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Hebei, one of China's most populous provinces, is facing increasing pressure on its elderly care services due to a rapidly aging population. Home‐Based Elderly Care (HBEC) has emerged as a potential solution to alleviate this pressure. However, this care model is significantly impacted by various external environmental changes. The study employed a literature analysis method, conducting a PEST analysis, to examine the environmental factors influencing the progress of HBEC in Hebei Province, China. The findings offer novel research perspectives to inform strategic development in the HBEC industry. The study identified 19 environmental factors, both favorable and adverse, shaping the development of HBEC in Hebei Province. Based on these findings, the study recommends integrating laws, regulations, and systems, clarifying government roles, optimizing funding structure, expanding service delivery channels, enhancing public awareness of elderly care, and broadening professional talent development pathways. These insights can be valuable for policymakers, educators, and researchers seeking to understand the challenges and opportunities in the field, ultimately improving the well‐being of China's elderly population. [ABSTRACT FROM AUTHOR]

Existing research on the detrimental effects of air pollution and its mixture on multiple chronic conditions (MCC) is not yet fully recognized. Our objective was to examine if individual and joint exposure to air pollution is associated with the incidence and patterns of MCC. Totally 10,231 CHARLS 2015 participants aged over 45 years and 1,938 without MCC were followed up in 2018 and 2020. Residential-levelcumulative personal exposure concentrations of PM1, PM10, PM2.5, CO, O3, NO2, SO2, NO3−, Cl−, NH4+, and SO42− at the residential level were determined utilizing a spatio-temporal random forest model with a spatial resolution of 0.1° × 0.1°. In the cross-sectional and longitudinal research, logistic regression, cox regression analysis, and quantile g-computation were utilized to estimate the single and joint effect with MCC and its patterns, respectively. Interaction analyses and stratified analyses were also performed. A correlation was observed between the prevalence of cardiovascular illnesses and the presence of all 11 major air pollutants. PM2.5, PM10, NH4+, NO3−, CO, and SO42− are associated with an increased frequency of respiratory disorders. An increase of PM2.5, PM1, PM10, NO2, and SO2 (a 10 µg/m3 rise), CO (a 0.1 mg/m3 rise), and PMCs (Cl−, NH4+, NO3−, and SO42−) (a 1 µg/m3 rise) corresponded to the HRs (95% CI) for developing MCC of 1.194 (95% CI: 1.043, 1.367), 1.362 (95% CI: 1.073, 1.728), 1.115 (95% CI: 1.026, 1.212), 1.443 (95% CI: 1.151, 1.808), 3.175 (95% CI: 2.291, 4.401), 1.272 (95% CI: 1.149,1.410), 1.382 (95% CI: 1.011, 1.888), 1.107 (95% CI: 1.003, 1.222), 1.035 (95% CI: 0.984, 1.088), and 1.122 (95% CI: 1.086, 1.160), respectively. SO2 was the predominant contributor to the combined effect (HR: 2.083, 95% CI: 1.659–2.508). Gender, age, drinking, and health status could modify the effects of air pollutants on MCC patterns. Long-term exposure to air pollution is correlated to the incidence and patterns of MCC in middle-aged and elderly Chinese individuals. Preventive methods are essential to safeguarding those susceptible to MCC. [ABSTRACT FROM AUTHOR]

Aligned with global goals for healthy and sustainable cities, urban compactness significantly promotes residents' transport-related physical activity and health. In Japan, amid demographic changes, municipalities have begun formulating Location Normalization Plans focused on making cities more compact. This study examines the associations between health and transport-related physical activity considerations in urban plans, including Location Normalization Plans, the demographic characteristics of municipalities, and the development of infrastructure that supports leisure-time physical activity. Analyzing responses from 725 of 1,374 Japanese municipalities, our research reveals that 38% of urban plans integrated health and physical activity in goals/visions, and 28% recognized these as challenges. The development of physical activity infrastructure such as sports facilities (48%), metropolitan parks (21%), and bicycle paths (14%) was more prevalent in larger municipalities. However, the incorporation of health and physical activity in planning goals/visions or challenges was not exclusive to larger municipalities; smaller ones also demonstrated this capability. Logistic regression analyses revealed that municipalities that included health considerations in their plans' goals/visions and challenges were more likely to develop or renovate physical activity infrastructure. Prioritizing health and physical activity in planning has the potential to support leisure-time and transport-related physical activity, helping to create healthy and sustainable cities. [ABSTRACT FROM AUTHOR]

Background: Depression in the elderly is becoming a major public health problem worldwide. It is a major public health problem associated with increased morbidity, mortality, and healthcare costs in low- and middleincome countries, including Ethiopia. However, especially in developing countries, they usually go undetected and untreated. There is little evidence of depressive symptoms among older people in Ethiopia. Therefore, this study aims to determine the prevalence of depressive symptoms and associated factors among the elderly population in the Gamo zone of southern Ethiopia. Methods: A community-based cross-sectional study was conducted among 840 randomly selected elderly individuals. A multi-stage sampling technique was employed to recruit participants. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS) screening tool. Data collection was performed through face-to-face interviews. Descriptive statistics were initially computed. Subsequently, logistic regression analysis was conducted to identify independent factors associated with the outcome variable. Result: The finding of the study showed that the prevalence of depressive symptoms among older people living in the Gamo zone was 424(50.48%) (95% CI=47.09-53.86). Age 70-74 years [AOR=2.81, 95% CI 1.64-4.81], 75 years and above [AOR=5.09, 95% CI 3.00-8.64], age 65-69 years [AOR=2.43, 95% CI 1.62-3.66]; being widowed [AOR=2.73, 95% CI 1.69-4.42], ever chewing khat [AOR=5.89, 95% CI 1.17-29.53], being poor economic status [AOR=9.35, 95% CI 3.58-24.45], being average economic status [AOR=5.36, 95% CI 2.15-13.37], having 1-2 stressful life events [AOR=5.13, 95% CI 3.35-7.86], having 3 and above stressful life events [AOR=11.02, 95% CI 6.59,18.41], living alone [AOR=2.65, 95% CI 1.43-4.93] and those who lived with children [AOR=3.16, 95% CI 1.70-5.88] were significantly associated with depression. Conclusion: Half of the study participants exhibited depressive symptoms. Urgent interventions are essential to enhance psychological well-being and mitigate the impact of various modifiable risk factors associated with depression symptoms in elderly individuals. This includes increasing social support, particularly for those who have experienced stressful life events, live alone, or have low economic status. Healthcare providers should implement routine screening for depressive symptoms and offer supportive counseling. Policymakers and stakeholders should prioritize improving access to mental health services. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionThe elderly population of India has been growing exponentially over the past few decades, caused by a decline in fertility and an increase in life expectancy. The growth eventually has transcended the disease burden on the public healthcare system. This calls for a need to evaluate the healthcare utilization pattern of the elderly based on their socioeconomic and working condition.Study used access to public and private healthcare services to measure healthcare utilization. Descriptive analysis and multivariable logistic regression were used to understand utilization patterns by working status and some selected sociodemographic parameters. All the results were reported at a 95% confidence interval.Using the data from the first wave of Longitudinal Ageing Study in India (LASI) with a sample of 22,680 older persons 60 years and above. The study identified that 50% of the working elderly access private services; however, 26% access public healthcare services. It was found that the working status of the elderly alone did not influence access to healthcare services, but education is also an essential indicator for utilizing healthcare services. Further, factors such as gender, marital status, religion, wealth, tobacco usage, self-rated health, ADL and IADL were significant predictors of healthcare services’ utilization for the elderly.This study suggests that there are not many differences found among working and non-working status with healthcare utilization, although some sociodemographic indicators are associated with the utilization of healthcare services, highlighting that increasing health needs among the elderly requires strengthening the quality and appropriate public investment in health. [ABSTRACT FROM AUTHOR]

