bluuebunny/crossref_metadata_2025_split huggingface dataset:
FROM PAST TO PRESENT: REFINING LONG-TERM CARE POLICIES IN RESPONSE TO CHINA’S AGING POPULATION
Authors: Wang Qingwei , Ma Yu , Chen Jiayu 
Published: January 2025

Abstract
The evolution of long-term care policy in China is a complex response to the nation’s demographic shift and economic changes. Despite extensive policy development, discrepancies between policy intentions and real-world demands of older adults persist. This study employs a longitudinal analysis to dissect the dynamics that have shaped China’s aging policies from the 1940s to 2023. By critically examining legislative documents and top-level directives, this research identifies gaps between policy formulations and market response and the challenges of navigating a fragmented regulatory landscape. A misalignment has emerged between the supply of Home and Community-Based Services and institutional care demand, resulting in resource underutilization and diverging from intended policy outcomes. The research further explores the regulatory fragmentation within China’s long-term care sector, indicating that decentralized supervision is a significant barrier to achieving cohesive governance and effective policy implementation. The findings illustrate the critical need for adaptive policy mechanisms that better align with demographic realities and consumer expectations. This paper contributes to the discourses on long-term care policy by offering insights into the effectiveness of China’s strategic initiatives in recent years and suggesting directions for future policy refinement. It aims to ensure sustainable care by addressing both the discrepancies in policy and market response and the challenges of fragmented authority.
SOCIOECONOMIC AND GENETIC DETERMINANTS OF COGNITIVE FUNCTION IN THE AGING POPULATION IN KAZAKHSTAN
Authors: Supiyev Adil , Gutierrez Angela , Terrera Graciela Muniz 
Published: January 2025

Abstract
Objective There is limited evidence about cognitive performance of older adults in Kazakhstan, a Central Asian nation that was formerly part of the Soviet Union. Our study aims to fill the gaps by assessing cognitive function and its determinants in the population of Astana city and its surrounding rural areas. Methods Between 2012 and 2015, 954 older adults aged 50–74 from urban and rural areas in Central Kazakhstan participated in this study (response rate: 59%). Trained practitioners administered four neuropsychological tests to assess cognitive function, including verbal memory, verbal fluency, attention, and concentration. Additionally, a standardised protocol was used, consisting of a structured questionnaire, objective physical examination, and blood sample collection. Results After controlling for age, sex, and cardiometabolic risk factors, our analysis revealed significant associations between cognitive function and residence, ethnicity, education levels, and selected socioeconomic factors. Notably, APOE4 status showed a strong association with cognitive decline, consistent with prior research. Furthermore, individuals with higher deprivation levels, men, rural residents, and those with lower education levels demonstrated significantly poorer cognitive function outcomes. Conclusion Understanding the association between cognitive function and selected socio-demographic factors within the Central Asian region contributes significantly to global health insights. The contrasts observed in residential environments and levels of deprivation emphasize the urgency of targeted interventions aimed at mitigating cognitive decline risks among vulnerable populations worldwide.
A SYSTEMATIC REVIEW OF MEASURES USED IN STUDIES LINKING SOCIAL ISOLATION, LONELINESS, AND PHYSICAL HEALTH
Authors: Nambisan Priya , Gangula Sushma , Ellis Julie , Taani Murad , Lee Yura 
Published: January 2025

Abstract
Social isolation (SI) and loneliness significantly impact public health, particularly among older adults, leading to adverse physical health outcomes. Despite extensive research in this field, there is considerable variability in how these factors are measured. Our systematic review, following the PRISMA method, identified 22 relevant studies. Among these, 18 primarily utilized secondary data and assessed social isolation through questions covering marital status, contact frequency with family, friends, and participation in social activities. Composite indices and scales were often constructed from these measures, with scores indicating low/high social isolation. However, it’s essential to note that loneliness, which can be felt despite social interaction, requires validated scales for accurate measurement. Out of the 22 studies, 4 didn’t employ validated scales for either SI or loneliness, while 6 lacked validation for SI, and 5 out of 20 for loneliness. Measurement scales varied for loneliness, from simple classifications to Likert scales, with higher scores indicating heightened loneliness. Some studies adopted established scales like the Bude and Lantermann scale, while others employed modified versions or analogues. Our analysis highlights the importance of using validated measures to assess these variables accurately. Markedly, different measurement approaches yielded distinct impacts on health outcomes. Moving forward, standardization and validation of measurement tools are critical for enhancing the reliability and comparability of research findings in this area.
HOW DOES DIGITAL USE AFFECT THE DAILY ACTIVITIES AND LONELINESS AMONG CHINESE OLDER ADULTS?
Authors: Chen Xiayu , Yu Zhan , Xu Qingwen 
Published: January 2025

