JMIR Aging最新文献

{"title":"Toward Data-Informed Care in Long-Term Care: Qualitative Analysis.","authors":"Suleyman Bouchmal, Katya Yj Sion, Jan Ph Hamers, Sil Aarts","doi":"10.2196/69423","DOIUrl":"10.2196/69423","url":null,"abstract":"<p><strong>Background: </strong>In long-term care (LTC) for older adults, data on client, employee, and organization levels are collected in various ways, covering quality of care, life, and work. There is, however, a lack of understanding of how to introduce data-informed care in LTC and thus create value from data.</p><p><strong>Objective: </strong>This study aims to investigate the experiences and perceptions of various stakeholders in LTC regarding data and data-informed care.</p><p><strong>Methods: </strong>A qualitative study using the World Café cocreation technique was conducted with a diverse group of LTC stakeholders. Four questions were addressed: (1) What thoughts do you have when you hear the term \"data\" in relation to LTC? (2) What purposes do data have (in the future) in LTC? (3) What knowledge and skills are needed to enable data-informed care? (4) How can data contribute to and improve multidisciplinary learning? Stakeholders' notes and the plenary summary were analyzed using conventional content analysis.</p><p><strong>Results: </strong>Stakeholders included nurses, members of client councils, data specialists, researchers, and managers (N=20; mean age 50, SD 13 years). Five themes were identified: (1) despite uncertainty, the benefits of using data outweigh the associated risks; (2) the lack of accessibility and uniformity hinders integrating data-informed care; (3) human resources and finance departments pioneer data usage; however, potential lies in clinical decision-making; (4) data-informed care demands individual, collective, and organizational prerequisites; and (5) multidisciplinary collaboration enriches collective knowledge regarding data.</p><p><strong>Conclusions: </strong>Introducing data-informed care requires enhancing data literacy of health care professionals, establishing clear communication about the role of data within the organization, and introducing new job positions, such as data scientists. Data-informed care was considered a multidisciplinary approach in which data have a supportive role to enhance collective understanding and are considered crucial for improving quality of care. .</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e69423"},"PeriodicalIF":4.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055938","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":"Association Between the Frailty Index Based on Laboratory Tests and All-Cause Mortality in Hospitalized Older Adults: Retrospective Cohort Study.","authors":"Eyal Pasternak, Tamar Freud, Yan Press","doi":"10.2196/70204","DOIUrl":"10.2196/70204","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a common issue among hospitalized older adult patients and is associated with numerous adverse health outcomes. Assessing frailty facilitates better decision-making for treatment plans, patient placement, and discharge planning. Approximately a decade ago, the frailty index based on laboratory tests (FI-Lab) metric was introduced. Although this index has been shown in numerous studies to predict adverse medical outcomes, including mortality, it has not been extensively evaluated among patients hospitalized in internal medicine departments for diverse indications.</p><p><strong>Objective: </strong>The aim of the study was to investigate the relationship between FI-Lab at admission and all-cause mortality during hospitalization and after discharge in patients aged 65 years and older admitted for diverse clinical indications to internal medicine departments.</p><p><strong>Methods: </strong>This retrospective cohort study included patients aged 65 years and older hospitalized in the internal medicine departments of a large tertiary hospital. Data included demographic variables, comorbidity, and all-cause mortality. The FI-Lab was calculated based on 16 available blood tests, as well as blood pressure and heart rate measurements. We used Cox proportional hazards regression models to evaluate associations with mortality. Model performance was assessed using the C-index and time-dependent receiver operating characteristic (ROC) curves. Hospitalization data were collected from December 25, 2016, to January 7, 2023.</p><p><strong>Results: </strong>During the study period, 31,443 patients were hospitalized in internal medicine departments, and FI-Lab was calculable for 31,398 of them. The mean age of the patients was 77.6 (SD 8.2) years, and 52.1% (16,346/31,443) were women. The mean FI-Lab score was 0.38 (SD 0.15). Based on FI-Lab scores, patients were categorized into 4 groups: robust, mildly prefrail, moderately prefrail, and frail. After adjusting for age, sex, and comorbidities, frail and prefrail patients exhibited higher mortality rates than robust patients. For each 0.01 increase in the FI-Lab score (as a continuous variable), adjusted analyses revealed a 5.5% increase in in-hospital mortality, a 2.9% increase in mortality within the first year after hospitalization, and a 1.9% increase in mortality beyond the first year.