中华疾病控制杂志

A dynamic epidemic prevention and control model based on cybernetics

WU Jianqi, WANG Xilu, LIU Junwei, ZHANG Jianghui, LI Chuan, ZHU Qingming, LI Jiangyuan, SU Jijuan, LIU Chang

2023, 27(6): 621-626. doi: 10.16462/j.cnki.zhjbkz.2023.06.001

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Infectious diseases have been one of the greatest threats to human life since ancient times. The COVID-19 pandemic, which has had a full impact on the world since 2019, also shows that it is a long way to go in studying infectious disease transmission patterns. The spread of the epidemic is regarded as a dynamic system. The negative feedback mechanism is introduced into the infectious disease transmission model. This paper reveals the role of control measures and technological means in epidemic prevention, which can provide guidance to help effectively prevent both major epidemics such as COVID-19 and biological weapons in the future.

Prevalence of dementia and its correlation with multimorbidity in community-dwelling older adults aged 65 and over in Hubei Province

ZHOU Fukai, TAN Wei, LIU Dan, CHENG Guirong, XU Lang, LIAN Pengfei, YANG Mengliu, YU Yafu, ZHANG Jingjing, ZENG Yan

2023, 27(6): 627-632. doi: 10.16462/j.cnki.zhjbkz.2023.06.002

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Objective To investigate the prevalence and risk factors of dementia in community-dwelling older adults, with a specific focus on analyzing the association between multimorbidity and dementia. Methods The study participants were from the baseline survey (2018-2020) of the Hubei memory and aging cohort study (registration number: ChiCTR1800019164). According to the unified inclusion and exclusion criteria, a total of 8 221 elderly people ≥ 65 years old were included, who had completed a complete set of neuropsychological assessments and clinical physical examinations. The participants were divided into two groups according to their comorbidity status, including hypertension, diabetes, coronary heart disease, and cerebrovascular disease, i.e. non-comorbidity group (including having no chronic disease or only one disease), comorbidity group (having two or more chronic diseases). Multivariate logistic regression was used to analyze the risk factors for dementia based on residence. Results The standardized prevalence of dementia was 7.06% (95% CI: 6.40%-7.72%), 4.34% (95% CI: 3.81%-4.87%), and 11.53% (95% CI: 10.70%-12.35%) in the total population, urban population and rural population, respectively, and the prevalence of dementia in individuals with comorbidities was higher than that in those without comorbidities. Older age, no spouse, lack of physical activity, and lack of intellectual activity were risk factors for dementia. Multimordism was closely related to dementia. The risk of dementia in the comorbidity group was 1.299 times higher than that in the non-comorbidity group (OR=1.299, 95% CI: 1.079-1.563, P=0.006). Conclusions Dementia prevalence significantly increased with the presence of chronic disease comorbidity, with a noteworthy difference between rural and urban residents. This finding underscores the demand of dementia and multimorbidity interventions among community-dwelling elderly populations, suggesting the implementation of the family doctor system to mitigate dementia prevalence.

The relationship between a plant-based diet and death in the elderly aged 65 and over in China

ZHENG Miao, MAO Xueyun, ZHU Feiyun, CHEN Rucheng, ZHENG Weijun

2023, 27(6): 633-638. doi: 10.16462/j.cnki.zhjbkz.2023.06.003

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Objective To investigate the relationship between a plant-based diet and death in the elderly population. Methods Based on the data of the Chinese Longitudinal Healthy Longevity and Happy Family Study (CLHLS-HF), this study analyzed the follow-up survey data of 15 300 samples from 2008 to 2018. The plant-based diet index (PDI) and unhealthy plant-based diet index (UPDI) were used as indicators to evaluate the plant-based diet, which was grouped according to the quintile and divided into five groups: Q1, Q2, Q3, Q4, and Q5. A Cox survival analysis was used to construct a model to study the effects of PDI and UPDI on the death of individuals aged 65 years and above. Results After adjusting for confounding factors such as demographic characteristics, health behaviors, and underlying diseases, a statistically significant association was found between PDI and death (P < 0.001). Compared with Q1(control group), Q3 (HR=0.900, 95% CI: 0.832-0.974), Q4 (HR=0.872, 95% CI: 0.804-0.947), and Q5 (HR=0.779, 95% CI: 0.715-0.850) reduced the risk of death by 10.00%, 12.80%, 22.10%, respectively, while Q2 was not statistically significant. The UPDI was statistically associated with death (P < 0.001), with Q3 (HR=1.182, 95% CI: 1.080-1.294), Q4 (HR=1.206, 95% CI: 1.101-1.321), and Q5 (HR=1.210, 95% CI: 1.104-1.327) increased the risk of death by 18.20%, 20.60%, and 21.00%, respectively, compared with Q1. And Q2 was not statistically significant. With the increase in PDI, the mortality risk of the population showed a downward trend; with the decrease in UPDI score, the mortality risk of the population showed an upward trend (P_trend < 0.001). Conclusion Based on the CLHLS-HF population, a reduced intake of plant foods, especially healthy ones, increases the mortality risk in the elderly.

