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The Healthy Caregiver? A Positive Impact of Informal Caregiving Status on Cognitive Functions Over Time From the Midlife in the United States Study. 健康护理者?美国中年以来非正式照顾状态对认知功能的积极影响研究。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-12-01 Epub Date: 2023-10-21 DOI: 10.1177/08982643231209482
Kallol Kumar Bhattacharyya, Yin Liu, Debasree Das Gupta, Victor Molinari, Elizabeth B Fauth

Objectives: The current study examined whether informal caregivers performed worse, better, or similar to non-caregivers on cognitive tests of executive functioning and episodic memory over 10 years. Methods: Data were from waves 2 (2003-04) and 3 (2013-14) of the Midlife in the United States (MIDUS) study (N = 2086). Multiple linear regression models examined whether caregiving at both waves 2 and 3 predicted better cognitive functioning at wave 3, than caregiving at only one time point or no caregiving (reference) while controlling for baseline covariates (i.e., sociodemographic, health, and functional status).

Results: After controlling for covariates, caregiving at both waves was independently associated with better performance in episodic memory (b = .24, SE = .10, p = .013) but not executive function (b = -.06, SE = .05, p = .246). Discussion:The findings partially supported both healthy caregiver and stress process models, indicating caregiving may be associated with better episodic memory but not executive functioning over time among the middle-aged and older adults.

目的:本研究调查了在10年的执行功能和情景记忆认知测试中,非正式照顾者的表现是否比非照顾者差、好或相似。方法:数据来自美国中年研究的第2波(2003-04)和第3波(2013-14)(N=2086)。多元线性回归模型检验了在控制基线协变量(即社会人口统计学、健康和功能状态)的同时,第2波和第3波的护理是否比只在一个时间点的护理或没有护理(参考)预测了第3波更好的认知功能。结果:在控制协变量后,两波的照顾与情景记忆的更好表现独立相关(b=.24,SE=.10,p=.013),但与执行功能无关(b=-.06,SE=.05,p=.246)。讨论:研究结果部分支持健康照顾者和压力过程模型,这表明在中老年人中,随着时间的推移,护理可能与更好的情景记忆有关,但与执行功能无关。
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引用次数: 0
Racial Differences in Older Adult's Mental Health and Cognitive Symptomatology: Identifying Subgroups Using Multiple-Group Latent Class Analysis. 老年人心理健康和认知症状的种族差异:使用多组潜在类别分析确定亚组。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-12-01 Epub Date: 2023-10-31 DOI: 10.1177/08982643231212547
Se Hee Min, Maxim Topaz, Chiyoung Lee, Rebecca Schnall

Introduction: Little is known on the potential racial differences in latent subgroup membership based on mental health and cognitive symptomatology among older adults.

Methods: This is a secondary data analysis of Wave 2 data from the National Social Life, Health, and Aging Project (N = 1819). Symptoms were depression, anxiety, loneliness, happiness, and cognition. Multiple-group latent class analysis was conducted to identify latent subgroups based on mental health and cognitive symptoms and to compare these differences between race.

Results: Class 1: "Severe Cognition & Mild-Moderate Mood Impaired," Class 2: "Moderate Cognition & Mood Impaired," and Class 3: "Mild Cognition Impaired & Healthy Mood" were identified. Black older adults were more likely to be in Class 1 while White older adults were more likely to be in Class 2 and Class 3.

Discussion: Clinicians need to provide culturally-sensitive care when assessing and treating symptoms across different racial groups.

引言:基于老年人的心理健康和认知症状,人们对潜在亚组成员的潜在种族差异知之甚少。方法:这是对国家社会生活、健康和老龄化项目(N=1819)第二波数据的二次数据分析。症状包括抑郁、焦虑、孤独、幸福和认知。根据心理健康和认知症状进行多组潜在类别分析,以确定潜在的亚组,并比较种族之间的这些差异。结果:确定了1级:“严重认知和轻度中度情绪障碍”、2级:“中度认知和情绪障碍”和3级:“轻度认知和健康情绪障碍”。黑人老年人更可能在1级,而白人老年人更容易在2级和3级。讨论:临床医生在评估和治疗不同种族群体的症状时,需要提供文化敏感的护理。
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引用次数: 0
An Intersectional Analysis of Moral Distress and Intention to Leave Employment Among Long-Term Care Providers in British Columbia. 不列颠哥伦比亚省长期护理提供者道德困境和离职意愿的交叉分析。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-12-01 Epub Date: 2023-11-09 DOI: 10.1177/08982643231212981
Julia Smith, Muhammad Haaris Tiwana, Hasina Samji, Rosemary Morgan, Simran Purewal, Jorge Andres Delgado-Ron

