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Aims: This study investigated the relationships between specific types of social participation and well‐being variables (i.e., life satisfaction, positive affect, negative affect, symptoms of depression and anxiety) in Chinese older adults in Hong Kong. Methods: This study was a cross‐sectional study. A convenience sample of 341 participants aged 55–95 years (mean, 70.92; SD, 9.03) was recruited to complete a survey questionnaire during the COVID‐19 pandemic (between April and June 2022). Five hierarchical multiple regression analyses were conducted to examine the relationships between different types of social participation (physical, cultural, recreational, religious, and voluntary work) and outcome variables. Results: After controlling for covariates, it was revealed that only physical activities were associated with all outcome variables. Religious and cultural activities were positively related to positive affect, while an inverse relationship was found between recreational activities and anxiety. Conclusions: With the restrictions on social participation arising from the COVID‐19 pandemic, these findings suggest that promoting different types of social interactions might foster various aspects of well‐being in Chinese older adults. To achieve successful aging, the role of physical activities might be of paramount importance even under adverse situations. Geriatr Gerontol Int 2024; 24: 364–369. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to investigate the independent associations of dietary factors with cognitive impairment (CI) and physical frailty (PF) among Chinese older adults. Methods: This study included 10,734 participants (mean age = 78.7 years) free of CI and PF at baseline from the Chinese Longitudinal Health Longevity Survey. Dietary intake was collected using a simplified food frequency questionnaire every 3–4 years. The Chinese version Mini-Mental State Examination was used to assess cognition function, participants with a score below 18 were defined as CI. PF was defined using the activities of daily living, instrumental activities of daily living, and functional limitation-related questions. The outcome was defined as the first onset of either CI or PF. Competing risk models were used to estimate the corresponding hazard ratios (HRs) and the 95% confidence intervals (95% CIs). Results: During the study follow-up (mean = 8.1 years), a total of 1220 CI cases and 1451 PF cases were newly identified. Higher frequency of fruits intake was associated with a lower hazard of CI (HR = 0.75, 95% CI 0.58–0.97), whereas higher intake of preserved vegetables demonstrated an opposite association (HR = 1.23, 95% CI 1.07–1.42). In terms of PF, we observed a lower risk associated with higher meat and poultry intake (HR = 0.72, 95% CI 0.61–0.88). In particular, a significant protective association of fish and aquatic products intake with PF was observed among participants with ≥ 28 natural teeth (HR = 0.52, 95% CI 0.27–0.99). Conclusion: Our findings suggest divergent roles of major dietary factors in the development of CI and PF among Chinese older adults. [ABSTRACT FROM AUTHOR]

Background: Smart nursing homes (SNHs) integrate advanced technologies, including IoT, digital health, big data, AI, and cloud computing to optimise remote clinical services, monitor abnormal events, enhance decision-making, and support daily activities for older residents, ensuring overall well-being in a safe and cost-effective environment. This study developed and validated a 24-item Expectation and Acceptability of Smart Nursing Homes Questionnaire (EASNH-Q), and examined the levels of expectations and acceptability of SNHs and associated factors among older adults in China. Methods : This was an exploratory sequential mixed methods study, where the qualitative case study was conducted in Hainan and Dalian, while the survey was conducted in Xi'an, Nanjing, Shenyang, and Xiamen. The validation of EASNH-Q also included exploratory and confirmatory factor analyses. Multinomial logistic regression analysis was used to estimate the determinants of expectations and acceptability of SNHs. Results: The newly developed EASNH-Q uses a Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree), and underwent validation and refinement from 49 items to the final 24 items. The content validity indices for relevance, comprehensibility, and comprehensiveness were all above 0.95. The expectations and acceptability of SNHs exhibited a strong correlation (r = 0.85, p < 0.01), and good test-retest reliability for expectation (0.90) and acceptability (0.81). The highest tertile of expectations (X2=28.89, p < 0.001) and acceptability (X2=25.64, p < 0.001) towards SNHs were significantly associated with the willingness to relocate to such facilities. Older adults with self-efficacy in applying smart technologies (OR: 28.0) and those expressing a willingness to move to a nursing home (OR: 3.0) were more likely to have the highest tertile of expectations compared to those in the lowest tertile. Similarly, older adults with self-efficacy in applying smart technologies were more likely to be in the highest tertile of acceptability of SNHs (OR: 13.8). Conclusions: EASNH-Q demonstrated commendable validity, reliability, and stability. The majority of Chinese older adults have high expectations for and accept SNHs. Self-efficacy in applying smart technologies and willingness to relocate to a nursing home associated with high expectations and acceptability of SNHs. [ABSTRACT FROM AUTHOR]

