Bussarawan Teerawichitchainan, Dahye Kim, Christine Ho
{"title":"Childlessness, Social Network Profiles in Midlife and Late Adulthood, and Their Implications for Subjective Well-being","authors":"Bussarawan Teerawichitchainan, Dahye Kim, Christine Ho","doi":"10.1093/geronb/gbae055","DOIUrl":"https://doi.org/10.1093/geronb/gbae055","url":null,"abstract":"Objectives Despite the rising prevalence of individuals reaching advanced age without children, little is known about the diversity in support networks within childless populations. We examine the network profiles of childless adults aged 50+ in Singapore, which observes high childlessness rates despite societal emphasis on familism. Methods We employ latent class analysis to derive network typology based on a 2022 nationwide survey in Singapore. Additionally, we use logistic regression analyses to investigate the sociodemographic correlates of childless individuals’ network types and the associations between these network types and subjective well-being. Results Childless Singaporeans form a heterogeneous group characterized by different support networks. Evidence suggests the centrality of parents in the childless’ social networks and the continuity of parent-child support exchanges that extend into the child’s midlife and late adulthood. When parents are absent, siblings/extended kin serve as their support sources. Age, sibship size, and socioeconomic status are key correlates of network types. Membership in diverse networks is beneficial to the subjective well-being of childless individuals. Although one-fifth of childless individuals in restricted networks demonstrate significantly poorer well-being, the remaining four-fifths show comparable, if not better, well-being than the non-childless. Discussion Results underscore the importance of differentiating network types among the childless, particularly when assessing their well-being. Contrary to the notion associating later-life childlessness with social isolation and vulnerabilities, many childless Singaporeans manage to construct non-child-based networks equipped with various supportive relations that cater to their needs. Nevertheless, persistent vulnerabilities among restricted network members deserve policymakers’ attention.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140564665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Htet Lin Htun, Achamyeleh Birhanu Teshale, Alice J Owen, Joanne Ryan, Robyn L Woods, Suzanne G Orchard, André Hajek, Thom Lysen, Raj C Shah, Trevor T-J Chong, Kerry M Sheets, Johanna Joyce, Anne M Murray, Rosanne Freak-Poli
{"title":"Social Activities and Risk of Dementia in Community-Dwelling Older People: Gender-Specific Findings from a Prospective Cohort Study","authors":"Htet Lin Htun, Achamyeleh Birhanu Teshale, Alice J Owen, Joanne Ryan, Robyn L Woods, Suzanne G Orchard, André Hajek, Thom Lysen, Raj C Shah, Trevor T-J Chong, Kerry M Sheets, Johanna Joyce, Anne M Murray, Rosanne Freak-Poli","doi":"10.1093/geronb/gbae050","DOIUrl":"https://doi.org/10.1093/geronb/gbae050","url":null,"abstract":"Objectives This study examines gender-specific associations between a wide range of social activities and dementia risk. Methods A prospective cohort study was conducted involving community-dwelling older Australians (≥70 years) without significant cognitive impairment at enrolment. During the first year of enrolment, we assessed 25 self-reported social activities covering various aspects, including support from relatives and friends, community participation, social interactions with surroundings, and loneliness. Dementia diagnosis followed DSM-IV criteria, adjudicated by an international expert panel. To estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between social activities and dementia, we performed Cox proportional hazards models, adjusting for age, educational attainment, baseline global cognition, and depressive symptoms. Results Among 9,936 participants who completed all social activity questionnaires (median [IQR]age:73.4[71.6-77.1] years; 47.4% men), dementia was diagnosed in 3.8% of men (n=181/4,705) and 2.6% of women (n=138/5,231) over a median 6.4 years (IQR:5.3-7.6, range:0.2-10.1) follow-up. Gender-specific relationships emerged: caregiving for a person with illness/disability in women (HR:0.65,95%CI:0.42-0.99), and having ≥9 relatives feeling close to call for help in men (HR:0.56, 95%CI:0.33-0.96; reference <9 relatives) were associated with reduced dementia risk. Unexpectedly, in women, having ≥5 friends with whom they felt comfortable discussing private matters was associated with a greater dementia risk (HR:1.69,95%CI:1.10-2.59; reference ≤2 friends). Imputed models further identified that babysitting/childminding was associated with a lower dementia risk in men (HR:0.75,95%CI:0.56-0.99). No other social activities showed significant associations with dementia. Discussion This study provides evidence of social activities influencing dementia risk. Further investigations are required to uncover the mechanisms driving these observed relationships.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140564582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hayami K Koga, Francine Grodstein, David R Williams, Aron S Buchman, Laura D Kubzansky
