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Geriatric syndrome awareness and its determinants in China: a cross-sectional study

BMC Geriatrics volume 24, Article number: 712 (2024) Cite this article

Abstract

Background

This study aims to investigate the awareness rate of six common geriatric syndromes and related influencing factors among the older adults aged 65 and above in China.

Methods

This is a multicenter cross-sectional study involving 6,653 participants aged 65 and older from four regions who completed a questionnaire on geriatric syndrome awareness. The questionnaire covered demographic data, health information, medication usage, and an assessment scale for knowledge of six geriatric syndromes (GS Awareness Scale).

Results

A total of 6,653 respondents were surveyed, with 5,318 valid questionnaires collected (79.93%), including 1,311 from Zhejiang (24.7%), 1,356 from Beijing (25.5%), 1,373 from Sichuan (25.8%), and 1,278 from Fujian (24.0%). The highest awareness was for falls, with 3,295 individuals (62.0%), followed by dementia with 2,929 individuals (55.1%), malnutrition with 2,907 individuals (54.7%), frailty with 2,156 individuals (40.5%), urinary incontinence with 2,006 individuals (37.7%), and sarcopenia with 1,914 individuals (36.0%). Univariate analysis showed that factors such as region, age, marital status, living situation, educational level, source of respondents, income status, and smoking had statistically significant differences in awareness rates (P < 0.05). Multivariate logistic regression results indicated that the source of respondents significantly affected the awareness rates (P < 0.05), with the older adults from rural areas having an increased risk of lower awareness compared to urban areas; age also significantly influenced the awareness rates (P < 0.05), with older age groups (76–85, 86–95 years) having a higher risk of reduced awareness compared to those aged 65–75 years.

Conclusions

The awareness of common geriatric syndromes among the older adults population aged 65 years and older in China is notably low. Consequently, there exists a critical need to enhance the formulation of policies regarding geriatric syndromes across various regions, aiming to elevate health literacy among this demographic.

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Background

Geriatric syndromes (GS) encompass a variety of non-specific clinical problem syndromes that primarily affect multiple body systems due to age-related multifactorial impairments. Common examples include dementia, frailty, sarcopenia, urinary incontinence, malnutrition, and falls [1,2,3]. These syndromes significantly increase mortality risk among the older adults, reduce life expectancy, severely impair quality of life, and impose considerable burdens on medical resources as well as socioeconomic and family structures [4,5,6,7]. Studies indicate that a majority of older adults experience at least one, if not multiple, geriatric syndromes [8, 9]. As the aging population in China expands, the incidence of various geriatric syndromes among this demographic continues to rise [10]. Research findings reveal that 72.8% of surveyed participants suffered from more than one geriatric syndrome, and 90.5% had at least one [11]. Another study, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), reported prevalence rates for probable sarcopenia, confirmed sarcopenia, and severe sarcopenia at 38.5%, 18.6%, and 8.0%, respectively [12]. Moreover, a separate investigation found that the overall weighted prevalence of frailty was 9.9% [13].

To mitigate the impacts of geriatric syndromes on the healthcare system, socioeconomic structures, and the health of older adults, it is crucial to develop policies that enhance health literacy and promote health management specific to geriatric syndromes [14,15,16]. Health promotion, a concept that encompasses a wide array of activities, aims to improve health determinants through public policies, the creation of healthy environments, community action, enhancement of personal skills, and the reorientation of health services [17]. Elevating awareness of geriatric syndromes among the older adults and increasing the overall awareness rate are essential components of self-management and health promotion for these conditions. Nonetheless, previous research has predominantly concentrated on the prevalence, risk factors, and associated morbidities of geriatric syndromes, with limited focus on the awareness levels of older adults regarding these syndromes [18].

In alignment with the World Health Organization's strategies for healthy and active aging, as well as the 'Healthy China' initiative, this study aims to address the existing research gap concerning the awareness rates of geriatric syndromes in China. Utilizing the phenotypes of geriatric syndromes as outlined by the Asia–Pacific Association of Geriatrics (APAGM) in 2013 [19] and adhering to China's geriatric health standards (WS/T802-2022), this research focuses on six prevalent geriatric syndromes: dementia, frailty, sarcopenia, urinary incontinence, malnutrition, and falls. The objective is to investigate both the awareness rates of these conditions and the factors influencing such awareness among the older adults population in China.

