Objectives: This study investigated the predictors of risk perception and its effect on older adults’ preventive behavior and/or medical care avoidance during the COVID-19 pandemic. Methods: Older respondents (age >50 years) from the MIT COVID-19 Preventive Health Survey reported their social distancing, hand washing, mask wearing, and medical care avoidance between July and October 2020 (n = 4395). Structural equation models were used. Results: Significant predictors of higher risk perception were female gender, older age, poorer health, city residency, personally knowing someone who had COVID-19, and correct knowledge of vaccine/treatment. Higher risk perception was subsequently associated with higher frequency/probability of practicing preventive behavior and/or avoiding medical care. Knowledge had the strongest path coefficient with risk perception. Discussion: Disseminating correct information to older adults could help them evaluate infection risk accurately. Educational programs on the precautions implemented at clinical settings to ensure patient safety may encourage older adults to seek timely medical care.

OBJECTIVES: This prospective cohort study examined the relationship between depressive symptoms and onset of functional disability over 2 years among US Chinese older adults, a rapidly growing minority older adult population. DESIGN AND SETTING: This study used survey data from 2713 Chinese older adults who completed both baseline (2011‐2013) and follow‐up (2013‐2015) interviews of the Population Study of Chinese Elderly in Chicago. Depressive symptoms were assessed at baseline by the nine‐item Patient Health Questionnaire. Functional disability was measured by three validated scales, Katz Index of Independence in Activities of Daily Living (ADLs), the Lawton Instrumental Activities of Daily Living (IADLs) scale, and the Rosow and Breslau mobility scale. Multivariate logistic regression was conducted to examine the relationship between baseline depressive symptoms and the development of functional disability (ADLs, IADLs, mobility) at 2‐year follow‐up while adjusting for covariates. RESULTS: Of the 2713 participants, 5.2% experienced ADL disability onset, 35.6% experienced IADL disability onset, and 23.3% experienced mobility disability onset over 2 years. After adjusting for covariates, the odds of ADL disability onset (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02‐1.11), IADL disability onset (OR = 1.05; 95% CI = 1.01‐1.09), and mobility disability onset (OR = 1.05; 95% CI = 1.01‐1.09) were consistently higher in US Chinese older adults with higher levels of depressive symptoms than their less‐depressed counterparts. Other significant risk factors included older age and more chronic physical conditions. CONCLUSION: Study findings underscore a significant relationship between depressive symptoms and onset of functional disability. Screening and, subsequently, treating depressive symptoms have the potential to reduce disability among US Chinese older adults. Culturally relevant depressive symptom screening may help identify Chinese older adults who are at greater risks for the development of functional disability. J Am Geriatr Soc 67:S538–S544, 2019.

Background: Dementia is a global public health priority due to rapid growth of the aging population. As China has the world’s largest population with dementia, this debilitating disease has created tremendous challenges for older adults, family caregivers, and health care systems on the mainland nationwide. However, public awareness and knowledge of the disease remain limited in Chinese society. Objective: This study examines online public discourse and sentiment toward dementia among the Chinese public on a leading Chinese social media platform Weibo. Specifically, this study aims to (1) assess and examine public discourse and sentiment toward dementia among the Chinese public, (2) determine the extent to which dementia-related discourse and sentiment vary among different user groups (ie, government, journalists/news media, scientists/experts, and the general public), and (3) characterize temporal trends in public discourse and sentiment toward dementia among different user groups in China over the past decade. Methods: In total, 983,039 original dementia-related posts published by 347,599 unique users between 2010 and 2021, together with their user information, were analyzed. Machine learning analytical techniques, including topic modeling, sentiment analysis, and semantic network analyses, were used to identify salient themes/topics and their variations across different user groups (ie, government, journalists/news media, scientists/experts, and the general public). Results: Topic modeling results revealed that symptoms, prevention, and social support are the most prevalent dementia-related themes on Weibo. Posts about dementia policy/advocacy have been increasing in volume since 2018. Raising awareness is the least discussed topic over time. Sentiment analysis indicated that Weibo users generally attach negative attitudes/emotions to dementia, with the general public holding a more negative attitude than other user groups. Conclusions: Overall, dementia has received greater public attention on social media since 2018. In particular, discussions related to dementia advocacy and policy are gaining momentum in China. However, disparaging language is still used to describe dementia in China; therefore, a nationwide initiative is needed to alter the public discourse on dementia. The results contribute to previous research by providing a macrolevel understanding of the Chinese public’s discourse and attitudes toward dementia, which is essential for building national education and policy initiatives to create a dementia-friendly society. Our findings indicate that dementia is associated with negative sentiments, and symptoms and prevention dominate public discourse. The development of strategies to address unfavorable perceptions of dementia requires policy and public health attention. The results further reveal that an urgent need exists to increase public knowledge about dementia. Social media platforms potentially could be leveraged for future dementia education interventions to increase dementia awareness and promote positive attitudes.