Abstract
The increasing integration of digital technology into everyday life has significant implications for the aging population. This study explores the relationship between Internet use and the psychosocial well-being of older adults, particularly examines whether digital engagement would have replaced (or enhanced) traditional activities and social interactions, and to what extent digital engagement has contributed to alleviating loneliness among older adults within the Chinese community-dwelling context. Utilizing data from the Chinese General Social Survey, which included 4,283 respondents aged 60 and over, we performed various regression models to examine the relationship among Internet use and daily activities, as well as Internet use and loneliness. Our research reveals the digital divide within the older population in China, where Internet users were the majority those with access to resources and learning and physical capacity, suggesting a deeper concern for technology equity. Our findings also indicate that Internet use among older adults is associated with increased participation in traditional activities, such as shopping, information seeking, and socializing with friends and relatives. Additionally, a higher intensity of Internet use correlates with lower levels of reported loneliness, indicating that Internet use could enhance social connections and overall well-being among older adults. These results highlight the potential of digital technologies to support active aging by fostering enhanced social interactions and engagement in daily life. It calls for developing holistic digital integration strategies and creating an age-friendly digital environment. The findings also provide valuable insights for policymakers and stakeholders in China and potentially in other contexts.
NEIGHBORHOOD AND PSYCHOSOCIAL PREDICTORS OF ALLOSTATIC LOAD AMONG LATINX ADULTS IN THE UNITED STATES
Authors: Gutierrez Angela , Supiyev Adil , Tobin Courtney Thomas , Sevi Barış , Terrera Graciela Muniz 
Published: January 2025

Abstract
Prior research highlights the independent roles of neighborhood and psychosocial risk and protective factors for accelerated physiological aging. However, the combined role of risk and protective neighborhood and psychosocial factors on allostatic load (AL) among middle-aged and older Latinx adults in the U.S. remains unclear. Utilizing data from Latinx adults ages 50 and older (n = 319) in the Health and Retirement Study (Time 1 = 2006/2008; Time 2 = 2010/2012; Time 3 = 2014/2016), this study aimed to examine the role of neighborhood (perceived physical disorder, neighborhood social cohesion) and psychosocial (loneliness, social support) factors in shaping baseline AL and change in allostatic load. Linear mixed models were used to estimate baseline AL and rate of change in AL, adjusting for sociodemographic factors. Higher loneliness was associated with higher baseline AL, p = 0.028. This association persisted when considering neighborhood factors, p = 0.025. When social support was added to the model, the association between loneliness and AL was attenuated and no longer statistically significant, p = 0.174. Findings provide evidence of a positive association between loneliness and baseline allostatic load. Finding also highlight social support as a protective factor for baseline AL among Latinx adults. Health promotion efforts should consider implementing culturally relevant approaches to foster social support and to promote healthy aging among Latinx adults.
GAME ENGAGEMENT AMONG MIDDLE-AGED AND OLDER ADULTS PREDICTS LATER-LIFE COGNITIVE PERFORMANCE
Authors: Mansoor Marrium , Katz Ben 
Published: January 2025

