Perceptions of Neighborhood Environment, Sense of Community, and Self-Rated Health: an Age-Friendly City Project in Hong Kong.

To examine the relationships between perceptions of neighborhood environment, sense of community, and self-rated heath, we recruited 1798 people aged 60 years and older living in Hong Kong. With reference to the checklist of the essential features of age-friendly cities developed by the World Health Organization, perceptions of neighborhood environment were assessed using a questionnaire covering physical and social environmental domains, which mapped onto "outdoor spaces and buildings," "transportation," "housing," "social participation," "respect and social inclusion," "civic participation and employment," "communication and information," and "community support and health services." Sense of community was measured by the Brief Sense of Community Scale.

Trajectories of frailty among Chinese older people in Hong Kong between 2001 and 2012: an age-period-cohort analysis.

Background: there is little evidence to suggest that older people today are living in better health than their predecessors did at the same age. Only a few studies have evaluated whether there are birth cohort effects on frailty, an indicator of health in older people, encompassing physical, functional and mental health dimensions.

Objectives: this study examined longitudinal trajectories of frailty among Chinese older people in Hong Kong.

Effects of Perceived Neighbourhood Environments on Self-Rated Health among Community-Dwelling Older Chinese.

In response to the growing number of older people living in cities, the World Health Organization (WHO) introduced the concept of "Age-Friendly Cities" (AFC) to guide the way in designing physical and social environments to encourage active ageing. Limited research has studied the effects of neighbourhood age-friendliness on elderly health outcomes. Using the example of a highly urbanized city in Asia, this study examined the effects of perceived age-friendliness of neighbourhood environments on self-rated health (SRH) among community-dwelling older Chinese.

Trends in activities of daily living disability in a large sample of community-dwelling Chinese older adults in Hong Kong: an age-period-cohort analysis.

Background: To examine the trends in activities of daily living (ADL) disability in older Chinese adults in Hong Kong between 2001 and 2012.

Methods: Using data from the Elderly Health Centres (EHCs) of the Department of Health comprising a total of 54 808 community-dwelling Chinese adults aged ≥65 years in 1 early cohort (1904-1917) and 10 3-year birth cohorts (1918-1920, 1921-1923, 1924-1926, 1927-1929, 1930-1932, 1933-1935, 1936-1938, 1939-1941, 1942-1944, 1945-1947), we examined trends in ADL disability by using age-period-cohort (APC) models. ADL disability was defined as being unable to perform at least 1 of 7 ADL activities (bathing, dressing, toileting, transferring, feeding, grooming, walking) independently.

Comparing the Age-Friendliness of Different Neighbourhoods Using District Surveys: An Example from Hong Kong.

Background: To address the age-friendliness of living environment in cities, the World Health Organization (WHO) launched the "Age-friendly cities" (AFC) initiative in 2005. To date, however, no universal standard tool for assessing age-friendliness of a community has been agreed.

Methodology: Two quantitative studies on AFC conducted in two Hong Kong districts-Sha Tin and Tuen Mun-were compared.

Frailty Screening in the Community Using the FRAIL Scale.

Objectives: To explore the feasibility of using the FRAIL scale in community screening of older Chinese people aged 65 years and older, followed by clinical validation by comprehensive geriatric assessment of those classified as pre-frail or frail.

Design: Two-phase study: screening of people aged 65 years and older by trained volunteers, followed by comprehensive geriatric assessment by multidisciplinary staff for those classified as pre-frail or frail.

Setting: Elderly Centers in the New Territories East Region of Hong Kong SAR China.

Ischemic heart disease hospitalization among older people in a subtropical city--Hong Kong: does winter have a greater impact than summer?

Globally, excess winter morbidity from ischemic heart disease (IHD) is reported. In subtropical regions, there is a need to quantify the difference in the adverse effect of cold winters compared with hot summers, particularly among the older people. Our objectives were to: (i) compare the effect of winter on IHD hospitalizations with that of summer; (ii) examine temporal trends in the excess winter hospitalizations; and (iii) investigate the effect of age, gender, and meteorological factors on predicting such excess.

Incidence, reversibility, risk factors and the protective effect of high body mass index against sarcopenia in community-dwelling older Chinese adults.

Aim: We examined the incidence and the reversibility of sarcopenia and their associated factors over a 4-year period using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria.

Methods: A total of 4000 community-dwelling older adults aged ≥ 65 years were evaluated for which detailed information regarding demographics, socioeconomic, medical history, lifestyle, and clinical factors were documented at baseline, 2 years, and 4 years later. Sarcopenia was defined according to the EWGSOP algorithm.

Trends in hip fracture incidence and mortality in Chinese population from Hong Kong 2001-09.

Background: there is a suggestion that while the age-adjusted incidence of hip fracture in the West may be declining, the incidence may be rising in Asia.

Objective: this study examines the incidence and post-fracture mortality from 2001 to 2009 among the population aged 65 years and over.

Methods: hip fracture incidence rates and case-fatality rates among Hong Kong population aged 65 and over for the period 2001-09 were obtained from the Hong Kong Hospital Authority (HA) database.

Challenge to long term care for the elderly: cold weather impacts institutional population more than community-dwelling population.

Objectives: To examine whether cold weather affects the institutional population more than the community-dwelling population in terms of morbidity requiring hospital admission.

Methods: Residence-based hospital discharge data were used to compile excess winter hospitalization (EWH) index for the older population (aged 65 years and above) living in institutions (residential care home for the elderly [RCHE] population) and the community-dwelling elderly population in Hong Kong. To separate the influence of influenza on the cold-related hospital admissions, episodes because of influenza were excluded from this study.

Analysis of spatio-temporal variations in stroke incidence and case-fatality in Hong Kong.

Geographical variations in stroke incidence and case-fatality have been documented worldwide. This study examines whether there are spatio-temporal variations in stroke incidence and case-fatality in Hong Kong and attempts to determine to what extent socioeconomic status (SES) and healthcare provision account for these variations. Residence-based hospital discharge data from the Hospital Authority (HA) in Hong Kong were geo-referenced and used to examine incidence rates and case-fatality rates by stroke subtype among the population aged 35 years and above in 1999-2007.

Relative contributions of geographic, socioeconomic, and lifestyle factors to quality of life, frailty, and mortality in elderly.

Background: To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes.

Methodology/principal Findings: Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality.