The relationship between fear of disease progression and social isolation in stroke patients: The mediating role of self-perceived burden and self-disclosure.

Introduction: Multicentric Carpotarsal Osteolysis (MCTO) is a rare, genetic disabling disease beginning in early childhood, resulting in the destruction and resorption of carpal and tarsal bones. The aim of this study was to describe the occupational therapy intervention on a child with MCTO to evaluate the impact of the treatment on daily function, autonomy, and participation in activities of daily living. Methods and case description: Interventions focused on self-care, power wheelchair mobility, and environmental adaptations. The Canadian Occupational Performance Measure measured the child’s progress. After 5 months, he was independent in directing his care and driving his power wheelchair; he also increased participation in games and social activities with peers. Conclusions: The intervention process and the occupational therapist’s role are detailed. This study contributes to future research to create standards of care aimed at improving patients’ functional independence and quality of life.

Socio-religious activities play a crucial role in strengthening solidarity and Islamic brotherhood within communities. This article describes efforts to revitalize Islamic brotherhood through a series of socio-religious sharing programs in Allaere Village, Tanralili District, Maros Regency. The programs included distributing dates before iftar, organizing communal fast-breaking, distributing Iqra and Dirosah books to enhance religious literacy, conducting social services, and delivering food packages to underprivileged residents. This study employed a descriptive qualitative method using field observations and documentation. The findings indicate that these sharing activities enhanced social interaction, reinforced emotional ties among residents, and fostered a spirit of cooperation and care for others. Additionally, the programs increased community participation in religious and social activities, reflecting strengthened Islamic brotherhood values. Overall, the socio-religious sharing movement proved to be an effective approach to promoting harmony, collective awareness, and social resilience in a rural Islamic community.

ObjectiveTo analyze potential subtypes and influencing factors of oral frailty in older ischemic stroke patients. To support clinical professionals in precisely identifying high-risk populations and to offer a scientific foundation for the creation of tailored and accurate nursing interventions.MethodA total of 319 older ischemic stroke patients admitted to the Second Affiliated Hospital of the University of South China between December 2024 and February 2025 were selected using a convenience sampling technique. Various assessments were conducted, including the General Information Questionnaire, the Pittsburgh Sleep Quality Index, the National Institutes of Health Stroke Scale, the Geriatric Depression Scale-15, and the Oral Frailty Index-8. Different subtypes of oral frailty were explored using latent profile analysis. Univariate analysis and multinomial logistic regression were performed to investigate the factors influencing the subtypes of oral frailty.ResultsOral frailty in older ischemic stroke patients can be classified into three categories: oral function decline—high oral frailty group (21.32%); medium in all dimensions—moderate oral frailty group (27.27%); and active social participation—low oral frailty group (51.41%). Multifactorial analysis indicated that age, cognitive impairment, depression, illness recurrence, living alone, albumin, total cholesterol, prothrombin time, and homocysteine are significant factors for moderate and high levels of oral frailty.ConclusionThis study delineated three distinct subtypes of oral frailty. It is imperative for healthcare professionals to pay particular attention to moderate and high levels of oral frailty in older patients with ischemic stroke. Tailored care plans should be devised for various patient subgroups to enhance their oral health outcomes.

Background: Cognitive impairment is a major health problem, so several studies worldwide have studied its aggravating and protective factors. However, few studies have looked into the prediction of better or worsening cognitive status based on the presence of the most relevant biopsychosocial factors. Thus, the aim of this study is to predict cognitive status classification, specifically into normal cognitive status, mild cognitive impairment, and severe cognitive impairment, based on the most studied risk and protective factors in the context of the Survey of Health, Ageing and Retirement in Europe and Harmonized Cognitive Assessment Protocol association (SHARE-HCAP) project. Methods: Participants were from five European countries, and measures included their cognitive status classification from SHARE-HCAP and several associated factors previously measured in the eighth wave of SHARE. Results: A multinomial logistic regression was performed, with normal cognition as the reference category. Most individuals were correctly classified. Conclusions: Frequent participation in social activities and good cognitive task performance were associated with a lower likelihood of mild cognitive impairment compared to normal cognitive status. In turn, higher scores in depression and social network were associated with an increased likelihood of being classified as MCI in contrast to normal cognition. Additionally, being a woman and having worse cognitive performance were predictors of severe cognitive impairment classification over normal cognition status. Depression also contributed to a higher likelihood of being classified as mild and severe cognitive impairment, in contrast to a normal cognitive status. These findings highlight the importance of preventive medical check-ups and interventions before the onset of the first cognitive decline symptoms.

ObjectivePopulation aging has intensified mental health challenges among middle-aged and older adults. This study examines how government attention to aging issues affects mental health outcomes in this demographic.MethodsUsing data from the China Health and Retirement Longitudinal Study (CHARLS) and municipal government work reports collected between 2011 and 2020, we constructed a government attention index. We employed fixed effects models to analyze the impact on depressive symptoms among middle-aged and older adults, exploring underlying mechanisms and population heterogeneity.ResultsHigher government attention significantly reduces depressive symptoms among middle-aged and older adults, with stronger effects observed in men and rural populations. Four key mechanisms drive these improvements: environmental enhancement, expanded social welfare, increased adult children visitation, and improved family financial status. Government attention also promotes participation in social and cultural activities but shows no significant impact on adult children’s economic support or sleep duration.ConclusionGovernment attention to aging issues substantially improves mental health outcomes among middle-aged and older adults. Policymakers should strengthen responses to create more supportive social environments for this growing demographic.

AimsDepression among middle-aged and older adults is a critical public health priority. Clarifying the dynamic evolution of depression is essential for establishing prevention and intervention strategies; however, relevant research is limited. The aim of this study was to elucidate the transition patterns underlying different depressive symptoms (DS) states.MethodsData from the China Health and Retirement Longitudinal Study were utilised in this study, which included participants aged ≥45 years with multiple DS assessments via the Center for Epidemiological Studies Depression Scale. Multi-state Markov models were employed to estimate transition probabilities and intensities between DS states, the total length of stay and mean sojourn time in each state and the hazard ratios (HRs) of factors.ResultsAmong 19,991 participants (average follow-up: 7.3 years), the 10-year cumulative probabilities of transition from non-DS to depressive states increased by 19.4% in males and 31.8% in females. Mild DS was the most unstable state, with the highest transition intensities (males: 1.029; females: 0.970) and shortest sojourn time (males: 0.959 years; females: 1.022 years). Sex and age strongly influenced depressive state transitions. Compared to participants without chronic disease, those with ≥3 chronic diseases had a higher risk of developing mild DS (HR = 1.685, 95% Confidence Interval [CI]: 1.530–1.856) and transitioning to death from both the non-DS (HR = 2.905, 95% CI: 2.293–3.681) and severe-DS (HR = 3.429, 95% CI: 1.290–9.112) states, but a lower likelihood of recovery from mild DS (HR = 0.821, 95% CI: 0.749–0.900) and severe DS (HR = 0.730, 95% CI: 0.630–0.847). Compared to no participation in social activities, frequent participation was associated with a lower risk of progression to the mild-DS state (HR = 0.851, 95% CI: 0.785–0.920) and a greater likelihood of recovery from severe DS (HR = 1.169, 95% CI: 1.034–1.322). Being underweight was associated with an increased risk of mild-DS onset (HR = 1.338, 95% CI: 1.129–1.587) and transitioning to death from both the non-DS and mild-DS states, compared with individuals of normal weight.ConclusionsOur study revealed a continuous population shift towards depressive states and identified the mild-DS state as a critical intervention state owing to its instability. In addition to sex and age, modifiable factors, including chronic disease conditions, social activity participation and weight status, significantly influenced DS-state transitions, offering actionable insights for precision prevention strategies.

An interactive dynamic online nomogram for predicting the heterogeneous trajectories of intrinsic capacity among older adults.

Patterns of social participation among people with developmental disabilities and associated factors in South Korea.

This study aims to analyze the transformation of traditional literary values into the attitudes and behaviors of school students. Traditional literature, as part of the nation’s cultural heritage, contains moral, ethical, social, and religious values that are highly relevant to shaping the character of the younger generation. However, globalization and the rapid development of information technology have diminished students’ appreciation of traditional literary works. This research employed a qualitative approach with a descriptive-analytical method. Data were collected through observations, in-depth interviews with teachers and students, and analysis of learning documents. Data analysis followed the interactive model of Miles and Huberman, consisting of data reduction, data presentation, and conclusion drawing, with validation conducted through source and technique triangulation. The findings indicate that integrating traditional literature into Bahasa Indonesia learning and extracurricular activities can instill values such as mutual cooperation, respect, responsibility, and honesty in students. Changes were evident in improved discipline, mutual respect, and active participation in school social activities. This study recommends strengthening a local wisdom-based curriculum to enhance character education through traditional literature.

Pennsylvania recently developed "Aging Our Way" to guide age-friendly policies and programs. Age-friendly policies reduce physical and social barriers to participation, but little information is available on how older people and younger people with disabilities characterize the age-friendliness of their environments. This study assessed the perceptions of adults with disabilities across the life course using a web-based survey based on the Age-friendly Community framework. The survey was available online, promoted at public meetings conducted by Pennsylvania Department on Aging (PDA) staff, and distributed via affiliate organizations. Results (n = 5,072) show that younger adults with disabilities (age 21-59) report lower levels of participation in social and community activities than older adults (age 60 +). Older and younger people with disabilities face similar barriers (e.g., transportation and accessibility). Age-friendly features were consistently associated with better physical health and lower social isolation. Including younger adults with disabilities is important for informing the design and impact of age-friendly policies.

BackgroundTo date, the social participation of breast cancer survivors has mainly been studied in terms of their return to work, while long-term studies on participation in social activities are rare. Against this backdrop, we analyze the influence of socioeconomic and sociodemographic factors on breast cancer survivors’ social activities on average five years following first surgery. Furthermore, we identify social subgroups that are most affected by low levels of social activities, taking long-term breast cancer-related complaints into account.MethodsThe study population is based on a multicenter longitudinal study on return to work after breast cancer. We used data of a third follow-up study with n = 372 breast cancer survivors, corresponding to a response rate of 81.9% with regard to the first sample. Participation in social activities comprises the dimensions of ‘sociocultural participation’, ‘social participation in institutions’ and ‘social participation in the private sphere’. Logistic regression analyses and CHAID decision tree analyses were applied to analyze the influence of socioeconomic factors (school education, income and occupational position), sociodemographic factors (age, marital status, labor force participation and migration status) and the number of cancer-related complaints on social participation.ResultsFive years after the primary surgery, younger survivors (≤ 61 years) with a high number of breast cancer-related complaints showed the greatest limitations in ‘social participation in the private sphere’. Marital status, labor force participation and migration status were of less importance in all the dimensions of social participation considered. By contrast, all socioeconomic factors proved to be significantly associated with sociocultural participation. In particular, women with a low household income with more than two breast cancer-related complaints were identified as a vulnerable group in terms of low sociocultural participation.ConclusionsWe found evidence of social inequalities in participation in social activities among breast cancer survivors. Our results indicate that a comprehensive assessment of social participation and early intervention are required to prevent long-term limitations in social activities, especially in socially disadvantaged breast cancer survivors.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12885-025-15297-0.

This study aims to understand how volunteer activities in social service activities affect the emotional well-being of the participants, especially from a social education perspective. This study was conducted on four Peduly Tangerang volunteers involved in social activities in various institutions such as orphanages, nursing homes, disability foundations, and ODGJ foundations. The research method used a descriptive qualitative approach with in-depth interviews. The results showed that participation in social activities resulted in significant changes in the volunteers' emotional condition, such as increased gratitude, happiness, and mental stress. Social activities also serve as an effective means of social learning in fostering empathy and social awareness. Volunteer activities function as a form of non-formal character education that plays a role in building solidarity and sustainable emotional well-being.

IntroductionPermanent ostomy surgery has been shown to improve patient survival rates; however, it also results in changes to body image, bowel habits, and lifestyle. These changes can significantly affect both the physical and mental well-being of patients, ultimately impacting their overall quality of life (QOL).ObjectiveThis study examines the effectiveness of the Information-Knowledge-Attitude-Practice (IKAP) nursing model in patients with permanent stomas, with a particular focus on its impact on self-efficacy and QOL. The goal is to enhance the self-care abilities of patients and their families, thereby promoting a swift return to normal social activities.MethodsA retrospective study design was used to select patients who underwent permanent ostomies in the Department of General Surgery at the hospital, between January 2015 and December 2022. Both the IKAP group (IKAP nursing model) and the control group included 94 patients. IKAP group included: (1) establishing an intervention group; (2) developing a public relations strategy and a tailored education program; (3) applying health education; and (4) implementing behavioral intervention. The two groups with various nursing modalities were assessed using the Basic Demographic Data Questionnaire, the Self-Efficacy Scale for Stoma Patients, the Quality-of-Life Scale for Stoma Patients, and data on stoma complications. SPSS software (version 20.0) was used for general description and single-factor analysis of data for comparison between groups.ResultsThree months postoperatively, the IKAP group performed better than the control group in terms of self-efficacy (92.09 10.12 vs 66.17 12.83, t = 8.219, P = 0.000). There was significant difference in the ostomy complication rate between the two groups (6 [6.38%] vs 17 [18.09%], c2 = 3.946, P = 0.041). In terms of QOL, the IKAP group scored better in the functional dimension and symptom dimension.ConclusionThe IKAP model can effectively improve self-efficacy and QOL, reduce complications, and enhance participation in social activities and family life for patients with permanent enterostomy.