Abstract
Although previous literature has linked intellectually stimulating activities to better cognitive outcomes for older adults through cross-sectional and experimental paradigms, fewer studies have looked at the relationship between gameplay at earlier ages and cognitive performance many years later in life. Here, a nationally representative sample of ~1200 middle and older adults drawn from the Health and Retirement Study (M=64.91 years, SD=7.68; Range = 50-91) was used to examine links between global cognition 14 years following self-reported gameplay frequency of two different types of gameplay - word games (WG) and card games (CG) - while accounting for baseline global cognition, age, gender, and years of education. Results indicated that only WG predicts global cognition (B= 0.05, p=0.039) such that more frequent gameplay earlier on was linked to better global cognition scores 14 years later. Although this association is modest and requires further exploration through cross-lagged models and more granular longitudinal studies, these results indicate that word games may play a role in cognitive engagement in later life that is similar to the protective effects of other intellectually stimulating activities. As computer and videogame play become more pervasive in older adult populations, future research should also focus on different types of games (including video games, mobile games, and/or board and puzzle games) to explore the nuances of game engagement throughout the life course and cognitive performance in later life.
TIME-TO-EVENT ANALYSIS IN EVALUATING THE ASSOCIATION OF FALL RISK APPRAISALS AND PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Nguyen Tho , Thiamwong Ladda , Liu Chang , Suarez Jethro Raphael , Park Joon-Hyuk , Xie Rui 
Published: January 2025

Abstract
Older adults are encouraged to participate in moderate-to-vigorous physical activity (MVPA) for 75 to 300 minutes per week for health benefits. However, the association of fall risk appraisal (FRA) with meeting the recommended activity levels remains uncertain. We assessed FRA in 134 participants aged 61 to 89 (mean age=74.26±6.85 years, 88.8% female, and 70.15% no history of falls) using the Short Fall Efficacy Scale-International and a static balance assessment, and categorized them into four FRA groups: rational (10.5%, low fear of falling (FOF) and normal balance), irrational (42.9%, high FOF but normal balance), incongruent (25.6%, low FOF and poor balance), and congruent (21.1%, high FOF but poor balance). Using time-to-event analysis based on daily accelerometer activity count data, we examined the impact of FRA on the duration of MVPA, light physical activity (LPA), and sedentary behavior (SB) across seven consecutive days. Kaplan-Meier curves demonstrate that older adults in the rational FRA group had the highest probability of sustaining MVPA throughout the day, whereas those in the congruent group had the lowest probability (log-rank p &lt; 0.001). Conversely, participants in the congruent group exhibited the highest likelihood of extending SB duration, while those in the rational group had the lowest (log-rank p &lt; 0.001). No significant differences were observed among FRA groups regarding LPA duration. The findings underscore the significance of mitigating a sedentary lifestyle and emphasize the importance of implementing targeted interventions to enhance the duration of MVPA as a pivotal determinant in diminishing the fall risks among older adults.
MULTIDIMENSIONAL SOCIAL RELATIONSHIP AND LONELINESS AMONG OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Park Soobin , Park Sojung , Kim BoRin , Amano Takashi , Baek Jihye 
Published: January 2025

Abstract
As a modifiable risk factor of cognitive impairment, loneliness has received growing attention in research. By focusing on older adults with cognitive impairment, this study aims to add to the knowledge about the complex association among cognitive impairment, social relationships, and loneliness We explored distinct patterns of multidimensional social relationships and examined how these patterns influence social and emotional loneliness among older adults with cognitive impairments. Data came from the 2018 Health and Retirement Study and aged over 65 years. To focus on older adults with cognitive impairments, we excluded respondents with high cognitive function measured by the Telephone Interview for Cognitive Status (TICS) score (N=640). Latent class analysis was used to identify subgroups of social relations using multidimensional indicators of social relations including quantity (e.g., frequency of social contact with varying modes, social network size) and quality (e.g., positive and negative social support). Five patterns of social relationships emerged: Lack Friends/Weak (16%), Lack Children/Positive Friends (10%), Lack Family (11%), Virtual Diverse (52%), and Diverse/Negative (11%). Regression analyses showed Diverse/Negative group (p&lt; 0.01) was significantly associated with a higher level of emotional loneliness compared to the Virtual Diverse group. All three groups (p&lt; 0.05) except Lack Children/Positive Friends (p&gt;.1) had significantly a higher level of social loneliness. Interestingly, more than half had a quantitatively diverse social relationship, maintaining rich social networks despite their cognitive impairment. Our findings highlight the importance of efforts that help decrease negative and secure positive or meaningful support as ways to reduce loneliness among cognitively impaired older adults.
PEER-LED EXERCISE RESULTS IN IMPROVED SLEEP EFFICIENCY WITHOUT CONCURRENT CHANGES IN MOOD
Authors: Banarjee Chitra , Lafontant Kworweinski , Suarez Jethro Raphael , Park Joon-Hyuk , Fukuda David , Stout Jeffrey , Lighthall Nichole , Thiamwong Ladda 
Published: January 2025

