Abstract
INTRODUCTION: To explore the clustering and influencing factors of unhealthy lifestyles among elderly adults with prediabetes in rural China. METHODS: A cross-sectional study was conducted in Yiyang, Hunan Province, China. Through multistage cluster random sampling and an oral glucose tolerance test, we screened 461 elderly adults aged 60 years and older with prediabetes out of 2144 elderly adults who were sampled. The prediabetic adults completed a survey examining four common lifestyle factors: diet, exercise, smoking, alcohol use and the ability to acquire diabetes-related knowledge and thereby promote one's own health-diabetes health literacy. The influencing factors were analyzed retrospectively with the Kruskal-Wallis test and ordinal logistic regression. RESULTS: A total of 425 elderly adults completed the survey, of whom 325 were identified with unhealthy lifestyle clustering. The Kruskal-Wallis test showed significant differences between unhealthy lifestyle clusters by age, gender, marital status, occupation and hyperlipidemia (P < 0.05). Ordinal logistic regression showed that female gender (OR = 0.23, 95% CI: 0.15 0.37), personal annual income ≥ 2800 CNY (OR = 0.61, 95% CI: 0.38 0.99) and occupation as a worker (OR = 0.56, 95% CI: 0.34 0.92) were protective factors against unhealthy lifestyle clustering. An unsatisfactory marital status (OR = 1.60, 95% CI: 1.02 2.51) and low diabetes health literacy (OR = 3.17, 95% CI: 1.03 9.81) were risk factors. CONCLUSION: In total, 76.47% of the prediabetic elderly adults in rural China showed unhealthy lifestyle clusters. Being male and having an unsatisfactory marital status, a low personal annual income, an occupation as a farmer and low diabetes health literacy were the main risk factors for unhealthy lifestyle clustering. More effective interventions should be implemented based on these risk factors to prevent diabetes in rural elderly adults.