JMIR Aging最新文献

{"title":"Usability and Impact of the Web-Based Dementia Foundations Educational Program in Personal Support Workers (PSWs), PSW Trainees, and Care Companions: Quasi-Experimental Study.","authors":"Anthony J Levinson, Stephanie Ayers, Sandra Clark, Patricia Gerantonis, Amy Schneeberg, Richard Sztramko","doi":"10.2196/67889","DOIUrl":"https://doi.org/10.2196/67889","url":null,"abstract":"<p><strong>Background: </strong>Personal support workers (PSWs) are often expected to provide ongoing support for complex conditions and have identified an increased need for training in several areas, including dementia and mental health. Web-based interventions may be helpful complements to traditional in-person continuing education and training, but their effectiveness must be explored further.</p><p><strong>Objective: </strong>This study's objective was to evaluate the usability, usefulness, satisfaction with, and effectiveness of the web-based Dementia Foundations Program among unregulated care providers who provide care to persons living with dementia or are in training.</p><p><strong>Methods: </strong>A cohort of 50 PSWs, PSW trainees, and paid care companions from 3 recruitment sites were invited to access the Dementia Foundations Program, a 4-hour self-paced web-based program composed of 4 courses, for up to 6 weeks. Usability, usefulness, and satisfaction were assessed using surveys after each course and following the program. Dementia knowledge and attitudes were measured using the Dementia Knowledge Assessment Scale and the Dementia Attitudes Scale, with differences between baseline and postprogram scores analyzed using repeated measures ANOVA.</p><p><strong>Results: </strong>Participants reported high levels of satisfaction with the program. Of the 50 participants, 46 (92%) agreed that the web-based training met their expectations, 47 (94%) agreed that the training covered a broad range of topics and was not missing any important content, and 49 (98%) agreed that the web-based training would benefit them. There was a significant postprogram improvement in dementia knowledge as measured by the Dementia Knowledge Assessment Scale, with an average 30% improvement across all cohorts. Dementia Attitudes Scale scores were also significantly improved postprogram across all cohorts.</p><p><strong>Conclusions: </strong>This pilot study in PSWs, PSW trainees, and unregulated care companions demonstrated high satisfaction levels with the web-based Dementia Foundations Program. There were substantial improvements in knowledge and small improvements in attitudes for participants, and it was perceived as a useful tool that complemented their existing education and training. The Dementia Foundations Program is a user-friendly and effective e-learning program, which can be conveniently scaled and spread to enhance unregulated care provider dementia education.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e67889"},"PeriodicalIF":5.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683327","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":"Multimodal Detection of Agitation in People With Dementia in Clinical Settings: Observational Pilot Study.","authors":"Abeer Badawi, Somayya Elmoghazy, Samira Choudhury, Sara Elgazzar, Khalid Elgazzar, Amer M Burhan","doi":"10.2196/68156","DOIUrl":"10.2196/68156","url":null,"abstract":"<p><strong>Background: </strong>Dementia is a progressive neurodegenerative condition that affects millions worldwide, often accompanied by agitation and aggression (AA), which contribute to patient distress and increased health care burden. Existing assessment methods for AA rely heavily on caregiver reporting, introducing subjectivity and inconsistency.</p><p><strong>Objective: </strong>This study proposes a novel, multimodal system for predicting AA episodes in individuals with severe dementia, integrating wearable sensor data and privacy-preserving video analytics.</p><p><strong>Methods: </strong>A pilot study involving 10 participants was conducted at Ontario Shores Mental Health Institute. The system combines digital biomarkers collected from the EmbracePlus (Empatica Inc) wristband with video-based behavioral monitoring. Facial features in video frames were anonymized using a masking tool, and a deep learning model was used for AA detection. To determine optimal performance, various machine learning and deep learning models were evaluated for both wearable and video data streams.</p><p><strong>Results: </strong>The Extra Trees model achieved up to 99% accuracy for personalized wristband data, while the multilayer perceptron model performed best in general models with 98% accuracy. For video analysis, the gated recurrent unit model achieved 95% accuracy and 99% area under the curve, and the long short-term memory model demonstrated superior response time for real-time use. Importantly, the system predicted AA episodes at least 6 minutes in advance in all participants based on wearable data.</p><p><strong>Conclusions: </strong>The findings demonstrate the system's potential to autonomously and accurately detect and predict AA events in real-time. This approach represents a significant advancement in the proactive management of behavioral symptoms in dementia care.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e68156"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643720","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}

