JMIR Aging最新文献

{"title":"Demoralization and Mental Disorders in Community-Dwelling Older Adults: Cluster Analysis.","authors":"Alice Onofrio, Maria Ferrara, Ilaria Domenicano, Martino Belvederi Murri, Tommaso Toffanin, Maria Giulia Nanni, Alessandra Canuto, Kerstin Weber, Jana Volkert, Holger Schulz, Martin Härter, Sylke Andreas, Luigi Grassi","doi":"10.2196/84657","DOIUrl":"https://doi.org/10.2196/84657","url":null,"abstract":"<p><strong>Background: </strong>Demoralization negatively affects the quality of life, especially in people with mental disorders.</p><p><strong>Objective: </strong>This study aims to assess demoralization in a cohort of community-dwelling older adults, to identify groups of individuals who share similar characteristics in terms of mental health conditions and the severity of demoralization domains, and to investigate the different characteristics across these groups.</p><p><strong>Methods: </strong>Participants were enrolled in 3 centers as part of the cross-sectional MentDis_ICF65+ study and were assessed using the Demoralization Scale and the Composite International Diagnostic Interview at baseline. A cluster analysis was conducted using the partitioning around medoids algorithm with Gower's distance to classify individuals based on demoralization severity and the diagnosis of mental health disorders, allocating individuals to a distinct number of patterns by examining their similarities across these variables.</p><p><strong>Results: </strong>Among the final sample of 1369 participants, 3 clusters were identified: the \"low psychopathology\" cluster, with very few mental health diagnoses; the \"affective\" cluster, characterized by affective disorders (100% of participants); and the \"anxiety\" cluster, characterized by anxiety disorders (100% of participants). Men were prevalent in the \"low psychopathology\" cluster (n=635, 59.1%; <i>P</i><.001), while women were more prevalent in the \"affective\" cluster (n=133, 72.3%; <i>P</i><.001) and the \"anxiety\" cluster (n=79, 71.8%; <i>P</i><.001). The \"affective\" cluster had the highest mean scores for disheartenment (17.1, SD 6.7; <i>P</i><.001), dysphoria (12.1, SD 3.5; <i>P</i><.001), and loss of meaning (11.8, SD 4.9; <i>P</i><.001) but the lowest for sense of failure (17.4, SD 3.2; <i>P</i><.001).</p><p><strong>Conclusions: </strong>The identification of different clusters of demoralization and mental health disorders in community-dwelling older adults, as well as sex-based differences, highlights the need for tailored mental health interventions in this vulnerable population.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e84657"},"PeriodicalIF":4.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799118","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":"Effect of an Intersectoral Telemedicine Intervention on Hospitalization in Nursing Home Patients: Specification Curve Analysis of a Stepped Wedge Cluster Randomized Trial.","authors":"John Grosser, Sophie Pauge, Birthe Aufenberg, Wolfgang Greiner, Miriam Hertwig, Jenny Unterkofler, David Brücken, Christian Hübel, Jörg Christian Brokmann","doi":"10.2196/75721","DOIUrl":"10.2196/75721","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of emergency medical services in Germany has significantly increased, particularly for nonemergency cases. This issue becomes especially relevant for nursing homes, where staff is confronted with resource shortages and organizational challenges, making emergency medical services involvement a common course of action. This leads to potentially avoidable hospitalizations for nursing home residents and exposes them to severe health risks, such as nosocomial infections. To address this, we developed the Optimal@NRW project, implementing an innovative intersectoral telemedicine intervention that includes an early warning system and mobile nonphysician medical assistants in order to enable outpatient treatment in acute medical cases for nursing home residents. We hypothesize that hospitalizations could be significantly reduced, as patients could be treated on-site in the absence of a life-threatening emergency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to determine the effect of an intersectoral telemedicine-based intervention for acute care situations on hospitalization among residents in nursing homes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a prospective multicenter cluster-randomized stepped wedge trial from May 2021 to April 2023 across 24 nursing homes in western Germany. Nursing homes were randomly assigned to one of four sequences and followed over eight 3-month periods. All sequences crossed stepwise from the control to the intervention phase. We collected primary data in an electronic patient record and claims data from statutory health insurance funds. In a specification curve analysis, we evaluated the intervention effect using multiple mixed-effects regression model specifications with varying modeling approaches, datasets, dependent and independent variables, and operationalizations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The number of participants ranged from 158 to 285 nursing home residents per sequence and period, totaling 1151 participants in the control phase and 1271 participants in the intervention phase. A total of 1260 regression models were analyzed. Approximately two-thirds of all models exhibited a negative (ie, protective) intervention effect. However, no models exhibited a statistically significant (ie, &lt;i&gt;P&lt;/i&gt;&lt;.05) intervention effect. The distribution of effect direction and size differed by modeling approach, choice of outcome, and dataset used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our results do not support the hypothesis of a significant reduction of hospitalizations among nursing home residents. The effectiveness of the intervention may have been compromised by external factors such as a flood disaster in the study region and the COVID-19 pandemic, which introduced unforeseen challenges. Future studies should prioritize targeted outcomes (potentially avoidable hospitalizations) that align with the specific intervention mechanism, while also allowing for extended implementa","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e75721"},"PeriodicalIF":4.