A Generative Expert-Narrated Simplification Model for Enhancing Health Literacy Among the Older Population

Older adults often face significant challenges in understanding medical information due to cognitive aging and limited health literacy. Existing simplification models, while effective in general domains, cannot adapt content for elderly users, frequently overlooking narrative tone, readability constraints, and semantic fidelity. In this work, we propose GENSIM-a Generative Expert-Narrated Simplification Model tailored for age-adapted medical text simplification. GENSIM introduces a modular architecture that integrates a Dual-Stream Encoder, which fuses biomedical semantics with elder-friendly linguistic patterns; a Persona-Tuned Narrative Decoder, which controls tone, clarity, and empathy; and a Reinforcement Learning with Human Feedback (RLHF) framework guided by dual discriminators for factual alignment and age-specific readability. Trained on a triad of corpora-SimpleDC, PLABA, and a custom NIH-SeniorHealth corpus-GENSIM achieves state-of-the-art performance on SARI, FKGL, BERTScore, and BLEU across multiple test sets. Ablation studies confirm the individual and synergistic value of each component, while structured human evaluations demonstrate that GENSIM produces outputs rated significantly higher in faithfulness, simplicity, and demographic suitability. This work represents the first unified framework for elderly-centered medical text simplification and marks a paradigm shift toward inclusive, user-aligned generation for health communication.