Xiang Qi

Abstract

Objective: To evaluate the impact of a function-focused multicomponent exercise program on long-term nursing home (LTNH) residents’ ability to maintain activities of daily living (ADL), physical performance, cognitive function, quality of life, and frailty. Methods: This multicenter single-group pre-post quasi-experimental study involved 148 participants from 16 LTNHs in Gipuzkoa, Spain. Participants underwent a twice-weekly, 6-month function-focused multicomponent exercise program and were assessed both before and after the intervention. Results: Following the intervention, participants significantly maintained ADL ability, improved physical performance and quality of life, and reduced frailty (all p < 0.05). Cognitive function showed a positive trend. Subgroup analysis showed consistent improvements across demographics and health variables. Conclusions: The exercise program effectively maintained or improved ability to perform ADL, cognitive function, physical performance, and quality of life while reducing frailty in LTNH residents, irrespective of individual characteristics. This highlights the importance of exercise interventions to preserve overall function and wellbeing in this population.

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Background: Food insecurity, a pervasive global issue exacerbated by the COVID-19 pandemic, has been linked to adverse mental health outcomes. However, the role of social capital in mitigating this relationship remains understudied, particularly in the Chinese context. Aims: This study investigated the associations between food insecurity and psychological distress (depressive and anxiety symptoms) and examined the potential moderating effects of bonding and bridging social capital among Chinese adults in Shanghai. Methods: This cross-sectional study included 3,220 Chinese adults (mean age: 34.45; 51.5% male) in Shanghai. Food insecurity was assessed using the modified Household Food Insecurity Access Scale, psychological distress was measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, and social capital was evaluated using the Revised Personal Social Capital Scale. Results: Multivariable linear regression analyses revealed that food insecurity was significantly positively associated with both depressive (β = 0.449, SE = 0.024) and anxiety symptoms (β = 0.391, SE = 0.022), after adjusting for sociodemographic characteristics, health status, and COVID-19-related factors. Higher levels of bonding and bridging social capital were significantly associated with fewer depressive and anxiety symptoms. Significant interactions (p

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Background: Despite Asians being the fastest-growing ethnic group in the US, most studies have focused on Asian Americans as an aggregate racial/ethnic group. The burden of mental health problems is increasing among caregivers due to population aging, yet little is known about the distress experienced by Asian caregivers when examined by disaggregated ethnic groups. Methods: Using 2019–2020 California Health Interview Survey data, we examined disparities in psychological well-beings between non-Hispanic White and Asian American adult caregivers, with an emphasis on understudied Asian ethnic groups. Psychological distress was measured using the Kessler 6 scale, with scores ≥6 indicating mental distress and ≥13 indicating serious mental illness. Multivariable logistic regression adjusted for socio-demographics, physical health, caregiving relationship, intensity of care, and care recipients’ characteristics. Results: The study included 8,722 caregivers (mean age, 58.7 years; 61.3% women; 14.1% Asian [379 Chinese, 260 Filipino, 167 Japanese, 138 South Asian, 105 Korean, 101 Vietnamese, 78 other Asian], 85.9% White). Overall, 26.8% had mental distress, and 8.5% had serious mental illness. Compared to White caregivers, Korean American caregivers had higher odds of mental distress (Odds Ratio [OR], 2.37; 95% CI, 1.47–3.82) and serious mental illness (OR, 2.15; 95% CI, 1.17–3.92), while Chinese (OR, 0.72; 95% CI, 0.55–0.95) and Japanese (OR, 0.67; 95% CI, 0.45–0.99) American caregivers had lower odds of mental distress. Korean American caregivers had the highest prevalence of mental distress (43.1%) and serious mental illness (15.3%), compared with White and other Asian American caregivers. Conclusion: Disaggregating data reveals significant mental health disparities among ethnic subgroups of Asian American caregivers. Tailored resources should address the distinct needs of ethnic subgroups of Asian American caregivers, considering language barriers, acculturation, and cultural norms that may exacerbate psychological distress.

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Few studies have compared pain management provided by informal and formal caregivers of older adults in China at the end of life. This study aims to address this gap by investigating the association between formal and informal care and painfulness at the end of life among older adults in China. Specifically, the study focuses on the influence of various types of informal care. Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted from 2002 to 2018, which is the largest nationally representative study of older adults in China, with a sample size of 21,849 deceased participants. Results from multiple logistic regressions suggest that informal care is associated with a more painful end-of-life experience compared to formal care, with care provided by adult children being a more favorable option within informal care. These findings underscore the urgent need to prioritize education on death and dying, improve the formal care system, and enhance professionalism within informal care.

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This study investigated to what extent socioeconomic status (SES) disparity associates with cognitive and physical impairment within older Asian Americans in comparison with other races/ethnicities. Data were from the National Health and Nutrition Examination Survey 2011–2018 that included 3,297 White, 1,755 Black, 1,708 Hispanic, and 730 Asian Americans aged ≥ 60. Physical functioning was measured by activities of daily living (ADL) or instrumental activities of daily living (IADL). Memory and language fluency were evaluated using the Alzheimer's Disease Word List Memory Task and Animal Fluency Tests, respectively. Multivariate logistic regressions were conducted to investigate the association between SES and physical and cognitive impairment within racial/ethnic groups, and seemingly unrelated regressions compared coefficients across subgroups. Asians with ≤ high school education had the highest prevalence of age- and sex-adjusted memory impairment among all races/ethnicities, while no difference was observed for those with > high school education. ADL/IADL disability odds did not differ between Asians and Whites, but Asians were more likely to exhibit impaired verbal fluency. Education disparity for ADL disability (OR, 3.40; 95% CI, 2.20–5.25) and memory impairment (OR, 11.57; 95% CI, 6.59–20.31) were largest among Asians compared to Whites, Blacks, and Hispanics. Income disparity for function impairment showed no significant difference across racial/ethnic groups (all P > 0.05). Asians experienced the highest burden of physical functioning and memory impairment due to education disparity. Efforts should focus on strengthening research infrastructure and creating targeted programs and services to improve cognitive and physical health for racially/ethnically underrepresented older adults with lower education attainment.

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