</p><p><strong>Conclusions: </strong>The FI-Lab is a readily available and informative metric of frailty in older hospitalized patients. Calculating this index can assist physicians with identifying patients at high risk of mortality and provide meaningful information to support clinical decision-making.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e70204"},"PeriodicalIF":4.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034294","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":"Representations of Older Adults' Digital Literacy in Canadian News Media: Critical Discourse Analysis Using Unified Theory of Acceptance and Use of Technology 2.","authors":"Alixe Ménard, Alexandra Maharaj, Sophie Harb, Sarah Fraser, Tracey O'Sullivan","doi":"10.2196/69373","DOIUrl":"https://doi.org/10.2196/69373","url":null,"abstract":"<p><strong>Background: </strong>The transition of social and health services to digital platforms has significant implications for the inclusion and well-being of older adults. Digital literacy is a key determinant of health and equity, particularly as services shift to digital platforms. For older adults, this is crucial for accessing essential services and information, aiding in emergency resource navigation and information access.</p><p><strong>Objective: </strong>This study examines how Canadian news media portray older adults' digital literacy, using the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) framework to guide the analysis.</p><p><strong>Methods: </strong>News media articles from Canada, published from May 4, 2023, to July 4, 2024, were analyzed. Articles were identified through database searches and manual reviews, with inclusion criteria focusing on mentions of older adults and digital literacy. Critical discourse analysis was conducted using UTAUT2 factors to interpret the media narratives.</p><p><strong>Results: </strong>Of the 103 articles reviewed, 54 met the inclusion criteria. Four key themes emerged: (1) Performance and effort expectancy: media frequently depicted older adults as needing significant help with digital technologies, indicating potential digital ageism. (2) Social influence: fearmongering narratives suggest insufficient technological skills could result in social exclusion and limited access to essential services. (3) Facilitating conditions: articles highlighted older adults' susceptibility to digital scams and fraud, reinforcing digital ageism. (4) Hedonic motivation: media portrayals emphasized active aging, illustrating how digital tools, such as home security systems, can enhance independence and quality of life.</p><p><strong>Conclusions: </strong>Many media narratives on older adults' digital literacy perpetuate digital ageism. The study highlights how negative portrayals of older adults' digital skills and their exclusion from digital spaces underscore the need for more inclusive media representations. Findings suggest that media outlets could play a crucial role in shifting to more supportive portrayals of older adults' engagement with technology. Improving media portrayals can enhance digital engagement and preparedness among aging populations, contributing to better overall quality of life.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e69373"},"PeriodicalIF":4.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972561","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":"Evaluating the Feasibility of a Dyadic, Touch-Based Multimedia Tablet Intervention and Its Effects on the Caregiver-Patient Relationship Among Individuals With Mild Cognitive Impairment: Qualitative Triangulation Study.","authors":"Alexa von Bosse, Anna Thum, Sonja Mahler, Henriette Schulz, Paulina Weuthen, Christophe Kunze","doi":"10.2196/75189","DOIUrl":"10.2196/75189","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Approximately 20% of the global population is affected by mild cognitive impairment (MCI), with around 15% progressing to dementia within 2 years. Touch-based multimedia applications can support cognitive, social, and physical functioning, potentially enhancing daily life and strengthening caregiver-patient relationships through shared engagement. Although interest in dyadic, technology-assisted interventions is increasing, empirical evidence on their feasibility and acceptability in home-based settings remains scarce. In particular, little is known about their impact on caregiver-care recipient dynamics and the factors that facilitate or hinder their use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to evaluate the feasibility of a dyadic, tablet-based multimedia intervention for individuals with MCI and their caregivers in a home setting, focusing on user experiences, use barriers and facilitators, and the intervention's impact on the caregiver-patient relationship.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We applied qualitative triangulation, combining naturalistic observations and semistructured interviews. Data were analyzed using qualitative content analysis. The intervention was codeveloped by a multidisciplinary team and implemented as a user-centered, tablet-based modular platform with customizable cognitive, physical, and interactive exercises.