In summary, this study aimed to investigate the awareness rates of the aforementioned six common geriatric syndromes and their influencing factors. The findings are intended to provide a scientific foundation for the development of health promotion policies targeting the older adults. Ultimately, the goal is to enhance the health literacy concerning geriatric syndromes among this population.

Methods

Study design

This study employed a multicenter, cross-sectional design. Participants were recruited through convenience sampling across multiple centers in China from January to December 2022. A questionnaire survey was conducted among the older adults aged 65 and above in four regions: Zhejiang, Beijing, Sichuan, and Fujian. The survey focused on the awareness rates of six common geriatric syndromes: dementia, frailty, sarcopenia, urinary incontinence, malnutrition, and falls.

Participants

Inclusion criteria: 1) Aged ≥65 years, regardless of gender; 2) Willing to sign an informed consent form and participate in the survey. Exclusion criteria: 1) History of severe mental illness; 2) Severe visual, auditory, or communication impairments; 3) Inability to cooperate fully with the completion of the entire survey questionnaire. All subjects in this study consisted of inpatients and outpatients of the geriatrics departments of the teaching hospital of Zhejiang Chinese Medical University, Xuanwu Hospital of Capital Medical University, West China Hospital of Sichuan University, and Fujian Medical University Union Hospital, as well as older adults in the community under the coverage of each hospital's medical community. All four hospitals are tertiary care hospitals with geriatric centers. A total of 6,653 individuals were surveyed across four regions, with 5,318 valid questionnaires collected (79.93%). This included 1,311 participants from Zhejiang (24.7%), 1,356 from Beijing (25.5%), 1,373 from Sichuan (25.8%), and 1,278 from Fujian (24.0%). See Fig. 1 below.

Fig. 1
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Flowchart

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Measurements

The geriatric syndromes awareness survey questionnaire consists of four parts: demographic data, medical history, medication use, and a survey scale for awareness of six geriatric syndromes (GS Awareness Scale). Demographic data includes gender, age, marital status, living situation, education level, employment status, source of respondents, income status, smoking status, and drinking status. The term "polypharmacy" refers to the simultaneous use of five or more different medications [20]. Geriatric comorbidity is defined as the occurrence of two or more chronic health problems at the same time in the same older individual, which may include organ diseases, psychological issues, geriatric syndromes, or other health problems that affect the older adults [21].

The GS Awareness Scale for the six geriatric syndromes was developed by expert members of our research team. It was refined through a Delphi expert consultation process and validated for reliability and validity. The scale includes separate sub-scales for awareness of dementia, frailty, sarcopenia, urinary incontinence, malnutrition, and falls. Each GS Awareness Scale contains six questions, with correct answers scored as 1 point and incorrect answers as 0 points. A score of ≥ 4 on a single syndrome scale is considered as awareness of that syndrome, and the percentage of respondents who are aware constitutes the awareness rate for that syndrome. Each of the six questions for each GS Awareness Scale consists of two questions on symptoms, two questions on risk factors, and two questions on interventions.

In the survey of the six major geriatric syndromes, being aware of more than four syndromes is considered partial awareness, and the percentage of the sampled population that is partially aware represents the partial awareness rate for geriatric syndromes. Awareness of all six syndromes is considered complete awareness, and the percentage of the sampled population that is completely aware represents the complete awareness rate for geriatric syndromes. An additional movie file shows this in more detail [see Additional file 1].

Data collection process

All survey questionnaires were administered face-to-face, filled out, and collected by investigators with a medical background who had received uniform training in Comprehensive Geriatric Assessment (CGA). Questionnaires with logical errors were excluded to ensure the reliability and authenticity of the data.

Statistical analysis

Statistical analysis was performed using SPSS25.0. The χ2 test was used to compare all data, which were presented as percentages and numbers. P < 0.05 was regarded as statistically significant when analyzing the association between the parameters linked to the rate of awareness using logistic regression analysis.

