Less exercise and more TV: leisure-time physical activity trends of Shanghai elders, 1998-2008.

BACKGROUND: Surveillance of physical activity trends in older adults is limited in developing nations. This study examined 10-year leisure-time physical activity trends of elderly residents of Shanghai, the largest Chinese city with the nation's highest proportion of senior citizens. METHODS: The study used panel data from the Shanghai Longitudinal Survey of Elderly Life and Opinion (1998, 2003, 2005 and 2008). Leisure-time physical activity questions included (i) 16 major leisure-time habitual activities and (ii) regular exercise in the previous 6 months. RESULTS: In comparison to 1998, for Shanghai elders, the trend for engaging in leisure-time habits not related to physical activity increased over time, becoming statistically significant in 2005 and 2008 (e.g. OR for watching TV in 2003, 2005 and 2008 is 1.04 [0.91, 1.19], 1.17 [1.00, 1.38] and 1.78 [1.51, 2.09], respectively). Simultaneously, the trend for engaging in regular exercise declined significantly in each observation year in comparison to 1998 (OR in 2003, 2005 and 2008 is 0.70 [0.61, 0.80], 0.36 [0.30, 0.42] and 0.28 [0.24, 0.33], respectively). Discussion An increasingly sedentary lifestyle has evolved over the past decade in Shanghai. This highlights a need for public health agencies to develop effective active lifestyle interventions and physical activity promotion programs for local elders.

Leisure participation and subjective well-being: Exploring gender differences among elderly in Shanghai, China.

OBJECTIVES: To explore the association between leisure participation and subjective well-being and the role gender in this issue among elderly Chinese in Shanghai, China. METHODS: Principal components analysis and logistic regressions are used to analyze the cross-sectional data of the 2013 Shanghai Elderly Life and Opinion Survey that contains 2884 respondents (60+ with a mean age of 72.6) recruited from a multistage cluster sampling design. Subjective well-being is measured by happiness and life satisfaction, and leisure participation is examined by the type and diversity of leisure activities. RESULTS: Principal components analysis identifies four major types of leisure activity that elderly Chinese are actively engaged in-detachment-recovery, aesthetic, social, and performing-arts activities. Among them, social activities and performing-arts activities have the most relevance to subjective well-being. Females are more likely to engage in social and performing-arts activities whereas males are more likely to engage in detachment-recovery and aesthetic activities. Performing-arts activities promote subjective well-being only for females. Social activities are beneficial for both gender groups, but more so for males than for females. While increased levels of leisure diversity are linearly related to increased odds of subjective well-being for females, moderate level of leisure diversity is found to be the most important for males. CONCLUSIONS: Leisure participation is positively related to subjective well-being among elderly Chinese, and thus could play a critical role in promoting healthy aging. The major gender differences as observed suggest the need to further explore gender-specific barriers in leisure participation.

Validating a Scale of Health Beliefs in Preventive Health Screenings Among Chinese Older Adults.

We aimed to examine the psychometric properties of a modified 16-item Attitudinal Index (AI), a measure of Chinese older adults' beliefs about preventive health screenings. We used the 2013 Shanghai Elderly Life and Opinion data including 3,418 respondents age 60+ who were randomly split into training and validation samples. We examined the validity and reliability of the modified AI. Psychometric evaluation of the modified AI revealed good response patterns. The overall scale had good reliability (Cronbach's α = .835). Exploratory factor analysis yielded four factors: barriers, fatalism, unnecessary, and detects (Cronbach's α = .815-.908). Confirmatory factor analysis of the modified AI's factor structure verified its four-factor structure (comparative fit index = 0.913, standardized root mean square residual = 0.048). The validity and reliability of the modified AI support its cultural appropriateness in measuring health beliefs among Chinese elderly. Further psychometric evaluation should focus on testing concurrent and criterion validity.

Concordance and Discordance of Self-Rated and Researcher-Measured Successful Aging: Subtypes and Associated Factors.

OBJECTIVES: To investigate subtypes of successful aging (SA) based on concordance and discordance between self-rated and researcher-defined measures and their associations with demographic, psychosocial, and life satisfaction factors. METHOD: We used multinomial logistic regression models to analyze 2013 cross-sectional survey data from 1,962 persons aged 65 and older in Shanghai that measured self-rated successful aging (SSA) with a single global assessment and researcher-defined successful aging (RSA) with a cumulative deficit index reflecting physical, physiological, cognitive, psychological, and social engagement domains. We generated four subtypes based on these two dichotomous variables: nonsuccessful aging (non-SA; meeting neither the criterion of RSA nor the criterion of SSA), RSA-only (meeting the criterion of RSA-only but not the criterion of SSA), SSA-only (meeting the criterion of SSA-only but not the criterion of RSA), and both-successful aging (both-SA; meeting both criteria of RSA and SSA). RESULTS: In the sample, 32% were nonsuccessful agers, 7% RSA-only, 34% SSA-only, and 27% successful agers. Female gender and older age were associated with lower likelihood of RSA-only and both-SA relative to non-SA, but with greater likelihood of SSA-only. Good socioeconomic conditions and social networks were associated with greater likelihood of SSA-only and both-SA relative to non-SA or RSA-only. Satisfaction with life domains was robustly and positively associated with good successful aging outcomes. DISCUSSION: Researcher-defined successful aging and self-rated successful aging are different measures with distinct social correlates. Subtypes of concordance and discordance provide a more holistic biopsychosocial conceptualization of successful aging.

