重庆市中老年社区居民性健康服务使用及相关因素分析

目的 了解我国重庆市中老年居民性健康服务使用情况,并探讨其潜在相关因素。方法 2020年6月至2022年12月,对重庆市≥50岁社区中老年人进行了多阶段抽样横断面调查。问卷调查内容包括社会人口学特征、一般健康特征、性健康特征以及性健康服务使用情况等相关信息。性健康服务使用情况定义为曾进行过HIV检测、最近1年曾进行过男科/妇科生殖健康体检。采用多因素logistic回归模型分析性健康服务使用的相关因素。结果 研究对象共794名（男性和女性分别为482名和312名）,年龄（62.8±8.2）岁。中老年社区居民HIV检测的比例为18.0%,生殖健康体检的比例为10.1%。多因素logistic回归分析结果显示,60~69岁年龄组（aOR=0.37,95%CI：0.18~0.76）、女性（aOR=11.34,95%CI：5.71~22.52）、月均收入≥5 000元（aOR=3.05,95%CI：1.01~9.27）、性活跃（aOR=4.99,95%CI：2.23~11.15）与最近1年进行生殖健康体检有关。结论 中老年人对性健康服务的利用比例较低。应进一步加强我国中老年人性健康教育,正确引导和应对中老年人之间的亲密关系,制定适宜中老龄人群的性健康服务。     

上海市50岁及以上人群主观幸福感及其影响因素研究

目的 应用日重现法评估上海市≥50岁中老年人群的主观幸福感水平,并探讨影响幸福感水平的相关因素。方法 在2009年10月至2010年6月间,使用多阶段整群随机抽样方法抽取上海市5个区≥50岁的中老年人8 872人,采用WHO全球老龄化与成年人健康研究项目制定的调查工具,获取调查对象的社会人口学及健康相关信息、并用日重现法进行幸福感测量,通过净效应值和U指数评估幸福感水平,通过单因素和多元线性回归模型分析幸福感的相关影响因素。结果 共纳入研究对象8 075人,其中男性3 759人（46.55%）、女性4 316人（53.45%）,年龄（63.1±9.9）岁。上海市≥50岁人群加权后净效应值为1.24（95% CI：1.15～1.33）,加权后U指数为1.55%（95% CI：1.10%～1.99%）。单因素线性回归模型显示年龄、文化程度、婚姻状态、财富水平、居住地、自报健康状况、WHODAS得分、患有慢性病与幸福感水平相关;多元线性回归结果显示,WHODAS得分越高,净效应值越低（P<0.05）。结论 上海市≥50岁中老年人群的主观幸福感水平较好,可能与年龄、文化程度、婚姻状态、家庭财富水平、居住地、自报健康状况、WHODAS得分等因素有关,加强老年人的社会支持、完善针对老年人的各项保障制度和服务设施,或有助于提升老年人的幸福感。     

中国中老年人群多维健康贫困时空跃迁全景测度研究

目的 了解中国中老年人群多维健康贫困指数的时空分布格局，为中老年人群多维健康贫困的精准消除提供循证依据。方法 收集2011、2013、2015和2018年中国健康与养老追踪调查（CHARLS）中37 296户中国家庭≥45岁中老年人群的个人基本信息、家庭结构和经济支持、健康状况、医疗服务利用和医疗保险、收入和消费等相关数据，采用课题组构建的健康贫困评价指标体系及多维健康贫困测度指数创新性地以健康权利、健康能力和健康风险三大维度测算2011—2018年中国中老年人群多维健康贫困指数并进行地区分解测度，分析中老年人群多维健康贫困指数的时空分布格局。结果 中国中老年人群2011、2013、2015、2018年的健康贫困指数和发生率分别为0.320和69.7%、0.326和69.0%、0.349和71.9%、0.291和63.0%,2011—2018年中老年人群健康权利、健康能力和健康风险的贡献度均值分别为0.143、0.450和0.416；基于多维健康贫困指数地区分解测度结果显示，2011年健康贫困最严重的地区为贵州（0.365）、甘肃（0.364）、新疆（0.395）、四川（0.377）、...     