{"title":"Purpose in life and its association to Parkinsonism","authors":"Hayami K Koga, Francine Grodstein, David R Williams, Aron S Buchman, Laura D Kubzansky","doi":"10.1093/geronb/gbae026","DOIUrl":"https://doi.org/10.1093/geronb/gbae026","url":null,"abstract":"Objectives Purpose in life has been associated with diverse health outcomes, however, few studies have examined its associations with progressive motor decline in older adults. We tested if higher purpose would be associated with lower likelihood of incident parkinsonism as well as with lower levels and slower rates of increase in parkinsonian signs. Methods Participants were 2,626 older adults from the Rush Memory and Aging Project and Minority Aging Research Study followed for an average of 7.2 years (SD=4.6). Purpose was measured using the purpose in life subscale of the modified Ryff’s and Keyes’s measure of psychological well-being. Four parkinsonian signs (i.e., parkinsonian gait, rigidity, bradykinesia, and tremor) were assessed using the United Parkinson’s Disease Rating Scale. We examined purpose with risk of developing incident parkinsonism using Cox proportional hazards models. We also used linear mixed effect models to assess the association between purpose and parkinsonian sign trajectories. Results After including demographics, health conditions, and health behaviors in the model, for a 1-SD increase in purpose, the hazards ratio for incident parkinsonism was 0.88 [95%CI 0.80, 0.97]. A 1-SD increase in purpose was associated with a -0.19 (95%CI -0.24, -0.15) point lower score in the global parkinsonian summary score at baseline but no differences in rate of change were evident. Discussion Higher purpose was associated with lower hazards of incident parkinsonism and lower levels of parkinsonian signs at baseline. Associations were seen even after adjustment for a wide range of covariates. Findings suggest higher purpose may contribute to maintenance of healthy physical function among older adults.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kira S Birditt, Nicky J Newton, Angela Turkelson, Courtney A Polenick, Zexi Zhou, Karen L Fingerman
{"title":"Daily Rumination among Older Men and Women: The Role of Perceived Family and Non-Family Social Partner Life Stress","authors":"Kira S Birditt, Nicky J Newton, Angela Turkelson, Courtney A Polenick, Zexi Zhou, Karen L Fingerman","doi":"10.1093/geronb/gbae027","DOIUrl":"https://doi.org/10.1093/geronb/gbae027","url":null,"abstract":"Objectives Women tend to ruminate more than men, and are generally more hypervigilant to the emotions of others in order to maintain positive social ties. Thus, compared to men, women may ruminate more when their social partners have greater life stresses. However, the literature on stressful events typically focuses on individuals’ experiences and perceptions of stressors experienced by specific social ties such as spousal partners and adult children. The purpose of this study was to examine links between perceptions of a broad array of family and non-family social partner stresses and daily rumination among older men and women. Methods Adults aged 65 and older 293 adults (N = 293, 55% women) completed baseline assessments of family and non-family life stressors and 5-6 consecutive nightly assessments regarding rumination, interpersonal tensions, worries and support provision. Results Multilevel structural equation models revealed that perceptions of greater family and non-family life stressors were associated with greater rumination. The links between family stress and rumination varied by gender: Family stress was related to greater rumination among women and not men. Moreover, among women, family and non-family stress-rumination links were accounted for by greater daily worries about others, and among men, the non-family stress-rumination link was due to greater interpersonal tensions as well as daily worries. Discussion These findings may be due in part to gender role socialization and women’s greater kin keeping and investment in family ties.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eunyoung Kwag, Dominic Bachmann, Kyungwan Kim, Igor Komnik, Wiebren Zijlstra
{"title":"Effects of cognitive inhibition preceding voluntary step responses to visual stimuli in young and older adults","authors":"Eunyoung Kwag, Dominic Bachmann, Kyungwan Kim, Igor Komnik, Wiebren Zijlstra","doi":"10.1093/geronb/gbae006","DOIUrl":"https://doi.org/10.1093/geronb/gbae006","url":null,"abstract":"Objectives Age-related changes in executive functions, especially inhibitory control, correlate to decreased balance control and increased fall risk. However, only few studies focused on performance of tasks integrating balance and inhibitory control. This study aims to determine the effects of cognitive inhibition preceding the initiation of voluntary steps in young and older adults. Methods Performance of three stepping tasks (a Simon-, Flanker-, and a combined Simon-Flanker task (SFT)) were analyzed in 23 young adults and 43 older adults. Each task included congruent and incongruent trials in different step directions. Analyses focused on temporal aspects of step responses as identified by changes in Center of Pressure (CoP) and foot position. A three-way repeated measures ANOVA was used to evaluate ‘inhibition’, ‘age’, and ‘task’ effects. Results With large effect sizes, ‘inhibition’ as well as ‘age’ resulted in longer durations of an initial preparatory phase as well as the step response phase. The SFT showed the largest ‘task’ effects. Duration of CoP movement had the largest impact on total step execution in older adults. A significant interaction effect of ‘age*inhibition’ was found on duration of CoP movement, but not on CoP onset. Discussion Overall, our results demonstrate that cognitive inhibition has more impact in older adults, the longer duration of CoP movements in older adults may reflect an ineffective step preparation. Our examination of the duration of subsequent phases which comprise perceptual processing and conflict resolution, response initiation, and step execution sheds light on how cognitive inhibition affects voluntary stepping behavior in young and older adults.