Analysis of liver dysfunction and its influencing factors in middle-aged and elderly people in Hainan Province

ZHANG Tao, LIN Guotian, LIN Liuting, ZHAO Chanjuan, ZHANG Fan

2023, 27(6): 639-644. doi: 10.16462/j.cnki.zhjbkz.2023.06.004

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Objective The aim of this study is to assess the prevalence of liver dysfunction among middle-aged and elderly people in Hainan and identify its associated factors. Methods This study is based on the baseline survey from the "Prospective Cohort Study of Chronic Diseases in Hainan Natural Population" in 2020, comprising 5 826 permanent residents aged 35- < 75 years in Hainan. Liver dysfunction prevalence and distribution data were collected via questionnaire surveys, and liver dysfunction indicators: alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyltransferase (GGT) were obtained through blood biochemical tests. The related factors of liver dysfunction were analyzed by χ² test and binary logistic regression analysis model. Results Among 5 826 subjects, the prevalence of liver dysfunction was 22.6% (1 318/5 826). There were statistic significant differences between liver dysfunction and variables such as gender, nationality, age, geographical location, education level, occupation, smoking and drinking habits, chronic disease status, drug intake, place of residence, and sleep satisfaction (all P < 0.05). Multivariate logistic regression showed that being male (OR=5.239, 95% CI: 4.189-6.552), belonging to Li nationality (OR=3.510, 95% CI: 2.233-5.517), being elderly (OR=1.015, 95% CI: 1.006-1.024), drug intake (OR=1.717, 95% CI: 1.284-2.295), rural residents (OR=1.931, 95% CI: 1.570-2.375), smoking [occasional versus non-smoking, 1.503 (1.210-1.866); regular versus non-smoking, 1.606 (1.330-1.940)], drinking [occasional versus non-drinking, 2.127 (1.733-2.611); regular versus non-drinking, 3.123 (2.493-3.915)] were main risk factors of liver dysfunction. Conclusions The prevalence of liver dysfunction is notably high among residents aged 35-74 years in Hainan. The main risk factors are age, gender, ethnicity (Li), drug intake, residing in rural areas, and habits of smoking and drinking. It is suggested to amplify health education efforts among the elderly and ethnic minority regions in Hainan Province.

Relationship between sleep quality and cognitive function and the mediating role of depression for older adults in the rural areas of Guizhou Province

XIONG Yan, YANG Jingyuan, ZHOU Quanxiang, QU Fang, CHEN Mingyan, YANG Xi, YANG Xing

2023, 27(6): 645-649. doi: 10.16462/j.cnki.zhjbkz.2023.06.005

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Objective This research seeks to examine how sleep quality influences the cognitive function of elderly individuals in rural areas of Guizhou Province, with a particular focus on the mediating role of depression. Methods We conducted a survey on 1 615 older adults living in rural areas of Guizhou Province using a general data questionnaire, the mini-mental state examination (MMSE), the Athens insomnia scale (AIS), and the patient health questionnaire-2 (PHQ-2). The structural equation model (SEM) was used to analyze the indirect effect of depression on the relationship between sleep quality and cognitive function. Results There were significant differences in cognitive function among older adults with different gender, ages, occupations, marital statuses, and educational levels (all P < 0.001). A direct association was identified between sleep quality and cognitive function (β=-0.061, 95% CI: -0.109-0.015), and depression displayed an indirect association between sleep quality and cognitive function (β=-0.113, 95% CI: -0.203-0.024). In addition, the mediating effect of depression (64.94%) on the correlation between sleep quality and cognitive function was greater than the direct effect of sleep quality on cognitive function (35.06%). Conclusions Sleep quality significantly affects the cognitive function of elderly individuals in rural areas of Guizhou Province. Additionally, depression plays a crucial mediating role in the relationship between sleep quality and cognitive function.

