JMIR Aging最新文献

{"title":"Digital Literacy Training for Low-Income Older Adults Through Undergraduate Community-Engaged Learning: Single-Group Pretest-Posttest Study.","authors":"Lisa M Soederberg Miller, Rachel A Callegari, Theresa Abah, Helen Fann","doi":"10.2196/51675","DOIUrl":"10.2196/51675","url":null,"abstract":"<p><strong>Background: </strong>Digital technology is a social determinant of health that affects older people's ability to engage in health maintenance and disease prevention activities; connect with family and friends; and, more generally, age in place. Unfortunately, disparities in technology adoption and use exist among older adults compared with other age groups and are even greater among low-income older adults.</p><p><strong>Objective: </strong>In this study, we described the development and implementation of a digital literacy training program designed with the dual goals of training low-income older adults in the community and teaching students about aging using a community-engaged learning (CEL) approach.</p><p><strong>Methods: </strong>The training program was embedded within a 10-week CEL course that paired undergraduates (N=27) with low-income older adults (n=18) for 8 weeks of digital literacy training. Older adults and students met weekly at the local senior center for the training. Students also met in the classroom weekly to learn about aging and how to use design thinking to train their older adult trainees. Both older adults and students completed pre- and posttraining surveys.</p><p><strong>Results: </strong>Older adults demonstrated increased digital literacy skills and confidence in the use of digital technology. Loneliness did not change from pre to postassessment measurements; however, older adults showed improvements in their attitudes toward their own aging and expressed enthusiasm for the training program. Although students' fear of older adults did not change, their comfort in working with older adults increased. Importantly, older adults and students expressed positive feelings about the trainee-trainer relationship that they formed during the training program.</p><p><strong>Conclusions: </strong>A CEL approach that brings together students and low-income older adults in the community has a strong potential to reduce the digital divide experienced by underserved older adults. Additional work is needed to explore the efficacy and scalability of this approach in terms of older adults' digital literacy as well as other potential benefits to both older and younger adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":" ","pages":"e51675"},"PeriodicalIF":4.9,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872264","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":"Digital Adoption by an Organization Supporting Informal Caregivers During COVID-19 Pandemic Showing Impact on Service Use, Organizational Performance, and Carers' Well-Being: Retrospective Population-Based Database Study With Embedded User Survey.","authors":"Ala Szczepura, Amir Jahan Khan, Deidre Wild, Sara Nelson, Sonja Woodhouse, Mark Collinson","doi":"10.2196/46414","DOIUrl":"10.2196/46414","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The COVID-19 pandemic has catalyzed a move from face-to-face to digital delivery of services by hospitals and primary care. However, little is known about the impact of digital transformation on organizations supporting unpaid caregivers. Since the start of the COVID-19 pandemic, the value of care provided by such informal caregivers is estimated to be £111 billion (US$ 152.7 billion) in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to analyze service uptake patterns (including digital service options) over the pandemic period in an English caregivers' support organization covering a population of 0.98 million; measure changes in organizational performance, service efficiency, and quality; and identify the views of caregivers on service provision and future digital delivery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective analysis of the use of digital versus nondigital support services (January 2019 to June 2021) by caregivers in city and rural geographic areas. We compared organizational performance and service quality indicators for 2 financial years (2019-2020 and 2020-2021). A survey was conducted to identify barriers and facilitators to digital service uptake, the computer proficiency of caregivers (the Computer Proficiency Questionnaire, 12-item version), and preferences for future digital service provision. Quantitative data were analyzed using Stata 13 (StataCorp LLC). Thematic analysis was used for open-text survey responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The number of caregivers registered with the organization rose from 14,817 in 2019 to 20,237 in 2021. Monthly contacts rose from 1929 to 6741, with remote contacts increasing from 48.89% (943/1929) to 86.68% (5843/6741); distinctive patterns were observed for city versus rural caregivers. There was an increase in one-to-one contacts (88.8%) and caregiver assessments (20.9%), with no expansion in staffing. Service quality indicators showed an improvement in 5 of 8 variables (all P&lt;.05). The 152 carers