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We recruited a total of 40 participants, comprising 20 (50%) individuals with MCI and their 20 (50%) caregivers. Our study confirmed the feasibility of a touch-based multimedia intervention for both groups. Despite initial challenges with navigation and touch interfaces, most participants demonstrated increased confidence and competence, particularly with tailored caregiver support. Instances of enhanced communication and emotional connection were described by care partners and then became visible during their interaction with the intervention. Shared moments of laughter, mutual encouragement, and coordinated task execution indicated that the intervention could create opportunities for relational closeness. Biography-related tasks proved particularly effective, stimulating meaningful conversation and storytelling that facilitated the sharing of personal memories and experiences. While some dyads experienced occasional tensions due to impatience, differing expectations, or dominant behavior by one partner, the overall atmosphere was one of cooperation, support, and adaptability. The intervention demonstrated how technology can serve as a tool to facilitate shared experiences, promote cognitive engagement, and enrich interpersonal relationships in everyday caregiving contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings show that the home-based implementation of a dyadic, touch-based multimedia intervention can be feasible for individuals with MCI and their caregivers. A key finding is that biographically oriented content fosters caregiver-p","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e75189"},"PeriodicalIF":4.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972630","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":"Medicaid Education and Eligibility Planning for Caregivers: Website Usability and Validation Study.","authors":"Marguerite DeLiema, Siyu Gao, Justine Scattarelli, Kelly Moeller, Olu Olofinboba","doi":"10.2196/77441","DOIUrl":"https://doi.org/10.2196/77441","url":null,"abstract":"<p><strong>Background: </strong>Most older Americans have not saved enough to cover long-term care costs. Medicaid-a public health care program for low-income individuals-can help Americans with qualifying care needs pay for assistance in a nursing home or for services in the home. Determining financial eligibility for Medicaid is complicated, and the application process is often managed by family caregivers with limited knowledge of Medicaid programs.</p><p><strong>Objective: </strong>A one-stop digital solution is needed to help family caregivers plan for the cost of long-term care services and learn about getting help paying for services through Medicaid. We aimed to develop a web application that (1) educates informal caregivers about Medicaid programs and eligibility criteria, (2) informs them about the cost of home and institutional care in their local area with and without Medicaid coverage, and (3) uses a custom algorithm to provide personalized financial eligibility information based on the care recipient's income, assets, and monthly spending.</p><p><strong>Methods: </strong>We first interviewed aging services providers and informal family caregivers, then developed a web application that was refined based on user experience interviews with English- and Spanish-speaking caregivers. In the final validation phase, asynchronous usability sessions were recorded with 109 informal caregivers who completed a series of tasks. Participants viewed and rated animated Medicaid \"explainer\" videos, input financial information to enable the custom algorithm to determine the care recipient's eligibility for Medicaid, adjusted settings on a care cost calculator to estimate the regional cost of home and institutional care services, and completed a Medicaid knowledge quiz before and after using the website.</p><p><strong>Results: </strong>After engaging with the website and watching the videos, scores on a Medicaid knowledge quiz increased by 61.2% (2-tailed t92=12.9, P<.001). Participants found it easy to enter the care recipient's financial information to determine Medicaid eligibility (out of 7; mean 5.9, SD 1.3) and perceived the care cost calculator as very helpful (out of 7; mean 6.3, SD 1.2). The website received a very high System Usability Scale rating of 88.3 out of 100 (SD 13.1). Caregivers verbalized wanting more education on complex financial concepts that impact Medicaid eligibility and asset preservation.</p><p><strong>Conclusions: </strong>A comprehensive Medicaid planning website can significantly improve caregivers' knowledge of Medicaid and provide them with a personalized roadmap for accessing care services. The custom algorithm powering the Medicaid eligibility determination could be further refined to account for state-based exceptions. This application may reduce caregiver burden and help support the long-term care planning process.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e77441"},"PeriodicalIF":4.