Gerontologist最新文献

{"title":"Older adults' perceptions of artificial intelligence in healthcare: an exploratory quantitative analysis.","authors":"Courtney L Olbrich, Kelly E Tenzek, Jennifer Stoll, Ranjit Singh, Robert G Wahler, Arya Rahgozar, Gavin Raffloer, Samaira Sharma, Andrew D Baumgartner","doi":"10.1093/geront/gnag101","DOIUrl":"https://doi.org/10.1093/geront/gnag101","url":null,"abstract":"<p><strong>Background and objectives: </strong>Artificial intelligence (AI) has the potential to improve healthcare outcomes. There is limited literature regarding older adults' perceptions on the application of AI. We explored older adults' perceptions of current communication, AI's role in healthcare delivery, and AI's use for various functions with and without clinician supervision.</p><p><strong>Research design and methods: </strong>As part of a larger mixed-methods study, we recruited older adults 65 and older (N = 753) to complete a 32-item survey with 5-point Likert scale and checkbox (yes-no) questions. The data were analyzed quantitatively.</p><p><strong>Results: </strong>87% of participants agree or strongly agree current communication with their doctor's office is good. Three factors emerged from exploratory factor analysis examining AI's role in healthcare delivery: perceived usefulness of AI (Cronbach's α = .84), AI as administrative aid (α = .84) and AI as independent agent (α = .56). Older adults were more comfortable with AI used under the supervision of a clinician rather than without supervision for diagnosis (75% vs. 5%, p < .001), treatment (76% vs. 5%, p < .001), medication management (74% vs. 17%, p < .001), scheduling (77% vs. 64%, p < .001), prescription refills (81% vs. 54%, p < .001), patient portal messages (55% vs. 20%, p < .001).</p><p><strong>Discussion and implications: </strong>Findings underscore a cautious optimism among respondents towards AI in healthcare contingent on clinician oversight and patient notification. Continued survey development measuring older adults' perceptions of AI will be beneficial in this context.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857621","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":"Kinship, Gender, and the Social Networks of Caregivers for Older Adults.","authors":"James P Murphy, Esther M Friedman, David P Kennedy","doi":"10.1093/geront/gnag072","DOIUrl":"https://doi.org/10.1093/geront/gnag072","url":null,"abstract":"<p><strong>Background and objectives: </strong>Caregiving for older adults falls disproportionately on women and family members, but little research addresses how gender and kinship intersect to shape caregiver social support. This study generates an empirical typology of caregiver social networks and examines the types' association with caregiver gender, relationship to the recipient, and their interaction.</p><p><strong>Research design and methods: </strong>Decision Editor: Joseph E. Gaugler, PhD, FGSA We collected personal network data from a nationally representative sample of 2,824 caregivers in December 2020 and January 2021. We used zero-inflated negative binomial regressions of network size and latent profile analysis to identify network types based on their size, density, family composition, and proportion sharing in caregiving responsibilities. We used multinomial logistic regressions to examine associations between network type and caregiver and care recipient characteristics.</p><p><strong>Results: </strong>We identified three network types: close-knit kin-based networks; larger networks sharing caregiving activities; and small networks in which few or no contacts assisted with caregiving. Women caring for a spouse/partner were more likely to have larger networks with broader care-sharing than either married men or other women; non-kin caregivers disproportionately had smaller networks lacking care-sharing.</p><p><strong>Discussion and implications: </strong>The results highlight the vulnerability of unpaid non-kin caregivers and suggest that interventions should consider the intersection of gender and kinship. This is important because the proportion of kinless older adults is expected to grow significantly, which may increase older adults' reliance on non-kin informal caregivers. Future work should examine whether differences in network type lead towards different outcomes by gender and caregiver-recipient relationship.