50岁及以上人群生活质量与体力活动的关联研究

目的 探讨上海市≥50岁人群体力活动水平和生活质量之间的关系。方法 2009年10月至2010年6月使用多阶段随机整群抽样方法抽取上海市5个区8 872名≥50岁的中老年人,使用全球体力活动问卷和WHO生活质量量表8项版（WHOQoL-8）评估体力活动水平和生活质量,并获取社会人口学及健康、社会参与等信息,采用两水平（个体层面和社区层面）线性模型分析不同年龄段的中老年人群其体力活动水平与幸福感的关系。结果 共纳入有效样本8 454份,年龄为（63.16±9.74）岁,体力活动水平较低的人群占59.95%,中等体力活动水平的人群比例为28.00%,高体力活动水平者仅占12.05%。WHOQoL-8生活质量得分为43.91±0.69,体力活动水平越高,WHOQoL-8得分越低,生活质量越好（P=0.00）。在控制社会经济因素和健康状况、社会参与等混杂因素后,对<80岁各个年龄段的中老年人群而言,体力活动水平的增高对提高生活质量具有显著作用（P<0.05）,然而对≥80岁的高龄人群,和低水平体力活动相比,中水平和高水平的体力活动对提升生活质量不具备有意义的影响,P值分别为0.06及0.47。结论 上海市≥50岁且<80岁的人群中,较高的体力活动水平与较好的生活质量相关。     

中国中老年人群甘油三酯和高密度脂蛋白胆固醇比值与认知障碍发病关系

目的 探讨中国中老年人群甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）比值与认知障碍发病的关系,为制定认知障碍的干预措施提供参考依据。方法 收集2011、2013、2015和2018年中国健康与养老追踪调查（CHARLS）中2011年基线调查时无认知障碍的6 883名≥45岁中老年人群的相关数据,将2011年基线调查中TG/HDL-C比值按四分位数分组,采用多因素非条件logistic回归模型分析中国中老年人群TG/HDL-C比值与认知障碍发病的关系,并采用限制立方样条（RCS）曲线拟合TG/HDL-C比值与中老年人群认知障碍发生风险的剂量反应关系。结果 随访至2018年,基线调查时6 883名无认知障碍的≥45岁中国中老年人群中发生认知障碍者2 532例,累积发病率为36.79%;认知障碍组和非认知障碍组中老年人群TG/HDL-C比值分别为（3.08±4.69）和（3.64±6.28）,认知障碍组中老年人群TG/HDL-C比值低于认知障碍正常组,差异有统计学意义（t=–3.875,P <0.001）。在调整了性别、年龄、文化程度、婚姻状况、居住地、吸烟情况、饮酒情况、是否高...     

中老年人群同型半胱氨酸分布特点及其健康教育

目的了解某炼化公司中老年人群血清同型半胱氨酸（homocysteine,Hcy）分布特点,为该地区高同型半胱氨酸血症（hyperhomocysteinemia,HHcy）人群提供健康教育对策。方法整理5113名某炼化公司40岁以上人群体检资料,分析不同性别、年龄段血清Hcy水平和HHcy检出率及与传统心血管疾病主要危险因素的相关关系。结果某炼化公司40岁以上中老年人群的血清Hcy水平为（11.52±7.6）μmol/L,各年龄段男性血清Hcy水平及HHcy检出率均高于女性（P〈0.05）;同性别年龄组之间HHcy检出率随年龄的增加呈增高趋势;男性、年龄、收缩压、体质量指数、高血压病和肌酐清除率与HHcy存在相关性（P〈0.05）。结论某炼化公司40岁以上中老年人群的血清Hcy水平存在有性别与年龄的差异,男性、年龄、收缩压、体质量指数、肌酐清除率和高血压病史是HHcy的危险因素。男性40岁、女性60岁以上人群是本地区实施HHcy健康教育的目标人群。     