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799066","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":"Measuring Implicit Attitudes Toward Digital Health Technologies in Older Adults Using an Influence-Aware Affect Misattribution Procedure: Development and Feasibility Study.","authors":"Anna Vinnikova, Jinyue Zhan, Kailing Jin, Xianfeng Ding, Wei Sang, Weina Xu, Qian Yang","doi":"10.2196/87989","DOIUrl":"https://doi.org/10.2196/87989","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Older adults often express positive attitudes toward digital health technologies in surveys, yet adoption remains low. Self-report measures may not capture automatic affective reactions such as anxiety or distrust. Implicit paradigms such as the affect misattribution procedure (AMP) can reveal these automatic attitudes, but parameters optimized for younger adults may not be suitable for older adults because of age-related slowing and changes in visual processing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to adapt and evaluate an influence-aware affect misattribution procedure (IA-AMP) for measuring implicit attitudes of older adults toward digital health technologies and to identify an age-appropriate prime duration that balances affect transfer strength with minimal conscious awareness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 2-phase methodological adaptation and feasibility study was conducted among older adults (aged ≥60 y). Phase 1 (n=40) involved the development and validation of age-relevant synthetic images depicting older adults using digital health tools. The images were evaluated based on valence, arousal, thematic relevance, and low-level perceptual features. Phase 2 (n=56) implemented an IA-AMP with 3 prime durations (75, 350, and 425 ms) across 2 sequential cohorts. The first cohort (batch 2A, n=29) used the initial awareness probe, whereas the second cohort (batch 2B, n=27) used a simplified awareness interface. The core IA-AMP target judgment task remained unchanged across batches. The primary inferential outcome was the binary trial-level target judgment, coded as pleasant or unpleasant. Trial-level responses were analyzed using binomial logistic mixed-effects models with prime valence, prime duration, their interaction, and batch as fixed effects, along with random intercepts for participant and prime image. Awareness analyses were restricted to batch 2B.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The primary generalized linear mixed-effects model showed a significant prime valence × prime duration interaction (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;2&lt;/sub&gt;=38.1; &lt;i&gt;P&lt;/i&gt;&lt;.001). Positive primes increased the odds of pleasant target judgments relative to negative primes at all durations (odds ratio [OR] 11.2, 95% CI 5.8-21.6, at 75 ms; OR 31.9, 95% CI 16.0-63.4, at 350 ms; and OR 45.6, 95% CI 22.1-94.0, at 425 ms; all Holm-adjusted &lt;i&gt;P&lt;/i&gt;&lt;.001). The positive-negative contrast was smaller at 75 milliseconds than at 350 and 425 milliseconds, whereas the contrasts at 350 and 425 milliseconds did not differ significantly. Batch sensitivity analyses showed stronger overall priming in batch 2B, but the prime valence × prime duration × batch interaction was not significant (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;2&lt;/sub&gt;=0.76; &lt;i&gt;P&lt;/i&gt;=.68).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The IA-AMP offers a promising approach for assessing the affective responses of older adults to digital health technologies beyond self-report. A prime duration of ap","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e87989"},"PeriodicalIF":4.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799169","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":"Aging Like Milk or Fine Wine: Content Analysis of Reactions to One's Future Self on TikTok.","authors":"Reuben Ng, Nicole Indran","doi":"10.2196/70794","DOIUrl":"10.2196/70794","url":null,"abstract":"<p><strong>Background: </strong>The \"aged\" filter has gone viral on TikTok. This filter leverages AI to superimpose signs of aging, such as wrinkles, crow's feet, and sagging skin, onto a user's face. Notably, several dermatologists have attested to the accuracy of this filter in simulating the effects of aging. Reactions among the TikTok community have been mixed, with some utterly dismayed but others wholeheartedly embracing the sight of their aged visages.</p><p><strong>Objective: </strong>This study takes a deep dive into the ways in which TikTok users react to their aged selves through a content analysis of videos featuring the aged filter. Understanding how they respond to the filter can shed light on the types of meanings commonly attributed to old age as a social construct. The following research questions form the premise of our content analysis of videos on TikTok: (1) How do individuals react to the way their possible future selves look? (2) What types of attitudes toward old age are being conveyed in these videos? (3) What do these responses say about prevailing cultural beliefs, values, and attitudes toward old age?