Multi-State Analysis of the Impact of Childhood Starvation on the Healthy Life Expectancy of the Elderly in China

Dong, Huiling; Du, Chunjing; Wu, Bingyi; Wu, Qunhong

doi:10.3389/fpubh.2021.690645

Cited by 7 publications

(2 citation statements)

References 28 publications

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“…Previous studies interviewed 13,185 individuals aged 65–99 years and found that childhood experiences of hunger affect socioeconomic status in adult life, which, in turn, can affect health outcomes in older adults ( 31 ). Our findings showed that high educational level and financial independence may reduce the probability of childhood hunger-mediated frailty in older age.…”

Section: Discussionmentioning

confidence: 99%

A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey

Gao

Han²,

Mo³

et al. 2022

Front. Med.

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BackgroundChildhood hunger not only directly affects the physical and mental health of children and adolescents but also has a long-term negative effect on later health outcomes. In this cross-sectional study, we used a nationally representative Chinese sample to examine the relationship between hunger in childhood and frailty in older adults.Materials and methodsThe data were obtained from the 2018 Chinese Longitudinal Healthy Longevity Survey. The frailty index with 44 health deficits was used to identify frailty. Childhood hunger was measured by the question “Did you often go to bed hungry as a child?” Insurance status was categorized as New Rural Cooperative Medical Scheme (NRCMS), Urban Basic Medical Insurance Scheme (UBMIS), others, and no insurance. Multivariate logistic regression analysis was performed to estimate the adjusted relationship between childhood hunger and frailty.ResultsA total of 7,342 older people aged 65 years and older were analyzed in this study. Older people who experienced childhood hunger were more likely to have frailty than those who did not (OR = 1.13, 95% CI: 1.02–1.26), after adjustment for sociodemographic characteristics, family/social support, socioeconomic status, insurance status, and health behaviors. The association of childhood hunger with frailty was found in the 65–79 years group (OR = 1.21, 95% CI: 1.03–1.43), women (OR = 1.25, 95% CI: 1.08–1.45), individuals with rural residence (OR = 1.16, 95% CI: 1.03–1.31), agricultural work (OR = 1.16, 95% CI: 1.00–1.34), financial dependence (OR = 1.18, 95% CI: 1.02–1.37), and those participating in NRCMS (OR = 1.35, 95% CI: 1.16–1.56). Participants with hunger in childhood who were 80 years or older (OR = 0.80, 95% CI: 0.65–0.98) had lower odds of frailty. NRCMS (OR = 1.42, 95% CI: 1.02–1.98) showed increased odds of childhood hunger-related frailty.ConclusionExposure to hunger during childhood is linked to frailty among older adults, and age, financial support, and insurance status may mediate this relationship. Targeted interventions and policies to address frailty in older adults should be implemented.

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Section: Discussionmentioning

confidence: 99%

A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey

Gao

Han²,

Mo³

et al. 2022

Front. Med.

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“…However, in studies about older Chinese people, the importance of health care services in the process of health level changes throughout the life cycle of individuals is not explored. Also, the indicators used to measure health level are mostly single measures of physical or psychological aspects of old age, which do not comprehensively reflect the quality of life of the older population (13)(14)(15)(16). Additionally, cross-sectional data does not reflect the overall development trend of the health of the older population, so it is insufficient to have an overall understanding of the mortality and health level of the older population in China.…”

Section: Introductionmentioning

confidence: 99%

Impact of access to childhood health services on healthy life expectancy of the older population

Liu,

Hou,

Wang

et al. 2023

Front. Public Health

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BackgroundLife course theory provides new perspectives on the impact of early experiences on health in old age, where unfortunate childhood experiences can alter an individual's health trajectory. This study aims to calculate the healthy life expectancy of the older population in China under different childhood experiences, and to explore the influence of childhood medical and health services on the health level of older adults.MethodsDifferences in healthy life expectancy of the older population under different childhood experiences were analyzed using the multi-state life table method to calculate the healthy life expectancy by sex and place of birth, based on the cohort data of Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018.ResultsThe probability of the transition risk from health to non-health gradually increased with age, while the probability of the transition risk from non-health to health decreased with age; In both urban and rural areas, on the probability of the transition risk from health to non-health, the older adults who were able to receive timely medical and health services in childhood were lower than those who failed to receive medical services in time (Z = −5.833, P < 0.05), but the probability of the transition risk from non-health to health was the opposite (Z = −5.334, P < 0.05); The probability of the transition risk from health to death is also higher in older adults who were unable to receive timely medical care in childhood (Z = −5.88, P < 0.05); The healthy life expectancy and its proportion in the remaining life expectancy of older people who received medical and health services in time during childhood were significantly higher than those of their peers (Z = −5.88, P < 0.05).ConclusionsThe lack of medical services in childhood has a negative effect on the health of older adults. The healthy life expectancy and its proportion of remaining life expectancy were higher for rural older adults than for urban older adults under the same health care conditions in childhood; the health benefits of good access to health care environment or conditions in childhood were greater for rural older females.

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Development of a Frailty Prediction Model Among Older Adults in China: A Cross‐Sectional Analysis Using the Chinese Longitudinal Healthy Longevity Survey

Tang,

Shen,

Zhou

et al. 2024

Nursing Open

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AimsTo identify the risk factors associated with frailty among older adults in China and develop a predictive model for assessing their frailty risk.DesignSecondary cross‐sectional analysis.MethodsThe 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) provided data for this study. A total of 9006 participants were included in the analysis. Their general demographic, socioeconomic status and health behaviour risk factors were collected in the CLHLS. Frailty was assessed using the Frailty Index. A visual nomogram model was constructed based on independent predictors identified using multivariate analysis. The nomogram's discrimination and calibration capabilities were evaluated using the C‐statistics and calibration curves. A 1000‐times resampling enhanced bootstrap method was performed for internal validation of the nomogram.ResultsThe results showed that living in rural settings, having a primary education level, having a spouse, having basic living security, smoking, drinking, exercising and social activities were protective factors against frailty. Increasing age, being underweight or obese, adverse self‐assessed economic status and poor sleep quality were risk factors of frailty. The AUC values of the internal validation set were 0.830. The calibration curve was close to ideal. The Brier score was 0.122. The above results showed that the nomogram model had a good predictive performance.ConclusionsA simple and fast frailty risk prediction model was developed in this study to help healthcare professionals screen older adults at high risk of frailty in China.ImpactThe frailty risk prediction model will assist healthcare professionals in risk management and decision‐making and provide targeted frailty prevention interventions. Screening high‐risk older adults and early intervention can reduce the risk of adverse outcomes and save medical expenses for older adults and society, thereby realising cost‐effective planning of health resources and healthy ageing.Patient or Public ContributionNo patient or public contribution. This study was a cross‐sectional, secondary analysis of the CLHLS data.

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Multi-State Analysis of the Impact of Childhood Starvation on the Healthy Life Expectancy of the Elderly in China

Cited by 7 publications

References 28 publications

A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey

A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey

Impact of access to childhood health services on healthy life expectancy of the older population

Development of a Frailty Prediction Model Among Older Adults in China: A Cross‐Sectional Analysis Using the Chinese Longitudinal Healthy Longevity Survey

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