Gerontologist最新文献

{"title":"Feasibility of a mind-body activity program for English and Spanish-speaking older adults with chronic pain delivered within shared medical visits in a community clinic.","authors":"Katherine A McDermott, Claire L Szapary, Elizabeth M Allen, Julie R Brewer, Clara C Vonderheide, Natalia Giraldo-Santiago, Nadine S Levey, Danielle E La Camera, Roger Pasinski, Jonathan Greenberg, Christine S Ritchie, Ana-Maria Vranceanu","doi":"10.1093/geront/gnaf124","DOIUrl":"https://doi.org/10.1093/geront/gnaf124","url":null,"abstract":"<p><strong>Background and objectives: </strong>Underserved older adults with chronic pain receive pain treatment predominantly in primary care. However, these clinics often lack resources and access to evidence-based psychosocial pain management. Shared medical visits, in which patients receive care in a group setting, offer a practical avenue for implementing psychosocial pain management. We conducted an open pilot study with exit interviews (NIH stage 1a) assessing the feasibility of GetActive+, an efficacious mind-body activity intervention for older adults with chronic pain in a community clinic delivered via shared medical visits.</p><p><strong>Research design and methods: </strong>Twenty English-speaking and thirteen Spanish-speaking older adults with chronic pain from a community primary care clinic participated in GetActive+. Our a priori set primary outcomes were feasibility (≥ 75% of patients approached agree to participate), acceptability (≥ 75% of patients enrolled complete 8/10 sessions), and fidelity (≥ 75% of session components delivered as intended). We also assessed preliminary quantitative outcomes, including multimodal physical function (ActiGraph, PROMIS physical function, 6-minute walk test), pain intensity and interference (Brief Pain Inventory; PEG), and emotional function (depression and anxiety symptoms).</p><p><strong>Results: </strong>We exceeded our benchmarks for feasibility (86.8%), acceptability (93.9%) and fidelity (97.9%). Participants demonstrated improvement in self-reported physical function and 6-minute walk test, pain intensity and interference, and depressive symptoms but not in ActiGraph step count or anxiety symptoms. Exit interviews supported the quantitative findings.</p><p><strong>Discussion and implications: </strong>GetActive+ exceeded feasibility benchmarks and offers promise in making psychosocial pain management more accessible in the community via group delivery by any available provider.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Toxicity in Dementia Caregiving: Sociodemographic Predictors in a U.S. Nationally-Representative Survey.","authors":"Danielle M Hart, Brandon Leggins, Clara Sanches, Elan L Guterman, Winston Chiong","doi":"10.1093/geront/gnaf092","DOIUrl":"https://doi.org/10.1093/geront/gnaf092","url":null,"abstract":"<p><strong>Background & objectives: </strong>\"Financial toxicity\" describes the negative effects of medical expenses on financial security and health-related quality of life. Beyond dementia, financial toxicity is used to address the financial and health consequences of illness. Here, we utilize the Comprehensive Score for financial Toxicity (COST) to examine the experience of financial toxicity in dementia caregiving.</p><p><strong>Research design & methods: </strong>We conducted a nationally-representative survey of 317 dementia caregivers. Financial toxicity was defined as COST <26 and categorized as mild (COST ≥14 & <26), moderate (COST >0 & <14), or severe (COST = 0). Nested multivariable regression examined potential predictors of financial toxicity. Mediation analyses were performed to assess whether the influence of basic caregiver demographic predictors were mediated by care recipient clinical characteristics, caregiver socioeconomic demographics, or relational characteristics.</p><p><strong>Results: </strong>52.7% of dementia caregivers in the U.S. experience financial toxicity. Of those, 73.1% endure mild, 25.7% moderate, and 1.2% severe toxicity. 69.5% of Black, 54.1% of Hispanic, and 42.3% of White caregivers report financial toxicity, with prevalence significantly higher in Black caregivers compared to White caregivers (p = 0.017). Older caregiver age was associated with less financial toxicity (p = 0.024). Caregiver employment status mediated this effect, with retirement associated with less financial toxicity (p <0.001) and unemployment associated with greater financial toxicity (p <0.001).</p><p><strong>Discussion & implications: </strong>Most dementia caregivers in the US experience financial toxicity, with Black caregivers bearing the highest risk. Older caregiver age protects against financial toxicity, reflecting the relationship between age and employment status.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triadic Primary Care Encounters Managing Medications among Individuals with Mild Cognitive Impairment and Dementia: Patient, Caregiver and Clinician Perspectives.","authors":"Rachel O'Conor, Allison Pack, Andrea M Russell, Dianne Oladejo, Emily Rogalski, Darby Morhardt, Richard H Fortinsky, Lee A Lindquist, Stephen D Persell, Michael S Wolf","doi":"10.1093/geront/gnaf122","DOIUrl":"https://doi.org/10.1093/geront/gnaf122","url":null,"abstract":"<p><strong>Background and objective: </strong>Individuals with mild cognitive impairment (MCI) or dementia work with family caregivers and clinicians to manage multidrug regimens; however, problems with medication management are common and contribute to avoidable hospitalizations among individuals with dementia. We sought to describe the initiation of these triadic clinical encounters and medication management to identify opportunities to enhance them.