JMIR Aging最新文献

{"title":"Response Time Dynamics From Noncognitive Ordinal Ecological Momentary Assessment as a Proxy for Symptom Change in Geriatric Depression: Longitudinal Observational Study.","authors":"Jooho Lee, Jeehang Lee, Sehwan Park, Gangho Do, Jihye Noh, Sangjoon Moon, Kyungmi Chung, Sang Joon Son, Jin Young Park","doi":"10.2196/83891","DOIUrl":"https://doi.org/10.2196/83891","url":null,"abstract":"<p><strong>Background: </strong>Depressive symptoms in older adults are amplified by social isolation and limited access to clinic-based mental health care. Ecological momentary assessment (EMA) enables remote self-monitoring and unobtrusively captures response times (RTs), which may serve as indicators of psychomotor and cognitive functioning.</p><p><strong>Objective: </strong>This study investigated the use of EMA-based RT dynamics for predicting symptom change and profiling potential responders for repeated self-monitoring in late-life depression.</p><p><strong>Methods: </strong>Forty-nine community-dwelling adults aged 65 years or older (mean age 70.7, SD 5.8 years; female: 35; male: 14) with a history of major depressive disorder received case management incorporating daily EMA. Participants provided self-reports of mood, appetite, sleep quality, and general well-being. Preassessment and postassessment included the 15-item Short Geriatric Depression Scale (GDS-15), the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), the 9-item Patient Health Questionnaire, and the Beck Anxiety Inventory. RTs were cleaned with an asymmetric IQR rule, z standardized within-person × response level, and modeled with exponential decay curves over successive EMA trials. The efficacy of EMA-adjunctive care was evaluated using pre-post comparisons of symptom scales. We then examined associations between RT-derived features and symptom change using correlational analyses. Finally, Bayesian multilevel modeling was applied to assess the clinical relevance of RT dynamics, including group differences in adaptation patterns.</p><p><strong>Results: </strong>Older adults at risk for depression showed significant symptom reductions over the 4-week EMA-adjunctive care period across all 4 psychological scales (CESD-R: mean Δ 11.5; rank-biserial r=0.78; GDS-15: mean Δ 2.14, Cohen d=0.76), alongside high EMA adherence (>90%). In correlational analyses, descriptive EMA score metrics and raw RTs showed modest, symptom-specific associations with symptom change (ΔCESD-R: |r|≈0.29; Δ9-item Patient Health Questionnaire: |r|≈0.32; ΔBeck Anxiety Inventory: |r|≈0.35) but were not significantly related to change in geriatric depression (ΔGDS-15: |r|≈0.24). In contrast, exponential-decay model parameters derived from standardized RT were significantly associated with geriatric depressive symptom change (Δ GDS-15), with the strongest effects observed for the feeling item (eg, decay rate θb: r=-0.398, asymptote θc: r=-0.321). Bayesian multilevel modeling further indicated that EMA-adjunctive care responders showed faster RT adaptation than nonresponders (median decay-rate ratio≈4.9, 95% credible interval 1.44-14.31), whereas differences in postadaptation RT levels were smaller and uncertain (median postadaptation RT ratio≈1.25, 95% credible interval 0.95-1.58). Sensitivity analyses showed consistent decay-rate effects across alternative specifications.</p><p><strong>Concl","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e83891"},"PeriodicalIF":4.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843842","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":"Effects of Multisensory Integration Training on Postural Stability Characteristics and Fall Risk in Older Adults: Systematic Review and Meta-Analysis.","authors":"Chaoyu Guo, Lulu Yin, Peng Chen, Jianglong Zhan, Zhongqi Yu, Teck Cheng Tan, Yaru Wei, Yixue Gong, Menghan Xu, Van Minh Le, Lin Wang","doi":"10.2196/80345","DOIUrl":"10.2196/80345","url":null,"abstract":"<p><strong>Background: </strong>The risk of falls escalates with advancing age, a consequence of the concomitant degeneration of multiple physiological systems, altered sensory processing capabilities, and reduced postural control. Multisensory integration (MSI) training has been demonstrated to enhance the brain's processing of multisensory information. However, existing studies show considerable variability in intervention duration and training modalities, limiting comparability across studies and contributing to inconsistent findings.</p><p><strong>Objective: </strong>This study aimed to systematically evaluate the effectiveness of MSI training on postural stability and fall risk in healthy older adults and provide an evidence base for clinical practice.</p><p><strong>Methods: </strong>Databases including PubMed, Embase, and Cochrane Library were searched by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The methodological quality of the included randomized controlled trials was assessed using the Cochrane risk of bias tool, and publication bias was evaluated through funnel plots. Meta-analyses using R packages quantified effects via standardized mean differences (SMDs) and 95% CIs, with fixed or random effects models selected based on heterogeneity (I²). Subgroup analyses explored age, intervention duration, and type.