JMIR Aging最新文献

{"title":"Sarcopenia and Risk of Cognitive Impairment: Cohort Study and Mendelian Randomization Analysis.","authors":"Tingting Sha, Yuqing Zhang, Jie Wei, Changjun Li, Chao Zeng, Guanghua Lei, Yilun Wang","doi":"10.2196/66031","DOIUrl":"10.2196/66031","url":null,"abstract":"<p><strong>Background: </strong>Over half the people over 60 years of age experience cognitive impairment, with limited treatment options, making it crucial to identify risk factors. Studies have examined the association between sarcopenia and cognitive impairment; however, the evidence is inconclusive and cannot be used to make causal inferences.</p><p><strong>Objective: </strong>This study aims to appraise the causal association of sarcopenia with cognitive impairment by triangulating the data from a cohort study and Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>Using UK Biobank data, we first examined the associations of sarcopenia and its indices (appendicular lean mass [ALM], handgrip strength, and gait speed) with cognitive function (fluid intelligence and prospective memory) by using mixed-effects regression models. Then, we explored the causal associations of genetically predicted sarcopenic indices with cognitive function through a 2-sample MR, and examined potential mediation by omega-3 fatty acids, vitamin D levels, physical inactivity, falls, frailty, sleep disorders, anxiety, depression, stroke, metabolic syndrome, and type 2 diabetes.</p><p><strong>Results: </strong>A total of 34,457 participants, with a mean age of 56.4 (SD 7.6) years, 51.1% (n=17,620) of which were female, completed baseline cognitive tests between 2006 and 2010 and attended at least 1 follow-up visit in 2012, 2014, or 2019, and were included in the observational analysis. The cohort study revealed that sarcopenia was significantly associated with cognitive impairment, which was evidenced by reduced fluid intelligence scores (β=-0.91, 95% CI -1.68 to -0.15; P=.02). Each of the sarcopenic indices also exhibited significant associations with either fluid intelligence or prospective memory (all P<.05). MR analyses yielded compelling evidence of positive associations between the genetically predicted increases in ALM (β=0.09, 95% CI 0.07-0.12; P<.001), handgrip strength (β=0.18, 95% CI 0.08-0.29; P<.001) and gait speed (β=0.78, 95% CI 0.53-0.29; P<.001) and improved cognitive function. The effects of ALM and handgrip strength on cognitive function were partially mediated by genetically predicted physical activity, with indirect effects of 0.01 (95% CI 0.00-0.02) for ALM and 0.02 (95% CI 0.00-0.05) for handgrip strength.</p><p><strong>Conclusions: </strong>Our study suggests that sarcopenia is a potential causal risk factor for cognitive impairment, with physical activity acting as a modifiable mediator in this relationship.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66031"},"PeriodicalIF":5.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the User Experience and Usability of Game-Based Cognitive Assessments for Older People: Systematic Review.","authors":"Rhys Mantell, Ye In Jane Hwang, Matthew Dark, Kylie Radford, Michael Kasumovic, Lauren Monds, Peter W Schofield, Tony Butler, Adrienne Withall","doi":"10.2196/65252","DOIUrl":"10.2196/65252","url":null,"abstract":"<p><strong>Background: </strong>Game-based cognitive assessments (GBCAs) have the potential to transform the field of cognitive testing by enabling more effective screening of age-related cognitive decline. However, we lack a strong understanding of the usability and overall user experience of these games. This is a risk because the primary target users for GBCAs, older people, are seldom involved in game design research and development.</p><p><strong>Objective: </strong>This study aims to address this gap by investigating the usability, acceptability, and enjoyability of GBCAs for older people.</p><p><strong>Methods: </strong>This study followed established practices for undertaking evidence-based systematic reviews.</p><p><strong>Results: </strong>The initial database search returned 15,232 records. After a thorough screening process, 8 studies remained for extraction and analysis. A synthesis of the included papers identified 2 overlapping yet distinct areas of focus: system usability and subjective user experience. Usability scores were mostly positive across the studies included. However, in several of the game studies, older adults and those with cognitive impairment tended to find GBCAs less usable. This trend was observed even when the games were explicitly designed for these populations, and the tasks were simplistic and representative of basic daily activities. In our second focus area, user experience, we identified the importance of perceived challenge in mediating gameplay experience across groups. That is, generating the appropriate level of difficulty for each user is important for positive user experiences, specifically enjoyment.