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12386547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972585","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":"Principal Component Analysis of Stair Negotiation and Floor Transition Kinematics in Older Adults With and Without Functional Disability: Cross-Sectional Study.","authors":"Juliana Moreira, Ivone da Silva Teles, Bruno Cunha, José Félix, Diana C Guedes, Leonel A T Alves, Rubim Santos, Andreia S P Sousa","doi":"10.2196/71530","DOIUrl":"https://doi.org/10.2196/71530","url":null,"abstract":"<p><strong>Background: </strong>Stair negotiation (ascending and descending) and transitions to level walking are complex motor tasks influenced by aging; yet the impact of functional disability on these changes remains underexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the lower limb joint positions, velocities, and the center of mass (CoM) displacement and velocity during stair negotiation and transitions in older adults with and without functional disability.</p><p><strong>Methods: </strong>Sixty community-dwelling adults, aged 60 years and older, were assessed for lower limb tridimensional joint positions and velocities during the instances of foot contact or leaving the step and foot contact or leaving the floor; the joint range of motion, angular velocity range, and the CoM displacement and angular velocity range were assessed during stair ascend and descend and transitions floor-to-stair and stair-to-floor through an optoelectronic system. Principal component analysis was used to assess 8 groups of variables to compute principal component models (I-VIII). Participants were classified as with or without disability based on functional disability indicators. Group differences were assessed using the Mann-Whitney U test.</p><p><strong>Results: </strong>From 240 variables, 41 key parameters were identified, mainly related to hip and knee angular velocities in the sagittal plane. Significant differences between older adults with disability (n=25) and without disability (n=35) were found in 12 principal components.</p><p><strong>Conclusions: </strong>Older adults with functional disability showed changes in the sagittal plane hip as well as in the knee angular velocity and mediolateral and vertical CoM displacement and velocity during stair negotiation and transitions. These findings can inform targeted strategies to improve mobility and stability in this population.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e71530"},"PeriodicalIF":4.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972627","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":"Web-Based Assessment of Cognition and Dementia Risk Factors in Over 3000 Norwegian Adults Aged 50 Years and Older: Cross-Sectional PROTECT Norge Study.","authors":"Ingelin Testad, Jon Arild Aakre, Martha Therese Gjestsen, Clive Ballard, Anne Corbett, Dag Aarsland, Ellie Pickering, Anastasia Ushakova","doi":"10.2196/69867","DOIUrl":"https://doi.org/10.2196/69867","url":null,"abstract":"<p><strong>Background: </strong>With the growing number of older adults in the Norwegian population and the associated rapid rise in dementia and cognitive impairment, novel and more efficient methodologies are needed to facilitate research, improve diagnostic triage, and deliver effective brain health interventions in the community. Platform for Research Online to Investigate Genetics and Cognition in Ageing Norge (PROTECT Norge) is a web-based, remote research platform on the aging brain, culturally adapted from the UK PROTECT study, incorporating a Norwegian cohort of adults aged 50 years and older, where participants complete study activities via a dedicated website. Data were collected through study activities, which included self-reported questionnaires and a computerized neuropsychological test battery.</p><p><strong>Objective: </strong>The study aimed to assess associations between dementia risk factors, including obesity, hypertension, smoking, and hearing loss, and cognition using baseline data from the PROTECT Norge study.</p><p><strong>Methods: </strong>Data from the PROTECT Norge study were used to assess associations between dementia risk factors and cognition. These associations were assessed using independent-sample t tests for each of the cognitive tests, which included paired associate learning, self-ordered search, digit span, and verbal reasoning tasks.</p><p><strong>Results: </strong>During the first 2 years of data collection, records from 3214 participants were obtained. Associations between established risk factors and cognitive performance were found, with significant detriments to cognitive performance on the computerized neuropsychological test battery. In the PROTECT Norge cohort, consisting of 74.5% females, the mean age was 64.1 (SD 7.7), and 94% of participants provided consent for contact regarding future research.