</p><p><strong>Results: </strong>A total of 14 randomized controlled trials were included in the meta-analysis. Results showed that MSI training significantly reduced center of pressure displacement in the anterior-to-posterior displacement (SMD -1.64, 95% CI -2.78 to -0.49, P<.001) and center of pressure displacement in the medio-to-lateral displacement (SMD -1.37, 95% CI -2.68 to -0.07, P<.001). In terms of postural stability, MSI training significantly improved Berg Balance Scale scores (SMD 3.42, 95% CI 2.41 to 4.44, P=.006). In terms of fall risk, MSI training significantly reduced the time to complete the timed up and go test, and intervention type significantly moderated this effect (SMD -1.43, 95% CI -2.36 to -0.50, P<.001). Additionally, MSI training reduced the risk of falls (SMD -1.27, 95% CI -2.03 to -0.52, P<.001).</p><p><strong>Conclusions: </strong>In conclusion, MSI training is an effective intervention for enhancing static and dynamic postural control and reducing fall risk in healthy older adults, suggesting a beneficial effect on postural stability and fall-related outcomes.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e80345"},"PeriodicalIF":4.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843846","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":"Smartphone-Based Field Assessment of Trunk Stability and Its Relationship With Whole-Body Balance in Older Adults: Cross-Sectional Study.","authors":"Javier De Los Ríos-Calonge, Casto Juan-Recio, Amaya Prat-Luri, Aarón Miralles-Iborra, Jose Ll Elvira, David Barbado, Francisco Jose Vera-Garcia","doi":"10.2196/83546","DOIUrl":"https://doi.org/10.2196/83546","url":null,"abstract":"<p><strong>Background: </strong>Maintaining balance is essential for older adults to preserve independence and reduce fall risk. However, empirical evidence linking trunk stability with balance and gait is scarce, partly due to the lack of accessible field tests. Smartphone-based accelerometry field tests offer a promising approach to assess trunk stability outside the laboratory.</p><p><strong>Objective: </strong>The study aimed to determine (1) the association between trunk stability and whole-body balance and gait and (2) the extent to which trunk stability and whole-body balance field tests align with laboratory-based assessments in older adults.</p><p><strong>Methods: </strong>A total of 53 physically active older adults performed 2 trunk stability tests (ie, the lumbopelvic stability [field] and the unstable sitting posturographic [laboratory] tests), 2 whole-body balance tests (ie, the tandem stance posturographic [laboratory] and the whole-body static balance [field] tests), and 2 gait-related tests (ie, the straight-line gait and the modified Timed Up and Go [field] tests) 2 times. A Spearman correlation analysis was performed after assessing the reliability of the variables.</p><p><strong>Results: </strong>Significant positive low-to-high correlations were found between the lumbopelvic stability and the whole-body static balance tests (0.380≤r≤0.700; P<.01). A low positive correlation (r=0.436; P<.01) was also observed between the unstable sitting posturographic test and the tandem stance posturographic test. No correlations were found between trunk stability and any gait-related test. No moderate-to-high relationships (0.289≤r≤0.487; P<.05) were found between laboratory and field tests (both for trunk stability and whole-body balance).</p><p><strong>Conclusions: </strong>Better static lumbopelvic control during exercises like the back bridge and the bird-dog is linked to improved whole-body balance in active older adults, suggesting that these positions be included in future interventions to enhance trunk stability. Accessible smartphone-based field tests for lumbopelvic stability offer a promising approach for the standardized assessment of trunk stability. However, direct extrapolation from field tools to laboratory findings is unfeasible due to a lack of correlation. These findings highlight the potential of smartphone-based field tests to complement clinical and research assessments of balance in older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e83546"},"PeriodicalIF":4.