The objective of the study was to identify the association between social support and psychosocial well-being among men and women aged over 65 years in Europe during the COVID-19 pandemic. Methods Cross-sectional data on 36 621 men (n=15 719) and women (n=20,902) aged 65 years or higher were obtained from the ninth round of the Survey of Health, Ageing and Retirement in Europe. The outcomes were measured by psychosocial well-being reflected with self-reported depression, nervousness, loneliness and sleep disturbances. Social support was measured in terms of receiving help from own children, relatives and neighbours/friends/colleagues since the pandemic outbreak. Result About one-third of the participants reported depression (31.03%), nervousness (32.85%), loneliness (32.23%) and sleep trouble (33.01%). The results of multivariable regression analysis revealed that social support was a protective factor to psychological well-being. For instance, receiving help from own children (RD=−0.13, 95% CI=−0.14 to –0.12), relatives (RD=−0.08, 95% CI=−0.11 to –0.06), neighbours/friends/colleagues (RD=−0.11, 95% CI=−0.13 to –0.09) and receiving home care (RD=−0.20, 95% CI=−0.22 to –0.18) showed significantly lower risk difference for depression. Similar findings were noted for loneliness, nervousness, and sleep trouble as well, with the risk difference being slightly different for men and women in the gender-stratified analysis. For instance, the risk difference in depression for receiving help from own children was −0.10 (95% CI=−0.12 to –0.08) among men compared with −0.12 (95% CI=−0.14 to –0.11) among women. The risk differences in the outcome measures were calculated using generalised linear model for binomial family. Conclusion Findings of the present study highlight a protective role of social support on psychological well-being among both men and women. Developing strategies to promote social support, especially among older adults, may mitigate the rising burden of psychological illness during the COVID-19 pandemic.

Malnutrition is a critical issue among older inpatients, yet limited large-scale research related to this issue has been conducted in China. This study aimed to examine the nutritional status and support of older inpatients in China, assess the associations between disease categories and malnutrition on admission, and explore effective nutritional intervention. A total of 24,139 older participants from the China Nutrition Fundamental Data 2020 Project were included. Malnutrition was measured by the Global Leadership Initiative on Malnutrition criteria. Adjusted odds ratios (aORs) were calculated using logistic analysis. The overall frequency of malnutrition on admission was 18.9%. Participants with infections were more likely to have malnutrition (aOR = 1.929, 95% CI 1.486-2.504). Risks that were also noted for malnutrition included neoplasms (aOR = 1.822, 95% CI 1.697-1.957), hemic and lymphatic diseases (aOR = 1.671, 95% CI 1.361-2.051), nervous system diseases (aOR = 1.222, 95% CI 1.126-1.326), respiratory diseases (aOR = 1.613, 95% CI 1.490-1.746), and digestive system diseases (aOR = 1.462, 95% CI 1.357-1.577). Further, 32.26% inpatients with malnutrition during hospitalization didn't receive nutritional support. Oral nutrition supplements, enteral tube feeding, and parenteral nutrition were associated with stable or improved nutritional status. Older inpatients were at a high risk for malnutrition but did not receive adequate nutritional intervention. More resources and attention need to be devoted to the nutritional status of older inpatients and targeted nutritional support.

Background: The suboptimal uptake of COVID-19 and influenza vaccines among those with non-communicable chronic diseases is a public health concern, because it poses a higher risk of severe illness for individuals with underlying health conditions, emphasizing the need to address barriers to vaccination and ensure adequate protection for this vulnerable population. In the present study, we aimed to identify whether people with chronic illnesses are more likely to get vaccinated against COVID-19 and influenza in the European Union. Methods: Cross-sectional data on 49,253 men (n = 20,569) and women (n = 28,684) were obtained from the ninth round of the Survey of Health, Ageing and Retirement in Europe (June – August, 2021). The outcome variables were self-reported COVID-19 and influenza vaccine uptake status. The association between the uptake of the vaccines and six preexisting conditions including high blood pressure, high blood cholesterol, chronic lung disease, diabetes, chronic bronchitis, and asthma was estimated using binary logistic regression methods. Results: The vaccination coverage for COVID-19 ranged from close to 100% in Denmark (98.2%) and Malta (98.2%) to less than 50% in Bulgaria (19.1%) and Romania (32.7%). The countries with the highest percentage of participants with the influenza vaccine included Malta (66.7%), Spain (63.7%) and the Netherlands (62.5%), and those with the lowest percentage included Bulgaria (3.7%), Slovakia (5.8%) and Poland (9.2%). Participants with high blood pressure were 3% less likely [Risk difference (RD) = -0.03, 95% CI = -0.04, -0.03] to report taking COVID-19 and influenza [RD = -0.03, 95% CI= -0.04, -0.01] vaccine. Those with chronic lung disease were 4% less likely [RD = -0.04, 95% CI= -0.06, -0.03] to report taking COVID-19 and 2% less likely [RD= -0.02, 95% CI = -0.04, -0.01] to report taking influenza vaccine. Men and women with high blood pressure were 3% less likely to have reported taking both of the vaccines. Conclusions: Current findings indicate a suboptimal uptake of COVID-19 and influenza vaccines among adult men and women in the EU countries. Those with preexisting conditions, including high blood pressure and chronic lung disease are less likely to take the vaccines.

Background: Systemic immune-inflammation index (SII) is associated with increased risk in a wide range of illnesses. However, few studies have explored the associations between SII and the risk of malnutrition. Therefore, this study aimed to investigate the association between SII and malnutrition in a nationwide, multicenter, cross-sectional study involving Chinese hospitalized patients.Design: From August 2020 to August 2021, a total of 40,379 hospitalized patients met the inclusion and exclusion criteria. Detailed demographic data, diagnoses, as well as physical and laboratory examination results were recorded. The diagnosis of malnutrition was used with two distinct methods: the Malnutrition Screening Tool 2002 (NRS 2002) + Global Leaders Initiative on Malnutrition (GLIM) criteria and the controlling nutritional status (CONUT) score. The risk factors for malnutrition were analyzed using binary logistic regression and multiple logistic regression to obtain odds ratios (OR) and 95% confidence intervals (CI). Restricted cubic spline (RCS), linear spline, and receiver operating characteristic (ROC) analysis were also used.Results: The prevalence of malnutrition diagnosed by the two methods was 13.4% and 14.9%, respectively. In the NRS 2002 + GLIM diagnostic model, lnSII showed statistical significance between the malnutrition and non-malnutrition group (6.28 ± 0.78 vs. 6.63 ± 0.97, p < 0.001). A positive association was observed between higher SII and the risk of malnutrition in both before and after adjustment models compared to the first quartile (Q₃ vs. Q₁, OR = 1.27, 95%CI: 1.15–1.40; Q₄ vs. Q₁, OR = 1.83, 95%CI: 1.67–2.00). However, a significant reduction in prevalence was observed when SII was in the second quartile (Q₂ vs. Q₁, OR < 1), as indicated by a restricted cubic spline with a U trend (p for nonlinear <0.001). According to the CONUT score, the prevalence of individuals with normal nutritional status decreased with increasing SII, while the occurrence of three different degrees of malnutrition generally increased. The Kappa value between the two diagnostic methods was 0.23, and the merged data observed an area under the ROC curve of 0.73 (95%CI: 0.714–0.742).Conclusion: The U-shaped association between SII and the prevalence of malnutrition was observed. Both lower and higher SII levels (either continuous or categorical variable) were significantly associated with an increased risk of malnutrition.

Malnutrition is a significant health issue in hospital settings, with persistent diagnostic challenges. Despite the Global Leadership Initiative on Malnutrition (GLIM) criteria providing a standardised approach, nationwide validation and implementation remain limited. We aimed to estimate the national prevalence of GLIM-defined malnutrition among Chinese adult inpatients and assess the predictive value of the GLIM criteria for short-term clinical outcomes. We conducted the China Nutrition Fundamental Data 2022 project among adult inpatients from 322 sites across 31 provinces in China between February and October 2023. Malnutrition was defined using the GLIM criteria through a standardised two-step process. The clinical outcomes included discharge outcomes, length of stay, hospitalisation costs, and 30-day mortality. We used logistic and multiple linear regression analyses to examine the association between malnutrition severity and clinical outcomes. The final analysis included 61,283 individuals. Malnutrition was prevalent in 24.6 % of the inpatients (moderate malnutrition: 13.8 %; severe malnutrition: 10.8 %). A dose-response relationship was observed between malnutrition severity and adverse clinical outcomes: moderate and severe malnutrition increased the risk of ineffective discharge outcomes by 1.533 (95 % CI: 1.362-1.725) and 2.200 (1.958-2.473) times, respectively, and 30-day mortality by 1.875 times (1.408-2.496) and 3.065 (2.332-4.028) times, respectively. Additionally, moderate and severe malnutrition were linked to a 0.97-day and 1.20-day increases in hospital stays, respectively. Malnutrition is prevalent among adult Chinese inpatients and strongly associated with adverse clinical outcomes. GLIM-based assessments and interventions are essential to reduce the burden of malnutrition.