JMIR Aging最新文献

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>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}

{"title":"Digital Self-Efficacy, Satisfaction With the Daily Life Changes Stemming From Digital Transformation, and the Moderating Effect of Social Capital in Middle-Aged and Older Adults: Cross-Sectional Survey Study.","authors":"Jeongeun Choi, Hyeonmi Cho, Hyangkyu Lee","doi":"10.2196/79845","DOIUrl":"10.2196/79845","url":null,"abstract":"<p><strong>Background: </strong>The swift pace of digital transformation has heightened individuals' dependence on digital technologies. This makes it imperative to explore how individual factors such as digital self-efficacy and social capital affect satisfaction with the daily life changes stemming from digital transformation. This investigation is particularly essential among middle-aged and older adults because they encounter numerous challenges and opportunities from digital transformation.</p><p><strong>Objective: </strong>This study examined the moderating effect of social capital on the relationship between digital self-efficacy and satisfaction with the daily life changes stemming from digital transformation among middle-aged and older adults.</p><p><strong>Methods: </strong>This study used data from the 2022 Digital Divide Survey conducted by the National Information Society Agency in South Korea. The sample included 4155 individuals aged 40 years or older, of whom 71.8% (n=2985) were classified as middle-aged (40-64 y) and 28.2% (n=1170) as older adults (65-96 y). Data were analyzed using multiple linear regression models with IBM SPSS (version 27.0) and the PROCESS macro.</p><p><strong>Results: </strong>Compared with the middle-aged group, the older adult group showed lower levels of digital self-efficacy, social capital, and satisfaction with the daily life changes stemming from digital transformation. The interaction term between digital self-efficacy and social capital was significant in the middle-aged group (B=-0.11, P=.002) and the older adult group (B=-0.24, P<.001). There was a positive association between digital self-efficacy and satisfaction in both groups, and this association was stronger among those with low social capital. Furthermore, this effect was more pronounced in the older adult group (B=0.71, P<.001 for low and B=0.47, P<.001 for high social capital) than in the middle-aged group (B=0.55, P<.001 for low and B=0.46, P<.001 for high social capital). Education level and digital competence were positively associated with satisfaction in both age groups; higher household income was positively associated with satisfaction only in the middle-aged group.</p><p><strong>Conclusions: </strong>Individuals with low social capital showed a stronger association between digital self-efficacy and satisfaction with the daily life changes stemming from digital transformation. Enhancing digital self-efficacy among older adults, especially those with low levels of social capital, may improve their satisfaction with the daily life changes stemming from digital transformation.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e79845"},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Pure Cognitive Training on Gait and Balance in Older Adults: Systematic Review and Meta-Analysis.","authors":"Xiaohan Li, Yat Leung Chan, Guoshi Liang, Cheuk Hin Lau, Tsz Yau Yuki Lam, Chak Hang Lam, Tsz Wing Chan, Hoi Kei Cheung, Wayne Lap Sun Chan, Chun Liang Hsu, Freddy Man Hin Lam","doi":"10.2196/85070","DOIUrl":"10.2196/85070","url":null,"abstract":"<p><strong>Background: </strong>Physical and cognitive function, both of which decline with aging, are significantly interrelated. Although numerous studies have investigated the effect of physical exercise on cognitive function, relatively few have examined the impact of pure cognitive training on physical performance.</p><p><strong>Objective: </strong>This review aimed to summarize the effects of pure cognitive training on balance and mobility in older adults.</p><p><strong>Methods: </strong>Electronic databases (PubMed, Embase, CINAHL, and PsycInfo) were searched in February 2025. Randomized controlled trials that investigated the effect of pure cognitive training on balance and mobility in older adults were included. Pure cognitive training refers to a strictly nonphysical approach involving guided practice on a standardized set of cognitive tasks aimed at optimizing cognitive functioning. For the outcomes, balance performance focused on standing balance tests and comprehensive balance assessment scales. Mobility performance primarily focused on gait speed under a single-task condition (ie, walking only), gait speed under a dual-task condition (ie, conducting cognitive tasks while walking), and the Timed Up and Go test. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate methodological quality. The level of evidence for the available outcomes was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Meta-analyses and sensitivity analyses of studies with high methodological quality were performed if 3 or more studies were obtained.</p><p><strong>Results: </strong>Fourteen studies were eventually included. The methodological qualities of 8 (57%) studies were rated as good, while those of 6 (43%) studies were rated as fair. A meta-analysis of studies with high methodological quality showed that pure cognitive training has a significant effect on cognitive-motor dual-task gait speed (standardized mean difference [SMD] 0.39, 95% CI 0.04-0.75; n=376 participants; moderate-quality evidence) but not single-task gait speed (SMD 0.12, 95% CI -0.05 to 0.30; n=506 participants; moderate-quality evidence). No significant improvements were found in functional mobility (SMD 0.29, 95% CI -0.60 to 1.18; n=566 participants; low-quality evidence) or balance (SMD 0.18, 95% CI -0.34 to 0.69; n=139 participants; very low-quality evidence).</p><p><strong>Conclusions: </strong>Cognitive training does not improve balance or mobility under single-task conditions but does improve walking speed under cognitive-motor dual-task conditions in older adults. A cognitive training protocol targeting executive function, consisting of 40- to 60-minute sessions conducted 2 to 3 times per week over a period of 8 to 10 weeks, has been shown to be effective.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e85070"},"PeriodicalIF":4.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621631","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 Ways in Which Stakeholders Make Decisions About AI and Novel Technologies for the Health Care of Older Adults: Qualitative Interview Study.","authors":"Zhang Zhang, Thomas Km Cudjoe, Sato Ashida, Jacqueline Massare, Kacey Chae, Phillip Phan, Peter Abadir, Alicia I Arbaje, Mathias Unberath, Nancy L Schoenborn","doi":"10.2196/86148","DOIUrl":"10.2196/86148","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has the potential to improve health among older adults, yet how different stakeholders decide to develop, finance, and adopt AI innovations is not well understood.</p><p><strong>Objective: </strong>This study aimed to understand the decision-making of different stakeholders regarding AI and technologies for the health care of older adults.</p><p><strong>Methods: </strong>We conducted semistructured interviews with 15 older adults and care partners, 15 clinicians, 8 health system or insurance leaders, 5 investors, and 6 technology developers. Data were analyzed using thematic content analysis.</p><p><strong>Results: </strong>All stakeholders considered cost, value, and usability important in adopting AI health technologies but emphasized different aspects of each concept. Older adults and care partners prioritized out-of-pocket costs and ease of use, whereas payers emphasized disease prevalence and implementation feasibility. Developers and investors focused on profitability and scalability, resulting in tension with end users' priorities. Participant suggestions included problem-driven design, greater stakeholder engagement, public-private partnerships, and educating older adults about AI.</p><p><strong>Conclusions: </strong>As with prior health-related technology innovations, aligning decisional priorities across stakeholders is critical to motivate impactful AI health technologies for older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e86148"},"PeriodicalIF":4.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621565","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 Multidimensional Digital Health Platform to Support Intrinsic Capacity and Healthy Aging: Pilot Feasibility Study.","authors":"Marcin Kolakowski, Andrea Lupica, Seif Ben Bader, Jaouhar Ayadi, Luca Gilardi, Angelo Consoli, Irina Georgiana Mocanu, Oana Cramariuc, Lionello Ferrazzini, Eva Reithner, Magdalena Velciu, Barbara Borgogni, Sofia Rivaira, Luca Antognoli, Sara Leonzi, Elisa Felici, Margherita Rampioni, Giacomo Cucchieri, Vera Stara","doi":"10.2196/79862","DOIUrl":"10.2196/79862","url":null,"abstract":"<p><strong>Background: </strong>By 2050, 22% of the global population will be aged 60 years or older, with Europe experiencing rapid aging. This increase in chronic diseases and functional decline demands a shift from fragmented, hospital-centric care to continuous care models. The World Health Organization's healthy aging framework prioritizes intrinsic capacity (IC)-defined as physical and mental abilities across the locomotion, vitality, sensory, cognition, and psychology domains. Digital health solutions enable remote monitoring but face barriers, such as low digital literacy and usability challenges among older adults.