Abstract
Sleep is an important physiological process for recovery and regulation of homeostatic processes in the human body. Changes in sleep have additionally been shown to affect mood, including anxiety and depression. The present study implements multimodal assessment of sleep and mood using the wearable FitBit® Charge 5, as well as subjective surveys, the PHQ-9 and GAI, evaluating anxiety and depression, respectively. The study sample included 108 community-dwelling older adults (mean age = 74.19 years ± 6.96; 89.8% female). Of these adults, 58 participated in weekly peer-led exercise and exercise, (strength-training and walking) at least 30 mins twice a week for eight weeks. Participants wore a FitBit® for a mean of 76.5 days ± 59.24, including at night. Using the FitBit®, the study evaluated time asleep and sleep efficiency, calculated based on the time asleep, deep and REM sleep, and restoration. Participants undergoing intervention exhibited a significant increase in both sleep duration (p&lt; 0.001; intervention=297.2 minutes, control=274.8 minutes) and efficiency (p&lt; 0.001; intervention=93.6, control=92.2), as evaluated by Wilcoxon tests. However, subjective assessments of anxiety (p=0.288) and depression (p=0.986) did not reveal significant differences. These results indicate that peer-led exercise results in a significant improvement in sleep, which is consistent with previous research. The lack of concordant results in mood suggests that more intensive exercise may be necessary to improve mood. Additionally, the study was limited by individual variability in FitBit® wear time. Future research should evaluate the long-term effects of increasing the time and intensity of peer-led exercise on sleep and mood.
SUPPORTING SOCIAL INTERACTION OF OLDER FAMILY CARE PARTNERS THROUGH A DIGITAL HEALTH PHYSICAL ACTIVITY PROGRAM
Authors: Baik Dawon 
Published: January 2025

Abstract
Older Family care partners (FCPs) experience more social isolation, mental and physical health issues than younger FCPs. Loneliness and social disconnectedness in older FCPs can lead to an increased risk of poor health and low well-being. To support social interaction and connectedness in older FCPs of persons with heart failure (HF-FCPs), we identified their needs and preferences on a technology-supported physical activity (PA) program using scenario-based design methods. The program included one-on-one PA coaching, using a fitness tracker and motivational text messaging. Fifteen HF-FCPs were recruited at a University Hospital between September and December 2022. We conducted semi-structured qualitative interviews. Participants were aged 65.9±4.4 years (M±SD), female (73%), and spouses (87%). HF-FCPs perceived that the program could support their social connectedness. Participants reported that interaction with a health coach via videoconferencing would be valuable for their social health in the context of caregiving (e, g., time constraints, caregiving duties limiting FCPs to the home). A group-based program was suggested to increase motivation for support and feedback from other FCPs. They indicated that texting would be useful to share their PA and caregiving experience and provide support and encouragement to other FCPs. Participants highlighted the need for their own social groups, because as one described: “There is a support group for people with the same condition and their caregivers, but it’s really talking about the condition itself, not about how we take care of ourselves.” Future studies should develop and test technology-based, caregiver-centered interventions for sedentary and socially isolated older FCPs.
DOMINANT BUT NOT NONDOMINANT HANDGRIP ASYMMETRY INFLUENCES ACTIVITY AND COGNITIVE FUNCTION CHANGE
Authors: Chen Liangchi , Han Sae Hwang , Lockman Jeffrey 
Published: January 2025