• We examined depressive symptom trajectories following transition to living alone • Three classes (low, moderate, and high stabilities) were detected • We identified baseline characteristics linked to the classes This study identified the trajectory classes of depressive symptoms after transitioning to living alone and the factors affecting these trajectories. Data from the initial to the seventh waves of the Korean Longitudinal Study of Aging were analyzed, focusing on four consecutive waves. We selected 369 participants aged ≥45 who transitioned to living alone between consecutive waves (T1 and T2). They were followed up for six years (T1 to T4) while living alone from T2 to T4. Using latent class growth modeling, three trajectories emerged: low-lessening, moderate-lessening, and high-stable. The highly stable class was associated with older age, more chronic diseases, lower satisfaction with health and financial status, and less frequent social interactions at T1 than the low-lessening class. These findings underscore the importance of community-based interventions for middle-aged and older adults with risk factors as they face an increased risk of depression over time after transitioning to living alone. [ABSTRACT FROM AUTHOR]

With the development of the social economy and the arrival of the aging era, the issue of elderly care has increasingly gained social attention. This matter not only concerns the personal interests of individuals but also represents a significant focal point in the construction of social welfare systems, influencing the development direction of multiple industries. As the elderly population continues to grow, there is a pressing need for innovative and sustainable care solutions. Among the diverse elderly care models, the forest therapy industry emerges as a new direction, providing seniors with a comfortable natural environment that promotes physical and mental health. This approach not only enhances the well-being of older adults but also serves as an important avenue for rational and sustainable development through the utilization of forest ecological products. This paper explores the connection between elderly care models and the forest therapy industry, offering insights into the current state and future development of the Chinese elderly care sector. By examining the benefits of integrating forest therapy into existing care frameworks, this study aims to provide practical recommendations. It is hoped that these insights will serve as a reference for stakeholders in the Chinese elderly care industry, promoting the positive role of forest therapy in optimizing and enhancing elderly care models for a healthier, happier aging population. [ABSTRACT FROM AUTHOR]

Although a number researchers have acknowledged that the aging population inhibits firm digital transformation, others find it promoting digital transformation in some firms. As the relevant literature to clarify such paradox is still scare, this paper wants to fill the gap regarding the labor cost theory, the capital-skill complementarity hypothesis, and the human capital externality theory. Based on the empirical tests of Chinese A-share listed companies from 2001 to 2022, this study detected a U-shaped relationship between the aging population and digital transformation. In terms of the institutional environment, higher marketization strengthens the U-shaped relationship by making the slopes on either side of it steeper. However, higher minimum wage levels weaken the U-shaped relationship. In terms of firm strategy, firms with stronger marketing capabilities strengthened the U-shaped relationship. However, firms with higher customer concentration weakened the U-shaped relationship. Overall, we enriched scholarly understanding of the impact of the aging population on digital transformation and demonstrated the dual potential impact of aging populations. Instead of assuming they are detrimental to the economy and society, positive contributions in the form of innovation and progress for companies can be detected. Highlights: • Aging is an unavoidable demographic problem in China, with very complex social roots behind it. • Increased aging has thwarted China's digital economy, but aging is not the only negative impact on digitization. • The digital transformation process of Chinese listed companies is distinctly heterogeneous in the face of aging shocks. • By taking into account the institutional environment and strategic development, Chinese companies can seek a proactive path of development to adapt to aging, and even accelerate digital transformation. [ABSTRACT FROM AUTHOR]

Background: Self-rated physical health (SRPH) is known as an important predictor of mortality. Previous studies mostly used baseline values of self-rated health to predict long-term mortality. The effect of change in self-rated physical health on mortality during the course of aging has rarely been researched. The present study aimed to determine SRPH over time in women and men of an aging population, assess whether and how change in SRPH affects mortality while adjusting for known determinants of mortality, and test effect modification by sex on the relation between course of SRPH and mortality. Methods: Data of N = 12,423 respondents of the 5-year follow-up of the Gutenberg Health Study (GHS) with participation at the baseline assessment were analysed. All-cause mortality from 5-year follow-up onwards was defined as the primary outcome. SRPH was assessed by a single item. Cox proportional hazards models with adjustment for age, sex, socio-economic status and physical diseases were fitted to assess the predictive power of baseline score and course of SRPH. Additionally, effect modification by sex was assessed. Results: During a median follow-up period of 7.3 years (quartiles 6.0-8.5 years), 618 (5%) participants died. Overall, 70.9% of the participants indicated good or very good SRPH at baseline (T1) and follow-up (T2), 6.9% rated their SRPH as not so good at T1 and T2, and 0.6% reported bad SRPH at T1 and T2. An improvement of SRPH was indicated by 9.6% and 12.0% indicated deterioration of their SRPH. Change in SRPH added substantial predictive information to the Cox proportional hazards models, when adjusting for relevant covariates. In men, deterioration and constantly bad SRPH were associated with the strongest increase in risk of mortality by 87%, resp. 228%. While improvements increased mortality risk in men (67%), women with an improved SRPH had a lower risk (57%). Conclusion: A sizeable subgroup of aging participants reported deterioration of SRPH over five years. The association between change of SRPH and mortality is modified by sex. Deterioration of SRPH predicts mortality over baseline-assessment even when adjusted for relevant covariates. SRPH should be assessed regularly as part of an older individual's health evaluation. Deterioration, constantly bad and improved SRPH should be taken seriously as unfavorable prognostic indicators, the latter only in men. [ABSTRACT FROM AUTHOR]