</p><p><strong>Research design and methods: </strong>We conducted semi-structured qualitative interviews among individuals with MCI or dementia, their family caregivers and primary care clinicians. Clinicians were not required to provide care for enrolled patients. Interview guides were informed by the Triadic Dementia Care Framework. Transcripts were analyzed following the Framework Method.</p><p><strong>Results: </strong>We enrolled 32 patients, 32 caregivers, and 25 clinicians. Patients, caregivers and clinicians all prioritized patient-focused clinical encounters, and noted transitions in medication management responsibilities typically occur after observing reduced patient capacity. During these transitions, clinicians noted they do not routinely provide an overview of their patients' medications to caregivers, yet caregivers expressed desire for this. Three cross-cutting themes also emerged: 1) balancing patient cognitive impairment limitations and retention of patient autonomy is important to all members of the triad; 2) historical relationship dynamics inform current clinical encounters and medication management; 3) additional time is needed to manage patients with multiple conditions and medications.</p><p><strong>Discussion and implications: </strong>Opportunities exist to utilize a multidisciplinary care team to initiate thoughtful early planning for transitions in medication management responsibilities and provide supplemental counseling and materials that reiterate the value of triadic relationships, and detail patient-medication guidance.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the accountability gap between aging and disability research.","authors":"Michelle Putnam, Susan L Stark","doi":"10.1093/geront/gnaf121","DOIUrl":"https://doi.org/10.1093/geront/gnaf121","url":null,"abstract":"<p><p>A critical issue for bridging aging and disability research is developing a shared conceptualization of disability. Models of disability in aging research often employ a medical perspective disability or sometimes reference ecological aging and person-environment frameworks, but do not typically identify social forces and actors being as accountable for remediating disability. However, disability researchers, often approach their work from the position that eliminating disability requires individual and social action; disability is not inherently a personal issue. Disability-related civil rights laws and policies in the U.S. have recognized social, cultural, economic, and environmental factors as contributing to disability. These laws apply equally to younger and older people experiencing disability and validate the right to equitable access to inclusion and participation. Recent federal and state actions provide an opportunity for reconsideration of how gerontologists think about social factors that contribute to disability. In this forum discussion, we articulate the importance of understanding the evolution of the theoretical concept of disability alongside legal and policy changes that have advanced disability rights, briefly describe the evolution of the ecological and social models of disability, and highlight how understanding disability within a broader social model has relevance for bridging aging and gerontology research.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging Alone (While Black): Living Alone, Loneliness, and Health Among Older Black Women.","authors":"H Shellae Versey, Joseph Gibbons","doi":"10.1093/geront/gnae175","DOIUrl":"10.1093/geront/gnae175","url":null,"abstract":"<p><strong>Background and objectives: </strong>Increasingly, Black women are aging alone. Yet information about health correlates and the residential context where older Black women are aging-in-place is lacking. The current study examines one aspect of Aging While Black that affects Black women-living alone without close family or kin in the household - among a sample of older Black women (N = 890).</p><p><strong>Research design and methods: </strong>Using hierarchical linear models and data from the 2014/2015 and 2019 waves of the Southeastern Pennsylvania Household Health Survey, living alone status (e.g., Level 1) and area-level indicators of residential segregation and social capital (e.g., Level 2) are examined as correlates of self-rated health and loneliness.</p><p><strong>Results: </strong>Our findings indicate that while Black women live in primarily segregated areas, living alone is associated with lower odds of loneliness and has no relation to self-rated health. Additionally, area-level social capital is correlated with a lower likelihood of reported loneliness.</p><p><strong>Discussion and implications: </strong>These results are somewhat contrary to the current aging-in-place literature that claims that living alone always contributes to social isolation, loneliness, and poorer health. For older Black women in urban settings, living alone may reflect independence rather than loneliness. Efforts to increase community supports and opportunities for maintaining social connectedness should be considered for future research and age-friendly policies.