Abstract
Handgrip strength (HGS) is commonly used in clinical and research settings for examining muscle function. Additionally, HGS asymmetry is often used as a screening tool for identifying functional and cognitive limitations among older adults. This longitudinal study examined changes in activity limitations and cognitive function associated with baseline handgrip asymmetry. We analyzed 8 waves of biennial data collected from adults 51 and older in the nationally representative Health and Retirement Study (2006–2020, N=7,053). HGS asymmetry ratio was measured at baseline and was calculated as nondominant HGS/dominant HGS; following earlier works, individuals with HGS asymmetry ratio smaller than 0.80 and higher than 1.20 were considered to have dominant and nondominant handgrip asymmetry, respectively. We used multilevel models to investigate whether HGS asymmetry was linked to a faster rate of change in activity limitations (evaluated with activities and instrumental activities of daily living items; range: 0–11) and cognitive function (evaluated with Telephone Interview for Cognitive Status; range: 0–27) during the observation period. Results indicated that individuals with dominant HGS asymmetry, but not non-dominant HGS asymmetry, developed activity limitations at a faster rate (b=.015, p=.030) and also showed a faster rate of cognitive decline (b=-.053, p=.005) compared to individuals with HGS symmetry. While the present findings are based on a U.S. sample, future research endeavors are aimed at investigating similar issues beyond the confines of the U.S. population.
INTERDISCIPLINARY COLLABORATION TO SUPPORT AGE FRIENDLINESS AND PREPARATION FOR INTERGENERATIONAL PROGRAMMING
Authors: Munly Kelly , Frederick Jared , Gaston Harriett 
Published: January 2025

Abstract
Human Development and Family Studies (HDFS) and History Programs at a small campus collaborated to support Adult Development and Aging students (N=72) to understand the life course context of older adults they prepared to work with in a long-term care practicum experience. This effort to prepare students for intergenerational programming is part of a larger effort toward Age Friendliness at this campus and in the surrounding community. Life course theory is the foundation of project aims and design. After HDFS faculty established a plan for collaboration with the History Program, they were able to provide two classes of Adult Development and Aging students (N=72) with historical insights on the life course experiences of the older adults that students would be working with. Context and life course experiences discussed included dynamics related to diversity—often considered invisible—resulting from the Great Migration, as well as socioeconomic moments in time that would also influence the life course for multiple generations. After each class of discussion facilitated by the History Program, students were asked to provide reflections on their Canvas course online platform on what they had heard in light of their imminent practicum experiences. Initial thematic analysis of student reflections suggest that discussions facilitated between the History and Human Development and Family Studies Programs across two classes enhanced student understanding and supported a stronger foundation toward Age Friendliness and readiness to engage in intergenerational programming.
SUPER AGE: THE RISE OF BIOSOCIAL SUPER AGE ESTIMATES AS ALTERNATIVES TO CHRONOLOGICAL AGE
Authors: Perzynski Adam , Gunzler Douglas , Dalton Jarrod , Berg Kristen 
Published: January 2025

Abstract
Recent discoveries have established conceptual and empirical linkages between the social characteristics of communities, biological and physiological variation and disease onset and outcomes. Cellular and molecular markers appear to be at least partially indicative of an accelerated aging process. We are approaching the widespread availability of “Super Ages”, highly accurate biosocial estimates of the aging of a human person. Super Ages have more predictive validity for disease and disability than chronological age. As compared with chronological age, Super Age estimates can be described as having an accelerated (hyper-aging) or decelerated (hypo-aging) character. We ask: What types of social changes– beneficial or detrimental– might be postulated based upon a shift toward incorporating biosocial measures of aging in age-graded policy and care delivery? We present case-based scenarios illustrative of the coming biosocial dilemma. Consider two matched neighborhoods each containing 400 adults with a chronological age between 40 and 50 years who have aged in place (Neighborhood A and Neighborhood B). All persons in Neighborhood A experience uniform social and environmental hazards while hazards are minimal in Neighborhood B. Molecular analyses find Neighborhood A adults experience hyper-aging of chronological age plus 4 to 7 years. Neighborhood B are as much as 3 to 5 years “younger” creating between community biosocial age gap of 9.5 years. Both neighborhoods experience equal access to health services. Guideline-based screening (i.e. breast, lung and colon cancer screening) is age-graded but Neighborhood A is more vulnerable. Super Age estimates are fraught with new policy and care delivery challenges.