</p><p><strong>Conclusions: </strong>These data show the associations between dementia risk factors and cognition and attest to the excellent feasibility of the PROTECT Norge cohort, with over 3000 participants included over a period of 2 years and accessibility for people with early cognitive impairment. This, combined with the cohort's willingness to participate in future studies (94%), positions PROTECT Norge as a tremendous opportunity for cost-efficient, large-scale brain health research and potentially for clinical digital cognitive health programs.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e69867"},"PeriodicalIF":4.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972639","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":"Cognitive Functioning Trajectories and Their Association With Mental Health in Older Adults With Hypertension: Secondary Analysis of the Chinese Longitudinal Healthy Longevity Survey Data.","authors":"Peiyun Wu, Cheng Lin, Jing Yang, Zhizhuo Wang","doi":"10.2196/74916","DOIUrl":"https://doi.org/10.2196/74916","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of research on the trajectories of cognitive functioning in older people with hypertension, as well as possible contributing factors and correlations between cognitive functioning and mental health.</p><p><strong>Objective: </strong>This study aimed to conduct a secondary longitudinal analysis to examine cognitive functioning trajectories and their associated factors in older people with hypertension.</p><p><strong>Methods: </strong>The data used in our study were retrieved from the Chinese Longitudinal Healthy Longevity Survey. The Chinese version of the Mini-Mental State Examination was used to assess cognitive functioning. The trajectories of cognitive functioning of older individuals with hypertension were determined by using group-based trajectory modeling. The binary logistic regression analyses were performed to examine how participant factors affected the trajectories of cognitive functioning in older individuals with hypertension. The relationships between cognitive functioning and mental health were investigated using multivariable linear regression models. Data were analyzed using SPSS (version 20.0; SPSS Inc) and Stata (version 16.0; StataCorp LLC).</p><p><strong>Results: </strong>A total of 642 older people with hypertension were included. Cognitive functioning was categorized into 2 trajectories according to group-based trajectory modeling: \"rapid decline\" (48/642, 7.9%) and \"slow decline\" (594/642, 92.1%). Binary logistic regression results showed that older adults with hypertension aged equal to or greater than 80 years had an elevated risk of rapid decline in cognitive functioning (odds ratio 5.484, 95% CI 2.365-12.719), and higher score in mental health was the protector of rapid decline in cognitive functioning during the following 13 years (odds ratio 0.918, 95% CI 0.852-0.988). In the unadjusted model, mental health was positively associated with cognitive functioning (β=.246, 95% CI 0.125-0.234, P<.001), and this association was maintained after partial or complete adjustment for covariates (β=.159, 95% CI 0.059-0.174, P<.001; β=.138, 95% CI 0.043-0.158, P=.001). Subgroup analyses by age showed that this positive correlation was only seen in the 60-69 years age group (β=.183, 95% CI 0.036-0.193, P=.004), while subgroup analyses by sex revealed that the association between these 2 indicators was no longer presented among males in the fully adjusted model (β=.082, 95% CI -0.024 to 0.119, P=.19), and BMI fully stratification demonstrated this association persisted in the healthy weight group (β=.125, 95% CI 0.039-0.210, P=.004).</p><p><strong>Conclusions: </strong>Our research showed that the decline in cognitive functioning is associated with lower mental health and occurs more rapidly in older adults with hypertension who are older than 80 years.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e74916"},"PeriodicalIF":4.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972577","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":"Implementing a Digital Physical Activity Intervention for Older Adults: Qualitative Study.","authors":"Cherish Boxall, Laura Dennison, Sascha Miller, Judith Joseph, Kate Morton, Jenny Corser, Joanna Kesten, Asgar Electicwala, Max J Western, Stephen Lim, Chloe Grimmett, Lucy Yardley, Katherine Bradbury","doi":"10.2196/64953","DOIUrl":"https://doi.org/10.2196/64953","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) in older adults can prevent, treat, or offset symptoms and deterioration from various health conditions and help maintain independence. However, most older adults are insufficiently active. Digital interventions have the potential for high reach at low cost.</p><p><strong>Objective: </strong>This paper reports on the implementation of \"Active Lives,\" a digital intervention developed specifically for older adults.</p><p><strong>Methods: </strong>This study had a qualitative design. The implementation team approached a range of National Health Service, public health, community, and third-sector organizations in the United Kingdom to offer Active Lives to as large and diverse groups of older adults as possible. Alongside real-world implementation activities, research was conducted to explore what supports and inhibits the implementation of a digital intervention for PA in older adults. Data collection involved interviews with implementation partners (n=15) and the implementation team (n=3) plus extensive field notes from stakeholder communications. Inductive thematic analysis was used to analyze the data.