Results

Demographic characteristics

We conducted a questionnaire survey among a total of 6,653 individuals aged 65 and above across four provinces, collecting 5,318 valid questionnaires (79.93%). This included 1,311 participants (24.7%) from Zhejiang, 1,356 (25.5%) from Beijing, 1,373 (25.8%) from Sichuan, and 1,278 (24.0%) from Fujian. Among the respondents, there were 2,391 men (45.0%) and 2,927 women (55.0%), with a gender ratio of 0.82:1. The age group was primarily concentrated between 65 to 75 years, with an average age of 76.13 ± 8.62. The majority of respondents were married and cohabiting, totaling 2,674 people (50.3%). Most lived with relatives, accounting for 2,893 individuals (54.4%). The most common education levels were elementary and junior high school, with 1,454 (27.3%) and 1,339 (25.2%) participants respectively. The vast majority of the surveyed population were retired, totaling 5,134 people (96.5%). As for the source of respondents, 3,670 (69.2%) came from urban areas and 1,631 (30.8%) from rural areas. Regarding income, the majority perceived their income as average, numbering 3,907 individuals (73.5%). In terms of smoking and drinking, the majority did not smoke or drink, with 4,698 (88.3%) and 4,550 (85.6%) respectively. See Table 1 below.

Table 1 Demographic characteristics of awareness rate
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Other marital status referred to as unmarried, divorced and various other marital statuses not listed in the questionnaire. Other living situation referred to “living with a caregiver who is not related in any way” and others not listed in the questionnaire. The question “How would you say your income situation is compared to those around you” was used to obtain respondents' participants feelings and answers about their income levels. A “no” answer to the smoking status referred to “never smoked or have quit smoking”. A “no” answer to the drinking status referred to “never drinking or have quit drinking”. Comorbidity was defined as the occurrence of two or more chronic health problems at the same time in the same participant. Polypharmacy referred to the simultaneous use of five or more different medications.

Disease information and medication use

In the survey of diseases across various systems and medication usage, cardiovascular diseases were found to be the most prevalent, affecting 3,423 individuals, accounting for 64.4% of the total surveyed population. The most commonly used medications were antihypertensive drugs, taken by 2,761 people (51.6%), followed by antidiabetic drugs used by 1,269 individuals (23.9%). These issues impact the individual's health status and persist for a year or more. See Tables 2 and 3 below.

Table 2 Disease information
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Table 3 Medication use
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Analysis of isolated factors affecting awareness rate of geriatric syndromes

This study shows that among the six major geriatric syndromes, the highest awareness was for falls, with 3,295 individuals (62.0%) being aware, followed by dementia with 2,929 people (55.1%), malnutrition with 2,907 individuals (54.7%), frailty with 2,156 people (40.5%), urinary incontinence with 2,006 individuals (37.7%), and sarcopenia with 1,914 people (36.0%). See Table 4 below. Figure 2 shows the percentage of people who answered yes to the six subordinate entries for each geriatric syndrome. The results showed that in each of the six syndromes, older adults had lower awareness rate of risk factors than symptoms and interventions (all P < 0.001).

Fig. 2
figure 2

Percentage of correct answers for each entry

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Table 4 Overall awareness rate of geriatric syndromes
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Grouped by different regions, except for partial awareness, the awareness rates of various geriatric syndromes in the Beijing area were higher than those in the other three regions (all P < 0.001). Except for urinary incontinence and partial awareness, the differences in awareness rates of geriatric syndromes between different gender groups were statistically significant (all P < 0.001). There were statistically significant differences in the awareness rates of geriatric syndromes among different age groups, and a declining trend in awareness was observed with increasing age (all P < 0.001). There were statistically significant differences in the awareness rates of geriatric syndromes among different marital status groups (P < 0.001), except for falls, where married individuals cohabiting had relatively higher awareness rates of the syndromes. Differences in awareness rates of geriatric syndromes among different living situations were statistically significant (P < 0.001), with the older adults living with relatives or alone having higher awareness compared to other living conditions. Categorized by educational level, the older adults with higher education levels had higher awareness rates of geriatric syndromes (all P < 0.001). Urban older adults had higher awareness rates of geriatric syndromes compared to rural older adults (all P < 0.001). Among different employment statuses, only the awareness rates of frailty and sarcopenia showed statistically significant differences (χ2 = 14.205, 15.057, both P < 0.001). Among different income groups, older adults with better income conditions had higher awareness rates of geriatric syndromes compared to other income groups (all P < 0.001). Except for partial awareness, the awareness rates of geriatric syndromes were higher among smokers and drinkers compared to non-smokers and non-drinkers (all P < 0.05). Except for urinary incontinence and complete awareness, older adults with comorbidities and polypharmacy had higher awareness rates of geriatric syndromes (all P < 0.05). See Table 5 at the end of the document.