健康人群血糖与代谢指标相关性的年龄分层研究

目的通过年龄分段探讨健康筛查者的血糖与其他代谢指标相关性的特点。方法随机抽取来我院查体中心的部分事业单位工作人员共1094例,分为20～29岁（232例）、30～39岁（249例）、40～49岁（218例）、50～59岁（200例）和≥60岁（159例）5个年龄段。次晨取空腹血进行空腹血糖（FBG）、血清总胆固醇、三酰甘油及血尿酸等生化测定及计算体重指数（BMI）。结果 〉50岁FBG较低年龄段明显升高,但在正常范围;老年人中血尿酸、血糖和年龄三者呈正相关,BMI、血脂指标未出现与血糖和年龄的相关性。结论中老年人潜在血糖和年龄伴随性改变。     

我国中老年人群骨关节炎罹患现状及其关联因素分析

目的 了解我国中老年人群罹患骨关节炎现状及其关联因素。方法 采用2015年和2018年中国健康养老追踪调查（CHARLS）数据,纳入中老年人群（≥45岁）作为研究对象,运用χ2检验和多因素logistic回归分析中老年人群骨关节炎的关联因素。结果 纳入7 050名中老年人,骨关节炎患病率为33.69％。多因素logistic回归结果表明,从个体社会人口学特征看,年龄≥60岁（OR = 2.254,95%CI:1.985～2.558）、女性（OR = 1.353,95%CI:1.200～1.527）是骨关节炎的危险因素;从慢性病患病情况看,患有高血压（OR = 1.228,95%CI:1.072～1.408）、心脏病（OR = 1.607,95%CI:1.361～1.897）、中风（OR = 2.303,95%CI:1.604～3.306）、肾脏疾病（OR = 2.147,95%CI:1.744～2.644）、胃部疾病或消化系统疾病（OR = 2.810,95%CI:2.487～3.175）是骨关节炎的危险因素;从居住环境看,居住在城市地区（OR = 0.637,95%CI:0.541～0.750）、住房有电梯（OR = 0.879,95%CI:0.785～0.985）、坐式厕所（OR = 0.669,95%CI:0.580～0.770）是骨关节炎的保护因素。结论 我国中老年人群骨关节炎患病状况不容乐观,其关联因素是多方面的,应从个体层面到环境层面重视对骨关节炎的防控。     

上海市中老年社区居民对性教育态度及相关因素分析

目的 了解上海市中老年社区居民对性教育的态度及其相关因素。方法 2020年6月至2022年12月,通过多阶段抽样方法,对上海市≥50岁中老年社区居民开展一项横断面调查。样本量估计数为735人。问卷包括社会人口学特征、健康特征、性教育史等相关信息。采用多因素logistic回归模型分析中老年社区居民对性教育态度的相关因素。结果 研究对象824人中,男性489人,女性335人,年龄（65.1±8.1）岁,年龄范围为60~69岁（45.3%）。49.4%的参与者支持在中老年人群中开展性教育（男性：45.2%;女性：55.5%）。多因素logistic回归分析结果显示,男性（aOR=0.61,95%CI：0.44~0.83）、≥70岁（aOR=0.62,95%CI：0.40~0.94）、城镇居民（aOR=2.54,95%CI：1.81~3.58）、自评健康状况为好/非常好（aOR=1.64,95%CI：1.04~2.58）、有抑郁症状（aOR=0.37,95%CI：0.15~0.85）、接受过性教育（aOR=8.64,95%CI：4.62~17.70）与其对性教育的态度有关。结论 上海市中老年社区居民中支持性教育的比例不高。该人群对性教育的态度与自评健康状况、抑郁症状、性教育史相关,专业医疗人员或医疗机构应着重关注具有关键特征的中老年社区居民,定制化干预以期提高我国中老年居民性健康教育支持意愿,促进性教育在该人群中的普及。     

