Abstract

Introduction: Multimorbidity burden is likely to vary across China, but relevant evidence is insufficient. The extent to which individual and provincial factors may affect spatial variations of multimorbidity has not been fully examined. This study aims to estimate the provincial multimorbidity burden among Chinese aged 45 and older, identifying which risk factors remain constant and which vary across China.

Abstract

Background: Cognitive impairment and frailty are prevalent in older adults, yet their longitudinal interplay and determinants remain underexplored, particularly in Chinese populations. This study aims to characterize the trajectories of cognitive function and frailty, examine their bidirectional associations, and identify the risk factors driving their progression.

Abstract

Objectives

To address the rising burden of dementia, China has prioritized the integration of cognitive care frameworks within primary care (PC). However, a functional gap persists: while screening has expanded, subsequent clinical management remains fragmented. This study investigates the structural and behavioral discontinuity contributing to the post-screening care gap in community-based geriatric care.

Abstract

BACKGROUND: Couple-based collaborative management (CCMM) has shown promise in supporting chronic disease self-management among older adults and addressing the growing public health burden, but its integration into primary care remains uncertain. This study explored primary care providers’ (PCPs) perceptions of CCMM using normalization process theory (NPT) to identify key factors influencing its routine implementation.

Abstract

BACKGROUND: Dementia, cardiovascular disease (CVD), and functional impairment (FI) often co-occur in aging populations, with abdominal obesity as a shared modifiable risk factor. The long-term impact of abdominal obesity on these comorbidities is unclear. We projected the 30-year burden of dementia, FI, and CVD in China under different trajectories of abdominal obesity prevalence.

摘要

目的

探讨应用数智化认知训练对延缓社区老年轻度认知障碍（MCI）患者认知功能下降的效果。

方法

纳入 60 例老年 MCI 患者作为研究对象，随机分为对照组 30 例，干预组 30 例。对照组接受辖区社工站的志愿者服务和社区卫生服务中心提供的常规护理和健康教育服务；干预组在对照组的基础上增加认知训练强化课程和为期 12 周（90min/周）的数智 化认知训练。 干预 12 周后，采用协方差分析评估干预组相较对照组对于改善认知功能的效果，并分析依从性与认知功能改善的相关性。

结果

采用协方差分析控制混杂因素后，干预12周的结果显示：干预组的MMSE评分显著高于对照组，调整后差值为3.21（95%CI：1.60～4.73，P<0.001，而AD8评分显著低于对照组，调整后差值为-0.72（95%CI：-1.10～-0.33，P=0.001）。非参数敏感性分析进一步证实，干预12周后干预组MMSE评分的提升幅度和AD8评分的下降幅度均大于对照组（均P<0.05）。组内前后比较分析表明，干预组在干预12周后MMSE评分较干预前显著提升（P<0.001）、AD8评分较干预前显著下降（P<0.001），而对照组干预前后两项评分均无显著变化（P>0.05）。此外，训练总时长和训练达标周数与MMSE评分的干预前后差值均呈显著正相关（P<0.05）。

结论

应用数智化认知训练系统进行认知训练能有效提高社区老年 MCI 患者的认知能力，且训练依从性越高，认知功能改善越显著。 该训练有利于老年人养成脑健康理念，值得在社区医疗机构进一步推广。

关键词: 

数智化认知训练；社区老年人；轻度认知障碍；认知功能；干预效果

Abstract

Anxiety and insomnia are correlated in older adults and their caregivers, yet the moderating role of mental health literacy (MHL) is unclear. This study aimed to explore dyadic effects of anxiety on insomnia among Chinese chronically ill older adults and family caregivers across age groups and whether MHL moderates these effects. Data came from 1033 dyads of older adults and their family caregivers in China through the Guangdong Mental Health Survey. Anxiety was assessed with the Generalized Anxiety Disorder-7, insomnia with the Insomnia Severity Index, and MHL with the Chinese National Mental Health Literacy Scale (consisting of mental health knowledge, attitudes, and capacity). The Actor-Partner Interdependence Moderation Model was applied for analysis. Young caregivers’ mental health attitudes, β = -0.558, p = 0.002, mitigated the effect of their anxiety on their insomnia, while older adults’ mental health knowledge, β = 0.428, p = 0.019, enhanced this relationship. Older adults’ mental health attitudes, β = -0.731, p = 0.004, reduced the impact of middle-aged caregivers’ anxiety on the latter’s insomnia. Middle-aged caregivers’ mental health capacity, β = -0.367, p = 0.004, attenuated the effect of older adults’ anxiety on caregivers’ insomnia. No significant moderating effects were observed in the dyad group of older adults and older caregivers. Within caregiving dyads, enhancing MHL can potentially reduce the impact of anxiety on insomnia. Interventions aimed at improving the mental health attitudes of older adults and caregivers are more likely to alleviate anxiety and insomnia than mental health knowledge and capacity.

Abstract

INTRODUCTION: This study updates the population attributable fractions (PAFs) for 12 dementia risk factors in China, categorized as early life (education), midlife (obesity, hypertension, hearing loss, alcohol abuse, and traumatic brain injury), and later life(smoking, depression, social isolation, physical inactivity, air pollution, and diabetes).