We examined the controversial relationship between obesity and depression among Chinese people aged 45 and over using data from the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were measured using the CES-D 10; overweight and obesity were defined using WHO, Asian and Chinese criteria. The proportion of depressive symptoms was 19.9% and 33.2% in men and women, respectively. Depressive symptoms decreased as BMI increased in both men and women (P < 0.05). Obese women were less likely to suffer from depressive symptoms than normal weight women according to WHO, Asian and Chinese criteria (P < 0.05). Obese men were less likely to suffer from depressive symptoms than normal weight men under the Chinese criteria (P < 0.05). The results indicate that there is an inverse association between obesity and depressive symptoms among Chinese men and women, supporting the “jolly fat” hypothesis in China, and suggest that individuals and medical providers should pay attention to underweight as well as obesity. In addition, our study illustrates the importance of establishing appropriate obesity cut-off points for individual countries.

Hypertension usually coexists with other chronic conditions and can cause disability in relation to activities of daily living. We examined the association between the number and categories of comorbid conditions and disability affecting activities of daily living in hypertension patients.The data were collected from the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS), which contains information about chronic conditions and disability. Additionally, socio-demographic characteristics of 3754 hypertension patients aged 45 and older were included in this study. Comorbid conditions included dyslipidemia, stroke, and 12 other chronic conditions. Disability in relation to activities of daily living was assessed using the basic activities of daily living (BADL) and the instrumental activities of daily living (IADL) instruments. Differences in BADL/IADL disability among patients with different comorbid conditions were compared using the chi-square test, and the influence of chronic conditions and socio-demographic characteristics on BADL/IADL disability was analyzed using logistic models.Without considering the influence of specific chronic conditions on BADL/IADL, hypertension patients with additional comorbid conditions were more likely to suffer from BADL/IADL disability. When considering the effect of specific chronic conditions, the number of comorbid conditions did not significantly influence BADL/IADL disability. Dyslipidemia, chronic lung disease, stroke, memory-related diseases, and arthritis/rheumatism were associated with BADL disability. Chronic lung diseases, heart diseases, stroke, stomach/digestive system diseases, emotional/nervous/psychiatric problems, memory-related diseases, arthritis/rheumatism, and asthma were associated with IADL disability. Additionally, female, people with lower education level, people living in village, and people living in middle and western China were more likely suffer from BADL/IADL disability.Comorbid conditions were associated with disability in activities of daily living in hypertension patients aged 45 and older. The specific comorbid conditions had a stronger effect on disability in activities of daily living than the number of comorbid conditions. In addition, we should pay attention to socioeconomic factors related to disability.

Background. Information on the risks of herpes zoster (zoster) preceding a cancer diagnosis and the role of cancer treatment on risk is limited. Methods. This was a prospective cohort of 241497 adults, with mean age 62.0 years at recruitment (2006-2009), linked to health datasets from 2006 to 2015. The relation between cancer diagnosis, treatment, and zoster risk was analyzed using time-varying proportional hazards models. Results. Over 1760 481 person-years of follow-up, 20 286 new cancer diagnoses and 16 350 zoster events occurred. Participants with hematological and solid cancer had higher relative risks of zoster than those without cancer (adjusted hazard ratio [aHR], 3.74 [95% confidence interval {CI}, 3.11-4.51] and 1.30 [95% CI, 1.21-1.40], respectively). Compared to those without cancer, zoster risk was also elevated prior to a hematological cancer diagnosis (aHR for 1-2 years prior, 2.01 [95% CI, 1.31-3.09]), but this was not the case for solid cancers (aHR for 1-2 years prior, 0.90 [95% CI, .75-1.07]). Compared to those without cancer, zoster risk among participants with solid cancers receiving chemotherapy was greater than in those without a chemotherapy record (aHR, 1.83 [95% CI, 1.60-2.09] and 1.16 [95% CI, 1.06-1.26], respectively). Conclusions. For hematological cancer, increases in zoster risk are apparent in the 2 years preceding diagnosis and treatment; for solid organ cancers, the increased risk appears to be largely associated with receipt of chemotherapy.