Successful aging in old age is important. However, the determinants of successful aging vary across populations due to cultural differences, and only a limited number of studies have addressed these determinants in Taiwan population. This study aimed to evaluate successful aging via better physical and mental functions as well as to explore associated determinants in an elderly Taiwan population that had no impaired cognitive function. A community-based cross-sectional survey was conducted in January 2009 in Taichung, Taiwan. A total of 903 elderly persons (≥65 years) without impaired cognitive function were enrolled. Those with physical and mental component scores in the top tertile of the Short-Form 36 were considered to be aging successfully. All participants completed a structured questionnaire and the comprehensive geriatric assessment measurements of the five components of frailty defined by Fried et al. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the relationship between associated factors and successful aging using logistic regression analysis. The prevalence of successful aging was 10.4% in elders. A higher proportion of successful aging was found in non-frail (16.9%) and pre-frail elders (7.2%) than in frail elders (0.9%). Multivariate logistic regression showed pre-frail elders to be associated with lower prevalence of successful aging relative to non-frail elders (OR: 0.45; 95% CI: 0.24–0.84). Relative to those aged ≤70 years, elders aged 71–75 years were associated with a lower prevalence of successful aging (OR: 0.27; 95% CI: 0.13–0.58). Successful aging was also more likely among those able to visit relatives and friends (OR: 3.86, 95% CI: 1.09–13.61) and among those without a history of falling (OR: 4.95; 95% CI: 1.79–13.74), pain (OR: 4.04; 95% CI: 2.18–7.50), or sleep disorders (OR: 2.36; 95% CI: 1.30–4.27). Successful aging was associated with age, frail status, chronic health-related problems and psychosocial support. However, whether or not these associations are causal requires further exploration.

Previous studies have reported the associations of frailty phenotype or its components with mortality. However, studies that explored the effects of transition in frailty status on mortality were far less in Asian or Chinese. The aim of this study was to evaluate baseline frailty status and one-year change of frailty status in relation to all-cause mortality in Taiwanese community-dwelling older adults who participated in the Taichung Community Health Study for Elders. We conducted a community-based prospective cohort study. A total of 921 community-dwelling elderly men and women aged 65–99 years in Taichung City were enrolled in 2009–2010 and were followed up through 2016. We adopted the definition of frailty proposed by Fried et al., including five components: shrinking, weakness, poor endurance and energy, slowness, and low physical activity. Cox proportional hazards models were used to determine adjusted hazard ratios (HRs) of mortality with 95% confidence intervals (CIs) for frailty at baseline and one-year change in frailty status. There were 160 deaths during the follow-up period. The mortality rates in groups of robust and frail were 20.26 and 84.66 per 1000 person-years respectively. After multivariate adjustment, the HR (CIs) for baseline frailty was 2.67 (1.73–4.12). Poor endurance and energy [1.88 (1.03–3.42)], slowness [2.60 (1.76–3.83)] and weakness [1.65 (1.16–2.33)] were found to be predictors of mortality. Increased risks in mortality for subgroups of robust-to-frail [2.76 (1.22–6.27)], frail-to-robust [3.87 (1.63, 9.19)], and frail-to-frail [4.08 (1.92–8.66)] over one-year period were observed compared with those remaining robust. Baseline frailty status and one-year change in frailty status are associated with 6-year all-cause mortality among Taiwanese elderly adults. Frailty may be useful for identifying older adults at high risks for mortality prevention.

Carotid intima–media thickness (IMT), plaque, and stenosis are widely used as early surrogate markers of subclinical atherosclerosis and strong predictors of future deaths and cardiovascular events. Albuminuria is an indicator of generalized endothelial dysfunction that speeds up atherosclerosis. However, previous studies reporting these associations cannot rule out the confounding effect of albuminuria. We aimed to examine the independent and joint relationships between IMT markers and 10-year mortality in community-dwelling Taiwanese adults. This work was a community-based prospective cohort study consisting of 2956 adults aged at least 30 years recruited in 2007 and followed up through 2019. Cox proportional hazard regression models were used to examine associations of these subclinical atherosclerosis markers with mortality. During an average of 9.41 years of follow up, 242 deaths occurred. The mortality rate was 8.70 per 1000 person-years. Compared with those with carotid IMT less than 1.0 mm, persons with severely increased carotid IMT (≥2.0 mm) had an increased risk for death (hazard ratio (HR): 1.79; 95% confidence interval (CI): 1.07, 3.00). Compared with those without carotid plaque, persons with carotid plaque were more likely to have an increased risk for death (1.65; 1.21–2.32). Compared with those with carotid stenosis less than 25%, persons with carotid stenosis of 25–36% had a significant increased risk for death (1.57; 1.12–2.22). Considering these three IMT markers along with the traditional risk factors (c-statistic: 0.85) significantly increased their predictive ability of mortality compared with any individual variable’s predictive ability (all p-values < 0.001 for comparisons of c-statistic values). Carotid IMT measures, including IMT thickness, carotid plaque, and carotid stenosis were significant independent predictors of mortality. Our study supports evidence of blood pressure-related media thickening markers to assess future mortality risks in Chinese adults of general population.

Objective. The objective of the study was to evaluate the prevalences and trends of multimorbidity and polypharmacy in older adults in Taiwan. Methods. An observational study was performed using the 2000-2013 database of the Taiwan National Health Insurance Program (analysis in 2018). Participants³ 65 yearswere included in the study. Multimorbidity was defined as participants having two or more chronic diseases annually. Polypharmacy was defined as the average daily number of prescribed medications ≥ 5. Results. The prevalences of multimorbidity were 42.4% in 2000 and 56% in 2013. The prevalences of polypharmacy were 22.9% in 2000 and 32.1% in 2013. Conclusions. From 2000 to 2013, multimorbidity and polypharmacy were prevalent among older adults in Taiwan. Public health efforts to intervene the primary prevention for chronic diseases should be considered in older adults.

The aim of this study was to evaluate the effect of MetS on arterial stiffness in a longitudinal study.

Background: Dyslipidemia is a major cardiovascular risk factor and common in diabetes patients. Most guidelines focus on optimal lipid levels, while variation of lipid profiles is far less discussed. This study aims to investigate the association of visit-to-visit variability in blood lipids with all-cause, cardiovascular, and non-cardiovascular mortality in patients with type 2 diabetes.Methods: We identified 10,583 type 2 diabetes patients aged ≥ 30 years with follow-up ≥ 3 years and who participated in the Diabetes Care Management Program at a medical center in Taiwan. Variability in lipid profiles within 3 years after entry was calculated using coefficient of variation. Cox proportional hazard models were used to evaluate lipid variability in relation to subsequent mortality.Results: Over a mean follow-up of 6.4 years, 1838 all-cause deaths (809 cardiovascular deaths) were observed. For each 10% increase in variability in high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol, the hazard ratios (95% confidence intervals) of all-cause mortality were 1.30 (1.22–1.37), 1.05 (1.01–1.09), and 1.10 (1.03–1.16), respectively; those of cardiovascular mortality were 1.27 (1.16–1.39), 1.08 (1.02–1.15), and 1.16 (1.07–1.27), respectively. Each 10% increase in high-density lipoprotein cholesterol variability conveyed 31% greater risk of non-cardiovascular mortality. High variability in total cholesterol and low-density lipoprotein cholesterol increased all-cause mortality in subgroups of nonsmoking, regular exercising, non-dyslipidemia, and more severe status of diabetes at baseline.Conclusions: Blood lipid variability except for triglyceride variability was associated with all-cause and cardiovascular mortality in patients with type 2 diabetes.