Search Results (738)

Social robots hold promise for enhancing later-life support, but user needs and preferences for multimodal interaction modalities remain underexplored. This study explores awareness, willingness, perceived barriers, and modality–function associations across multiple interaction modalities among middle-aged and older adults, and proposes a conceptual five-layer architecture for design guidance. A questionnaire survey with 199 Chinese respondents (aged 45–64: 89.4%, 65+: 10.6%) examined perceptions of voice, visual, gestural, affective, sEMG, and brain–computer interface interactions. Voice and visual modalities were the most preferred; gesture and affective interactions were moderately accepted; awareness of sEMG was high but may reflect confusion with other sensor technologies; and BCI awareness and willingness were low. Based on survey findings and the literature, a conceptual five-layer architecture is presented to inform future social-robot design. The sample predominantly comprised middle-aged participants, so findings reflect prospective later-life users rather than the broader older-adult population. This study offers user-centered insights into multimodal social-robot interaction and provides design implications for future development rather than evaluating emotional-health interventions. Full article

Background: The diffusing capacity of the lung for carbon monoxide (DLCO) is a key measure of alveolar–capillary gas exchange, but its clinical significance in chronic obstructive pulmonary disease (COPD) remains incompletely defined. This study aimed to characterize the demographic, clinical, functional, and comorbid profiles of COPD patients stratified by the degree of DLCO impairment, and to evaluate the potential value of DLCO as a marker for disease severity and clinical phenotyping in a Chinese cohort. Methods: This single-center retrospective cross-sectional study enrolled 650 patients diagnosed with COPD (according to GOLD 2025 criteria) who underwent pulmonary function tests between January 2024 and February 2025 at the university-town hospital of Chongqing Medical University. Patients were stratified by predicted DLCO% into four groups: normal (≥80%), mild impairment (60–79%), moderate impairment (40–59%), and severe impairment (<40%). Demographic, clinical, laboratory, pulmonary function, echocardiographic, and chest CT data were collected. Comparisons across groups were performed using ANOVA/Kruskal–Wallis tests, chi-square or Fisher’s exact tests, and Spearman correlation analysis (IBM SPSS Statistics 25.0). Due to the exploratory nature of the study, no adjustment for multiple comparisons was applied. Results: Progressive DLCO impairment was associated with a higher proportion of male patients (69.2% to 90.9%, p = 0.018), older age (67.3 ± 9.0 to 72.9 ± 6.7 years, p < 0.001), lower BMI (median from 23.9 to 20.0 kg/m², p < 0.001), and higher smoking prevalence (58.7% to 87.5%, p = 0.001). The prevalence of pulmonary tuberculosis rose markedly (0.58% to 9.09%, p = 0.037). All spirometric parameters declined (e.g., FEV1%pred from 67.3% to 32.6%, p < 0.001). Systemic inflammatory markers (NLR, SII) increased, while hemoglobin and albumin decreased (both p < 0.001). Respiratory failure occurred in 30.0% of the severe DLCO group (predominantly type I, p <0.001). Echocardiography revealed a decline in left ventricular ejection fraction (61.2 ± 5.0% to 59.1 ± 4.0%, p = 0.012) and a trend toward higher pulmonary hypertension risk (27.8%, p = 0.056). DLCO%pred correlated positively with FEV1%pred (r = 0.394, p < 0.001) and oxygen saturation (r = 0.151, p < 0.001), and negatively with NLR (r = −0.165, p < 0.001) and SII (r = −0.149, p < 0.001). Conclusions: In COPD, DLCO impairment is associated with distinct clinical phenotypes, including male sex, advanced age, malnutrition, increased tuberculosis risk, worse lung function, systemic inflammation, and respiratory/cardiac dysfunction. These findings support DLCO as a valuable complementary marker for disease severity characterization in COPD. Longitudinal studies are needed to confirm its prognostic value. Full article

