Prevalence and risk factors associated with circadian syndrome in community-dwelling middle-aged to older adults: Based on health ecology model.

OBJECTIVES: To explore the prevalence and risk factors associated with circadian syndrome (CricS) in community-dwelling middle-aged to older adults. METHOD: We performed a cross-sectional analysis of 13,516 participants from the China Health and Retirement Longitudinal Study (CHARLS). We used logistic regression to compute the odds ratios (OR) and 95 % confidence intervals (Cls), using covariates derived through the health ecology model. RESULTS: The overall prevalence of CricS was 31.5 % (25.0 % males and 37.1 % females). With controlling all covariates, social isolation (OR 1.164, 95%CI 1.033-1.310), irritable mood (OR 1.689, 95%CI 1.488-1.917), fear responses (OR 1.546, 95%CI 1.262-1.894), chronic disease (OR 1.577, 95%CI 1.392-1.788), and financial debt (OR 0.806, 95%CI 0.657-0.990) were significantly correlated with increased CricS risk in males, whereas CricS syndrome was significantly associated with age (OR 1.285, 95%CI 1.214-1.361), married (OR 1.258, 95%CI 1.089-1.452), current drinkers (OR 0.835, 95%CI 0.716-0.974), social isolation (OR 1.175, 95%CI 1.065-1.296), irritable mood (OR 1.346, 95%CI 1.210-1.497), fear responses (OR 1.202, 95%CI 1.047-1.378), chronic disease (OR 1.363, 95%CI 1.225-1.517), chronic pain (OR 1.177, 95%CI 1.058-1.309), and universal basic income (OR 0.742, 95%CI 0.611-0.900) in females. CONCLUSION: CricS is common in middle-aged to older adults, and health behavior factors have an important impact on CricS. The potential predictors identified for CricS should be further studied to prevent the occurrence of adverse health events in the presenium stage.

Associations of visual, hearing, and dual sensory impairment with motoric cognitive risk syndrome: Observational and Mendelian randomization analyses.

BACKGROUND: Dementia is associated with individual vision impairment (VI) and hearing impairment (HI). However, little is known about their associations with motoric cognitive risk syndrome (MCR), a pre-dementia stage. We investigated the association of VI, HI, and dual sensory impairment (DSI) with MCR and to further evaluate causal relationships using Mendelian randomization (MR) approach. METHODS: First, an observational study was conducted in the China Health and Retirement Longitudinal Study (CHARLS). Evaluate the cross-sectional and longitudinal associations of VI, HI, and DSI with MCR using the logistic regression models and Cox proportional hazard models, respectively. Second, evaluate the causal association between VI and HI with MCR using MR analysis. The GWAS data was used for genetic instruments, including 88,250 of European ancestry (43,877 cases and 44,373 controls) and 504,307 with "white British" ancestry (100,234 cases and 404,073 controls), respectively; MCR information was obtained from the GWAS with 22,593 individuals. Inverse variance weighted was the primary method and sensitivity analysis was used to evaluate the robustness of MR methods. RESULTS: In the observational study, VI (HR: 1.767, 95%CI: 1.331-2.346; p < 0.001), HI (HR: 1.461, 95%CI: 1.196-1.783; p < 0.001), and DSI (HR: 1.507, 95%CI: 1.245-1.823; p < 0.001) were significantly associated with increased risk of MCR. For the MR, no causal relationship between VI (OR: 0.902, 95% CI: 0.593-1.372; p = 0.631) and HI (OR: 1.016, 95% CI: 0.989-1.043; p = 0.248) with MCR risk, which is consistent with the sensitivity analysis. CONCLUSION: VI, HI, and DSI were significantly associated with MCR, but MR analysis failed to provide evidence of their causal relationship. Emphasized the importance of sensory impairment screening in identifying high-risk populations for dementia.

Prevalence and predictive risk factors of self-stigmatization in patients with rare diseases: Based on health ecology model.

BACKGROUND AND AIMS: Given the cause of self-stigmatization of patients with rare diseases is complicated, and the self-stigmatization can be prevented by managing the related risk factors. This study aimed to report the prevalence as well as influencing factors associated with self-stigmatization in patients with rare diseases. METHODS: From January to April 2022, the respondent-driven sampling (RDS) method was used to select patients with rare diseases through the Chinese Organization for Rare Disorders as the subjects. Based on the theoretical model of health ecology, logistic regression analysis was used to explore the association between self-stigmatization level and sample characteristics of patients with rare diseases. RESULTS: A total of 530 patients were included, 50.2% of whom were male, and most of them are under 45 years old (86.5%). The prevalence of self-stigmatization in patients with rare diseases was 85.7%. Logistic regression analysis indicated that age (OR: 0.624, 95% CI: [0.399, 0.976]), mental health status (OR: 0.184, 95% CI: [0.076, 0.445]), family relations (OR: 0.180, 95% CI: [0.074, 0.434]), full time work (OR: 2.835, 95% CI: [1.024, 7.849]) and medical insurance (OR: 0.296, 95% CI: [0.105, 0.835]) were risk factors for self-stigmatization of patients with rare diseases. CONCLUSIONS: Chinese patients with rare diseases have a high level of self-stigmatization, and the potential risk factors are multi-level and multi-dimensional.