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling Pathways by Which the Caregiver TLC Psychoeducational Program Affects Psychological Health of Caregivers.","authors":"Julian Montoro-Rodriguez, Charlie L Reeve, Dolores Gallagher-Thompson, Jennifer Ramsey, Ann Choryan Bilbrey, Bruno Kajiyama","doi":"10.1093/geront/gnaf020","DOIUrl":"10.1093/geront/gnaf020","url":null,"abstract":"<p><strong>Background and objectives: </strong>The study seeks to elucidate the pathways by which the Caregiver Thrive, Learn & Connect (TLC) psychoeducational program affects the psychological health of caregivers by examining the degree to which changes in self-efficacy, personal gains, and emotional support mediate the changes in perceived depression, anxiety, and burden.</p><p><strong>Research design and methods: </strong>Using pre-post data from the Caregiver TLC randomized controlled trial (n = 81) for each outcome and mediator pair, a series of multiple regression models were executed to test the degree to which the program's total effects on changes in depression, burden, and anxiety from baseline to post-intervention are due to changes in each mediator variable from pre- and post-intervention assessments. Caregivers were primarily female (85%), White (62%), and Black (38%), with a median age of 62 and household income of $75,000+. Caregivers reported caring for a person with dementia (69%) or chronic health conditions (31%).</p><p><strong>Results: </strong>Mediation path modeling indicated that changes in self-efficacy were affected by participation in the Caregiver TLC program, mediating between 32% and 63% of the total treatment effect on the outcome variables. Change in personal gains and change in emotional support also demonstrated meaningful mediation effects, albeit smaller in magnitude.</p><p><strong>Discussion and implications: </strong>Results confirm that the observed positive impact of the Caregiver TLC program is due to changes in self-efficacy (in particular) and to a lesser degree to changes in personal gains and emotional support. These results confirm that strengthening caregivers' perceived self-efficacy to manage stress plays a significant role in improving psychosocial functioning.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Aging Stereotypes and Clinical Insomnia in Older U.S. Military Veterans.","authors":"Julia T Boyle, Ian Fischer, Hannah M Bashian, Jennifer Moye, Becca R Levy, Robert H Pietrzak","doi":"10.1093/geront/gnaf036","DOIUrl":"10.1093/geront/gnaf036","url":null,"abstract":"<p><strong>Background and objectives: </strong>Insomnia symptoms are more prevalent in older age and may be impacted by negative perceptions of aging; however, more research is needed. The present study characterizes the relationship between negative aging stereotypes and clinical insomnia symptoms in a nationally representative sample of older U.S. veterans.</p><p><strong>Research design and methods: </strong>Data were analyzed from 3,000 U.S. veterans (aged 60-99) who participated in the National Health and Resilience in Veterans Study (NHRVS). Multivariable regression analyses were conducted to examine associations between negative aging stereotypes (assessed with the Expectations Regarding Aging scale) and clinical insomnia (assessed with the Insomnia Severity Index).</p><p><strong>Results: </strong>A total of 213 veterans (7.1%) screened positive for clinical insomnia and scored significantly higher on measures of negative emotional (p < .001), physical (p = .003), and cognitive (p = .013) aging stereotypes relative to veterans without clinical insomnia. Multivariable regression analyses revealed that, after adjusting for covariates, greater endorsement of negative stereotypes regarding emotional aging was associated with significantly greater odds of screening positive for clinical insomnia (OR = 1.56, 95%CI = 1.26-1.95, p < .001), sleep disturbance (OR = 1.49, 95%CI = 1.25-1.77, p < .001) and daytime dysfunction (OR = 1.58, 95%CI = 1.34-1.88, p < .001). Veterans who \"somewhat\" and \"fully\" endorsed these negative stereotypes were 3- and 6 times more likely to screen positive for clinical insomnia, respectively (probabilities = 0.110 and 0.246 vs 0.040).</p><p><strong>Discussion and implications: </strong>Negative aging stereotypes, particularly those related to emotional aging, are independently associated with clinical insomnia in older U.S. veterans. Efforts to modify these stereotypes in older veterans may help improve overall sleep quality.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Opportunities in Searching for Missing Persons with Dementia: Insights From Specialized Police Officers.","authors":"Jeong Ah Yoo","doi":"10.1093/geront/gnae178","DOIUrl":"10.1093/geront/gnae178","url":null,"abstract":"<p><strong>Background and objectives: </strong>Getting lost can cause profound distress for individuals with dementia and their families, while also imposing a significant burden on society. Existing literature primarily focuses on the incidence and consequences of such cases, overlooking the challenges and issues involved in locating them. To address this gap, the present study aimed to explore the firsthand experiences and efforts of police officers in charge of missing cases.</p><p><strong>Research design and methods: </strong>This study utilized a cross-sectional research design and conducted in-depth interviews with purposefully sampled police officers responsible for missing persons with dementia in South Korea. The qualitative information gathered from the interviews was analyzed using content and thematic analysis.