completing the survey had similar demographics to all registered caregivers. The Computer Proficiency Questionnaire, 12-item version, mean score of 25.61 (SD 4.40) indicated relatively high computer proficiency. The analysis of open-text responses identified a preference for the organization to continue to offer face-to-face services as well as web-based options. The digital services that were the most highly rated were carers' well-being assessments, support needs checks, and peer support groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings show that staff in the caregiver support organization were agile in adapting their services to digital delivery while dealing with increased numbers of registered clients and higher monthly contacts, all without obvious detriment to service quality. Caregivers indicated a preference for blended services, even while recording high computer proficiency. Considering the economic importance of unp","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e46414"},"PeriodicalIF":4.9,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916605","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":"Tailored Self-Management App to Support Older Adults With Cancer and Multimorbidity: Development and Usability Testing.","authors":"Sang-Wha Sien, Francis Kyerepagr Kobekyaa, Martine Puts, Leanne Currie, Margaret Tompson, Penelope Hedges, Joanna McGrenere, Caroline Mariano, Kristen R Haase","doi":"10.2196/53163","DOIUrl":"10.2196/53163","url":null,"abstract":"<p><strong>Background: </strong>Globally, cancer predominates in adults aged older than 60 years, and 70% of older adults have ≥1 chronic condition. Cancer self-management interventions can improve symptom management and confidence, but few interventions target the complex needs of older adults with cancer and multimorbidity. Despite growing evidence of digital health tools in cancer care, there is a paucity of theoretically grounded digital self-management supports for older adults. Many apps for older adults have not been co-designed with older adults to ensure that they are tailored to their specific needs, which would increase usability and uptake.</p><p><strong>Objective: </strong>We aim to report on the user evaluations of a self- and symptom-management app to support older adults living with cancer and multimorbidity.</p><p><strong>Methods: </strong>This study used Grey's self-management framework, a design thinking approach, and involved older adults with lived experiences of cancer to design a medium-fidelity app prototype. Older adults with cancer or caregivers were recruited through community organizations or support groups to participate in co-designing or evaluations of the app. Data from interviews were iteratively integrated into the design process and analyzed using descriptive statistics and thematic analyses.</p><p><strong>Results: </strong>In total, 15 older adults and 3 caregivers (n=18) participated in this study: 10 participated (8 older adults and 2 caregivers) in the design of the low-fidelity prototype, and 10 evaluated (9 older adults and 1 caregiver) the medium-fidelity prototype (2 older adults participated in both phases). Participants emphasized the importance of tracking functions to make sense of information across physical symptoms and psychosocial aspects; a clear display; and the organization of notes and reminders to communicate with care providers. Participants also emphasized the importance of medication initiation or cessation reminders to mitigate concerns related to polypharmacy.</p><p><strong>Conclusions: </strong>This app has the potential to support the complex health care needs of older adults with cancer, creating a \"home base\" for symptom management and support. The findings from this study will position the researchers to conduct feasibility testing and real-world implementation.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53163"},"PeriodicalIF":4.9,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877547","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":"Assessing the Quality of ChatGPT Responses to Dementia Caregivers' Questions: Qualitative Analysis.","authors":"Alyssa Aguirre, Robin Hilsabeck, Tawny Smith, Bo Xie, Daqing He, Zhendong Wang, Ning Zou","doi":"10.2196/53019","DOIUrl":"10.2196/53019","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) such as ChatGPT by OpenAI holds great promise to improve the quality of life of patients with dementia and their caregivers by providing high-quality responses to their questions about typical dementia behaviors. So far, however, evidence on the quality of such ChatGPT responses is limited. A few recent publications have investigated the quality of ChatGPT responses in other health conditions. Our study is the first to assess ChatGPT using real-world questions asked by dementia caregivers themselves.</p><p><strong>Objectives: </strong>This pilot study examines the potential of ChatGPT-3.5 to provide high-quality information that may enhance dementia care and patient-caregiver education.