搜索结果：Psychology and aging

With the accelerating pace of population aging in China, depression among older adults has emerged as a significant public health challenge. Existing research has yet to fully elucidate the underlying processes linking community environment to depression among older adults, particularly from an age-differentiated perspective. To address this gap, this study constructed an integrated model positing aging anxiety and social adaptation stress as mediators and age as a moderator, aiming to systematically examine the pathways associated with the relationship between community environment and depression among older adults and their heterogeneity across age groups. Using valid data from 10,562 respondents in the 2023 China Longitudinal Aging Social Survey (CLASS 2023), the analysis was conducted via structural equation modeling. The findings indicate: first, a significant negative correlation exists between community environment and depression; second, both aging anxiety and social adaptation stress exhibit significant indirect associations in this relationship, with the indirect effect of social adaptation stress being stronger. More importantly, the association between community environment and depression is stronger for older-old adults and is primarily linked to the pathway involving aging anxiety. In contrast, its association with depression in younger-old adults is channeled to a larger extent through social adaptation stress. This study unveils the pattern of dual pathways and differential patterns related to age that characterize the relationship between community environment and depression among older adults. The findings provide empirical evidence and theoretical support for future efforts to build age friendly communities and implement stratified healthy aging policies.

Mental health issues such as depression, loneliness, and cognitive decline are prevalent among older adults. They are particularly pronounced in rural areas due to socioeconomic disadvantages, limited health literacy, and social isolation. These challenges have been exacerbated by the COVID-19 pandemic, highlighting the urgent need for accessible, community-based mental health strategies. Social prescribing-linking individuals to nonmedical community resources-offers a promising model, especially when coupled with culturally relevant and digitally facilitated interventions. This study aimed to evaluate the effectiveness of a pilot social prescribing project for individuals aged 65 years and older residing in rural South Korea. Specifically, it examined the changes in social support, loneliness, depression, cognitive function, and life satisfaction among the older adults before and after the intervention and the relationships among these factors. A quasi-experimental, nonequivalent control group pretest-posttest design was conducted with 294 participants from Wonju City, Gangwon-do (n=148 in the experimental group, n=146 in the control group). The 8-week intervention featured a community-based music storytelling program incorporating local cultural elements and digital education. Statistical analyses, including t tests, difference-in-differences analysis, and structural equation modeling, were conducted to evaluate changes in scores and the effectiveness of the program intervention. The study confirmed that the social prescribing pilot project effectively reduced depression and increased social support and life satisfaction compared with the control group (P<.05, 95% CI). While cognitive function showed slight improvement, the change was not statistically significant. Social support emerged as a key mediating factor, positively influencing cognitive function and life satisfaction, and was negatively associated with depression. There was no statistically significant direct effect found between loneliness and cognitive function or social support. This pilot study supports the feasibility and mental health benefits of integrating community and digital support through culturally embedded social prescribing for rural older adults. The findings highlight the importance of leveraging local resources and social networks to address mental health disparities in underserved aging populations, offering valuable insights for policymakers and practitioners developing inclusive aging and health promotion strategies.

Older adults facing social or structural marginalization for reasons such as lower literacy, digital exclusion, financial constraints, restricted living environments, or complex health histories, face persistent barriers to much-needed health screening. Digital health tools, particularly those using audio computer-assisted self-interview (ACASI) technology, offer potential to overcome these barriers (audio-delivered and self-administrable), but their application to marginalized populations remains underexplored. Moreover, guidance is limited for developing such tools which require collaboration within cross-disciplinary teams. This paper presents development insights and user testing findings from the ASCAPE (Audio App-Delivered Screening for Cognition and Age-Related Health in Prisoners) project, which aimed to develop equitable digital frailty and cognition screening for older people in Australian prisons. This study aims to describe the collaborative development of the "ASCAPE-HS" prototype, a tablet-based ACASI-delivered Frailty Index and aging screener, and to synthesize key lessons from the project that can inform equitable digital health tool development in hard-to-reach older adults. Also, to present findings on the usability and acceptability of ASCAPE-HS in a diverse community sample. The ASCAPE-HS prototype was developed through an iterative process involving researchers, clinicians, software developers, and end users under a digital health equity framework. The prototype included a self-administered, audio-delivered Frailty Index, alongside other items relevant to aging. The design process prioritized accessibility, sociocultural relevance, and technical feasibility, with regular multidisciplinary consultation and iterative refinement. Exploratory user testing with 20 older adults (aged 47-93 years, including n=5 who had not finished secondary schooling, n=3 people with previous imprisonment history, and n=9 with mild or moderate cognitive impairment) provided feedback on usability and acceptability. A 50-item Frailty Index was developed, alongside an additional selection of holistic questions that could meaningfully capture age-related health, and transferred to an iOS app (Apple, Inc), with ACASI features. Key elements included lay wording, consistent interface, simple "tapping" response options with repeatable audio feedback, a tutorial, and artificial intelligence-generated audio guidance. Key development considerations were synthesized into a checklist for teams undertaking similar projects. Successful strategies for the collaborative design process included diverse teams abreast of emerging literature and policy with varying expectations for engagement during development, and dedicating time to flexible, iterative development processes. Acceptability (median scores &#x2265;4 out of 5 across 6 constructs) and usability (mean System Usability Scale score 79.0, SD 8.8) were high. A collaborative approach can produce ACASI-based health screening tools that are well-received by older adults. We highlight the feasibility of integrating frailty and aging assessment into a usable and acceptable digital tool, and offer actionable principles for collaborative, evidence-based development of equitable health screening tools in diverse, hard-to-reach populations.