This study aims to test the endogeneity among green growth, foreign debt, and aging population for Indonesia and Malaysia using a vector autoregression approach from 1975 to 2023. This study can provide important insights into how economic and demographic factors interact in the context of green growth and foreign debt, as well as offer more informed policy recommendations for both countries. Endogeneity analysis in this context will help design more effective and adaptive policies to address global and local economic dynamics toward achieving sustainable development goals. The key findings of this study indicate similar results in both countries, showing causality between the aging population and foreign debt. Furthermore, there is a one-way relationship where only green growth affects foreign debt. Additionally, there are divergent findings between the two countries: green growth and aging population do not influence each other in Indonesia, whereas in Malaysia, it is only aging population that affects green growth. Recommendations from this study suggest that both countries need to promote sustainable health for aging populations through the development of productive investments and risk management in the use of foreign debt. [ABSTRACT FROM AUTHOR]

Abstract Existing research on the detrimental effects of air pollution and its mixture on multiple chronic conditions (MCC) is not yet fully recognized. Our objective was to examine if individual and joint exposure to air pollution is associated with the incidence and patterns of MCC. Totally 10,231 CHARLS 2015 participants aged over 45 years and 1,938 without MCC were followed up in 2018 and 2020. Residential-levelcumulative personal exposure concentrations of PM1, PM10, PM2.5, CO, O3, NO2, SO2, NO3 −, Cl−, NH4 +, and SO4 2− at the residential level were determined utilizing a spatio-temporal random forest model with a spatial resolution of 0.1° × 0.1°. In the cross-sectional and longitudinal research, logistic regression, cox regression analysis, and quantile g-computation were utilized to estimate the single and joint effect with MCC and its patterns, respectively. Interaction analyses and stratified analyses were also performed. A correlation was observed between the prevalence of cardiovascular illnesses and the presence of all 11 major air pollutants. PM2.5, PM10, NH4 +, NO3 −, CO, and SO4 2− are associated with an increased frequency of respiratory disorders. An increase of PM2.5, PM1, PM10, NO2, and SO2 (a 10 µg/m3 rise), CO (a 0.1 mg/m3 rise), and PMCs (Cl−, NH4 +, NO3 −, and SO4 2−) (a 1 µg/m3 rise) corresponded to the HRs (95% CI) for developing MCC of 1.194 (95% CI: 1.043, 1.367), 1.362 (95% CI: 1.073, 1.728), 1.115 (95% CI: 1.026, 1.212), 1.443 (95% CI: 1.151, 1.808), 3.175 (95% CI: 2.291, 4.401), 1.272 (95% CI: 1.149,1.410), 1.382 (95% CI: 1.011, 1.888), 1.107 (95% CI: 1.003, 1.222), 1.035 (95% CI: 0.984, 1.088), and 1.122 (95% CI: 1.086, 1.160), respectively. SO2 was the predominant contributor to the combined effect (HR: 2.083, 95% CI: 1.659–2.508). Gender, age, drinking, and health status could modify the effects of air pollutants on MCC patterns. Long-term exposure to air pollution is correlated to the incidence and patterns of MCC in middle-aged and elderly Chinese individuals. Preventive methods are essential to safeguarding those susceptible to MCC.

Abstract Aligned with global goals for healthy and sustainable cities, urban compactness significantly promotes residents’ transport-related physical activity and health. In Japan, amid demographic changes, municipalities have begun formulating Location Normalization Plans focused on making cities more compact. This study examines the associations between health and transport-related physical activity considerations in urban plans, including Location Normalization Plans, the demographic characteristics of municipalities, and the development of infrastructure that supports leisure-time physical activity. Analyzing responses from 725 of 1,374 Japanese municipalities, our research reveals that 38% of urban plans integrated health and physical activity in goals/visions, and 28% recognized these as challenges. The development of physical activity infrastructure such as sports facilities (48%), metropolitan parks (21%), and bicycle paths (14%) was more prevalent in larger municipalities. However, the incorporation of health and physical activity in planning goals/visions or challenges was not exclusive to larger municipalities; smaller ones also demonstrated this capability. Logistic regression analyses revealed that municipalities that included health considerations in their plans’ goals/visions and challenges were more likely to develop or renovate physical activity infrastructure. Prioritizing health and physical activity in planning has the potential to support leisure-time and transport-related physical activity, helping to create healthy and sustainable cities.

Abstract Background Self-rated physical health (SRPH) is known as an important predictor of mortality. Previous studies mostly used baseline values of self-rated health to predict long-term mortality. The effect of change in self-rated physical health on mortality during the course of aging has rarely been researched. The present study aimed to determine SRPH over time in women and men of an aging population, assess whether and how change in SRPH affects mortality while adjusting for known determinants of mortality, and test effect modification by sex on the relation between course of SRPH and mortality. Methods Data of N = 12,423 respondents of the 5-year follow-up of the Gutenberg Health Study (GHS) with participation at the baseline assessment were analysed. All-cause mortality from 5-year follow-up onwards was defined as the primary outcome. SRPH was assessed by a single item. Cox proportional hazards models with adjustment for age, sex, socio-economic status and physical diseases were fitted to assess the predictive power of baseline score and course of SRPH. Additionally, effect modification by sex was assessed. Results During a median follow-up period of 7.3 years (quartiles 6.0-8.5 years), 618 (5%) participants died. Overall, 70.9% of the participants indicated good or very good SRPH at baseline (T1) and follow-up (T2), 6.9% rated their SRPH as not so good at T1 and T2, and 0.6% reported bad SRPH at T1 and T2. An improvement of SRPH was indicated by 9.6% and 12.0% indicated deterioration of their SRPH. Change in SRPH added substantial predictive information to the Cox proportional hazards models, when adjusting for relevant covariates. In men, deterioration and constantly bad SRPH were associated with the strongest increase in risk of mortality by 87%, resp. 228%. While improvements increased mortality risk in men (67%), women with an improved SRPH had a lower risk (57%). Conclusion A sizeable subgroup of aging participants reported deterioration of SRPH over five years. The association between change of SRPH and mortality is modified by sex. Deterioration of SRPH predicts mortality over baseline-assessment even when adjusted for relevant covariates. SRPH should be assessed regularly as part of an older individual’s health evaluation. Deterioration, constantly bad and improved SRPH should be taken seriously as unfavorable prognostic indicators, the latter only in men.