</p><p><strong>Conclusions: </strong>On the basis of these findings, we identified key learnings for researchers interested in designing and developing GBCAs. These include (1) recognizing that validity is essential but not sufficient on its own; (2) clearly defining the intended user; (3) designing games that align with the unique preferences and needs of older people; and (4), whenever possible, providing each user with their optimal level of challenge.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023433298; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433298.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e65252"},"PeriodicalIF":5.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276191","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":"Culturally Adapted STAR-Caregivers Virtual Training and Follow-Up for Latino Caregivers of People Living With Dementia: Single-Arm Pre-Post Mixed Methods Study.","authors":"Miguel Angel Mariscal, Celeste Garcia, Lily Zavala, Magaly Ramirez","doi":"10.2196/66053","DOIUrl":"10.2196/66053","url":null,"abstract":"<p><strong>Background: </strong>Latino caregivers are at an increased risk of negative health outcomes due to the responsibilities of caring for someone with dementia. Although interventions exist to address caregiver burden, they often do not meet the cultural needs of Latino caregivers.</p><p><strong>Objective: </strong>This study aimed to pilot test the cultural adaptation of the STAR-Caregivers Virtual Training and Follow-Up (STAR-VTF) intervention. The intervention is an evidence-based training program designed to teach family caregivers strategies to manage behavioral and psychological symptoms of dementia (BPSD). Our research team has conducted past studies to identify and perform culturally relevant adaptations to the training modules of STAR-VTF, and this study aimed to pilot these culturally adapted modules with a sample of Latino caregivers.</p><p><strong>Methods: </strong>Data on feasibility, usability, and acceptability were collected from a pilot test in which Latino caregivers (n=16) used the training modules of the STAR-VTF intervention over a 7-week period. Participants completed usability surveys following the completion of each module, and acceptability was assessed through semistructured interviews (n=14) postintervention. Preliminary outcome measures were also collected, and a descriptive analysis was conducted. The primary outcomes were the Revised Memory and Behavior Problem Checklist (RMBPC) and the Preparedness for Caregiving Scale.</p><p><strong>Results: </strong>The pilot study results suggest that it is feasible to deliver the culturally adapted STAR-VTF intervention to Latino caregivers, with 94% (15/16) of participants maintaining enrollment through intervention completion. The intervention's usability was found to be \"good\" based on an average System Usability Score of 76.7 out of 100 across all training modules. Caregivers were generally satisfied with the training modules. In addition, preliminary outcome results demonstrated a trend of decreased BPSD pre- versus postintervention (RMBPC subscale score: 28.24 to 21.34). Findings also demonstrated decreased caregiver reaction to BPSD pre- versus postintervention (RMBPC subscale score: 40.40 to 37.21) and increased caregiver preparedness based on pre- and postintervention (Preparedness Caregiving Scale score: 1.98 to 2.43).</p><p><strong>Conclusions: </strong>The pilot study demonstrated that the culturally adapted STAR-VTF intervention is feasible and perceived as easy to use by a small sample of Latino caregivers. We aim to refine the cultural adaptations of the STAR-VTF intervention further based on feedback from study participants. Future studies are necessary to test the efficacy of the intervention and support the broad dissemination of the culturally adapted intervention.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66053"},"PeriodicalIF":5.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267510","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 Literacy and Its Association With Subjective Health Status and Healthy Lifestyle Behaviors Among Korean Older Adults: Cross-Sectional Study.","authors":"Soon Young Lee, Yejin Kim, Bomgyeol Kim, Sang Gyu Lee, Suk-Yong Jang, Tae Hyun Kim","doi":"10.2196/64974","DOIUrl":"10.2196/64974","url":null,"abstract":"<p><strong>Background: </strong>With an aging population driven by advances in medical technology, digital literacy has become essential for improving the quality of life of older adults, enhancing access to health information, and promoting healthy lifestyles. Furthermore, the COVID-19 pandemic may have influenced the subjective health perceptions and healthy lifestyle behaviors of older adults. However, there is limited research exploring the relationship between digital literacy, subjective health perceptions, and healthy lifestyle behaviors in Korea.