</p><p><strong>Methods: </strong>Our interprofessional team used a formal rating scale (scoring range: 0-5; the higher the score, the better the quality) to evaluate ChatGPT responses to real-world questions posed by dementia caregivers. We selected 60 posts by dementia caregivers from Reddit, a popular social media platform. These posts were verified by 3 interdisciplinary dementia clinicians as representing dementia caregivers' desire for information in the areas of memory loss and confusion, aggression, and driving. Word count for posts in the memory loss and confusion category ranged from 71 to 531 (mean 218; median 188), aggression posts ranged from 58 to 602 words (mean 254; median 200), and driving posts ranged from 93 to 550 words (mean 272; median 276).</p><p><strong>Results: </strong>ChatGPT's response quality scores ranged from 3 to 5. Of the 60 responses, 26 (43%) received 5 points, 21 (35%) received 4 points, and 13 (22%) received 3 points, suggesting high quality. ChatGPT obtained consistently high scores in synthesizing information to provide follow-up recommendations (n=58, 96%), with the lowest scores in the area of comprehensiveness (n=38, 63%).</p><p><strong>Conclusions: </strong>ChatGPT provided high-quality responses to complex questions posted by dementia caregivers, but it did have limitations. ChatGPT was unable to anticipate future problems that a human professional might recognize and address in a clinical encounter. At other times, ChatGPT recommended a strategy that the caregiver had already explicitly tried. This pilot study indicates the potential of AI to provide high-quality information to enhance dementia care and patient-caregiver education in tandem with information provided by licensed health care professionals. Evaluating the quality of responses is necessary to ensure that caregivers can make informed decisions. ChatGPT has the potential to transform health care practice by shaping how caregivers receive health information.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53019"},"PeriodicalIF":4.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899861","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 Personalized and Interactive Web-Based Advance Care Planning Intervention for Older Adults (Koda Health): Pilot Feasibility Study.","authors":"R Lynae Roberts, Katelin D Cherry, Desh P Mohan, Tiffany Statler, Eric Kirkendall, Adam Moses, Jennifer McCraw, Andrew E Brown Iii, Tatiana Y Fofanova, Jennifer Gabbard","doi":"10.2196/54128","DOIUrl":"10.2196/54128","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) is a process that involves patients expressing their personal goals, values, and future medical care preferences. Digital applications may help facilitate this process, though their use in older adults has not been adequately studied.</p><p><strong>Objective: </strong>This pilot study aimed to evaluate the reach, adoption, and usability of Koda Health, a web-based patient-facing ACP platform, among older adults.</p><p><strong>Methods: </strong>Older adults (aged 50 years and older) who had an active Epic MyChart account at an academic health care system in North Carolina were recruited to participate. A total of 2850 electronic invitations were sent through MyChart accounts with an embedded hyperlink to the Koda platform. Participants who agreed to participate were asked to complete pre- and posttest surveys before and after navigating through the Koda Health platform. Primary outcomes were reach, adoption, and System Usability Scale (SUS) scores. Exploratory outcomes included ACP knowledge and readiness.</p><p><strong>Results: </strong>A total of 161 participants enrolled in the study and created an account on the platform (age: mean 63, SD 9.3 years), with 80% (129/161) of these participants going on to complete all steps of the intervention, thereby generating an advance directive. Participants reported minimal difficulty in using the Koda platform, with an overall SUS score of 76.2. Additionally, knowledge of ACP (eg, mean increase from 3.2 to 4.2 on 5-point scale; P<.001) and readiness (eg, mean increase from 2.6 to 3.2 on readiness to discuss ACP with health care provider; P<.001) significantly increased from before to after the intervention.</p><p><strong>Conclusions: </strong>This study demonstrated that the Koda Health platform is feasible, had above-average usability, and improved ACP documentation of preferences in older adults. Our findings indicate that web-based health tools like Koda may help older individuals learn about and feel more comfortable with ACP while potentially facilitating greater engagement in care planning.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e54128"},"PeriodicalIF":5.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284972","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":"Advocating for Older Adults in the Age of Social Media: Strategies to Achieve Peak Engagement on Twitter.","authors":"Reuben Ng, Nicole Indran, Luyao Liu","doi":"10.2196/49608","DOIUrl":"10.2196/49608","url":null,"abstract":"<p><strong>Background: </strong>Over the last decade, many organizations dedicated to serving the needs and interests of older adults have turned to social media platforms, such as Twitter, subsequently rebranded X, to improve the visibility of age-related issues. However, notwithstanding their growing digital presence and participation, minimal attention has been paid to the use of social media among these advocacy groups. To achieve policy change, advocacy organizations must first be able to engage and mobilize audiences.