This study centers on retirement planning achievement, examining its impact mechanism on older adults’ mental health and its boundary conditions. Drawing on self-determination theory (SDT) and conservation of resources (COR) theory, we tested a parallel mediation and a moderated mediation model using data from an online survey with 900 Chinese retirees aged 55–74. Structural equation modelling revealed that retirement planning achievement directly and positively predicted mental health, and indirectly through three pathways: greater active social participation, higher retirement enjoyment, and reduced retirement loss. Furthermore, retirement adjustment exhibited dual, and opposing, moderating effects on the direct path: low retirement loss, as a psychological resource, significantly amplified the positive impact of planning achievement (a resource gain spiral), whereas high retirement enjoyment attenuated its effect (a ceiling effect). Income-group analysis revealed that both the parallel mediation and moderated mediation models were fully supported in the average-income group, but effects were non-significant for the insufficient-income group and weakened in the sufficient-income group. These findings suggest that retirement planning achievement represents a key pathway to promoting mental health in later life, but its benefits are constrained by psychological resources and socioeconomic status. The “achievement dividend” is greatest among well-adjusted retirees in the average-income group, highlighting the heterogeneity in retirement adjustment and providing evidence for targeted, equitable ageing-support policies.

Development-induced displacement and resettlement is a complex process that disrupts the social, economic, and cultural lives of affected communities. Women, in particular, are disproportionately impacted due to their central roles in household management, community engagement, and cultural preservation. Understanding how resettlement affects women’s social security is critical for designing equitable and effective resettlement policies. This study aims to examine the social and economic impacts of development-induced resettlement on women’s social security, focusing on how displacement alters access to livelihoods, social networks, cultural roles, and overall well-being. The study adopts a qualitative approach based on secondary data. Scholarly journal articles published in refereed academic journals were reviewed, and qualitative content analysis was used to systematically interpret the literature. Michael Cernea’s Impoverishment Risks and Reconstruction (IRR) Model was applied as an analytical framework to assess the socio-economic risks women face during and after resettlement. Findings indicate that development-induced resettlement significantly affects women’s social security across multiple dimensions. Socially, resettlement disrupts traditional networks, weakens community bonds, and reduces women’s participation in cultural and social activities. Economically, women face landlessness, joblessness, reduced access to resources, and increased workloads, particularly when male household members migrate for employment. These impacts exacerbate psychological stress, health vulnerabilities, and food insecurity. The study highlights that women’s social security is closely tied to household and community stability, and disruptions in women’s roles have cascading effects on families and communities. Cernea’s IRR Model effectively captures these multidimensional risks, illustrating how each risk uniquely impacts women during resettlement. Development-induced resettlement poses multidimensional challenges to women’s social security. To mitigate these impacts, resettlement planning must incorporate gender-sensitive policies, transparent communication, and active involvement of women at all stages. Ensuring women’s access to resources, decision-making, and compensation is essential for safeguarding their social security, supporting family well-being, and promoting sustainable community development.

Purpose: This study aimed to examine the multidimensional factors associated with the completion of advance directives (ADs) among community-dwelling older Koreans, guided by conceptual frameworks developed in Asian contexts.Methods: Data from the 2023 National Survey of Older Koreans (sixth wave) were analyzed for 9,951 community-dwelling older Koreans aged 65 years or older. Complex sample cross-tabulation and binary logistic regression analyses were conducted.Results: In total, 11.1% of community-dwelling older Koreans had completed an AD. Significant factors associated with AD completion were identified across four domains—personal situation: age, educational level, religion, and housing preference in the event of poor health; socio-cultural: presence of children, participation in social activities and satisfaction with social relationships; physical and illness: the number of chronic diseases; and value system: awareness of hospice and palliative services, participation in death preparedness education, and documentation of organ donation.Conclusion: Among older Koreans, AD completion represents more than a documentation process; it reflects a complex decision-making process shaped by their values and life circumstances, underscoring the need for supportive interventions. As the highest AD completion rates are found among older adults, related policies should be aligned with older adult-centered policy frameworks.