Taiwan's status as a super-aged society underscores the need for efficient strategies to promote healthy aging. While the benefits of mindfulness-based interventions for sleep and mental health are evident, there is a shortage of cultural adaptations for Taiwan's older adults. Current courses mainly focus on mindfulness-based stress reduction, while neglecting mindfulness-based elder care, and mindful sustainable aging principles. However, the abstract nature of some mindfulness concepts, combined with limited digital support and localized resources, makes it challenging for older adults to engage effectively. To enhance healthy aging outcomes in older community-dwelling adults in Taiwan, this study developed an 8-week theory-based mindfulness curriculum that combined the mindfulness-based stress reduction, mindfulness-based elder care, and mindful sustainable aging frameworks with digital health support. This research employed a mixed methods feasibility study design. We used the modified Delphi method in phase 1 to reach agreement on curriculum content and digital material selection. Ten older adults participated in the pilot study, which comprised phase 2. We used quantitative measurements to assess mindfulness, sleep quality, cognition, heart rate variability, perceptions of aging, healthy aging perspectives, and physical function and activity at baseline, at weeks 4 and 8, and at a 1-month follow-up. Qualitative interviews were conducted to gather insights into participants' experiences. Participants achieved significant improvements in mindfulness, sleep quality, aging perception, healthy aging outlook, and physical function during the study (all P<.05). Cognition, heart rate variability, and physical activity levels showed no significant changes throughout the study. The qualitative data supported these findings, as participants selected simple practices, such as mindful breathing, which they practiced daily to enhance their emotional well-being and social connections. Participants valued the digital learning materials for aiding their practice; however, some older adults with reading difficulties faced challenges accessing the content. Using the Delphi method resulted in an acceptable and feasible theory-based digitally supported mindfulness program that improved several indicators of healthy aging in older adults in Taiwan. Our findings need to be validated using longer trials to assess cognitive and physiological effects. Furthermore, digital accessibility requires further development.

While older adults' social media use has been widely studied for its instrumental benefits, such as accessing health information or maintaining family ties, research has largely focused on identity-based platforms that mirror offline social networks, leaving pseudonymous, interest-driven environments such as Reddit underexplored. Although older adults actively participate in these spaces to share personal narratives and engage beyond their existing social roles, the literature has yet to center their own voices, with most existing work focusing on caregivers or younger users discussing older adults rather than older adults speaking for themselves. Integrating a life course perspective with the concept of subjective age cohort, this study examines how Reddit users who explicitly self-identify as being in their 50s, 60s, or 70s engage in self-expression and personal experience sharing within pseudonymous online spaces. Using data collected via the Reddit application programming interface, this study analyzed posts and comments from 848 self-identified older Reddit users, including 488 future older adults in their 50s (57.5%) and 360 current older adults in their 60s and 70s (42.5%) identified through age-based flairs in the subreddit r/AskOldPeople. A fine-tuned large language model (BLOOM-560m; F1-score=0.96) classified 4,055,275 sentences into three personal experience domains: (1) health and wellness, (2) personal relationships and identity, and (3) professional and financial life. Chi-square analysis compared domain distributions across age groups. BERTopic topic modeling identified thematic patterns within each domain. Of 569,107 personal experience sentences identified, personal relationships and identity comprised the largest share (n=268,212, 47.1%), followed by professional and financial (n=186,768, 32.8%) and health and wellness (n=114,127, 20.1%). Chi-square analysis revealed significant between-group differences (&#x3c7;22=34.7; P<.001): current older adults shared proportionally more about health and wellness, whereas future older adults shared more about relationships and identity. Topic modeling further revealed qualitatively distinct emphases within each domain. Future older adults' posts frequently discussed menopause, depression, and friendships, while current older adults more frequently addressed chronic illness, aging, and financial security. Both groups used pseudonymity to disclose sensitive or stigmatized topics. This study demonstrates that older adults' personal experience sharing on pseudonymous platforms is shaped by the simultaneous interplay of life course stage, age cohort background, and platform affordances, rather than by any single factor. Pseudonymous environments such as Reddit enable disclosures of health vulnerabilities, contested social identities, and emotional experiences that are structurally discouraged on identity-based networks, and this has direct implications for how digital inclusion is conceptualized and practiced. Beyond operational literacy, supporting older adults' expressive inclusion in interest-based, pseudonymous online communities represents a meaningful yet underaddressed dimension of digital participation policy.