Background: Although the application of smart home technology in the Chinese eldercare market is widespread, its effectiveness from the users’ perspective remains underexplored. This qualitative study examines the perceptions and experiences of older adult users in adopting and applying the Care-on-Call services (Ping An Tong; PAT), a prominent example of smart home technology for eldercare in Mainland China. Methods: Individual and dyadic interviews were conducted with 28 older adult users from diverse physical, socioeconomic, and familial backgrounds. Thematic analysis was performed. Results: Two overarching themes were illustrated based on thematic analysis. First, the multifaceted challenges of using PAT encompass an incomplete cognition of the services, unfamiliarity with PAT systems, psycho-cultural resistance, ‘do it yourself, don’t bother others’, economic concerns of additional costs, and ethical concerns regarding information security and privacy. Second, bridging the technology divide highlights the empowerment of PAT use among older adults through a variety of educational methods to effectively utilize the services, enhancing service effectiveness through the integration of smart home technology and social service provision, and increasing service accessibility through inclusive services. The disparities in smart home technology application between China and the West are also discussed. Conclusions: Psychosocial support, organizational programs, and the integrated service model are recommended to promote the utilization of smart home technology among older adults in China. Full article

Introduction: Chinese seniors in North America represent a growing population, and Traditional Chinese medicine (TCM) continues to play an important role in their health practices; however, TCM use has not been comprehensively synthesized from an immigrant perspective in North America. The purpose of this scoping review is to explore the use of TCM by Chinese seniors in Canada and the United States of America (USA). Methods: This scoping review is written in accordance with PRISMA guidelines. PubMed, PsycINFO, CINAHL, AgeLine, ERIC, ProQuest, Nursing and Allied Health Database, PsycARTICLES, Sociology Database, and Education Research Complete were selected for the literature search, which was conducted in August 2025. Articles were included if they investigated the use of any form of TCM among Chinese seniors aged 65 years or older living in the USA and Canada, and were published in an English-language peer-reviewed journal. Results: Twenty-four studies were included in this review, with a total sample size of 7288. The findings indicated that, in the majority of the included studies, over half of the Chinese seniors used some form of TCM. TCM therapies included over-the-counter herbal products, TCM-based physical activities, TCM practitioner consulting, and TCM food practices and therapies. Use of TCM among Chinese seniors was related to musculoskeletal symptoms, cardiovascular symptoms, mental health, severe acute respiratory syndrome prevention, cancer screening, and oral health. Chinese seniors tend to integrate TCM with Western medicine in their healthcare practices. Several factors from individual, familial, and community levels influenced Chinese seniors’ use of TCM. Conclusions: Future research should investigate the integration of TCM with Western healthcare, the training of healthcare providers to improve their understanding of TCM, and the underlying mechanisms of TCM products. Full article

Insomnia is common among older adults and is associated with adverse health outcomes, yet evidence on its relationship with healthy lifestyle in Chinese older adults is limited. This study included 4929 participants from the Hubei Memory and Aging Cohort Study (HMACS). A healthy lifestyle score (range 0–6) was constructed based on body weight, drinking alcohol, smoking, regular exercise, diet, and cognitive activity. Participants were categorized into unfavorable (0–2), average (3), and favorable (4–6) lifestyle groups. Insomnia was defined using the Athens Insomnia Scale (AIS ≥ 6), or the Pittsburgh Sleep Quality Index (PSQI > 5). Multivariable logistic regression models were applied to assess the associations of overall and individual healthy behaviors with insomnia risk. Stratified analyses by smoking status and substitution analyses were conducted. Healthier lifestyle was associated with lower risk of insomnia. Compared with the unfavorable group, participants with favorable lifestyle had a 17.5% lower risk of insomnia. Among individual lifestyle behaviors, healthy diet and active cognitive activity were associated with reduced insomnia risk. Stratified analyses showed these associations were only evident among non-current smokers. Substitution analyses suggested that replacing unhealthy behaviors with healthy ones was associated with a lower insomnia risk. Favorable lifestyle, particularly healthy diet and active cognitive activity, is associated with lower insomnia risk among older adults, with stronger associations observed among non-current smokers. Full article

