longevity nutrition

Seasonal and temporal trends in leading causes of hospitalisation among older adults in Hong Kong: a retrospective study across community and institutional care settings

15 April 2026

Qian Xing Xing, Chau Pui Hing, Lai Eric T C, Wong Grace Lai-Hung, Woo Jean

Summary

1. Plain-language summary of what the study found: This study revealed that the leading causes of hospitalization among older adults in Hong Kong change seasonally and vary significantly between those living independently and those in nursing homes. A key finding was the consistent and increasing trend of non-specific symptoms and signs (e.g., general weakness, dizziness) as a top reason for hospital admission across all settings.

2. Key findings:

Community-dwelling older adults: In winter, top causes were non-specific symptoms, cancers, genitourinary, circulatory, and respiratory diseases. In summer, digestive diseases replaced respiratory issues in the top five.
Nursing home residents: Respiratory diseases, non-specific symptoms, genitourinary, circulatory, and digestive issues were consistently the top five causes in both winter and summer.
Increasing trend: "Symptoms, signs and abnormalities not classified elsewhere" (non-specific symptoms) emerged as a top two cause for hospitalization and showed a significant increasing trend across all older adult groups.
Declining trend: Hospitalizations due to circulatory diseases generally decreased in both community and nursing home settings.
Other trends: Cancers and genitourinary diseases showed increasing trends in community-dwelling older adults.

3. Practical takeaways for someone interested in nutrition and longevity: Given the prevalence of chronic diseases and non-specific symptoms leading to hospitalization, a focus on holistic nutritional strategies is vital for promoting longevity. A balanced, nutrient-dense diet can support immune function (potentially reducing respiratory infections common in nursing homes), help manage chronic conditions like heart disease and digestive issues, and may contribute to lowering cancer risk. Adequate hydration and addressing potential nutritional deficiencies can also help prevent the "non-specific symptoms" often linked to frailty and decline.

4. Study limitations: As a retrospective study based on existing medical records, it identifies trends and associations rather than direct causes. The broad category of "symptoms, signs and abnormalities not classified elsewhere" limits understanding of the specific underlying issues or their potential nutritional links.

Abstract

Abstract Objectives With an ageing population, understanding leading causes of hospitalisation in older adults is critical for care strategies. These leading causes may vary across residential settings and by seasonal patterns. This study examines the temporal trends of leading causes of hospitalisation among older adults in community-dwelling and nursing home settings, specifically comparing patterns during winter and summer seasons. Design, setting, participants and main outcome measures A retrospective analysis of electronic medical records from Hong Kong public hospitals (2012–2018) was conducted for three million adults aged ≥65. Age-standardised and sex-standardised monthly hospitalisation rates and average annual percentage change (AAPC, representing the average yearly percentage change in rates) were examined for leading causes during summer and winter across settings. Results Among community-dwelling individuals, the top five causes in 2018 were symptoms, signs and abnormalities not classified elsewhere (NEC), neoplasms, genitourinary, circulatory and respiratory diseases in winter, with digestive diseases replacing respiratory diseases in summer. Symptoms, signs and abnormalities NEC (AAPC: 2.7% (95% CI 1.8% to 3.6%) in winter; 3.4% (2.8% to 4.0%) in summer), neoplasms (2.4% (1.4% to 3.4%) in winter; 2.5% (1.6% to 3.4%) in summer), genitourinary (2.5% (2.1% to 2.9%) in winter; 2.4% (1.8% to 3.0%) in summer) and digestive diseases (2.5% (1.6% to 3.3%) in winter; 2.6% (1.7% to 3.5%) in summer) increased, while circulatory diseases decreased in winter. In nursing home residents, the top five causes in 2018 were respiratory diseases, symptoms, signs and abnormalities NEC, genitourinary, circulatory and digestive diseases in winter and summer. Symptoms, signs and abnormalities NEC increased (2.9% (0.9% to 5.0%) in winter; 2.9% (0.8% to 5.1%) in summer), while circulatory diseases declined across seasons. Genitourinary diseases remained stable across seasons, whereas digestive diseases declined in winter. Conclusions In Hong Kong’s ageing population, seasonal and temporal shifts in hospitalisation causes were observed. Symptoms, signs and abnormalities NEC emerged as the top two causes across settings, highlighting challenges for primary care and hospital management and need for enhanced prevention and care strategies.

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