Structural and social determinants across chronosystems critically shape educational transitions and cognitive aging in India by influencing cognitive reserve through life-course. Drawing on Bronfenbrenner's Ecological Systems Theory and the Cumulative Disadvantage/Advantage frameworks, we conceptualize genderism as a structural and social determinant of cognitive health operating across multiple ecological levels - national (macrosystem), regional/states (mesosystem), and household/family or individual (microsystem) - within India's chronosystem. Using Wave 1 of the Longitudinal Aging Study in India (LASI, 2017-2018), we assessed cognitive health across five domains, i.e., memory, orientation, attention, object naming, and executive function among older adults in 36 states and Union Territories of India. Three-level regression models examined how microsystem operating at individual (e.g., age, sex, education, childhood SES, widowhood, health behaviors), and household level (monthly per capita expenditure, indoor air quality, urban/rural residence), and mesosystem operating at state-level (e.g., women's education and employment rates) factors interact to shape cognitive health outcomes. Cognitive health outcomes showed wide gender gaps with regional sex disparities with the largest gap among those with education less than primary education (men: 24; women: 21) which reversed among those with post-secondary education (women: 33; men: 33). Widowed women and those with poor health indicators had significantly lower cognitive health scores. At the microsystem household-level, urban residence (&#x3b2; = 2.64), and households with cleaner cooking fuel use (&#x3b2; = 1.61) while at the mesosystem state-level, the % of women with at least primary education (&#x3b2; = 1.82) and the % of women who were employed (&#x3b2; = 0.62) were associated with improved cognitive health outcomes. The findings reveal how genderism across chronosystems accumulate over the life course highlighting the need for national-state-level policies that enhance women's access to education, employment, health, and nutrition to mitigate gendered disparities in late life cognitive health among Indian adults.

Personality traits influence social behaviors and health outcomes, yet their role in shaping social isolation among older adults remains insufficiently understood. Social isolation is a modifiable risk factor associated with mortality, cognitive decline, and reduced quality of life; therefore, identifying factors associated with social isolation across the aging population is important. To examine the association between Big Five personality traits and both baseline social isolation and future risk of social isolation at 3-, 6-, and 9-year follow-up in a nationally representative cohort of older adults. Data for this cohort study were collected from the National Health and Aging Trends Study (NHATS), with personality traits assessed at baseline in NHATS rounds 3 (2013) and 4 (2014), with follow-up assessments of social isolation in 2014, 2017, and 2020. Participants included those who completed the Midlife Development Inventory (MIDI) and were not socially isolated at baseline. Data analysis was performed from 2011 to 2020. Personality traits were defined using the Big Five framework, which measures conscientiousness, extraversion, neuroticism, openness, and agreeableness. These traits were assessed using 10 MIDI items. Logistic regression models estimated cross-sectional and longitudinal associations between personality traits and social isolation over a 3-, 6-, and 9-year follow-up, with sequential adjustment for demographic and health-related covariates. Social isolation was defined using a validated 4-item typology. The baseline analytic sample included 2672 community-dwelling individuals (mean [SD] age, 71.1 [10.2] years; 1549 [58.0%] female). Among the 2102 participants who were not socially isolated at baseline (mean [SD] age, 72.9 [9.6] years; 1252 [59.6%] female), higher extraversion (odds ratio [OR], 0.82; 95% CI, 0.73-0.92) and higher agreeableness (OR, 0.70; 95% CI, 0.60-0.82) scores were associated with lower odds of social isolation, whereas conscientiousness was associated with greater isolation risk in fully adjusted models (OR, 1.07; 95% CI, 0.93-1.23). In longitudinal analyses, extraversion had a consistent association with lower odds of social isolation at 3 years (OR, 0.75; 95% CI, 0.63-0.89), independent of demographic and health factors. No personality trait was significantly associated with social isolation at 6 or 9 years after full adjustment, although neuroticism (OR, 1.21; 95% CI, 1.01-1.44) and conscientiousness (OR, 1.37; 95% CI, 1.13-1.67) showed short-term associations in unadjusted models. This longitudinal study of community-dwelling older adults found that personality traits, particularly extraversion and agreeableness, were associated with social isolation among older adults, with extraversion emerging as a stronger factor associated with short-term isolation risk. These findings suggest the importance of incorporating personality into strategies aimed at identifying older adults at risk for social isolation and designing tailored interventions to strengthen social connectedness.

