Association between multimorbidity and falls and fear of falling among older adults in eastern China: a cross-sectional study.

Background: Growing evidence has reported an association between multimorbidity and falls and fear of falling (FOF) in older adults, however, the results regarding this association from China are limited. Our study aimed to investigate the association between multimorbidity and falls and FOF in older adults in eastern China. Methods: We conducted a cross-sectional study in Zhejiang Province, Eastern China, which recruited a provincial representative sample of adults aged ≥ 60 years. A structured questionnaire including demographic characteristics, chronic diseases, history of falls in the past 12 months, and FOF, was administered by all participants. The exposure variable was multimorbidity, which was defined as the presence of two or more chronic diseases and medical conditions in the same individual. The outcomes included a history of falls and FOF. Multivariate logistic regression was used to evaluate the association between multimorbidity and falls and FOF in older adults. Results: In total of 7,774 participants were included in the analysis, among whom 3,898 (50.1%) were female, with a mean ± standard deviation age is 72.9 ± 8.4 years. Multimorbidity was associated with the increased risk of falling in older adults [adjusted odds ratio (OR), 1.99; 95% confidence interval (CI):1.55-2.36]. The ORs for having experienced single fall and repeated falls were 1.85 (95% CI: 1.42-2.42) and 3.45 (95% CI: 1.47-6.97), respectively, with multimorbidity compared with those without chronic diseases. The older adults with multimorbidity were more likely to report FOF compared with those without chronic diseases (adjusted OR, 1.49; 95%CI:1.30-1.70). Moreover, the association between multimorbidity and FOF remained significant in the older adults with a history of fall (OR, 1.57; 95%CI:1.04-2.38). Conclusion: The association between multimorbidity and falls and FOF is significant in the Chinese population and the effects of multimorbidity on falls and FOF do not vary according to the frequency and history of falls in older adults.

Healthy lifestyle and the risk of conventional adenomas and serrated polyps: Findings from a large colonoscopy screening population.

Evidence on the link between healthy lifestyle and colorectal cancer (CRC) precursors is limited. Our study aimed to examine and compare the associations of healthy lifestyle with CRC precursors in adenoma (AD)-carcinoma and serrated pathways. A total of 24 480 participants including 6309 ADs, 1343 serrated polyps (SPs), and 16 828 polyp-free controls were included. A healthy lifestyle score (HLS) was constructed based on five lifestyle factors including cigarette smoking, alcohol drinking, physical activity, diet and body weight, and categorized into least, slightly, moderately and most healthy. Multivariable logistic regressions were used to estimate odds ratio (OR) and 95% confidence interval (CI). Inverse dose-response associations between the HLS and risk of ADs were observed (OR per 1 score increment for ADs: 0.82 [95% CI 0.79-0.84]; for SPs: 0.73 [95% CI 0.69-0.78]), and the association with SPs was more evident than with ADs (OR 0.90, 95% CI 0.85-0.96). Compared to participants with the least healthy lifestyle, those with the most healthy lifestyle had 47% lower risk of ADs (OR 0.53, 95% CI 0.47-0.59) and 70% lower risk of SPs (OR 0.30, 95% CI 0.23-0.39), respectively. These inverse associations were consistent across lesion stage and anatomic subsite and not modified by any stratification factors. The risk advancement periods for the most vs the least healthy lifestyle were -9.49 years for ADs and -20.69 years for SPs. Our findings help confirm the preventive role of healthy lifestyle in colorectal carcinogenesis.

Worldwide trends in cervical cancer incidence and mortality, with predictions for the next 15 years.

BACKGROUND: Cervical cancer is 1 of the most common cancers in females worldwide. Understanding the most recent global patterns and temporal trends of cervical cancer burden might be helpful for its prevention and control. METHODS: Data on cervical cancer (International Classification of Diseases, Tenth Revision, code C53) incidence and mortality in 2018 were extracted from the GLOBOCAN 2018 database and further analyzed for their correlations with the Human Development Index. Temporal trends were analyzed using the annual percent change with joinpoint analysis among 31 countries with highly qualified data from the Cancer Incidence in Five Continents Plus and World Health Organization mortality databases. Future trends for the next 15 years were predicted using an open-source age-period-cohort model. RESULTS: Cervical cancer incidence and mortality rates were both negatively correlated with the Human Development Index (r = -0.56 for incidence, r = -0.69 for mortality; P < .001) in cross-sectional analysis, and both remained stable in 12 countries or even decreased in 14 and 18 countries for incidence and mortality, respectively, during the most recent 10 data years. Similar findings were observed for the next 15 years. CONCLUSIONS: Cervical cancer burden was correlated with socioeconomic development. An overwhelming majority of countries had stable or decreasing trends in incidence and mortality rates, especially in those with effective cervical cancer screening programs and human papillomavirus vaccination. LAY SUMMARY: The authors investigated the most up-to-date data from official databases released by the International Agency for Research on Cancer and found that cervical cancer incidence and mortality were negatively correlated with socioeconomic development. Among the 31 countries analyzed, most (26 countries were analyzed for incidence, and 30 were analyzed for mortality) had stable or even decreasing temporal trends over the most recent 10 years, especially in those with effective cervical cancer screening programs. In addition, the predicted trends for the next 15 years were basically consistent with the observed trends among most of the analyzed countries (19 countries for incidence and 26 countries for mortality).

Association between social health status and health-related quality of life among community-dwelling elderly in Zhejiang.