{"title":"Development and Validation of a Rule-Based Natural Language Processing Algorithm to Identify Falls in Inpatient Records of Older Adults: Retrospective Analysis.","authors":"Xing Xing Qian, Pui Hing Chau, Daniel Y T Fong, Mandy Ho, Jean Woo","doi":"10.2196/65195","DOIUrl":"10.2196/65195","url":null,"abstract":"<p><strong>Background: </strong>In order to address fall underestimation by the International Classification of Diseases (ICD) in clinical settings, information from clinical notes could be incorporated via natural language processing (NLP) as a possible solution. However, its application to inpatient notes has not been fully investigated.</p><p><strong>Objective: </strong>This study aims to develop and validate a rule-based NLP algorithm to identify falls based on inpatient admission notes from older patients.</p><p><strong>Methods: </strong>This retrospective study used 12-year electronic inpatient records of patients aged ≥65 years from public hospitals in Hong Kong. A random sample of 1000 patients was drawn to develop the NLP algorithm. Manual review was the gold standard for assessing the algorithm's performance, with sensitivity, specificity, precision, and F1-score calculated at the record, episode, and patient levels. In addition, the study compared the number of falls identified by ICD codes and clinical notes independently and combined.</p><p><strong>Results: </strong>Our rule-based NLP algorithm showed excellent performance, with a sensitivity, specificity, precision, and F1-score of 93.3%, 99.0%, 87.5%, and 0.903 at the record and episode levels, and 92.9%, 98.3%, 89.7%, and 0.912 at the patient level. The combined identification strategy using ICD codes and the NLP method provided the most comprehensive capture of fall-related episodes and fallers.</p><p><strong>Conclusions: </strong>The NLP method proved efficient and accurate in detecting falls from clinical notes in inpatient episodes. For comprehensive capture of fall episodes and fallers, we recommend the combined use of the NLP algorithm and ICD codes, which should be applied in future fall epidemiology studies and clinical practice for identifying high-risk groups of fall interventions.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e65195"},"PeriodicalIF":5.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592503","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}

{"title":"Design of a Mobile App and a Clinical Trial Management System for Cognitive Health and Dementia Risk Reduction: User-Centered Design Approach.","authors":"Hannes Hilberger, Bianca Buchgraber-Schnalzer, Simone Huber, Theresa Weitlaner, Markus Bödenler, Alara Abaci, Jeroen Bruinsma, Ana Diaz, Anna Giulia Guazzarini, Jenni Lehtisalo, Seungjune Lee, Vasileios Loukas, Francesca Mangialasche, Patrizia Mecocci, Tiia Ngandu, Anna Rosenberg, Elisabeth Stögmann, Konsta Valkonen, Elena Uhlik, Helena Untersteiner, Laura Kneß, Helmut Ahammer, Sten Hanke","doi":"10.2196/66660","DOIUrl":"10.2196/66660","url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of dementia is a major concern, with approximately 45% of cases linked to 14 modifiable risk factors. The European project LETHE aims to develop a personalized digital intervention model to delay or prevent cognitive decline through risk factor management.</p><p><strong>Objective: </strong>The objective of our study was to design a clinical trial platform for older individuals at risk of cognitive decline, including a mobile app for study participants and a clinical trial management system (CTMS) for health professionals.</p><p><strong>Methods: </strong>Using a user-centered design approach, workshops and feedback rounds involved potential participants representing the target group and professionals. The LETHE app's usability was assessed among 156 older adults enrolled in a 2-year multinational randomized controlled trial evaluating the feasibility of a digitally supported lifestyle program for dementia risk reduction. The randomized controlled trial is currently ongoing; the System Usability Scale (SUS) was administered 1 month after baseline to map first user experiences. Feedback on the LETHE CTMS was collected from 21 users.</p><p><strong>Results: </strong>Of the 78 participants in the trial intervention group, 66 (85%) provided responses for the mobile app, with a median SUS score of 70 (IQR 55-82). Within the control group, 73% (57/78) of responses were received, with a median SUS score of 73 (IQR 63-90). For the CTMS, we received 71% (15/21) of responses, and the feedback was mostly positive. A ranking of the features that could be considered beyond state of the art showed that the integration of personalized activities (mean 2.23, SD 1.17) and real-time appointments (mean 2.46, SD 1.51) were considered the most novel ones.</p><p><strong>Conclusions: </strong>The LETHE app and CTMS were developed to support a personalized digital intervention method within a study involving 156 participants. Limitations include participants having digital literacy and internet access, potentially impacting the generalizability of the findings. Despite these limitations, positive feedback and high usability scores suggest promising potential for the LETHE app and CTMS in supporting personalized interventions to prevent cognitive decline in older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66660"},"PeriodicalIF":5.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555217","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}

