To analyze and compare the characteristics and influencing factors of seeking medical treatment for patients with chronic diseases of different ages in China.

The cross-sectional data of China Family Panel Studies (CFPS) in 2018 were used to select patients with chronic diseases as the study subjects (n=5 231), including 18-44 years old, 45-59 years old, 60-74 years old, and over 75 years old. Logistic regression was used to analyze the influencing factors.

In urban areas, about 60% or more of patients with chronic diseases generally chose to go to the hospital for medical treatment. Multivariate regression analysis showed that patients aged 75 and above were more likely to go to the hospital than those aged 60 to 74 years old. In the subgroup analysis of young, middle-aged and elderly patients with chronic diseases, there were differences in the effects of education level, employment, and income level on the choice of location. In rural areas, about 50% of young, middle-aged and elderly patients with chronic diseases generally chose to seek treatment in primary health care institutions. Multivariate regression analysis showed that in rural areas, chronic patients aged 18-59 were more likely to go to hospital than those aged 60-74 (18-44: OR=1.50, 95%CI: 1.00-2.24, 45-59: OR=1.33, 95%CI: 1.05-1.70). In the subgroup analysis of young, middle-aged and elderly patients with chronic diseases, there were differences in gender, education level, marital status, region, income level, health status, depression status and other factors, while the influence of work status on site selection was similar.

In urban and rural areas, the factors affecting the location choice of chronic diseases of different ages vary. It is suggested to improve the understanding and trust of middle-aged and young people to primary medical institutions, and the advantages of primary medical institutions in providing comprehensive and continuous chronic disease management services should be further consolidated.

To develop the influenza vaccine hesitation scale for the elderly aged 60 and above and evaluate its applicability.

Based on the Chinese version of the parents’ hesitation scale for children’s influenza vaccination, combined with the characteristics of the elderly population, the influenza vaccine hesitation scale for the elderly aged 60 and above was developed, and the reliability and validity of the scale were evaluated.

The scale finally included 3 dimensions and 14 items, the score of the total scale was 32.82 ±7.99, and the correlation coefficient between each item and the score of the total scale was between 0.20 and 0.87 (all P < 0.05). Exploratory factor analysis showed that the Kaiser-Meyer-Olkin （KMO） value of the scale was 0.916 (χ²_{approximation} = 14 315.26, P<0.05). Confirmatory factor analysis showed that the cumulative variance contribution rate of 14 common factors was 80.6%, GFI=0.909, IFI=0.961, TLI=0.952, and CFI=0.961,indicating that the overall fitness and structural validity of the model were good. Taking whether the elderly were vaccinated with influenza vaccine or not in the influenza season in 2022, the total vaccine hesitation score and the scores of “confidences”,“risk” and “support” were significantly correlated with the school standard (all P < 0.05). The Cronbach’s α coefficient of the scale was 0.859, indicating that the internal consistency reliability of the scale was high.

The influenza vaccine hesitation scale for the elderly developed in this study is good in reliability, validity and applicable stability, which can be used to evaluate the hesitation level of influenza vaccine in people aged 60 and above.

To analyze the spatial distribution characteristics, efficiency, and influencing factors of pension institutions in Dongguan, so as to provide reference for optimizing the resource allocation of pension institutions in Dongguan.

The resource allocation data of pension institutions in Dongguan were obtained by questionnaire survey, and the spatial distribution characteristics and efficiency of pension institutions were analyzed and evaluated based on GIS and three-stage DEA model.

There was a good spatial coupling between the resources of pension institutions in Dongguan and the elderly population over 60 years old; the lowest occupancy rate was 12.50%, the highest was 100.005%, and the phenomenon of “difficulty in finding a bed” and “half of the beds were vacant” coexisted. In the third stage, the average comprehensive efficiency decreased from 0.679 to 0.635, and environmental factors had a great influence on the efficiency of resource allocation in Dongguan. There were great differences in the efficiency of pension institutions in different areas. The comprehensive efficiency of urban areas was 0.784, which exceeded the average level of the whole city (0.635). The comprehensive efficiency of the eastern industrial park was only 0.439, which did not reach the average level of the whole city. The per capita regional GDP and the level of aging had a negative impact on efficiency.

It is suggested to rationally allocate the resources of pension institutions, optimize regional development planning, promote the upgrading of institutional pension services, improve the efficiency of resource allocation, and provide improved reference scheme for improving the service level of pension institutions in Dongguan.