</p><p><strong>Methods: </strong>To build a comprehensive dataset, we compiled all publicly available videos (N=2682) using the following hashtags as search queries: \"#AgedFilter,\" \"#OldFilter,\" and \"#AgeFilter.\" Collectively, these hashtags amassed >2,068,100,000 views at the time of writing this manuscript. After applying our exclusion criteria, the dataset comprised 681 videos, which received a total of 34,382,236 likes, 1,204,741 favorites, and 211,006 comments. Both deductive and inductive approaches informed our content analysis.</p><p><strong>Results: </strong>A total of 7 themes emerged from our content analysis. Half of the videos (n=342, 50%) fell under theme 1, \"anxiety about aging.\" The second-largest theme (n=95, 14%) focused on the \"pursuit of youthfulness\" (theme 2). Theme 3 was about \"aging with confidence\" (n=84, 12%) and theme 4 was about the \"beauty of aging\" (n=54, 8%). Theme 5 examined the \"privilege of aging\" (n=48, 7%) and theme 6 examined \"generational connections\" (n=43, 6%). Theme 7 covered the \"inevitability of aging\" (n=15, 2%).</p><p><strong>Conclusions: </strong>This study marks one of the first attempts to analyze videos using the aged filter on TikTok. Our findings suggest that ageist beliefs may be prevalent among some users. Going forward, there is value in adopting a definition of beauty that transcends age. By doing so, aging can be reframed as a natural part of life to be embraced rather than as a grim reality to be dreaded.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e70794"},"PeriodicalIF":4.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799058","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: Development and Validation of Machine Learning Models for Predicting Falls Among Hospitalized Older Adults: Retrospective Cross-Sectional Study.","authors":"Xiyao Yang, Juan Ren, Dan Su, Manzhen Bao, Miao Zhang, Xiaoming Chen, Yanhua Li, Zonggui Wang, Xiujing Dai, Zengzeng Wei, Shuiyu Zhang, Yuxin Zhang, Juan Li, Xiaolin Li, Junjin Xu, Nan Mo","doi":"10.2196/101284","DOIUrl":"https://doi.org/10.2196/101284","url":null,"abstract":"","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e101284"},"PeriodicalIF":4.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763733","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":"Why Frailty Should Be Assessed in Older Adults Affected by Leprosy and How the Use of Smartphones Could Enhance This Health Monitoring.","authors":"Luzielma Macedo Gloria, Josafá Gonçalves Barreto, João Sérgio de Sousa Oliveira, Areolino Pena Matos, Bianca Callegari, Givago Souza","doi":"10.2196/55963","DOIUrl":"10.2196/55963","url":null,"abstract":"<p><strong>Unlabelled: </strong>Leprosy is endemic in many low-income countries, affecting mainly the poorest communities. The disease can lead to sensorimotor functional losses that can predispose patients to reduced independence. In older adults, these losses associated with leprosy are added to those already resulting from natural aging and associated comorbidities, which can contribute to the clinical picture of frailty syndrome in these older adults. Early detection of frailty can reduce several serious consequences for these individuals, preventing loss of quality of life and financial costs to patients and the health care system. Sensors built into smartphones have been proposed as low-cost, and highly sensitive tools for detecting motor loss and could help monitor the risk of some frailty features in older people affected by leprosy.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e55963"},"PeriodicalIF":4.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685946","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":"Preparation for Future Care in Community-Dwelling Older Adults With Prefrailty and Frailty: Development and Pilot Test of a Digital Intervention.","authors":"Qiqi Ni, Jing Dong, Weilin Jiang, Jia Yi, Ran Yan, Yuhan Chen, Li Wang, Yiyu Zhuang","doi":"10.2196/92492","DOIUrl":"10.2196/92492","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;China's rapidly aging population and high burden of frailty make proactive preparation for future care increasingly urgent, yet few older adults engage in such preparation. Existing interventions often overlook the heterogeneity between prefrail and frail populations and lack precision-oriented digital strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Building on a series of prior empirical studies, this study aimed to develop and pilot-test a digital intervention to support preparation for future care among community-dwelling older adults with prefrailty and frailty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The \"Yi Yang Plan,\" a WeChat mini-program, was developed through a rigorous multiphase process, including a scoping review, a convergent mixed methods study, and a structural equation model. These findings informed the design of a tailored, stage-specific intervention targeting the distinct needs of prefrail and frail older adults. An interdisciplinary team subsequently refined the intervention using an iterative design approach. The intervention modules comprised 4 processes: Awareness Enhancement, Care Resources, Care Decision-Making, and Care Planning. Pilot testing involved expert panel consultations and think-aloud tests. Expert characteristics, engagement, and authority coefficients were assessed, and feedback was synthesized using content analysis. Feasibility and acceptability among older adults and their family members were evaluated through task completion metrics, satisfaction surveys, think-aloud protocols, and semistructured interviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven experts participated in the consultation, with an engagement coefficient of 100% and an authority coefficient of 