JMIR Aging最新文献

{"title":"Model-Based Feature Extraction and Classification for Parkinson Disease Screening Using Gait Analysis: Development and Validation Study.","authors":"Ming De Lim, Tee Connie, Michael Kah Ong Goh, Nor 'Izzati Saedon","doi":"10.2196/65629","DOIUrl":"10.2196/65629","url":null,"abstract":"<p><strong>Background: </strong>Parkinson disease (PD) is a progressive neurodegenerative disorder that affects motor coordination, leading to gait abnormalities. Early detection of PD is crucial for effective management and treatment. Traditional diagnostic methods often require invasive procedures or are performed when the disease has significantly progressed. Therefore, there is a need for noninvasive techniques that can identify early motor symptoms, particularly those related to gait.</p><p><strong>Objective: </strong>The study aimed to develop a noninvasive approach for the early detection of PD by analyzing model-based gait features. The primary focus is on identifying subtle gait abnormalities associated with PD using kinematic characteristics.</p><p><strong>Methods: </strong>Data were collected through controlled video recordings of participants performing the timed up and go (TUG) assessment, with particular emphasis on the turning phase. The kinematic features analyzed include shoulder distance, step length, stride length, knee and hip angles, leg and arm symmetry, and trunk angles. These features were processed using advanced filtering techniques and analyzed through machine learning methods to distinguish between normal and PD-affected gait patterns.</p><p><strong>Results: </strong>The analysis of kinematic features during the turning phase of the TUG assessment revealed that individuals with PD exhibited subtle gait abnormalities, such as freezing of gait, reduced step length, and asymmetrical movements. The model-based features proved effective in differentiating between normal and PD-affected gait, demonstrating the potential of this approach in early detection.</p><p><strong>Conclusions: </strong>This study presents a promising noninvasive method for the early detection of PD by analyzing specific gait features during the turning phase of the TUG assessment. The findings suggest that this approach could serve as a sensitive and accurate tool for diagnosing and monitoring PD, potentially leading to earlier intervention and improved patient outcomes.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e65629"},"PeriodicalIF":5.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Predictive Dashboard With Prescriptive Decision Support for Falls Prevention in Residential Aged Care: User-Centered Design Approach.","authors":"S Sandun Malpriya Silva, Nasir Wabe, Amy D Nguyen, Karla Seaman, Guogui Huang, Laura Dodds, Isabelle Meulenbroeks, Crisostomo Ibarra Mercado, Johanna I Westbrook","doi":"10.2196/63609","DOIUrl":"https://doi.org/10.2196/63609","url":null,"abstract":"<p><strong>Background: </strong>Falls are a prevalent and serious health condition among older people in residential aged care facilities, causing significant health and economic burdens. However, the likelihood of future falls can be predicted, and thus, falls can be prevented if appropriate prevention programs are implemented. Current fall prevention programs in residential aged care facilities rely on risk screening tools with suboptimal predictive performance, leading to significant concerns regarding resident safety.</p><p><strong>Objective: </strong>This study aimed to develop a predictive, dynamic dashboard to identify residents at risk of falls with associated decision support. This paper provides an overview of the technical process, including the challenges faced and the strategies used to overcome them during the development of the dashboard.</p><p><strong>Methods: </strong>A predictive dashboard was co-designed with a major residential aged care partner in New South Wales, Australia. Data from resident profiles, daily medications, fall incidents, and fall risk assessments were used. A dynamic fall risk prediction model and personalized rule-based fall prevention recommendations were embedded in the dashboard. The data ingestion process into the dashboard was designed to mitigate the impact of underlying data system changes. This approach aims to ensure resilience against alterations in the data systems.</p><p><strong>Results: </strong>The dashboard was developed using Microsoft Power BI and advanced R programming by linking data silos. It includes dashboard views for those managing facilities and for those caring for residents. Data drill-through functionality was used to navigate through different dashboard views. Resident-level change in daily risk of falling and risk factors and timely evidence-based recommendations were output to prevent falls and enhance prescriptive decision support.</p><p><strong>Conclusions: </strong>This study emphasizes the significance of a sustainable dashboard architecture and how to overcome the challenges faced when developing a dashboard amid underlying data system changes. The development process used an iterative dashboard co-design process, ensuring the successful implementation of knowledge into practice. Future research will focus on the implementation and evaluation of the dashboard's impact on health processes and economic outcomes.</p><p><strong>International registered report identifier (irrid): </strong>RR2-https://doi.org/10.1136/bmjopen-2021-048657.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e63609"},"PeriodicalIF":5.