To explore the pathways through which social support influences value co-creation behaviors in older adults, clarify the mediating role of service co-creation literacy, and examine the moderating effect of sense of community.

A random sampling method was employed to select elderly individuals from communities in Changzhi City as research subjects from September to November 2024. Data from 424 community-dwelling elderly individuals were included in the analysis. The data were analyzed using SPSS 24.0, and the PROCESS macro with the bootstrap method was utilized to test mediating and moderating effects.

(1) Social support has a significant direct effect on value co-creation behavior (β=0.114, 95% CI: 0.029-0.199, P=0.009); (2) Service co-creation literacy has a significant partial mediating effect between social support and value co-creation behavior, with a mediating effect size of 0.125(95% CI:0.060-0.189,P<0.001), accounting for 52.3% of the total effect; (3) Sense of community has a moderating effect on the impact of service co-creation literacy on value co-creation behavior (β=0.147,P<0.001).

This study reveals that by constructing a mechanism that emphasizes strengthening the social support system within community health services, cultivating service co-creation literacy among the elderly, and enhancing the sense of community, it is possible to effectively stimulate the elderly population’s participation in value co-creation behaviors in health services.

To explore the factors of depression symptoms in middle-aged and elderly patients with chronic diseases in China and establish a risk prediction model to provide a reference for achieving healthy aging.

Based on data from the fifth waves of the China Health and Retirement Longitudinal Survey, patients with chronic diseases aged ≥ 45 years were included in the study and randomly divided into training and testing sets at a ratio of 7:3. Based on the Health Ecology Model, factors were analyzed by chi-square test and binary logistic regression and a nomogram was constructed. The performance of the risk prediction model was evaluated using the area under the receiver operating characteristic curve, calibration curves, and the Hosmer-Lemeshow test.

The prevalence incidence of depression symptoms among middle-aged and elderly patients with chronic diseases was 49.71%. The results showed that gender, age, number of chronic diseases, BADL status, IADL status in the personal characteristics layer, late sleep duration and whether often bothered by pain in the behavior pattern layer, type of residence and satisfaction with children in the interpersonal network layer, education level and availability of shower facilities in the life and work layer were significantly correlated with depression symptoms among middle-aged and elderly patients with chronic diseases. The AUC values for the training and testing sets of depression symptoms risk prediction model among middle-aged and elderly participants with chronic diseases in China were 0.762 and 0.753, respectively. The calibration curve demonstrated good agreement between predicted and actual probabilities, and the Hosmer-Lemeshow test (P>0.05) confirmed the model’s satisfactory predictive performance.

The prevalence incidence of depression symptoms is relatively high among middle-aged and elderly patients with chronic diseases in China. Improving the quality of life of this population across multiple dimensions is essential for promoting healthy aging.

To explore the association between frailty status and RA through trajectory analyses, and to provide a scientific basis for targeted measures to reduce the risk of RA.

Survey data from the 2004-2018 American Health and Retirement Study (HRS) were analyzed for potential categories of frailty using growth mixture models for the three waves of data from 2004-2010. Using 2010 as the baseline, four waves of data from 2010 to 2018 were tracked to analyze the association between different frailty statuses and participants’ RA risk, and Cox proportional risk models were used to describe the associations between different frailty states and the development of RA.

The baseline population totaled 3 677 individuals, including 1 337 (36.4%) males; 2 340 (63.6%) females. Four frailty trajectories were identified through growth mixture modeling, with a high frailty lowering group (10.6%), a persistent high frailty group (20.1%), a persistent low frailty group (34.0%), and a low frailty elevation group (35.3%). Analysis of Cox proportional risk regression modeling showed that, in the fully adjusted model with the low frailty elevation group as the reference, the persistent high frailty group had a 0.255-fold increased risk of developing RA 0.255-fold (HR=1.255, 95% CI: 1.001-1.576), and the risk of developing RA increased 0.422-fold in the high frailty-reduced group (HR=1.422, 95% CI: 1.071-1.888).

Frailty is a risk factor for RA, and the risk of developing RA is increased in the high frailty reduction group and the persistent high frailty group.

To describe and analyze the changes in the burden of cardiovascular disease (CVD) attributed to tobacco in China from 1990 to 2021, as well as to provide a basis for scientific prevention and control of CVD.

Weextracted CVD death and disability adjusted life year (DALY) data attributed to tobacco in China from the 2021 Global Burden of Disease Database from 1990 to 2021, analyzed their trends by Joinpoint software, and used Bayesian Age Period Queue Model (BAPC) to predict the changes in CVD disease burden attributed to tobacco in China from 2022 to 2030.

