JMIR Aging最新文献

{"title":"Development of a Dementia Case Management Information System App: Mixed Methods Study.","authors":"Huei-Ling Huang, Yi-Ping Chao, Chun-Yu Kuo, Ya-Li Sung, Yea-Ing L Shyu, Wen-Chuin Hsu","doi":"10.2196/56549","DOIUrl":"10.2196/56549","url":null,"abstract":"<p><strong>Background: </strong>Case managers for persons with dementia not only coordinate patient care but also provide family caregivers with educational material and available support services. Taiwan uses a government-based information system for monitoring the provision of health care services. Unfortunately, scheduling patient care and providing information to family caregivers continues to be paper-based, which results in a duplication of patient assessments, complicates scheduling of follow-ups, and hinders communication with caregivers, which limits the ability of case managers to provide cohesive, quality care.</p><p><strong>Objective: </strong>This multiphase study aimed to develop an electronic information system for dementia care case managers based on their perceived case management needs and what they would like included in an electronic health care app.</p><p><strong>Methods: </strong>Case managers were recruited to participate (N=63) by purposive sampling from 28 facilities representing two types of community-based dementia care centers in Taiwan. A dementia case management information system (DCMIS) app was developed in four phases. Phase 1 assessed what should be included in the app by analyzing qualitative face-to-face or internet-based interviews with 33 case managers. Phase 2 formulated a framework for the app to support case managers based on key categories identified in phase 1. During phase 3, a multidisciplinary team of information technology engineers and dementia care experts developed the DCMIS app: hardware and software components were selected, including platforms for messaging, data management, and security. The app was designed to eventually interface with a family caregiver app. Phase 4 involved pilot-testing the DCMIS app with a second group of managers (n=30); feedback was provided via face-to-face interviews about their user experience.</p><p><strong>Results: </strong>Findings from interviews in phase 1 indicated the DCMIS framework should include unified databases for patient reminder follow-up scheduling, support services, a health education module, and shared recordkeeping to facilitate teamwork, networking, and communication. The DCMIS app was built on the LINE (LY Corporation) messaging platform, which is the mobile app most widely used in Taiwan. An open-source database management system allows secure entry and storage of user information and patient data. Case managers had easy access to educational materials on dementia and caregiving for persons living with dementia that could be provided to caregivers. Interviews with case managers following pilot testing indicated that the DCMIS app facilitated the completion of tasks and management responsibilities. Some case managers thought it would be helpful to have a DCMIS desktop computer system rather than a mobile app.</p><p><strong>Conclusions: </strong>Based on pilot testing, the DCMIS app could reduce the growing challenges of high caseloads faced by ca","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e56549"},"PeriodicalIF":5.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308691","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":"Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study.","authors":"Atsuko Tajika, Atsushi Nakagomi, Yasuhiro Miyaguni, Chie Koga, Katsunori Kondo, Toshiyuki Ojima","doi":"10.2196/53384","DOIUrl":"10.2196/53384","url":null,"abstract":"<p><strong>Background: </strong>Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain.</p><p><strong>Objective: </strong>This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education.</p><p><strong>Methods: </strong>The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered \"No\" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019.</p><p><strong>Results: </strong>After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively.</p><p><strong>Conclusions: </strong>These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53384"},"PeriodicalIF":5.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297320","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":"Requirement Analysis of Different Variants of a Measurement and Training Station for Older Adults at Risk of Malnutrition and Reduced Mobility: Focus Group Study.","authors":"Lisa Happe, Marie Sgraja, Vincent Quinten, Mareike Förster, Rebecca Diekmann","doi":"10.2196/58714","DOIUrl":"10.2196/58714","url":null,"abstract":"<p><strong>Background: </strong>Demographic change is leading to an increasing proportion of older people in the German population and requires new approaches for prevention and rehabilitation to promote the independence and health of older people. Technical assistance systems can offer a promising solution for the early detection of nutritional and physical deficits and the initiation of appropriate interventions. Such a system should combine different components, such as devices for assessing physical and nutritional status, educational elements on these topics, and training and feedback options. The concept is that the whole system can be used independently by older adults (aged ≥70 years) for monitoring and early detection of problems in nutrition or physical function, as well as providing opportunities for intervention.