Search Results (447)

Digital technologies are increasingly integrated into elderly care systems and have important implications for sustainable social development. This study investigates whether China’s Smart Health and Elderly Care (SHEC) Pilot Program enhances elderly care service provision and improves the spatial equity of resource distribution. Using prefecture-level data on elderly care institutions from 2010 to 2021, this paper employs a staggered difference-in-differences (DID) approach to identify the impact of SHEC on elderly care service provision. SHEC is treated as a digitally oriented policy initiative rather than a direct measure of digital technology adoption intensity. The results show the following: First, the pilot program significantly expands the service capacity of the elderly care system, as reflected in increases in both the number of elderly care institutions and bed capacity. Second, the policy has stronger effects on service capacity expansion in less-developed and high-aging regions, whereas the estimated effects are limited in more-developed and low-aging regions. Third, the analysis also provides exploratory evidence on potential supply-side and demand-side mechanisms. Finally, the equity analysis based on the Theil index suggests that participation in SHEC improves allocative equity, thereby supporting sustainable social development. This paper contributes to the literature by highlighting how digital empowerment-oriented policy interventions in the elderly care sector promote the sustainable expansion and equitable allocation of public service resources. Full article

Background/objective: Hypertension and type 2 diabetes are major causes of morbidity in older adults. Although pharmacological treatments remain the cornerstone of management, structured physical activity has been shown to provide additional benefits, yet evidence from institutionalized populations in Latin America is limited. This study evaluated the impact of a 12-month supervised exercise program on blood pressure (BP), glycated hemoglobin (HbA1c), and body composition in elderly people attending welfare homes in Mexico. Methods: A community-based intervention trial was conducted (February 2018–January 2019) with 260 adults (aged > 60 years) with hypertension and/or diabetes. Participants were allocated based on shelter site to either a control group (n = 129; pharmacological treatment only) or an intervention group (n = 131; pharmacological treatment plus five one-hour supervised recreational physical activity sessions per week). Monthly anthropometric, clinical, and biochemical measurements were analyzed using parametric/non-parametric tests and estimation of effect size (Cohen’s d). Results: Median age was 70 years (86% female). After 12 months, systolic BP decreased from 148.4 to 129.7 mmHg in the intervention group vs. 147.7 to 131.3 mmHg in controls. Diastolic BP showed greater reduction in the intervention group (−25%; 93.1 to 68.9 mmHg) than in controls (−13.5%; 88.1 to 76.2 mmHg). HbA1c reductions were also superior in the intervention group (–2.28% vs. –1.86%). Both groups lost fat mass, but lean mass preservation was limited. Conclusions: Structured community-based physical activity significantly improves BP, glycemic control, and body composition, supporting its integration into routine institutional care with limited resources. Full article

Background/Objectives: Mandibular reconstruction following ablative oral surgery is particularly challenging in elderly patients due to comorbidities and reduced physiological healing potential. While vascularized bone flaps represent the gold standard, the combination of an anterolateral thigh (ALT) flap and a bone reconstruction metallic plate may be considered as a less invasive alternative. This systematic review aimed to evaluate the effectiveness of such reconstructive techniques, in terms of success rate and complication rate, in patients aged over 55. Methods: Studies were included if the sample size consisted of at least 20 patients undergoing mandibular reconstruction with an ALT flap and plate following oral cavity resection for benign or malignant conditions. Studies were excluded if relevant outcomes were not reported and the mean age was <55 years. An electronic search was conducted in PubMed, Scopus, Web of Science and Embase. The last search was made on 26 February 2026. Data extracted included patient demographics, clinical outcomes and postoperative plate-related and overall complications. Risk of bias assessment was undertaken using the Joanna Briggs Institute tool for cohort studies and case series. Proportional meta-analysis was conducted to estimate the overall clinical success and the complication rate. Results: Of the 525 studies initially screened, four studies including a total of 329 patients (292 males, 37 females) with an overall mean age > 55 years were included. Mean hospital stay ranged from 10 to 24 days. The overall clinical success rate of the ALT flap procedure was 97% (95% confidence intervals (CIs): 92%, 99%). Flap-related complications were rare, with flap loss reported in only one patient and partial necrosis or failure affecting up to 6.6% of cases. Conversely, the overall plate-related complications rate was 28% (95% CI: 15%, 41%), with plate exposure rates ranging from 10% to 38.7% in the included studies. Wound complications, including infection and fistula formation, ranged from 20% to 38.7% of patients. Conclusions: In patients over 55, despite the not negligible rate of complications, the use of ALT flaps and reconstruction plate represents a viable alternative to vascularized bone flaps for mandibular reconstruction, particularly when comorbidities or frailty preclude more complex procedures. Further studies with a large sample size are needed to validate these findings and guide clinical decision-making. Full article

