Changes in the prevalence of chronic disability in China: evidence from the China Health and Retirement Longitudinal Study

Liu, N; Cadilhac, Dominique A.; Kilkenny, Monique F; Liang, Yu

doi:10.1016/j.puhe.2020.03.032

Cited by 29 publications

(31 citation statements)

References 22 publications

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“…1 In China, we are currently experiencing accelerating population aging accompanied by increasing burden from functional impairment, which often leads to elevated risks for disability, economic burden, and poor quality of life. 7,9,69 Understanding functional impairment risks, especially in middle age and old age, has thus become indispensable for measuring future health needs and directing appropriate public health investments. We found in this study that the wider context inclusive of spouses is necessary to consider when studying health; however, the available interventions currently are generally aimed at JAMA Network Open | Public Health the affected person but pay little attention to family members.…”

Section: Discussionmentioning

confidence: 99%

Spousal Concordance in the Development of Functional Limitations Among Married Adults in China

Wang

Hou

et al. 2021

JAMA Netw Open

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IMPORTANCE Functional limitation is increasingly common as people age and is often associated with negative consequences. Evidence of the dynamics of functional limitation within couples in China is still inadequate.OBJECTIVES To examine whether functional limitation was associated within middle-aged and older couples and to explore sex differences in spousal associations. DESIGN, SETTING, AND PARTICIPANTSIn this nationwide, population-based cohort study performed from January 1, 2011, to December 31, 2018, participants were selected using multistage probability sampling, and 5207 community-dwelling couples (10 414 individuals) 45 years or older were included in the nationally representative China Health and Retirement Longitudinal Study. Data analysis was performed from January 1 to February 28, 2021. EXPOSURESThe exposure variable was the presence of functional limitation in spouses. Functional limitation was measured by the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) scales and was defined as having difficulty in independently performing at least 1 ADL or IADL item. MAIN OUTCOMES AND MEASURESThe main outcome was functional limitation in index participants. Multivariable logistic regression with generalized estimating equations was used to estimate the reciprocal association of functional limitation within couples over time. RESULTS A total of 5207 married, different-sex couples (mean [SD] age, 59.1 [8.8] years for husbands and 57.0 [8.2] years for wives) were included in the study. For husbands, the number (percentage) of participants classified with baseline functional limitation was 1140 (21.9%), the number (percentage) with ADL limitation was 684 (13.1%), and the number (percentage) with IADL limitation was 834 (16.0%). For wives, the number (percentage) of participants classified with baseline functional limitation was 1502 (28.8%), the number (percentage) with ADL limitation was 887 (17.0%), and the number (percentage) with IADL limitation was 1183 (22.7%). Longitudinal results demonstrated an association in spouses developing functional limitation (adjusted odds ratio[OR], 2.55; 95% CI, 2.41-2.69; P < .001), ADL limitation (adjusted OR, 2.26; 95% CI, 2.11-2.41; P < .001), and IADL limitation (adjusted OR, 2.58; 95% CI, 2.43-2.73; P < .001). Subgroup analyses by sex revealed similar patterns of spousal health concordance in terms of all studied outcomes, indicating no sex specificity. CONCLUSIONS AND RELEVANCE This population-based cohort study suggests that amongChinese middle-aged and older couples there is significant concordance in the development of functional limitation. This study of spousal functional ability from a dyadic perspective may help in (continued) Key Points Question Are spouses concordant in the development of functional limitation over time in middle and old age? Findings In this cohort study of 10 414 community-dwelling participants (5207 married, different-sex couples) 45 years or older in China, significant interdependent associations were ...

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Section: Discussionmentioning

confidence: 99%

Spousal Concordance in the Development of Functional Limitations Among Married Adults in China

Wang

Hou

et al. 2021

JAMA Netw Open

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“…Difficulty with ADL in the past 3 months was measured using the Barthel Index for ADL ( Wade and Collin, 1988 ; Liu N. et al, 2020 ). ADL information was collected with six questions about difficulty in dressing, bathing, eating, getting into or out of bed, using the toilet, and controlling urination and defecation.…”

Section: Methodsmentioning

confidence: 99%

“…ADL information was collected with six questions about difficulty in dressing, bathing, eating, getting into or out of bed, using the toilet, and controlling urination and defecation. Respondents were also asked whether they had any difficulty performing IADL ( Lawton and Brody, 1969 ; Liu N. et al, 2020 ), including doing household chores, preparing hot meals, shopping for groceries, making phone calls, taking medications, or managing money, in the past 3 months. Each item was scored from 1 (“don’t have any difficulty”) to 4 (“can’t do it”) points, with the highest score indicating the greatest symptom burden.…”

Section: Methodsmentioning

confidence: 99%

Depression and Life Satisfaction Among Middle-Aged and Older Adults: Mediation Effect of Functional Disability

Wang

Lin

et al. 2021

Front. Psychol.