</p><p><strong>Objective: </strong>This study aims to develop technical and digital elements for a measurement and training station (MuTs) with an associated app. Through focus group discussions, target group requirements, barriers, and favorable components for such a system were identified.</p><p><strong>Methods: </strong>Older adults (aged ≥70 years) were recruited from a community-based setting as well as from a geriatric rehabilitation center. Focus group interviews were conducted between August and November 2022. Following a semistructured interview guideline, attitudes, requirements, preferences, and barriers for the MuTs were discussed. Discussions were stimulated by videos, demonstrations of measuring devices, and participants' ratings of the content presented using rankings. After conducting 1 focus group in the rehabilitation center and 2 in the community, the interview guide was refined, making a more detailed discussion of identified elements and aspects possible. The interviews were recorded, transcribed verbatim, and analyzed using content analysis.</p><p><strong>Results: </strong>A total of 21 older adults (female participants: n=11, 52%; mean age 78.5, SD 4.6 years) participated in 5 focus group discussions. There was a strong interest in the independent measurement of health parameters, such as pulse and hand grip strength, especially among people with health problems who would welcome feedback on their health development. Participants emphasized the importance of personal guidance and interaction before using the device, as well as the need for feedback mechanisms and personalized training for everyday use. Balance and coordination were mentioned as preferred training areas in a MuTs. New training options that motivate and invite people to participate could increase willingness to use the MuTs.</p><p><strong>Conclusions: </strong>The target group is generally open and interested in tracking and optimizing diet and physical activity. A general willingness to use a MuTs independently was identified, as well as a compelling need for guidance and feedback on measurement and training to be part of the station.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e58714"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297334","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":"Factors Influencing Malnutrition Among Older Adult Residents in the Western Region of Saudi Arabia: Sex Differential Study.","authors":"Mai Adil Ghabashi, Firas Sultan Azzeh","doi":"10.2196/55572","DOIUrl":"10.2196/55572","url":null,"abstract":"<p><strong>Background: </strong>The global population of older adults is on the rise. As people age, their physical functions gradually decline, leading to a decrease in the overall functioning of different organ systems. Due to these changes, older individuals are at a higher risk of encountering various adverse health outcomes and complications, such as malnutrition.</p><p><strong>Objective: </strong>This study aims to investigate the prevalence of malnutrition and its associated factors among older adults dwelling in the western region of Saudi Arabia. We have analyzed these factors separately for both men and women to understand any potential sex differences.</p><p><strong>Methods: </strong>A nonrandomized cross-sectional study was conducted for older adults aged ≥60 years in the western region of Saudi Arabia. Personal information was obtained through a closed questionnaire. The Mini Nutritional Assessment Short Form was used to determine the malnutrition status of older adults. Consequently, the individuals were divided into 2 groups: normal and malnourished. To assess the risk factors related to malnutrition, the odds ratio (OR) and 95% CI were determined using a binary logistic regression.</p><p><strong>Results: </strong>The prevalence of malnutrition in men and women was around 7% and 5%, respectively. Potential risk factors related to malnutrition in men were higher age (OR 1.263, 95% CI 1.086-1.468; P=.002), being widowed (OR 8.392, 95% CI 1.002-70.258; P=.049), and having dental problems (OR 9.408, 95% CI 1.863-47.514; P=.007). On the other hand, risk factors associated with malnutrition in women were lower BMI (OR 0.843, 95% CI 0.747-0.952; P=.006) and being disabled (OR 18.089, 95% CI 0.747-0.952; P=.006).</p><p><strong>Conclusions: </strong>The findings of this study provide important insights into the risk factors for malnutrition among older adults in the western region of Saudi Arabia. While the overall prevalence of malnutrition was relatively low, the analysis revealed distinct risk factors for older men and women. Interventions developed based on the identified risk factors may prove effective in addressing the issue of malnutrition within this population.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e55572"},"PeriodicalIF":5.