Abstract Although a number researchers have acknowledged that the aging population inhibits firm digital transformation, others find it promoting digital transformation in some firms. As the relevant literature to clarify such paradox is still scare, this paper wants to fill the gap regarding the labor cost theory, the capital-skill complementarity hypothesis, and the human capital externality theory. Based on the empirical tests of Chinese A-share listed companies from 2001 to 2022, this study detected a U-shaped relationship between the aging population and digital transformation. In terms of the institutional environment, higher marketization strengthens the U-shaped relationship by making the slopes on either side of it steeper. However, higher minimum wage levels weaken the U-shaped relationship. In terms of firm strategy, firms with stronger marketing capabilities strengthened the U-shaped relationship. However, firms with higher customer concentration weakened the U-shaped relationship. Overall, we enriched scholarly understanding of the impact of the aging population on digital transformation and demonstrated the dual potential impact of aging populations. Instead of assuming they are detrimental to the economy and society, positive contributions in the form of innovation and progress for companies can be detected.

Objective: To compare postoperative stay in octogenarians and younger patients undergoing gynecologic oncology robot‐assisted surgery. Methods: A retrospective review of robot‐assisted surgery in Gynecological Oncology division during 2019–2022. We included all consecutive cases. Octogenarians (age ≥80 years) and younger patients were investigated by univariable analysis for characteristics and outcome. Results: A total of 816 robot‐assisted surgeries were performed, 426 (52.2%) endometrial cancer, 159 (19.5%) ovarian cancer, 27 (3.3%) cervical cancer, 35 (4.3%) endometrial intraepithelial neoplasia, and in 169 (20.7%) the final pathology was benign. There were 60 (7.4%) octogenarians and 756 (92.6%) younger patients. The proportion of patients with an American Society of Anesthesiology score greater than 2 was higher among octogenarians (66.7% vs 32.0%, P < 0.001). The median console time, surgical time, and total operation theater time were similar between groups (P = 0.303, P = 0.643 and P = 0.688, respectively). Conversion rate did not differ between groups (0.4% among younger patients vs 0% in octogenarians, P > 0.99). The median length of stay in the recovery room was similar in both groups (median 170 min, interquartile range [IQR] 125–225 min vs 170 min, IQR 128–240 min in octogenarians, P = 0.731). Length of hospital stay was similar in both age groups; median 1 day (IQR 1–1) among octogenarians versus 1 (0–1) in younger patients (P = 0.136). Conclusion: Octogenarians undergoing robotic surgery have no increased risk of length of stay or conversion to laparotomy compared with younger patients. Synopsis: Robot‐assisted surgery is safe in a gynecologic oncology aging patient population. [ABSTRACT FROM AUTHOR]

In this study, we employ 'hidden workers' as a key concept to integrate the three vulnerable subgroups of aging workers: underemployed, unemployed, and discouraged workers. (1) Background: The challenges faced by underemployed, unemployed, and discouraged workers in the older population are complex. It would be beneficial to visualize the intellectual landscape of these three distinct groups in aging populations to understand which aspects have been highlighted by various disciplines and where gaps exist. (2) Method: Through a scientometric analysis of more than 50 years of research, this study identified the size, scope, and structure of knowledge on hidden workers in an aging population using 2831 articles collected from the Web of Science database in January 2024. (3) Results: Indeed, the multidisciplinary nature of hidden workers goes beyond welfare and labor economics and involves issues such as health, occupational science, behavior change, policy interventions, and circles around the keyword of unemployment. Keyword co-occurrence and co-citation analysis confirm that the spectrum of research on hidden workers is being carried out distinctly within distinct disciplines across the broader aging research horizon. (4) Conclusions: The relatively scattered and uneven intellectual, conceptual, and social landscape of research on hidden workers in aging populations evidently falls short of providing concerted policy recommendations for the population group. This study provides a conceptual understanding of hidden workers in different research clusters and identifies gaps and opportunities for future research. [ABSTRACT FROM AUTHOR]

Lifelong learning as a future education in today's circumstances is an essential challenge for inventing the future of our societies. Lifelong learning is more than adult education and/or training-it is a mindset and a habit for people to acquire as human being's responsibility. People are living longer and, in some parts of the world, healthier lives. Longer lives must be planned for. Societal aging may affect economic growth and many other issues, including the sustainability of families, the ability of states and communities to provide resources for older citizens, and international relations. It is, therefore, the role and responsibilities of all sectors to seek a better model to develop this particular. [ABSTRACT FROM AUTHOR]

Among the growing floating population in China, many older people—who migrate along with their adult children to provide family support—have formed a specific social group: lao-piao-zu. This group of older migrants is a population with particular experiences and challenges, which merits more scholarly attention to their well-being. The study first presents a three-dimensional conceptual framework for understanding multimodal mobile phone communication among older migrants. Guided by this framework and based on a face-to-face survey (N = 376) conducted in China's first-tier city Shenzhen, the study specifically examined how various forms of mobile communication could affect psychological well-being (PWB) among these older migrants. The results showed that mobile phone use could increase multimodal communication activities. However, only communication with the hometown could reduce loneliness and promote PWB. We argue that mobile communication has limited effects on older migrants' PWB. It is a promising channel for maintaining remote ties; however, it should be considered more as a form of compensation than as the optimal option for older people who are away from their hometowns. [ABSTRACT FROM AUTHOR]