</p><p><strong>Results: </strong>Five broad themes were developed, capturing implementation barriers and facilitators. These were (1) complex and opaque networks and influencers, (2) forming an understanding of Active Lives and its fit, (3) a landscape of competition and conflicting interests, (4) navigating unclear approval processes, and (5) shifting strategies: small and effortful to high reach and passive. Identifying key decision makers proved arduous, consuming significant time and resources, and proposals from enthusiastic implementation partners often proved impractical or overly burdensome. Health care professionals demonstrated a comprehensive understanding of the potential benefits of digital interventions in alleviating operational burdens and improving patient care. However, stakeholders from disparate sectors held reservations about digital intervention and had different views on the best approaches to supporting PA among older adults. This discord was exacerbated by conflicts with existing local initiatives, such as group exercise programs, which occasionally hindered the implementation of Active Lives. Furthermore, bureaucratic hurdles within National Health Service trust approval processes acted as formidable obstacles, dampening progress and resolve, highlighting the need for guidance in identifying sustainable and scalable practices.</p><p><strong>Conclusions: </strong>The findings highlight important implementation challenges to digital PA interventions for older adults such as bureaucratic barriers and alignment with ongoing initiatives. This research emphasizes the necessity for strategic direction and multilevel guidance to efficiently implement digital interventions for PA among community-dwelling older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e64953"},"PeriodicalIF":4.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972558","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 Iso-Inertial Resistance Training on Muscle Power in Middle-Older Adults: Randomized Controlled Trial.","authors":"Aïda Cadellans Arroniz, Daniel Romero Rodríguez, Víctor Zárate, Flora Dantony, Marc Madruga Parera, Silvia Ortega Cebrian, David Blanco","doi":"10.2196/66414","DOIUrl":"https://doi.org/10.2196/66414","url":null,"abstract":"<p><strong>Background: </strong>Resistance training is commonly used to prevent the decline in muscle power associated with aging.</p><p><strong>Objective: </strong>This study aims to evaluate the effectiveness of iso-inertial (IN) training on power, physical performance, and variables associated with the risk of falls, compared to gravitational (GR) training, in physically active middle-older adults.</p><p><strong>Methods: </strong>A parallel-group, randomized controlled trial was conducted at Espai Esport Wellness Center (Granollers, Spain). In total, 44 physically active adults (age >57) were randomized 1:1 to either the IN (n=21) or GR (n=23) training groups (using R software; R Core Team). Participants completed a 6-week training program (2 sessions/week) consisting of 3 exercises (forward lunge, side lunge, and forward lunge with row). The primary outcome includes power in the eccentric phase of each exercise, evaluated using both IN and GR devices. Secondary outcomes include concentric power, physical performance, and variables associated with the risk of falls. Only outcome evaluators were blinded. We used multivariate linear regression models for the analysis.</p><p><strong>Results: </strong>In total, 27 participants completed the program (IN: n=15 IN; GR: n=12). IN training resulted in better eccentric power gains compared to GR training when assessed using the IN system, although the difference was only statistically significant for the side lunge. For forward lunge, between-group difference was 4.50 W (95% CI -2.94 to 11.94 W, P=.23); for side lunge, between-group difference was 9.24 W (95% CI 2.99-15.49 W; P<.01); and for forward lunge with row, between-group difference was 15.25 W (95% CI -0.63 to 31.13 W; P=.06). We observed no significant differences for the eccentric power using the GR system evaluation, concentric power, physical performance, and variables associated with the risk of falls. Both groups showed significant improvements from baseline across all outcomes.</p><p><strong>Conclusions: </strong>Although IN training appeared to result in greater power gains during the eccentric phase when assessed with the IN system, statistically significant differences were observed only for the side lunge exercise. Both training systems seemed equally effective in improving eccentric power as evaluated with the GR system, concentric power, physical performance, and reducing variables associated with the risk of falls.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66414"},"PeriodicalIF":4.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972568","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}