BackgroundCognitive impairment has become a major public health issue. Depressive symptoms and cognitive impairment are closely related disorders in the aging population. However, the effect of proactive health on the association between depressive symptoms and cognitive impairment was not clear. This study aimed to examine the mediating role of proactive health in the effect of depressive symptoms on cognitive impairment.MethodsThis population-based cross-sectional study recruited 3607 participants aged 60 and above from the China Health and Retirement Longitudinal Study. Direct relationships between depressive symptoms, proactive health, and cognitive impairment were analyzed using multiple logistic regression. The bootstrap method was used to test the mediating role of proactive health in the effect of depressive symptoms on cognitive impairment.ResultsAfter adjusting the confounders, participants in the depressive symptoms group (OR 1.223, 95% CI: 1.047–1.429) and depression group (OR 1.889, 95% CI: 1.399–2.551) had an increased risk of cognitive impairment, while those who had fair proactive health (OR 0.623, 95% CI: 0.458–0.873) and good proactive health (OR 0.454, 95% CI: 0.319–0.648) had a decreased risk of cognitive impairment. The mediation effect of proactve health accounted for 7.19% of the total effect regarding depressive symptoms with cognitive impairment.ConclusionsThis study revealed that depressive symptoms not only directly influenced cognitive impairment among older adults but also indirectly via proactive health. Exercise should be encouraged among the older people to promote their participation in social activities, thereby improving their proactive health and ultimately preventing cognitive impairment.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-025-06525-0.

Background Health promotion interventions supporting the development of strategies for social participation when ageing is an important concern within occupational therapy. Therefore, a new intervention has been developed. Aim To present a protocol for a feasibility study evaluating the feasibility of Health Web 1.0, a web-based occupational therapy group intervention supporting older adults’ social participation and meaningful activities in daily life. Material and methods This feasibility study follows the framework for developing and evaluating complex interventions. This study will be conducted using a pre-test and posttest design without a control group to evaluate feasibility and potential results. Qualitative and quantitative data will be collected concurrently in a mixed-method design. The Health Web 1.0 will be conducted in municipal primary healthcare settings. The intervention is provided through a digital communication platform, delivered by occupational therapists. Results Not applicable (N/A). Conclusions and significance The intervention will have significance for occupational therapists to adapt to a more proactive role in supporting a meaningful everyday life when ageing. Additionally, the group format and digital delivery of the intervention will provide possibilities to use resources more effectively.

Chronic diseases are highly prevalent among older adults and may be associated with their ability to achieve successful aging, which encompasses five key components: absence of major chronic diseases, freedom from disability, high cognitive function, no depressive symptoms, and active social participation. However, many disease conditions are excluded from conventional definitions of successful aging. This study aims to quantify the predictive effects of multiple chronic diseases on overall successful aging and its five core components, thus providing new evidence to refine aging frameworks. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) covering the years 2011, 2013, and 2015. Six common chronic diseases not traditionally included in the successful aging definition were selected: hypertension, dyslipidemia, arthritis, kidney disease, liver disease, and digestive disease. Six machine learning models were applied to construct prediction frameworks of successful aging and chronic diseases. The SHapley Additive Explanations (SHAP) and ALE (Accumulated Local Effects) analyses were used to quantify the impact of each chronic disease on the prediction of successful aging, providing both global and individual-level interpretability. Logistic regression was conducted to examine the associations between key diseases identified by SHAP and the five components of successful aging. A total of 4,385 participants were included initially in this study, and a total of 1,104 participants were selected after propensity score matching for subsequent analysis. After hyperparameter tuning with Optuna, the XGBoost model was chosen for model interpretation and prediction (F1 = 0.781, F2 = 0.891, AUC = 0.707, AUPRC = 0.724). SHAP analysis indicated that hypertension, kidney disease, and arthritis were the most influential predictors of successful aging. Additionally, SHAP results highlighted that sleep duration was also among the most important features. Subsequent logistic regression further revealed that, beyond their associations with the disease component, kidney disease and arthritis were significantly linked to depressive symptoms and cognitive function, while hypertension was strongly associated with physical functioning. Our findings highlight that several chronic diseases not traditionally included in successful aging criteria are significantly associated with aging outcomes. Extending the disease spectrum within the definitions of successful aging may enhance individual-level assessment and provide insights for future research on targeted health interventions for the older adults. Furthermore, these findings may help raise awareness of health factors associated with successful aging.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-24154-w.