Background and Objectives: Population ageing is a major challenge of the 21st century and is associated with declining physical and mental abilities, increased disease burden, and higher mortality. Latvia has the lowest healthy life expectancy in the European Union. Social well-being is an important component of healthy and active ageing and may be associated with older adults' quality of life (QoL). This study aimed to assess the relationship between social well-being, as a component of health, and QoL, including its components (control, autonomy, self-realisation and pleasure), among adults aged 50 and older in Latvia. Materials and Methods: Data from 1643 Latvian participants in wave 9 of the Survey of Health, Ageing, and Retirement in Europe (2022) were analysed using linear regression. QoL was measured using the 12-item Control, Autonomy, Self-Realisation, and Pleasure (CASP-12) scale. Social well-being factors included household composition, education, employment status, financial capacity, living area, social network (SN) characteristics, and received help, based on self-reported questionnaires. Results were considered statistically significant if the p-value was less than 0.05. Results: The factors positively associated with overall QoL were being employed, better financial capacity, greater satisfaction with SN, larger SN, participation in social activities, and higher educational attainment. Being employed and the ability to make ends meet easily were positively associated with all QoL components. Higher satisfaction with the SN and participation in social activities were positively related to the control, autonomy, pleasure, and self-realisation components. Conclusions: These findings underscore the importance of social and economic resources for QoL in later adulthood, suggesting that both the quality of social relationships and material security play a central role in shaping overall QoL and its components among older adults.

The cumulative use of anticholinergic and sedative medications has been associated with lower physical function in older adults. This study aimed to identify which physical function attributes are most impacted in subgroups aged 45-64 and 65-85 years. Baseline data from 30,097 community-living Canadians in the Canadian Longitudinal Study on Aging were analysed using a cross-sectional design. Anticholinergic and sedative medications use was quantified using the Drug Burden Index (DBI). Physical functioning was measured via the timed 4-meter walk, Timed Up and Go (TUG), single leg balance, chair rise and grip strength. Physical functioning profiles were generated using latent profile analysis of the five tests. Associations between DBI scores and physical functioning were assessed through linear regression and multinomial logistic regression. The mean age of participants was 63.0, 50.9% were female, 18.3% had a DBI score 0&#x2009;<&#x2009;DBI&#x2009;<&#x2009;1 and 8.7% a DBI score&#x2009;&#x2265;&#x2009;1. Adjusted regression models showed the greatest reduction in standardized scores for the TUG test among participants with DBI&#x2009;&#x2265;&#x2009;1 (&#x3b2;: -6.05; -6.77 to -&#x2009;5.33) relative to DBI&#x2009;=&#x2009;0. Latent profile analysis indicated that the two profiles with the poorest physical functioning were associated with higher odds of exposure to 0&#x2009;<&#x2009;DBI&#x2009;<&#x2009;1 and DBI&#x2009;&#x2265;&#x2009;1, whereas the profile reflecting the best functioning was associated with reduced odds of exposure to DBI&#x2009;&#x2265;&#x2009;1. Associations of similar magnitude were observed across age strata (45-64 and 65-85 years). Cumulative anticholinergic and sedative medication burden was inversely associated with physical functioning. These findings were consistent across middle-aged and older adults.