Investigating the influence of women’s family status on farmers’ adoption of digital and intelligent production transformation holds significant value in bridging the gender gap in research on modern agricultural production transformation and in facilitating the digital and intelligent transformation of the agricultural sector. Drawing on survey data from Henan Province collected through a household survey conducted in July 2024 by the research team, which employed a combination of stratified and random sampling, and focusing on farmers’ adoption of plant protection drone technology, this paper employs the Triple-Hurdle model to examine the impact of women’s family status on farmers’ digital and intelligent production transformation decisions and the underlying mechanisms. The baseline regression results show that the improvement of women’s family status facilitates farmers’ digital and intelligent production transformation decisions. Specifically, it enhances farmers’ willingness to adopt digital and intelligent production transformation, promotes their adoption behavior of plant protection drone technology, and increases the degree of adoption of such technology. The mechanism analysis reveals that the improvement of women’s family status promotes farmers’ digital and intelligent production transformation decisions by increasing their satisfaction with the institutional environment. The heterogeneity analysis of household characteristics indicates that women’s family status has a greater facilitating effect on the willingness of farmers with lower female labor force participation and those with heavier child or elderly dependency burdens to undergo digital and intelligent production transformation. The heterogeneity analysis of village environmental characteristics shows that women’s family status has a greater facilitating effect on the willingness and behavior of farmers in villages with a larger number of technical personnel to undergo digital and intelligent production transformation. Additionally, it has a greater facilitating effect on the willingness of farmers in villages with a stronger culture of gender equality to undergo such transformation. Using plant protection drone adoption as an example, this paper provides preliminary evidence of the positive impact of women’s family status on the digital and intelligent transformation of agriculture. However, due to the inherent limitations of cross-sectional data, our exploration of the dynamic process of transformation remains inadequate. Therefore, future research is warranted to employ longitudinal panel data to further validate the findings of this study. Full article

The progressive aging of the atrial fibrillation (AF) population, frequently characterized by high ischemic and bleeding risks, has led to a substantial increase in referrals for left atrial appendage occlusion (LAAO). The expansion of indications and the high procedural success rate of LAAO have further contributed to rising procedural volumes. However, this growth introduces important challenges: LAAO candidates are often elderly and frail, with increased anesthesia-related risks, and high-volume catheterization laboratories may face logistical constraints, particularly in centers without dedicated anesthesiology support. The current gold standard approach, transesophageal echocardiography (TEE) under general anesthesia (GA), ensures optimal imaging and procedural control but may increase procedural complexity and perioperative risks. In response, minimalist strategies are increasingly explored, targeting either the anesthetic protocol or the imaging modality. Conscious sedation (CS) protocols have been adopted to reduce anesthesia-related burden while maintaining TEE guidance. Alternatively, imaging-based strategies aim to replace TEE with less invasive modalities, including intracardiac echocardiography (ICE), transesophageal–intracardiac echocardiography (TE-ICE), and MicroTEE. Each approach presents specific advantages and limitations regarding safety, feasibility, operator expertise, and institutional resources. Taken together, these findings support a patient-centered approach to LAAO, whether traditional or minimalist, in which the choice of anesthetic strategy and echocardiographic guidance is driven by institutional resources, operator expertise, and individual patient characteristics rather than by expected differences in procedural or clinical efficacy. This review summarizes current evidence on minimalist LAAO pathways and discusses their role in achieving a tailored, resource-conscious procedural model. Full article