Table 5 Analysis of isolated factors affecting awareness rate of geriatric syndromes
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Logistic regression analysis of multiple factors affecting awarenesss rate of geriatric syndromes

Using awareness rates as the dependent variable (aware = 1, not aware = 0), variables from univariate analysis with P < 0.05 were included in logistic regression analyses. The results of the multivariate logistic regression analyses for the awareness of the six geriatric syndromes, as well as partial and complete awareness, are as follows. Using the first category of each group of independent variables as the reference group, the results show that the source of the respondents has a statistically significant impact on the awareness rates of the geriatric syndromes, as well as partial and complete awareness. Compared to urban sources, older adults from rural sources have an increased risk of reduced awareness rates. Except for partial awareness, the impact of education level on all awareness rates is statistically significant. Compared to illiterates, all other education levels (elementary and above) promote an increase in awareness rates. Age has a statistically significant impact on all awareness rates; compared to older adults aged 65 to 75, those aged 76 to 85 and 86 to 95 have an increased risk of reduced awareness rates. See Fig. 3 and Fig. 4 below.

Fig. 3
figure 3

Regression analyses of awareness rate of geriatric syndromes

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Fig. 4
figure 4

Regression analyses of awareness rate of geriatric syndromes

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Discussion

According to the 2020 China population census, the proportion of older adults over the age of 65 exceeds 11% in all four provinces: 16.93% in Sichuan, 13.27% in Zhejiang, 13.3% in Beijing and 11.10% in Fujian. The degree of ageing in these four provinces was among the highest in the country, which was representative to a certain extent. In addition, the ratio of men to women aged 65 and over is 0.87:1, which was similar to the ratio of men to women included in this study. This study was conducted in four provinces with National Geriatrics Centers or National Clinical Research Centers for Geriatric Diseases. These four provinces were chosen because, on the one hand, they are led by the hospitals where the geriatrics centers are located, which ensures the scientific and rigorous implementation of the study, and on the other hand, they are representative of the four provinces with the highest ranking of aging among Chinese provinces. In addition, the four provinces were also selected to be geographically representative.

Currently, there is no universally accepted international standard for the phenotypes of geriatric syndromes. In 2013, geriatric societies across the Asia–Pacific region proposed that geriatric syndromes should encompass conditions such as dementia, incontinence, delirium, falls, hearing impairment, visual impairment, sarcopenia, malnutrition, and frailty [19]. Similarly, the Education Committee Writing Group (ECWG) of the American Geriatrics Society identified 13 common geriatric syndromes, which include dementia, inappropriate prescribing of medications, incontinence, depression, delirium, iatrogenic problems, falls, osteoporosis, sensory alterations (hearing and visual impairment), failure to thrive, immobility and gait disturbances, pressure ulcers, and sleep disorders [19]. In contrast, the standard for healthy Chinese older adults (WS/T802—2022) delineate nine criteria for assessing older adults health, which encompass self-care abilities, age-related changes in vital organs without significant functional abnormalities, controlled health risk factors within an age-appropriate range, good nutritional status, essentially normal cognitive function, a positive and optimistic attitude, sufficient health literacy and maintenance of a healthy lifestyle, active participation in family and social activities, and strong social adaptability [22] . Frailty is a common and important geriatric syndrome. It is associated with many adverse clinical outcomes. The overall weighted prevalence of frailty among community-dwelling older adults in China was 9.9%, with the prevalence of frailty showing an increasing trend year by year in China [13]. Dementia has become a global challenge as a disease whose prevalence is gradually rising with increasing global ageing [23]. Falls, as a common syndrome experienced by one in three of the older adults annually, were also included in this study [24]. Sarcopenia is associated with a variety of adverse health outcomes in older adults, and the incidence of it in Chinese older adults is increasing as China's aging population rapidly progresses [12]. Malnutrition is one of the most common syndromes. Malnutrition leads to a decline in quality of life, intrinsic capacity, health and an increase in medical costs, placing a greater burden on the family and on social and medical resources [25]. Drawing from the importance and clinical incidence of each geriatric syndrome, this study included six prevalent geriatric syndromes: dementia, frailty, sarcopenia, urinary incontinence, malnutrition, and falls.

