Background: Medical students are affected by high levels of general anxiety disorder. However, few studies have specifically focused on the applicability of universal anxiety screening tools in this sample. This study was aimed to evaluate the psychometric property of the 7-item Generalized Anxiety Disorder Scale (GAD-7) among Chinese medical university students.Methods: A questionnaire survey was conducted among 1,021 medical postgraduates from six polyclinic hospitals. Internal consistency and convergent validity of the GAD-7 were evaluated. Factor analyses were used to test the construct validity of the scale. An item response theory (IRT) framework was used to estimate the parameters of each item. Multi-group confirmatory analyses and differential item function analyses were used to evaluate the measurement equivalence of the GAD-7 across age, gender, educational status, and residence.Results: Cronbach's α coefficient was 0.93 and the intraclass correlation coefficients ranged from 0.71 to 0.87. The GAD-7 summed score was significantly correlated with measures of depression symptoms, perceived stress, sleep disorders, and life satisfaction. Parallel analysis and confirmatory factor analysis supported the one-factor structure of the GAD-7. Seven items showed appropriate discrimination and difficulty parameters. The GAD-7 showed good measurement equivalence across demographic characteristics. The total test information of the scale was 22.85, but the test information within the range of mild symptoms was relatively low.Conclusions: The GAD-7 has good reliability, validity, and measurement invariance among Chinese medical postgraduate students, but its measurement precision for mild anxiety symptoms is insufficient.

The development of 5G technology has brought major advances and diverse challenges in healthcare services for older people, and access to equitable telemedicine is a high priority. Smartphones are most commonly used device to access the internet and bring the convenience of telemedicine to the user's fingertips. In the period where aging and informatization coexist in China, the role of smartphones in their daily lives, long-term care, and future opportunities and challenges needs serious reconsideration. We provide the latest evidence of smartphone use among the older adults of China and expound on issues about fairness in accessing mobile health, the substantial digital divide, and potential drawbacks of problematic smartphone use.

Background: The Barthel Index (BI) is among the most widely used instruments for evaluating physical function, yet its applicability has not been well studied in the oldest‐old population.Objective: To test the psychometric properties of the BI for evaluating physical activities of daily living (ADL) in a large representative sample of oldest‐old population in China.Methods: Participants were 1750 oldest‐old adults (aged 80–116 years, 72.11% female) including 956 centenarians. ADL were assessed during face‐to‐face interviews. Multiple methodologies were applied to evaluate the reliability, validity and measurement invariance of the BI. An item response theory (IRT) framework was conducted to estimate the parameters of each item.Results: 48.91% participants had function dependence. Cronbach's α coefficient of the BI was 0.902, but ‘Stair climbing’ impaired the overall internal consistency. The known‐group validity of the BI was confirmed by significant differences in the BI score across age (P < 0.001), gender (P < 0.001), education (P < 0.001) and ethnicity (P = 0.038). The criterion‐related validity was supported by significant correlations between the BI score with depression symptoms (r = −0.36, P < 0.001), subjective well‐being (r = 0.23, P < 0.001) and self‐report health status (r = 0.22, P < 0.001). Factor analysis yielded a two‐factor structure (somatic function and physiological self‐care) with appropriate invariance. Ten items showed acceptable discrimination parameters (1.80–5.87) and difficulty parameters (−2.65–1.11) but had variant test information (1.73–10.22). ‘Bower control’ and ‘Bladder control’ were not conducive to the local independence.Conclusions: The BI has appropriate reliability, validity and measurement precision for community‐based Chinese oldest‐old and centenarians, but individual items have low quality. Somatic disability and incontinence are two latent categories of functional dependence in this population. Living environment needs to be taken into consideration for ADL instrument development and modification.

The Asian Working Group for Sarcopenia 2019 consensus emphasized nutritional assessment and intervention for community-dwelling older people with sarcopenia status. This study aimed to examine the association of serum albumin and dietary protein intake (DPI) with all-cause mortality among older adults at risk of sarcopenia. We enrolled 1763 older adults at risk of sarcopenia in the Chinese Longitudinal Healthy Longevity Survey (2012–2018) using calf circumference and handgrip strength. Serum albumin concentrations were measured using bromocresol green methods, and DPI frequency was evaluated using a semi-quantitative questionnaire at baseline. Cox proportional hazards models were used to explore the association of serum albumin and DPI with all-cause mortality. During 5606.3 person-years of follow-up (median: 3.28 years), 802 older people died. After adjusting for socio-demographics, health behaviors, and clinical characteristics, we observed an inverse linear association between serum albumin and all-cause mortality (P_non-linear = 0.429). Participants with low albumin levels (<40.0 g/L) had a 43 % higher risk of mortality than their counterparts (hazard ratio (HR) = 1.43, 95 % confidence interval (CI) = 1.22–1.66). There was no significant association between DPI and mortality (P_s > 0.05). Moreover, the association between low albumin and all-cause mortality remained significant in the lower DPI subgroup (HR = 1.47, 95 % CI = 1.18–1.85), but was not significant in the high DPI subgroup (HR = 1.15, 95 % CI = 0.92–1.39). Serum albumin levels are inversely associated with all-cause mortality in community-based older adults at risk of sarcopenia. Sufficient dietary protein consumption may attenuate the effect of low serum albumin on increased mortality and potential mechanisms for the interaction warrant further exploration.

According to data from China’s seventh national population census in 2020, around 13.5% of the country’s total population or some 190 million individuals were aged ≥65 years [1]. Projections indicate that by 2030, this proportion will exceed 20%, signalling a substantial demographic shift toward an aged society [2]. Engagement in recreational activities such as physical […]