Aging in a suitable residential environment is essential for the health and well-being of older adults. This study aims to analyze the residential environment preferences (REPs) of older people in China to create a residential environment suitable for their physical and mental health, enhancing their life satisfaction. This study used a sample questionnaire to identify relevant characteristics and analyze preferences, which were validated using non-parametric tests and Pearson's correlation coefficient tests. The questionnaire consisted of 33 questions on characteristics of the residential environment on a 7-point Likert scale and was administered to 433 older adults aged 60 and over in 28 provinces in China. The results showed that "community safety" was the most important environmental characteristic, with an average importance rating of 5.77 out of 6. Accessible building design (average rating of 4.91), emergency response systems (average rating of 4.49), and indoor thermal comfort (average rating of 4.45) were also key factors in promoting aging in place. There was a positive correlation between the community environment and the indoor environment (e.g., community safety and indoor sound insulation, r = 0.209, p < 0.01), and both were, to some extent, negatively correlated with building features (e.g., public toilets and private courtyards, r = −0.278, p < 0.01; indoor thermal comfort and green building design, r = −0.165, p < 0.01). Age and physical health had a strong influence on preferences, but gender had little influence. This study paves the way for future research and policy development on age-friendly housing to ensure sustainable and supportive residential environments for the aging population. [ABSTRACT FROM AUTHOR]

Purpose: The global population has been experiencing an unprecedentedly rapid demographic transition as the populations have been growing older in many countries during the current decades. The purpose of this study is to introduce a Grey Exponential Smoothing model (GESM)-based mechanism for analyzing population aging. Design/methodology/approach: To analyze the aging population of Sri Lanka, initially, three major indicators were considered, i.e. total population, aged population and proportion of the aged population to reflect the aging status of a country. Based on the latest development of computational intelligence with Grey techniques, this study aims to develop a new analytical model for the analysis of the challenge of disabled and frail older people in an aging society. Findings: The results suggested that a well-defined exponential trend has been seen for the population ages 65 and above, a total of a million) during 1960–2022; especially, the aging population ages 65 and above has been rising rapidly since 2008. This will increase to 24.8% in 2040 and represents the third highest percentage of elderly citizens living in an Asian country. By 2041, one in every four Sri Lankans is expected to be elderly. Originality/value: The study proposed a GESM-based mechanism for analyzing the population aging in Sri Lanka based on the data from 1960 to 2022 and forecast the aging demands in the next five years from 2024 to 2028. [ABSTRACT FROM AUTHOR]

This study examines the impact of aging on the effectiveness of various fiscal expenditures, including government consumption, one-time government transfers to households, public investment and R&D spending, using a dynamic stochastic general equilibrium model. Our findings reveal that (1) Aging enhances the effects of the transfer on augmenting GDP. (2) Regardless of aging, R&D expenditure consistently stands out over all time spans, with younger society benefiting more. (3) Public investment ranks second among for different fiscal policies in the long run, while shows bigger impact in younger society. (4) One-time transfer has only a temporary effect and is the least effective in boosting GDP in both young and old societies. (5) Multipliers for public investment and R&D expenditure increase with the accumulation of public capital and TFP. Their multiplier of young society is larger than old society because impact on consumption is much more effective. [ABSTRACT FROM AUTHOR]

Singapore's rapidly aging population poses significant challenges to the government's long-term fiscal sustainability as it structurally affects government revenue and expenditure. Amidst the demographic trends, total government spending has skyrocketed to unprecedented amounts in 2020 in response to the COVID-19 pandemic. This paper evaluates Singapore's fiscal sustainability and intergenerational fiscal impacts through the lens of generational accounting and actuarial analyses, before and after COVID-19. Our model predicts a pre-COVID absolute intergenerational gap of S$512 thousand between future generations and current newborns, implying that there is considerable intergenerational inequity. This gap increases by a further S$67 thousand after factoring in COVID-19's impact on government net spending and short-term fertility rates. Fiscal balance can be restored in the short term and intergenerational equity in the long term, after incorporating key policy changes such as Goods and Services Tax (GST) hike and carbon tax increases. [ABSTRACT FROM AUTHOR]

COVID-19 has highlighted strengths and weaknesses in healthcare systems all over the word. Despite the differences in primary care models in Europe, this study investigates the state-of-the-art of general practitioners (GPs) before the COVID-19 pandemic spread as a result of the reform process of the previous two decades. The GPs numbers over 100,000 inhabitants has been considered as a proxy of public health investment in GPs. Is the number of GPs increased or decreased in the last 20 years of reform processes in European countries? The main hypothesis is that European healthcare systems would have increased the number of GPs coherently with WHO recommendations. Comparative data on the number of GPs per 100,000 inhabitants in 21 European countries are investigated between 1995 and 2014 (the last available data). Data show that the number of family doctors over 100,000 inhabitants in European countries has increased over the last 20 years, except for Italy, where it has strongly reduced. Primary care has had a crucial role in managing the pandemic. Results of this study suggest that a country such as Italy, which has not invested in family doctors in the last two decades, would have been less equipped to manage the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Japan is a leading exemplar of rapidly aging countries, holding very low fertility rate. Under such circumstances, the present paper examines two important aspects of residential energy consumption patterns of Japan up to the year 2040: (i) presenting two future scenarios of residential energy consumption and (ii) reexamining the effectiveness of traditional strategy to reduce energy consumption mainly through energy efficiency improvement. Before presenting the two main topics of the paper, three important factors are discussed: (i) the population aging effect; (ii) the generation gap in energy use patterns; and (iii) the decline in family size. These factors influence the relationship between the aging population and residential energy consumption. Then, a brief explanation is given for survey data sources, six household types in 11 regions of Japan, and four types of energy carriers. The first scenario assumes that residential energy consumption pattern of each household type remains unchanged from the current situation and that the population projection holds true. The total residential energy consumption will decrease by only 6% between 2020 and 2040. Yet, per capita residential energy consumption will increase despite the fact that the population size will decrease by 10.6%. The second scenario assumes that slightly higher energy efficiency improvements than in the past 15 years will continue to reduce energy consumption from 2020 to 2040. The simulation result of this optimistic scenario also suggests that conventional energy conservation strategies alone are far from sufficient to reduce residential energy consumption per capita. Thus, an alternative strategy to overcome the spell of Jevons’ paradox is urgently required. Frugality combined with lifestyle and behavior change should be seriously attempted to achieve sustainable future for societies including aging countries like Japan. [ABSTRACT FROM AUTHOR]

