Background Cognitive impairments are associated with increased risk for progression to dementia. In China, limited surveys have been conducted to estimate the national prevalence and risk factors associated with cognitive impairment in China. This study aims to assess the national prevalence and modifiable risk factors for cognitive impairments in the Chinese elderly population. Methods This cross-sectional study was based on the 2018 China Health and Retirement Longitudinal Study. The Mini Mental State Examination (MMSE) is recommended to test for cognitive impairment. Univariate and multivariate logistic regression models were used in assessing risk factors for cognitive impairments in the Chinese elderly population. Results A total of 3768 participants aged 60 years or older were enrolled in this study. The national prevalence of cognitive impairments was 22.24% in China, and the prevalence of cognitive impairment was higher in the south-west region than in the north region (29.94 vs. 16.53%, p < 0.05). The risk for cognitive impairments was higher in the following participants: not married or not living with spouse relative to married with spouse present (OR = 1.39, 95% CI, 1.15–1.70; p = 0.001), nap duration of ≥ 90 min relative to 30–60 min (OR = 1.54, 95% CI, 1.20–1.98; p = 0.001), sleep duration of ≥ 8 h relative to 6–8 h (OR = 1.73, 95% CI, 1.29–2.31; p < 0.001), and depression relative to no depression (OR = 1.67, 95% CI, 1.41–1.97; p < 0.001). The risk of cognitive impairment was lower in participants living in the urban areas relative to the rural areas (OR = 0.57, 95% CI, 0.47–0.69; p < 0.001) and consuming alcohol once a month relative to never consuming alcohol (OR = 0.69, 95% CI, 0.51–0.94; p = 0.02). Conclusion Cognitive impairment prevalence was high in the Chinese elderly population. The potentially modifiable risk factors for cognitive impairment should be further assessed in the development of interventions for the elderly Chinese population.

https://www.frontiersin.org/articles/10.3389/fpubh.2022.1032666/pdf

Prevalence and associated factors of cognitive impairment among the elderly population: A nationwide cross-sectional study in China

Background: The prevalence of lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) increases in males. Although several risk factors, including metabolic syndrome (MetS), depression etc., were identified, the underlying etiological factor remains unclear. Recently, circadian syndrome (CircS) was proposed as a novel risk cluster based on MetS. To compare the predictive power of the CircS and MetS for LUTS/BPH, this study was performed. Materials and Methods: In the baseline survey, 4,390 males aged 40 years above from the China Health and Retirement Longitudinal Study were enrolled. Of them, 3,658 males were followed in the 2015 survey. Logistic regression was adopted to examine the relationships between CircS, MetS and LUTS/BPH. To further verify the association, propensity score matching was used for sensitivity analyses. Moreover, the participants who had LUTS/BPH at the baseline were excluded to test the longitudinal relationships between CircS, MetS and LUTS/BPH. Additionally, we employed the receiver-operating characteristic (ROC) curve analysis to compare the predictive power using the number of CircS and MetS components. The DeLong test was used to test the disparities of area under curves (AUCs). Results: The prevalence of CircS and MetS in aging males was 30.23% and 38.36%, respectively. The odds ratios for prevalent LUTS/BPH were 1.61 (95% CI = 1.29 - 2.00, P < 0.001) and 1.34 (95% CI = 1.08 - 1.66, P < 0.01), respectively, in aging males. This increased risk was also observed in incident LUTS/BPH. The prevalence of LUTS/BPH in normal, CircS alone, MetS alone and both CircS and MetS groups were 6.96%, 8.77%, 7.83% and 10.77%, respectively. The AUCs for CircS predicting prevalent and incident LUTS/BPH were higher than those for MetS (0.582 versus 0.556 for incident LUTS/BPH, P < 0.001; 0.574 versus 0.561 for prevalent LUTS/BPH, P < 0.05). Conclusion: The CircS predicts both incident and prevalent LUTS/BPH better than MetS.

/pdf/the-circadian-syndrome-predicts-lower-urinary-tract-symptoms-svs10xcoek.pdf

The Circadian Syndrome Predicts Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia Better Than Metabolic Syndrome in Aging Males: A 4-Year Follow-Up Study.