The number of CVD deaths attributed to tobacco in China rose from 54 300 in 1990 to 101 400 in 2021, with the standardized mortality rate decreasing from 75.59 per 100 000 in 1990 to 52.32 per 100 000 in 2021, representing an average annual decrease of 1.24% (95% CI: -1.53%~-0.95%). The DALYs caused by CVD attributed to tobacco in China increased from 15 158 million person-years in 1990 to 23 530 million person-years in 2021, with the standardized DALY rate decreasing from 1 766.25 per 100 000 in 1990 to 1 145.78 per 100 000 in 2021, representing an average annual decrease of 1.42% (95% CI: -1.63%~-1.20%). Prediction models indicated that the CVD disease burden attributed to tobacco in China from 2022 to 2030 will decrease over time, with the standardized mortality rate and standardized DALY rate potentially reaching 45.47 per 100 000 and 967.51 per 100 000, respectively, in 2030.

Although the standardized mortality rate and DALY rate of CVD attributed to tobacco in China have shown a downward trend from 1990 to 2021, the disease burden is still relatively heavy, with significant differences between genders and ages. This suggests that early prevention of CVD in the elderly population, especially in the elderly male population, should be further strengthened to effectively reduce the burden of CVD disease attributed to tobacco in China.

This study aims to investigate the association between polycyclic aromatic hydrocarbons (PAHs) exposure and the atherogenic index of plasma (AIP) by analyzing data from the National Health and Nutrition Examination Survey (NHANES).

Participants aged ≥20 years were selected from NHANES 2009-2016. Due to the left-skewed distribution of urinary PAHs metabolites (OH-PAHs), logarithmic transformation (lg) was applied to approximate a normal distribution. Participants were categorized into four quartiles based on lgOH-PAHs levels. A multiple linear regression model was used to evaluate the association between PAHs and AIP. A smoothing curve fitting approach was employed to explore potential nonlinear relationships, and subgroup analyses were conducted.

A total of 3 084 participants were included, including 1 560 females (50.6%) with an average age of (49.1±17.6) years.After adjusting for age, sex, race, education level, marital status, the ratio of family income to poverty, body mass index (BMI), smoking, alcohol consumption, hypertension, and high cholesterol, multiple linear regression analysis indicated a positive association between the highest quartile of PAHs exposure (Q4) (β=0.056, 95% CI: 0.021-0.091) and AIP compared to the lowest quartile (Q1). In sex-stratified subgroup analyses, higher PAHs exposure (Q4) (β=0.068, 95% CI: 0.010-0.126) was positively associated with AIP in the male population. A similar positive correlation was also found in the female population (β=0.047, 95% CI: 0.001-0.094). In BMI-stratified analyses, the association between PAHs exposure and AIP was significant in participants with BMI <25(β=0.096, 95% CI: 0.032-0.160). Smoothing curve fitting demonstrated an inverted U-shaped relationship between PAHs concentration and AIP.

This study found a strong association between PAHs exposure and AIP, suggesting that PAHs exposure may be an important risk factor for increased AIP.

To analyze the effects of nighttime sleep duration on postpartum depressive symptoms of couples in Anhui Province on both partners based on the actor-partner interdependence model.

Depression screening using the Edinburgh Postnatal Depression Scale (EPDS) was performed on couples who brought their babies for child health checkups at 42 days, 3 months, 6 months, and 12 months postpartum to maternal and child healthcare facilities in Huaibei City, Jieshou City, Ma'anshan City, and Huangshan City, Anhui Province, from November 2023-October 2024, using the Edinburgh Postnatal Depression Scale (EPDS).To describe the general condition and detection of depressive symptoms in couples, and to analyze the association between the length of nighttime sleep and postpartum depressive symptoms in couples through the actor-partner interdependence model.

A total of 2 424 couples were included in the analysis, and the overall detection rates of depressive symptoms at the four postpartum time points were 18.7% and 19.7% for husbands and wives, respectively. The detection rates of depressive symptoms at the 4 postpartum time points were 17.0%, 20.4%, 19.7%, and 17.8% for husbands and 19.7%, 19.6%, 21.1%, and 18.3% for wives. Spearman's correlation analysis showed that the wife's nighttime sleep duration was negatively correlated with both her own and her husband's depression scores, and positively correlated with the husband's nighttime sleep duration, and the husband's nighttime sleep duration was negatively correlated with his own and his wife's depression scores.Furthermore, the wife's depression scores were positively correlated with her husband's depression scores. The actor-partner interdependence model showed that both wives' and husbands' nocturnal sleep duration were able to predict their own depressive symptoms(β=-0.890, 95% CI=-1.016--0.763, β=-0.417, 95% CI=-0.550--0.284, all P<0.001), the actor effect was significant; in terms of the partner effect, nighttime sleep duration of both wives and husbands predicts each other’s depressive symptoms(β=-0.200, 95% CI=-0.292--0.108, P<0.001).

Postpartum depression is more prevalent among couples in four sites in Anhui Province, and nighttime sleep duration is negatively associated with postpartum depression, with both couples interacting with each other, suggesting that psychological interventions need to be carried out jointly by both couples.