Disease burden of type 2 diabetes mellitus in China from 1990 to 2019

ZHOU Wuming, CUI Xuanxuan, LU Zongqing, HUA Tianfeng, ZHANG Jin, YANG Min

2023, 27(6): 650-654. doi: 10.16462/j.cnki.zhjbkz.2023.06.006

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Objective This study aims to evaluate the disease burden of type 2 diabetes mellitus(T2DM) in China from 1990 to 2019. Methods Data from the Global Burden of Disease Study 2019 data were employed to analyze the T2DM burden in China. Results In 2019, the rates of incidence, prevalence, mortality, disability adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) of T2DM in China were 262.88/100 000, 6 328.79/100 000, 11.84/100 000, 675.18/100 000, 234.65/100 000 and 440.52/100 000, respectively. These metrics showed an increase by 63.56%, 116.09%, 118.67%, 104.19%, 80.33% and 119.67%, respectively, in comparison to 1990. In 2019, the disease burden of T2DM in China, after standardized age, was lower than that in the United States and globally. In 2019, Chinese men exhibited a higher burden of T2DM compared to women after standardization. The DALY rate of T2DM increased from 330.67/100 000 in 1990 to 675.18/100 000 in 2019, marking an increase of 104.19%. Conclusions China′s standardized disease burden indicators for T2DM are lower than those of the United States and the world, but these indicators have been following an upward trajectory year after year, both in crude and after standardization. Therefore, China′s efforts to prevent and treat T2DM still need to be further strengthened.

Disease burden of musculoskeletal disorders in China from 1990 to 2019

WU Huiyi, YUAN Qin, ZHANG Yang, LAN Yajia

2023, 27(6): 655-661. doi: 10.16462/j.cnki.zhjbkz.2023.06.007

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Objective To analyze the past temporal trends of musculoskeletal disorders in China from 1990 to 2019. Methods Incidence, prevalence and disability adjusted life year (DALY) data for musculoskeletal disorders, including rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout, were retrieved from the Global Health Data Exchange (GHDx), to evaluate the disease burden.The joinpoint regression model was utilized to analyze the trend of these disorders from 1990 to 2019, with the trends measured using the average annual percentage change (AAPC). Results In 2019, the age-standardized incidence rate for musculoskeletal disorders in China was 3 764.99/100 000 and the DALY rate was 1 585.44/100 000.These rates decreased by 17.80% and 6.05%, respectively, compared with 1990.The age-standardized rates of incidence and DALY for all musculoskeletal disorder categories were higher in women, except for gout.From 1990 to 2019, the age-standardized rates of incidence and DALY were decreased for total musculoskeletal disorders, with AAPCs of-0.68% and-0.22%, respectively.The rates for low back pain exhibited a significant decrease, but those for gout markedly increased.The disease burden attributable to high body mass index (BMI) for osteoarthritis, low back pain, and gout demonstrated a declining trend.However, the burden attributed to smoking and occupational ergonomic factors for low back pain decreased, while that attributed to impaired kidney function for gout increased. Conclusions From 1990 to 2019, the overall disease burden of musculoskeletal disorders in China has decreased, primarily due to the decline in low back pain.Nevertheless, the burden caused by other musculoskeletal conditions, such as rheumatoid arthritis, osteoarthritis, neck pain, and gout, remains a significant public health challenge.

Influencing factors of cerebral hemorrhage among residents in Inner Mongolia

TIAN Zixuan, HAN Le, YAN Tao, MIAO Yu, GUO Shuyi, ZHANG Nan, ZHANG Xingguang

2023, 27(6): 662-667. doi: 10.16462/j.cnki.zhjbkz.2023.06.008

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Objective To elucidate the incidence of intracerebral hemorrhage (ICH) among residents of different demographics in Inner Mongolia and analyze the influencing factors, thereby providing a scientific basis for the prevention of ICH in this region. Methods Multi-stage stratified cluster sampling was used to establish a study population from six cities.Follow-up data were collected from December 1, 2015, to December 31, 2021, encompassing general information, medical history, treatment history, physical examination, and laboratory tests.Univariate and multivariate Cox regression analyses were utilized to examine the correlation of sex, age, and blood pressure with ICH incidence. Results The study comprised 36 367 participants, among which 385 cases (1.05%) of initial ICH were recorded during the follow-up period.Multivariate Cox regression analysis identified increasing age (HR>1.000, P < 0.05), Mongolian ethnicity (HR=1.768, P < 0.05), and hypertension (HR=1.492, P < 0.05) as risk factors for ICH onset.In contrast, being female (HR=0.434, P < 0.05) and having a higher education level (HR < 1.000, P < 0.05) emerged as protective factors. Conclusions In Inner Mongolia, the risk of ICH is closely associated with certain factors, including being male, advancing age, hypertension, low education level, and Mongolian ethnicity.This study underscores the importance of targeted interventions to prevent ICH in populations at risk in this region.