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"135 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139664887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Could 70 be the New 60? Investigating the Association between Internet Use and Subjective Age among Chinese Older Adults","authors":"Menghan Zhao, Yuanfeng Huang, Youlang Zhang","doi":"10.1093/geronb/gbad200","DOIUrl":"https://doi.org/10.1093/geronb/gbad200","url":null,"abstract":"Objectives The widespread use of the Internet brings both opportunities and challenges for older adults. To understand its potential benefits and drawbacks, we focus on the association between Internet use and multiple indicators of subjective age (threshold age, felt age, and look age) and the underlying mechanisms. Method A nationally representative sample of older adults aged 60 and over from three waves (collected in 2016, 2018, and 2020) of the China Longitudinal Aging Social Survey was used in the analysis. A three-step random effect model and mediation analysis was used to examine the relationship between Internet use and subjective age and the mediating roles of volunteering and feeling valued by society. Structural equation modeling with a serial multiple mediation model was conducted for robustness checks. Results The participants generally considered 70 as the threshold for “old age.” Although the mediation analysis did not show a significant indirect effect of Internet use on older adults' subjective age through volunteering, Internet use was linked with older adults’ subjective age directly and indirectly through feeling valued by society. Compared to moderate Internet users, nonusers felt less valued by society and, therefore, had a younger threshold age and older subjective ages. Heavy Internet users showed a lower level of participation in volunteer activities. Discussion The results support previous theories about the mental and social health benefits of Internet use among older adults. However, Internet use intensity should receive more attention; excessive use may reduce the duration of older adults’ offline social interactions.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139070917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Camila Carlos Bezerra, Noeli das Neves Toledo, Sonia Maria Dozzi Brucki, Juliana Nery Souza-Talarico
{"title":"COVID-19 and Cognitive and Mental Health during Post-Infection Phase: A Study Among Middle-Aged and Older Indigenous Adults from Brazilian Amazons","authors":"Camila Carlos Bezerra, Noeli das Neves Toledo, Sonia Maria Dozzi Brucki, Juliana Nery Souza-Talarico","doi":"10.1093/geronb/gbad197","DOIUrl":"https://doi.org/10.1093/geronb/gbad197","url":null,"abstract":"Objectives to examine the rate of self-reported COVID-19 and its association with mental and cognitive health during the post-infection phase among middle-aged and older indigenous adults. Method A cross-sectional study was conducted, including one hundred forty-one individuals ≥50 and over from a urban indigenous community in Amazonas, Brazil. COVID-19 was deduced from self-reported infections. Cognitive function was evaluated using the Mini-Mental State Exam (MMSE), Brief Cognitive Screening Battery (BCSB), and language fluency tests. Meanwhile, mental health was assessed through validated scales examining happiness, stress and depression symptoms. The association between the rate of COVID-19 and cognitive and mental wellbeing was analyzed using logistic and linear regressions, adjusted for covariates. Results From March 2020 to February 2022, 65.2% of the urban indigenous group tested positive for COVID-19. Lower functional capacity decreased the odds of contracting COVID-19 (p=0.03). Adjusted linear regression models, showed that COVID-19 was associated with higher BCSB learning (p= 0.017) and delayed recall (p=0.028). Female, higher age, lower functional capacity and hospitalization were associated with worse cognitive performance (p<0.05). No impact of mental health indicators on past COVID-19 infection was noted. Discussion COVID-19 was prevalent among urban Indigenous Brazilians. Unexpectedly, it was linked to enhanced learning and memory, not mental health issues. Cognitive performance was lower for males, older individuals, those with less functional ability, and hospitalized patients, indicating that participant characteristics and disease severity affect the COVID-19 and cognition relationship. Longitudinal studies across diverse Indigenous communities are necessary to understand COVID-19's impact on their cognitive and mental health.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139071279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rowan L F ten Kate, Tineke Fokkema, Theo G van Tilburg
{"title":"Gender Differences in Social Embeddedness Determinants of Loneliness among Moroccan and Turkish Older Migrants","authors":"Rowan L F ten Kate, Tineke Fokkema, Theo G van Tilburg","doi":"10.1093/geronb/gbad177","DOIUrl":"https://doi.org/10.1093/geronb/gbad177","url":null,"abstract":"Objectives Moroccan and Turkish migrants residing in Northwestern Europe have high loneliness levels. This study examines gender differences in loneliness within this migrant population. The migrants have gender-segregated social roles at home and in public which might lead to gender differences in what aspects of social relationships can explain variation in loneliness. Methods Respondents are from the Longitudinal Aging Study Amsterdam with 446 first-generation Moroccan and Turkish migrants in the Netherlands, aged between 55 and 66 years. We use interaction effects to test for gender differences in determinants of loneliness. Results Men and women have a similar, moderate level of loneliness. Having a spouse and receiving care from children are more strongly related with lower loneliness levels in men than in women. Co-ethnic ties play an equally important role for men and women. In men, frequent mosque attendance is related with greater loneliness, but not in women. Discussion Family ties are more protective against loneliness for older men than for older women, possibly indicating that migrant women’s expectations regarding family go above and beyond having a spouse, receiving intergenerational care, or having frequent contact with children. In addition, migrant older men’s higher expectations regarding a public social life could make their social life in the Netherlands less fulfilling, resulting in greater loneliness.