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843778","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":"Segmentation of Older People's Needs and Readiness for Smart Homes by Residentially Based Lifestyles in Spain: Survey Study.","authors":"Jiyeon Yu, Angélica de Antonio, Elena Villalba-Mora","doi":"10.2196/75110","DOIUrl":"https://doi.org/10.2196/75110","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Globally, the older population is increasing rapidly, becoming one of the most significant demographic trends of the 21st century. This growth poses important social, health, and technological challenges for societies that must adapt their environments and services to promote independent and healthy aging. In Spain, the population aged 65 years and older reached 18% of the total population in 2020, and projections indicate that this proportion will continue to rise in the coming decades. Within this context, smart homes have emerged as one of the most promising avenues to support aging in place and improve the quality of life. Smart homes encompass a wide variety of functions, including environmental control, safety monitoring, communication, and other assistive technologies, that may help older people stay healthy, safe, and independent in their own homes. However, older people are not a homogeneous group. Their lifestyles, health conditions, and technological experiences differ substantially, which means that, as with any assistive technology, smart home functions must match the real and perceived needs of the target users to ensure acceptance, adoption, and long-term use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this study, as a step forward toward the adaptability of smart home technology, we present a method to analyze the practical needs of smart home functions for older people. Specifically, we aim to understand the Spanish older population's readiness and needs for smart homes and to provide insights that can guide the design of more adaptive and user-centered solutions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted an online survey focusing on residentially based lifestyles, health conditions, and preferences for smart home functions, targeting older adults living in Spain. The survey collected information about participants' demographic profiles, daily activities, health self-assessment, and attitudes toward technology. A total of 102 valid responses were analyzed. We then classified the older adults according to their residentially based lifestyles using clustering techniques and analyzed the preferences and needs for smart home functions in each identified group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four clusters emerged based on the information provided by the participants: (1) high quality of life and independent life, (2) poor quality of life, (3) social-centered life, and (4) creative and personal-centered hobbies at home. On the basis of this classification, we explored each group's specific needs for smart homes and estimated their readiness to embrace different aspects of technology. As a result, the top-priority smart home functions for each group were identified and compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This research contributes to understanding the practical user needs of smart homes as assistive technologies for older people. It provides a methodological approach to anticipate and prioritize fu","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e75110"},"PeriodicalIF":4.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843770","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":"Integrating Community and Digital Support Through Social Prescribing to Improve Mental Health in Rural Older Adults in South Korea: Quasi-Experimental Study.","authors":"Bo Zhao, Joo Aeh Lim, Subeen Lim, Hye Jin Yoon, Hae Kyung Kim, Seok Mi Hong, Xinyu Zhang, Eun Woo Nam","doi":"10.2196/76201","DOIUrl":"https://doi.org/10.2196/76201","url":null,"abstract":"<p><strong>Background: </strong>Mental health issues such as depression, loneliness, and cognitive decline are prevalent among older adults. They are particularly pronounced in rural areas due to socioeconomic disadvantages, limited health literacy, and social isolation. These challenges have been exacerbated by the COVID-19 pandemic, highlighting the urgent need for accessible, community-based mental health strategies. Social prescribing-linking individuals to nonmedical community resources-offers a promising model, especially when coupled with culturally relevant and digitally facilitated interventions.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a pilot social prescribing project for individuals aged 65 years and older residing in rural South Korea. Specifically, it examined the changes in social support, loneliness, depression, cognitive function, and life satisfaction among the older adults before and after the intervention and the relationships among these factors.</p><p><strong>Methods: </strong>A quasi-experimental, nonequivalent control group pretest-posttest design was conducted with 294 participants from Wonju City, Gangwon-do (n=148 in the experimental group, n=146 in the control group). The 8-week intervention featured a community-based music storytelling program incorporating local cultural elements and digital education. Statistical analyses, including t tests, difference-in-differences analysis, and structural equation modeling, were conducted to evaluate changes in scores and the effectiveness of the program intervention.