Evaluating self-management types in hypertensive patients and their effect on blood pressure using latent profile analysis

CHEN Ping, GONG Litong, SUN Xinying

2023, 27(6): 668-672. doi: 10.16462/j.cnki.zhjbkz.2023.06.009

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Objective This study aims to identify the types of self-management employed by hypertensive patients, to assess their blood pressure control status, and to examine the relationship between the two. Methods A questionnaire survey and physical examinations were administered to hypertensive patients from the Daxing District in Beijing.Latent profile analysis was used to explore the self-management types.General linear regression was used to investigate the relationships between self-management types and blood pressure levels.Chi-square tests were used to examine the characteristics of self-management types. Results A total of 1 260 patients with hypertension were included in this study.Their self-management types could be categorized into four types: negative management (21.98%), lifestyle-positive management (9.68%), medication-positive management (32.22%) and comprehensive-positively management (36.12%).Compared with negative management type, the level of SBP in patients with comprehensive-positively management was significantly lower (β=-4.948, t=-2.098, P=0.012).Male patients, those with education below primary school level, and individuals under 35 years of age showed a tendency toward negative management practices. Conclusions According to different behaviors in lifestyle management and medication-taking, the self-management types of patients with hypertension can be divided into four types.Notably, the SBP levels in patients utilizing comprehensive-positive management were significantly lower compared to those following negative management practices.Future efforts should concentrate on enhancing patients′ self-management capabilities according to their specific needs.

Characteristics and risk factors of early death among newly diagnosed HIV/AIDS in China, 2011-2020

JIN Yichen, QIN Qianqian, CAI Chang, CHEN Fangfang, TANG Houlin

2023, 27(6): 673-677. doi: 10.16462/j.cnki.zhjbkz.2023.06.010

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Objective To understand epidemiological characteristics, trends and related factors associated with early death (death within one year after diagnosis) among newly diagnosed HIV/AIDS in China, providing evidence for policy making to reduce mortality of HIV/AIDS. Methods Data between 2011 and 2020 on early death among newly diagnosed HIV/AIDS aged ≥15 years old were collected from China Information System for Disease Control and Prevention.Joinpoint regression model was adopted to analyze the trend of early mortality.Multivariate and multinominal logistic regression was performed to explore risk factors of early death among HIV/AIDS. Results Of newly diagnosed HIV/AIDS patients, 10.68% died within one year after diagnosis.The proportion of early death declined quickly between 2011 and 2015[annual percentage change annual percentage change (APC)(%, 95%CI)=-9.95(-11.29--8.59)].Multivariate logistic regression indicated that male[OR (95% CI)=1.60(1.57-1.63)], age ≥ 30 years old[30- < 45 years old: OR (95% CI)=1.89(1.83-1.95);45- < 60 years old: OR (95% CI)=2.73(2.64-2.81);≥60 years old: OR (95% CI)=4.39(4.25-4.53)], having a middle school education or lower[OR (95% CI)=1.59(1.55-1.63)], heterosexual[OR (95% CI)=1.81(1.76-1.86)]and inject drug[OR (95% CI)=1.86(1.77-1.96)]transmission, diagnosed by medical institutions[OR (95% CI)=3.33(3.23-3.43)], voluntary counseling and test[OR (95% CI)=2.13(2.06-2.20)], baseline CD4⁺T lymphocyte count lower than 200/mm³[OR (95% CI)=4.83(4.75-4.92)], and failure to initiate antiretroviral treatment within 30 days after diagnosis[OR (95% CI)=2.69(2.64-2.74)]increased the risk of early death.Multinominal logistic regression indicated that risk factors of early death remained consistent among HIV/AIDS who died within different time frames. Conclusions There is a high proportion of early death among HIV/AIDS patients in China.Intensified efforts to enhance HIV screening and promote timely initiation of ART are needed.Continued commitment to HIV prevention and treatment is essential to reduce HIV/AIDS mortality.

Using respondent-driven sampling to estimate the population size of men who have sex with men in Qingdao