Self-Rated Health, Interviewer-Rated Health, and Their Predictive Powers on Mortality in Old Age.

OBJECTIVES: This study examines the potential use of interviewer-rated health (IRH) as a complementary measure of self-rated health (SRH) through a systematic comparison of their components and mortality-predictive powers in the Chinese elderly population. METHODS: This study used a nationwide dataset with more than 12,000 adults aged 65 or older drawn from the 2005 and 2008 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS). RESULTS: Disability, cognitive function, chronic disease conditions, psychological well-being, and health behaviors influenced both the SRH and IRH of Chinese older adults; these factors, especially disabilities, explained a large portion of the association between SRH and mortality. However, the impact of these factors on the association between IRH and mortality was limited. Furthermore, when both SRH and IRH were included in the analytical models, the association between SRH and mortality disappeared, while the association between IRH and mortality still persisted. DISCUSSION: Although there is some difference between IRH and SRH, IRH captures similar health information as SRH and is strongly predictive of mortality independent of SRH; thus, IRH could be a good supplementary measurement for well-adopted SRH.

Social Engagement and Health: Findings From the 2013 Survey of the Shanghai Elderly Life and Opinion.

What are the social factors that matter most to the health of elderly Chinese? Are there any gender and age differences? Using a representative sample of elderly Chinese in Shanghai, the most developed city in China with the nation's largest proportion of elderly residents, this study found that economic conditions, chronic health status, living arrangements, social activity participation, and caring for grandchildren are factors that are most important to the health of elderly Chinese. This is true for both self-rated health and psychological well-being. The beneficial effects of participation in social activities are particularly salient for elderly women and for the old-old, whereas the salutary effects of caring for grandchildren are more substantial for elderly men and for the young-old. Our findings suggest the importance of social engagement in promoting health and successful aging of elderly Chinese and disclose the moderating roles of gender and age in this focal relationship.

Expression of MTLC gene in gastric carcinoma.

AIM: To investigate the expression of c-myc target from laryngeal cancer cells (MTLC) gene in gastric carcinoma (GC) tissues and the effect of MTLC over-expression on gastric carcinoma cell line BGC823. METHODS: RT-PCR was performed to determine the expression of MTLC mRNA in GC and matched control tissues. BGC823 cells were transfected with an expression vector pcDNA3.1-MTLC by liposome and screened by G418. Growth of cells expressing MTLC was observed daily by manual counting. Apoptotic cells were determined by TdT-mediated dUTP nick-end labeling (TUNEL) assay. RESULTS: The expression of MTLC mRNAs was down-regulated in 9(60%) of 15 cases of GC tissues. The growth rates of the BGC823 cells expressing MTLC were indistinguishable from that of control cells. A marked acceleration of apoptosis was observed in MTLC-expressing cells. CONCLUSION: MTLC was down-regulated in the majority of GC tissues and could promote apoptosis of GC cell lines, which suggests that MTLC may play an important role in the carcinogenesis of gastric carcinoma.

Trends in ADL and IADL disability in community-dwelling older adults in Shanghai, China, 1998-2008.

OBJECTIVES: We investigated trends in activities of daily living (ADL) and instrumental activities of daily living (IADL) disability from 1998 to 2008 among elder adults in Shanghai, China. METHOD: Our data came from 4 waves of the Shanghai Longitudinal Survey of Elderly Life and Opinion (1998, 2003, 2005, and 2008). ADL and IADL disabilities were recorded dichotomously (difficulty vs. no difficulty). The major independent variable was survey year. Covariates included demographics, socioeconomic conditions, family and social support, and other health conditions. Nested random-effect models were applied to estimate trends over time, referenced to 1998. RESULTS: In comparison with the baseline year (1998), older adults in 2008 had lower odds of being ADL disabled, though the effect was no longer statistically significant when other health conditions were taken into account. Elders in 2003, 2005, and 2008 were 20%-26%, 17%-38%, and 53%-64% less likely to be IADL disabled than those in 1998, respectively, depending on the set of covariates included in the model. DISCUSSION: Shanghai elders experienced substantial improvements in both ADL and IADL disability prevalence over the past decade. The trend toward improvement in IADL function is more consistent and substantial than that of ADL function.