As digital innovations rapidly penetrate aging populations, live-streaming e-commerce acts as a profound external disruption to the informal healthcare subsystem, fundamentally reshaping Health Shared Decision-Making in Elderly Households (HSDM-EH). This study investigates how the nested interplay of affective strategies and algorithmic mechanisms reconfigures this traditional socio-technical balance. Employing a directed content analysis, we conducted methodological triangulation with two complementary data sources: in-depth interviews and behavioral observations from a maximum-variation sample of 40 Chinese families. Our findings reveal a three-stage structural evolution: the de-bounding of the informal healthcare subsystem through the decentering of institutional and familial authority; the synergistic control of affect and algorithms that scales deprofessionalized trust; and the subsequent escalation of systemic friction, marking a failure of organizational resilience. Ultimately, we propose a Socio-Technical Nested Agency Model, demonstrating that algorithmic interventions effect a soft transfer of health authority away from familial oversight to commercial platforms. This socio-technical reconfiguration generates unintended policy feedback that undermines grassroots health initiatives, highlighting the urgent need for cross-sectoral regulatory frameworks to mitigate algorithmic risks and enhance the digital health inclusivity of aging populations. Full article

Growth in the elderly population will inevitably increase the demand for care and assistance, which must be matched by a sufficient number of individuals capable of providing the care and assistance required. This study aims to estimate the present and future caregiver support ratio (CSR) at the national level across Europe and at the Italian subnational level. Italy was selected due to its higher proportion of elderly citizens compared with other EU countries. The CSR is defined as the number of potential caregivers aged 45–64 years (the age range most commonly involved in caregiving) per citizen aged 80 and over (the most likely to require long-term caregiving). Data were obtained from Eurostat for the EU-level analysis, whereas those pertaining to Italy were sourced from the Italian National Institute of Statistics. CSR projections were made for the decades spanning 2030 to 2080. The findings show that the ratio of potential caregivers aged 45–64 to individuals aged 80 or over will steadily decline over the coming decades, implicating challenges for gerontological social policies. The results reveal variation in the CSR for the 27 European countries—with a decline from 5:1 in 2025 to 2:1 by 2050—and across the 20 Italian regions, as well as differences in the projected trends in CSR variations over the medium (until 2050) and long term (until 2080). Technology may offer possible solutions to address some of the challenges associated with the aging demographic. Full article

Objective: To validate the Oldfry instrumental device for efficiently detecting the risk of falls and frailty in older adults. Design and Methods: An observational, analytical, cross-sectional, multicenter, non-randomized study to validate an instrumental device. It was conducted in several nursing homes for the elderly in the province of Castellón, Comunidad Valenciana, Spain, from February to April 2024. The estimated necessary sample size was 149 people. Specific selection criteria and voluntary acceptance to participate in the study were established. Sociodemographic, anthropometric, and other variables such as fall history in the past year were collected. A descriptive and comparative analysis of the variables was performed. The validity and reliability of the device in its measurements were determined to compare the results of the Timed Up and Go (TUG) test and the Short Physical Performance Battery test (SPPB), with respect to the Oldfry instrumental device. Informed consent was obtained from all participants, and the study was approved by the Bioethics Committee of the University Jaume I. Results: The sample consisted of 151 participants with a median age of 84 years (IQR [78.0–91.0]), comprising 39.10% men and 60.90% women, 65 years of age or older. Oldfry presents a sensitivity of 45.90% and a specificity of 72.7% for the risk of falls with a correlation R: 0.773 and an ICC concordance: 0.821. For frailty assessment, it shows a sensitivity of 91.90% and a specificity of 9.10% with an R: 0.854 and ICC: 0.805. Conclusions: This device has proven to be an effective tool for detecting both the risk of falls and frailty in older adults residing in institutions, showing high levels of reliability, sensitivity, and high concordance and correlation in both measurements. Future studies are anticipated to evaluate the benefits of this application. Full article