ZHU Limin, HUANG Guihua, SONG Xin, FU Yong, GE Lin, LI Peilong, LI Dongmin

2023, 27(6): 678-683. doi: 10.16462/j.cnki.zhjbkz.2023.06.011

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Objective To explore the experience of respondent-driven sampling (RDS) in the estimation of population size of men who have sex with men (MSM) and to estimate population size of MSM in Qingdao, providing a reference for HIV/AIDS epidemic estimation and resource allocation in Qingdao. Methods An RDS-based survey was conducted from August to October, 2022, gathering information about the general demographics and social network size of MSM in Qingdao.RDS Analyst 0.72 software was used to evaluate the recruitment effectiveness of RDS.The willingness of MSM in Qingdao to participate in the survey and their attitude towards incentive measures were understood through qualitative interviews.The MSM size in Qingdao was estimated by successive sampling-population size estimation. Results A total of 671 participants were included in this study, including 10 seeds, with over 20 people in the recruitment chains where the seeds were located.The recruitment waves ranged from 4 to 14.The age group, marital status, education attainment and census register of the participants reached equilibrium between the 5th and 10th waves, with the homogeneity coefficients for demographic characteristics all approaching 1.All of 10 interviewees said they would participate in such surveys regardless of incentives.Based on the self-reported social network size of the study subjects and the visibility, the estimated MSM population in Qingdao was 80 405-93 410 and 69 284-80 236, accounting for 1.88%-2.19% and 1.62%-1.88% of adult males in Qingdao, respectively. Conclusions RDS recruitment is effective for MSM, and the RDS-based successive sampling-population size estimation indicates that MSM comprises 1.62% to 2.19% of the local adult male population in Qingdao.

Prognostic study of mild cognitive impairment progressing to Alzheimer′s disease based on polygenic risk score and machine learning modeling strategy

WANG Rong, CHEN Shuai, ZHAO Caili, LI Zimeng, CUI Jing, WANG Xiaocong, ZHAO Chunni, LIU Long

2023, 27(6): 684-690. doi: 10.16462/j.cnki.zhjbkz.2023.06.012

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Objective To provide the theoretical basis for modeling the fifth-year prognostic prediction of the conversion from mild cognitive impairment (MCI) to alzheimer′s disease (AD), this study explored the prognostic prediction performance of polygenic risk score and machine learning methods on the progression from MCI to AD from the perspective of whole genome and candidate genome. Methods Using clumping and thresholding (C+T), polygenic risk scores-continuous shrinkage (PRS-CS), random survival forest (RSF), and survival support vector machine (SSVM) to predict the fifth-year prognostic prediction of patients who progressed from MCI to AD.The polygenic risk score of AD obtained by C+T and PRS-CS were included as independent predictors in Cox proportional hazards regression model, while RSF and SSVM were directly included in all single nucleotide polymorphisms (SNPs) related to AD from the perspective of candidate genome for statistical modeling.Finally, C-index was used as the evaluation index of the prediction effect of the model. Results The difference in C-index between the whole genome and candidate genome was less than 0.01 for both C+T and PRS-CS methods, while the maximum difference of C-index between the two methods was 0.04, and there was no statistical difference between them.The machine learning methods significantly outperformed the PRS methods.The C-index of RSF and SSVM reached 0.76, indicating significance increases of 0.07 and 0.11 over C+T and PRS-CS, respectively (all P < 0.05). Conclusions Machine learning methods perform well and provide a more feasible statistical modeling scheme for the prognostic prediction of the progression of MCI to AD.

The correlation between CMTM2 methylation and prognosis of patients in hepatocellular carcinoma

XU Yuqiu, XU Yuge, GUO Xuefeng, LIU Guoyu, DU Yuanxiao, LYU Xiao, BEI Chunhua

2023, 27(6): 691-697. doi: 10.16462/j.cnki.zhjbkz.2023.06.013

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Objective To determine the relationship between the methylation of the CMTM2 gene, its expression, and the prognosis of patients with hepatocellular carcinoma (HCC). Methods The CMTM2 methylation and gene expression data were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. R software and Perl script were used to integrate the data. Correlation analysis was performed on the methylation and expression of CMTM2 in HCC and adjacent tissues. The differences in prognosis among HCC patients with varying levels of CMTM2 methylation were assessed. The Mass ARRAY nucleic acid mass spectrometry was used to detect the changes of CMTM2 methylation levels in HCC cells before and after treatment with DNA methylation inhibitors to verify the effect of DNA methylation on CMTM2 gene expression in vitro. Results Expression of the CMTM2 gene was found to be lower in HCC tissues than in adjacent tissues (P=0.007 5), and CMTM2 methylation was higher in HCC tissues than in adjacent tissues (P < 0.001). Kaplan-Meier survival analysis showed that patients with CMTM2 hypermethylation had shorter overall survival (HR=1.454 8, 95% CI: 1.022 3-2.070 5, P=0.037) and disease-free survival (HR=1.514 8, 95% CI: 1.095 3-2.094 8, P=0.012). The CMTM2 gene was hypermethylated at the cg07153665 site in the promoter region. Treatment with DNA methylation inhibitors significantly reduced the methylation level at the cg07153665 site, while the CMTM2 expression level was significantly upregulated. Conclusions Hypermethylation at the cg07153665 site affects the overall survival and disease-free survival of hepatocellular carcinoma patients by regulating the expression of CMTM2, suggesting that cg07153665 may be a potential prognostic assessment indicator and therapeutic target for hepatocellular carcinoma patients.