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Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The popularity of mobile phones has led to the explosion of mobile service provision in different sectors such as; marketing, health, and sports. Studies evidenced that the use of the mobile service is generally associated with the younger generation while ignoring the aging population. The purpose of this paper was to investigate factors affecting the intention to adopt mobile marketing among the aging population in Zanzibar. This study was guided by an extension of the Technology Acceptance Model. The study utilized the quantitative method whereby 382 questionnaires were distributed to pensioners using a stratified sampling design. Structural equation modeling was employed to analyze the collected data. The analysis was aided by SEMAMOS version 25. The study found out that perceived ease of use and technology anxiety strongly influenced the consumers’ intention to adopt mobile marketing. Furthermore, it was also revealed that attitude had partial mediation on the relationship between consumers’ perception and behavioral intention. This finding implied that mobile business vendors should design mobile marketing apps withuser-friendly interfaces with a clear view of products and services for aging consumers. The finding of this study is vital to aging consumers because will improve the standard of living in the current mobile phone era. [ABSTRACT FROM AUTHOR]

Objective: To determine the factors affecting the quality of life (QoL) among aging population during the Corona Virus Disease-19 (COVID-19) crisis. Methods: This cross sectional study was conducted at Central, Northern, Northeastern, and Southern regions of Thailand from June to November 2021. Elderly persons aged 60 and above with Thai nationality included in the study. The QoL was measured with the WHO Quality of Life (WHOQoL-BREF-THAI) instrument which consisted of 26 items. QoL scores ranged from 26 to 130 points, classified as poor (26-60), moderate (61-95), and good (96-130). Results: Of total 400 participants, the mean age was 68.32 ±6.93 years. Not good QoL was observed in 3 (0.8%) participants, moderate QoL was observed in 213 (53.2%) participants, and good QoL was observed in 184 (46.0%) participants. A significant association of QoL found with education level (p-value 0.002), alcohol drinking (p-value 0.003), exercise (p-value <0.001), comorbidities (p-value <0.001), and hearing/knowing about COVID-19 (p-value 0.015). The chances of good QoL was 2 times significantly higher in participants who did exercise as compared to participants who did not perform exercise (cOR 2.03, 95% CI 1.35 to 3.07, p-value <0.001). Conclusion: The study concluded that exercise, higher education, avoiding alcohol, and good health significantly improve the QoL among the elderly during the COVID-19 pandemic. Moreover, regular exercise notably doubles the likelihood of better QoL. [ABSTRACT FROM AUTHOR]

BACKGROUND: Both anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA) reliably improve pain and function for a variety of indications. However, there remain concerns about these procedures among elderly patients due to their general health, the potential for lesser functional gain, and the possible need for revision at an even older age. The purpose of this review is to compare the clinical outcomes, radiographic outcomes, and complications of ATSA and RTSA among patients older than 70 years. METHODS: A systematic review was performed using searches of PubMed, Embase, and Cochrane databases. The inclusion criteria were studies with patients older than 70 years who were treated with a primary ATSA or RTSA and clinical results reported at a minimum of 2 years. All indications for primary RTSA except for tumor were included. Outcomes of interest included patient-reported outcomes (PROs), range of motion, patient satisfaction, radiographic changes, complication and revision rates, and implant survival. RESULTS: A total of 24 studies met the inclusion criteria. At a mean follow-up of 3.4 years for ATSA and 3.1 years for RTSA, there were significant improvements in pain, range of motion, and PROs for both prostheses. Patients who underwent ATSA generally had better motion and functional outcomes compared to those who underwent RTSA, though these comparisons were made across different indications for arthroplasty. The satisfaction rate was 90.9% after ATSA and 90.8% after RTSA. Furthermore, 10.2% of ATSA patients and 9.9% of RTSA patients experienced a surgical complication, whereas 2.3% of ATSA and 2.2% of RTSA patients underwent a revision. Secondary rotator cuff tear was the most common complication after ATSA, occurring in 3.7% of patients, but only 1.1% of patients required revision surgery. Both ATSA and RTSA implant survivorship was reported to range from 93.1% to 98.9% at 5- and 8-year follow-up, respectively. Patient mortality was estimated to be 19.3% with a mean time to death of 6.1 years. CONCLUSIONS: Elderly patients with primary osteoarthritis and an intact rotator cuff can have predictable pain relief, restoration of functional range of motion, and significant improvement in PROs after ATSA with low complication rates. Secondary rotator cuff failure and revision arthroplasty occur infrequently at early to mid-term follow-up. Although elderly patients who underwent ATSA generally had better functional outcomes compared to those who underwent RTSA for differing indications, patient satisfaction after both procedures were similar.

BackgroundThe sudden outbreak of the COVID-19 Pandemic has caused serious damage to the continuous learning of older adults around the world. While the existing literature focused more on older adults’ learning in developed countries, few studies explored older adults’ learning in developing countries with low social and cultural capital.MethodsThis study took family-school cooperation in China as the platform and explored learning challenges and solutions through unstructured interviews with 12 older adults.ResultsThe study found that due to policies of working and studying from home, older adults face obstacles in accessing physical learning institutions and digital learning knowledge, skills, and psychology. I further found that the older adults were not forced to accept the challenge passively, but created a lifelong learning model with Chinese characteristics by building self-learning based on personal initiative, developing sustainable intergenerational learning rooted in Chinese family culture, and participating in online learning in schools and enterprises under the government guidance.ConclusionThis study provided new knowledge for understanding the learning challenges and solutions of older adults in rural China. It is emphasized that policy value and practice enlightenment were highlighted and discussed in conversations with active aging, intergenerational learning, and harmonious societies.

Background: Depression is a common issue among elderly people in both developing and developed countries. Existing research indicates that cooking with solid fuels has a negative impact on the mental health of middle-aged and elderly people (aged 45 and older). However, the potential role of the residential environment in this process is not yet clear. Clarifying this issue may help identify effective interventions to improve public health for elderly people. This study aimed to explore the association between cooking with solid fuels and depressive symptoms, as well as the potential mediating role of the residential environment in this relationship. Method: This study utilized cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) for 2020, involving approximately 19,000 respondents aged 45 years and older. Propensity score matching (PSM) was used to explore the association between cooking with solid fuels and depressive symptoms. Additionally, a range of potential covariates were adjusted, and the Sobel test was applied to assess the potential mediating effect of the residential environment on this relationship. Results: According to the fully adjusted model, cooking with solid fuels was significantly associated with an increased risk of depressive symptoms in middle-aged and older adults (β = 0.315, P < 0.001), and this finding was confirmed through robustness tests using different propensity score matching methods. Heterogeneity analysis revealed that this association was particularly significant among men (β = 0.318, P < 0.001), those aged 60–74 (β = 0.347, P < 0.001), and individuals with a middle school education (β = 0.353, P < 0.001). Mediation effect analysis revealed that indoor cleanliness (β = 0.0090, P < 0.001), indoor broadband coverage (β = 0.0077, P < 0.001), and the installation of indoor air purifiers (β = 0.0010, P < 0.1) mediated the relationships between cooking with solid fuels and depressive symptoms. Conclusion: Given the growing attention given to improving indoor environments and enhancing mental health, the findings of this paper highlight that improving indoor cleanliness, increasing broadband coverage indoors, and installing air purifiers can effectively intervene in and prevent depressive symptoms caused by cooking with solid fuels.