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297318","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":"Nursing Staff's Perspectives of Care Robots for Assisted Living Facilities: Systematic Literature Review.","authors":"Katie Trainum, Jiaying Liu, Elliott Hauser, Bo Xie","doi":"10.2196/58629","DOIUrl":"10.2196/58629","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Care robots have been proposed in response to nursing shortages in assisted living facilities (ALFs) and the growing population of older adults. While the use of care robots may improve the general health and well-being of older adults, their introduction changes the work of nursing staff fundamentally, and it has implications for the entire health care system. In developing such technology, it is important to include end users, but so far, the nursing staff's perspectives have largely been ignored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to examine the literature on nursing staff's attitudes, needs, and preferences related to the use of care robots in ALFs, in order to discover gaps in the literature and guide future research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 protocol. On May 12, 2023, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, the IEEE Xplore Digital Library, and the ACM Digital Library using predetermined search terms. Included publications, written in English, focused on the predevelopment phase, in which information was gathered on nursing staff's attitudes, needs, and preferences regarding care robots for ALFs. Publications were excluded if they did not provide peer-reviewed empirical data. The studies' findings were summarized, coded, and analyzed into major themes using thematic analysis and narrative synthesis. Their quality was assessed using McGill University's Mixed Methods Appraisal Tool and the Joanna Briggs Institute's critical appraisal tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The final sample included 15 studies. Most of the studies (n=11, 73%) were rated as good quality; however, there was a general lack of reporting on important methodological decisions and sample characteristics. Nursing staff desired care robots that could assist with physically demanding tasks and reduce their workload but had mixed feelings on whether robots could or should assist with social tasks. In addition, nursing staff are concerned about the ethics of care robots, as well as about their safety, accessibility, and operability. The nursing staff's culture, qualification, and role in the facility may influence their perspectives of care robots. The studies lacked theory-driven designs and large sample sizes. Eight (53%) studies mentioned using a participatory design approach, but a lack of established criteria for what constitutes participatory design leads to varying degrees of methodological quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There was consensus among nursing staff that care robots should serve as nursing assistants to reduce workload. Whether robots could or should assist with social tasks remains a question. Further research is needed to mitigate nursing staff's concerns and understand the socioecological factors that influence their perspectives of care robots and their adoption in","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e58629"},"PeriodicalIF":5.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297332","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":"Investigating Acoustic and Psycholinguistic Predictors of Cognitive Impairment in Older Adults: Modeling Study.","authors":"Varsha D Badal, Jenna M Reinen, Elizabeth W Twamley, Ellen E Lee, Robert P Fellows, Erhan Bilal, Colin A Depp","doi":"10.2196/54655","DOIUrl":"10.2196/54655","url":null,"abstract":"<p><strong>Background: </strong>About one-third of older adults aged 65 years and older often have mild cognitive impairment or dementia. Acoustic and psycho-linguistic features derived from conversation may be of great diagnostic value because speech involves verbal memory and cognitive and neuromuscular processes. The relative decline in these processes, however, may not be linear and remains understudied.</p><p><strong>Objective: </strong>This study aims to establish associations between cognitive abilities and various attributes of speech and natural language production. To date, the majority of research has been cross-sectional, relying mostly on data from structured interactions and restricted to textual versus acoustic analyses.</p><p><strong>Methods: </strong>In a sample of 71 older (mean age 83.3, SD 7.0 years) community-dwelling adults who completed qualitative interviews and cognitive testing, we investigated the performance of both acoustic and psycholinguistic features associated with cognitive deficits contemporaneously and at a 1-2 years follow up (mean follow-up time 512.3, SD 84.5 days).</p><p><strong>Results: </strong>Combined acoustic and psycholinguistic features achieved high performance (F₁-scores 0.73-0.86) and sensitivity (up to 0.90) in estimating cognitive deficits across multiple domains. Performance remained high when acoustic and psycholinguistic features were used to predict follow-up cognitive performance. The psycholinguistic features that were most successful at classifying high cognitive impairment reflected vocabulary richness, the quantity of speech produced, and the fragmentation of speech, whereas the analogous top-ranked acoustic features reflected breathing and nonverbal vocalizations such as giggles or laughter.</p><p><strong>Conclusions: </strong>These results suggest that both acoustic and psycholinguistic features extracted from qualitative interviews may be reliable markers of cognitive deficits in late life.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e54655"},"PeriodicalIF":5.