</p><p><strong>Objective: </strong>This study aimed to investigate digital literacy's impact on Korean older adults' subjective health status and healthy lifestyle behaviors.</p><p><strong>Methods: </strong>Data of 8664 respondents (aged 65 years and older) from the 2020 National Survey of the Older Koreans were analyzed. Digital literacy was measured based on the use of IT devices (ITDs), difficulty using online information, and inconvenience of ITDs. Statistical analyses, such as the Rao-Scott chi-square test, Wilcoxon rank sum test, and multiple regression analysis, were conducted.</p><p><strong>Results: </strong>Respondents with above-average ITD use (adjusted odds ratio [aOR] 1.73, 95% CI 1.50-1.99) and less difficulty using online information (aOR 1.41, 95% CI 1.24-1.61) had higher odds of perceiving themselves as healthy. Conversely, high difficulty using ITDs was associated with lower odds of respondents perceiving themselves as healthy (aOR 0.84, 95% CI 0.82-0.87). Furthermore, high ITD use predicted engagement in healthy lifestyle behaviors (aOR 1.51, 95% CI 1.33-1.72), whereas high difficulty using ITDs predicted lower odds of engagement (aOR 0.94, 95% CI 0.92-0.97). In contrast, there was no difference in the odds of engaging in healthy lifestyle behaviors regardless of difficulty using online information (aOR 1.03, 95% CI 0.92-1.15).</p><p><strong>Conclusions: </strong>This study underscores the significant association between digital literacy and improved health outcomes among older adults. Promotion of digital literacy and relevant policies is essential to help older adults effectively obtain health information online, thereby improving their quality of life and overall health.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e64974"},"PeriodicalIF":5.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235447","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 Relationship Between Sleep Disorders and Combination of Diabetes and Sarcopenia in Adults Aged 45 Years or Older: 10-Year Nationwide Prospective Cohort Study.","authors":"Shugang Li, Yimi Wang, Linzhi Li, Hao Wu","doi":"10.2196/66372","DOIUrl":"10.2196/66372","url":null,"abstract":"<p><strong>Background: </strong>With changes in lifestyle, the issue of sleep disorders is becoming increasingly common. Diabetes and sarcopenia have been found to be independently associated with sleep disorders. However, fewer studies have explored the interaction between the combination of diabetes and sarcopenia at different stages and sleep disorders.</p><p><strong>Objective: </strong>This study aimed to explore the relationship between the combination of diabetes and sarcopenia and the incidence of sleep disorders in adults aged 45 years and older.</p><p><strong>Methods: </strong>Based on data from the CHARLS (China Health and Retirement Longitudinal Study), we selected participants with comprehensive diagnostic information on diabetes and sarcopenia from 2011 who had normal sleep duration at baseline and checked their follow-up information of sleep duration from 2013, 2015, 2018, and 2020. Diabetes was classified into diabetes (D), prediabetes (PD), and nondiabetes (ND), and sarcopenia was divided into sarcopenia (S), possible sarcopenia (PS), and nonsarcopenia (NS). The participants were divided into DS, DPS, DNS, PDS, PDPS, PDNS, NDS, NDPS, and NDNS groups. Kaplan-Meier survival curves, the log-rank test, Cox proportional hazards regression, and restricted cubic spline models were used for statistical analysis.</p><p><strong>Results: </strong>A total of 4936 participants were included in this study. The DS group had the highest incidence of sleep disorders: 49.32%, 28.57%, 36.36%, and 80.00% in 2013, 2015, 2018, and 2020 respectively. In the crude model, compared with the NDNS group, the risk of sleep disorders was increased in the DS group (hazard ratio [HR] 1.707, 95% CI 1.196-2.437), PDS (HR 1.599, 95% CI 1.235-2.071), NDS (HR 1.465, 95% CI 1.282-1.674), and DPS group (HR 1.318, 95% CI 1.097-1.583). The risk was increased but not statistically significant in the PDPS group (HR 1.160, 95% CI 0.987-1.365). After adjusting for covariates, the risk of sleep disorders remained statistically significant in the DS group (HR 1.515, 95% CI 1.059-2.167) and was significantly higher in the PDS (HR 1.423, 95% CI 1.096-1.847) and NDS (HR 1.279, 95% CI 1.113-1.468) groups than that in the NDNS group. The nonlinear associations between appendicular skeletal muscle mass, grip strength, 5-time chair test, fasting plasma glucose, and sleep disorders were observed and described.</p><p><strong>Conclusions: </strong>The combination of diabetes and sarcopenia significantly increases the risk of sleep disorders in adults aged 45 years and older. and the implementation of progression control of both diabetes and sarcopenia may be helpful to prevent sleep disorders in this population.