中老年人营养和户外活动与骨质疏松骨折的相关性研究

骨质疏松（Osteoporasis，以下简称OP）是中老年人群的常见病，是因某些原因引起的以骨密度减少为特征，骨质丢失为结果的骨质疏松现象，它是引起中老年人骨折的最直接的原因之一。我们研究了中老年人骨质疏松及骨折与有关因素的关系，报告如下。1资料与方法1．1严格选择同一水源、饮用哈尔滨市自来水20年以上、居住在哈尔滨工程大学院内的教工及家属共80名，年龄为50～76岁，平均年龄58．89岁，大致健康，均没有接触铅、铜、铝等有害有毒物史；在受同等程度轻度外伤（如骑自行车或走路自行摔倒）条件下，分男女未发生骨折组（健康对照组…     

Public health and aging: health-related quality of life among low-income persons aged 45-64 years--United States, 1995-2001

Health-related quality of life (HRQOL) data are used to track population trends, identify health disparities, and monitor progress in achieving national health objectives for 2010. Low-income (i.e., annual household income of <15,000 dollars) adults aged > or =55 years have substantially more unhealthy days than low-income adults aged > or =65 years and adults aged 55-64 years with higher incomes. To verify this finding and determine whether it extends to low-income adults at younger ages, CDC analyzed HRQOL and related factors among a subset of respondents to the 1995-2001 Behavioral Risk Factor Surveillance System (BRFSS) surveys. This report summarizes the results of that analysis, which found that low-income adults aged 45-64 years have worse HRQOL than all other adults. Unemployment, inability to work, and activity limitation partially explain these HRQOL disparities in this age-income group. Targeting these risk factors and improving access to health care and social services (e.g., job training programs) could help increase the quality and years of healthy life and eliminate health disparities for persons in this age group.     

Emerging health care-associated infections in the geriatric population

The increasing number of persons >65 years of age form a special population at risk for nosocomial and other health care-associated infections. The vulnerability of this age group is related to impaired host defenses such as diminished cell-mediated immunity. Lifestyle considerations, e.g., travel and living arrangements, and residence in nursing homes, can further complicate the clinical picture. The magnitude and diversity of health care-associated infections in the aging population are generating new arenas for prevention and control efforts.     

Sexual activity and risk-taking in later life

The primary study objective was to identify the prevalence of sexual activity and sexual risk-taking behaviour among a sample of older community-based adults. Secondary objectives included gathering data about past experiences of consultations regarding sexual health issues with general practitioners (GPs) and at genitourinary medicine (GUM) clinics, and exploring participants' STI and HIV/AIDS-related information needs. Individuals over the age of 50 were identified from four electoral wards within Sheffield, UK by means of a postal screen based on the electoral register. Respondents self completed a short postal questionnaire. Three hundred and nineteen individuals aged over 50 years selected at random from the general population responded. Approximately 80% of respondents were currently sexually active and 7% engaged in behaviours that may place them at risk of contracting a sexually transmitted infection (STI). Risk takers were typically male, aged between 50 and 60 years and married. Being male was also related to reporting current or past sexual health concerns. In total, of 75 respondents reporting such concerns, two thirds had discussed these concerns with their GP or attended a GUM clinic. Levels of satisfaction with such consultations were generally high, but declined with increasing age. Overall, most participants felt they had not received very much information about STIs and HIV, and about one quarter reported that they would like to receive more information on these topics. These data have implications for all health and social care professionals who work with older people and indicate a potential need for education to help professionals meet the sexual health needs of their older patients/clients. Further implications for sexual health promotion and the need for additional research in this field are also discussed.     