{"title":"Exploring Literature on Data Governance in the Health Care of Older Persons: Scoping Review.","authors":"Angely Garcia, Ayra Mae Balingbing, Yves Palad","doi":"10.2196/73625","DOIUrl":"10.2196/73625","url":null,"abstract":"<p><strong>Background: </strong>Health data are growing rapidly, and the processing of such data is evolving. Research on data governance in older persons' health care is unexplored, providing little guidance for practice and future studies.</p><p><strong>Objective: </strong>This scoping review aimed to synthesize available information on data governance in the context of older persons' health based on evidence from literature.</p><p><strong>Methods: </strong>The study followed the methodological framework of Arksey and O'Malley and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Online databases, namely, PubMed, Cochrane, Ovid, ACM, IEEE Xplore, and Google Scholar were searched by 2 independent reviewers (AG and AMB) for studies on older persons' health data governance published from January 2000 to April 2024. The independent reviewers performed the search, screening, data extraction, and review of full-text papers. A third reviewer (YP) made the final decision for unresolved discrepancies between the first 2 reviewers. The framework by the World Health Organization Pan American Health Organization, a high-level framework for planning and implementing data governance in public health, was used in the data extraction and analysis. Descriptive statistics were used, and a descriptive approach was used to summarize the results of the scoping review.</p><p><strong>Results: </strong>A total of 9840 titles were identified and 57 papers were included. Of these, 35 (61.4%) focused on technology, 19 (33.3%) on processes, and 3 (5.3%) on people. Data controller, processor, researchers, data subject or patient (including family or relatives), and relevant organizations were involved in older persons' data governance. Data governance frameworks were designed and implemented by reviewing the current evidence, involving the stakeholders throughout the process, implementing specific procedures (eg, collection and aggregating health data), and monitoring and evaluating them.</p><p><strong>Conclusions: </strong>The review underscores the importance of the involvement of relevant stakeholders and the use of various innovative tools and approaches in governing data related to the health of older persons. Meanwhile, research specifically addressing data governance for older persons' health conditions is limited. To enhance health outcomes for older persons, effective data governance is essential, alongside further research on relevant policies and practices.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e73625"},"PeriodicalIF":5.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512540","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}

{"title":"Exploring Older Adult's Views of the Age-Inclusivity of Physical Activity Websites Using the Think Aloud Method: Qualitative Analysis.","authors":"Veda Clemson, Elisabeth Grey, Julie Barnett, Ella Burfitt, Fiona Gillison","doi":"10.2196/68951","DOIUrl":"10.2196/68951","url":null,"abstract":"<p><strong>Background: </strong>Older adults are the least active in our society and may face additional barriers to taking part in physical activity compared with those experienced by younger people because of factors such as lower digital literacy and negative stereotypes of aging.</p><p><strong>Objective: </strong>This study aimed to explore how older adults navigate websites that provide access to physical activity opportunities and facilities and make judgments about their suitability.</p><p><strong>Methods: </strong>Semistructured interviews were embedded within a think-aloud approach. Participants were shown a series of websites and asked to navigate through the websites as if they were going to take up what was on offer, articulating their thoughts and comments out loud as they progressed. Participants viewed up to 4 websites, rotated from a pool of 8, including leisure centers, exercise products, gyms, or community organizations. Additional questions were asked about perceptions of the inclusivity of the websites at the end of the interview. Digital recordings were made and transcribed verbatim, and analyzed using thematic analysis.</p><p><strong>Results: </strong>Nineteen participants (6 male and 13 female) aged between 65 and 84 years were recruited from southern England; one-third reported having poor digital ability prior to taking part. Three overarching themes relating to the research question were identified as follows: (1) signals of age-inclusivity, (2) limiting beliefs, and (3) confidence in making judgments. Older adults inferred a lot of information about how welcome they would be in physical activity settings from the images and language used on websites. They showed a preference for imagery that was inclusive of age, body shape, and physical ability, not only for those depicting older adults themselves. Some adults reported firm views about the type and intensity of physical activity that is appropriate for older adults, and many expressed a specific dislike of gyms, based on both the (young) age of most users and perceived emphasis towards aesthetic rather than health-related exercise. While most participants could navigate websites successfully, they preferred to visit venues and speak to staff to gain greater confidence that they would feel welcome and that the activities would be at a suitable level.</p><p><strong>Conclusions: </strong>Websites providing access to physical activity could be more inclusive of older adults by using more diverse imagery, providing clearer descriptions of the activities on offer, along with details of the level of fitness or ability needed to take part, and providing alternatives to web-based booking. Additional societal-level approaches to reducing age-limiting self-stereotyping may also be useful in expanding the opportunities for older adults to access mainstream provisions for physical activity.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e68951"},"PeriodicalIF":5.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334041","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}