Depression and the increased risk of sarcopenia are prevalent among the elderly population. However, the causal associations between these factors remain unclear. To investigate the potential association between depression and the risk of sarcopenia in older adults, this study was performed.In the baseline survey, a total of 14,258 individuals aged 40 and above from the China Health and Retirement Longitudinal Study (2015) participated. We initially described the baseline prevalence of the disease. Then, logistic regression and restricted cubic spline (RCS) regression were conducted to assess the relationship between depression and sarcopenia. Subgroup analysis was performed to validate the robustness of the findings. Additionally, we conducted Mendelian randomization analysis using the inverse variance weighting estimator to assess the causal relationship between depression and sarcopenia. Furthermore, we adopted six methods, including MR-Egger, simple median, weighted median, maximum likelihood, robust adjusted profile score (RAPS), and MR Pleiotropy Residual Sum and Outlier (MR-PRESSO), for sensitivity analyses.Depression patients exhibited higher risks of sarcopenia in all five models adjusting for different covariates (P < 0.05). The RCS analysis demonstrated a linear relationship between depression and sarcopenia (P < 0.05). In the subgroup analysis, increased risk was observed among participants aged 60−70, married or cohabiting individuals, non-smokers, non-drinkers, those with less than 8 h of sleep, BMI below 24, and individuals with hypertension (all P < 0.05). Mendelian randomization results revealed that genetically proxied depression led to a reduction in appendicular skeletal muscle mass (all P < 0.05).Our study provides observational and causal evidences that depression can lead to sarcopenia. This finding emphasizes the importance of timely identification and management of depression, as well as implementing targeted educational programs as part of comprehensive strategies to prevent sarcopenia.

Depression and risk of sarcopenia: a national cohort and Mendelian randomization study

BACKGROUND Because it is unclear whether lower urinary tract symptoms (LUTS) are associated with cardiovascular disease (CVD) in the Japanese population, we explored the association in general Japanese men aged 55-75 years.Methods and Results:The cross-sectional study included male participants who had both national health checkup data and the International Prostate Symptom Score (IPSS) in the same calendar year between 2009 and 2017. LUTS severity was evaluated by IPSS. A robust Poisson regression model was used to assess the association between LUTS severity and the composite CVD outcome [coronary artery disease (CAD), stroke, or atrial fibrillation (AF)] and each component of the composite outcome. Prevalence ratio (PR) was adjusted for conventional cardiovascular risk factors. Of 16,781 male participants (mean age, 67±5 years), mild LUTS were observed in 9,243 (55.1%); moderate, 6,445 (38.4%); and severe, 1,093 (6.5%). Compared with the mild LUTS group, moderate LUTS [PR 1.18, 95% confidence interval (CI) 1.10-1.25, P<0.001] and severe LUTS (PR 1.38, 95% CI 1.24-1.53, P<0.001) were significantly associated with a higher prevalence of CVD. LUTS severity was associated with higher prevalence of CAD and stroke, but not AF. CONCLUSIONS The severity of LUTS was associated with a higher prevalence of CVD, especially CAD and stroke, independent of conventional CVD risk factors.

/pdf/association-of-lower-urinary-tract-symptoms-based-on-the-205kgkc4vy.pdf

Association of Lower Urinary Tract Symptoms Based on the International Prostate Symptom Score and Cardiovascular Disease

Lower Urinary Tract Symptoms (LUTS) are frequently present in the general population as patients age with approximately a third of individuals experiencing LUTS during their lifetime. LUTS can be further defined as having any of the following symptoms: urinary hesitancy, straining, nocturia, increased urination frequency, and dysuria. LUTS has the potential for patients to contribute their symptoms to what can normally occur as we age. This can lead to a decrease in patients seeking care and could negatively impact patients' health-related quality of life (HRQL). In conjunction with LUTS, we obtained from our analysis that LUTS and depression are closely related and worsening depressive symptoms may increase the severity of LUTS. We also discerned three categories of factors that can yield major depression namely adversity, internalizing, and externalizing factors. Within these categories, trauma, social support, genetic factors, and minimal education appeared to increase the risk of depression in patients. With the recent increase in mental health awareness and more access to mental health care amid the COVID-19 Pandemic, further screening, and collaboration between providers to treat both urological and psychiatric symptoms could improve patient outcomes. It is important for providers to have an increased understanding of the mental and physical impact both LUTS and depression can have on patients' wellbeing. This has the potential to help patients be more open about their symptoms with the aim of better addressing LUTS and depression to positively impact their HRQL.

Lower Urinary Tract Symptoms in Depression: A Review.

Lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) and depression are both increasing in Chinese aging males However, the relationship still remains unknown To explore their relationship, a retrospective cohort study based on propensity score matching (PSM) was conducted by analyzing the China Health and Retirement Longitudinal Study dataset After data cleaning, a total of 5125 participants were enrolled and subjected to PSM; 1351 pairs were matched and followed for 2 years Further logistic regression and restricted cubic spline (RCS) were performed to evaluate, model and visualize the relationship between depression and LUTS/BPH Moreover, subgroup analyses and sensitivity analyses were adopted to verify the robustness of the conclusions Before PSM, depressive patients showed higher odds of LUTS/BPH in all three models adjusting for different covariates (P 005) The results of sensitivity analyses indicated identical increased risks of LUTS/BPH in all four models (all P < 0001) In conclusion, depression enhances the risks of LUTS/BPH in aging males

Depressive males have higher odds of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a retrospective cohort study based on propensity score matching.

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Depressive males have higher odds of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a retrospective cohort study based on propensity score matching.