Chronic pain increases the risk of motoric cognitive risk syndrome at 4 years of follow-up: evidence from the China Health and Retirement Longitudinal Study.

BACKGROUND AND PURPOSE: Slower gait speed and subjective cognitive concerns are characteristics of the motoric cognitive risk (MCR) syndrome. This study aimed to examine if changes in pain may be hallmarks of early MCR, through investigating the magnitude of the association of chronic pain and the risk of MCR at 4 years follow-up. METHODS: In total, 3711 participants without dementia or any mobility disability aged ≥60 years were studied, including 1413 with chronic pain, enrolled in the China Health and Retirement Longitudinal Study, a prospective cohort study. MCR assessed at wave 1 (2011) and wave 3 (2015) was used as the exposure. Cox regression analysis was used to examine the longitudinal association between chronic pain and MCR after adjusting for individual factors, behaviors/physiology factors and societal factors. Four years later, the incident MCR was evaluated. RESULTS: After adjusting for individual factors, chronic pain was found to increase the risk of MCR development over time by about 1.5 times (hazard ratio 1.562, 95% confidence interval 1.228-1.986; p < 0.001) and to be linked with incident MCR at baseline (odds ratio 1.397, 95% confidence interval 1.149-1.698; p < 0.001). These associations remained substantial when behaviors/physiology factors and societal factors were taken into account in the analytical models. CONCLUSIONS: The findings of our study imply that incident MCR may be exacerbated by chronic pain. Further exploration is required to find out whether chronic pain is a modifiable risk factor for MCR.

Association of polypharmacy and motoric cognitive risk syndrome in older adults: A 4-year longitudinal study in China.

BACKGROUND: Polypharmacy is related to motoric cognitive risk (MCR) syndrome is not fully understood. Therefore, our aim was to fill this gap in knowledge. METHODS: This population-based prospective longitudinal study used data from the China Health and Retirement Longitudinal Study. It included 3827 dementia-free older adults (age >60 years) who were followed from 2011 to 2015. Data on subjective cognitive complaints, walking speed, and polypharmacy were reported by the participants. The cross-sectional relationship between polypharmacy and the MCR at baseline was examined using multinomial logistic regression, and Cox regression will be used to analyze the impact of polypharmacy on MCR over a four-year period. RESULTS: At baseline, 492 (12.9%) participants had been diagnosed with MCR. With 4 years of follow-up, 304 (12.5%) were classified as having incident MCR. Controlling for microsystem factors, polypharmacy (OR: 1.273, 95 % CI: 1.051-1.541; p < .05) was associated with MCR at baseline and every unit increase in polypharmacy was linked to a 53.8% (HR:1.538, 95 % CI: 1.227-1.927; p < .001) increase more likely to developing incident MCR. They adjusted for meso/ exosystem and macrosystem factors, and these associations remained significant, coping resources are believed to have a role in the relationships between polypharmacy and MCR in older persons. CONCLUSION: Polypharmacy is significantly associated with MCR incidence during 4 years of follow-up in older adults. Future studies should independently confirm this observation for potentially bringing clinical benefits to older people with polypharmacy.

Longitudinal association between falls and motoric cognitive risk syndrome among community-dwelling older adults.

The motoric cognitive risk (MCR) syndrome is a predementia syndrome associated with dementia and mortality risk. This longitudinal study aimed to investigated the longitudinal association between MCR and falls in older adults, including 3,720 participants in the China Health and Retirement Longitudinal Study. A total of 482 participants (13.0%) met the MCR requirements at baseline. There were 226 incident cases of MCR (13.0%) throughout follow-up (duration: 4 years). Controlling for microsystem factors, a single fall (OR: 2.412, 95 % CI: 1.100-5.290; p < .05) was associated with incident MCR at baseline and to almost 2.0 times (HR: 2.021, 95 % CI: 1.031-3.961; p < .05) more inclined to develop MCR over time, compared to those without falls. These associations remained significant when meso/ exosystem factors and macrosystem factors were included in the analytic models. Falls may be useful in predicting MCR risk in the near future among Chinese older adults.

Pornography Consumption, Sexual Attitude, and Condomless Sex in China.

Studies have found that pornography consumption is associated with a higher likelihood of having condomless sex. Past research was primarily conducted with Western populations from developed countries. Consequently, less is known about sexual and reproductive health in developing countries and regions. A national sample of 11,957 university-level students was used to investigate the association between pornography consumption, sexual attitudes, and condomless sex. Our findings suggest that a higher frequency of pornography consumption is associated with an increased likelihood of having condomless sex and more positive attitudes toward premarital sex and one-night stand.

Factors influencing the acceptability of HIV/AIDS voluntary counselling and testing: a quantitative study of 41336 female university students in China.

This study shows that there is a huge gap between young females' willingness and practice of accepting voluntary counselling and testing (VCT). Only 2.16% (894/41336) of the participants have had HIV/AIDS tests. The study identified age, education major, confidentiality, attitude, accuracy, self-assessment and expense as major factors associated with young female people's acceptance of VCT in China. Therefore, in order to promote HIV VCT among young females, it is necessary for future programs to be sensitive to the targeted population's needs.