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66372"},"PeriodicalIF":5.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209795","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":"Longitudinal Remote Sleep and Cognitive Research in Older Adults With Mild Cognitive Impairment and Dementia: Prospective Feasibility Cohort Study.","authors":"Victoria Grace Gabb, Jonathan Blackman, Hamish Morrison, Haoxuan Li, Adrian Kendrick, Nicholas Turner, Rosemary Greenwood, Bijetri Biswas, Amanda Heslegrave, Elizabeth Coulthard","doi":"10.2196/72824","DOIUrl":"10.2196/72824","url":null,"abstract":"<p><strong>Background: </strong>Sleep holds promise as a modifiable risk factor for neurodegenerative diseases and dementia. Clinical trials to modify sleep in people at risk of or in the early stages of dementia are needed. Monitoring natural sleep from home could support pragmatic and decentralized large-scale clinical trials. However, whether longitudinal sleep research can be successfully delivered remotely in this population has not been established yet.</p><p><strong>Objective: </strong>We investigated the feasibility of remote longitudinal research using wearable devices, web-based cognitive tasks, and a smartphone app to record sleep and cognition in older adults with mild cognitive impairment (MCI) or dementia.</p><p><strong>Methods: </strong>Older adults with MCI or dementia due to Alzheimer disease or Lewy body disease and cognitively healthy participants completed at-home sleep and circadian monitoring (digital sleep diaries, actigraphy, wearable sleep electroencephalography, and saliva samples) and digital cognitive assessments for 8 weeks. Feasibility outcomes included recruitment, retention, and data completeness.</p><p><strong>Results: </strong>In total, 41 participants consented (n=10, 24% participants with Alzheimer disease; n=11, 27% participants with Lewy body disease; and n=20, 49% controls). There were predominantly male and White British participants, with a mean age of 70.9 (SD 5.9) years. Retention was very high, with 40 (98%) participants completing 8 weeks of remote monitoring. Data completeness for sleep electroencephalography was 91% and ranged from 79% to 97% for all remote tasks and was overall high across all participant subgroups. In total, 30% (12/40) of participants reported receiving external support with completing study tasks.</p><p><strong>Conclusions: </strong>High rates of retention, data completeness, and data quality suggested that longitudinal multimodal sleep and cognitive profiling using novel and remote monitoring technology is feasible in older adults with MCI and dementia and healthy older adults, even without study partner support. Remote monitoring should be considered for mechanistic and interventional trials. Careful consideration should be given to how to ensure remote monitoring technologies reduce burden and enhance inclusivity, particularly in communities traditionally underserved by research and those with lower digital literacy.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.2196/52652.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e72824"},"PeriodicalIF":5.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175178","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":"Impact of a Light Volleyball Intervention Program on Improving Physical Attributes of Older Adults in Hong Kong: Preliminary Study of a Randomized Controlled Trial.","authors":"Ka Man Leung, Yuchen Shi","doi":"10.2196/62886","DOIUrl":"10.2196/62886","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity, which increases the risk of chronic diseases in older adults, is prevalent among older adults in Hong Kong. To address this problem, the Hong Kong government has been proactively promoting active aging.</p><p><strong>Objective: </strong>Following the World Health Organization's strategy to prevent chronic diseases in older adults and aligning with the global goal of active aging, this study evaluated the effects of a 16-week light volleyball (LVB) intervention program on the physical health of older adults in Hong Kong.</p><p><strong>Methods: </strong>A total of 276 participants aged ≥60 years were recruited and randomly assigned to 1 of 3 groups: an LVB intervention group, a Taichi control group (ie, with light physical activity), and a control group. Tests on components of fitness were conducted before and after the intervention.</p><p><strong>Results: </strong>Participants from the LVB intervention group exhibited significant improvements in lower body strength (F2,272= 7.23, P=.001, η2=.05), agility (F2,272= 6.05, P=.003, η2=.043), and dynamic balance (F2,272= 9.41, P=.001, η2=.065) when compared with those from the Taichi active control group and control group.