Background: Walking speed is an important health indicator in older adults, although its measurement can be challenging because of the functional decline due to aging and limited environment. The aim of this study was to examine whether hand grip strength can be a useful proxy for detecting slow walking speed in this population. Methods: A cross-sectional study was conducted using the cohort from the Yilan Study in Taiwan. Community-dwelling older adults aged 65 years and older were included. Slow walking speed was defined as a 6-meter walking speed < 1.0 m/s, according to the 2019 Asian Working Group for Sarcopenia diagnostic criteria. Stepwise multiple linear regression was used to determine the most significant variables associated with walking speed. Receiver operating characteristic analysis was used to determine the optimal cutoff values for hand grip strength in detecting slow walking speed. Results: A total of 301 participants with an average age of 73.9 ± 6.8 years were included; 55.1 % participants were women. In stepwise multiple linear regression analysis that included various variables, hand grip strength was found to be the most explainable factor associated with walking speed among all participants and among participants of each sex. The optimal cutoff values for hand grip strength in the detection of slow walking speed were 19.73 kg for all participants (sensitivity: 55 %, specificity: 83 %, area under the curve: 0.74, accuracy: 66.9 %), 35.10 kg for men (sensitivity: 92 %, specificity: 42 %, area under the curve: 0.70, accuracy: 66.4 %), and 17.93 kg for women (sensitivity: 62 %, specificity: 80 %, area under the curve: 0.76, accuracy: 67.9 %). Conclusions: Hand grip strength was found to be a useful proxy for the identification of slow walking speed in older adults.

Background: Single-item measures of physical and mental health are feasible for older adults, but their validity for that age group is unclear. This study tested validity of a global self-rated health and a global self-rated happiness measure in a large sample of community-dwelling older adults in Taiwan. Methods: A cross-sectional sample of 3,982 men and women aged 65 or older in Yilan, Taiwan, provided data on global self-rated health and happiness using 100-point numerical scales. The Physical Component Summary of the 12-Item Short Form Health Survey (version 2) and the Groningen Activity Restriction Scale were used to test the validity of the self-rated health item. The Mental Component of that 12-item scale and the Hospital Anxiety and Depression Scale were validators regarding the self-rated happiness item. Criterion validity was tested using the 12-Item Short Form Health Survey (version 2). Results: The correlations between the self-rated health and happiness measures and the 12-Item Short Form Health Survey (version 2) validators were positive and statistically significant, supporting convergent validity. Sufficient divergent validity was demonstrated through the negative and significant relationship between the self-rated health item and the Groningen Activity Restriction Scale scores and the negative and significant relationship between the self-rated happiness item and the Hospital Anxiety and Depression Scale. Optimal cut-off scores for physical and mental health states depended on age and gender. Conclusion: The global self-rated health and happiness measures were validated. Cut-off scores for evaluating older adults' physical and mental health should be age- and gender-specific.

Previous findings on the associations between body mass index (BMI) and subjective health outcomes among older adults are inconsistent. The aims of this study were to explore the associations of BMI with health-related quality of life (HRQoL), self-rated health (SRH) and happiness among older adults. This study was part of the Yilan study, which was a community-based survey conducted in the Yilan city in Taiwan. A total of 3722 older adults were randomly recruited during 2012–2016. HRQoL was measured using the Short Form-12 Health Survey physical component summary (PCS) and mental component summary (MCS) scores and SRH and happiness were also evaluated. By hierarchical regression, after adjusting for covariates, compared with normal-weight participants, overweight did not have significantly different PCS scores (B = 0.20, 95% confidence interval [CI]: −0.45 to 0.85, p = 0.546) but obese had significantly lower PCS scores (B = −0.97, 95% CI: −1.68 to −0.26, p < 0.0001); overweight and obese participants had significantly better MCS scores (B = 1.00, 95% CI: 0.40 to 1.61, p = 0.001 and B = 1.22, 95% CI: 0.60 to 1.88, p < 0.0001, respectively); overweight participants had significantly higher SRH scores (B = 1.08, 95% CI: 0.16 to 2.00, p = 0.022) but underweight had significantly lower SRH scores (B = −2.88, 95% CI: −4.81 to −0.95, p = 0.003); overweight and obese participants had better happiness scores (B = 1.55, 95% CI: 0.45 to 2.66, p = 0.006 and B = 1.68, 95% CI: 0.49 to 2.88, p = 0.006, respectively). In conclusion, compared with normal-weight individuals, overweight individuals had better mental HRQoL, SRH and happiness but underweight older people reported poorer SRH and obese reported poorer physical HRQOL but better mental HRQoL and self-rated happiness.

Objectives: Given the close relationship between sleep-wake disturbances and depression, an in-depth investigation of such a relationship is imperative. The present study aims at elucidating the relationship between various sleep-wake disturbances and depression in older adults and at examining the influence of co-occurring anxiety on such associations. Method: A community-based survey using the cohort from the Yilan Study in Taiwan was conducted from August 2013 to November 2016. Adults aged 65 and older were randomly selected to participate in the study. The Hospital Depression and Anxiety Scale was used to measure clinical depressive and anxiety symptoms. Insomnia and daytime sleepiness were defined through the Athens Insomnia Scale and the Epworth Sleepiness Scale, respectively. Furthermore, the use of hypnotics, subjective sleep duration and sleep-wake scheduling were evaluated. Their relationship with depression was examined through logistic regression analyses. Results: There were 2620 participants surveyed and 247 (9.4%) had depression. Before controlling for anxiety, insomnia (OR: 1.78, 95% CI: 1.23-2.55), daytime sleepiness (OR: 1.79, 95% CI: 1.27-2.53), and long sleepers (OR: 1.77, 95% CI: 1.24-2.53) have a higher likelihood for depression in the multivariable regression analysis. However, when including anxiety into the multivariable regression model, only those with daytime sleepiness and long sleepers had an elevated risk for depression. Therefore, the association between insomnia and depression turned to be statistically non-significant. Conclusion: In older adults, various sleep-wake disturbances differ in their relationship with depression. In addition, daytime sleepiness and long sleep duration were mostly characteristic of depression when co-occurring anxiety was considered.

Atrial fibrillation (AF) is currently recognized as one of the most common cardiac arrhythmias worldwide, with the increasing prevalence that has been estimated to be as high as 9% among the elderly. Health-related quality of life (HRQoL) has become an important patient-centered health outcome measurement, but the impacts created by AF and other arrhythmias with similar symptoms, such as frequent atrial and ventricular premature contractions (APCs and VPCs, defined as ≥ 3 beats/5 minutes), have not been extensively evaluated. The Yilan Study is a population-based community health survey, which in part aims to evaluate the prevalence and impacts of these arrhythmias on the HRQoL in a community dwelling elderly population. A total of 1,732 citizens from the Yilan, Taiwan, aged 65 years or older (45.8% male) were enrolled and visited at their homes, where HRQoL was measured utilizing the Short Form-12 Health Survey. Each participant's heart rhythm was recorded with an electrocardiographic monitor for 5 minutes. The results disclosed that the prevalence of AF of this aged population was 5.8%, similar to the mean global prevalence. Besides, the prevalence of frequent APCs and frequent VPCs in these elderly people were 7.1% and 5.5%, respectively. After multiple regression analysis, elderly people with AF had lower scores in the physical component of HRQoL, while those elderly people with frequent VPCs had lower scores in the mental component. Ultimately, these findings can provide additional useful and population-specific information about AF, and assist medical professionals in designing more effective strategies for cardiac arrhythmia treatments.