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting Sleep/Wake Rhythm Disruption Related to Cognition in Older Adults With and Without Mild Cognitive Impairment Using the myRhythmWatch Platform: Feasibility and Correlation Study.","authors":"Caleb D Jones, Rachel Wasilko, Gehui Zhang, Katie L Stone, Swathi Gujral, Juleen Rodakowski, Stephen F Smagula","doi":"10.2196/67294","DOIUrl":"https://doi.org/10.2196/67294","url":null,"abstract":"<p><strong>Background: </strong>Consumer wearable devices could, in theory, provide sufficient accelerometer data for measuring the 24-hour sleep/wake risk factors for dementia that have been identified in prior research. To our knowledge, no prior study in older adults has demonstrated the feasibility and acceptability of accessing sufficient consumer wearable accelerometer data to compute 24-hour sleep/wake rhythm measures.</p><p><strong>Objective: </strong>We aimed to establish the feasibility of characterizing 24-hour sleep/wake rhythm measures using accelerometer data gathered from the Apple Watch in older adults with and without mild cognitive impairment (MCI), and to examine correlations of these sleep/wake rhythm measures with neuropsychological test performance.</p><p><strong>Methods: </strong>Of the 40 adults enrolled (mean [SD] age 67.2 [8.4] years; 72.5% female), 19 had MCI and 21 had no cognitive disorder (NCD). Participants were provided devices, oriented to the study software (myRhythmWatch or myRW), and asked to use the system for a week. The primary feasibility outcome was whether participants collected enough data to assess 24-hour sleep/wake rhythm measures (ie, ≥3 valid continuous days). We extracted standard nonparametric and extended-cosine based sleep/wake rhythm metrics. Neuropsychological tests gauged immediate and delayed memory (Hopkins Verbal Learning Test) as well as processing speed and set-shifting (Oral Trails Parts A and B).</p><p><strong>Results: </strong>All participants meet the primary feasibility outcome of providing sufficient data (≥3 valid days) for sleep/wake rhythm measures. The mean (SD) recording length was somewhat shorter in the MCI group at 6.6 (1.2) days compared with the NCD group at 7.2 (0.6) days. Later activity onset times were associated with worse delayed memory performance (β=-.28). More fragmented rhythms were associated with worse processing speed (β=.40).</p><p><strong>Conclusions: </strong>Using the Apple Watch-based myRW system to gather raw accelerometer data is feasible in older adults with and without MCI. Sleep/wake rhythms variables generated from this system correlated with cognitive function, suggesting future studies can use this approach to evaluate novel, scalable, risk factor characterization and targeted therapy approaches.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e67294"},"PeriodicalIF":5.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Unmet Needs of Informal Dementia Caregivers in Clinical Practice: User-Centered Development of a Digital Assessment Tool.","authors":"Olga A Biernetzky, Jochen René Thyrian, Melanie Boekholt, Matthias Berndt, Wolfgang Hoffmann, Stefan J Teipel, Ingo Kilimann","doi":"10.2196/59942","DOIUrl":"https://doi.org/10.2196/59942","url":null,"abstract":"<p><strong>Background: </strong>Despite the increasing interventions to support family caregivers of people with dementia, service planning and delivery is still not effective.</p><p><strong>Objective: </strong>Our study aimed to develop a digitally-supported needs assessment tool for family caregivers of people with dementia that is feasible, time-efficient, understood by users, and can be self-completed in the primary care setting.</p><p><strong>Methods: </strong>The development of the unmet needs assessment tool was part of a cluster-randomized controlled trial examining the effectiveness of a digitally supported care management programme to reduce unmet needs of family caregivers of people with dementia (GAIN [Gesund Angehörige Pflegen]) and was conducted in 3 phases. Using an iterative participatory approach with informal caregivers, health care professionals including general practitioners, neurologists, psychologists, psychiatrists, nurses, and Alzheimer Society representatives, we developed a digital self-completion unmet needs assessment tool focusing on informal caregivers' biopsychosocial health und quality of life in connection to their caregiver responsibilities. Data were collected through group discussions, written feedback, protocols, think-aloud protocols, and interviews, and analyzed thematically.</p><p><strong>Results: </strong>Data from 27 caregivers, including caregivers of people with dementia (n=18), health care professionals (n=7), and Alzheimer Society representatives (n=2) were collected. Thematic analysis identified 2 main themes: content of the assessment tool and usability and handling of the digital tablet-based assessment tool. The feedback provided by the stakeholders led to new aspects and changes to make the tool comprehensive, easy to read, and easy to handle. The overall mean completion time was reduced from the initial 37 minutes to 18 minutes, which renders the assessment tool fit to be self-completed in waiting rooms of primary care practices or other settings.</p><p><strong>Conclusions: </strong>The input of the 3 stakeholder groups has supported the development of the assessment tool ensuring that all aspects considered important were covered and understood and the completion of the assessment procedure was time-efficient and practically feasible. Further validation of the assessment tool will be performed with the data generated as part of the GAIN trial.