</p><p><strong>Objective: </strong>This study evaluates the impact of a multidimensional, artificial intelligence-driven digital health platform (CAREUP) on the dynamic monitoring and personalized enhancement of IC in community-dwelling older adults through the integration of real-time physiological, cognitive, and behavioral data streams.</p><p><strong>Methods: </strong>This pilot feasibility study was conducted from September to December 2024 in Italy, Romania, and Austria. It involved 66 older adults as primary users and 17 caregivers as secondary users. The CAREUP system included Android apps (Careplan and Positive Health), smart devices, and a dashboard. Users followed a 2-month plan. We assessed usability (System Usability Scale [SUS]), user experience (User Experience Questionnaire short version [UEQ-S]), and acceptance (qualitative) at 3 time points (T0, T1, and T2), along with health and quality-of-life measures.</p><p><strong>Results: </strong>Of the 66 enrolled participants, 61 primary users (37 women and 24 men; mean age 73.9 years) completed the study. The overall SUS score was 68, indicating acceptable but improvable usability, with significant variation across countries. The UEQ-S score of 1.45 indicated a good overall user experience, with high Hedonic Quality (1.66) suggesting strong emotional appeal and Pragmatic Quality (1.23) reflecting above-average usability. Most participants (49/61, 80%) rated the platform as interesting, helpful, and efficient, and 48 out of 61 (79%) were willing to recommend it to friends. Secondary outcomes demonstrated stable physical and mental health and maintained independence in daily activities. Technical connectivity issues and device complexity emerged as the primary barriers to adoption.</p><p><strong>Conclusions: </strong>CAREUP demonstrated feasibility for IC monitoring, with acceptable usability and a positive user experience. However, technical challenges and cross-country variations indicate a need for adaptations to address cultural differences and varying levels of digital literacy. Prioritizing reliability, simplifying the system, and providing user support will be essential to enhance broader adoption.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e79862"},"PeriodicalIF":4.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608242","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":"Feasibility and Preliminary Effects of a Pressure Sensor-Based Exergame on Cognitive and Sensorimotor Frailty in Low-Income Older Adults Receiving Public Community Care Services: Pilot Randomized Controlled Trial.","authors":"Sunmi Song, Suk-Chan Hahm, Seyun Chang, Jinseung Lee, Heewon Kang, Sang Hun Lee, Junesun Kim","doi":"10.2196/93467","DOIUrl":"10.2196/93467","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Age-related cognitive and sensorimotor declines co-occur and reinforce one another, increasing vulnerability to functional dependence and falls. Exergaming offers integrated cognitive-motor training, but most systems lack features that support personalized care for socially vulnerable, community-dwelling older adults. Low-income older adults receiving Public Community Care services bear a disproportionate burden of cognitive and sensorimotor decline, yet remain underrepresented in digital health research. As part of a broader program to develop a digital health monitoring-to-intervention framework, we evaluated a pressure sensor-based exergame designed to deliver targeted cognitive-motor training within the existing Public Community Care infrastructure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluates the feasibility and preliminary effects of the Brain Step exergaming intervention on cognitive and sensorimotor frailty in low-income older adults living alone who were receiving Public Community Care services through a pilot study (study 1) and a randomized controlled trial (RCT; study 2).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Study 1 (n=15) was a 12-week single-arm pilot study. Study 2 was a parallel-group pilot RCT conducted in Seoul, South Korea. Thirty-one low-income older adults living alone who were receiving Public Community Care services (mean age 81.5 years; 26/31, 84%, female) were randomized to the intervention (n=16) or control (n=15) group. The 16-week intervention used custom hardware with integrated safety bars and arcade-style games that progressed from single- to dual-task challenges. Primary outcomes were cognitive function (Korean Mini-Mental State Examination [K-MMSE]), physical function (Berg Balance Scale [BBS] and Timed Up and Go [TUG]), and sarcopenia indicators (appendicular skeletal muscle mass [ASM], Appendicular Skeletal Muscle Mass Index, and grip strength). Secondary outcomes were the Korean Montreal Cognitive Assessment, physical fitness (Figure-8 Walk, 30-second Sit-to-Stand, and 2-Minute Step Test), and fall incidence. Generalized estimating equations with Benjamini-Hochberg false discovery rate (FDR) correction for multiple testing were applied.