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845719","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":"Cultural Adaptation of the Workplace Age-Friendliness Measure to German with Validation in Austrian Organizations.","authors":"Gert Lang, Raphael Eppler-Hattab","doi":"10.1093/geront/gnag082","DOIUrl":"https://doi.org/10.1093/geront/gnag082","url":null,"abstract":"<p><strong>Background and objectives: </strong>The workplace age-friendliness measure is a multidimensional, four-factor instrument measuring organizational support for maintaining the employability of older workers that was developed in English and Hebrew. This study aimed to adapt it culturally for use in organizations where German is spoken, and to validate its psychometric properties in the context of workplace health promotion initiatives.</p><p><strong>Research design and methods: </strong>The English version of the scale was cross-translated into German and piloted in a convenience sample in Austria. It was then circulated in six Austrian organizations across various industries and regions, mostly from health and education sectors, within their workplace health promotion projects, resulting in 1,725 employee responses. This sample was used to report on and validate the scale's psychometric properties.</p><p><strong>Results: </strong>Confirmatory factor analysis demonstrated construct validity and measurement equivalence across multigroup socio-demographic variables of age, gender, and education. The results also supported the four-factor solution of the construct, with acceptable internal consistency and reliability. Correlations demonstrated the criterion (concurrent) validity of the scale with related constructs. An analysis of variance revealed meaningful differences in factor mean scores across individual and organizational characteristics.</p><p><strong>Discussion and implications: </strong>This is the first study to develop and validate a German-language version of the workplace age-friendliness measure. As a reliable and valid instrument, it can be used to assess organizations' practices regarding their support for an aging workforce. Further implications and limitations of using this instrument in future empirical research are discussed.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846103","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":"Person-Centered Dementia Care Strategies and Facilitators in Low-Resource Long-Term Care: Staff Insights.","authors":"Yoon Chung Kim, Nancy Kusmaul, Sarah Holmes, Michael Lepore, Jing Wang, Laura Davie, Alison C Rataj, Briana Murray, Kirsten Corazzini","doi":"10.1093/geront/gnag099","DOIUrl":"https://doi.org/10.1093/geront/gnag099","url":null,"abstract":"<p><strong>Background and objectives: </strong>Person-centered care is considered best practice in dementia care, emphasizing autonomy, dignity, and relationship-based individualized care. However, little is known about how person-centered dementia care (PCDC) is implemented in low-resource long-term care (LTC) settings. This study identified PCDC strategies used by staff providing care for residents with dementia in low-resource LTC settings and key facilitators supporting the use of PCDC strategies.</p><p><strong>Research design and methods: </strong>We conducted a qualitative analysis of semi-structured interviews with 27 staff (20 direct care staff and 7 administrators) from four LTC facilities (nursing homes and assisted living) in urban Maryland and rural New Hampshire. Participants were drawn from a larger study in federally designated medically underserved areas. Template analysis was used to analyze data and identify themes related to PCDC strategies and facilitators.</p><p><strong>Results: </strong>LTC staff described PCDC strategies for residents with dementia across three domains: communication-based interactional approaches, preserving dignity and autonomy, and tailoring care to individual preferences. Key facilitators identified included fostering communication, responsiveness to residents' needs, organizational support, and resource optimization. Despite limited resources, information-sharing systems, teamwork, engagement with care partners, positive attitudes, motivation, empowerment, adaptability, and dementia training facilitated PCDC implementation, highlighting that multilevel facilitators are key to delivering quality dementia care.</p><p><strong>Discussion and implications: </strong>Findings emphasize the importance of communication and teamwork, responsiveness to residents' needs, supportive organizational structures, and resource optimization in implementation of PCDC in low-resource settings. Future research should incorporate the perspectives of residents and care partners and examine PCDC implementation across broader contexts.