Women live longer than men even during severe famines and epidemics

Background Disability in aged people became one of the major challenges in China due to the acceleration of population aging, yet appropriate methods are limited to discriminate the degree of combined basic activity of daily living (BADL) and instrumental activity of daily living (IADL).The present study explored an empirical typology of the activity of daily living (ADL) and its association with health status among the elderly in China. Methods Data throughout the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was retrieved and Latent profile analysis (LPA) was conducted to identify the subgroups of ADL for included elderly subjects. Multinomial regression was performed to detect the effect of identified characteristics with class subgroups, and restricted cubic spine was drawn to show the relationship between ADL disability with age and BMI. Results The overall participants (n = 8108) were divided into three ADL classes by LPA - ‘no BADL limitation- IADL impairment’ (Class one, n = 1526, 19%), ‘no BADL limitation-no IADL limitation’ (Class two, n = 6062, 75%) and ‘BADL impairment- IADL impairment’ (Class three, n = 520, 6%). Compared with the participants in Class two, the oldest-old, living without spouse, lacking exercise and social activity, having experience of falls, having comorbidity of diabetes, heart disease, stroke, decreased cognitive function, depression symptom were highly associated with BADL/IADL difficulties in Class one and Class three,. Additionally, malnutrition and asthma were associated with combined ADL/IADL impairment (Class three), and illiteracy only was associated with IADL impairment (Class one). Furthermore, a significant U-shape relation was detected between age and BMI with ADL disability. The elderly with IADL impairment was less likely to evolve combined BADL/IADL impairment aged at 80–90, and the elderly with underweight or obese may have higher risk of combined BADL/IADL impairment. Conclusion A novel ADL assessment was explored using LPA, by which elderly people could be defined as three distinct classes of combined ADL/IADL. The predictors identified in the ADL classes could enlighten targeted intervention to address the onset of functional disability and consequent problems with the elderly.

Background: The Infant Mortality Rate (IMR) in Sub-Saharan Africa (SSA) remains the highest relatively to the rest of the world. In the past decade, the policy on reducing infant mortality in SSA was reinforced and both infant mortality and parental death decreased critically for some countries of SSA. The analysis of risk to death or attracting chronic disease may be done for helping medical practitioners and decision makers and for better preventing the infant mortality. Methods: This study uses popular statistical methods of re-sampling and one selected model of multiple events analysis for measuring the survival outcomes for the infants born in 2016 at Kigali University Teaching Hospital (KUTH) in Rwanda, a country of SSA, amidst maternal and child's socio-economic and clinical covariates. Dataset comprises the newborns with correct information on the covariates of interest. The Bootstrap Marginal Risk Set Model (BMRSM) and Jackknife Marginal Risk Set Model (JMRSM) for the available maternal and child's socioeconomic and clinical covariates were conducted and then compared to the outcome with Marginal Risk Set Model (MRSM). That was for measuring stability of the MRSM. Results: The 2117 newborns had the correct information on all the covariates, 82 babies died along the study time, 69 stillborn babies were observed while 1966 were censored. Both BMRSM JMRSM and MRSM displayed the close results for significant covariates. The BMRSM displayed in some instance, relatively higher standard errors for nonsignificant covariates and this emphasized their insignificance in MRSM. The models revealed that female babies survive better than male babies. The risk is higher for babies whose parents are under 20 years old parents as compared to other parents' age groups, the risk decreases as the APGAR increases, is lower for underweight babies than babies with normal weight and overweight and is lower for babies with normal circumference of head as compared to those with relatively small head. Conclusion: The results of JMRSM were closer to MRSM than that of BMRSM. Newborns of mothers aged less than 20 years were at relatively higher risk of dying than those who their mothers were aged 20 years and above. Being abnormal in weight and head increased the risk of infant mortality. Avoidance of teenage pregnancy and provision of clinical care including an adequate dietary intake during pregnancy would reduce the IMR in Kigali.

Summary A systematic review and meta‐analysis of observational studies was performed to provide a deeper understanding of the associations between foetal and childhood exposure to famine and the risks of type 2 diabetes mellitus (T2DM), metabolic syndrome, hypertension, hyperglycaemia, dyslipidaemia, obesity, overweight, coronary heart disease, stroke, and nonalcoholic fatty liver disease (NAFLD) in adulthood. Both foetal and childhood exposure to famine were positively associated with the risks of T2DM (foetal exposure: RR 1.37, 95% CI, 1.23‐1.52; childhood exposure: RR 1.33, 95% CI, 1.08‐1.64), metabolic syndrome (RR 1.26, 95% CI, 1.07‐1.50; RR 1.24, 95% CI, 1.13‐1.35), hypertension (RR 1.30, 95% CI, 1.07‐1.57; RR 1.33, 95% CI, 1.02‐1.74), hyperglycaemia (RR 1.27, 95% CI, 1.11‐1.45; RR 1.25, 95% CI, 1.10‐1.42), dyslipidaemia (RR 1.48, 95% CI, 1.33‐1.66; RR 1.27, 95% CI, 1.12‐1.45), obesity (RR 1.19, 95% CI, 1.02‐1.39; RR 1.13, 95% CI, 1.00‐1.28), overweight (RR 1.17, 95% CI, 1.07‐1.29; RR 1.07, 95% CI, 1.00‐1.14), coronary heart disease (RR 1.22, 95% CI, 1.00‐1.51; RR 1.21, 95% CI, 1.09‐1.35), and moderate‐to‐severe NAFLD (RR 1.66, 95% CI, 1.07‐2.57; RR 1.68, 95% CI, 1.41‐1.99) in adulthood. No association was observed for the risks of stroke or mild NAFLD. Adjustments for age, alcohol, smoking, body mass index, and physical activity nullified some associations. The associations were generally stronger in women than in men. In summary, foetal and childhood exposure to famine may confer greater risks of developing certain cardiometabolic conditions in adulthood, particularly in women. The extent to which risks for cardiometabolic conditions are associated with early‐life famine appears to be determined by certain factors in adulthood.