JMIR Aging最新文献

{"title":"The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study.","authors":"Kasem Seresirikachorn, Rachasak Somyanonthanakul, Matthew Johnson, Panisa Singhanetr, Jiraporn Gatedee, David Friedman, Nazlee Zebardast","doi":"10.2196/68771","DOIUrl":"10.2196/68771","url":null,"abstract":"<p><strong>Background: </strong>Falls are the leading cause of injury among older adults, with vision impairment recognized as a significant risk factor. However, many existing studies have been limited by small sample sizes, retrospective designs, or insufficient adjustment for confounding factors. To overcome these limitations, we used data from the University of Michigan's Health and Retirement Study (HRS) to analyze the association between self-reported vision and fall risk among older adults in a large, nationally representative sample.</p><p><strong>Objective: </strong>The objective of this study was to investigate the association between vision impairment and falls and assess whether subjective vision impairment predicts future falls in older adults.</p><p><strong>Methods: </strong>This cross-sectional and longitudinal analysis used data from the HRS (1996-2020) to assess the relationship between self-reported vision, glaucoma history, and falls among US adults aged 65 years and older. HRS uses a biennial, multistage area probability sample survey design, collecting data with community-dwelling individuals followed up every 2 years until death, tracking health, economic, and social outcomes. Multivariate logistic regression was used to analyze associations between self-reported vision and self-reported falls in the past 2 years.</p><p><strong>Results: </strong>A total of 38,835 respondents contributed 117,834 observations. The weighted proportion of participants reporting falls was 37.9% (95% CI 37.7%-40.1%). Significant risk factors for falls included overall eyesight impairment (adjusted odds ratio [aOR] 1.36, 95% CI 1.20-1.56), distance vision impairment (aOR 1.37, 95% CI 1.32-1.42), near vision impairment (aOR 1.33, 95% CI 1.27-1.37), and glaucoma (aOR 1.15, 95% CI 1.07-1.24). A similar association was observed for serious falls, where overall eyesight impairment (aOR 1.20, 95% CI 1.03-1.44), distance vision impairment (aOR 1.14, 95% CI 1.07-1.22), near vision impairment (aOR 1.12, 95% CI 1.05-1.18), and glaucoma (aOR 1.15, 95% CI 1.05-1.26) were significant. In longitudinal analyses, overall vision impairment (aOR 1.23, 95% CI 1.16-1.29), distance vision impairment (aOR 1.27, 95% CI 1.20-1.38), near vision impairment (aOR 1.23, 95% CI 1.19-1.32), and glaucoma (aOR 1.25, 95% CI 1.13-1.37) increased the risk of future falls. Reported overall vision was significantly associated with the number of falls in both the same (P<.001) and subsequent (P<.001) survey cycles.</p><p><strong>Conclusions: </strong>Both distance and near vision impairment, as well as glaucoma, are associated with a higher risk of falls in older adults and present possible areas for intervention and prevention.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e68771"},"PeriodicalIF":4.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761579","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":"Enhancing Enrollment and Adherence in Long-Term Wearable Research on Dementia: Qualitative Systematic Review and Meta-Synthesis.","authors":"Colleen M Peterson, Renée M St Louis, Carol Flannagan","doi":"10.2196/63768","DOIUrl":"10.2196/63768","url":null,"abstract":"<p><strong>Background: </strong>With the rapid expansion of wearable technologies, there is increased interest in their utility for passive data collection applications in research on aging. Wearables can be beneficial for research with people with dementia and their families, who have burdens that can make both study participation and reliable data collection more difficult, especially as dementia progresses, but their use also has challenges. Population-specific issues affecting the success of wearables for data collection can include remembering to wear a device, fluctuating acceptance of the device or study participation, and reliance on already strained caregivers.</p><p><strong>Objective: </strong>This study aimed to systematically evaluate contemporary wearables research to describe persons with dementia's experiences with wearables, their desired qualities, and protocol needs to enhance participant buy-in and sustained wearing for better quality dementia research.</p><p><strong>Methods: </strong>We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist for systematic reviews and searched 3 scholarly databases using Medical Subject Headings (MeSH) terms for papers published since 2018 featuring the use or discussion of wearable devices for persons with dementia. We screened 1757 abstracts and retained 58 for full-text review.