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"305 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138742753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nigel Walsh Harriman, Daniel Ohene-Kwofie, Sun Jae Jung, Sabrina Hermosilla, Francesc Xavier Gómez-Olivé, Elyse A Jennings
{"title":"In-Person Social Interactions and Anxiety During the COVID-19 Pandemic: Exploring the Role of Household Size and Virtual Social Contact Among Midlife and Older Black South African Adults","authors":"Nigel Walsh Harriman, Daniel Ohene-Kwofie, Sun Jae Jung, Sabrina Hermosilla, Francesc Xavier Gómez-Olivé, Elyse A Jennings","doi":"10.1093/geronb/gbad175","DOIUrl":"https://doi.org/10.1093/geronb/gbad175","url":null,"abstract":"Objectives The current study investigates how physical distancing during the COVID-19 pandemic was associated with increased anxiety among a cohort of midlife older Black South African adults and the extent to which household size and virtual social contact modify this association for men and women. Methods We analyze data from a phone survey conducted from July 2021 to March 2022 as part of Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (n=2,080). We employ logistic regression to estimate the association between changes in in-person social interactions and anxiety symptoms and examine whether the association is modified by household size and changes in virtual social contact. We perform analyses separately for women and men. Results Declines in in-person social interactions were associated with increased anxiety for women and men (OR=2.52, p<0.001). For women only, declines were greater for those living in larger households (OR=1.11 p=0.032). Declines were buffered by increased virtual social contact for both women (OR=0.55 p=0.025) and men (OR=0.45 p=0.019). Discussion Although the anxiety symptoms of women and men were similarly impacted by declines in in-person social interaction, the modifying influence of household size is unique to women, likely due to gender-specific social roles. For women, living in larger households may mean greater caregiving burden, exacerbating the detrimental association between physical distancing and anxiety. On the other hand, both women and men may have used virtual means to connect with friends and family living outside their homes, buffering against increased anxiety.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138824057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The phenomenon and determinants of healthcare service utilization for older adults with multimorbidity in China: An explanatory, mixed-method study","authors":"Jingjie Wu, Erxu Xue, Yujia Fu, Binyu Zhao, Chuyang Lai, Jing Shao, Dandan Chen, Nianqi Cui, Hui Zhang, Leiwen Tang, Zhihong Ye","doi":"10.1093/geronb/gbad174","DOIUrl":"https://doi.org/10.1093/geronb/gbad174","url":null,"abstract":"Objective The objective of this study was to explore the phenomenon and determinants of healthcare service utilization in Chinese older adults with multimorbidity. Methods We adopted a mixed-methods explanatory design from July 2022 to May 2023. The quantitative research was a social network analysis to explore the phenomenon of healthcare service utilization in target participants. The quantitative results were further interpreted as the participant’s propensity for healthcare services and the potential for information sharing between healthcare providers through shared patients. Logistic regression was conducted to identify individual determinants for healthcare service utilization. The quantitative research was followed by qualitative interviews with stakeholders to deeply understand the phenomenon of interest from the individual, healthcare system, and societal perspectives. Results We recruited 321 participants for the quantitative study. They preferred using medication services from primary healthcare providers, pharmacists at private pharmacies, and hospital specialists and preferred using other services from hospital specialists. Dense relationships arose from shared patients among healthcare providers across various professions and settings, making it possible to share patient information. Primary healthcare providers were particularly important in the process, as they were closely related to others through patient-sharing. Health status was identified through logistic regression and qualitative interviews as an individual determinant for healthcare service utilization. More determinants were explored in qualitative interviews with 30 stakeholders, including trust, resource allocation, healthcare accessibility, medical treatment process, and healthcare awareness. Discussion Strategies should be proposed to intervene with patients’ nonoptimal propensity toward healthcare services and promote information sharing among healthcare providers.","PeriodicalId":501650,"journal":{"name":"The Journals of Gerontology: Series B","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138564202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}