(1) Objectives: This study aims to investigate the bidirectional relationship between depressive symptoms and cognitive function among older adults in China, addressing a research gap in the context of developing nations. (2) Methods: A total of 3813 adults aged 60 and older participating in 2013, 2015, and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS) were included. A fixed-effects model and cross-lagged panel model (CLPM) was utilized. (3) Results: First, the results indicated that a significant negative correlation existed between depressive symptoms and cognitive function in older adults during the study period (β = −0.084, p < 0.001). Second, after controlling for unobserved confounding factors, the deterioration and improvement of depressive symptoms still significantly affected cognitive function (β = −0.055, p < 0.001). Third, using the cross-lagged panel model, we observed a reciprocal relationship between depressive symptoms (Dep) and cognitive function (Cog) among Chinese older adults (Dep2013 → Cog2015, β = −0.025, p < 0.01; Dep2015 → Cog2018, β = −0.028, p < 0.001; Cog2013 → Dep2015, β = −0.079, p < 0.01; Cog2015 → Dep2018, β = −0.085, p < 0.01). (4) Discussion: The reciprocal relationship between depressive symptoms and cognitive functioning in older adults emphasizes the need for integrated public health policies and clinical interventions, to develop comprehensive intervention strategies that simultaneously address depressive symptoms and cognitive decline. [ABSTRACT FROM AUTHOR]

Subjective cognitive decline (SCD) is common in older adults and may also be an early marker for future cognitive impairment. Depression is an important influencing factor for subjective cognitive decline in old age. However, the mediating effects of general self-efficacy in depression and subjective cognition are yet to be explored. This study included 308 participants who were ≥60 years. Participants were asked to complete the self-report measures of the Geriatric Depression Scale-15 (GDS-15), Subjective Cognitive Decline-Questionnaire (SCD-Q), and General Self-Efficacy Scale (GSES). We used correlations, regressions, and structural equation models for the analyses. The bootstrapping method was performed to confirm the mediation effect. The subjective cognitive decline was found to be significantly and positively correlated to depression. Bootstrapping mediation analyses indicated that depression could affect SCD not only directly but also indirectly through general self-efficacy. General self-efficacy partly played a mediating role between depression and SCD. Hence, community workers and clinicians should actively help the elderly experiencing low levels of general self-efficacy to reduce their SCD. [ABSTRACT FROM AUTHOR]

Few studies have assessed the association between perceived availability of home‐ and community‐based services (HCBSs) and self‐reported depression among Chinese older adults, which the present study attempts to rectify. This cross‐sectional study enrolled 11,941 participants aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey 2018 wave. The 10‐item Center for Epidemiologic Studies Depression Scale (CESD‐10) was used to evaluate depression, and perceived availability was measured for four categories of HCBSs: daily life assistance, medical care services, emotional support and social services, and other. These four categories and the number of services in each were used to represent the perceived availability of service provision. Binary logistic models were used to explore the relationship between perceived availability of HCBSs and depression in older adults. Perceived daily life assistance was found to be negatively associated with depression symptoms among Chinese older adults in both urban and rural areas [rural: OR (95%CI) = 0.66 (0.55–0.78), p < 0.001; urban: OR (95% CI) = 0.69(0.60–0.79), p < 0.001], while perceived levels of medical care services, emotional support and social services, and other were not associated with depression symptoms in rural or urban areas. Our primary finding was that providing daily life assistance at the community level may help to meet more older adults' daily needs, thus potentially decreasing the risk of depression. [ABSTRACT FROM AUTHOR]

Aim: Hearing loss and depression in older adults are associated with a lower social participation rate. However, few studies have thoroughly analyzed the relationship between them. Methods: The data were obtained from the China Health and Retirement Longitudinal Study carried out in 2011, 2013 and 2015, and data from 24 306 participants ranging in age from 50 to 80 years were used in this study. Hearing loss, depression and social participation were assessed by self‐reported hearing status, the 10‐item Center for the Epidemiological Studies of Depression Short Form, and self‐reported social participation activity types and frequency. The fixed effects logistic regression and random effects logistic regression were used to examine the relationship between hearing loss and social participation. The Sobel method was used to explore the relationship between hearing loss, depression and social participation. Results: Compared with older adults without hearing loss, persons with hearing loss engaged in significantly fewer types of activities (β = −0.070, 95% CI −0.109, −0.031, P < 0.001) and at a lower frequency (β = −0.176, 95% CI −0.260, −0.093, P < 0.001). Depression significantly existed in the relationship between hearing loss and social participation as a mediating variable, and the percentage of indirect effects in this relationship were 16.5% and 20.8%. Conclusions: The findings of this study suggest that when facing an aging society, improving the hearing status of older adults should be considered by policymakers. More efforts should be made to help older adults cope with depression. Geriatr Gerontol Int 2022; 22: 529–535. [ABSTRACT FROM AUTHOR]

