Prevalence of falls, injury from falls and associations with chronic diseases among community-dwelling older adults in Guangzhou, China: a cross-sectional study.

Introduction: As a developing country with the largest older adult population in the world, strengthening the research on falls among the older adults is undoubtedly an urgent item in China. This study aimed to explore the prevalence and risk factors associated with falls and injury from falls among community-dwelling older adults in Guangzhou, China, particularly focusing on their associations with chronic diseases. Methods: A total of 1,629 participants aged 65 years and above were selected from 11 counties in Guangzhou by the multi-stage stratified random sampling method in 2021. Socio-demographic characteristics, health and lifestyle factors, the status of falls, and injury from falls were measured by structured questionnaires through face-to-face interviews. Chi-square tests and logistic regression analysis were used to identify factors associated with falls and injury from falls. Chord diagrams were used to explore their associations with chronic diseases. Results: A total of 251 participants (15.41%, 95% CI: 13.98%-17.25%) reported falls, and 162 participants (9.46%, 95% CI:7.72%-11.55%) indicated an injury from falls. Logistic regression analysis showed the results as follows: female patients (adjusted OR = 1.721, 95% CI: 1.681-1.761) aged ≥80 years (1.910, 1.847-1.975), unemployed (1.226, 1.171-1.284), uninsured (1.555, 1.448-1.671), average monthly household income of 2,001-4,000 CNY (1.878, 1.827-1.930), number of services provided by the community health center ≥13 times per year (1.428, 1.383-1.475), illness within 2 weeks (1.633, 1.595-1.672), high-intensity physical activity (2.254, 2.191-2.32), sedentary (1.094, 1.070-1.117), and number of chronic disease illnesses ≥3 (1.930, 1.870-1.993). Meanwhile, those risk factors were also associated with injury from falls. The older adults with medium-intensity physical activity were at lower risk (0.721, 0.705-0.737) of falls and higher risk (1.086, 1.057-1.117) of being injured from falls. Chord diagrams showed the correlations between chronic diseases and falls and injury from falls among community-dwelling older adults in Guangzhou, China. Conclusion: The high prevalence of falls is found among community-dwelling older adults in Guangzhou, China, which is related to multiple factors such as demographic variables, lifestyle, and health status, especially for chronic diseases. Therefore, targeted interventions should be developed and implemented urgently.

Key Social Determinants to Narrow the Gap between Health-adjusted Life Expectancy and Life Expectancy in Megacities.

Objective: Improvement in the quality of life is reflected in the narrowing of the gap between health-adjusted life expectancy (HALE) and life expectancy (LE). The effect of megacity expansion on narrowing the gap is rarely reported. This study aimed to disclose this potential relationship. Methods: Annual life tables were constructed from identified death records and population counts from multiple administrative sources in Guangzhou, China, from 2010 to 2020. Joinpoint regression was used to evaluate the temporal trend. Generalized principal component analysis and multilevel models were applied to examine the county-level association between the gap and social determinants. Results: Although LE and HALE in megacities are increasing steadily, their gap is widening. Socio-economic and health services are guaranteed to narrow this gap. Increasing personal wealth, a growing number of newborns and healthy immigrants, high urbanization, and healthy aging have helped in narrowing this gap. Conclusion: In megacities, parallel LE and HALE growth should be highly considered to narrow their gap. Multiple social determinants need to be integrated as a whole to formulate public health plans.

Association between meteorological factors and elderly falls in injury surveillance from 2014 to 2018 in Guangzhou, China.

Introduction: With rapid increase in the aging population, falls injuries have become an important public health problem. However, limited data have been reported on the associations between meteorological factors and falls injuries in the elderly. This study assessed the epidemiology of falls injuries and explored this association in the elderly in Guangzhou, China. Methods: Data on elderly falls injury cases and meteorological variables from 2014 to 2018 in Guangzhou were collected from the Guangzhou Injury Monitoring System and Guangzhou Meteorological Bureau, respectively. The monthly average data on falls injuries and meteorological factors were applied to the data analysis. These correlations were conducted using Pearson correlation analysis. A multiple linear regression model was used to estimate the effects of meteorological factors on falls injuries in the elderly in Guangzhou, China. Results: Accounting for 49.41% of causes of elderly injury were falls in the Guangzhou Injury Monitoring System from 2014 to 2018, which occupied first place for five consecutive years. The monthly number of elderly falls injury cases was lowest in April and highest in December, and had a positive correlation with monthly mean wind speed (r = 0.187, P < 0.01) and a negative correlation with monthly atmospheric pressure (r = -0.142, P < 0.05). A multiple linear regression model was constructed (F = 10.176, P < 0.01), which explained 23.7% of the variances (R 2 = 0.237). Monthly mean wind speed (ß = 76.85, P < 0.01) and monthly mean atmospheric pressure (ß = -3.162, P < 0.01) were independent factors affecting monthly elderly falls injuries. Conclusions: Falls are the primary cause of injury among elderly people in Guangzhou, China. Meteorological factors are related to falls injuries in the elderly population. Decreasing activity during high wind and low atmospheric pressure weather may help reduce the number of elderly falls injury cases.