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297331","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":"Predicting Adherence to Computer-Based Cognitive Training Programs Among Older Adults: Study of Domain Adaptation and Deep Learning.","authors":"Ankita Singh, Shayok Chakraborty, Zhe He, Yuanying Pang, Shenghao Zhang, Ronast Subedi, Mia Liza Lustria, Neil Charness, Walter Boot","doi":"10.2196/53793","DOIUrl":"10.2196/53793","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment and dementia pose a significant challenge to the aging population, impacting the well-being, quality of life, and autonomy of affected individuals. As the population ages, this will place enormous strain on health care and economic systems. While computerized cognitive training programs have demonstrated some promise in addressing cognitive decline, adherence to these interventions can be challenging.</p><p><strong>Objective: </strong>The objective of this study is to improve the accuracy of predicting adherence lapses to ultimately develop tailored adherence support systems to promote engagement with cognitive training among older adults.</p><p><strong>Methods: </strong>Data from 2 previously conducted cognitive training intervention studies were used to forecast adherence levels among older participants. Deep convolutional neural networks were used to leverage their feature learning capabilities and predict adherence patterns based on past behavior. Domain adaptation (DA) was used to address the challenge of limited training data for each participant, by using data from other participants with similar playing patterns. Time series data were converted into image format using Gramian angular fields, to facilitate clustering of participants during DA. To the best of our knowledge, this is the first effort to use DA techniques to predict older adults' daily adherence to cognitive training programs.</p><p><strong>Results: </strong>Our results demonstrated the promise and potential of deep neural networks and DA for predicting adherence lapses. In all 3 studies, using 2 independent datasets, DA consistently produced the best accuracy values.</p><p><strong>Conclusions: </strong>Our findings highlight that deep learning and DA techniques can aid in the development of adherence support systems for computerized cognitive training, as well as for other interventions aimed at improving health, cognition, and well-being. These techniques can improve engagement and maximize the benefits of such interventions, ultimately enhancing the quality of life of individuals at risk for cognitive impairments. This research informs the development of more effective interventions, benefiting individuals and society by improving conditions associated with aging.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53793"},"PeriodicalIF":5.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297333","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 the Feasibility of Digital Voice Assistants for Delivery of a Home-Based Exercise Intervention in Older Adults With Obesity and Type 2 Diabetes Mellitus: Randomized Controlled Trial.","authors":"Costas Glavas, David Scott, Surbhi Sood, Elena S George, Robin M Daly, Eugene Gvozdenko, Barbora de Courten, Paul Jansons","doi":"10.2196/53064","DOIUrl":"10.2196/53064","url":null,"abstract":"<p><strong>Background: </strong>Current clinical guidelines for the management of type 2 diabetes mellitus (T2DM) in older adults recommend the use of antihyperglycemic medications, monitoring of blood glucose levels, regular exercise, and a healthy diet to improve glycemic control and reduce associated comorbidities. However, adherence to traditional exercise programs is poor (<35%). Common barriers to adherence include fear of hypoglycemia and the need for blood glucose level monitoring before exercise. Digital health strategies offer great promise for managing T2DM as they facilitate patient-practitioner communication, support self-management, and improve access to health care services for underserved populations. We have developed a novel web-based software program allowing practitioners to create tailored interventions and deliver them to patients via digital voice assistants (DVAs) in their own homes.</p><p><strong>Objective: </strong>We aim to evaluate the feasibility of a 12-week, home-based, personalized lifestyle intervention delivered and monitored by DVAs for older adults with obesity and T2DM.</p><p><strong>Methods: </strong>In total, 50 older adults with obesity aged 50-75 years with oral hypoglycemic agent-treated T2DM were randomized to the intervention (DVA, n=25) or a control group (n=25). Participants allocated to the DVA group were prescribed a home-based muscle strengthening exercise program (~20- to 30-min sessions) and healthy eating intervention, delivered via DVAs (Alexa Echo Show 8; Amazon) using newly developed software (\"Buddy Link\"; Great Australian Pty Ltd). Control group participants received generalized physical activity information via email. Outcomes were feasibility, DVA usability (System Usability Scale), and objectively assessed physical activity and sedentary time (wrist-worn accelerometers).</p><p><strong>Results: </strong>In total, 45 (90%) out of 50 participants completed this study. Mean adherence to prescribed exercise was 85% (SD 43%) with no intervention-related adverse events. System usability was rated above average (70.4, SD 16.9 out of 100). Compared with controls, the DVA group significantly decreased sedentary time (mean difference -67, SD 23; 95% CI -113 to -21 min/d), which was represented by a medium to large effect size (d=-0.6).</p><p><strong>Conclusions: </strong>A home-based lifestyle intervention delivered and monitored by health professionals using DVAs was feasible for reducing sedentary behavior and increasing moderate-intensity activity in older adults with obesity and T2DM.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621000307808; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381364&isReview=true.