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e59942"},"PeriodicalIF":5.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older Adults' Perspectives on Participating in a Synchronous Online Exercise Program: Qualitative Study.","authors":"Giulia Coletta, Kenneth S Noguchi, Kayla Beaudoin, Angelica McQuarrie, Ada Tang, Rebecca Ganann, Stuart M Phillips, Meridith Griffin","doi":"10.2196/66473","DOIUrl":"https://doi.org/10.2196/66473","url":null,"abstract":"<p><strong>Background: </strong>Older adults face several barriers to exercise participation, including transportation, lack of access, and poor weather conditions. Such barriers may influence whether older adults meet the Canadian 24-Hour Movement Guidelines. Recently, older adults have adopted technology for health care and are increasingly using digital health technologies to improve their access to care. Therefore, technology may be a valuable tool to reduce barriers to exercise and increase exercise participation rates within this population.</p><p><strong>Objective: </strong>This study aimed to explore older adults' perceptions and experiences of exercise, in general, and specifically related to our synchronous online exercise program for community-dwelling older adults.</p><p><strong>Methods: </strong>A total of 3 registered kinesiologists and 1 physiotherapist with experience working with older adults delivered an 8-week, thrice-weekly synchronous online group-based exercise program for older adults in 3 cohorts. The program focused on strength, balance, and aerobic activity. Following the program, a qualitative study with interpretive descriptive design was conducted to explore participants' perceptions and experiences. Participants were invited to take part in a 30-minute, one-on-one semistructured interview via Zoom with a research team member. Interview data were thematically analyzed to identify common themes.</p><p><strong>Results: </strong>A total of 22 older adults (16 women, 6 men; mean age 70, SD 4 years) participated in interviews. Three themes were identified as follows: (1) health, exercise, and aging beliefs; (2) the pandemic interruption and impacts; and (3) synchronous online exercise programs attenuate barriers to exercise. Participants discussed their exercise beliefs and behaviors and their desire to safely and correctly participate in exercise. Older adults found that their physical activity was curtailed, routines disrupted, and access to in-person exercise programs revoked due to the pandemic. However, many suggested that our synchronous online exercise program was motivational and attenuated commonly reported environmental barriers to participation, such as transportation concerns (eg, time spent traveling, driving, and parking), accessibility and convenience by participating at a location of their choice, and removing travel-related concerns during poor weather conditions.</p><p><strong>Conclusions: </strong>Given these reported experiences, we posit that synchronous online exercise programs may help motivate and maintain adherence to exercise programs for older adults. These findings may be leveraged to improve health outcomes in community-dwelling older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66473"},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Digitally Capable Aged Care Workforce: Demands and Directions for Workforce Education and Development.","authors":"Kathleen Gray, Kerryn Butler-Henderson, Karen Day","doi":"10.2196/54143","DOIUrl":"10.2196/54143","url":null,"abstract":"<p><p>As the aged care sector undergoes digital transformation, greater attention is needed to development of digital health capability in its workforce. There are many gaps in our understanding of the current and future impacts of technology on those who perform paid and unpaid aged care work. Research is needed to understand how to make optimal use of both digital resources and human resources for better aged care. In this Viewpoint, we reflect on a workshop held during an international conference that identified shared concepts and concerns to shape further research into workforce capability. Digital technologies and digital data can increase quality of care in a system that operates through partnerships among service providers, service users, and community members. To realize this potential, digital health learning and development are needed in the aged care workforce. As digital dimensions of aged care services expand, the sector needs clearer direction to implement approaches to workforce learning and development. These must be appropriate to support the safe and ethical performance of care work and to increase the satisfaction of those who care and those for whom they care.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e54143"},"PeriodicalIF":5.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employers' Perspectives of Caregiver-Friendly Workplace Policies for Caregiver-Employees Caring for Older Adults in Hong Kong: Thematic Analysis.","authors":"Maggie Man-Sin Lee, Eng-Kiong Yeoh, Eliza Lai-Yi Wong","doi":"10.2196/68061","DOIUrl":"https://doi.org/10.2196/68061","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Caregiver-friendly workplace policies (CFWPs) are rare in Hong Kong. With Hong Kong facing a \"silver tsunami\" in the near future, it is important to understand the need for such policies and the views of employers for future facilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to identify the support that is currently provided or that could be provided to caregiver-employees (CEs) caring for older adults in Hong Kong and assess the challenge and facilitative support for employers to adopt CFWPs in the specific context of Hong Kong.