To summarize the key elements and shortcomings of relevant policies in the field of mental health in China, so as to provide reference for the formulation and improvement of follow-up policies in the field of mental health in China.

Using NVivo11Plus software and content analysis method, a two-dimensional analysis framework of “policy tool-policy object” was constructed to quantitatively analyze 141 relevant policy texts in the field of mental health at the national level from 1999 to 2023 in China.

China has paid growing attention to mental health, and the National Health Commission, the Ministry of Education, and the Ministry of Civil Affairs were the core departments of policy formulation. The internal structure of supply-oriented policy tools was out of balance, and the application of environmental policy tools was insufficient. Demand-based policy tools were the least used, accounting for 49.96%, 28.36%, and 21.68%, respectively. The policy object was concentrated in the whole system, health system, and education system, accounting for 32.81%, 24.59%, and 21.94%, respectively.

It is suggested that the policy design balance the structure of policy tools, increase the supply of resources, apply strategies and measures, strengthen mental health education and promotion, strengthen community grass-roots mental health services, and standardize the development of social mental health service institutions so as to improve mental health and mental hygiene policy system.

To analyze the current situation of cognitive function of the elderly in China and the influence of internet use on the cognitive function of the elderly.

In total 10 546 people aged 60 and above were included in the study. The t-test and variance analysis were used to analyze the differences of cognitive function among elderly groups with different characteristics. Multiple linear regression model was used to explore the effect of internet use on the cognitive function of the elderly.

A total of 2 987 elderly people used the internet, accounting for 28.32% of the total, and the average score of cognitive function of the elderly who used the internet was 14.75±1.86. The average score of cognitive function of the elderly who had not used the internet was 13.34±2.91. There was a significant difference between the two groups (t=-29.48, P < 0.001). The use of the internet was related to the cognitive function of the elderly (β = 0.12, 95%CI: 0.608-0.845, P < 0.001), and the cognitive function of the elderly who used the Internet was better.

Internet use has an impact on the cognitive function of the elderly, and it is suggested that targeted measures be taken to improve the cognitive function of the elderly.

To study the relationship between social participation and depression trajectory and to explore the mediating effect of quality of life.

Based on the data of the four periods of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, the heterogeneous trajectory of depressive symptoms in the elderly was identified by group-based trajectory model, the relationship between social participation and depression trajectory was studied by multi-class logistic regression, and the mediating effect of quality of life on social participation and depression trajectory of the elderly was analyzed by Karlson-Holm-Breen （KHB） method.

A total of 4 931 elderly people aged between 60 and 105 with at least two periods of depression were included, and four depression trajectory groups were identified: long-term non-depression group (61.69%), increased depression group (16.69%), depression remission group (13.83%), and long-term high depression group (7.79%). Compared with the subjects in the long-term non-depression group, the more social participation, the less likely the depression trajectory was attributed to the depression remission group, the increased depression group, and the long-term high depression group (RRR=0.899, 95%CI: 0.812-0.994; RRR=0.885, 95%CI: 0.786-0.995; RRR=0.747, 95%CI: 0.630-0.885). In addition, quality of life played a significant mediating role in the relationship between the two, and the mediating effect of self-rated health accounted for the largest contribution of 30.33% in the elevated depression group. The mediating effect of physical pain accounted for the largest contribution of 27.94% and 29.09, respectively in the depression remission group and the long-term high depression group. Similar results were obtained in the robustness test.

There is heterogeneity in the depression trajectory of the elderly, social participation has a significant impact on the attribution of depression trajectory, and quality of life is an important factor of social participation affecting depression trajectory.

To analyze the multiple mediating effects of social support and sense of meaning of life on the quality of death in elderly terminally ill patients.

By using convenience sampling method, 276 elderly patients and their attending nurses were investigated with general data questionnaire, perceived social support scale, life significance source scale for the elderly, family care index scale, and ICU nurse version QODD-14 scale. Pearson was used to analyze the correlation, and Amos software was used to establish structural equation model (SEM) and mediate effect test.

(1) The scores of quality of death, family function, social support, and sense of life were 62.52±8.67, 7.54±1.14, 52.53±7.64, and 107.54±13.58, respectively. (2) The quality of death of elderly deathbed patients was positively correlated with family function, social support, and sense of life meaning (r = 0.762, 0.886, and 0.795, P < 0.05). Family function was positively correlated with social support and sense of life meaning (r = 0.528, 0.499, P < 0.05). There was a positive correlation between social support and sense of life meaning (r = 0.665, P < 0.05). (3) Specific intermediary effect of social support accounted for 20.22%, specific intermediary effect of sense of life meaning accounted for 17.06%, and multiple intermediary effect of social support-sense of life meaning accounted for 6.54%.