Life expectancy in China has increased. This paper explores the age when older adults (aged 60 and above) consider themselves to be an 'older person' and how age-related loss of resources (five dimensions: early cumulative factors, decline and loss of health resources, reduction and loss of economic resources, weakening and loss of social support resources, and personal role transition and experiences of losing family members) could impact their perceived old age. Using two waves of data from the China Longitudinal Ageing Social Survey (CLASS) in 2014 and 2016 (6,244 participants in 2014 and 2,989 participants in both 2014 and 2016), we found that the mean perceived old age is around 70 years at baseline (2014). Higher level of educational attainment and occupational types (early cumulative factors), better health condition, receiving support from friends and taking care of grandchildren are significantly associated with the perception that old age begins at an older age at baseline, while being Han-Chinese, being an urban resident (early cumulative factors) and reporting better health condition have significant positive effects on the perception that old age begins at an older age in the later wave. Our findings suggest that the age standard of older adults should be adjusted dynamically in response to social development and longevity, and also highlight the importance of early cumulative factors in shaping the ageing process besides age-related factors. [ABSTRACT FROM AUTHOR]

Few studies have assessed the impact of home and community‐based services (HCBSs) provision on cognitive function among older adults over time. This study examined the longitudinal association between HCBSs provision and cognitive function in Chinese older adults. The study included 5,134 participants aged 65 years and older in the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014. The Mini‐Mental State Examination (MMSE) was used to evaluate cognitive function over the same time period. Participants were asked what kind of HCBSs were provided in his or her community. However, they were not asked whether services were utilised. The study used the number of HCBSs provided each wave to represent the strength of HCBSs, and used the MMSE score of each wave to represent the older adults' cognitive function status. A latent growth model was used to explore the relationship between HCBSs provision and cognitive function of older adults. The number of HCBSs provided was positively associated with older adults' cognitive function (2008: β = 0.03, p = 0.031; 2011: β = 0.06, p < 0.001; 2014: β = 0.06, p < 0.001) after controlling for gender, age, residence, education, income, medical insurance, activities of daily living disability, instrumental activities of daily living disability, serious illness, living arrangement and marital status. Results provided longitudinal evidence that an increase in HCBSs provision at a national level can result in better cognitive function in Chinese older adults. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults. Methods: Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed. Results: Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression. Conclusion and implications: The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals. [ABSTRACT FROM AUTHOR]

This study examined the association between anxiety symptoms, depressive symptoms, and Traditional Chinese Medicine (TCM) use among U.S. Chinese older adults. Data was obtained from the Population Study of Chinese Elderly in Chicago (N = 3157; mean age = 72.8). Anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS‐A). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9). TCM modalities included herbal products, acupuncture, massage therapy, Taichi, and other types of TCM. Although not significant, there was a trend indicating that higher levels of anxiety symptoms showed a higher rate of acupuncture use and massage therapy. Older Chinese Americans with depressive symptoms were more likely to use acupuncture and massage therapy; and they were less likely to use other TCM. Future research is needed to identify reasons for TCM use; and how these factors mediate or moderate the relationship between psychiatric symptoms and TCM use. [ABSTRACT FROM AUTHOR]

Promoting life satisfaction in later life has long been both a policy and practice challenge. This study examined the association between older adults' self-image and life satisfaction, and that between their intergenerational relationships and life satisfaction. Given that sources of wellbeing for older men and women may vary due to socially constructed realities in early life, gender differences were also investigated in the correlates of life satisfaction. A face-to-face questionnaire survey was conducted in 2014 with a sample of 1,099 older adults aged 60 years and over from four cities in China. Findings of this study showed that older adults’ self-image and intergenerational relationships were significantly associated with their life satisfaction after controlling for certain socio-demographic characteristics, and health and self-care ability. The correlates of life satisfaction were shown to differ between older men and women. Programmes and Services should be developed for older adults to explore and identify positive aspects of themselves, to improve their relationships with their adult children, and to foster a more positive image of ageing in wider society. In addition, service providers should take gender differences in correlates of life satisfaction into account in service and intervention programme development. [ABSTRACT FROM AUTHOR]