Risk prediction of human lung ventilation dysfunction in coal miners based on machine learning

DING Yu, XUE Sheng, CHEN Qianwei, ZOU Yuanjie, MU Min, YE Dongqing

2023, 27(6): 698-704. doi: 10.16462/j.cnki.zhjbkz.2023.06.014

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Objective The objective of this study was to explore the factors influencing lung ventilation dysfunction in coal miners and establish a high-accuracy predictive model using machine learning algorithms. This would aid in early detection of high-risk individuals and ensure better health safety measures for miners. Methods A total of 679 miners from a northern Shaanxi coal mine who underwent occupational health examination between April 20 and May 3, 2021, were enrolled in the study. Using unconditional multivariate logistic regression analysis and Spearman correlation test to ascertain variables, we built logistic regression (LR), random forest (RF), support vector machines (SVM), and extreme gradient boosting (XGBoost) models. The models′ performance was evaluated on metrics such as accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F1 score, and area under the receiver operating characteristic (ROC) curve. Results The accuracy rates of LR, RF, SVM and XGBoost models were 69.61%, 70.59%, 72.06% and 75.49%, respectively. The sensitivity was 61.22%, 58.16%, 60.20% and 64.29%, respectively. The specificities were 77.36%, 82.08%, 83.02% and 85.85%, respectively. The positive predictive values were 71.42%, 75.00%, 76.62% and 80.77%, respectively. The negative predictive values were 68.33%, 67.97%, 69.29% and 72.22%, respectively. F1 scores are 0.66, 0.66, 0.67 and 0.72. The areas under the ROC curve are 0.78, 0.78, 0.78 and 0.81, respectively. Among all models, the XGBoost model exhibited superior performance, and the prediction accuracy was high. Conclusions The XGBoost model proved to be an effective tool in predicting the risk of pulmonary ventilation dysfunction in coal miners. This model could form a corresponding theoretical basis for the health management of coal miners.

Construction and validation of a risk assessment model for mild cognitive impairment in Chinese elderly based on Meta-analysis

ZHANG Yifang, ZHANG Haixin, ZHANG Wenling, QU Yimin, JIANG Yu, LI Jinlei

2023, 27(6): 705-710. doi: 10.16462/j.cnki.zhjbkz.2023.06.015

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Objective To establish a risk assessment model for mild cognitive impairment (MCI) in elderly Chinese individuals and verify the effect of the model. Methods Meta-analysis was used to derive influencing factors and exposure rates for MCI in the Chinese elderly from existing literature. The Rothman-Keller model was used to construct the risk assessment model of MCI in the Chinese elderly population. Verification data were collected from the Health Examination Center of Penglai People′s Hospital and Rongcheng People′s Hospital of Shandong Province, spanning November 2021 to June 2022, and encompassed 2 545 elderly people aged 60 and above. The model′s efficacy was verified by calculating the area under the curve (AUC), sensitivity, and specificity of the receiver operating characteristic (ROC) curve using Stata 17.0. Results A total of 49 articles were included in the Meta-analysis. Gender, age, family history of dementia, education, smoking, drinking, exercise, living alone, insomnia, overweight/obesity, hypertension, hyperlipidemia, diabetes, cardiovascular diseases, and cerebrovascular diseases were included to establish the Rothman-Keller model. The AUC of the model was 0.772, and the sensitivity and specificity were 78.04% and 63.95%, respectively. Conclusions The MCI risk assessment model established in this study proved effective for the elderly population in China. With its high sensitivity, this model can be used to identify MCI in the community population, facilitating early detection of high-risk people and enabling proactive measures to prevent the development of MCI and dementia.

Advances in research on the association between chronic pain and multidimensional frailty in the older adults

QI Kaili, LI Jie, YUAN Yemin, ZHANG Shimin, WANG Xiyuan, ZHOU Yanxin, ZHANG Yuxun, ZHOU Chengchao

2023, 27(6): 711-716. doi: 10.16462/j.cnki.zhjbkz.2023.06.016

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Frailty has evolved from a single concept emphasizing physical frailty to a multidimensional concept, including physical frailty, cognitive frailty, and social frailty. Chronic pain is a global public health issue that negatively impacts older adults′ life quality. Previous research has discovered that chronic pain is a significant risk factor for physical frailty in older adults. Studies on chronic pain, cognitive frailty, and social frailty have also increased in recent years. This study systematically reviews the progress of research on chronic pain and multidimensional frailty in older adults, summarizes the assessment methods of chronic pain and multidimensional frailty in older adults, and explores the correlation between chronic pain and multidimensional frailty in older adults and their potential mechanisms, with the aim of contributing to the early prevention of multidimensional frailty and its intervention in older adults, and effectively promoting healthy aging.