</p><p><strong>Results: </strong>We present synthesized preferences, barriers, and facilitators to buy-in and adherence to wearables in dementia research. A total of 29 factors were categorized into 4 overarching categories aligned with study development: device selection, protocol considerations, enhancing recruitment, and promoting adherence.</p><p><strong>Conclusions: </strong>These findings inform researcher guidelines for wearable device selection and protocol design to enhance the utility of wearables in future longitudinal research featuring persons with dementia and their caregivers.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e63768"},"PeriodicalIF":4.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Technology Supporting Aging-in-Place Using an Equity Lens Through Focus Groups and World Café-Informed Research Agenda: Qualitative Study.","authors":"Marianne Saragosa, Ibukun-Oluwa Omolade Abejirinde, Evan MacEachern, Michelle LA Nelson, Kristina M Kokorelias, Sidra Bharmal, Brina Ludwig Prout, Marian Mohamed","doi":"10.2196/71093","DOIUrl":"10.2196/71093","url":null,"abstract":"<p><strong>Background: </strong>Older adults prefer to age in their home or community of choice, which could include naturally occurring retirement communities (NORCs). As a place with a high density of older adults, NORCs could be sites where technology is leveraged to support independence and aging in the right place. However, there is limited research on how technology adoption and use occur in NORCs in ways that support older adults.</p><p><strong>Objective: </strong>This study aims to cocreate a research agenda on equity-informed technology considerations that help older adults live independently in NORCs.</p><p><strong>Methods: </strong>This is a 2-phase sequential qualitative descriptive study of 5 community-based focus groups and an in-person World Café event. We use the focus group method to acquire data about older adults' experiences with and perceptions of using technology to support aging-in-place in NORC settings. This data informs the design and facilitation of deliberate dialogues at the World Café event. Three questions helped to guide the small group discussions. The World Café is a creative, collaborative, and conversation-generating method that aims to generate exchanges between people with different views on a particular topic.</p><p><strong>Results: </strong>In total, 45 NORC residents participated in a focus group about their experience and use of technology. The data revealed 3 central categories that highlight the perception of the use of technology to support the independence of participants in their homes and communities, its challenges, and areas to consider when deploying technology for helping older adults age in place. The subsequent World Café event included 40 participants and a combination of NORC residents, service providers, researchers, technology innovators, and policy makers. Insights drawn from the focus groups and World Café informed a 10-question research agenda about equity-informed technology principles that span accessible support, accessible interfaces, affordable and equitable access, available digital literacy training, accessible data, and accessible partnerships.</p><p><strong>Conclusions: </strong>Our study explores NORCs as potential environments for offering a transformative opportunity to address equity considerations for technology supporting aging in place. Our findings and research agenda highlight critical areas for consideration, including leveraging partnerships, integrating public and private technology ecosystems, and designing technology with older users that evolves with the population's needs. Notably, by embedding principles of equity, inclusivity, and user-centered design, the collective of developers, researchers, and service providers can ensure that emerging technology serves diverse aging populations equitably and effectively.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e71093"},"PeriodicalIF":4.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754633","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":"Association of a Healthy Lifestyle With All-Cause and Cause-Specific Mortality Among Individuals With Probable Sarcopenia: Population-Based Cohort Study.","authors":"Ning Wang, Yuqing Zhang, Junqing Xie, Na Lu, Aojie Zheng, Changjun Li, Jie Wei, Chao Zeng, Guanghua Lei, Yilun Wang","doi":"10.2196/65374","DOIUrl":"10.2196/65374","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Individuals with probable sarcopenia have shown excess mortality, yet no specific treatment regimen has been established. While lifestyle factors improve health and longevity in general populations, their role in probable patients with sarcopenia remains unclear due to differing lifestyle patterns. Clarifying this could inform strategies to address this unmet need.