Objectives: In this study, we aimed to explore the relationship between intersectional inequities and moral distress among those working in Long-Term Care (LTC) in British Columbia, Canada. Methods: This was a cross-sectional and retrospective study. We assessed moral distress, of 1678 respondents, using a modified Moral Distress Scale, and an equivalent distress mitigation score, at the intersections of gender and racial/ethnic identity. Then, we explored which worker attributes were more predictive of intention to leave work. Results: We found notable difference in experiences of moral distress across intersecting identities, including high moral distress scores among Indigenous men and women, and white women. Significant differences in mitigation scores were also found by intersectional identities. Discussion: Moral distress was the most important predictor of intention to leave work. The differences across racial and gender identity groups suggest the need for tailored interventions to address moral distress among LTC providers.

目的:在这项研究中,我们旨在探索加拿大不列颠哥伦比亚省长期护理(LTC)工作人员之间的交叉不平等与道德困境之间的关系。方法:这是一项横断面和回顾性研究。我们在性别和种族/民族认同的交叉点上,使用改良的道德痛苦量表和等效的痛苦缓解评分,评估了1678名受访者的道德痛苦。然后,我们探讨了哪些员工特质更能预测离职意向。结果:我们发现,不同身份的人在道德痛苦经历方面存在显著差异,包括土著男女和白人女性的道德痛苦得分较高。跨部门身份也发现缓解得分存在显著差异。讨论:道德困境是离职意向的最重要预测因素。种族和性别认同群体之间的差异表明,需要有针对性的干预措施来解决长期护理提供者的道德困境。
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引用次数: 0
Social Activity Restriction and Psychological Health Among Caregivers of Older Adults With and Without Dementia. 老年痴呆症和非痴呆症护理者的社会活动限制与心理健康。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-12-01 Epub Date: 2023-11-08 DOI: 10.1177/08982643231209089
Elliane Irani, Fei Wang, Kylie Meyer, Scott Emory Moore, Kedong Ding

Objectives: We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups.

Methods: Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with (N = 541) and without (N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers' age, gender, race, education, relationship to care recipient, and self-rated health.

Results: Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting friends and family was associated with higher distress and lower well-being in non-dementia caregivers. Any activity restriction had stronger association with distress for caregivers of older adults with versus without dementia.

Discussion: Findings highlight the need for tailored interventions based on caregivers' perceptions of meaningful social activities and dementia-friendly communities to promote social participation.

目的:我们研究了患有和不患有痴呆症的老年人的照顾者的社交活动限制与心理困扰和幸福感之间的关系,以及确定的两组之间的关系是否不同。方法:使用2017年全国护理研究的数据,我们确定了患有(N=541)和未患有(N=1701)痴呆症的老年人的护理人员。对线性回归模型进行了估计,并根据照顾者的年龄、性别、种族、教育程度、与照顾对象的关系以及自我评估的健康状况进行了调整。结果:限制探访朋友和家人以及参加宗教仪式与痴呆症护理人员的更高痛苦相关。限制探访朋友和家人与非痴呆症护理人员的更高痛苦和更低幸福感有关。任何活动限制都与患有痴呆症和没有痴呆症的老年人的照顾者的痛苦有更强的关联。讨论:研究结果强调,需要根据照顾者对有意义的社会活动的看法和对痴呆症友好的社区进行量身定制的干预,以促进社会参与。
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引用次数: 0
Network Types and Functional Health in Old Age: It is Not Just the Size of the Network That Matters. 网络类型与老年人的功能健康:重要的不仅仅是网络的大小。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-12-01 Epub Date: 2023-10-20 DOI: 10.1177/08982643231209351
Talha Ali, Michael R Elliott, Toni C Antonucci, Belinda L Needham, Jon Zelner, Carlos F Mendes de Leon

Objectives: Findings on the effect of network size and support on functional health are mixed. We examine whether network types, that simultaneously incorporate multiple network characteristics, are associated with functional health in late life.