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53064"},"PeriodicalIF":5.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297317","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":"Determinants of Successful Implementation of Assistive Technologies for Dementia: Exploratory Survey.","authors":"Henriëtte Geralde Van der Roest, Hannah Liane Christie, Manuel Angel Franco-Martin, Rose-Marie Dröes, Marjolein Elizabeth de Vugt, Franka Meiland","doi":"10.2196/53640","DOIUrl":"10.2196/53640","url":null,"abstract":"<p><strong>Background: </strong>Despite positive results for the use of assistive technologies (ATs) in dementia, the uptake of ATs lags behind. It is considered important to assess determinants of successful or unsuccessful implementation of ATs.</p><p><strong>Objective: </strong>We explored factors that influence the implementation of ATs for community-dwelling people with dementia, with the aim to better understand potentially effective implementation strategies.</p><p><strong>Methods: </strong>A cross-sectional survey for researchers was developed and disseminated, exploring factors that influence either successful or unsuccessful implementation of ATs for dementia. The survey consisted of closed and open questions.</p><p><strong>Results: </strong>The response rate was 10% (21/206); the 21 respondents who completed the survey were from 8 countries. Determinants of implementation were described for 21 ATs, of which 12 were successfully and 9 were unsuccessfully implemented. Various types of ATs were included, such as online platforms, sensors, or physical aids. The main determinants of implementation success were related to the AT itself, contextual factors, research activities, and implementation strategies. There was a lack of research data on some ethical issues and cost-effectiveness.</p><p><strong>Conclusions: </strong>This study provided insight into some main barriers to and facilitators of implementation of ATs in dementia related to the AT itself, context, research-related activities, and applied implementation strategies. Lessons were formulated for various stakeholders to improve the implementation effectiveness of ATs in dementia.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53640"},"PeriodicalIF":5.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297316","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 Voice-Activated Device Exercise and Social Engagement Program for Older Adult-Care Partner Dyads: Pilot Clinical Trial and Focus Group Study Evaluating the Feasibility, Use, and Estimated Functional Impact of EngAGE.","authors":"Megan Huisingh-Scheetz, Roscoe F Nicholson Iii, Saira Shervani, Chelsea Smith, Margaret Danilovich, Laura Finch, Yadira Montoya, Louise C Hawkley","doi":"10.2196/56502","DOIUrl":"10.2196/56502","url":null,"abstract":"<p><strong>Background: </strong>Maintaining exercise is essential for healthy aging but difficult to sustain. EngAGE is a socially motivated exercise program delivered over a voice-activated device that targets older adult-care partner dyads.</p><p><strong>Objective: </strong>This 10-week pilot study aimed to assess EngAGE feasibility and use, obtain user experience feedback, and estimate potential impact on function.</p><p><strong>Methods: </strong>In total, 10 older adults aged ≥65 years were recruited from an independent living residence together with their self-identified care partners. EngAGE delivered National Institute on Aging Go4Life exercises to older adults daily, while care partners received progress reports and prompts to send encouraging messages that were read aloud by the device to the older adult. Older adults' use was tracked, and physical function was assessed at baseline and follow-up. Follow-up focus group data provided qualitative feedback.</p><p><strong>Results: </strong>On average, participants completed 393.7 individual exercises over the 10-week intervention period or 39.4 exercises/wk (range 48-492, median 431, IQR 384-481, SD 112.4) without injury and used EngAGE on an average of 41 of 70 days or 4.1 d/wk (range 7-66, median 51, IQR 23-56, and SD 21.2 days). Mean grip strength increased nonsignificantly by 1.3 kg (preintervention mean 26.3 kg, SD 11.0; postintervention mean 27.6 kg, SD 11.6; P=.34), and 4 of 10 participants improved by a minimal clinically important difference (MCID) of 2.5 kg. Further, the time for 5-repeated chair stands significantly reduced by 2.3 seconds (preintervention mean 12, SD 3.6 s; postintervention mean 9.7, SD 2.7 s; P=.02), and 3 of 9 participants improved by an MCID of -2.3 seconds. Furthermore, 3-meter usual walk performance was brisk at baseline (mean 2.1, SD 0.4 s) and decreased by 0.1 seconds (postintervention 2, SD 0.4 s; P=.13), although 5 of 9 participants improved by a MCID of 0.05 m/s. Qualitative results showed perceived benefits, favored program features, and areas for improvement.</p><p><strong>Conclusions: </strong>We present a pilot study of a new voice-activated device application customized to older adult users that may serve as a guide to other technology development for older adults. Our pilot study served to further refine the application and to inform a larger trial testing EngAGE's impact on functional outcomes, a necessary step for developing evidence-based technology tools.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e56502"},"PeriodicalIF":5.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297315","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}