Background: Through a meta-analysis and systematic review, the present study aimed to evaluate the prevalence, associated factors and prognosis of sarcopenic obesity in the elderly in the community. Methods: From database inception to 31 December 2025, this study performed a full database of PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, CNKI, CBM, WANFANG, and VIP database. Two researchers undertook a systematic process of data extraction and literature quality evaluation. Stata 17 was used to evaluate the prevalence, associated factors and prognosis of sarcopenic obesity in the elderly in the community. Results: Our study included a total of 37 sources, encompassing 80,337 elderly individuals in the community. The results showed that the sarcopenic obesity prevalence in this population was 10%(95%CI: 8–11%), with a 95% prediction interval of 1.4–31.2%, and its occurrence was related to multiple associated factors such as age (OR = 1.83, 95%CI: 1.21–2.76), male (OR = 3.38, 95%CI: 1.53–7.49), low physical activity (OR = 1.56, 95%CI: 1.13–2.16), moderate-to-high physical activity (OR = 0.62, 95%CI: 0.51–0.77), low income (OR = 1.71, 95%CI: 1.04–2.83), unemployment (OR = 1.88, 95%CI: 1.29–2.75) and insufficient energy intake (OR = 1.23, 95%CI: 1.02–1.50). The poor prognosis of sarcopenic obesity in the elderly in the community, including falls, disability, increased risk of hospitalization, and death, seriously affects their quality of life. Conclusions: The prevalence of sarcopenic obesity in the elderly in the community is relatively high. Age, gender, income level and other factors are closely associated with the occurrence of sarcopenic obesity and can lead to serious adverse consequences. It is recommended that primary medical institutions should focus on people at a high risk of sarcopenic obesity. Community medical personnel can formulate targeted prevention and control measures according to their associated factors to achieve early screening, diagnosis and intervention. Full article

Background and Objectives: Postoperative delirium and postoperative cognitive dysfunction are common complications in older adults undergoing elective non-cardiac surgery, associated with increased morbidity and mortality, functional decline, and prolonged hospital stay. Prolonged preoperative fasting may intensify inflammatory responses and insulin resistance. Preoperative oral carbohydrate loading within ERAS protocols may modulate this response and reduce cognitive risk. Materials and Methods: A scoping review was conducted following the methodological recommendations of Arksey and O’Malley, the Joanna Briggs Institute, and PRISMA-ScR. A systematic search was performed in PubMed and Scopus for studies published up to September 2025. Randomized controlled trials and observational studies including adults ≥ 65 years undergoing elective non-cardiac surgery were included if they evaluated fasting modifications or preoperative carbohydrate loading and reported postoperative delirium or cognitive dysfunction. Results: A total of eight publications were included: four randomized controlled trials, one prospective cohort study, two cross-sectional studies, and one descriptive/correlational study. Populations included older adults undergoing elective abdominal, orthopedic, colorectal, or hip surgery, as well as hospitalized elderly surgical patients. Interventions included oral carbohydrate loading, assessment of preoperative nutritional status, and enteral versus parenteral nutrition. Only four of the eight included studies directly evaluated neurocognitive outcomes. Postoperative delirium was assessed in three studies, using the Confusion Assessment Method in two studies and the Delirium Rating Scale in one study. Postoperative cognitive dysfunction was evaluated in one study using a Mini-Mental State Examination-based cognitive assessment, while the remaining four studies did not assess neurocognitive outcomes and instead focused on metabolic, inflammatory, or perioperative well-being outcomes. Conclusions: Available evidence suggests that perioperative fasting protocols and preoperative carbohydrate loading may influence metabolic and inflammatory responses related to postoperative neurocognitive outcomes in older adults. However, evidence remains limited and heterogeneous. Findings are exploratory and hypothesis-generating, highlighting the need for well-designed trials assessing neurocognitive outcomes in geriatric surgical populations. Full article

Background and Objectives: This study aimed to evaluate the safety and feasibility of reduced-port laparoscopic distal gastrectomy (RPLDG) in elderly patients. Materials and Methods: Electronic medical records of 226 patients who underwent RPLDG performed by a single high-volume surgeon at a single institution (Chonnam National University Hospital) between January 2015 and April 2020 were retrospectively analyzed. Among these patients, 60 were aged ≥ 75 years (elderly group), and 166 were younger than 75 years (non-elderly group). Patient characteristics, surgical outcomes, and short-term postoperative outcomes were compared between the two groups. Results: Surgical outcomes were comparable between the age groups. However, medical complication events, assessed using an event-based approach allowing multiple events per patient, were more frequent in patients aged ≥ 75 years. Compared with the non-elderly group, the elderly group demonstrated a higher frequency of overall postoperative complication events (18 [30%] vs. 29 [18%], p = 0.040), primarily attributable to medical complications (9 [15%] vs. 6 [4%], p < 0.01). The elderly group also showed a delayed time to first gas passage (3.5 [3.0–4.0] vs. 3.0 [3.0–3.0] days, p < 0.001). However, no statistically significant differences were observed in length of hospital stay (7.0 [6.0–10.0] vs. 6.0 [6.0–8.0] days, p = 0.262) or intraoperative blood loss (p = 0.831). No significant differences were found in surgical complication events (p = 0.05) or Clavien–Dindo grade ≥ 3 complication events (p = 0.13). In the risk factor analysis for complications, univariate analysis identified age ≥ 75 years as a significant factor. However, in the multivariate analysis, only respiratory comorbidities, liver disease, and poor ECOG performance status remained independent risk factors, whereas age ≥ 75 years was no longer statistically significant (p = 0.193). The finding regarding liver disease should be interpreted with caution because of the extremely small sample size. Conclusions: RPLDG appears to be a viable surgical option for patients aged ≥ 75 years, demonstrating acceptable surgical outcomes and severe complication rates comparable to those observed in non-elderly patients. Full article