Methods: Data are from the National Social Life, Health, and Aging Project (N = 3005). We estimated the longitudinal effect of membership in five multidimensional network types on disability in six activities of daily living using negative binomial regression, and on mobility (assessed using a timed walk test) using a generalized linear mixed model.

Results: Compared to those in the large without strain network, older adults in the small, restricted, high contact network had fewer disabilities but worse mobility, while those in the large network with strain also had worse mobility.

Discussion: Care plans focusing on function and mobility should consider multiple aspects of older adults' social networks including network size, diversity, and relationship strain.

目的:关于网络规模和支持对功能健康的影响的研究结果喜忧参半。我们研究了同时包含多种网络特征的网络类型是否与晚年的功能健康有关。方法:数据来源于国家社会生活、健康和老龄化项目(N=3005)。我们使用负二项回归估计了五种多维网络类型的成员资格对六种日常生活活动中的残疾的纵向影响,并使用广义线性混合模型估计了流动性(使用定时步行测试评估)的纵向影响。结果:与没有压力的大型网络中的老年人相比,在小型、受限、高度接触的网络中,老年人的残疾较少,但行动能力较差,而在有压力的大网络中,他们的行动能力也较差。讨论:关注功能和流动性的护理计划应考虑老年人社交网络的多个方面,包括网络规模、多样性和关系紧张。
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引用次数: 0
Variation in Adult Cognition Across Domains and Life Course Place Effects in the UK. 英国成人认知在不同领域的差异和生命历程中的地点效应。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-24 DOI: 10.1177/08982643241264586
Michael Topping, Jason Fletcher, Jinho Kim

This study explores the role that place of birth and place of residence have in variation in cognition in adulthood in the UK. We take advantage of both the large sample size and number of cognitive domains in the UK Biobank to estimate the effect of place of birth and place of residence on adulthood cognition using multilevel modeling. We find, consistent with studies in the US, that place effects at both time points contribute modest variation (<3% of the variation) across all measured cognitive domains, suggesting a relative lack of contribution of shared environments in explaining future Alzheimer's Disease and Related Dementias. Moreover, the geographical contribution to cognitive function in adulthood was slightly larger for females than for males. This study is among the first to explore the impact of both the independent and joint associations of place of birth and place of residence with different cognitive domains.

本研究探讨了出生地和居住地对英国人成年后认知能力差异的影响。我们利用英国生物库样本量大、认知领域多的优势,采用多层次建模法估计出生地和居住地对成年期认知的影响。我们发现,与美国的研究结果一致,这两个时间点的地方效应都会造成适度的变化 (
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引用次数: 0
The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact. 老年男男性行为者的创伤后应激障碍与酒精滥用和吸烟的关系:没有证据表明运动或志愿活动的影响。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-12-01 Epub Date: 2023-11-17 DOI: 10.1177/08982643231215475
Benjamin W Barrett, Steven Meanley, Mark Brennan-Ing, Sabina A Haberlen, Deanna Ware, Roger Detels, M Reuel Friedman, Michael W Plankey

Objectives: To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus.

Methods: Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes.

Results: Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus.

Discussion: There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.