Background and Objectives: Chronic kidney disease (CKD) is an increasingly important global health challenge and is frequently accompanied by psychiatric symptoms, including anxiety. A multidimensional assessment of anxiety in hemodialysis (HD) using the Endler Multidimensional Anxiety Scales (EMAS) has not, to our knowledge, been previously reported. We aim to evaluate the reliability, convergent validity, and exploratory domain-level structure of EMAS in HD patients treated at a dialysis center in Craiova, Romania. Materials and Methods: A total of 103 HD patients underwent clinical and sociodemographic/socioeconomic profiling, cognitive screening using the Mini-Mental State Examination (MMSE), and EMAS administration at two time points (4-week interval) for test-retest evaluation. The anxiety subscale of the Depression, Anxiety, and Stress Scale-21R (DASS-21R) was administered to assess convergent validity. Internal consistency (Cronbach's &#x3b1;), temporal stability (test-retest correlations and intraclass correlation coefficients), and convergent validity (Pearson correlations) were computed. Exploratory factor analyses were conducted on EMAS domain scores (state, trait, and perceived anxiety domains) as an exploratory structural check. Results: EMAS state and trait anxiety scores were higher in women than in men, while perceived anxiety showed a more heterogeneous pattern across dimensions. Total state anxiety increased with age, particularly after 50 years. Domain-level internal consistency was good for state and acceptable for trait components (standardized &#x3b1; &#x2248; 0.84 and 0.78 across administrations), whereas perceived anxiety domains showed low cross-domain coherence, consistent with context-specific appraisal. The DASS-21R anxiety subscale showed good internal consistency (&#x3b1; = 0.863). Convergent validity analyses indicated small, domain-specific associations between EMAS scores and DASS-21R anxiety. Domain-level EFA supported a theoretically coherent pattern in which state and trait domains clustered distinctly, while perceived anxiety domains formed a partially separable factor; this pattern was broadly consistent across both administrations. Conclusions: In this HD cohort, EMAS demonstrated good reliability and limited but domain-specific evidence of convergent validity, and exploratory domain-level analyses supported its multidimensional organization. Further studies with larger samples are warranted for item-level structural testing and to inform feasibility-oriented shortening for potential clinical use.

Osteoporosis increases fracture risk in older adults and is associated with impaired health-related quality of life (HRQoL). Osteoporosis-specific HRQoL instruments are widely used, but their measurement performance in older populations has not been comprehensively synthesised. To systematically identify and synthesise development and validation studies of osteoporosis-specific HRQoL instruments for older adults, and to appraise their measurement properties using COSMIN criteria and a modified GRADE approach to inform instrument selection for clinical trials, routine care, and research. Systematic review. Community-dwelling; Long-term care facility; Primary care facility. Older persons aged 60&#xa0;years or over. We searched Medline (Ovid), Embase, PsycINFO (Ovid), and AMED (Ovid) from inception to August 2024. We extracted and appraised evidence for COSMIN-defined measurement properties: content validity, structural validity, internal consistency, cross-cultural validity or measurement invariance, reliability, measurement error, criterion validity, hypothesis testing for construct validity, and responsiveness. Methodological quality was assessed using the COSMIN Risk of Bias checklist, measurement properties were rated against COSMIN criteria for good measurement properties, and certainty of evidence was graded using a modified GRADE approach. Forty-three studies reported the development and/or validation of nine osteoporosis-specific HRQoL instruments; language and version adaptations resulted in 15 instrument variants. Content validity was the most prominent limitation: only OPTQoL and the English Mini-OQLQ demonstrated sufficient evidence for multiple content validity components, while most widely used instruments lacked adequate evidence on item relevance, comprehensiveness, or comprehensibility. Evidence for internal structure was limited, with structural validity sufficient for ECOS-16 and QoLOS-NVFX, insufficient for QUALEFFO-41, and indeterminate for most other instruments. Cross-cultural validity and measurement invariance were almost entirely unexamined. By contrast, reliability and hypothesis testing for construct validity were more consistently supported, often with moderate-to-high certainty. Measurement error, interpretability, and responsiveness were poorly reported across instruments. The evidence base supports purpose-driven selection of osteoporosis-specific HRQoL instruments rather than a single preferred instrument. Across included studies, ECOS-16 shows the most consistently supported measurement properties in older adults for longitudinal assessment, although important evidence gaps remain (notably measurement error and cross-cultural validity). When brevity is the primary feasibility constraint in routine care, the Mini-OQLQ may be considered; however, evidence for responsiveness is limited.