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With increasing age, middle-aged and older persons face a series of physical and mental health problems. This study aimed to explore the latent relationships among age, functional disability, depression, and life satisfaction. The data were obtained from the Wave 2 (in 2013–2014) and Wave 3 (in 2015–2016) surveys of the China Health and Retirement Longitudinal Study. The analytic sample in the present study included 15,950 individuals aged 45 years and over. The participants answered the same questions concerning depression and life satisfaction in both study waves, and functional disability was measured based on the activities of daily living and instrumental activities of daily living. Age was directly associated with functional disability, life satisfaction, and depression. Functional disability was positively correlated with depression and negatively correlated with life satisfaction. Functional disability strongly mediated the relationships among age, depression, and life satisfaction. Depression and life satisfaction were found to have enduring effects and effects on each other. Additionally, the model revealed a gender difference. Depression in middle-aged people should receive closer attention. Avoiding or improving functional disability may be an effective way to improve life satisfaction and reduce the level of depression in middle-aged and older persons. If prevention work successfully decreases depression, the life dissatisfaction of middle-aged and older people could be improved. Additionally, for the prevention of functional disability and depression and improvement in life satisfaction, gender differences need to be considered.

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“…Regarding the increasing amount of alcohol use among middle-aged and older people in the past decades, our ndings add to the evidence on the detrimental effects of alcohol use (19,20), which can be used to inform public health strategies on alcohol control.…”

Section: Discussionmentioning

confidence: 66%

Association of alcohol use with memory decline in middle-aged and older Chinese: a longitudinal cohort study

Tian

Zhang

Jiang

et al. 2022

Preprint

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Background Previous studies on associations of alcohol use with memory decline and mild cognitive impairment (MCI) showed inconclusive results. We examined these associations using longitudinal data from the Guangzhou Biobank Cohort Study (GBCS) and explored whether these associations varied by sex. Methods Memory function was assessed by delayed 10-word recall test (DWRT) and immediate 10-word recall test (IWRT) at both baseline (2003–2008) and follow-up (2008–2012) examinations, expressed as the mean annual change and mean annual rate of change in scores. MCI was defined by DWRT score of less than 4. Generalized linear models and restricted cubic spline were used for data analysis. Results Of 14,827 participants without MCI at baseline, 90.2% were never or occasional drinkers, 5% moderate drinkers, 1.5% excessive drinkers, and 3.3% former drinkers. The mean (standard deviation) age was 60.6 (6.6) years old. During an average of 4.1 years follow-up, 968 (6.5%) participants developed MCI. After adjusting for confounders, compared with never or occasional drinkers, moderate and excessive drinkers had significant decline in DWRT score (β, 95% confidence interval (CI) = -0.04 (-0.08 to -0.01), and − 0.07 (-0.14 to 0.01), respectively), and IWRT score (β, 95% CI = -0.10 (-0.19 to -0.01), and − 0.15 (-0.30 to 0.01), respectively) annually. With respect to the mean annual rate of change, moderate and excessive drinkers also showed greater decline in DWRT score (β, 95% CI = -1.02% (-1.87% to -0.16%), and − 1.64% (-3.14% to -0.14%), respectively). The associations did not vary by sex (all p values for interaction ≥ 0.10). Conclusions Compared to never or occasional alcohol use, moderate and excessive alcohol users had greater memory decline, especially for immediate recall memory and the associations did not vary by sex.

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Changes in the prevalence of chronic disability in China: evidence from the China Health and Retirement Longitudinal Study

Cited by 29 publications

References 22 publications

Spousal Concordance in the Development of Functional Limitations Among Married Adults in China

Spousal Concordance in the Development of Functional Limitations Among Married Adults in China

Depression and Life Satisfaction Among Middle-Aged and Older Adults: Mediation Effect of Functional Disability

Association of alcohol use with memory decline in middle-aged and older Chinese: a longitudinal cohort study

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