目的:确定在老年(≥40岁)男男性行为者(MSM)中,创伤后应激障碍(PTSD)和物质使用(酒精滥用或吸烟)之间的关联是否通过运动或志愿活动介导/调节,以及这种介导/调节是否因HIV血清状态而异。方法:采用多中心艾滋病队列研究资料。三个数据集在不同时间段测量PTSD(10/1/2017-3/31/2018, 898名男性;2018年4月1日- 2018年9月30日,890名男性;2018年1月10日至2019年3月31日,共895名男性)。纵向中介分析估计运动和志愿活动对结果的中介作用。结果:9%的男男性行为者有PTSD的证据。无论药物使用结果如何,运动或志愿活动都没有统计学上显著的中介作用。患有PTSD的男同性恋者在未来就诊时吸烟的几率大约是没有PTSD的男同性恋者的两倍。结果不受HIV血清状态的影响。讨论:对于患有PTSD的老年男男性行为者,特别需要有效的戒烟干预。
{"title":"The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact.","authors":"Benjamin W Barrett, Steven Meanley, Mark Brennan-Ing, Sabina A Haberlen, Deanna Ware, Roger Detels, M Reuel Friedman, Michael W Plankey","doi":"10.1177/08982643231215475","DOIUrl":"10.1177/08982643231215475","url":null,"abstract":"<p><strong>Objectives: </strong>To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus.</p><p><strong>Methods: </strong>Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes.</p><p><strong>Results: </strong>Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus.</p><p><strong>Discussion: </strong>There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.</p>","PeriodicalId":51385,"journal":{"name":"Journal of Aging and Health","volume":" ","pages":"700-718"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Age-Related Trajectories of Health Decline Among Immigrants and Natives in Europe: The Effect of Education. 欧洲移民和本地人健康衰退的年龄相关轨迹:教育的影响。
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-11-29 DOI: 10.1177/08982643241303973
Aïda Solé-Auró, Isabel Sáenz-Hernández, Luīze Ratniece

Background: The ability to age healthily is highly dependent on individual characteristics that include gender, social class, a range of biological and contextual factors, and migrant background. Indeed, immigration has changed the demographic composition and social structure of many European countries, generating an increasing interest in how societies, and immigrants in particular, are aging. Research Design: This paper compares the age-related trajectories of health decline in three health measures (activity limitation indicator, self-perceived health, and chronic conditions) among 7,429 immigrants and 81,424 native-born populations aged 50 years old and over using longitudinal data from seven waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) (2004-2020). Analysis: We use descriptive and multivariate models (random-effects regression models) to analyze the association between migration status and each health outcome. We are particularly interested in determining the age-related trajectory of this association across three levels of education, exploring at the same time the effect of the interaction between immigration status and age on health. Results: Our results highlight potential gaps in health between immigrants and native-born people that are particularly large for the low-educated group. In other words, the health decline is more marked for low-educated immigrants compared to native-born populations in particular for activity limitation indicator and self-perceived health, while it is less pronounced with the accumulation of chronic conditions. Conclusions: Our findings should serve to enhance the design of the provision of social services and support and the promotion of equal opportunities.

背景:健康衰老的能力高度依赖于个人特征,包括性别、社会阶层、一系列生物和环境因素以及移民背景。事实上,移民已经改变了许多欧洲国家的人口构成和社会结构,使人们越来越关注社会,特别是移民,是如何老龄化的。研究设计:本文使用2004-2020年欧洲健康、老龄化和退休调查(SHARE)七波的纵向数据,比较了7,429名移民和81,424名50岁及以上的本地出生人口在三项健康指标(活动限制指标、自我感知健康和慢性病)中健康下降的年龄相关轨迹。分析:我们使用描述性和多变量模型(随机效应回归模型)来分析迁移状态与每种健康结果之间的关系。我们特别感兴趣的是确定这种关联在三个教育水平上的年龄相关轨迹,同时探索移民身份和年龄之间的相互作用对健康的影响。结果:我们的研究结果突出了移民和本地出生的人在健康方面的潜在差距,这种差距在受教育程度较低的人群中尤为明显。换句话说,与本地出生人口相比,受教育程度低的移民的健康状况下降更为明显,特别是在活动限制指标和自我感知健康方面,而慢性疾病的积累则不那么明显。结论:我们的研究结果应有助于加强提供社会服务和支持的设计,促进平等机会。
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引用次数: 0
Educational Disparities in Preventable Deaths: Do They Explain the Longevity Gap Between Mexico and Spain? 可预防死亡中的教育差异:它们能解释墨西哥与西班牙之间的长寿差距吗?
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-11-26 DOI: 10.1177/08982643241303585
Octavio Bramajo, Víctor M García-Guerrero, Iñaki Permanyer

Objective: Determine how preventable causes of death contribute to the life expectancy gap between Mexico and Spain.