BackgroundBased on its definition of an individual’s quality of life, the World Health Organization identified the following six basic domains of this concept: physical domain, psychological domain, level of independence, social relationships, environment and spirituality. The aim of the study was to examine these quality of life dimensions in pre-older and older adults in relation to selected sociodemographic variables.MethodsThe study included 2,040 adults aged 55 or older. It was conducted using a diagnostic survey by means of a questionnaire with sociodemographic questions and the EQ-5D-3L descriptive system.ResultsThe vast majority of male and female respondents reported no problems in most EQ-5D-3L dimensions. However, the mean EQ-5D-3L index score indicated a slight difference in scores between men and women. A statistically significant difference between male and female respondents in individual dimension scores was found only for the usual activities dimension. The proportion of respondents reporting no problems decreased with age in most dimensions, except for anxiety/depression. Age was statistically significantly correlated with all individual dimension scores and the index score. The vast majority of respondents across all education levels reported no problems in most dimensions. Education was statistically significantly correlated with all individual dimension scores and the index score.ConclusionThe vast majority of respondents across both sexes and all education levels reported no problems in most EQ-5D-3L dimensions. The proportion of respondents reporting no problems decreased with age in most EQ-5D-3L dimensions. Systematic research on dimensions of health-related quality of life will help design measures for healthy and successful ageing.

BackgroundDepression in the elderly is becoming a major public health problem worldwide. It is a major public health problem associated with increased morbidity, mortality, and healthcare costs in low- and middle-income countries, including Ethiopia. However, especially in developing countries, they usually go undetected and untreated. There is little evidence of depressive symptoms among older people in Ethiopia. Therefore, this study aims to determine the prevalence of depressive symptoms and associated factors among the elderly population in the Gamo zone of southern Ethiopia.MethodsA community-based cross-sectional study was conducted among 840 randomly selected elderly individuals. A multi-stage sampling technique was employed to recruit participants. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS) screening tool. Data collection was performed through face-to-face interviews. Descriptive statistics were initially computed. Subsequently, logistic regression analysis was conducted to identify independent factors associated with the outcome variable.ResultThe finding of the study showed that the prevalence of depressive symptoms among older people living in the Gamo zone was 424(50.48%) (95% CI=47.09-53.86). Age 70–74 years [AOR=2.81, 95% CI 1.64-4.81], 75 years and above [AOR=5.09, 95% CI 3.00-8.64], age 65–69 years [AOR=2.43, 95% CI 1.62-3.66]; being widowed [AOR=2.73, 95% CI 1.69-4.42], ever chewing khat [AOR=5.89, 95% CI 1.17-29.53], being poor economic status [AOR=9.35, 95% CI 3.58-24.45], being average economic status [AOR=5.36, 95% CI 2.15-13.37], having 1–2 stressful life events [AOR=5.13, 95% CI 3.35-7.86], having 3 and above stressful life events [AOR=11.02, 95% CI 6.59,18.41], living alone [AOR=2.65, 95% CI 1.43-4.93] and those who lived with children [AOR=3.16, 95% CI 1.70-5.88] were significantly associated with depression.ConclusionHalf of the study participants exhibited depressive symptoms. Urgent interventions are essential to enhance psychological well-being and mitigate the impact of various modifiable risk factors associated with depression symptoms in elderly individuals. This includes increasing social support, particularly for those who have experienced stressful life events, live alone, or have low economic status. Healthcare providers should implement routine screening for depressive symptoms and offer supportive counseling. Policymakers and stakeholders should prioritize improving access to mental health services.

Objective: To determine the factors affecting the quality of life (QoL) among aging population during the Corona Virus Disease-19 (COVID-19) crisis. Methods: This cross sectional study was conducted at Central, Northern, Northeastern, and Southern regions of Thailand from June to November 2021. Elderly persons aged 60 and above with Thai nationality included in the study. The QoL was measured with the WHO Quality of Life (WHOQoL-BREF-THAI) instrument which consisted of 26 items. QoL scores ranged from 26 to 130 points, classified as poor (26-60), moderate (61-95), and good (96-130). Results: Of total 400 participants, the mean age was 68.32 ±6.93 years. Not good QoL was observed in 3 (0.8%) participants, moderate QoL was observed in 213 (53.2%) participants, and good QoL was observed in 184 (46.0%) participants. A significant association of QoL found with education level (p-value 0.002), alcohol drinking (p-value 0.003), exercise (p-value

Automated vehicles (AVs) hold the potential to reduce road accidents, mitigate traffic congestion, and improve travel experience. However, the possible countervailing impacts from the changes in underserved populations' vehicle travel demand tend to be overlooked. To determine the vehicle travel demand changes that resulted from underserved populations aged between 6 and 80, this paper explores the latent effect of AVs on vehicle kilometers traveled (VKT) in a fully AV environment using person trip survey data from the cities of Sanya, Shijiazhuang, and Shenzhen in China. This paper uses the natural decline hypothesis of travel demand and proposes a regression model to investigate the difference among the cities' latent vehicle travel demand. Results show that the average VKT of the overall population in Sanya, Shijiazhuang, and Shenzhen increased by 33.4%, 47.0%, and 46.8%, respectively. The analysis of the regression model confirms that the current travel behavior of individuals can affect the degree of increase in their average VKT. Integrating AVs into public transport, increasing the acceptance of automated shared mobility options, transforming road space use type, and prototyping AV designs with various features and needs are potential methods to cope with the countervailing impacts. The total VKT of the overall population increased by approximately 10%–25% depending on the city. The conclusions of this paper provide informative insights into the evaluation of VKT for underserved populations and contribute to the deployment of AVs to address equity and inclusion issues.