</p><p><strong>Results: </strong>The study confirmed that the social prescribing pilot project effectively reduced depression and increased social support and life satisfaction compared with the control group (P<.05, 95% CI). While cognitive function showed slight improvement, the change was not statistically significant. Social support emerged as a key mediating factor, positively influencing cognitive function and life satisfaction, and was negatively associated with depression. There was no statistically significant direct effect found between loneliness and cognitive function or social support.</p><p><strong>Conclusions: </strong>This pilot study supports the feasibility and mental health benefits of integrating community and digital support through culturally embedded social prescribing for rural older adults. The findings highlight the importance of leveraging local resources and social networks to address mental health disparities in underserved aging populations, offering valuable insights for policymakers and practitioners developing inclusive aging and health promotion strategies.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e76201"},"PeriodicalIF":4.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843835","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":"A Novel Combined Audiovisual-Semantic Digital Tool for Early-Stage Cognitive Decline Detection: Development and Validation Study.","authors":"Qiwei Wu, Binyu Zhao, Zihao Zheng, Betsy Seah, Xueping Zhang, Jing Shao","doi":"10.2196/91165","DOIUrl":"https://doi.org/10.2196/91165","url":null,"abstract":"<p><strong>Background: </strong>Dementia poses a significant public health challenge. Early detection is crucial for timely intervention but remains difficult in community settings, as many existing cognitive screening tools are either insufficiently sensitive to subtle decline or too burdensome for widespread use.</p><p><strong>Objective: </strong>This study aimed to develop and validate a novel combined audiovisual-semantic digital tool for rapid and acceptable community-based screening of cognitive decline in older adults.</p><p><strong>Methods: </strong>A total of 156 older adults completed 6 progressively complex task variants shifting from unimodal to multimodal stimuli and from basic to superordinate semantic categorization. Performance was measured using reaction time, accuracy, false alarms, and inverse efficiency. Diagnostic utility was assessed via logistic regression and receiver operating characteristic curve analysis, whereas qualitative interviews evaluated acceptability.</p><p><strong>Results: </strong>Task outcomes showed significant declines across the cognitive continuum from no cognitive impairment to mild cognitive impairment to dementia (P<.001). The integrated audiovisual-semantic condition at the basic categorization level reliably differentiated cognitive groups and achieved higher area under the curve values for distinguishing no cognitive impairment from cognitive impairment and mild cognitive impairment from dementia compared to basic-level tasks. Incorporating semantic processing enhanced diagnostic discrimination. Participant feedback was highly positive, with 48.7% (76/156) describing the tasks as \"fun/interesting.\"</p><p><strong>Conclusions: </strong>The audiovisual-semantic integrated digital tool is a valid, well-accepted, and time-efficient instrument for cognitive screening in older adults. Its design, which increases cognitive load through multimodal and semantic integration, improves sensitivity to early decline, supporting its potential for practical community application.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e91165"},"PeriodicalIF":4.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843748","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":"Effects of Digital-Based Exercise Interventions on Concerns About Falling, Falls Efficacy, and Physical Performance Among Older Adults: Systematic Review and Meta-Analysis.","authors":"Zhaojun Wang, Bochi Zhu, Meng Zhou, Xiaojie Xie, Xueyan Zhang","doi":"10.2196/87070","DOIUrl":"https://doi.org/10.2196/87070","url":null,"abstract":"<p><strong>Background: </strong>Falls are prevalent and serious health problems among older adults. Concerns about falling and reduced falls efficacy are common fall-related psychological impairments, representing 2 distinct emotional and cognitive constructs, respectively. The impact of digital-based exercise interventions on these specific constructs remains unclear.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to synthesize current evidence on digital-based exercise interventions for concerns about falling and falls efficacy among older adults, with a specific focus on determining their differential effects on emotional and cognitive constructs and evaluating their impact on physical performance.</p><p><strong>Methods: </strong>The PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CINAHL, CNKI, SinoMed, VIP, and Wanfang databases were systematically searched from their inception dates to May 2025. We searched for published randomized controlled trials on the effects of digital-based interventions on the fear of falling, concerns about falling, and falls efficacy among older adults. The study followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was performed using Stata 17.0 software (StataCorp LLC).