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative research design with semistructured individual in-depth interviews with employers from Hong Kong was adopted for this study. A purposive snowball sampling method was used to recruit participants from the 7 primary industries mentioned in the Hong Kong census and from all 3 employer types (private, public, and nongovernmental organizations), which allowed the inclusion of participants sensitized to the idea and potential of CFWPs. Thematic framework analysis was used to evaluate the data collected during the interviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We interviewed 17 employers and managers from 7 major industries in Hong Kong (2.5 to 120,000 employees). There were 4 (24%) male and 13 (76%) female participants, and the participant age ranged from 30 to 50 years. All participants held managerial positions at the time of the interview. Of the 17 participants, 13 were from private companies, 2 were from public institutions, and 2 were from nongovernmental organizations. Four of the companies had a global presence. Four main themes were identified: (1) current support and potential support for CEs (which was limited to discretionary annual leave and unpaid leave when annual leave was exhausted), (2) challenges in adopting CFWPs, (3) facilitating support for adopting CFWPs, and (4) incentives for adopting CFWPs. The participants rated information and resources for CEs (mean 8.56, SD 0.37), bereavement leave (mean 8.47, SD 0.63), flexible working hours (mean 8.32, SD 0.48), and caregiver-inclusive corporate culture (mean 8.32, SD 0.48) as essential CFWPs for CEs in Hong Kong.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;While several studies have reported the types of CFWPs and their impacts on CEs, stakeholders' perspectives on CFWPs have been rarely investigated. This study found that although employers consider CFWPs as necessary and see them as a catalyst for a long-term win-win situation, the current support for CEs is discretionary and industry-specific. Government leadership is critical for formulating, piloting, and implementing CFWPs to create a friendly environment that encourages disclosure with trust and respect across industrial sectors in Hong Kong. This study identified the current unmet needs and demands of CEs from the employer's perspective, the barriers to large-scale adoption of CFWPs, and the path forward to inform further d","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e68061"},"PeriodicalIF":5.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unsupervised Deep Learning of Electronic Health Records to Characterize Heterogeneity Across Alzheimer Disease and Related Dementias: Cross-Sectional Study.","authors":"Matthew West, You Cheng, Yingnan He, Yu Leng, Colin Magdamo, Bradley T Hyman, John R Dickson, Alberto Serrano-Pozo, Deborah Blacker, Sudeshna Das","doi":"10.2196/65178","DOIUrl":"https://doi.org/10.2196/65178","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer disease and related dementias (ADRD) exhibit prominent heterogeneity. Identifying clinically meaningful ADRD subtypes is essential for tailoring treatments to specific patient phenotypes.</p><p><strong>Objective: </strong>We aimed to use unsupervised learning techniques on electronic health records (EHRs) from memory clinic patients to identify ADRD subtypes.</p><p><strong>Methods: </strong>We used pretrained embeddings of non-ADRD diagnosis codes (International Classification of Diseases, Ninth Revision) and large language model (LLM)-derived embeddings of clinical notes from patient EHRs. Hierarchical clustering of these embeddings was used to identify ADRD subtypes. Clusters were characterized regarding their demographic and clinical features.</p><p><strong>Results: </strong>We analyzed a cohort of 3454 patients with ADRD from a memory clinic at Massachusetts General Hospital, each with a specialist diagnosis. Clustering pretrained embeddings of the non-ADRD diagnosis codes in patient EHRs revealed the following 3 patient subtypes: one with skin conditions, another with psychiatric disorders and an earlier age of onset, and a third with diabetes complications. Similarly, using LLM-derived embeddings of clinical notes, we identified 3 subtypes of patients as follows: one with psychiatric manifestations and higher prevalence of female participants (prevalence ratio: 1.59), another with cardiovascular and motor problems and higher prevalence of male participants (prevalence ratio: 1.75), and a third one with geriatric health disorders. Notably, we observed significant overlap between clusters from both data modalities (χ²₄=89.4; P<.001).</p><p><strong>Conclusions: </strong>By integrating International Classification of Diseases, Ninth Revision codes and LLM-derived embeddings, our analysis delineated 2 distinct ADRD subtypes with sex-specific comorbid and clinical presentations, offering insights for potential precision medicine approaches.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e65178"},"PeriodicalIF":5.