{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:55:47Z","timestamp":1788386147800,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Promoting healthy aging\u2014a core public-health objective\u2014demands hospital environments that support functional recovery and well-being. Excessive ward noise, however, is a modifiable environmental factor that may thwart this goal by amplifying anxiety and diminishing older adults\u2019 self-rated health, yet the magnitude and mechanism of this effect remain poorly quantified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>We undertook a cross-sectional survey in March\u2013August 2024 at a tertiary hospital in Hebei Province, China. Continuous bedside monitoring captured 24-h A-weighted equivalent sound levels (LAeq) for 270 surgical in-patients aged \u2265 60\u202fyears. Exposure was grouped into quartiles [\u2264 45, 45.1\u201350, 50.1\u201355, &amp;gt; 55\u202fdB(A)]. Poor self-rated health (SRH, scores 1\u20133\/5) and anxiety (Generalized Anxiety Disorder-7) were assessed concurrently. Hierarchical logistic models estimated associations per 5\u202fdB(A) increment; bias-corrected bootstrap mediation quantified the proportion of the noise\u2013health relation transmitted through anxiety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median LAeq was 52.1\u202fdB(A), well above the WHO daytime limit of 35\u202fdB(A). The prevalence of poor SRH rose from 28% in the quietest quartile to 58% in the noisiest (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). After adjustment for demographic, socioeconomic, clinical and ward factors, each 5\u202fdB(A) increase in LAeq raised the odds of poor SRH by 16% (OR\u202f=\u202f1.16, 95% CI 1.00\u20131.33, <jats:italic>p<\/jats:italic>\u202f=\u202f0.047). Anxiety independently predicted poor SRH (OR\u202f=\u202f1.10 per GAD-7 point) and mediated 23% of the total noise effect (indirect <jats:italic>\u03b2<\/jats:italic>\u202f=\u202f0.048, 95% CI 0.019\u20130.086, <jats:italic>p<\/jats:italic>\u202f=\u202f0.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hospital sound levels substantially above international guidelines constitute a modifiable environmental barrier to healthy aging, deteriorating older adults\u2019 self-perceived health partly by intensifying anxiety. Integrating acoustic standards into hospital quality metrics and coupling noise reduction with early anxiety management represent feasible public-health strategies to support functional recovery and well-being in rapidly aging populations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1652514","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:25:49Z","timestamp":1759123549000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Environmental noise and self-rated health in older surgical patients undergoing general anesthesia: a cross-sectional study of anxiety as a behavioral pathway for healthy aging"],"prefix":"10.3389","volume":"13","author":[{"given":"Jie","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingcan","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieyin","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1016\/s0140-6736(15)00516-4","article-title":"The 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