults, but its cause remains unclear. Selenium is an essential micronutrient and a powerful antioxidant in the brain and nervous system. Several recent studies have reported a relationship between selenium levels and depression. This study aimed to investigate the relationship between 4 genes co-associated with selenium and geriatric depression. 1486 participants were included in this study from 5 communities in Ningxia Hui Autonomous Region during 2013 to 2016 in a health examination program for urban and rural residents. Polymorphisms of 4 selenium-related genes were analyzed in 1266 healthy volunteers and 220 patients with depression. The genotyping of rs2830072, rs2030324, rs6265, rs11136000, rs7982, rs10510412, rs1801282, rs1151999, rs17793951, rs709149, rs709154, and rs4135263 were performed by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) technology. The analysis of selenium-related genes showed that there were significant differences between depression and controls for allele and genotype frequencies of peroxisome proliferator activated receptor gamma (PPARG) rs10510412, rs709149, and rs709154 (all P < .05). In this study, when adjusting for age, sex, marital status, education, and alcohol consumption, results showed that rs709149 and rs709154 were still significantly correlated with geriatric depression in the codominant, dominant, overdominant, and log-additive models. Logistic regression analysis showed that rs709149 AG or GG gene carriers were 1.630 and 1.746 times more susceptible to depression than AA gene carriers (95% CI = 1.042-2.549; 1.207-2.526). The results of this study suggest that the rs709149 polymorphism of the selenium-related gene PPARG is a genetic risk factor for depression in older adults.

Trimethylamine N-Oxide and Related Metabolites in the Serum and Risk of Type 2 Diabetes in the Chinese Population: A Case-Control Study.

Background: Trimethylamine N-oxide (TMAO) and its precursors have an association with type 2 diabetes mellitus (T2DM); however, the evidence is unclear. The current study examined the association of serial measures of serum TMAO and related metabolite concentrations with the risk of T2DM. Methods: Our study was designed as a community case-control study with 300 participants (150 T2DM and 150 non-T2DM). We examined the association of serum concentrations of TMAO and its related metabolites [trimethylamine, choline, betaine, and L-carnitine] using UPLC-MS/MS. The association between these metabolites and the risk of T2DM was analyzed using a restricted cubic spline and binary logistic regression. Results: A higher serum choline concentration was significantly associated with an increased risk of T2DM. Serum choline > 22.62 µmol/L was independently associated with an increased risk of T2DM, and the odds ratio was 3.615 [95% CI: (1.453,8.993), P = 0.006]. Similarly, serum betaine and L-carnitine concentrations had a markedly decreased risk of T2DM even after adjusting for the traditional risk factors for T2DM and betaine (0.978 [95% CI:0.964-0.992], P = 0.002) and L-carnitine (0.949 [95% CI: 0.9222-0.978], P = 0.001), respectively. Conclusion: Choline, betaine, and L-carnitine are associated with the risk of T2DM and may be appropriate risk markers to protect high-risk individuals from T2DM.

Mediating role of depressive symptoms on the relationship between sleep duration and cognitive function.

Although some studies have shown the association between sleep duration and cognitive impairment is positive, the mechanism explaining how sleep duration is linked to cognition remains poor understood. The current study aims to explore it among Chinese population. A cross-sectional study of 12,589 participants aged 45 or over was conducted, cognition was assessed by three measures to capture mental intactness, episodic memory, and visuospatial abilities. The Center for Epidemiologic Studies Depression Scale 10 (CES-D10) was administered during the face-to-face survey to assess depressive status. Sleep duration was reported by the participants themselves. Partial correlation and linear regression were used to explore the association between sleep duration, cognition, and depression. The Bootstrap methods PROCESS program was used to detect the mediation effect of depression. Sleep duration was positively correlated with cognition and negatively with depression (p < 0.01). The CES-D10 score (r = - 0.13, p < 0.01) was negatively correlated with cognitive function. Linear regression analysis showed sleep duration was positively associated with cognition (p = 0.001). When depressive symptoms were considered, the association between sleep duration and cognition lost significance (p = 0.468). Depressive symptoms have mediated the relationship between sleep duration and cognitive function. The findings revealed that the relationship between sleep duration and cognition is mainly explained by depressive symptoms and may provide new ideas for interventions for cognitive dysfunction.