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845720","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":"Caregivers With Poorer Health Are Less Likely to Engage in an Intervention to Prepare for Their Own Health Care Emergency.","authors":"Kris Wain, Andrea E Daddato, Blythe Dollar, James Lagrotteria, Heather M Young, Anna Satake, Chan Zeng, Rebecca S Boxer","doi":"10.1093/geront/gnag097","DOIUrl":"https://doi.org/10.1093/geront/gnag097","url":null,"abstract":"<p><strong>Background and objectives: </strong>Preparation for an unexpected caregiver health event may improve outcomes for spouses with dementia. Using the patient activation framework, this study examined characteristics of spousal caregivers who did and did not accept an offer for an emergency preparedness toolkit (EPT), a low-touch intervention designed to help caregivers prepare for their own unexpected health event.</p><p><strong>Research design and methods: </strong>Caregivers were linked to spouses with dementia and invited to request the EPT. Pre-exposure characteristics were measured during the 12-months preceding the EPT invitation date; post-exposure measures were captured during the 6-months after invitation. Multivariable logistic regression estimated associations between caregiver characteristics and EPT request, reported as marginal effects expressed in percentage point (pp) differences. Chi-square tests compared post-exposure measures by EPT request.</p><p><strong>Results: </strong>We identified 1,062 eligible caregivers; 489 (46%) requested the EPT and 573 (54%) did not. Each additional chronic condition in the caregiver was associated with a 2.7pp decrease in EPT request. A caregiver hospitalization was associated with a 12.2pp decrease. Post-exposure analyses estimated caregivers not requesting the EPT were 1.9pp more likely to be hospitalized and discharged to a skilled-nursing-facility, and 1.9pp more likely to die during follow-up.</p><p><strong>Discussion and implications: </strong>Spousal caregivers with poorer health were less likely to respond to an offer to prepare for their own health event. Yet, caregivers at higher risk for health events may be most in need of emergency preparedness. As reliance on spousal caregivers grows, interventions that better balance caregivers' self-care with responsibilities for a spouse with dementia may strengthen preparedness and improve health outcomes for both partners.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846060","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":"Factors Associated with Respite Care Use Among Veteran Caregivers: A Machine Learning Analysis.","authors":"Melissa Harris-Gersten, Zhen Li, Pujan Patel, Jeanie Lo, Megan Shepherd-Banigan, Katherine Miller, Josephine Jacobs, Susan Nicole Hastings, Nadya Majette, Cassandra Dictus, Timothy Jobin, Courtney Van Houtven","doi":"10.1093/geront/gnag098","DOIUrl":"https://doi.org/10.1093/geront/gnag098","url":null,"abstract":"<p><strong>Background and objectives: </strong>Respite care provides temporary relief to family caregivers yet remains underused, and the factors shaping its utilization among Veteran caregivers are not well understood. This evaluation examined caregiver‑ and Veteran‑specific characteristics associated with respite care use within the Department of Veterans Affairs (VA) Caregiver Support Program's Program of General Caregiver Support Services (PGCSS).</p><p><strong>Research design and methods: </strong>We analyzed survey and administrative data from 1,727 caregivers of Veterans enrolled in PGCSS who completed baseline surveys between 2018 and 2021. Caregivers were predominantly female (96%) with a mean age of 62 years; Veterans averaged 70 years. Respite use within two years of survey completion was identified through linked VA data. Guided by Andersen's Healthcare Utilization Model, 34 caregiver and Veteran variables were evaluated with random forest models to identify characteristics that most strongly differentiated respite users from non‑users.</p><p><strong>Results: </strong>Respite care was used by 23.5% of caregivers. Use was more common among older caregivers and Veterans (predisposing factors), among caregivers reporting greater burden, depression, or financial strain and Veterans with higher frailty, functional limitation, or dementia (need factors), and among caregivers perceiving stronger communication and collaboration with the clinical team (enabling factors). Model performance was strong (testing accuracy = 0.79 with all variables; 0.77 with the top 15), and results remained consistent in a sensitivity analysis limited to caregivers of Veterans who survived the two‑year follow‑up period.