</p><p><strong>Objective: </strong>Our study aims to elucidate how different tweet features affect the time it takes for posts uploaded by age advocacy organizations to reach peak engagement.</p><p><strong>Methods: </strong>We collated 204,905 tweets from 53 age advocacy organizations posted over a 12-year period. The engagement score of each tweet was calculated by combining well-established metrics, namely likes, retweets, quote tweets, and replies. We ran Cox models with tweet features as predictors and time-to-peak engagement as the outcome. \"Peak engagement\" (event) refers to engagement scores above the 75th percentile, and \"time\" refers to months taken to reach peak engagement per tweet.</p><p><strong>Results: </strong>Approximately 1 in 2 tweets (n=103,068, 50.3%) had either no hashtags or just 1 hashtag. Around two-thirds (n=131,220, 64%) of the tweets included a URL. Visual information was highly underused, with most tweets not including GIFs (n=204,202, 99.7%), videos (n=199,800, 97.5%), or photos (n=143,844, 70.2%). Roughly half (n=101,470, 49.5%) of the tweets contained mentions and 9.3% (n=19,009) of tweets were replies. Only 4.5% (n=9285) of tweets were quote tweets. Most tweets were uploaded in the afternoon (n=86,004, 42%) and on a weekday (n=180,499, 88.1%). As hypothesized, features associated with peak engagement were the inclusion of visual elements like photos, which increased peak engagement by 3 times (P<.001), and the use of 3 or more hashtags (P<.001). Quote tweets increased engagement by 3 times (P<.001), as compared to regular tweets, controlling for account-level covariates. Tweets from organizations with a higher tweet volume were 40% less likely to reach peak engagement (P<.001).</p><p><strong>Conclusions: </strong>Social media as a networked platform has the potential to reach users on a global scale and at an exponential speed. Having uncovered the features that are more likely to reach peak engagement on Twitter, our study serves as an invaluable resource for age advocacy organizations in their movement to create a more age-inclusive world.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e49608"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11084120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877480","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":"Technology Use Among Older Adults and Their Caregivers: Cross-Sectional Survey Study.","authors":"Shinduk Lee, Marcia G Ory, Deborah Vollmer Dahlke, Matthew Lee Smith","doi":"10.2196/50759","DOIUrl":"10.2196/50759","url":null,"abstract":"<p><strong>Background: </strong>Informal caregivers are called upon to provide substantial care, but more needs to be known about technology use among older adult and caregiver dyads.</p><p><strong>Objective: </strong>This study described technology use among older adults and their caregivers, explored potential correlates of technology use, and highlighted implications for practice.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among unpaid caregivers of older adults (n=486). Primary outcomes were self-reported technology (devices and functions) use among caregivers and their oldest care recipient. The concordance of technology use among caregivers and care recipients was also examined. Multivariable regression models were conducted separately for caregivers and care recipients.</p><p><strong>Results: </strong>Greater proportions of caregivers used all examined technologies, except for the medication alerts or tracking function, than care recipients. Caregivers used an average of 3.4 devices and 4.2 functions, compared to 1.8 devices and 1.6 functions used by their care recipients. Among caregivers, younger age, higher income, and higher education were associated with more technology use (P<.05). Among care recipients, younger age, not having cognitive dysfunction, and caregiver's technology use were associated with more technology use (P<.05).</p><p><strong>Conclusions: </strong>Understanding technology use patterns and device adoption across diverse caregiver and care recipient populations is increasingly important for enhancing geriatric care. Findings can guide recommendations about appropriate technology interventions and help providers communicate and share information more effectively with patients and their caregivers.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e50759"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11084119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877548","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":"Correction: Detecting Anomalies in Daily Activity Routines of Older Persons in Single Resident Smart Homes: Proof-of-Concept Study.","authors":"Zahraa Khais Shahid, Saguna Saguna, Christer Åhlund","doi":"10.2196/58394","DOIUrl":"10.2196/58394","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2196/28260.].</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e58394"},"PeriodicalIF":4.