{"title":"Peer Volunteers' Journeys Through Training and Engagement in Older Adult Communities: Descriptive Qualitative Study.","authors":"Shefaly Shorey, Jeremy Soon Leong Seow, Rathi Mahendran, Geok Hua Wee, Lee Gan Goh, Ee Heok Kua","doi":"10.2196/71810","DOIUrl":"10.2196/71810","url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of mental health conditions such as depression and anxiety among the aging population underscores the need for accessible and effective psychosocial support, particularly for community-dwelling older adults who face barriers like social stigma and limited mental health literacy. Peer volunteers have emerged as a promising resource to support these individuals; yet, they often lack the requisite training for effective intervention.</p><p><strong>Objective: </strong>This study aims to explore the experiences of peer volunteers who participated in a Psychological First Aid training program.</p><p><strong>Methods: </strong>Using a descriptive qualitative research design, semistructured interviews were conducted with 13 older adults between September and October 2024, and data were thematically analyzed.</p><p><strong>Results: </strong>Three themes were identified: (1) dimensions of volunteerism from motivations to resistance, (2) empowerment through collaborative learning, and (3) recommendations for designing inclusive, holistic training programs.</p><p><strong>Conclusions: </strong>The findings of this study showed positive outcomes such as personal growth and strengthened social connections among participants. However, enhancements in teaching methods, logistical arrangements, and session regularity are recommended to optimize the Psychological First Aid program. These insights can guide the development of more robust training models to support both peer volunteers and the older adult communities they serve.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e71810"},"PeriodicalIF":5.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289682","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}

{"title":"Effectiveness of Gamification on Enjoyment and Satisfaction in Older Adults: Systematic Review and Meta-Analysis.","authors":"Javier Bravo-Aparicio, Iria Trillo-Charlín, Juan Avendaño-Coy, Hector Beltran-Alacreu","doi":"10.2196/72559","DOIUrl":"10.2196/72559","url":null,"abstract":"<p><strong>Background: </strong>Sedentary behavior is highly prevalent among older adults, with adherence to exercise being a major challenge. Exercise offers substantial physical, psychological, and social benefits, but enjoyment is a key factor influencing adherence. Technology-based interventions have shown promise in enhancing motivation and participation, demonstrating higher adherence rates than conventional treatments, although challenges such as motivation loss and technological barriers persist. This review evaluates the effectiveness of active video game interventions on enjoyment and satisfaction in older adults.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aims to determine whether active video games are superior to other interventions in generating greater enjoyment or satisfaction in older adults.</p><p><strong>Methods: </strong>PubMed, Cochrane, PEDro, SPORTDiscus, CINAHL, Web of Science, and Scopus databases were searched from inception to September 30, 2024, to identify randomized clinical trials or crossover studies. The primary outcome was enjoyment or satisfaction, assessed using various scales, including the Physical Activity Enjoyment Scale, Intrinsic Motivation Inventory, User Satisfaction Questionnaire, and Likert-type scoring scales. Secondary outcomes included adherence rates and adverse effects. Cochrane Risk of Bias 2 tool was used to evaluate the risk of bias.</p><p><strong>Results: </strong>Five studies were included in the quantitative analysis. The results indicated a significant improvement in enjoyment or satisfaction compared to the control groups (standardized mean difference 0.34, 95% CI 0.05-0.64; P=.02; I2=24%), although the effect size was small. Secondary outcomes could not be analyzed due to insufficient data in the selected studies.</p><p><strong>Conclusions: </strong>Active video game interventions may improve enjoyment and satisfaction in older adults, but the evidence remains of low certainty.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e72559"},"PeriodicalIF":5.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286663","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}