This study revealed that among the six major geriatric syndromes, the highest awareness rate is for falls (62%), followed by dementia (55.1%), malnutrition (54.7%), frailty (40.5%), urinary incontinence (37.7%), and sarcopenia (36.0%). Awareness rate varied widely between different geriatric syndromes. The high awareness rate for falls is related to their high incidence. Falls are common among the older adults, with about 29% of those aged 65 and above living in the community experiencing falls each year [26], and among those over 80, one in two falls annually [24]. A study showed that the prevalence of falls among community-dwelling older people in China was as high as 14.3% [27]. Another study based on Prevention and Intervention on Neurodegenerative Disease for Elderly in China (PINDEC)project showed that the falls prevalence rate was 14.7% after complex weighting among the 21,084 Chinese community-dwelling older adults included in this study [28]. According to the Chinese Center for Disease Control and Prevention, falls have become the leading cause of injury-related deaths among Chinese individuals over 65 [29]. As people age, the decline in physical functions makes the older adults more susceptible to fractures, infections, and other complications from falls. Prolonged bed rest after a fall can further lead to pressure ulcers, malnutrition, and an increased incidence of various geriatric syndromes. The prevention and control of falls among the older adults have become an international consensus [30]. Initiatives to prevent falls in the older adults have been incorporated into the "Healthy China 2030" Planning Outline and the "Healthy China Action (2019—2030)". The increase in awareness of falls is an important outcome of these initiatives.

In terms of frailty awareness, Lina et al. [13] reported that the overall weighted prevalence of frailty in China was 9.9%, with a higher prevalence of 12.7% observed in the southwestern region, including Sichuan. They noted that frailty prevalence increased with age and was significantly higher among females and rural residents. These findings align with our study, where the awareness rate of frailty in Sichuan was found to be 14.5%. We observed a decrease in awareness with increasing age and a relatively low awareness among females and older adults residing in rural areas.

Among all geriatric syndromes studied, awareness of sarcopenia was found to be the lowest. The concept of sarcopenia was relatively late to gain recognition, having been first proposed by Rosenberg in 1997. The Asia Working Group for Sarcopenia (AWGS) further refined the definition of sarcopenia in 2019 as the “age-related loss of skeletal muscle mass plus loss of muscle strength and/or reduced physical performance” [31]. A cross-sectional study conducted in Malaysia [18] revealed moderate to low public knowledge of sarcopenia, with only 6.9% of respondents demonstrating a good understanding of the condition. Our findings align closely with these studies, indicating that awareness of sarcopenia, especially among the older adults, remains low.

Our study investigated the awareness of various geriatric syndromes among the older adults populations in four provinces: Beijing, Fujian, Sichuan, and Zhejiang. These regions were selected to provide a diverse geographic representation. The findings indicate that awareness rates of all geriatric syndromes were highest in the Beijing area compared to the other three provinces. In particular, the older adults in the Zhejiang region demonstrated substantial awareness in areas such as dementia, frailty, malnutrition, and falls. Conversely, awareness among the older adults in Sichuan was notably lower.

The relatively high awareness of geriatric syndromes in Beijing may be linked to the region's advanced economic development as well as targeted health literacy education initiatives for the older adults. Health literacy is defined as the ability of individuals to access, comprehend, and utilize basic health information and services to make informed decisions about their health [32, 33]. It acts as a midstream determinant of health and can be effectively enhanced within high-risk groups [32]. Research indicates that nearly 40% of respondents encounter challenges in accessing, understanding, evaluating, and applying health information. Furthermore, 8.18% of individuals exhibit inadequate health literacy, while 30.94% face difficulties related to health literacy [34]. According to data released by the Beijing Municipal Health Commission in 2018, there is a noticeable decline in health literacy with advancing age; the highest literacy rate was observed in the 30 to 39 age group at 41.7%, whereas the lowest was in the 60 to 69 age group at merely 14.1% [35]. By 2020, the health literacy rate among the older adults aged 60 to 69 in Beijing showed improvement, rising to 17.2%, an increase of 3.1 percentage points from 2018 [36]. The National Health Commission's assessment in 2023 reported that the overall national health literacy rate was 29.70%, with Beijing residents achieving a rate of 40.5% [37, 38]. Comparatively, in Zhejiang, the health literacy rate stood at 41.54% in 2023 [39]. In Fujian, it was 30.27% in 2023 [40], while in Sichuan, the rate reached 27.7% in 2021 [41].