The global population is experiencing rapid aging, and the mental health needs of older adults have become an urgent public health concern, with anxiety levels becoming increasingly prevalent among older adults. In Thailand, stress and anxiety among older adults are anticipated to double in the next decade. Neuroticism, characterized by emotional instability and an impulse for negative feelings, is a significant psychological characteristic associated with anxiety. Older adults with higher neuroticism have heightened sensitivity to stress and frequently struggle with emotional regulation, hence increasing their vulnerability to anxiety and other mental health disorders. Loving-kindness, a core Buddhist principle, has been shown to benefit mental health by reducing stress, anxiety, and depression, primarily in Western or short-term settings. However, there is limited research assessing its role among older adults in Buddhist cultural contexts, such as Thailand. This study investigated whether loving-kindness moderated the relationship between neuroticism and anxiety symptoms among 232 Thai adults aged 60 and above, using secondary data collected between December 2019 and September 2022. Measures included the Neuroticism Inventory, Core Symptom Index for anxiety, and the Inner Strength-Based Inventory for loving-kindness. Multiple regression analysis evaluated potential moderating effects. The results revealed that anxiety had a positive correlation with neuroticism and a negative correlation with loving-kindness and education; nevertheless, an unexpected pattern occurred in the moderation analysis. Loving-kindness specifically enhanced the correlation between neuroticism and anxiety at high levels, rather than mitigating it. Older adults exhibiting higher levels of neuroticism and loving-kindness reported increased anxiety symptoms. Education was identified as a protective factor, exhibiting a negative correlation with anxiety. Loving-kindness did not mitigate the effect of high neuroticism on anxiety in Thai older adults. Rather, it intensified this correlation, indicating that robust prosocial characteristics lacking sufficient emotional regulation may exacerbate stressful emotions. These findings contradict prevailing theories regarding the universal advantages of loving-kindness and underscore the necessity for therapies that incorporate loving-kindness with emotional regulation and self-care in older adults.

Positive mental health (PMH) has recently become a key topic in biomedical research. Previous studies have explored the correlation between biological and psychological measures, but only a few have focused on the relationship between PMH and aging. This study aimed: (i) to explore the association between PMH and biological aging; (ii) to determine if and to what extent the observed association could be explained by shared genetic and environmental effects. A total of 401 twins (age 19-81 years, 32% male) from the Italian Twin Registry were recruited, and the twin study design was applied. A self-report psychological test battery was used to evaluate several PMH components. Blood samples were collected from participants to determine telomere length (TL) and mitochondrial DNA copy number (mtDNAcn). TL was negatively associated with attachment anxiety (r = -0.11, p = 0.037). A bivariate twin model provided heritability estimates of 0.14 (95% CI 0.001-0.43) for TL and 0.32 (0.16-0.45) for attachment anxiety, and a substantial negative genetic correlation [rg = -0.55 (-1.00-0.00)] between them. Under the limitations of a cross-sectional study with a self-report wellbeing assessment, these results suggest that anxiety in the relationship with a partner may contribute to accelerated TL shortening, and shared genetic factors may underlie this link.

In the context of a rapidly aging global population, influenza vaccine hesitancy among Chinese older adults remains a critical public health issue. Concurrently, the proliferation of digital health information has raised concerns about the negative effects of information overload and cyberchondria. However, the psychological pathways linking these digital phenomena to vaccine hesitancy, particularly for older adults, remain underexplored. This study aims to examine the association between health information overload on excessive online search (cyberchondria) and influenza vaccine hesitancy among Chinese older internet users. Grounded in the Stereotype Embodiment Theory (SET), the study specifically examines the mediating role of self-perceptions of aging. A self-reported online questionnaire was distributed to 791 Chinese internet users aged 55 or older. The research hypotheses were tested using Partial Least Squares Structural Equation Modeling (PLS-SEM) in SmartPLS. Results indicate that health information overload was significantly correlated with cyberchondria (&#x3b2; = 0.501, p < 0.001), psychological growth (&#x3b2; = -0.236, p < 0.001), physical change (&#x3b2; = -0.229, p < 0.001), and psychosocial loss (&#x3b2; = 0.254, p < 0.001). Similarly, cyberchondria was a significant predictor of psychological growth (&#x3b2; = -0.184, p < 0.001), physical change (&#x3b2; = -0.312, p < 0.001), and psychosocial loss (&#x3b2; = 0.285, p < 0.001). Finally, physical change (&#x3b2; = -0.209, p < 0.001) and psychosocial loss (&#x3b2; = 0.247, p < 0.001) showed a significant statistical relationship with vaccine hesitancy. The findings highlight the critical importance of fostering positive aging attitudes in health communication strategies. Health practitioners and policymakers should develop age-friendly digital environments and educational campaigns that not only provide accurate information but also empower older adults to perceive aging more rationally, thereby potentially encouraging proactive health behaviors.