The relationship between different types of daily living abilities and depression among older adults

CUI Longyan, DING Ding, WANG Minghui, HE Fanrong, Ma Jingyao, CHEN Junfeng

2023, 27(6): 717-721. doi: 10.16462/j.cnki.zhjbkz.2023.06.017

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Objective This study seeks to understand the current situation of depression and the level of daily living abilities in China′s elderly population, and to analyze their interconnection. Methods We selected individuals aged 60 years and above from China Health and Retirement Longitudinal Study between 10th July to 13th September in 2018. Chi-square test and logistic regression models were used to explore the effect of daily living ability on depression among the elderly. Results Our study revealed that 43.82% of Chinese elders experienced symptoms of depression. Furthermore, the rates of impaired basic activities of daily living (BADL) and impaired instrumental activities of daily living (IADL) were 8.78% and 25.82%, respectively. Elderly individuals with impaired BADL (OR=1.621, 95% CI: 1.304-2.016, P < 0.001) and IADL (OR=1.520, 95% CI: 1.321-1.748, P < 0.001) demonstrated a higher propensity towards depression. Notably, IADL impairment influenced depression rates among the elderly across various regions, whereas BADL impairment showed no discernible effect on depression rates in middle-aged seniors. Conclusions Declining daily living abilities increase the likelihood of depression among the elderly. Accordingly, attention should be paid to the mental health status of elderly groups with disabilities, and regional disparities should be considered when allocating resources for senior care.

Relationship between dietary inflammatory and frailty among rural residents over the age of 60 in the Yili region of Xinjiang

ZHAO Hui, FU Wenhui, AILI Dilihumaer, LUO Tao, QIAO Tingting, ZHANG Guozhen, DAI Jianghong

2023, 27(6): 722-725. doi: 10.16462/j.cnki.zhjbkz.2023.06.018

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Objective This study aims to investigate the association between dietary inflammation and frailty among rural residents over 60 years old in Yili, Xinjiang. Methods A total of 1 682 residents over 60 years old were recruited from Huocheng County, Yili Region, Xinjiang, from January to May, 2019. A questionnaire survey and physical examination were conducted. Dietary inflammation and frailty of subjects were evaluated by energy-density dietary inflammatory index (EDII) and frailty index. A logistic regression analysis model was employed to analyze the relationship between dietary inflammation and frailty. Results The prevalence of prefrailty and frailty were 50.65% and 8.97%, respectively. These rates were higher among males, Uygurs, individuals with lower education levels, lower annual family income, those who were divorced, widowed, or unmarried, and subjects who engaged in less physical activity. After adjusting for gender, ethnicity, family annual income, marital status and physical activity, the risk of prefrailty and frailty increased with the EDII score (all P_trend < 0.05). Individuals in EDII tertiles T2 (versus T1) were more likely to be pre-frailty (OR=1.37, 95% CI: 1.04-1.82, P=0.027) and frailty (OR=2.18, 95% CI: 1.26-3.76, P=0.005). Individuals in EDII T3 also had greater odds of pre-frailty (OR=1.32, 95% CI: 1.02-1.72, P=0.036) and frailty (OR=2.17, 95% CI: 1.28-3.68, P=0.004). Conclusions Dietary inflammation is associated with pre-frailty and frailty, and diet may participate in the occurrence and development of frailty through inflammatory effects.

Analysis of trends in thyroid cancer deaths in China from 1990 to 2019

YAO Chengzhi, XU Jieru, ZHANG Min, DUAN Zhaohui, ZHAO Xiangling, XIONG Wenjing, RANG Weiqing

2023, 27(6): 726-732. doi: 10.16462/j.cnki.zhjbkz.2023.06.019

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Abstract:
Objective This study aims to analyze the trends in thyroid cancer mortality among males and females in China from 1990 to 2019, and to explore the underlying causes of the gender-based trend disparities and identify high-risk groups. Methods Thyroid cancer mortality data of males and females aged 5- < 95 years in China from 1990 to 2019 were collected and collated from the Global Health Data Exchange. Age-period-cohort (APC) model was used to analyze the influence of age, period and cohort on the mortality of thyroid cancer. Results The standardized mortality rate of male thyroid cancer continued to rise from 1990 until it peaked in 2013, after which it started to decline gradually. Meanwhile, the age-standardized mortality rate of female thyroid cancer consistently decreased. APC model showed that the net drift of males and females was 1.38% and -2.94%, respectively. Both genders demonstrated an increase in thyroid cancer death risk with age, with the ascending trend of the "J" shape being more pronounced in men. In males, the risk of thyroid death increased with time and cohort, while that of females decreased with time and cohort. Conclusions The age-standardized mortality rate of thyroid cancer among men first increased and then gradually declined, whereas it continuously decreased among women. Older women, particularly those born earlier, demonstrated a higher risk of dying from thyroid cancer. Meanwhile, older men, especially those born more recently, were found to have an elevated risk of death.