Background: Nursing homes are congregate settings for elderly individuals where infectious diseases can easily spread. The elderly are at high risk of contracting and dying from influenza, and the most effective way to prevent this is to receive the influenza vaccine. Methods: This study conducted a cross-sectional survey of elderly people in nursing homes to investigate the occurrence of influenza symptoms during the 2024–2025 flu season, as well as vaccination status and reasons for receiving or not receiving the vaccine. Bivariate logistic regression was used to determine the factors influencing the vaccination rate. Results: Of the 1024 elderly people who participated in the survey, 25.39% reported experiencing flu-related symptoms in the previous flu season. While 16.21% of the elderly expressed willingness to receive vaccination, only 5.57% actually received it. Influenza vaccination was positively correlated with educational attainment (aOR 3.800, 95% CI 1.480–9.758 for middle school; aOR 5.138, 95% CI 1.738–15.191 for high school), monthly household income (aOR 0.216, 95% CI 0.072–0.644 for >8000), ability for self-care (aOR 0.269, 95% CI 0.123–0.591), and the scale of the nursing home (aOR 9.033, 95% CI 1.531–53.305 for 151–299; aOR 2.629, 95% CI 1.359–5.084 for ≥300). Willingness to receive the influenza vaccination was positively correlated with an unhealthy health status (aOR 0.398, 95% CI 0.204–0.779), symptoms of influenza (aOR 2.730, 95% CI 1.861–4.007), nursing home location (aOR 1.537, 95% CI 1.099–2.941 for outer suburbs), and the scale of the nursing home (aOR 1.991, 95% CI 1.154–3.435 for 151–299; aOR 2.158, 95% CI 1.374–3.390 for ≥300). Most elderly people who received the vaccine believed that vaccination could effectively prevent flu and that it could reduce the risk of complications, the rest were not vaccinated due to concerns about adverse reactions, mobility issues, or the distance to vaccination sites. Conclusions: Low awareness of flu vaccines and physical inability to travel to vaccination sites may be potential barriers to receiving the flu vaccine. It is worrying that the influenza vaccination rate is low among the elderly in nursing homes in Shanghai. As a result, it is crucial to prioritize targeted monitoring and intervention strategies for vulnerable populations living in collective institutions. Full article

Postoperative stroke is a serious and fatal condition that often affects elderly surgical patients. This rare but severe complication arises from complex interactions between comorbidities, physiologic instability and demographic disturbances that traditional risk tools often fail to capture.This study aims to develop and validate a machine learning model with an improved ability to predict the risk of postoperative stroke in elderly patients utilising the comprehensive clinical and demographic ICU data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. External validation was performed on MIMIC-III and the eICU Collaborative Research Database, with eICU being the primary validation set. We identified postoperative surgical intensive care unit (SICU) patients aged 55 years or older from all databases. A strict temporal window of the first 24 h of ICU admission was applied across all three datasets while extracting features like laboratory measurements and vital sign summaries in order to ensure that all predictor values were derived from a fixed observation period at the beginning of ICU stay. After preprocessing, applying Multivariate Imputation by Chained Equations (MICE) imputation and initial screening of 88 candidate variables, 20 clinically meaningful predictors were selected through a multistage feature selection pipeline incorporating RFECV and permutation importance. SHAP analysis and LIME analysis were used for interpretability. We evaluated ten machine learning techniques, including Logistic Regression, Decision Tree, Random Forest, K-Nearest Neighbors (KNNs), Support Vector Machine (SVM–RBF Kernel), Gradient Boosting (GBDT), Neural Network, XGBoost, CatBoost, Naive Bayes. Among them, Random Forest demonstrated strong predictive performance by achieving an AUROC of 0.8072 (95% CI [0.7890, 0.8253]) on the internal validation set. The model also achieved AUROC of 0.7557 (95% CI [0.7267, 0.7794]) and 0.9144 (95% CI [0.8893, 0.9378]) on the external validation sets eICU and MIMIC-III, respectively. Mean systolic blood pressure, Elixhauser score, minimum calcium, and minimum INR (PT) were consistently identified as the most influential predictors through both SHAP analysis and LIME analysis, thus strengthening model interpretability. Our findings suggest that a Random Forest-based predictive model can provide an accurate and generalisable prediction of postoperative stroke in elderly ICU patients using routinely collected physiologic and laboratory data. This also supports early risk stratification and targeted postoperative monitoring. Full article