Methods: We used a linear integral decomposition to analyze the impact of preventable mortality on life expectancy between ages 30-75 (temporary life expectancy) between Mexico and Spain in 2018. Additionally, we computed cause-deleted life tables to estimate potential gains in temporary life expectancy. Analyses were stratified by educational attainment, sex, and age.

Results: Low-educated Mexicans showed the largest gains in temporary life expectancy from removing preventable deaths (3.4 years for males, 1.6 for females), partially explaining the gap with Spain. Removing these deaths would close the gap almost entirely due to a higher relative decrease for middle- and high-educated individuals.

Discussion: While access to adequate healthcare is crucial for improving population health, appropriate non-medical public policies can significantly reduce mortality disparities between Mexico and Spain, especially for individuals from higher educational backgrounds.

目标:确定可预防的死亡原因如何导致墨西哥和西班牙之间的预期寿命差距:确定可预防死因如何导致墨西哥和西班牙之间的预期寿命差距:我们使用线性积分分解法分析了 2018 年可预防死亡率对墨西哥和西班牙 30-75 岁预期寿命(临时预期寿命)的影响。此外,我们还计算了因果删除生命表,以估算临时预期寿命的潜在收益。分析按教育程度、性别和年龄进行分层:低学历墨西哥人因去除可预防死亡而获得的临时预期寿命收益最大(男性为 3.4 年,女性为 1.6 年),这部分解释了与西班牙的差距。由于中高学历人群的相对预期寿命缩短幅度更大,因此消除可预防死亡几乎可以完全缩小与西班牙的差距:讨论:虽然获得适当的医疗保健对改善人口健康至关重要,但适当的非医疗公共政策也能显著缩小墨西哥与西班牙之间的死亡率差距,尤其是对于教育背景较高的人而言。
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引用次数: 0
Use of Medications With Somnolence Adverse Effects and Somnolence Symptoms Among Older Adults in the U.S. 美国老年人使用具有嗜睡不良反应和嗜睡症状的药物情况
IF 2.2 3区 医学 Q2 GERONTOLOGY Pub Date : 2024-11-26 DOI: 10.1177/08982643241298734
Jocelyn Wilder, Diane Lauderdale, Dima M Qato

Objectives: Nearly half of older adults experience somnolence, but the link between medications with somnolence as an adverse effect and somnolence is unclear. This study investigated the association between polypharmacy and somnolence symptoms (excessive sleepiness or long sleep duration).

Methods: Data from the National Social Life, Health, and Aging Project (NSHAP) 2010-2011 was used to examine the concurrent use of medications with potential somnolence as an adverse effect and the prevalence of somnolence symptoms.

Results: Among the 2638 older adults (mean, 71 years), 49.0% used medications with potential somnolence adverse effects. The adjusted prevalence of somnolence symptoms was significantly higher among those using three or more medications (58%) than those not using such medications (31.2%) (difference, 20.4%; 95% CI 12.5, 28.4).

Discussion: In this cross-sectional study, medications with somnolence as a potential adverse effect were commonly used, and the findings suggest a link between polypharmacy and the increased risk of somnolence symptoms.

目的:近一半的老年人会出现嗜睡症状,但以嗜睡为不良反应的药物与嗜睡之间的关系尚不清楚。本研究调查了多种药物治疗与嗜睡症状(过度嗜睡或睡眠时间过长)之间的关系:方法:利用 2010 至 2011 年国家社会生活、健康和老龄化项目(NSHAP)的数据,研究同时使用可能会导致嗜睡不良反应的药物与嗜睡症状的发生率:结果:在 2638 名老年人(平均 71 岁)中,49.0% 的人服用了可能会引起嗜睡不良反应的药物。经调整后,使用三种或三种以上药物者(58%)的嗜睡症状发生率明显高于未使用此类药物者(31.2%)(差异为 20.4%;95% CI 为 12.5 至 28.4):讨论:在这一横断面研究中,将嗜睡作为潜在不良反应的药物是常用药物,研究结果表明,多药治疗与嗜睡症状风险增加之间存在联系。
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引用次数: 0
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Journal of Aging and Health
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