Family function can indirectly affect the quality of death by regulating social support and sense of life meaning.

To investigate the relationship between frailty and social activity of the elderly in China, and to study the influencing factors of frailty in the elderly, so as to provide scientific basis for the healthy life of the elderly.

Based on 43 health related variables in China Health and Retirement Longitudinal Study (CHARLS) 2018 database, the frailty index (FI) was constructed to evaluate the frailty of the elderly. Binary logistic regression was used to explore the effect of social activity on the frailty of the elderly.

A total of 1 519 elderly people aged 60 and above were included in the CHARLS 2018 database, including 401 frail elderly, with a frailty rate of 26.4%. The participation rate of the elderly in social activities was 48.5%,and there were 439 elderly people with high level of social activity, accounting for 28.9% of the total. After adjusting for confounding factors, the risk of debilitation in the elderly with high level of social activity was 41.9%, lower than that in those with medium and low level of social activity (OR=0.581, 95%CI: 0.439-0.77).

The degree of social activity affects the frailty of the elderly, and the social activity of the elderly in China is generally low. The elderly should be encouraged to participate in social activities, and attention should be paid to the older and female elderly.

To investigate the relationship between childhood bullying and loneliness of the floating elderly in mega-cities.

By using the method of quota sampling, an effective questionnaire survey was conducted among 1 000 migrant elderly people ≥ 60 years old in Qingyundian Town, Daxing District, Beijing in 2022. The information of social demography, loneliness, and childhood bullying were collected. Univariate analysis and ordinary least squares (OLS) regression model were used to analyze the relationship between childhood bullying and loneliness of the floating elderly in mega-cities.

After adjusting demographic variables, socio-economic status variables, physical health variables, length of stay in Beijing, and proficiency in Mandarin and social integration, the loneliness scores of floating elderly people in mega-cities who suffered childhood bullying increased by an average of 5.616 (4.153-7.079) points. Self-rated health, Mandarin proficiency, marital satisfaction, and social integration played a regulatory role in“childhood bullying-loneliness”. Compared with model 1, the 95%CI of models 2, 3, and 4 changed from 8.014 (6.580-9.447) to 7.498 (6.027-8.968), 7.402 (5.961-8.843), and 5.616 (4.153-7.079), respectively. Sub-sample regression showed that the results were stable in different gender, age, household registration, and marriage and spouse mobility (all P < 0.01), but there were differences in education level.

The floating elderly in mega-cities who suffered childhood bullying have a higher level of loneliness, and self-rated health, proficiency of Mandarin, marital satisfaction, and social integration are helpful to weaken the above-mentioned relationship.

To investigate the cognitive function of the elderly with different exercise frequencies, and to analyze the effect of exercise frequency on the cognitive function of the elderly.

By using the method of stratified proportional sampling, 4 414 people aged 60 and above were selected from the streets of Yinzhou district of Ningbo. Mini-mental state examination (MMSE) was used to screen the cognitive function of the elderly in the community, and the generalized linear model was used to analyze the influence of exercise frequency and other factors on the cognitive function of the elderly.

The average MMSE score of 4 414 elderly people was 27.05±3.25. The MMSE scores of the elderly who never exercised, rarely exercised, and exercised regularly were 26.03±3.82, 27.04±3.19, and 27.53±2.88, respectively, and the difference was statistically significant (F=72.596, P < 0.001). There were significant differences in cognitive function among the elderly with different exercise frequencies in the fields of orientation, memory, attention and calculation, recall, and language ability (F=13.120, F=13.309, F=33.508, F=32.575, and F=65.312, P<0.01). The results of generalized linear model analysis showed that after controlling other factors, compared with never exercise, the MMSE scores of rare exercise and regular exercise were 2.291 times (95%CI: 1.808-2.904) and 2.470 times (95%CI: 1.973-3.094), respectively.

Exercise frequency is closely related to the cognitive function of the elderly aged 60 and above in the community. Exercise can alleviate the cognitive dysfunction of the elderly in the community and actively mobilize the whole body to prevent Alzheimer’s disease. The elderly should be encouraged to participate in more exercises suitable for them.