</p><p><strong>Discussion and implications: </strong>Both caregiving intensity and care‑recipient complexity characterize respite use even within a system of broad service availability. Findings provide a foundation for future hypothesis‑driven studies and inform efforts to align respite programs more closely with caregiver-Veteran needs.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845397","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":"Words matter: An examination of terminology to define culturally informed dementia caregiving interventions.","authors":"Lauren J Parker, Manka Nkimbeng, Fayron Epps, Tony Stallings, Jaylah James, Ishan C Williams","doi":"10.1093/geront/gnag042","DOIUrl":"https://doi.org/10.1093/geront/gnag042","url":null,"abstract":"<p><p>Despite the documented reliance on family caregivers, systems and programming to support family caregivers are often not inclusive, nor do they provide culturally relevant opportunities. Cultural factors, in part, may be useful to understanding disparities in care outcomes and to inform support mechanisms for caregivers. However, there is lack of specificity of terminology to describe how culture is considered in dementia care interventions. The purpose of this Forum manuscript is to clarify the meaning of the terminology of culture (i.e., cultural tailoring, cultural adaptation) and to provide exemplars of evidenced-based supports that utilized the term in dementia caregiving support. This work aims to demonstrate the importance of culturally informed interventions to address disparities in care outcomes and to offer best practices to advance the science of culturally informed dementia care interventions.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845780","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":"Healthcare access barriers among older refugee newcomers in the United States.","authors":"Hyojin Im, Megan M Taylor","doi":"10.1093/geront/gnag088","DOIUrl":"https://doi.org/10.1093/geront/gnag088","url":null,"abstract":"<p><strong>Background and objectives: </strong>Older refugees in the United States face substantial healthcare access barriers shaped by displacement, trauma, and systemic challenges. Despite growing recognition of these barriers, research remains limited. This study examined multilevel predictors of healthcare access barriers among older refugees using the Older Adult Immigrant Adapted Model for Health Promotion (OAHM), an ecological framework integrating individual, interpersonal, community, and structural factors.</p><p><strong>Research design and methods: </strong>Data were drawn from the Annual Survey of Refugees (2020-2022), yielding a nationally representative sample of 840 refugees aged 50 and older. Healthcare access barriers were measured as cumulative difficulties across cost, transportation, language, knowledge, and appointment access. Using Poisson regression with LASSO regularization and multiple imputation, we identified salient predictors across ecological levels while accounting for missing data and overfitting.</p><p><strong>Results: </strong>The final model explained 65 percent of variance in barrier counts. Structural and social conditions were dominant: cumulative resettlement challenges showed the strongest association with barriers (IRR = 1.60, p<.001), followed by perceived discrimination (IRR = 1.49-1.52, p<.001) and neighborhood unsafety (IRR = 1.34, p<.01). Poorer physical health modestly increased barriers (IRR = 1.14, p<.05), while residing in the United States for two to three years was protective (IRR = 0.81, p<.05). The model demonstrated excellent classification performance (AUC = 0.858).</p><p><strong>Discussion and implications: </strong>Healthcare access barriers among older refugees reflect structural adversity and social exclusion rather than individual characteristics alone. Findings support ecological models emphasizing multilevel determinants and suggest interventions should address resettlement coordination, discrimination reduction, and community welcoming alongside healthcare system improvements to achieve equity for aging refugee populations.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845708","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":"Lifestyle, socioeconomic and biological determinants of survival in Nonagenarians and Centenarians: A systematic review and meta-analysis.","authors":"Óscar Caballero, Antonio García-Hermoso, Juan Hurtado-Amonacid, Rodrigo Yáñez-Sepúlveda, José Francisco López-Gil, Yasmin Ezzatvar","doi":"10.1093/geront/gnag079","DOIUrl":"https://doi.org/10.1093/geront/gnag079","url":null,"abstract":"<p><strong>Background and objectives: </strong>Identifying factors associated with survival beyond age 90 is essential for understanding healthy aging trajectories. This study sought to investigate the associations between biological, socioeconomic, and lifestyle factors and survival in individuals aged ≥90 years.