</p><p><strong>Results: </strong>Despite various preventive programs and tracking technologies available, traditional methods such as foot searches remain more practical due to difficulties in utilizing such means by individuals with dementia. Additionally, their unpredictable characteristics and the lack of adequate and systematic societal support make even traditional searches challenging. Therefore, cooperation and awareness from caregivers and the community are crucial for police search and rescue operations. The study also highlights the importance of tailored response measures and legal support, as well as the need for collaborative efforts across societal domains for successful outcomes.</p><p><strong>Discussion and implications: </strong>The findings of this study are anticipated to contribute to a broader understanding of this pressing issue and provide critical insights for developing more effective response measures.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the Internalized Care Stigma Scale (ICSS): Measuring Care Stigma Aimed at Informal Care for Older Adults in Germany.","authors":"Larissa Zwar, Hans-Helmut König, Emily Delfin, André Hajek","doi":"10.1093/geront/gnaf012","DOIUrl":"10.1093/geront/gnaf012","url":null,"abstract":"<p><strong>Background and objectives: </strong>In this study, we developed and validated the Internalized Caregiver Stigma Scale (ICSS) to measure internalized stigma targeting informal care for older adults (≥60 years) in Germany.</p><p><strong>Research design and methods: </strong>The ICSS scale was developed in the Attitudes Towards Informal Caregivers project based on stigma theories and (cognitive) pretesting with informal caregivers. Informal long-term caregivers (aged ≥40 years; n = 433) of older relatives (aged ≥60 years) were quota-sampled from the online panel GapFish in December 2023 (twice as many female and middle-aged [aged 40-64 years] caregivers than male and younger [18-39 years] or older adults [65+ years] were included in the sample). Caregiver identification and the Social Impact Scale were used for validation of the newly developed measure. Factor structure, reliability, and concurrent validity were tested.</p><p><strong>Results: </strong>A correlated 2-factor model with excellent goodness-of-fit criteria and good to excellent internal consistency of the factors and the total scale was confirmed for the ICSS. The negative ICSS subscale correlated highly, and the positive ICSS subscale correlated weakly, with the care-specific Social Impact Scale. Both ICSS subscales were weakly correlated with caregiver identification. Both aspects of self-stigma showed significant associations with sociodemographic and care-specific factors in the regression models.</p><p><strong>Discussion and implications: </strong>The ICSS is the first scale measuring internalized stigma targeting informal care for older adults directly and shows excellent psychometric criteria. It provides the necessary tool for a new approach to analyze the complex psychosocial mechanisms in this highly relevant care context.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delineating Care Recipient Burden Constructs: Development and Validation of the CARE-2B Scale for Care Recipient Self-Perceived Burden and Proxy Assessment of Caregiver Burden.","authors":"Maja Kuharic, Brendan Mulhern, Lisa K Sharp, Robin S Turpin, A Simon Pickard","doi":"10.1093/geront/gnae143","DOIUrl":"10.1093/geront/gnae143","url":null,"abstract":"<p><strong>Background and objectives: </strong>Care Recipient Self-Perceived Burden (CR-SPB) to Caregivers is an important but overlooked aspect within the caregiver-care recipient relationship. This study aimed to (a) develop and validate the CARE-2B (Care Recipient's Two Burden) Scale, assessing both CR-SPB and their proxy assessment of caregiver burden (Proxy-CB); and (b) examine whether the CR-SPB and Proxy-CB differ from caregiver burden's own assessment and other health and social care constructs.</p><p><strong>Research design and methods: </strong>Data were collected from 504 caregiver-care recipient dyads in the United States using an online panel between August 2022 and February 2023. Care recipients completed the CARE-2B Scale, which includes two subscales: CR-SPB and Proxy-CB. Care recipients also completed measures related to health and well-being: SPB-scale, EQ-5D-5L, and EQ Health and Well-Being (EQ-HWB). Caregivers completed Care-Related Quality of Life (CarerQoL) and Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer). Psychometric analysis included exploratory and confirmatory factor analysis, item response theory (IRT), and construct validity.</p><p><strong>Results: </strong>CR-SPB correlated strongly with the SPB-scale (r = 0.73), whereas Proxy-CB correlated more strongly with caregiver-reported burden (r = 0.61). Both CR-SPB and Proxy-CB items demonstrated good discrimination and information coverage in IRT analysis. Exploratory factor analysis further supported the distinctiveness of CR-SPB and Proxy-CB, with CR-SPB items loading on a separate factor from caregiver burden and health constructs, whereas Proxy-CB aligned with caregiver-reported burden.</p><p><strong>Discussion and implications: </strong>The CARE-2B Scale innovatively assesses both CR-SPB and Proxy-CB from the care recipient's perspective, providing new insights into the caregiving relationship. This dual-perspective measure has implications for enhancing care strategies for individuals with chronic conditions or disabilities and their caregivers.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}