Glioma prognosis is shaped by molecular markers such as IDH mutation, WHO grade, and MGMT methylation, yet heterogeneity persists within defined subgroups. Sidekick Cell Adhesion Molecule 1 (SDK1), an immunoglobulin superfamily member mediating homophilic adhesion, has been documented in glioma tissue but lacks systematic prognostic evaluation. I assessed SDK1’s prognostic value using the Chinese Glioma Genome Atlas (CGGA, N = 503) and The Cancer Genome Atlas (TCGA, N = 572) through multivariate Cox regression, subgroup analyses, differential gene expression, pathway enrichment, ssGSEA-based immune profiling, and molecular subtype association. High SDK1 expression was independently associated with poor overall survival in both cohorts (CGGA: adjusted HR = 1.48, 95% CI 1.16–1.89, p = 0.002; TCGA: HR = 1.76, 95% CI 1.19–2.61, p = 0.005; pooled HR = 1.55, I² = 0%). Effect estimates varied across subgroups, with significant associations in WHO grade IV and IDH-wildtype strata but not in grade II or older patients. Cross-validated differentially expressed genes were enriched in extracellular matrix organization and focal adhesion pathways. Notably, SDK1 expression showed weak but statistically significant correlations with COL1A1-associated mesenchymal program scores (CGGA: R = 0.12, p = 0.008; TCGA: R = 0.15, p < 0.001) and oncostream-related gene signatures (CGGA: R = 0.16, p < 0.001; TCGA: R = 0.086, p = 0.039), suggesting a modest association with mesenchymal invasion programs. SDK1-high tumors showed elevated M2 macrophage and Treg signatures with upregulated immune checkpoints, though cohort-dependent differences were observed. Multivariate Cox analysis demonstrated that the prognostic significance of SDK1 is independent of tumor mutational burden (TMB), with no significant correlation or interaction observed between them (p > 0.05). SDK1 is a candidate prognostic biomarker in glioma co-occurring with ECM remodeling and immunosuppressive features, warranting experimental validation for clinical translation. Full article

The processing difficulty of subject relative clauses (SRCs) and object relative clauses (ORCs) in Mandarin Chinese has been a controversial issue in psycholinguistics. Memory-based accounts and experience-based accounts make contrastive predictions regarding the processing asymmetry. Given that older adults tend to have lower memory and richer language experience, the processing of relative clauses in older adults can reveal which theoretical account offers a more adequate explanation of sentence comprehension. The present study compared the processing of Mandarin SRCs and ORCs in older and younger adults using a self-paced reading paradigm. The results revealed that both groups showed lower accuracy for SRCs than ORCs, but this effect was larger in older adults. These age-related differences cannot be attributed to different strategic trade-off mechanisms and task experience. During online processing, older adults performed more slowly than younger adults, but no significant interaction was found between age and RC type. These findings suggest that aging affects sentence comprehension at the post-interpretive and decision processes, while online syntactic processing remains relatively preserved but globally slowed. The findings are largely consistent with memory-based accounts, indicating that age-related changes in sentence comprehension may be attributed to memory decline in older adults. Full article

Objectives: This data-driven study aimed to explore the characteristics and initial hearing aid (HA) fitting parameters among older adults in Mainland China. Methods: Data were extracted from Oticon’s internal database, focusing on 82,834 older adults aged 55 or above who sought HAs for the first time. Results: Demographic details (e.g., age and gender), hearing-related data (e.g., the severity of hearing loss), and HA parameters (i.e., laterality of fitting, HA style, earpieces, gain settings, directionality settings, and noise reduction settings) were analyzed. The mean age was 71. There were more males (54.7%) than females, and the majority (78.1%) had at least moderately severe hearing loss. Bilateral fittings were common (76.6%), with receiver-in-canal (RIC) HAs being the dominant style (80%) and open fittings prevalent (44.1%). HA gain was set to below prescribed targets, along with adaptive directionality (93.4%) and low noise reduction levels (>68%). Conclusions: These findings offer insights into the Chinese hearing healthcare market. Future research should incorporate data from follow-up sessions to provide a more comprehensive understanding of the landscape, such as adjustments needed after initial fitting after first-time users have spent some time adapting to the use of HAs. Full article