This study aimed to estimate the work capacity of older Indonesians based on their health condition and other characteristics. Two analytic methods were used in this analysis—the Milligan–Wise method and the Cutler–Meara–Richards-Shubik method—and they found relatively small and substantial additional work capacities, respectively. The results showed that mortality alone may not be able to explain the additional work capacity due to only small improvements in the health conditions of older people. The effect of poverty, the dominance of the informal sector, low educational attainment and skills, and inadequate government social protection and assistance were also responsible for the continued employment of older people until serious health conditions halted their economic activities. Thus, several features were highlighted in this study: (i) the feasibility of extending the pensionable age, (ii) flexible terms for a pension scheme for informal workers, (iii) improved health conditions by expanding the noncontributory health insurance, and (iv) upgraded skills for older workers.

With the global increase in the aging population, the pain management in elderly patients has becoming a great concern. This paper reviewed the guideline related the pain management for the elderly. The quality and rating of guidelines were evaluated by using AGREE Ⅱ, and the recommendations for pain management care were summarized. It provides a basis for standardizing the pain management in the elderly, so that clinical practitioners can form the pain management guidelines according to the characteristics of the elderly in China. (随着人口老龄化趋势加重, 老年人群的疼痛管理尤为重要。本研究通过对老年人疼痛相关指南的筛查, 使用指南研究与评价工具(AGREEⅡ)进行质量评价、评级, 形成推荐意见的汇总, 旨在为规范老年疼痛管理提供依据, 以及为制定符合我国老年人特点的老年疼痛管理指南提供参考。)

Abstract Background Given Japan’s rapidly aging population, the Ministry of Health, Labour and Welfare's policy of reducing hospital beds and replacing medical care with nursing care requires the establishment of a coordinated system of medical and care services tailored to regional characteristics. To gain useful knowledge for the development of such a system, this study aimed to identify differences in the structure of the relationship between medical and care resources due to differences in regional characteristics. Methods Initially, regional characteristics were used to group all 334 secondary medical areas (SMA) in Japan by principal component analysis. Subsequently, the related structure of the distribution of medical and care resources for each group were compared. For these comparisons, first, the related structure of the distribution of medical and care resources nationwide was modeled using structural equation modeling. Secondly, multigroup analysis was conducted to investigate differences among the models across groups. Results The nationwide SMAs were grouped largely based on urbanicity and middle-density regionality. The groups with high urbanicity and high middle-density regionality consisted of SMAs with a high and medium population density. By contrast, the low middle-density regionality group consisted of SMAs containing large cities with a high population density and depopulated areas with a low population density. The model of the related structure of the distribution of medical and care resources differed among these groups. In the non-urbanicity and middle-density regionality groups, nursing care abundance tended to increase acute care abundance. In addition, in all groups, nursing care abundance tended to increase long-term hospitalization care abundance and clinic care abundance (with beds). Conclusions The key finding of this study was that the government’s objective of reducing hospital beds may not be achieved solely by expanding nursing homes. This is because many of the models did not show a tendency that higher nursing care abundance reduces the values of the factors which increase more hospital beds. This finding was particularly relevant in middle-density regionality groups. This finding suggests that the location of nursing homes should be monitored because of concerns about the oversupply of nursing homes and sprawl in those areas.

ABSTRACTIn Singapore, population aging and rising life expectancy are increasing herpes zoster (HZ) burden, which may be reduced by vaccination. The present study modeled the public health impact of HZ vaccination in Singapore using ZOster ecoNomic Analysis (ZONA) model adapted with Singapore-specific key model inputs, where available. Base case analysis was conducted in adults ≥ 50 years of age (YOA), exploring three vaccination strategies (no vaccination, recombinant zoster vaccine [RZV], zoster vaccine live [ZVL]) under mass vaccination setting (30% coverage). Scenario and sensitivity analyses were performed. Out of 1.51 million adults in 2021 (base case population), 406,513 (27.0%) cases of HZ, 68,264 (4.5%) cases of post-herpetic neuralgia (PHN), and 54,949 (3.6%) cases of other complications were projected without vaccination. RZV was estimated to avoid 73,129 cases of HZ, 11,094 cases of PHN, and 9,205 cases of other complications over the subjects’ remaining lifetime; ZVL would avoid 17,565 cases of HZ, 2,781 cases of PHN, and 1,834 cases of other complications. The number needed to vaccinate to prevent one case of HZ/PHN was lower for RZV (7/41) than ZVL (26/163). Among all five age-stratified cohorts (50–59/60–64/65–69/70–79/≥80 YOA), RZV (versus no vaccination/ZVL) avoided the largest number of cases in the youngest cohort, 50–59 YOA. Results were robust under scenario and sensitivity analyses. Mass vaccination with RZV is expected to greatly reduce the public health burden of HZ among Singapore individuals ≥ 50 YOA. Findings support value assessment and decision-making regarding public health vaccination strategies for HZ prevention in Singapore.

Numerous researchers acknowledge that the occupational pension protects employees. However, in China, the total cost of occupational pensions is shared between employees and employers, representing a significant financial commitment. This study aimed to explore the effect of the occupational pension on corporate social responsibility (CSR) and organizational resilience. Drawing on insights from cost-stickiness and resource-based theories, we developed a model that elucidated the influence of occupational pensions on firms' approaches to CSR within the context of COVID-19 and how this, in turn, impacted organizational resilience. This study categorized CSR into strategic and responsive activities, employing the concept of cost stickiness as a framework. We analyzed a sample of 34,145 observations from Chinese A-share listed companies spanning the period 2010–2023 to examine the influence of occupational pension adjustments on CSR strategies. The findings of this study revealed that the cost pressure associated with contributions to occupational pensions prompted firms to decrease their engagement in responsive CSR activities while enhancing their strategic CSR initiatives. Furthermore, it was observed that strategic CSR contributed to improved organizational resilience, whereas responsive CSR did not exhibit the same effect. The relationship between occupational pension contributions and CSR was found to be significantly and negatively moderated by factors such as the minimum wage and population aging. Conversely, the relationship between CSR and organizational resilience was significantly and positively moderated by digital transformation and marketing capabilities. [ABSTRACT FROM AUTHOR]