Background: Radiotherapy (RT) combined with androgen deprivation therapy (ADT) is a standard treatment for non-metastatic high-risk (HR) prostate cancer (PC). However, the benefit of elective nodal irradiation (ENI) in clinically node-negative (cN0) patients, although suggested, remains controversial, particularly in the elderly. We report the outcomes of elderly HR PC patients treated with prostate-only RT (PORT) and ADT in a “real-word” setting. Methods: Between 2016 and 2022, 43 consecutive elderly patients (median age 76 years) with HR- or very HR-PC according to NCCN criteria version 1.2026 (cN0, cT3-cT4 and/or ISUP Grade Group 4–5 and/or PSA serum levels at diagnosis ≥ 20 ng/mL) were treated at our institution. All patients were staged with abdominal MRI or CT and bone scan; nineteen patients (44.2%) also underwent 68Ga-PSMA-11 or 18F-fluorocholine PET/CT. All patients received PORT (predominantly moderate hypofractionation, 67.5–70 Gy in 25–28 fractions) and ADT (median duration 24 months). To ensure consistency, all oncological endpoints—Biochemical Failure-Free Survival (BFFS; Phoenix criteria), Disease-Free Survival (DFS), Metastasis-Free Survival (MFS), Prostate Cancer-Specific Survival (PCSS), and Overall Survival (OS)—were calculated from a unified time-zero (initiation of first oncological treatment). DFS was defined as a composite endpoint including biochemical failure, radiological recurrence, or initiation of salvage therapy. Results: at a median follow-up of 60 months, no patient reached the Phoenix threshold, resulting in a 100% 5- and 7-year BFFS. However, 4 patients (9.3%) experienced radiological recurrence detected via PET/CT before reaching the nadir + 2 threshold, yielding an estimated 5-year and 7-year DFS of 94.7% and 71.8%, respectively. The 5- and 7-year MFS was of 97.6% and 88.7%, respectively. Seven deaths occurred, all non-PC related, resulting in a 5-year OS of 86.7% and a Prostate Cancer-Specific Survival of 100%. Gastrointestinal toxicity was notably low (no acute or late G3-G4 events). Conclusions: Our findings suggest that PORT, when combined with long-term ADT and modern staging, provides excellent disease control and a favorable safety profile in elderly HR PC patients. Given the high rate of competing mortality in this population, treatment de-escalation via PORT appears to be a clinically reasonable strategy. These results are hypothesis-generating and warrant validation in prospective randomized trials. Full article

(1) Background: Rapid global aging has surged demand for elderly family care, a role long dominated by women. This study aims to reveal the specific manifestations of the gender division of labor in elderly family care through a systematic evidence synthesis, covering care tasks, care types, impacts, and driving factors. (2) Methods: We searched four databases (Web of Science (SSCI subsets), Scopus, PubMed, and ProQuest) for articles published between 2015 and 2025. After screening, 45 peer-reviewed articles from 16 countries or regions were included, and thematic analysis was employed for data extraction and evidence synthesis. (3) Findings: The results indicate a differentiated gender division of labor and inequality in elderly family care, where female caregivers bear a greater burden in terms of task assumption, care time allocation, and perception of care impacts. The formation of the gender division of labor results from a dynamic interplay among multiple factors, including objective needs, social norms, and institutional influences. Promisingly, men are increasingly participating in family care for the elderly. (4) Conclusions: The study suggests that gender-sensitive policies should address the gender gap for elderly family care and provide targeted support to alleviate the unequal distribution of care burdens. Full article