Social capital, depressive symptomatology, and frailty among older adults in the western areas of China.

We aimed to explore the relationship between social capital (SC) and frailty, and the mediation role of depressive symptoms in this relationship. A cross-sectional study among 2,591 older adults aged ≥60 years old was conducted from September 2020 to May 2021. SC, depressive symptoms, and frailty were measured using the social capital scale, the 9-item patient health questionnaire, and the FRAIL scale, respectively. The mediation model was tested by Bootstrap PROCESS. After controlling for socio-demographical covariates, the SC was negatively correlated with frailty (r = -0.07, P = 0.001), and depressive symptomatology (r = -0.08, P<0.001); while the depressive symptomatology was positively correlated with frailty (r = 0.33, P<0.001). Logistic regression results showed that SC was associated with a lower risk of frailty (OR = 0.94; 95% CI: 0.92-0.97; P<0.001). Depressive symptomatology partially mediated (explained 36.4% of the total variance) the association between SC and frailty. Those findings suggest that SC may protect older adults from frailty by reducing depressive symptoms. Prevention and intervention implications were also discussed.

A predictive model for the risk of cognitive impairment in community middle-aged and older adults.

Identifying individuals at high risk of cognitive impairment is essential for treatment and prevention strategies. We aimed to develop and validate a prediction model for evaluating the risk of cognitive impairment. Data were from the China Family Panel Studies (CFPS) and China Health and Retirement Longitudinal Study (CHARLS). A total of 14,265 subjects were selected for model development. The area under the curve(AUC) for the training, internal, and external validation sets were 0.775, 0.920, and 0.727, respectively. This model could be used to identify middle-aged and older adults aged 45 years and older at high risk of cognitive impairment.

Association of Parental Famine Exposure With Offspring Depression and Cognition Function.

Background: The effect of early exposure to famine on depression and cognition in adulthood has been shown, but the intergenerational association of famine remain to be explored. This study focused on exploring the association of parental famine exposure with depression and cognition in the offspring. Methods: Based on the Chinese Family Panel Studies database, which is a longitudinal survey, we included 5,150 individuals born between 1959 and 1961 and divided them into fetal-exposed, infancy-exposed (birth year = 1957-1958), school-age-exposed (birth year = 1949-1956), adolescent-exposed (birth year = 1946-1948), and unexposed groups. We used one-way analysis of variance, multiple linear regression, and one follow-up measurement to analyze the association between parental famine exposure and offspring depression and cognitive function. Results: Compared with the unexposed group, the correlations between parental famine exposure during fetal period and their cognitive function (mother: ß = -1.614, 95% CI: -2.535, -0.693; p = 0.001; father: ß = -2.153, 95% CI: -3.104, -1.202, p < 0.001) were significant. For the offspring, there was a negative correlation between famine exposure of fathers during the fetal period and depression in their offspring (ß = -0.477, 95% CI: -0.907, -0.047; p = 0.030). There was a negative correlation between maternal famine exposure during the infant and adolescent period and cognitive function in the offspring (math test: ß = -0.730, 95% CI: -1.307, -0.153; p = 0.013; word test: ß = -2.346, 95% CI: -4.067, -0.625; p = 0.008). Limitations: Not all variables related to depression and cognition function were included in the CFPS database, and the other unknown or unmeasured confounders may explain our results.

Association between reading and depression in Chinese adults.

Qualitative evidences have shown that having the habit of reading might be beneficial for mental health. The present study aims to examine the relationship between reading and depression. National cross-sectional survey data of adults aged >40 years in mainland China were used. The Center for Epidemiological Studies Depression Scale questionnaire was utilized to detect depression status. Multilevel binary logistic and linear regression models were employed to reveal the association, and restricted cubic spline with 4 knots was adopted to describe the non-linear association of reading quantity and depression. The prevalence of depression was 13.02% in the target population. It was found that the habit of reading was negatively associated with depression, the odds ratio was 0.809 (95% confidence interval: 0.657-0.997). Diverse association between reading and depression was observed in different age groups, and a significant association was identified among the elderly, but not in the middle-aged population. Restricted cubic spline showed several books read per year might lower the risk of depression and 20-items Center for Epidemiological Studies Depression Scale score. A lower prevalence of depression was observed in the target population. The habit of reading was negatively associated with depression. Age-specific association was observed. It is worth paying attention to the reading habit that could be beneficial in the elderly for mental health intervention, but it needs to be confirmed by experimental study.