Family involvement is critical to end-of-life (EOL) care among older adults. This study aims to examine the association and pathways between family relationships and older Chinese Americans’ attitude toward family involvement in EOL care discussions. Data were collected from 260 Chinese Americans aged 55 years and above. Structural equation modeling was used to examine the total and indirect effects of family relationships on attitude toward family involvement in discussing EOL care plans. Family relationships had a significant positive total effect on attitude toward family involvement in EOL care. Indirect effects of family relationships on attitude toward family involvement in EOL care through self-efficacy, perceived benefits, and perceived barriers of discussing EOL care with family members were all significant. Findings provide empirical evidence of how family relationships affect older Chinese Americans’ attitude toward family involvement in EOL care and underline the need for family-centered EOL interventions for this population.

OBJECTIVES: Research has examined the relationships between positive social support (PSS) and elder mistreatment (EM) but less is known regarding the negative aspect of social support (NSS), especially among minority groups in the United States. This study aimed to investigate the relationships between PSS/NSS from different sources and EM among US Chinese older adults. Design: Population‐based cross‐sectional study. Setting: Greater Chicago, IL, area. PARTICIPANTS: A representative sample of Chinese older adults aged 60 years or older (N = 3157) from the Population Study of ChINese Elderly in Chicago in 2011 to 2013. Measurements: We applied a 10‐item widely used instrument to assess EM. PSS and NSS from spouse/family members/friends were measured by a 12‐item scale. Multivariate logistic regression analyses were conducted to examine the relationships. RESULTS: After adjusting for confounders, higher levels of overall PSS from all three sources, including spouse, family members, and friends (odds ratio [OR] = 0.88 [95% confidence interval {CI} = 0.85‐0.91]), were associated with lower risk of EM. But participants with a higher level of overall NSS from all three sources (OR = 1.51 [95% CI = 1.41‐1.61]) were more likely to experience EM. The results on the relationships between PSS from spouse (OR = 0.70 [95% CI = 0.64‐0.76]), PSS from family members (OR = 0.73 [95% CI = 0.68‐0.79]), and EM were similar to overall PSS. But PSS from friends had a nonsignificant association with EM. Greater levels of NSS from spouse (OR = 1.84 [95% CI = 1.64‐2.07]), family members (OR = 2.36 [95% CI = 2.03‐2.75]), and friends (OR = 1.69 [95% CI = 1.32‐2.17]) were associated with increased risks of EM. CONCLUSION: Higher levels of SS were not always associated with lower risks of EM among US Chinese older adults. NSS might have counter effects. Future qualitative or longitudinal research needs to explore detailed cultural explanations and casual relationships between SS and EM. J Am Geriatr Soc 67:S499–S505, 2019.

Abnormalities in cell cycle regulation are reported to be strongly associated with tumorigenesis and progression of tumors. Wnt/β-catenin signaling pathway and cell cycle play key roles during the genesis and development of hepatocellular carcinoma (HCC). Current studies indicated that expressions of cyclin A, E and D1 were affected after silencing of β-catenin gene in HCC, but it is unclear if other cyclins are affected. To determine the relation, small interference RNA (siRNA) against β-catenin was transfected into HCC cell lines HepG2 and SMMC-7721, and cell cycle and cyclin B1 and cyclin C protein expression were detected. Cell cycle was arrested in G0/G1 at 72h after transfection and the cell cycle began to transfer from G0/G1 to G2/M through S and had a trend to revert at 96h. In addition, β-catenin protein expression was decreased at both 72 and 96h, although the level was slightly higher at 96h than that at 72h. However, cyclin B1 expression decreased at 72h and increased at 96h, cyclin C expression increased at 72h and decreased at 96h. These findings suggest that silencing β-catenin gene may induce the changes of cell cycle and cyclin B1 and cyclin C protein expression. Wnt/β-catenin signaling pathway probably takes part in the genesis and development of HCC through regulating cell cycle and the expression of cyclin B1 and cyclin C.