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aim to quantify the impact of a healthy lifestyle on all-cause and cause-specific mortality in probable sarcopenic populations using a large-scale prospective cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants were selected from the UK Biobank, aged 40-69 years, during 2006-2010. Probable sarcopenia was identified according to EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria, resulting in 20,654 participants being included in this study. Death dates and underlying causes were obtained from the National Health Service Information Center. Cox proportional hazard models and population-attributable risk were used to assess the associations between healthy lifestyle factors and premature mortality risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 20,654 individuals with probable sarcopenia were included in this study. The median age of the population was 62.0 (IQR 56.0-66.0) years, and 60.6% (n=12,528) were women. During a median follow-up duration of 11.5 (IQR 10.8-12.3) years, 2447 participants died. All healthy lifestyle factors, including nonsmoking (P&lt;.001), moderate alcohol intake (P&lt;.001), regular physical activity (P&lt;.001), a healthy diet (P=.01), limited television-watching time (P&lt;.001), adequate sleep duration (P=.001), and strong social connections (P&lt;.001), were independently associated with lower mortality risk. To evaluate the cumulative associations between modifiable lifestyle factors and mortality outcomes (all-cause and cause-specific) among patients with probable sarcopenia, we developed a healthy lifestyle index. Participants were assigned one point per adherence to each optimal lifestyle factor. Compared with individuals with 0-2 healthy lifestyle scores, hazard ratios of all-cause mortality for those with 3 to 6-7 factors were 0.67 (95% CI 0.59-0.76), 0.51 (95% CI 0.45-0.57), 0.43 (95% CI 0.38-0.49), and 0.33 (95% CI 0.29-0.39), respectively (P for trend &lt;.001). There was also a dose-response relationship between the number of healthy lifestyle factors and mortality from cancer, cardiovascular disease, respiratory disease, digestive disease, and other causes (all P for trend&lt;.001). Population-attributable risk analysis indicated that 25.7% (95% CI 22%-29%) of deaths were attributable to a poor lifestyle (scoring 0-5).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A healthy lifestyle is associated with a lower risk of all-cause mortality and mortality due to cancer, cardiovascular disease, respiratory disease, and digestive disease among individuals with probable sarcopenia. Adop","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e65374"},"PeriodicalIF":4.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733671","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":"Frequency of Electronic Personal Health Record Use in US Older Adults: Cross-Sectional Study of a National Survey.","authors":"Lavlin Agrawal, Richelle Oakley DaSouza, Pavankumar Mulgund, Pankaj Chaudhary","doi":"10.2196/71460","DOIUrl":"10.2196/71460","url":null,"abstract":"<p><strong>Background: </strong>Electronic personal health records (ePHRs) hold significant potential to improve health management for older adults by enhancing access to medical information and facilitating communication with health care providers. However, usage remains low among individuals aged 65 and older. While existing research has identified barriers such as low self-efficacy, limited digital literacy, and usability challenges, the specific factors influencing the use of ePHRs among older adults are not yet fully understood.</p><p><strong>Objective: </strong>This study integrates the Aging and Technology framework with the Patient Technology Acceptance Model to examine key predictors of ePHR use among older adults, including age, education, issue involvement, performance expectancy, effort expectancy, and self-efficacy, while controlling for demographic factors such as gender, race, and income.</p><p><strong>Methods: </strong>This study utilizes data from the Health Information National Trends Survey (HINTS 5 cycle 3), which includes 532 respondents representing 13,136,180 US adults aged 65 years and older, after applying survey weights. Structural equation modeling was used to analyze the factors influencing the frequency of ePHR access over the past 12 months.</p><p><strong>Results: </strong>The findings indicate that older adults with higher self-efficacy used ePHRs more frequently. Additionally, issue involvement, performance expectancy, and effort expectancy were positively associated with ePHR use. Notably, self-efficacy partially mediated the relationship between age and the frequency of ePHR use.