With the aging population, cognitive decline in the elderly population is of much concern. Researchers have studied different protective factors against cognitive decline, and one factor that has proven to be effective is an individual's social network. In this study, we aimed to assess the association between social contact frequency with others, as a proxy measure of social network, and cognitive function in the elderly Korean population. We used the data from the Korean Frailty and Aging Cohort Study (KFACS), which was followed biennially, and our final analysis consisted of the baseline, first, second, and third follow-up data. The main independent variable social contact frequency was divided into three groups: "Frequently" (everyday), "Moderately" (1-3 times a week), "Rarely" (once a month or less), and the main dependent variable fluid intelligence was turned into a z-score and used as a continuous variable. In the final analysis, generalized estimating equation (GEE) was used to analyze the longitudinal association between social contact frequency and fluid intelligence. In our study, more frequent contact with friends was associated with better cognitive function across all time points for males (Moderately: &#x3b2;&#x2009;=&#x2009;0.04, S.E.&#x2009;=&#x2009;0.02, 95% CI&#x2009;=&#x2009;0.01&#x2009;~&#x2009;0.07; Frequently: &#x3b2;&#x2009;=&#x2009;0.06, S.E.&#x2009;=&#x2009;0.02, 95% CI&#x2009;=&#x2009;0.03&#x2009;~&#x2009;0.10) and females (Moderately: &#x3b2;&#x2009;=&#x2009;0.08, S.E.&#x2009;=&#x2009;0.02, 95% CI&#x2009;=&#x2009;0.04&#x2009;~&#x2009;0.12; Frequently: &#x3b2;&#x2009;=&#x2009;0.09, S.E.&#x2009;=&#x2009;0.02, 95% CI&#x2009;=&#x2009;0.05&#x2009;~&#x2009;0.13) compared to Rarely group when the target of contact was friends. Contact with family or neighbors did not show any significant association with fluid intelligence. Our findings provide valuable insights in this line of work by specifying the type of contact that is beneficial for the elderly population and could aid future researchers developing interventions against cognitive decline.

Against the social backdrop of the simultaneous deepening of population aging and digital transformation, older adults' subjective experience and evaluation of their own aging process have increasingly become core psychological elements influencing their physical and mental health as well as social integration. A nationally representative sample of older adults aged 60 and over from 3 waves (collected in 2018, 2020, and 2023) of The China Longitudinal Aging Social Survey was used in the analysis. Adopted as two-dimensional measures of Views on Aging (VoA) were subjective age and perceived old age, with their age trajectories among older adults and the cohort differences driven by digital engagement systematically examined via hierarchical growth curve models, and robustness checks conducted through propensity score matching. Findings show that VoA of older adults become increasingly positive with age, with significant generational differentiation; digital engagement effectively boosts the positivity of their VoA (reflected in lower subjective age and higher perceived old age), while this positive effect diminishes marginally with age and displays distinct cohort differences. This study provides longitudinal empirical evidence on the reshaping effects of digital technologies on older adults' VoA, and theoretical support for promoting active aging and building an age-friendly environment in the digital society.

Healthy aging has emerged as a global priority. However, older adults' participation in health promotion programs remains low, and traditional health promotion models have achieved limited success in fostering sustained engagement among this population. Mobile health (mHealth)-based gamification interventions offer a promising way to address these challenges. However, no published reviews support or oppose the use of mHealth-based gamification interventions as health promotion strategies in older adults. The study aimed to identify mHealth interventions using gamification to promote health among older adults. Our scoping review was conducted following the Joanna Briggs Institute recommendations for scoping reviews and Arksey and O'Malley's framework. The process followed PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines and PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Literature Search Extension) checklist. A comprehensive literature search was conducted across 8 databases: PubMed, Scopus, Web of Science, Embase, Cochrane Library, CINAHL, PsycARTICLES, and IEEE Xplore Digital Library, from their inception to December 10, 2025. Two reviewers independently screened titles, abstracts, and full texts via Rayyan, with disagreements resolved by a third reviewer. This scoping review identified 11 studies. Only 1 article was published before 2022. The interventions were found to improve enjoyment and motivation (n=5), cognitive function (n=3), physical activity (n=2), and digital literacy (n=2). Individual studies also reported improvements in mental health (n=1) and adherence (n=1), a reduction in suicidal ideation (n=1), improvements in physical function (n=1), the promotion of social engagement (n=1), and the identification of mild cognitive impairment (n=1). Game elements used were ranked by frequency as progress, challenges, goals, levels, reward, sensation, storytelling or narration, leaderboard, surprise, and avatar. No research was found to use the game element of "social sharing." mHealth types included augmented and virtual reality-based training systems, wearable devices, mobile phones, tablets, and Windows platforms and devices. Notably, only 4 studies applied theoretical frameworks, and 3 omitted the concrete approach to gamification. As the first scoping review to identify and map mHealth-based gamification interventions for older adults, this study highlights their potential as an innovative approach to health promotion. By systematically synthesizing evidence regarding intervention designs, gamification strategies, and preliminary health outcomes, it establishes a foundation for future inquiry. However, this review is limited by the small number of included studies, precluding broad generalizations. Future research should assess long-term impacts, integrate theoretical frameworks, establish reporting guidelines, design personalized social-interactive interventions, and expand to broader health domains. Ultimately, these insights provide targeted guidance for developing age-appropriate digital health solutions, contributing to the realization of active aging.