基于GIS的福建省60岁及以上不健康和生活不能自理二类老年人口空间分布特征研究

目的 研究福建省60岁及以上不健康和生活不能自理老年人口的地理空间分布特点,进而掌握人口老龄化的发展规律和趋势。 方法 利用2010 年第六次人口普查中的福建省各县市区的自评健康数据,结合空间自相关分析方法,研究分析了福建省60岁及以上不健康及生活不能自理老年人口的空间格局。 结果 2010年福建省60岁及以上不健康及生活不能自理老年人口占比具有显著的空间正相关性和潜在的空间依赖性,且其空间分布都存在较明显的空间分异,其中60岁及以上不健康老年人口占比整体呈现“东北部热,东南部冷”的空间分布格局。60岁及以上生活不能自理的老年人口占比整体呈现“东北部和西南部热,东南部冷”的空间分布格局。 结论 60岁及不健康及生活不能自理的老年人口有明显的聚集区域,且这些聚集区域均呈现了团状集聚且连续分布的现象。经济发展水平对2010年福建省60岁及以上老年人口健康状况存在较大的影响。     

Sexual Dysfunctions and Difficulties in Denmark: Prevalence and Associated Sociodemographic Factors

Sexual dysfunctions and difficulties are common experiences that may impact importantly on the perceived quality of life, but prevalence estimates are highly sensitive to the definitions used. We used questionnaire data for 4415 sexually active Danes aged 16–95 years who participated in a national health and morbidity survey in 2005 to estimate the prevalence of sexual dysfunctions and difficulties and to identify associated sociodemographic factors. Overall, 11% (95% CI, 10–13%) of men and 11% (10–13%) of women reported at least one sexual dysfunction (i.e., a frequent sexual difficulty that was perceived as a problem) in the last year, while another 68% (66–70%) of men and 69% (67–71%) of women reported infrequent or less severe sexual difficulties. Estimated overall frequencies of sexual dysfunctions among men were: premature ejaculation (7%), erectile dysfunction (5%), anorgasmia (2%), and dyspareunia (0.1%); among women: lubrication insufficiency (7%), anorgasmia (6%), dyspareunia (3%), and vaginismus (0.4%). Highest frequencies of sexual dysfunction were seen in men above age 60 years and women below age 30 years or above age 50 years. In logistic regression analysis, indicators of economic hardship in the family were positively associated with sexual dysfunctions, notably among women. In conclusion, while a majority of sexually active adults in Denmark experience sexual difficulties with their partner once in a while, approximately one in nine suffer from frequent sexual difficulties that constitute a threat to their well-being. Sexual dysfunctions seem to be more common among persons who experience economic hardship in the family.     

The practice of preventive mammography in Catalonia [Spain]: a step forward

OBJECTIVE: To determine and compare the practice of periodic preventive mammography in women aged 50-69 years in the eight health regions of Catalonia in 1994 and 2002. METHODS: Data from the 1994 and 2002 Catalan Health Survey Interview were used. A cross-sectional survey of a representative sample of the non-institutionalized population of Catalonia was performed. All women aged 20 years old or older who directly answered the questionnaire (5,986 and 3,265 women in 1994 and 2002, respectively) were included. The influence of age, social class, type of health insurance and health region was evaluated using multivariate logistic regression analysis. RESULTS: In 1994, women aged 40-49 years reported a higher proportion of mammographic screening (42.8% of women in this age group) than the other groups, while in 2002 the highest proportion (76.3%) was observed in women aged 50-59 years. Rates of screening mammography in women aged 50-69 years were 26.9% in 1994 and 69.1% in 2002, increasing in all health regions and reducing differences among regions. In 1994 and 2002 women in the most advantaged social classes (I, II and III) reported higher proportions of mammographic screening than those in social class V, although this gap was smaller in 2002. CONCLUSIONS: The practice of preventive periodic mammography has significantly increased in women in the target group (women aged 50-69 years). Preventive mammography was lower in non-targeted age groups except in the group of women aged 40-49 years old, in which it was significantly increased. No significant differences in the practice of mammographic screening were observed among health regions in 2002.     