Health literacy extends beyond individual capabilities, encompassing the responsibility of organizations to render health-related information and services accessible and comprehensible to the public [42]. Globally, governments are enhancing the health literacy of their populations through the formulation of targeted policies and programs, inspired by the growing scholarly interest in health literacy [43]. Specifically, Beijing has incorporated initiatives to improve residents' health literacy within the frameworks of the 'Healthy China 2030' and 'Healthy Beijing 2030' planning outlines. The city has also developed a comprehensive older adults health service system, which includes health education aimed at geriatric syndromes and the implementation of health management programs for the older adults that integrate artificial intelligence to monitor their health status. In Zhejiang, the 'Five Major Actions' policy on older adults health services has facilitated early screening and timely intervention for issues such as vision, oral health, nutritional status, cognitive functions, and psychological health, thus improving awareness of these syndromes among the older adults. Furthermore, hospitals in Zhejiang rated second class and above have established geriatric departments dedicated to enhancing the management of geriatric syndromes and promoting comprehensive geriatric assessment techniques, thereby improving health education for hospitalized older adults patients. In Sichuan, free health management services, including health examinations for those aged 65 and over, are provided with a focus on the integrated prevention and treatment of major chronic diseases such as hypertension and diabetes. Annually, at least 6.5 million older adults individuals aged 65 and over benefit from free health check-ups and other health management services, emphasizing the integration of medical care and health maintenance.

Inconsistently with our expectations, smokers and drinkers performed better than non-smokers and non-drinkers in the awareness survey. Probably because smokers and drinkers were the focus of more attention and health education by clinicians in health education because smoking and drinking in older adults are associated with many adverse clinical outcomes.

Our study provided a comprehensive overview of the prevalence of multiple geriatric syndromes and analyzed factors influencing awareness rates within the same cohort of older adults. The objective was to furnish evidence that could inform the development of future health promotion policies, with the ultimate goal of enhancing health literacy concerning geriatric syndromes. Future initiatives should prioritize tailored health education for older adults with diverse characteristics to effectively promote health. There were some limitations to this study. Due to the large number of geriatric syndromes included in this study, the factors affecting the awareness rates of individual geriatric syndromes could not be discussed in depth. Secondly, whether there was an interaction between the awareness rates of the geriatric syndromes included in the study needs to be further explored in future work. In addition, this study did not investigate the correlation between the prevalence of geriatric syndromes and their awareness rates among participants. In the future, it is expected that more detailed data on the prevalence of geriatric syndromes and their awareness rates in each province can be included, and corresponding intervention and follow-up studies can be conducted to provide more reliable evidence to support the prevention, health education, and intervention guidance of geriatric syndromes.

Conclusions

This study investigated the awareness rates and influencing factors of six common geriatric syndromes among the older adults population aged 65 and above in China. The findings indicate that the awareness rates of these syndromes are relatively low. There is a critical need to enhance the management of these syndromes and to develop targeted health promotion policies that are tailored to the diverse demographic characteristics of the older adults in various regions. Such initiatives are essential to improve health literacy concerning geriatric syndromes among the older adults.

Availability of data and materials

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was financially supported by the Zhejiang Provincial Department of Science and Technology’s Major Social Welfare Program (2023C03162), the Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents (2022-01), the National High Level Hospital Clinical Research Funding (2023-NHLHCRF-YYPPLC-ZR-16), the Zhejiang Province Medical and Health Science and Technology Plan Project 2024KY001, the Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project 2024ZL002.

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Author notes

  1. Difei Wu and Xiyan Yu equally contributed to this paper and shared first authorship.

Authors and Affiliations

  1. Zhejiang University, School of Medicine, Hangzhou, 310058, China

    Difei Wu

  2. The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, 310053, China

    Xiyan Yu

  3. Department of Geriatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310003, China

    Fangzhou Li & Xujiao Chen

  4. The First Department of Health Care, China-Japan Friendship Hospital, Beijing, 100029, China

    Wei Qiao

Authors
  1. Difei Wu
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  4. Wei Qiao
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  5. Xujiao Chen
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Contributions

WD, YX, LF, QW and CX contributed to conceptualization and methodology. WD analyzed the data and wrote the original draft. WD and YX contributed to data collection. QW and CX supervised this study. All the authors contributed to interpreting the results, and revising and approving the final manuscript.

Corresponding authors

Correspondence to Wei Qiao or Xujiao Chen.

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Ethics approval and consent to participate

This study was approved by the Medical Ethics Committee of Zhejiang Provincial Hospital of Chinese Medicine and all the participants provided written informed consent to use their data.

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Not applicable.

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The authors declare no competing interests.

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Wu, D., Yu, X., Li, F. et al. Geriatric syndrome awareness and its determinants in China: a cross-sectional study. BMC Geriatr 24, 712 (2024). https://doi.org/10.1186/s12877-024-05291-9

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Keywords

BMC Geriatrics

ISSN: 1471-2318

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