Objectives:China has entered the aging society, but the social support systems for the elderly are underdeveloped, which may make the elderly feel anxiety about their health and life quality. Given the prevalence of generalized anxiety disorder (GAD) in the elderly, it is very important to pay more attention to the treatment for old adults. Although cognitive behavioral therapy targeting intolerance of uncertainty (CBT-IU) has been applied to different groups of patients with GAD, few studies have been performed to date. In addition, the effects of CBT-IU are not well understood, especially when applied to older adults with GAD. Method:Sixty-three Chinese older adults with a principal diagnosis of GAD were enrolled. Of these, 32 were randomized to receive group CBT-IU (intervention group) and 31 were untreated (control group). GAD and related symptoms were assessed using the Penn State Worry Questionnaire, Intolerance of Uncertainty Scale–Chinese Version, Beck Anxiety Inventory, Beck Depression Inventory, Why Worry-II scale, Cognitive Avoidance Questionnaire, Generalized Anxiety Disorder Questionnaire-IV, and Generalized Anxiety Disorder Severity Scale across the intervention. The changes between pre and after the intervention were collected, as well as the six-month follow-up.Ftest and repeated-measures ANOVA were conducted to analyze the data. Results:Compared to control group, the measures’ scores of experimental group decreased significantly after the intervention and six-month follow-up. Besides the main effects for time and group were significant, the interaction effect for group × time was also significant. These results indicated the improvement of the CBT-IU group and the persistence of effect after six months. Conclusion:Group CBT-IU is effective in Chinese older adults with GAD. The effects of CBT-IU on GAD symptoms persist for at least six months after treatment. [ABSTRACT FROM AUTHOR]

It has been well documented that in the 21st century, there will be relatively more older people around the world than in the past. Also, it seems that technology will expand in this era at an unprecedented rate. Therefore, it is of critical importance to understand the factors that influence the acceptance of technology by older people. The positive impact that the use of mobile applications can have for older people was confirmed by a previous study (Plaza et al., 2011). The study reported here aimed to explore and confirm, for older adults in China, the key influential factors of smartphone acceptance, and to describe the personal circumstances of Chinese older adults who use smartphone. A structured questionnaire and face to face individual interviews were used with 120 Chinese older adults (over 55). Structural Equation Modeling was used to confirm a proposed smartphone acceptance model based on Technology Acceptance Model (TAM), and the Unified Theory of Acceptance and Use of Technology (UTAUT). The results showed that those who were younger, with higher education, non-widowed, with better economic condition related to salary or family support were more likely to use smartphone. Also, cost was found to be a critical factor influencing behavior intention. Self-satisfaction and facilitating conditions were proved to be important factors influencing perceived usefulness and perceived ease of use. [ABSTRACT FROM AUTHOR]

Objective: The current study aims to examine the factorial structure and psychometric properties of a brief version of the Reminiscence Functions Scale (RFS), a 14-item assessment tool of reminiscence functions, with Chinese older adults.Method: The scale, covering four reminiscence functions (boredom reduction, bitterness revival, problem solving, and identity) was translated from English into Chinese and administered to older adults (N = 675). Confirmatory factor analysis and hierarchical confirmatory factor analysis were conducted to examine its factorial structure, and its psychometric properties and criterion validity were examined.Results: Confirmatory factor analysis supports a second-order model comprising one second-order factor and four first-order factors of RFS. The Cronbach's alpha of the subscales ranged from 0.75 to 0.90.Conclusion: The brief RFS contains a second-order factorial structure. Its psychometric properties support it as a sound instrument for measuring reminiscence functions among Chinese older adults. [ABSTRACT FROM AUTHOR]

Social robots can be an effective solution for the challenges facing an aging population. In this study, we apply the warmth and competence theoretical framework (Fiske et al., 2007) and the "computers as social actors" theory (Reeves & Nass, 1996) to understand how older Chinese adults perceive social robots. We surveyed 1480 Chinese older adults living in rural areas in Mainland China and tested two alternative hypotheses predicting the direction of the relationships between perceived warmth and competence and concerns about social robots. The results indicate that perceived competence was linked to increased technical, financial, and privacy concerns, while perceived warmth was connected to increased psychological concerns and decreased technical and financial concerns. These findings reveal that when social robots fulfill their promises to reduce older adults' health vulnerabilities, they can add a layer of psychological vulnerabilities. The conflicts between these two types of vulnerabilities may explain people's hopes and fears of social robots. • Chinese older adults use warmth and competence to judge social robots. • Chinese older adults perceive small sized and animal shaped robots as high warmth. • Chinese older adults rate steel-made machine-like robots and android as high competence. • Social robots can both reduce and add older adults' vulnerabilities. • The better the technology, the more socially and psychologically vulnerable people may feel. [ABSTRACT FROM AUTHOR]