</p><p><strong>Conclusions: </strong>To promote active aging among older adults in Hong Kong, the findings of this preliminary study, along with forthcoming follow-up tests, will provide health specialists and practitioners with valuable insights regarding the health benefits of the LVB community program for older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e62886"},"PeriodicalIF":5.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175176","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 12-Month Digital Peer-Supported App Intervention to Promote Physical Activity Among Community-Dwelling Older Adults: Follow-Up Study of a Nonrandomized Controlled Trial.","authors":"Kento Tabira, Yuko Oguma, Shota Yoshihara, Megumi Shibuya, Manabu Nakamura, Natsue Doihara, Akihiro Hirata, Tomoki Manabe, Takashi Yamashita","doi":"10.2196/66610","DOIUrl":"10.2196/66610","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mobile apps and peer support are known to effectively promote physical activity in older adults, which, in turn, improves physical function. Previously, we investigated the feasibility and impact of using digital peer-supported apps (DPSAs) to increase physical activity among older adults over a 3-month period. However, the long-term feasibility and impact on sustainable behavior change remain unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the 12-month feasibility of the DPSA and to obtain preliminary estimates of its effects on physical activity and physical function among older Japanese adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This nonrandomized controlled trial recruited older adults aged 65 years or older from 2 physical activity programs. Participants chose either the intervention (app program + exercise instruction) group or the control (exercise instruction only) group. Only those participants who had completed the 3-month intervention and wished to continue in the 12-month follow-up intervention study were included. DPSA feasibility was assessed using retention and adherence rates. Physical activity was assessed using accelerometers, capturing daily step count, light-intensity activity, moderate to vigorous intensity activity, and sedentary behavior. Physical function was evaluated using grip strength and the 30-second chair stand test (CS-30). Accelerometer measurements were collected every 3 months over 12 months (5 time points, including baseline), whereas physical function was measured at baseline, 3 months, and 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The follow-up study included 44 of 66 participants from the 3-month intervention study, with 26 participants in the intervention group and 18 participants in the control group. The 12-month retention rate for participants in the DPSA intervention group was 73% (19/26), whereas the retention rate among all 41 participants, including those who chose not to participate in the follow-up study, was 46% (19/41). The adherence rate was 85.9%. The average number of steps per day (95% CI) in the intervention group changed before and after DPSA use (P=.048). We observed an increase of 1736 (β=1736, 95% CI 232-3241) steps per day compared with baseline. No significant change was observed in the control group. There were significant within-group differences in CS-30 scores for both intervention (P&lt;.001) and control (P=.03) groups over the 12-month period. Specifically, there was a significant change in CS-30 scores (95% CI) between the baseline and 12-month assessments for the intervention (β=6.5, 95% CI 3.8-9.1; P&lt;.001) and control (β=3.8, 95% CI 0.6-7.1; P=.02) groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Participants with long-term DPSA use observed increases in average daily steps and CS-30 scores before and after DPSA use, although only a limited number of older adults had long-term access to the DPSA. Identifying ways to expand long-term","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66610"},"PeriodicalIF":5.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175123","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":"Socioculturally Appropriate Internet-Based Geriatric Care Model for Older Adults Living With HIV: Experience-Based Co-Design Approach.","authors":"Kristina M Kokorelias, Marina B Wasilewski, Dean Valentine, Andrew D Eaton, Erica Dove, Paige Brown, Stuart McKinlay, Christine L Sheppard, Esther Su, Hardeep K Singh, Ashley Flanagan, Alice Zhabokritsky, Reham Abdelhalim, Rabea Parpia, Rahel Zewude, Laura Jamieson, Sharon Walmsley, Luxey Sirisegaram","doi":"10.2196/67122","DOIUrl":"10.2196/67122","url":null,"abstract":"<p><strong>Background: </strong>Older adults living with HIV face challenges accessing regular geriatric care, and while virtual care services could offer a solution, they may come with limitations.</p><p><strong>Objective: </strong>This study aimed to co-design a culturally appropriate virtual care model tailored to older adults' needs using the experience-based co-design methodology.