Comparing the socioeconomic status--health gradient among adults 50 and older across rural and urban areas of Thailand in 1994 and 2007

This paper examines associations between three indicators of socioeconomic status, education, income and bank savings, as well as one composite of these three measures, and self-assessed health for adults aged 50+ across rural and urban Thailand, comparing 1994 and 2007. Between 1994 and 2007 Thailand experienced rapid social changes that could impact on health overall and across groups, including population aging, socioeconomic development and changes in health policy. This led us to test whether overall health has improved as a result and whether the SES health gradient has changed. The data come from comparable survey sources from over seventy-thousand respondents, collected by Thailand's National Statistical Office. Generalized proportional ordered logit models were run that include up to three-way interactions of SES by year by rural versus urban location of residence are run. The three-way interactions allow for testing and of whether changes over time are due to complex intertwined effects. Results indicate that a) there has been improvement in health among the population aged 50 years and older in Thailand; b) there has been a flattening in the SES - health gradient in rural areas, and c) there has been little change in the gradient in urban areas, and if anything, there has been a widening of the relationship between income and health in urban Thailand. Divergence in the way the gradient has changed across rural and urban Thailand may point to the impact of social policy that has been aimed at poorer rural residents.     

Sexual behavior in healthy married elderly men

Sexual behavior was evaluated in 81 men aged 60–71 years (34 men aged 60–65 years and 47 men aged 66–71 years). All subjects were married, physically healthy, and with no psychopathology or marital problems. Sexual function was evaluated by a self-report three-point rating scale. Thirty-six percent of the whole study population reported impotence, with no significant difference between the two age groups. About half of the total population reported regular masturbatory activity. A decline in frequency of sexual intercourse and an increase in frequency of masturbation in subjects aged 66–71 years as compared to subjects aged 60–65 indicates that the interest in sexuality continues in elderly men although the form of sexual expression changes from active sexual intercourse to a self-pleasuring/autoerotic form. Evaluation of sexual activity in advanced age is recommended and appropriate therapy in case of sexual dysfunction should be offered to elderly men.     

Relative contributions of health behaviours versus social factors on perceived and objective weight status in Canadian adolescents

ObjectivesPublic health interventions for adolescent “obesity prevention” have focused predominantly on individualistic health behaviours (e.g., diet and physical activity) at the expense of recognizing body weight diversity and the array of social factors (e.g., stigma and discrimination of marginalized identities) that may be linked to weight status. Research is needed to examine the extent to which individualistic health behaviours versus social factors contribute to weight status in adolescents. As such, the aim of this study was to investigate the relative contribution of individualistic health behaviours versus social factors to objective and perceptual indices of weight status.MethodsCross-sectional survey data were collected as part of the Toronto Public Health Student Survey and comprised students 12 to 19 years of age (N = 5515). Measures included perceived and objective weight status, social and demographic factors (e.g., gender, sexual orientation, school connectedness), and health behaviours (e.g., physical activity, nutritious consumption).ResultsFindings from latent variable regression models partially supported hypotheses, whereby social factors (i.e., age, sex, socio-economic access, sexual minority status) contribute similar amounts of variance, or relatively more variance in weight indices, compared to health behaviours (e.g., physical activity, nutritious consumption).ConclusionContrary to traditional views of adolescent weight status, physical activity (i.e., school-based, individual, active transport) and nutritious consumption (i.e., fruits, vegetables, milk) were not associated with weight status, when considering social factors. These findings challenge the utility of public health approaches that target individualistic behaviours as critical risk factors in “obesity prevention” efforts in adolescence.     

STI epidemiology in the global older population: emerging challenges

This paper reviews the evidence concerning the epidemiology of sexually transmitted infections (STIs) with a particular focus on older people. Evidence from North America, Australia, China and Korea clearly shows increasing rates of many STIs in the population group aged 50 years and older. Similar changes are identified in three studies conducted in sub-Saharan Africa. There is a significant lack of detailed epidemiological data from Asia-Pacific and many African countries. There is also a lack of health education and health programmes directed towards older people. It is likely that sexual ageism is the dynamic that underpins this lack of focus and resources for older people.