Selenium (Se) is an essential trace element. The bioactivity of Se arises from its incorporation into the 21st amino acid, selenocysteine (Sec). Twenty-five human genes have been identified that encode selenoproteins, each of which contains at least one Sec residue. Selenoprotein functions include antioxidant responses, thyroid hormone synthesis, and maintenance of cellular redox homeostasis. Due to its role in critical cellular functions, Se deficiency is associated with morbidities of the cardiovascular system and connective tissue in regions of countries with low soil Se content. While these morbidities are geography-specific and have been mitigated in adults through public health interventions, preterm infants remain susceptible to Se deficiency worldwide. Infants born preterm are deprived of fetal Se accrual in the 3rd trimester of pregnancy, a deficiency compounded by higher Se needs than term infants and older infants and dependence on parenteral nutrition (PN) and fortification. In addition, the composition of selenoproteins and selenometabolites in human milk is different from that in formula and PN, yet little is known about the biological impact of these differences. The knowledge gap in optimal Se supplementation is reflected in discrepant guidelines between North American and European/Chinese nutrition societies, whose recommended Se supplementation in preterm infants differs by more than 2-fold. In this review, we describe the biosynthesis, metabolism, and maternal-fetal transfer of Se. In addition, we address how developmentally regulated aspects of metabolism may impact how preterm infants respond to supplementation with different forms of Se. Lastly, we highlight current challenges and recommendations for optimizing Se levels in neonates based on available data. Full article

Background/Objectives: To identify major dietary patterns among adults aged ≥45 years and examine their associations with metabolic health–obesity phenotypes. Materials and Methods: We analyzed 32,091 adults aged ≥45 years from the 2015 China Adults National Chronic Disease and Nutrition Surveillance. Diet was assessed using three consecutive 24 h dietary recalls, with household condiment weighing used to improve estimation of cooking oil and salt intake. Dietary patterns were derived using principal component analysis and categorized into quartiles. Multinomial logistic regression adjusted for energy intake and key sociodemographic/lifestyle factors to estimate odds of metabolically unhealthy non-obesity (MUNO), metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) versus metabolically healthy non-obesity (MHNO). Results: Four patterns with geographic variation were identified: (1) the Rice–Vegetable–Pork pattern; (2) the Fruit–Egg–Dairy pattern; (3) the Red Meat–Offal–Snack pattern; and (4) the Soybeans–Tubers–Grains pattern. Compared with Q1, Q4 of Pattern 1 was associated with lower odds of MHO (OR = 0.42, 95% CI: 0.38–0.46) and MUO (OR = 0.40, 95% CI: 0.36–0.44). Pattern 2 and Pattern 3 were associated with higher odds of MHO (Q4 vs. Q1: OR = 1.42 and 1.21) and MUO (OR = 1.36 and 1.14, all p < 0.001). Pattern 4 was inversely associated with MHO (OR = 0.85, 95% CI: 0.79–0.92) but positively associated with MUNO (OR = 1.16, 95% CI: 1.08–1.24). Conclusions: The Rice–Vegetable–Pork pattern was associated with more favorable obesity-related metabolic phenotypes, whereas energy-dense, animal-derived patterns were associated with higher odds of obesity phenotypes; the Soybeans–Tubers–Grains pattern showed mixed associations. Full article