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the single-arm pilot study (study 1), a pre-post increase in BBS scores and a reduction in TUG time survived FDR correction among the primary outcomes (both FDR-adjusted P=.002), as did all 3 secondary physical fitness outcomes (Figure-8 Walk, FDR-adjusted P=.006; 30-second Sit-to-Stand, FDR-adjusted P=.01; and 2-Minute Step Test, FDR-adjusted P=.02). The K-MMSE Visuospatial subscale showed an uncorrected pre-post improvement (P=.02), with differential risk-stratified patterns for Recall (P=.04) and Attention (P=.006). In the pilot RCT (study 2), a nominally significant group × time interaction was observed for ASM (P=.04, FDR-adjusted P=.11), with the intervention group maintaining muscle mass while the con","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e93467"},"PeriodicalIF":4.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585277","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":"Usability of the Coach-Supported Dementia Prevention App ENHANCE (Tailored Intervention for Brain Health and Cognitive Enrichment) in Older Adults: 1-Week Mixed Methods Study.","authors":"Tsz Kiu Clare Yu, Gill Livingston, Richard Boczko, Kealan Forristal, James Jamison, Carl Leckstein, Vrushti Mehta, Hee Kyung Park, Aneesha Singh, Andrew Sommerlad, Sergi G Costafreda","doi":"10.2196/92800","DOIUrl":"10.2196/92800","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Multidomain dementia-prevention interventions delivered via apps have the potential to reach large populations. However, existing trials have tended to recruit more socioeconomically advantaged participants, raising concerns that the resulting interventions may be less usable for older adults from minority ethnic, lower educational, or lower socioeconomic backgrounds, who are at higher risk of dementia. The Tailored Intervention for Brain Health and Cognitive Enrichment (ENHANCE) app was designed to address this by prioritizing accessibility and engagement across diverse user groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated the usability and user experience of the ENHANCE prototype during a 1-week at-home supported-use test and explored factors influencing use and engagement among older adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We purposively recruited adults aged 60-80 years without dementia for a 1-week mixed methods usability evaluation through community settings, including groups underrepresented in dementia-prevention trials. Participants had at least 1 of 10 prespecified dementia risk factors, attended a face-to-face onboarding session with a coach, used the app at home for 7 days with ongoing coach support, and completed a posttest interview and satisfaction survey. We analyzed quantitative data, including app usage metrics and survey responses descriptively, and used reflexive thematic analysis of qualitative data from onboarding sessions, posttest interviews, coaching calls, and in-app messages.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ten participants participated in the study. The mean age was 68 (SD 6) years, and 7 were females. Participants represented a wide range of deprivation (Index of Multiple Deprivation deciles: mean 4, SD 2, range 1-8), with 6 from ethnic minority backgrounds. All met prespecified minimum-use targets (watching a module video, completing a check-in, and playing assigned games at least once). Many demonstrated additional voluntary engagement: 5 rewatched the risk factor video, 7 used the in-app messaging feature, and among the 5 participants with the hypertension module, blood pressure was logged on an average of 5 out of 7 days. Survey responses indicated high satisfaction, perceived usefulness, and ease of use; 9 participants intended to continue using the app and would recommend it to peers. Qualitative analysis identified engagement facilitators, including rewarding game design, familiar interfaces, appropriately challenging gameplay, consistent virtual rewards, trusted expert information combined with peer stories, and coach support. Barriers included unclear visual cues, insufficient accommodation of motor or sensory impairments, and visual discomfort in some games.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Older adults found the ENHANCE prototype usable, acceptable, and engaging over 1 week. Human coaching, inclusive design, and integration of expert and peer narratives were ","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e92800"},"PeriodicalIF":4.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580635","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}