0.88. Recommendations were synthesized into four key themes: (1) establishing mechanisms for care plan updating and review, (2) strengthening user-centered design, (3) implementing dynamic resource management and robust data security measures, and (4) enhancing integration with community care systems and policy frameworks. A total of 20 older adults and 20 family members were recruited. All participants successfully completed the assigned tasks, with a mean completion time of 20.7 (SD 5.2) minutes. Satisfaction ratings were generally favorable. The qualitative findings indicated that the intervention was perceived as useful and professionally designed, while also identifying several challenges, including variability in preparation for future care readiness and educational levels, limited interactivity, insufficient practical content, and reliance on support from adult children. Suggested improvements included enhanced personalization, additional supportive tools, improved usability, greater involvement of adult children, and stronger integration with offline services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The \"Yi Yang Plan\" demonstrated preliminary scientific validity, feasibility, and acceptability as a multidisciplinary, collabora","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e92492"},"PeriodicalIF":4.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680300","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 Care Needs in Community-Dwelling Older Adults Using Explainable Machine Learning and a Multidimensional Approach Integrating Health, Social, and Environmental Factors: Cross-Sectional Study.","authors":"Hyeri Shin","doi":"10.2196/93371","DOIUrl":"10.2196/93371","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rapid population aging and a worsening shortage of care workers necessitate the identification of older adults who require proactive interventions. Although machine learning (ML) has been increasingly applied in gerontology, existing studies have predominantly focused on social isolation, loneliness, depression, falls, and frailty in isolation rather than on the integrated construct of care needs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop and interpret an explainable ML model that identifies care needs in community-dwelling Korean older adults. Beyond physical health indicators such as disease and functional status, this study adopted a comprehensive approach that included mental health, cognitive function, health behaviors, and socioenvironmental determinants, such as social participation, social support, and the housing environment, to present an integrated model encompassing both health and social care needs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were obtained from the 2023 Korea Senior Survey, a nationally representative sample of 10,078 community-dwelling adults aged 60 years and older. The data were split 70:30 into training (n=7054) and held-out test (n=3024) sets. Seven algorithms were compared (logistic regression, decision tree, support vector machine, random forest, gradient-boosted decision trees, extreme gradient boosting, and light gradient boosting machine) using stratified 5-fold cross-validation on the training set. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC). Model interpretability used Shapley additive explanations with bootstrap stability assessment across folds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Model A (excluding activities of daily living or instrumental activities of daily living [IADL]) achieved good discrimination (AUC 0.892, 95% CI 0.866-0.918), adequate calibration (calibration slope=0.826), and positive clinical net benefit, demonstrating that upstream factors alone can identify older adults with care needs without relying on functional status. Shapley additive explanations analysis identified age, nutritional risk, employment status, depressive symptoms, self-rated health, cognitive function, household income, and home modification as the leading predictors, with high rank stability across cross-validation folds. Model B (including activities of daily living or IADL) yielded a higher AUC (0.976, 95% CI 0.962-0.989), but this reflected the near-tautological relationship between IADL and self-reported care needs rather than genuine upstream predictive value. Using an objective composite outcome yielded equivalent discrimination (AUC 0.892), supporting robustness to the outcome definition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Explainable ML models offer high predictive accuracy and strong interpretability for identifying care needs among older adults. Care needs in community-dwelling Korean older adults can be identified ","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e93371"},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649365","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":"Exergaming Interventions for Preventing Falls and Injurious Falls in Older People: Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Charlotte Eost-Telling, Lisa McGarrigle, Chunhu Shi, Annemarie Money, Yang Yang, Kimberly Lazo Green, Saima Ahmed, Rachel Christie, Abodunrin Aminu, Kim Delbaere, Eling D de Bruin, Emma Stanmore, Chris Todd","doi":"10.2196/89807","DOIUrl":"10.2196/89807","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Exergames, which combine physical exercise with interactive gameplay, are increasingly being incorporated into fall prevention programs for older adults. Gamified elements, such as real-time feedback and progress tracking, may enhance motivation, engagement, and adherence. Although several systematic reviews have examined the effects of exergaming on balance and physical function, fewer have focused specifically on clinically meaningful outcomes, such as falls and injurious falls, or on indicators that may influence real-world adoption of exergames.