White lie-telling reflects children’s integration of moral cognition and situational adaptation, yet its mechanisms in prosocial dilemmas remain understudied in Chinese cultural contexts that prioritize “face-saving”—a core construct that shapes interpersonal behavior in Eastern societies. This study investigates how situational cues and developmental differences shape children’s white lie decisions by disentangling the interactive effects of external expectations and recipient presence. A total of 629 children aged 4–11 years (Study 1) and 6–11 years (Study 2) participated in two studies using a modified “painting evaluation task” Study 1 manipulated emotional expectation and recipient presence to establish baseline situational effects, while Study 2 introduced target expectation to create a prosocial value conflict between providing immediate emotional comfort and supporting long-term developmental goals. The Study 1 showed the highest white lie rate under the “emotional expectation + recipient presence” condition, with white lie rates exhibiting a significant developmental increase with age. Binary logistic regression identified these two factors as critical predictors of children’s white lie behavior. In Study 2, amid such prosocial value conflicts, older children showed lower white lie rates than younger peers, who prioritized others’ long-term goals via cost benefit analysis. Notably, recipient presence still moderated face-saving decisions, even for older children. This research makes three key contributions to the field. Firstly, it integrates Chinese “face culture” into situational manipulation, highlighting recipient presence as a culture-specific moderator and mitigating the Western-centric bias in prior research. Secondly, it constructs a prosocial moral dilemma to uncover children’s developmental transition from emotion-driven to value-based rational decision-making, extending existing developmental theories on moral cognition. Thirdly, it advances understanding of prosocial lying motivation beyond blind empathy by quantifying the interactive effects of dual expectations and revealing that children engage in deliberate cost benefit analysis that aligns with others’ overall long-term interests. Full article

Short-form video (SFV) platforms have become a central part of older adults’ digital lives, yet their psychological implications remain theoretically contested. Drawing on social empowerment theory, Self-Determination Theory, attachment theory, and the displacement hypothesis, this study examined whether different sources of social support—family, peer, and community—exert differential effects on life satisfaction through SFV engagement and social connectedness. Survey data were collected from 385 community-dwelling Chinese older adults (mean age = 70.6 years) and analyzed using bootstrapped serial mediation models with 5000 resamples. The results revealed clear source differentiation, as family support most strongly predicted SFV engagement and showed the largest total association with life satisfaction, consistent with a social empowerment mechanism. Community participation showed a weaker but still positive association with engagement, whereas peer support was unrelated to engagement. Across pathways, higher SFV engagement was associated with lower social connectedness, while greater social connectedness was associated with higher life satisfaction. However, none of the chained indirect effects reached significance, suggesting that social support influenced life satisfaction primarily through direct rather than serially mediated pathways. These findings demonstrate the importance of disaggregating social support by source and contribute to a more precise framework for understanding older adults’ digital well-being. Full article

Background: Frailty is a fluctuating health state that may worsen or improve over time and is linked to adverse outcomes, including musculoskeletal disorders such as arthritis. However, evidence on whether frailty changes predict arthritis onset remains limited. This study examined the relationship between changes in frailty status and incident arthritis among Chinese adults aged 45 years and older. Methods: We performed a longitudinal cohort analysis using data from the China Health and Retirement Longitudinal Study (CHARLS). Frailty was quantified with a 30-item Frailty Index (FI) and categorized as robust, pre-frail, or frail. Frailty transitions were defined by changes in FI-based categories across survey waves. Incident arthritis was identified as self-reported physician-diagnosed arthritis during follow-up. Associations between frailty transitions and arthritis onset were evaluated using Cox regression, reporting hazard ratios (HRs) and 95% confidence intervals (CIs). Models were adjusted for demographic characteristics, health behaviors, and biochemical indicators, and sensitivity analyses were conducted to verify result stability. Results: Among 4982 participants (mean age 58.97 years; 45.58% female). Relative to robust individuals, baseline pre-frailty (HR 1.67, 95% CI 1.41–1.97) and frailty (HR 2.76, 95% CI 1.97–3.85) were associated with higher arthritis risk. Participants whose frailty status worsened from robust to pre-frail or frail also showed higher arthritis risk (HR 1.68, 95% CI 1.34–2.10). In contrast, transitions from frail to pre-frail or robust were associated with lower risk (HR 0.44, 95% CI 0.21–0.92). Higher cumulative frailty burden and greater frailty progression were also associated with increased arthritis risk. Conclusions: Frailty transitions are strongly associated with incident self-reported physician-diagnosed arthritis. Monitoring frailty trajectories may improve arthritis risk stratification and support prevention strategies. Full article