{"title":"Effectiveness of Walking Prescription Using Mobile Health Technology on the Changes in Daily Steps in Older Adults With Cognitive Impairment: Randomized Controlled Study.","authors":"Hee Jung Kim, Yun Jung Hwang, Jee Eun Park, Dong Young Lee","doi":"10.2196/63081","DOIUrl":"10.2196/63081","url":null,"abstract":"<p><strong>Background: </strong>Walking is frequently recommended as a beneficial physical activity for older adults, as it can enhance both their physical and mental well-being and help prevent cognitive decline and dementia. While it is known that mobile health (mHealth) technology can help improve physical activity among older adults, there is limited research on its effectiveness for older individuals with cognitive impairment.</p><p><strong>Objective: </strong>This study aimed to determine the effectiveness and feasibility of walking prescriptions using mHealth technology for older adults with cognitive impairment.</p><p><strong>Methods: </strong>In total, 60 older adults (mean=76.1, SD 5.4) years; female, n=34) with mild cognitive impairment or mild dementia (n=28 and n=32, respectively; Mini-Mental State Examination [MMSE], mean=20.7, SD 4.0) who visited the memory clinic were enrolled. They were randomly assigned into three groups: (1) group A (n=20) was prescribed with a goal of daily steps based on their telemonitored activity using a smart band; (2) group B (n=19) only wore a smart band without a prescription; and (3) group C (n=21) took a monthly education to encourage their walking. All participants took monthly face-to-face sessions with a coach to check their performance and modify the goal of daily steps. Changes in daily steps (primary outcome), cognitive function, physical status, and depressive symptoms from baseline to post-intervention (12 weeks) and follow-up (24 weeks) were assessed by unblinded researchers. Linear mixed effect models with factors of group (reference: control), time (reference: baseline), and their interaction were used for data analysis. Post hoc analyses using paired t tests were also conducted.</p><p><strong>Results: </strong>For group A, there was a significant group × time interaction effect on daily steps both at 12 and 24 weeks (β (SE)=2205.88 (672.34), P=.001; β (SE)=2194.63 (884.33), P=.015). Group B showed increased numbers of steps only at 12 weeks but not at 24 weeks. Group C showed a continuous decrease in daily steps during the study period. Regarding secondary outcomes, group C showed a significant decline in cognitive function measured by MMSE both at 12 and 24 weeks. However, groups A and B showed stationary MMSE scores during 24 weeks. The number of withdrawn participants did not differ among the 3 groups.</p><p><strong>Conclusions: </strong>Our findings suggest that walking prescriptions using mHealth technology can effectively increase daily steps in older adults with cognitive impairment.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e63081"},"PeriodicalIF":5.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276190","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}

{"title":"Sarcopenia and Risk of Cognitive Impairment: Cohort Study and Mendelian Randomization Analysis.","authors":"Tingting Sha, Yuqing Zhang, Jie Wei, Changjun Li, Chao Zeng, Guanghua Lei, Yilun Wang","doi":"10.2196/66031","DOIUrl":"10.2196/66031","url":null,"abstract":"<p><strong>Background: </strong>Over half the people over 60 years of age experience cognitive impairment, with limited treatment options, making it crucial to identify risk factors. Studies have examined the association between sarcopenia and cognitive impairment; however, the evidence is inconclusive and cannot be used to make causal inferences.</p><p><strong>Objective: </strong>This study aims to appraise the causal association of sarcopenia with cognitive impairment by triangulating the data from a cohort study and Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>Using UK Biobank data, we first examined the associations of sarcopenia and its indices (appendicular lean mass [ALM], handgrip strength, and gait speed) with cognitive function (fluid intelligence and prospective memory) by using mixed-effects regression models. Then, we explored the causal associations of genetically predicted sarcopenic indices with cognitive function through a 2-sample MR, and examined potential mediation by omega-3 fatty acids, vitamin D levels, physical inactivity, falls, frailty, sleep disorders, anxiety, depression, stroke, metabolic syndrome, and type 2 diabetes.</p><p><strong>Results: </strong>A total of 34,457 participants, with a mean age of 56.4 (SD 7.6) years, 51.1% (n=17,620) of which were female, completed baseline cognitive tests between 2006 and 2010 and attended at least 1 follow-up visit in 2012, 2014, or 2019, and were included in the observational analysis. The cohort study revealed that sarcopenia was significantly associated with cognitive impairment, which was evidenced by reduced fluid intelligence scores (β=-0.91, 95% CI -1.68 to -0.15; P=.02). Each of the sarcopenic indices also exhibited significant associations with either fluid intelligence or prospective memory (all P<.05). MR analyses yielded compelling evidence of positive associations between the genetically predicted increases in ALM (β=0.09, 95% CI 0.07-0.12; P<.001), handgrip strength (β=0.18, 95% CI 0.08-0.29; P<.001) and gait speed (β=0.78, 95% CI 0.53-0.29; P<.001) and improved cognitive function. The effects of ALM and handgrip strength on cognitive function were partially mediated by genetically predicted physical activity, with indirect effects of 0.01 (95% CI 0.00-0.02) for ALM and 0.02 (95% CI 0.00-0.05) for handgrip strength.</p><p><strong>Conclusions: </strong>Our study suggests that sarcopenia is a potential causal risk factor for cognitive impairment, with physical activity acting as a modifiable mediator in this relationship.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66031"},"PeriodicalIF":5.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276192","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}