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the effectiveness of exergaming interventions for preventing falls and injurious falls in people aged ≥60 years and to synthesize evidence on implementation-related outcomes, including adherence, acceptability, concerns about falling, quality of life, adverse events, and cost-effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;MEDLINE, Embase, CINAHL Plus, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to February 2025 for randomized controlled trials evaluating exergaming interventions in older adult populations across all settings. Outcomes included fall rate, number of fallers and injurious falls, and implementation-related secondary outcomes. Risk of bias was assessed using RoB 2.0, and certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were synthesized narratively and, where appropriate, pooled using meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine studies (N=1385) met the inclusion criteria. Comparator-specific analyses suggested that exergaming may reduce fall rates compared with active intervention comparators, although the magnitude and certainty of effect varied, and substantial heterogeneity was present across analyses. Moderate-certainty evidence also suggested that exergames reduced the number of older adults experiencing one or more falls at 12-month follow-up compared with usual care (risk ratio 0.75, 95% CI 0.61-0.92). Evidence for injurious falls, quality of life, concerns about falling, adherence, acceptability, and cost-effectiveness was limited or inconsistent. When pooled across all control groups, exergaming interventions were associated with a lower overall fall rate than comparator interventions (incidence rate ratio 0.53, 95% CI 0.41-0.68), although substantial heterogeneity was present (I²=76%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Low- to moderate-certainty evidence suggests that exergames may reduce fall rates, particularly in comparisons with active intervention control groups, and may reduce the number of fallers compared with usual care. These findings indicate that exergaming may offer a useful adjunct to established fall prevention strategies for older adults, particularly where sustained engagement with conventional exercise is challenging. However, su","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e89807"},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649423","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":"Evaluation of a Gamification-Based Intervention to Enhance Intergenerational Communication: Pre-Post Mixed Methods Evaluation.","authors":"Eliza Lai-Yi Wong, Clement Cheuk Wai Ng, Dorothy Yingxuan Wang, Carol Ka Po Wong, Shirley Shuk Kuen Lui, Annie Wai-Ling Cheung, Eng-Kiong Yeoh","doi":"10.2196/77190","DOIUrl":"10.2196/77190","url":null,"abstract":"<p><strong>Background: </strong>Intergenerational communication has been recognized as a key factor in enhancing social connections among older adults by improving the quality of interactions, which is a crucial component of healthy aging. However, effective interventions to foster intergenerational communication and engagement remain scarce at this stage.</p><p><strong>Objective: </strong>This study examined the effects of a gamification intervention for intergenerational dialogue on intergenerational communication and health-related capacity across 3 age cohorts and further analyzed the differential impacts of intervention characteristics on the game experience, in terms of satisfaction and engagement.</p><p><strong>Methods: </strong>A 2-stage exploratory method was adopted with a cocreation approach to develop a theoretical framework of intergenerational dialogue for the gamification-based intervention, the Healthy Aging in Dialogue Tabletop Game, followed by a mixed methods study involving pre- and postintervention surveys and qualitative interviews to evaluate the effectiveness of the intervention in the young (aged 18-39 years), middle-aged (aged 40-64 years), and older adult (aged ≥65 years) groups. Intergenerational communication was assessed using tools measuring satisfaction and competence, whereas health-related capacity was evaluated using health literacy and patient enablement tools.</p><p><strong>Results: </strong>A total of 68 respondents completed the intervention and evaluation, with 23, 14, and 31 respondents in the young, middle-aged, and older adult groups, respectively. This intergenerational intervention yielded notable benefits in intergenerational communication satisfaction (Cohen d=0.745), communication competence (Cohen d=0.377), and health literacy (Cohen d=0.409), especially among older adults. Patient enablement was significantly higher in older adults (mean score 6.10, SD 2.18) than in young adults (mean score 4.22) (P=.04). In addition, this study highlighted the importance of leveraging gamification to enhance intergenerational communication and engagement, ultimately combating social isolation among older adults.</p><p><strong>Conclusions: </strong>The intergenerational dialogue tabletop game provided an enjoyable platform for cross-generational dialogue and enhanced each age group's communication competence, allowing participants to contribute and learn from one another. The findings provide additional evidence for aging research and shed light on approaches to foster social interaction and connection, thereby promoting health and active aging.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e77190"},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649436","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}