To explore the quantitative association and dose-response relationship between systemic immune inflammatory index (SII) and the risk of hypertension among petrochemical workers.

This cohort study included 2 386 occupational workers from a large petrochemical enterprise in southern China. Baseline data were collected in 2018 through occupational health monitoring, and follow-up data were obtained annually through regular physical exams until 2023. The study gathered demographic information, occupational exposure data, blood pressure, blood sugar, blood lipid levels, and SII results via questionnaires, hazard monitoring, physical exams, and laboratory tests. We used multivariate Cox proportional hazard regression models and restricted cubic spline analysis to examine the quantitative association and dose-response relationship between SII and new-onset hypertension. Stratified analyses were performed based on occupational exposure, age, and gender.

During the follow-up period, 645 new cases of hypertension were identified. SII was positively correlated with hypertension risk in a dose-dependent manner. The SII was categorized into three groups (T1, T2, and T3). After adjusting for covariates, the hypertension risk in the T2 and T3 groups was 1.40 (95% CI:1.16-1.70) and 1.30 (95% CI: 1.06-1.58), respectively, compared to the T1 group. The relationship between SII and hypertension risk followed a nonlinear, inverted U-shape: risk increased with higher SII values up to a point, then decreased (P=0.005, nonlinear P=0.007). Subgroup analysis revealed that the patterns observed in workers under 39 years old and male workers were consistent with the overall population. Noise exposure did not affect the association between SII and hypertension risk, but no such association was found among workers exposed to benzene and its homologs.

SII is positively correlated with hypertension risk in petrochemical workers in a dose-dependent manner, exhibiting a nonlinear dose-response relationship. These findings provide a basis for using SII in hypertension risk assessment and prevention strategies in petrochemical workers.

To analyze the prevalence of three cardiovascular diseases categories (hypertension, coronary heart disease and stroke), and their impact on activity of daily living (ADL) among the elderly in rural Dayao County of Yunnan Province.

A multi-stage stratified random sampling method was employed in selecting 1 382 rural residents≥60 years from Dayao County for questionnaire survey and physical examination.Multivariate logistic regression models were applied to analyze the association between the prevalence of hypertension, coronary heart disease (CHD), stroke and ADL.

Among the interviewed respondents, the prevalence of hypertension, CHD, stroke, and the impaired rate of physical activity of daily life (PADL), instrumental activity of daily life (IADL) and ADL was 66.2%, 14.6%, 5.9%, 6.6%, 36.5%, and 37.2%, respectively. The prevalence of hypertension, CHD, and stroke and impaired rate of PADL, IADL, and ADL increased with age (, P<0.05). Females had higher prevalence of hypertension, impaired rate of IADL and ADL than males (χ²=7.319, χ²=56.112, χ²=52.510, P<0.05). Older adults with lower level of education had lower prevalence of CHD (χ²=3.930, P<0.05) while they had higher impaired rate of PADL, IADL, and ADL than their counterparts (χ²=7.438, χ²=99.487, χ²=101.057, P<0.001). Similarly, older adults with lower household incomes had lower prevalence of CHD and stroke (χ²=6.442,χ²=4.250, P<0.05) while they had higher impaired rate of IADL and ADL (χ²=6.517, χ²=4.934, P<0.05) than their counterparts. The outcomes of the analysis utilizing multivariate logistic regression suggested that hypertensive older adults (OR=1.760, 95% CI: 1.037-2.985) and older adults who suffered from stroke (OR=3.692, 95% CI:1.989-6.856) were more likely to have higher impaired rate of PADL than their counterparts.

There is a relatively high prevalence of three types of cardiovascular diseases while low level of daily living activity among older adults in Dayao County. Reducing the prevalence of hypertension and stroke would be helpful to alleviate the impaired rate of activity of daily living.

To analyzing the relationship between dietary quality and depression.

Data from seven consecutive cycles of NHANES dietary data from 2007-2020. Using HEI-2015, AEHI, MDS, PDI, hPDI, uPDI and CDAI to evaluate dietary quality; analyzing the relationship between various dietary indices and depression through multivariate weighted logistic regression, and through Restricted Cubic Spline (RCS) analyzes the nonlinear relationship between dietary indices and depression, and conducts sensitivity analysis to ensure the stability of the results.

A total of 18 490 study participants were included, with a weighted mean age of 46.39±16.38 years. logistic regression results showed that the risk of depression was reduced in the HEI Q4 group compared with the HEI Q1 group (OR=0.786; 95% CI: 0.664-0.929), and in the PDI Q2 group compared with the PDI Q1 group (OR=0.847; 95% CI: 0.750-0.955). no nonlinear relationship was found between HEI, AHEI, MDS, PDI, hPDI and depression, and a nonlinear relationship was shown between uPDI, CDAI and depression.

The quality of meals has a significant impact on the occurrence of depression. Promote high-quality meals and increase the antioxidant capacity of food, which helps to prevent and slow down the occurrence and development of depression.