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869671","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 Use of Digital Technologies in the Promotion of Health Literacy and Empowerment of Informal Caregivers: Scoping Review.","authors":"Suzete Soares, Louíse Viecili Hoffmeister, Maria de Fátima Fernandes, Adriana Henriques, Andreia Costa","doi":"10.2196/54913","DOIUrl":"10.2196/54913","url":null,"abstract":"<p><strong>Background: </strong>Informal caregivers (IC) play an important role in the community as health care providers for people who are dependent on self-care. Health literacy contributes to empowerment, better care, and self-management of one's own health and can be developed using digital technologies.</p><p><strong>Objective: </strong>This study aims to map scientific evidence about the use of digital technologies to promote health literacy and the empowerment of ICs.</p><p><strong>Methods: </strong>We conducted a scoping review following the Joanna Briggs Institute methodology. The CINAHL, MEDLINE, Scopus, and PubMed databases were searched to find primary studies on the theme. Inclusion criteria were based on the Population, Concept, and Context logic. To be selected for analysis, studies must have involved informal or family caregivers aged ≥18 years who provide care to dependent persons and who have access to the internet and digital devices (computer, smartphone, and tablet). A total of 2 independent researchers (SS and LVH) performed the screening process. This study is part of a main project that was approved by the Ethics Committee for Health of the Regional Health Administration of Lisbon and Tagus Valley (reference 058/CES/INV/2022).</p><p><strong>Results: </strong>A total of 9 studies were included in the review. The analysis of the studies showed that ICs use digital tools, such as computers and smartphones, with smartphones being the preferred tool. ICs use the internet to access information; manage home tasks; communicate with relatives, their peers, and health care professionals; and take part in forums. Due to difficulties in leaving their houses, forums are highly valued to preserve human connections.</p><p><strong>Conclusions: </strong>The use of digital technologies to convey clear, objective, reliable, and accessible information is a strategic action for promoting health literacy and for contemplating the variable care needs of ICs. By working with ICs in the development of new technologies, researchers are building a new tool that meets ICs' needs.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e54913"},"PeriodicalIF":4.9,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852688","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":"Automatic Spontaneous Speech Analysis for the Detection of Cognitive Functional Decline in Older Adults: Multilanguage Cross-Sectional Study.","authors":"Emilia Ambrosini, Chiara Giangregorio, Eugenio Lomurno, Sara Moccia, Marios Milis, Christos Loizou, Domenico Azzolino, Matteo Cesari, Manuel Cid Gala, Carmen Galán de Isla, Jonathan Gomez-Raja, Nunzio Alberto Borghese, Matteo Matteucci, Simona Ferrante","doi":"10.2196/50537","DOIUrl":"10.2196/50537","url":null,"abstract":"<p><strong>Background: </strong>The rise in life expectancy is associated with an increase in long-term and gradual cognitive decline. Treatment effectiveness is enhanced at the early stage of the disease. Therefore, there is a need to find low-cost and ecological solutions for mass screening of community-dwelling older adults.</p><p><strong>Objective: </strong>This work aims to exploit automatic analysis of free speech to identify signs of cognitive function decline.</p><p><strong>Methods: </strong>A sample of 266 participants older than 65 years were recruited in Italy and Spain and were divided into 3 groups according to their Mini-Mental Status Examination (MMSE) scores. People were asked to tell a story and describe a picture, and voice recordings were used to extract high-level features on different time scales automatically. Based on these features, machine learning algorithms were trained to solve binary and multiclass classification problems by using both mono- and cross-lingual approaches. The algorithms were enriched using Shapley Additive Explanations for model explainability.</p><p><strong>Results: </strong>In the Italian data set, healthy participants (MMSE score≥27) were automatically discriminated from participants with mildly impaired cognitive function (20≤MMSE score≤26) and from those with moderate to severe impairment of cognitive function (11≤MMSE score≤19) with accuracy of 80% and 86%, respectively. Slightly lower performance was achieved in the Spanish and multilanguage data sets.</p><p><strong>Conclusions: </strong>This work proposes a transparent and unobtrusive assessment method, which might be included in a mobile app for large-scale monitoring of cognitive functionality in older adults. Voice is confirmed to be an important biomarker of cognitive decline due to its noninvasive and easily accessible nature.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":" ","pages":"e50537"},"PeriodicalIF":4.9,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933356","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}