BACKGROUND: Population aging is an inevitable trend and previous studies have showed the relationship between social health related factors and health-related quality of life (HR-QOL) in the elderly. The objective of this study is to investigate the association of social health status with HR-QOL among community-dwelling elderly in Zhejiang. METHODS: This cross-sectional study was based on community-dwelling elderly individuals from July 2018 to September 2018 in Zhejiang, China. HR-QOL was measured by the 12-item Short-Form Health Survey (SF-12). Social health status was estimated by the long-form of the Social Health Scale for the Elderly (SHSE-L) and classified into three categories (poor, moderate and good). Multivariable linear regression models were conducted to evaluate the association between social health status and HR-QOL (PCS, MCS and SF-12 total score). RESULTS: A total of 2952 elderly participants were included in this study. The mean age was 70.68 ± 7.75 years (mean ± SD); of the eligible participants, more than half (50.4%) were females; the mean scores were 48.10 ± 8.49, 47.70 ± 7.09 and 47.90 ± 5.86 for PCS, MCS and SF-12 total score, separately. Results from the multivariable models showed that social health status was positively related to HR-QOL after adjusting for covariates. Compared with individuals with a poor social health status, those who had a moderate or good social health status were more likely to report better HR-QOL (for moderate social health status: ß = 1.90(95%CI: 1.09, 2.71) for PCS, ß = 1.78(1.08, 2.48) for MCS, ß = 1.84(1.29, 2.39) for SF-12 total score; for good social health status: ß = 3.29(2.24, 4.34) for PCS, ß = 3.10(2.12, 4.01) for MCS, ß = 3.20(2.48, 3.91) for SF-12 total score). CONCLUSION: In our study, we found that social health status was positively associated with HR-QOL among the elderly in Zhejiang. Our findings could provide valuable information for decision-makers to develop interventions to improve the HR-QOL of the elderly.

Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China.

OBJECTIVE: Mental disorders of the elderly population in China deserve attention. Social health is significantly associated with depression. This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults. METHODS: We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province, China. Face-to-face interviews were used to complete a structured questionnaire for all participants. We used the Social Health Scale for the Elderly (SHSE) to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms. Multivariate logistic regression was used to evaluate the association between social health status and depressive symptoms. RESULTS: Of the total of 3757 participants included, 1887 (50.23%) were female, and the mean±standard deviation (SD) age was (70.0±8.3) years. The rate of depressive symptoms was 25.92%. The social health score was higher in non-depressed participants than in depressed participants (raw score 50.7 vs. 48.3, P<0.001). Participants with "moderate" or "good" social health had a significantly lower risk of depressive symptoms than those with "poor" social health (odds ratio (OR)=0.55, 95% confidence interval (CI): 0.46-0.66 for moderate social health; OR=0.45, 95% CI: 0.35-0.60 for good social health). The association between social health and depressive symptoms was consistent across several subgroups. CONCLUSIONS: Social health is significantly inversely associated with depressive symptoms. The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits, but systematic assessment to guide intervention merits further investigation.

The Blood Levels of Trace Elements Are Lower in Children With Tic Disorder: Results From a Retrospective Study.

Background: Tic disorders (TD) are common neuropsychiatric disorders among children and adolescents. It is controversial that trace elements may participate in the pathogenesis of TD. Our study aimed to investigate the trace elements status of zinc (Zn), copper (Cu), iron (Fe), and magnesium (Mg) in children with TD, in comparison to healthy controls. Methods: The medical records of eligible TD children and normal healthy children from January 1 to December 31, 2018 in the outpatient clinic were retrospectively reviewed. The clinical information of all subjects were collected including age, gender, diagnosis, previous health records, and serum trace elements level (Cu, Zn, Fe, Mg) at the time of diagnosis before initiating treatment. Results: In total, 1204 TD children (7.63 ± 2.45 years) and 1,220 healthy children (7.27 ± 3.15 years) who were divided into two gender and three age groups (2-4years, 5-9years, ≥10 years) were reviewed in our study. Our study showed that TD children generally had lower whole blood levels of Zn, Cu, Fe than the normal controls (P < 0.01). No significant difference was observed in whole blood levels of Mg. After adjusting for gender, the trends still remained. Further analysis was performed according to age, the trends still remained in Zn and Fe in all age groups (P < 0.05). However, we observed an almost significantly (P = 0.055) lower level of Cu in TD of 2-4 years group while significant differences in other two groups (P < 0.01). Further multiple linear regression and point biserial correlation showed that the lower blood levels of Zn, Cu, and Fe were correlated with the incidence of TD. Conclusion: The present results indicated that lower blood levels of zinc, iron, copper were associated with TD. Trace elements may be used as an auxiliary treatment for TD and need to be further explored.

Association Between Multimorbidity and Depressive Symptom Among Community-Dwelling Elders in Eastern China.

PURPOSE: This study aimed to investigate the prevalence of depressive symptoms and the association between multimorbidity and depressive symptoms among the elderly in eastern China. PATIENTS AND METHODS: A multicenter cross-sectional study was conducted in four cities (Jianggan, Yiwu and Anji in Zhejiang Province and Taixing in Jiangsu Province) in eastern China. We collected the information on 27 chronic conditions through the self-reported medical history and used the Geriatric Depression Scale (GDS) short form to evaluate depressive symptoms. Multivariate Logistic regression was used to evaluate the relationship between multimorbidity and depressive symptoms. RESULTS: Five thousand two hundred and ninety-six participants were included into the current study, among which 2687 (50.74%) were female, with the mean ± SD age 72.0 ± 8.1 years old. The overall prevalence of depressive symptoms in eastern China was 23.5%. And the percentage of multimorbidity in depressed participants was higher compared with non-depressed participants (50.8% vs 38.8%, P<0.001). The univariate model and adjusted model suggested that participants with multiple chronic diseases were more likely to have a depressive symptom (adjusted OR=1.42; 95% CIs 1.19-1.70). CONCLUSION: Depressive symptom was significantly associated with multimorbidity among the community-dwelling elderly population in eastern China.