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Telehealth Adoption Among Older Adults: Cross-Sectional Survey Study.","authors":"Siow-Hooi Tan, Yee-Yann Yap, Siow-Kian Tan, Chee-Kuan Wong","doi":"10.2196/60936","DOIUrl":"10.2196/60936","url":null,"abstract":"<p><strong>Background: </strong>The aging population and the accompanying rise in chronic diseases have intensified the need to study the adoption of telehealth services. However, the success of telehealth services depends not only on their ease and usefulness but also on addressing broader concerns. Despite being a substantial user group in traditional health services, older adults may encounter barriers to adopting telehealth services. Increasing the adoption of telehealth among the older adult population is crucial for enhancing their access to care and managing the challenges of aging effectively.</p><p><strong>Objective: </strong>We aimed to explore factors influencing the adoption of telehealth services among older adults in Malaysia, going beyond the conventional framework by incorporating transition cost and subjective well-being as additional constructs.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 119 adults aged ≥60 years in Malaysia, using 39 survey items adapted from existing studies. Data analysis was performed using partial least squares structural equation modeling, with both the measurement model and structural model being evaluated. To determine the predictive relevance of the model, PLSpredict was applied. In addition, importance-performance map analysis was conducted to further expand on the structural model results by assessing the performance of each variable.</p><p><strong>Results: </strong>Of the 119 participants, 52 (43.7%) were women and 67 (56.3%) were men. The study found that subjective well-being (β=0.448; P<.001) was the most significant factor, followed by attitude (β=0.242; P<.001), transition cost (β=-0.163; P<.001), and perceived usefulness (β=0.100, P=.02) in influencing telehealth service intention. Furthermore, perceived ease of use (β=0.271; P<.001), availability (β=0.323; P<.001), subjective well-being (β=0.261; P<.001), and trust (β=0.156, P=.004) positively influenced perceived usefulness, while inertia (β=0.024, P=.22) did not. In addition, availability (β=0.420; P<.001) and subjective well-being (β=0.260; P<.001) were positively related to perceived ease of use, with inertia (β=-0.246; P<.001) having a negative impact. The importance-performance map analysis results showed that subjective well-being (importance=0.532) was the most crucial factor for older adult users, while availability (importance=70.735) had the highest performance in telehealth services.</p><p><strong>Conclusions: </strong>This research underscores the importance of catering to the subjective well-being of older adults and optimizing the availability of telehealth services to encourage adoption, ultimately advancing health care accessibility and quality for this vulnerable demographic.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e60936"},"PeriodicalIF":5.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Edentulousness and the Likelihood of Becoming a Centenarian: Longitudinal Observational Study.","authors":"Xindi Wei, Longfei Zhuang, Yuan Li, Junyu Shi, Yijie Yang, Hongchang Lai, Beilei Liu","doi":"10.2196/68444","DOIUrl":"10.2196/68444","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, the global life expectancy has risen notably to approximately 73.5 years worldwide, coinciding with a rapid growth in the older adult population, which presents a significant public health challenge in promoting healthy aging and longevity.</p><p><strong>Objective: </strong>This study aimed to prospectively investigate the link between edentulousness and the likelihood of reaching centenarian status among individuals aged 80 years and older.</p><p><strong>Methods: </strong>Data from the Chinese Longitudinal Healthy Longevity Survey were analyzed. Logistic regression models were used to assess the relationship between edentulousness and the likelihood of becoming a centenarian. Demographic characteristics, lifestyle habits, and disease histories were adjusted as confounding factors. Several sensitivity analyses, including propensity score matching and 2-year lag analyses, were conducted to further assess the association between edentulousness and the likelihood of becoming a centenarian. The correlation between the number of natural teeth as a continuous variable and the likelihood of becoming a centenarian was evaluated as well.</p><p><strong>Results: </strong>The study included 4239 participants aged 80-100 years. After adjusting for all covariates, the likelihood for becoming a centenarian increased in the nonedentulous group compared to the edentulous group (odds ratio [OR] 1.384, 95% CI 1.093-1.751). The relationship persisted after propensity score matching analysis (OR 1.272, 95% CI 1.037-1.561). The association remained statistically significant after excluding participants with a follow-up duration of less than 2 years (OR 1.522, 95% CI 1.083-2.140; P=.02). Furthermore, a significant positive association between the number of natural teeth and the likelihood of becoming a centenarian was found after adjusting for all covariates (OR 1.022, 95% CI 1.002-1.042; P=.03), which aligned with the main results of the study.</p><p><strong>Conclusions: </strong>The findings revealed that the presence of natural teeth was linked to an increased probability of becoming a centenarian, underscoring the importance of maintaining oral health even in advanced age.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e68444"},"PeriodicalIF":5.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}