Background/Objectives: Frailty is common among rural Chinese older adults despite relatively high daily physical activity, a phenomenon known as the “rural frailty paradox.” Conventional moderate-to-vigorous physical activity (MVPA) metrics rely on absolute cut-points and are often highly correlated with activity volume, limiting their ability to distinguish the roles of activity volume and activity intensity distribution. We therefore applied a cut-point-free accelerometer approach using average acceleration (AvAcc) and intensity gradient (IG) to distinguish activity volume from activity intensity distribution and to examine whether activity intensity distribution, together with diet quality, could help explain the rural frailty paradox beyond total activity volume alone. Methods: In this cross-sectional analysis of the Healthy Aging and Lifestyle Enhancement study, 1203 rural older adults were included. Physical activity (PA) was objectively measured using triaxial accelerometers to derive AvAcc and the IG. Diet quality was assessed using the China Prime Diet Quality Score (CPDQS), and frailty was assessed using the Fried frailty phenotype adapted for rural Chinese older adults. Multiple linear regression, joint effect models, and restricted cubic spline analyses were conducted after adjustment for age, sex, chronic disease status, total energy intake, and related covariates. Results: In mutually adjusted models, higher IG and CPDQS were independently associated with lower frailty scores, whereas AvAcc was not. In the fully adjusted model, IG (β = −0.14, p < 0.001) and CPDQS (β = −0.10, p < 0.001) were inversely associated with frailty score, while AvAcc showed no significant association (p = 0.665). In joint analyses, compared with the low-IG/low-CPDQS group, participants with high IG/high CPDQS had the lowest frailty scores (β = −0.28, p < 0.001), followed by those with low IG/high CPDQS (β = −0.20, p = 0.002). Restricted cubic spline analyses indicated a non-linear association between IG and frailty and an approximately linear inverse association for CPDQS. Conclusions: These findings suggest that, among rural older adults, frailty may be more strongly associated with activity intensity distribution than with total activity volume alone. Together with diet quality, this may help explain the rural frailty paradox. Full article

Objectives: We aimed to investigate the medication experience of older adults with multiple chronic conditions in rural areas and to analyze its associated factors, so as to provide evidence for developing targeted medication management interventions. Design: This was a single-center cross-sectional study. Methods: From June to July 2025, a convenience sample of 539 older adults with multiple chronic conditions was recruited from a county hospital in Henan Province, China. The survey utilized a general information questionnaire, the Chinese version of the Medication Experience Scale, the Safe Medication Knowledge Scale, the Perceived Social Support Scale, the Chinese version of the Chronic Disease Self-Efficacy Scale, and the Chinese version of the Medication Errors Scale. Results: The medication experience score among rural older adults with multiple chronic conditions was (117.14 ± 17.19). Multivariate hierarchical regression analysis revealed that age, marriage status, source of income, medical insurance schemes, duration of medication use, safe medication knowledge, perceived social support, self-efficacy for chronic disease management, and medication errors were significant factors associated with medication experience (all p < 0.05). Conclusions: The medication experience among older adults with multiple chronic conditions in our study sample was at a moderate level. Age, marriage status, source of income, medical insurance schemes, duration of medication use, safe medication knowledge, perceived social support, self-efficacy for chronic disease management, and medication errors were associated factors of medication experience for older adults with multiple chronic conditions. Countermeasures should be implemented to improve medication experience in this population. Full article