Demographic and clinical characteristics of resectable hepatocellular carcinoma in China and Japan.

BACKGROUND/AIMS: To describe and compare the demographic and clinical characteristics of hepatocellular carcinoma (HCC) patients subject to surgical operation at two referral centers in China and Japan. METHODOLOGY: Information on surgical HCC patients was retrieved from medical records. All patients were subjected to regular follow-up. The characteristics of HCC cases from two countries were described and compared. RESULTS: A total of 353 newly diagnosed cases subject to surgical resection for HCC from 1995 to 1999 were analyzed in China and Japan. Differences were noted in the demographic and clinical characteristics of HCC patients between the two countries, such as average age of incidence, history of blood transfusion, serum examination, and history of hepatic viral infection. Statistical analysis also indicated differences in surgical systematic anatomical resection (p < 0.001), liver cirrhosis (p < 0.05), tumor diameter, and distant metastases (p < 0.001). The Chinese patients in early TNM stage I showed poorer outcomes in terms of cumulative survival in comparison with Japanese patients (p < 0.001). CONCLUSIONS: HCC patients in Japan were diagnosed earlier, subject to more standard treatment, and had better prognosis. Examination with a larger population and more clinical data, including repeated treatment for recurrent HCC, will be required to provide a more accurate assessment of HCC in the two countries.

[Analysis of hepatitis virus infection in hepatocellular carcinoma patients receiving surgical operation in China and Japan].

OBJECTIVE: To describe and compare the hepatitis virus infection in hepatocellular carcinoma (HCC) patients receiving surgical operation in China and Japan. METHODS: Information of surgical HCC patients was retrieved from the medical records. The concerned characteristics of the HCC cases from two countries were described and compared. RESULTS: A total of 425 diagnosed cases that underwent surgical resection for HCC in China were investigated, and the corresponding cases in Japan were 247. The proportion of the hepatitis virus infection was 75.53% in patients with HCC from China. Within the infection cases, 91.28% were positive for HBsAg but negative for anti-HCV. The proportion was 82.59% in patients with HCC from Japan. Within the infection cases, 77.94% were positive for anti-HCV but negative for HBsAg. The proportion of hepatocirrhosis in the hepatitis virus infection patients with HCC were 89.10% and 68.14% in China and Japan, respectively. CONCLUSION: The hepatitis B virus infection showed be a main cause of HCC in China, however, the HCC in Japan be mostly related to hepatitis C virus infection.

[A study on acquired immune deficiency syndrome related behaviors in male clients of female sex workers].

OBJECTIVE: To study the socio-demographic characteristics, acquired immune deficiency syndrome (AIDS) related behaviors of male clients of female sex workers and their determinants. METHODS: Contacting subjects through 5 ways including volunteers of female sex workers (FSWs), sexually transmitted disease (STD) clinics, long-distance bus stations, long-distance cargo station while adopting methods as snowballing, employing an anonymous questionnaire. Data was analyzed by logistic regression analysis. RESULTS: (1) The majority of clients were 25-45 years old, married and of junior high school or above educational levels; (2) Among male clients of FSWs, numbers of having had commercial sexual intercourse was between 1 to 240, averaged 24 in the previous year. It significantly related to their occupation and the experience of their friends or colleagues who ever visited female sex workers; (3) 27.98% of them used condom every time during commercial sexual intercourse, which significantly related to the score of knowledge on AIDS, concourse of sex intercourse and inhabitation; (4) 28.36% of them had ever contracted STD, which significantly related to the frequency of commercial sexual intercourse in the previous year, risk awareness of being infected with human immunodeficiency virus, and frequency of condom use during commercial sexual intercourse. CONCLUSION: The proportion of always using condom was low among male clients of FSWs, and had had STDs. And it's necessary for active and specific intervention programs to them.

[A study on the estimation of the size of male homosexual population].

OBJECTIVE: To study the practical survey method on estimating the size of male homosexual population. METHODS: Nine male homosexual gathering spots were selected and three methods as division method, capture-mark-recapture method and multiplier method were applied in counting the numbers of homosexual men in one city in Sichuan province. RESULTS: Number of counting through division method was 877 and the three numbers through capture-mark-recapture method were 1408, 1207 and 949 respectively. However, appropriate data was not obtained by multiplier method. CONCLUSIONS: Division method was easy to operate with its high credibility, but costly. Capture-mark-recapture method was less costly less both in capital and time, and the results could be testified to each other. Multiplier method should be modified before applied to obtain reliable information.