Background and Objectives: To assess the reliability and construct validity of the Functional Rating Index (FRI) in Italian-speaking individuals with chronic non-specific low back pain (CLBP), in order to improve assessment and clinical management in this population. Materials and Methods: This cross-sectional study consecutively enrolled 75 individuals with CLBP (52 females; mean age 48.71 &#xb1; 19.18 years; mean pain duration 298.64 &#xb1; 427.52 weeks). Internal consistency and test-retest reliability were evaluated using Cronbach's &#x3b1; and the intraclass correlation coefficient [ICC2,1], respectively, while measurement error was estimated through the minimum detectable change (MDC). Construct validity was examined by testing a priori hypotheses through correlations (Pearson's r) between the FRI and disability measures (Roland-Morris Disability Questionnaire, RMQ; Oswestry Disability Index, ODI), pain intensity (Numerical Rating Scale, NRS), and quality of life (Short-Form Health Survey, SF-36). Results: Cronbach's &#x3b1; was 0.88, and test-retest reliability showed an ICC2,1 of 0.86 (95%CI: 0.82-0.93). The MDC was 18.05, corresponding to approximately 20% of the total score. The Italian FRI demonstrated strong correlations with the RMQ (r = 0.70) and ODI (r = 0.77), and a moderate correlation with the NRS (r = 0.60). The physical and social domains of the SF-36 showed stronger negative correlations with the FRI than the mental and emotional domains. Conclusions: The Italian version of the FRI is a reliable and valid instrument for individuals with CLBP and is recommended for both clinical practice and research applications.

Concentrations of plasma neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) should be easily interpretable in the context of a patient's profile. To develop reference intervals (RI) for NfL and GFAP, accounting for common physiological modifiers of biomarkers and to compare these RIs with concentrations from participants with neurological conditions. This cross-sectional study included participants with no cognitive impairment (self-reported, assessed by Mini-Mental State Examination score &#x2265;27, or determined by a physician) to generate and validate the RIs as well as individuals, recruited from tertiary clinics, with subjective cognitive decline or mild cognitive impairment due to Alzheimer disease (AD), AD dementia, frontotemporal dementia (FTD), dementia with Lewy bodies, vascular dementia (VaD), or multiple sclerosis, for the comparison group. Age, biological sex (self-reported), body mass index (BMI), and kidney function (measured by estimated glomerular filtration rate [eGFR]). Plasma NfL and GFAP RIs, quantified on the Simoa HD-X, defined over age and adjusted for sex, BMI, and/or eGFR. In 7989 cognitively unimpaired participants (median [range] age, 54 [30-90] years; 4877 [61.3%] female; mean [SD] BMI, 25.9 [4.2]; mean [SD] eGFR, 80.7 [14.7] mL/min/1.73 m2), older age, lower BMI, and reduced kidney function were associated with increased NfL and GFAP concentrations; female sex was associated with increased GFAP concentrations. Median NfL and GFAP concentrations were 6.58 (6.58-6.58) pg/mL and 23.4 (23.4-23.4) pg/mL higher, respectively, in participants with severe compared with no kidney damage (ie, 45 mL/min/1.73 m2 vs 90 mL/min/1.73 m2). Median NfL and GFAP concentrations were 1.72 (1.72-1.72) pg/mL and 12.6 (12.6-12.6) pg/mL lower, respectively, in participants with obesity compared with those with normal weight (ie, BMI of 30 vs 20). Median GFAP concentrations were 6.17 (6.17-6.17) pg/mL higher in female compared with male participants. NfL concentrations were most elevated in participants with FTD (165 of 179 participants [92.2%] had concentrations greater than the median) and VaD (55 of 60 participants [91.7%] had concentrations greater than the median). GFAP concentrations were most elevated in participants with AD dementia (396 of 479 participants [82.7%] had concentrations greater than the median). A user-friendly interface was developed to visualize the biomarker RIs in the context of an individual's age, BMI, eGFR, and sex. In this cross-sectional study of 7958 individuals, RIs to identify normal or abnormal biomarker concentrations in the context of a cognitively unimpaired individuals were established to aid the use of plasma NfL and GFAP measures in clinical practice for neurological diseases.