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Set in the rapid development of population aging, this study focuses on the relationship between health and medical expenditure of the elderly population. Taking the health and medical expenditure of the elderly as the research object, this study analyzes the characteristics and the intrinsic relationship between them. Based on the future elderly model, this study calculates the transition probability of the elderly's self-assessment health state using the Health Transition Model and estimates the medical expenditure of the elderly by the Two-Part Model. Based on the above, this study predicts the trend of the population size and medical expenditure of the elderly in the next 15 years (2020–2035). Based on the results, the policy suggestions are put forward. To begin with, strengthening health management and health services for the elderly in the construction of healthy China. Next, building a comprehensive system of health care for the elderly in government, society, family, and individual. Then, establishing a long-term care service system as soon as possible. In addition, it is better to establish lifelong health consciousness and cultivate healthy accomplishment behavior. Finally, it is necessary to promote gender mainstreaming in the health field.

Abstract
Background
Perfluoroalkyl and polyfluoroalkyl substances (PFAS) represent a category of pervasive and enduring environmental pollutants that present a risk to human health. Although growing evidence suggests that probiotics can potentially alleviate the adverse effects of PFAS, large cross-sectional studies on the relationship between probiotic consumption and PFAS remain lacking.

Objective
The objective of this study is to assess the association between the exposure of probiotics and serum levels of PFAS.

Methods
This analysis included individuals aged 20 and above who took part in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2018. Probiotic consumption was considered when a participant reported consuming yogurt during the two 24-h dietary recall or using a probiotic supplement in dietary supplement questionnaires over the past 30 days.

Results
This study involved 9469 adults, out of which 1333 had been exposed to probiotics. We found negative associations between probiotic consumption and serum concentrations of perfluorooctanoic acid (PFOA) (β: − 0.19, 95% CI − 0.35 to − 0.02; P = 0.027), and perfluorooctane sulfonic acid (PFOS) (β: − 0.1.27, 95% CI − 2.23 to − 0.32; P = 0.010). The consumption of probiotic supplements alone was associated with reduced perfluorononanoic acid (PFNA) (β: − 0.19, 95% CI − 0.28 to − 0.10; P < 0.001). No statistically significant association was identified between probiotic consumption and perfluorohexane sulphonic acid (PFHxS).

Conclusion
In this cross-sectional, nationally representative study, probiotic ingestion was negatively associated with several serum PFAS compounds. These findings carry substantial implications for designing interventions that target the reduction of accumulated PFAS levels in the body and mitigating the resulting adverse health effects.