Epidemic characteristics of the changing trend of typhoid and paratyphoid in Chinese Mainland from 2004 to 2018

LI Rongxiu, LIANG Yuting, YANG Nan, SU Yongjian, CHEN Xilu, LI Hai, DONG Baiqing

2023, 27(6): 733-740. doi: 10.16462/j.cnki.zhjbkz.2023.06.020

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Objective This study aims to investigate the epidemiological characteristics of typhoid and Paratyphoid fever in China from 2004 to 2018, providing evidence for the prevention and control of these diseases. Methods Data on typhoid and paratyphoid cases and deaths from 2004 to 2018 were collected from the shared data Center of China Public Health Science and demographic data of the National Bureau of Statistics. Excel 2019 software was used to create a database of typhoid and paratyphoid fever. The joinpoint regression model was used to estimate the average annual percent change (AAPC) of typhoid and paratyphoid fever incidence in different age groups, provinces, and districts in China from 2004 to 2018. The changing trend characteristics of typhoid and paratyphoid fever incidence were then analyzed. Results From January 2004 to December 2018, a total of 18 195 cases of typhoid and paratyphoid fever were reported nationwide (the annual average incidence rate was 1.358 6/100 000), and the mortality rate was 0.326 1/1 000. From 2004 to 2018, both the incidence and mortality rate of typhoid and paratyphoid fever showed a downward trend (all P < 0.05). The incidence of typhoid and Paratyphoid fever from 2008 to 2018 showed an accelerated decline (APC: -24.96%, P < 0.001) compared to the period from 2004-2018 (APC: -4.10%, P=0.003). The incidence rates in 21 provinces showed a significant downward trend (all P < 0.05), 10 provinces showed a steady trend, and the incidence rate of the seven regions showed a downward trend. The annual average incidence rate in the seven regions showed a downward trend. The annual average incidence rate decreased the most in southwest China, and the least in South. The incidence of typhoid and paratyphoid fever was high in people under the 39-year-old group, and the highest incidence rate was in the 0- < 10-year-old group (1.906/100 000). The annual average mortality of typhoid and paratyphoid fever was the highest in the age group≥80 years old (1.363 6 / 1 000), and the mortality of patients over 30 years old showed a rapid increase with age. Conclusions From 2004 to 2018, the annual reported incidence of typhoid and paratyphoid fever in China shows a steady decline. There were still different degrees of epidemics and sporadic cases in different provinces, and the incidence decline was different. The incidence rate is higher in the 0- < 10-year-old group, and the mortality is higher in the≥80-year-old group. The situation of prevention and control of typhoid and paratyphoid fever should still be paid great attention to.

Analysis of tuberculosis infection among first-year students in junior high school in Zepu County of Xinjiang, 2021

YANG Shengyuan, APIZI Amina, SUN Xiaojuan, TANG Lihong, HE Yi, ABULIMITI Alimujiang, MIJITI Abudoumomingjiang, YISILAMU Abudoukeyoumu

2023, 27(6): 741-744. doi: 10.16462/j.cnki.zhjbkz.2023.06.021

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Objective To understand the current status of tuberculosis (TB) infection among first-year students in junior high school in Zepu County and provide a reference for TB prevention and control in schools. Methods The tuberculin skin test (TST) was used to screen the TB infection among first-year students in junior high school in Zepu County in 2021. Subsequent analysis was centered on TST results. Results In the 2021 academic year, 4 358 first-year students in junior high school in Zepu County completed TB infection screening, and the infection rate of TB was 1.86%. The infection rates in different schools(χ²=78.754, P < 0.001) and different regions(χ²=14.527, P < 0.001) were statistically significant. There was no significant difference in the infection rates of varying gender groups(χ²=0.573, P=0.449) and those with or without accommodation(χ²=2.306, P=0.129). Conclusions The infection rate of TB was low among first-year students in junior high schools in Zepu County. Schools should organize health education initiatives under the supervision of the health department to raise awareness of TB prevention and control measures and foster self-protection practices among first-year students.

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2023 Vol. 27, No. 6

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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