</p><p><strong>Results: </strong>Eighteen studies involving 2435 participants were included. Meta-analyses revealed significant effects of digital-based exercise interventions on falls efficacy (standardized mean difference 0.70, 95% CI 0.51-0.90; P<.001), balance function (mean difference [MD] 4.03, 95% CI 2.57-5.49; P<.001), functional mobility (MD -1.65, 95% CI -2.52 to -0.77; P<.001), and physical function (MD 0.57, 95% CI 0.12-1.02; P=.006) among older adults. However, digital-based exercise interventions had no significant effect on concerns about falling, which is the emotional construct related to falls (standardized MD -0.12, 95% CI -0.28 to 0.05; P>.05).</p><p><strong>Conclusions: </strong>The meta-analysis assessed the efficacy of digital-based exercise interventions on fall-related psychological impairments among older adults and revealed that the effects differed across the constructs. These findings suggest that digital-based exercise interventions have potential benefits for improving falls efficacy and physical performance among older adults compared with controls. However, the effect of digital-based exercise interventions on concerns about falling, which is the emotional construct related to falls, remains uncertain among older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e87070"},"PeriodicalIF":4.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821839","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":"Integrated High-Throughput Targeted Metabolomics and Machine Learning for Early Prediction and Prevention of Postoperative Delirium in Older Adult Surgical Patients: Prospective Multicenter Cohort Study.","authors":"Gengrui Zhong, Xiaoli Huang, Congye Li, Deqiang Wang, Dingding Huang, Menghan Sun, Quanhong Zhou, Yong Guo","doi":"10.2196/78495","DOIUrl":"https://doi.org/10.2196/78495","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a common and severe complication in older adult patients with hip fracture, yet its pathogenesis remains unclear.</p><p><strong>Objective: </strong>This study aimed to develop a predictive model for POD following hemiarthroplasty in older adult patients by integrating high-throughput targeted metabolomics and machine learning.</p><p><strong>Methods: </strong>In this prospective multicenter cohort study, 260 older adult patients undergoing hemiarthroplasty for hip fracture were enrolled. Preoperative serum samples were analyzed via high-throughput targeted metabolomics. Differential metabolites were screened using random forest (RF) and least absolute shrinkage and selection operator regression. Predictive models were constructed using gradient boosting, logistic regression, and RF, with performance evaluated using receiver operating characteristic curves and the area under these curves (area under the receiver operating characteristic curve [AUC]).</p><p><strong>Results: </strong>Absolute quantification of 201 metabolites revealed 41 (20.4%) significantly differentially expressed metabolites. RF and least absolute shrinkage and selection operator regression identified 16 candidate biomarkers. The logistic regression model demonstrated optimal performance, achieving an AUC of 0.855 (95% CI 0.800-0.910) in the overall cohort. Upon 7:3 partitioning into training and test sets, the model maintained robust predictive accuracy, with AUCs of 0.844 and 0.856, respectively.</p><p><strong>Conclusions: </strong>Integration of preoperative metabolomics and machine learning enabled accurate prediction of POD in older adult patients with hip fracture, facilitating personalized risk stratification and tailored clinical management.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e78495"},"PeriodicalIF":4.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821894","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":"Telehealth Barriers and Digital Ageism Experienced by Older Veterans: Formative Ethnographic Study to Inform a Telepharmacy Randomized Trial.","authors":"Maria Venegas, Megan B McCullough, Chelsea E Hawley, Judith L Beizer, William W Hung, Lauren R Moo","doi":"10.2196/79409","DOIUrl":"10.2196/79409","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As telehealth has become an increasingly common mode of care delivery, older adults may face structural, technological, and interactional barriers that limit their ability to engage with video-based care. Although digital ageism, defined as the presence of age-related stereotypes, lowered expectations, or assumptions about older adults' technology-related competence, has been described in prior literature, less is known about how such dynamics surface during real-time telehealth encounters and how they may shape participation in technology-focused clinical trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This formative ethnographic study aimed to (1) document real-world barriers encountered by older adults immediately before and during video telehealth visits and (2) inform recruitment