Effects of oral exposure to leachate from boiled-water treated plastic products on gut microbiome and metabolomics.

By simulating plastic exposure patterns in modern society, the impact of daily exposure to plastic products on mammals was explored. In this study, Institute for Cancer Research (ICR) mice were used to establish drinking water exposure models of three popular kinds of plastic products, including non-woven tea bags, food-grade plastic bags and disposable paper cups. Feces and urine of mice were collected for gut microbiome and metabolomics analysis. Our results showed that the diversity and composition of gut microbiota changed at genus level compared to control group. Lactobacillus, Parabacteroides, Escherichia-shigella and Staphylococcus decreased while Lachnospiraceae increased treated with non-woven tea bags. Escherichia-shigella and Alistipes increased while Parabacteroides decreased treated with food grade plastic bags. Muribaculaceae decreased in the gut microbiota of mice treated with disposable paper cups. Metabolomics has seen changes in the number of metabolites and enrichment of metabolic pathways related to inflammatory responses and immune function. Inflammatory responses were found in histological and biochemical examination. In summary, this study demonstrated that long-term oral exposure to leachate form boiled-water treated plastic products might have effects on gut microbiome and metabolome, which further provided new insights about potential adverse effects for human beings.

The association of depressive symptoms with disability among adults in China.

BACKGROUND: The symptoms that patients with major depressive disorder (MDD) experience are the dominant contributing factors to its heavy disease burden. This study sought to identify key symptoms leading to disability in patients with MDD. METHODS: Subjects consisted of patients who had a 12-month MDD diagnosis based on the China Mental Health Survey (CMHS). World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess the degree of disability. The associations between depressive symptoms and disability were analyzed using a linear regression and logistic regression with a complex sampling design. RESULTS: Of the 32,552 community residents, 655 patients were diagnosed with 12-month MDD. The disability rate due to MDD was 1.06% (95% CI: 0.85%-1.28%) among adults in Chinese community and 50.7% (95% CI: 44.3%-57.1%) among MDD patients. Depression was associated with all functional losses measured by the WHODAS. Feelings of worthlessness in life or inappropriate guilt, and psychomotor agitation or retardation were the key symptoms related to disability. Economic status, co-morbidity of physical diseases or anxiety disorders were correlates of disability scores. LIMITATIONS: The disability rate might be underestimated due to the exclusion of MDD patients living in hospitals. The effect of treatments on disability was excluded. CONCLUSIONS: Psychological symptoms, not somatic symptoms, contribute to disability in MDD patients. Disability worsens when physical diseases or anxiety disorders are present. More attention could be paid to psychological symptoms, physical diseases, and anxiety disorders in MDD patients with disabilities.

Association Between Reading Habit and Sleep Among Age Over 40 Years Community Residents: A Population-Based Evidence Study.

PURPOSE: Sleep disturbance is a paramount public health concern that besets many modern middle-aged and elderly community residents. Reading is important to adults as it facilitates the completion of daily tasks, and might be associated with sleep issues. The present study aimed to analyze the association between reading and sleep using Chinese national survey data. PATIENTS AND METHODS: The 2018 China Family Panel Studies survey data were used, and the target sample was extracted according to age (>40 years). Reading behavior and reading quantity were chosen as independent variables, and sleep duration, sleep-onset time, and sleep quality were selected as dependent variables. A multilevel mixed linear/ordinal logistic regression model was employed to evaluate the association, and restricted cubic splines with 4 knots were employed to flexibly model the association of reading quantity and sleep duration. RESULTS: A total of 18,740 adults were selected, and the reading rate was 15.04%. Reading habit was significantly negatively associated with weekday sleep duration, but not with duration at weekends, as determined from the full set of confounders adjusted models. Reading behavior was also associated with delayed sleep-onset time (OR: 0.935, 95% CI: 0.908-0.964), but not with sleep quality. Reading quantity showed a nonlinear relationship with sleep duration, appropriate reading quantity was related with long sleep duration. CONCLUSION: Reading was associated with short sleep duration on weekdays, but not with sleep quality. Furthermore, reading was related to late sleep-onset time, and for the middle-aged and elderly Chinese populations, appropriate reading quantity was related with long sleep duration.