Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-01
Abstract： ABSTRACT: Objective To understand the differences in the demand for elderly care services between urban and rural residents in the Pearl River Delta (PRD), and to provide reference for promoting the balanced development of elderly care services in urban and rural areas. Methods Using multi-stage stratified random sampling method, we selected 7 community health service centers in 2 prefecture-level city in the PRD, and conducted a questionnaire survey on 1919 permanent residents aged 60 years and above who visited the centers. Results A total of 641 urban elderly people (33.4%) and 1278 rural elderly people (66.6%) were surveyed in the PRD. The proportion of elderly people with only children in urban areas is significantly higher than that in rural areas (22.2% vs 8.7%; p<0.001). The proportion of urban elderly people who purchase socialized elderly care services when needed is significantly higher than that of rural elderly people (30.0% vs 15.3%; p<0.001). The proportion of rural elderly people agreeing to the concept of raising children and preventing aging is higher than that of urban elderly people (76.1% vs 58.2%; p<0.001); 37.3% and 19.9% of urban and rural elderly people respectively stated that sudden public health incidents have an impact on their elderly care planning. The proportion of elderly people in rural areas who prefer family based elderly care is higher than that in urban areas (71.8% vs 57.1%; p<0.001). The proportion of urban elderly people clearly expressing their willingness to choose institutions for elderly care is significantly higher than that of rural elderly people (62.6% vs 44.0%; p<0.001). Taking family elderly care as a reference, among urban elderly people, the willingness to choose institutional elderly care is lower for those with "surplus" monthly household income and expenditure [OR (95% CI): 0.038 (0.006-0.246)] and "basically equal" [OR (95% CI): 0.072 (0.012-0.431)], and those who agree to the concept of raising children and preventing aging [OR (95% CI): 0.318 (0.110-0.923)]. Urban males [OR (95% CI): 1.544 (1.058-22.54)] and the elderly who purchase socialized elderly care services [OR (95% CI): 2.208 (1.213-4.020)] and those who believe that sudden public health events have an impact on their elderly care planning [OR (95% CI): 1.806 (1.183-2.757)] tend to prefer community based home-based elderly care. The rural elderly with local registered residence registration are more inclined to institutional pension [OR (95% CI): 4.237 (1.031-17.405)] and community home-based pension [OR (95% CI): 1.463 (1.057-2.024)], while those who have more than one child [OR (95% CI): 0.156 (0.050-0.482)], and the rural elderly who agree with the concept of raising children to prevent old age [OR (95% CI): 0.318 (0.110-0.923)] are less willing to choose community home-based pension, Rural elderly people who believe that sudden public health events have an impact on elderly care planning [OR (95% CI): 3.260 (1.002-10.600)] tend to prefer institutional elderly care. Conclusions There is a significant difference in the attitudes of elderly people in urban and rural areas towards the concept of raising children and preventing aging. Urban elderly people are more likely to accept socialized elderly care services compared to rural elderly people, and the impact of sudden public health events on elderly care planning is similar between urban and rural areas. It is suggested that in addition to strengthening the function of family elderly care, urban and rural elderly care resources should be reasonably allocated based on the differences between urban and rural areas.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-11-23 Cooperative journals: 《中国全科医学》
Abstract：
Background Dyslipidemia is the most important and causally independent risk factor for atherosclerotic cardiovascular disease(ASCVD）, and the prevalence of dyslipidemia in elderly residents in Guangdong Province is high, It is necessary to pay attention to the prevalence of dyslipidemia in the elderly and its influencing factors, and to prevent and control dyslipidemia in a targeted manner. Objective To investigate the epidemiological status of dyslipidemia and its risk factors among elderly residents in Yuexiu District, Guangzhou, who were included in the national basic public health service. Methods Using the method of cross-sectional study, we selected 65-year-old elderly residents in Yuexiu District, Guangzhou City, who were enrolled in the national basic public health services in 2020, and used the 2020 health examination data to describe the epidemiological characteristics of patients' basic conditions, BMI and lipid levels, and used restricted cubic spline (RCS) fitted logistic regression models To analyze the changing relationship between age, BMI and the prevalence of dyslipidemia. Results A total of 18,891 elderly residents were included, and the prevalence of dyslipidemia was 53.65%, with a standardized prevalence of 53.89%.The prevalence of hypercholesterolemia(HTC), hypertriglyceridemia(HTG), mixed hyperlipidemia and low high-density lipoprotein cholesterol were 21.43%, 16.50%, 14.51% and 3.80%, respectively, and the standardized prevalence was21.57%,16.53%,14.61%,3.78%, respectively. Single Factor Analysis of chi-square analysis showed that gender, age, education and BMI were the influencing factors for the prevalence of dyslipidemia (P <0.05); Multifactorial Logistic regression analysis showed that female (OR=1.72，95%CI 1.65~1.79), BMI (OR=1.04，95%CI 1.04~1.05) Age (OR=0.97, 95% CI 0.97-0.98) was a protective factor for the occurrence of dyslipidemia, and there was a cholesterol paradox phenomenon for age. Age, BMI and the prevalence of dyslipidemia in elderly residents over 65 years old showed a non-linear relationship, and age and the prevalence of dyslipidemia showed a fluctuating downtrend; as the BMI level increased the risk of dyslipidemia prevalence showed a trend of increasing and then decreasing, and the OR increased significantly under low BMI, while under high BMI, the OR decreased, and the increase without fluctuation was not statistically significant. Conclusion The prevalence of dyslipidemia was high among elderly residents aged 65 years who were included in the national basic public health services in Yuexiu District, Guangzhou. The prevalence of dyslipidemia in this elderly group decreased with increasing age, and the risk of dyslipidemia prevalence showed a trend of rising and then decreasing with increasing BMI level. It suggests that there are some special features in the management of dyslipidemia in the elderly has some special characteristics, and the analysis of risk factors for dyslipidemia in the elderly group should be focused on and early prevention and control should be carried out.
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