and implementation procedures for a subsequent telepharmacy randomized controlled trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted in-home, real-time ethnographic observation of 20 community-dwelling veterans aged ≥65 years participating in pharmacist-led video visits for medication management. Recruitment occurred over approximately 6 to 10 months using mailed invitation letters (&gt;300 sent), supplemented with outbound telephone calls. Data sources included structured field notes completed independently by an in-house anthropologist and the remote clinical pharmacist, as well as observational documentation of previsit preparation, visit navigation, and postvisit reflections. Data were analyzed using qualitative rapid analysis, with iterative team review and triangulation across data sources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants had a mean age of 74 (SD 3.18) years; 19 of 20 (95%) were male, and 18 of 20 (90%) identified as White. All participants completed a video visit with technical support as needed. Structural barriers (eg, broadband access and device availability) and usability challenges (eg, audio-video setup and navigation) were common. Although digital ageism was not a predefined analytical category, age-related assumptions about technology emerged during observation, including participants attributing anticipated or experienced difficulties to age and expressing surprise or pride following successful completion of the visit. These age-related interpretations were analytically distinct from access and usability barriers and were interpreted as manifestations of digital ageism, particularly as internalized age-based expectations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Formative ethnographic observation provided critical insights into how older adults experience telehealth encounters in real-world contexts and informed adaptations to recruitment and implementation procedures for a subsequent randomized controlled trial. Although digital ageism was not an original study aim, age-related assumptions about technology emerged as an important interpretive factor shaping engagement with video-based care. Incorporating ethnographic ","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e79409"},"PeriodicalIF":4.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821881","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":"The Effectiveness of Digital Interventions to Increase Preventive Care Uptake in Older Adults: Systematic Review.","authors":"Lindsay Burton, Kathy L Rush, Mindy A Smith, Robert Janke","doi":"10.2196/83446","DOIUrl":"10.2196/83446","url":null,"abstract":"<p><strong>Background: </strong>Older adults face increasing health risks associated with aging and chronic disease; yet, uptake of recommended clinical preventive services remains low. Digital health interventions have the potential to enhance access and engagement, but their effectiveness in older adult populations remains unclear.</p><p><strong>Objective: </strong>This systematic review aimed to examine the range and types of digital clinical preventive service interventions and assess their impact on preventive care uptake among older adults.</p><p><strong>Methods: </strong>We conducted a systematic review of peer-reviewed research literature published since 2014. Eligible studies included experimental and quasi-experimental designs evaluating digital interventions targeting community-dwelling adults aged 60 years and older. Interventions focused on high-priority preventive services, including cancer screening and adult immunizations. Data were extracted using a standardized form and synthesized narratively due to heterogeneity in study designs and outcomes.</p><p><strong>Results: </strong>In total, 24 studies involving over 1.3 million participants from 11 countries were included. Interventions used a range of digital tools, including telephone calls, SMS text messages, patient portals, and video-based education. While some digital and automated interventions demonstrated modest improvements in preventive services uptake, results were mixed. Interventions incorporating personalized elements (eg, tailored telephone counseling or in-person education) were generally more effective than generic, automated communications. Few studies reported on digital literacy support or intervention reach, and engagement with digital platforms was often low.</p><p><strong>Conclusions: </strong>Digital interventions can support modest improvements in preventive services uptake among older adults, particularly when personalized or combined with human interaction. However, assumptions of digital fluency and limited reporting on engagement constrain generalizability. Future research should prioritize inclusive design, detailed reporting, and strategies that address digital equity to better support older adult populations.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e83446"},"PeriodicalIF":4.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783681","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}