</p><p><strong>Methods: </strong>We used a qualitative, experience-based co-design approach with 19 older adults living with HIV. The process involved 3 phases: identifying needs through interviews and questionnaires, codeveloping a care model prototype through focus groups and a workshop, and refining the model using feedback from a world café format. Data were analyzed using thematic content analysis.</p><p><strong>Results: </strong>The co-design process led to a virtual care model prototype that directly addressed participants' key needs. These included personalized communication methods, simplified technology interfaces for easier access, and culturally responsive care practices. Participants emphasized the importance of privacy in virtual consultations, flexible scheduling to accommodate health fluctuations, and ongoing support for managing both HIV and aging-related conditions. Their feedback shaped a model designed to bridge service gaps, offering a more inclusive, accessible, and patient-centered approach to virtual geriatric care.</p><p><strong>Conclusions: </strong>This study co-designed a potential virtual geriatric care model grounded in the experiences of older adults living with HIV. By integrating participants' insights throughout the design process, the model offers a promising approach to improving care for this vulnerable population. Future directions for research to test this model are proposed.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e67122"},"PeriodicalIF":5.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162616","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 Having Online Health Consultations During the COVID-19 Pandemic Among Middle-Aged and Older Adults in Germany: Representative Longitudinal Survey Study.","authors":"Ariana Neumann, Hans-Helmut König, André Hajek","doi":"10.2196/60311","DOIUrl":"10.2196/60311","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, telemedicine services represented a widely implemented alternative to in-person doctor and therapist appointments. Consequently, rates of telemedicine use rapidly increased worldwide, also in Germany. Research regarding longitudinal determinants of telemedicine use is needed, particularly from nationally representative German samples, to improve understanding of the use behavior of major target groups such as middle-aged and older adults.</p><p><strong>Objective: </strong>This study aimed to longitudinally investigate determinants of online health consultation use among middle-aged and older individuals during the COVID-19 pandemic in Germany.</p><p><strong>Methods: </strong>Nationally representative longitudinal data of German middle-aged and older adults (≥46 years old) were taken from the German Ageing Survey (DEAS). Data from the Compact Survey (conducted between June and July 2020) and wave 7 (conducted between November 2020 and March 2021) of the DEAS were observed (pooled analytic sample N=5456). Having experienced consultations with doctors or therapists on online platforms served as the outcome measure. Associations with socioeconomic, health- and health behavior-related, psychological, and COVID-19-related determinants were tested using random effects logistic regressions.</p><p><strong>Results: </strong>In our sample, 49% (2673/5456) of participants were female and the mean age of the participants was 67.8 (SD 9.4) years. Past experience with online health consultations was reported by 10.3% (561/5456) of the sample. Online health consultation use was associated with high education (OR 1.43, 95% CI 1.06-1.93; P=.02), poor self-rated health (OR 0.60, 95% CI 0.49-0.75; P<.001), and higher frequency of physical activity (reference: low frequency; medium frequency: OR 1.58, 95% CI 1.15-2.17; P=.005; high frequency: OR 1.73, 95% CI 1.09-2.76; P=.02). Moreover, greater levels of loneliness (OR 1.43, 95% CI 1.06-1.93; P=.04) and life satisfaction (OR 1.33, 95% CI 1.02-1.73; P=.04) as well as perceiving the COVID-19 crisis as a greater personal threat (OR 1.08, 95% CI 1.01-1.15; P=.02) were associated with having online health consultations during the COVID-19 pandemic.</p><p><strong>Conclusions: </strong>Online health consultation use does not seem to be exclusively associated with the health of middle-aged and older patients. Study findings emphasize the longitudinal association of education and psychosocial factors as well as health factors with telemedicine use during the COVID-19 pandemic in Germany. This knowledge may help to improve and adapt services to this patient group, which could contribute to higher utilization rates in the future. Future studies are needed to verify these initial findings under postpandemic circumstances and across different countries.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e60311"},"PeriodicalIF":5.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152167","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}