</p><p><strong>Research design and methods: </strong>Systematic review with meta-analysis. Cohort studies reporting information on lifestyle, socioeconomic and biological determinants of survival in individuals aged ≥90 years (nonagenarians, centenarians, and supercentenarians) were searched in the MEDLINE, EMBASE, and Web of Science databases up to June 2025. Random effects meta-analyses via the empirical Bayes method generated pooled hazard ratios (HRs). Meta-regression and sensitivity analyses were conducted.</p><p><strong>Results: </strong>Twenty-three studies were included. Being a woman (HR = 0.83; 95% confidence interval [CI], 0.80-0.86), having normal cognition (HR = 0.55; 95%CI, 0.40-0.76), having activities of daily living (ADL) independence (HR = 0.69; 95%CI, 0.63-0.76), having high handgrip strength (HR = 0.69; 95%CI, 0.48-0.99), not smoking (HR = 0.83; 95%CI, 0.74-0.93), and alcohol abstinence (HR = 0.88; 95%CI, 0.78-0.99) were associated with lower mortality. Education level was not significantly associated with survival. Meta-regression revealed no modifying effect of age or follow-up length. Multivariate meta-analysis confirmed the independent contribution of each factor and ranked ADLs (p < 0.001), cognition (p < 0.001), and handgrip strength (p < 0.001) as the top three survival predictors.</p><p><strong>Discussion and implications: </strong>Survival in the oldest-old is closely linked to female sex, preserved cognitive and physical function, and healthy lifestyle choices. The consistent predictive value of ADLs, cognition, and handgrip strength highlights the relevance of modifiable factors for promoting longevity, even in advanced age.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845654","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":"Lifestyle Migration for Retirement: Intentions and Influencing Factors Among Adults Aged 45 and Older in China-a Scoping Review.","authors":"Yanyi Liu, Hong Yan, Yanjun Huang, Chuan Pu, Fei Wang","doi":"10.1093/geront/gnag093","DOIUrl":"https://doi.org/10.1093/geront/gnag093","url":null,"abstract":"<p><strong>Background and objectives: </strong>As an emerging retirement model, lifestyle migration is garnering growing interest among China's middle-aged and older adults. However, existing research on the factors influencing willingness to engage in this form of migration remains fragmented and lacks comprehensive synthesis.</p><p><strong>Research design and methods: </strong>Following the PRISMA-ScR guidelines, a systematic search was conducted across CNKI, Wanfang, CQVIP, NSSD, Web of Science Core Collection, PubMed, Embase, and CINAHL Complete databases (from inception to 2026.03). The Population-Concept-Context (PCC) framework guided the inclusion and exclusion criteria, encompassing all studies on retirement relocation intentions and influencing factors among Chinese adults aged 45 and older adults. Two researchers independently screened the literature and extracted data, with findings synthesized through thematic analysis.</p><p><strong>Results: </strong>26 documents were included (25 Chinese, 1 English), published between 2014 and 2026, covering 16 Chinese provinces, municipalities, or autonomous regions. Most used cross-sectional designs and focused on urban residents (total sample = 9,452). Willingness rates ranged from 17.6% to 89.08%. Maslow's Hierarchy of Needs was the most widely applied theory. Influencing factors fell into five categories: individual characteristics, family and social support, objective conditions of the destination, psychological and behavioral intentions, and institutional and structural constraints.</p><p><strong>Discussion and implications: </strong>Existing studies preliminarily uncover the multidimensional mechanisms of travel-based retirement willingness but lack consistent measures and strong theoretical grounding. Future work should strengthen interdisciplinary collaboration, develop localized theoretical models, and address the needs of rural, older adults, and vulnerable populations to advance an inclusive aging care system.</p><p><strong>Registration doi: </strong>10.17605/OSF.IO/5SC2D.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845667","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}