</p><p><strong>Conclusions: </strong>These findings suggest that enhancing self-efficacy, improving usability, and increasing the perceived benefits of ePHRs are critical for boosting usage among older adults. The study underscores the need for targeted interventions to support older users, simplify digital interfaces, and provide accessible educational resources, ultimately contributing to better health outcomes and an improved quality of life for older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e71460"},"PeriodicalIF":4.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733672","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":"Creating User Personas to Represent the Needs of Dementia Caregivers Who Support Medication Management at Home: Persona Development and Qualitative Study.","authors":"Anna Jolliff, Priya Loganathar, Richard J Holden, Anna Linden, Himalaya Patel, Jessica R Lee, Aaron Ganci, Noll Campbell, Malaz Boustani, Nicole E Werner","doi":"10.2196/63944","DOIUrl":"10.2196/63944","url":null,"abstract":"<p><strong>Background: </strong>Caregiver-assisted medication management plays a critical role in promoting medication adherence and quality of life for people living with Alzheimer disease or related dementias (ADRD). The current landscape of digital and nondigital interventions to support medication management does not meet caregivers' needs, contexts, and levels of technological proficiency. Intervention development can be facilitated using personas or data-driven archetypes that represent end users' traits relevant to solution design.</p><p><strong>Objective: </strong>This study aims to understand the strategies and unmet needs of ADRD caregivers who manage medications and use this understanding to create personas that can inform customized caregiver interventions.</p><p><strong>Methods: </strong>Participants were self-identified primary caregivers of people with ADRD living with or near the care recipient. Virtual contextual inquiry was completed in three stages: (1) enrollment interview, (2) virtual observation over a 1-week period, and (3) postobservation interview. Codebook thematic analysis of interview transcripts was used to identify dimensions of caregivers' approaches to medication management. A reflexive, team-based affinity diagramming approach was used to identify attributes within these dimensions and group attributes into personas.</p><p><strong>Results: </strong>Participants (N=25) were aged 62.32 (SD 11.86) years on average, and 17 (68%) of them were female. Caregivers varied across 6 dimensions relevant to medication management: strategies for medication acquisition, medication storage and organization, medication administration, monitoring the care recipient for symptoms, communication with care network regarding medication, and acquiring information about medication. Three personas were created to represent the observed strategies, unmet needs, and levels of technology use related to medication management: Checklist Cheryl, in Control; Social Sam, Keeps it Simple; and Responsive Rhonda, Stays Relaxed.</p><p><strong>Conclusions: </strong>Caregivers in this study demonstrated a range of characteristics and values that informed their approach to medication management. They used a combination of technology-based strategies and strategies situated in their physical environments to manage medications. The personas created can be used to inform interventions, such as digital tools, that address caregivers' unmet needs.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e63944"},"PeriodicalIF":4.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715205","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 and Impact of the Web-Based Dementia Foundations Educational Program in Personal Support Workers (PSWs), PSW Trainees, and Care Companions: Quasi-Experimental Study.","authors":"Anthony J Levinson, Stephanie Ayers, Sandra Clark, Patricia Gerantonis, Amy Schneeberg, Richard Sztramko","doi":"10.2196/67889","DOIUrl":"10.2196/67889","url":null,"abstract":"<p><strong>Background: </strong>Personal support workers (PSWs) are often expected to provide ongoing support for complex conditions and have identified an increased need for training in several areas, including dementia and mental health. Web-based interventions may be helpful complements to traditional in-person continuing education and training, but their effectiveness must be explored further.</p><p><strong>Objective: </strong>This study's objective was to evaluate the usability, usefulness, satisfaction with, and effectiveness of the web-based Dementia Foundations Program among unregulated care providers who provide care to persons living with dementia or are in training.</p><p><strong>Methods: </strong>A cohort of 50 PSWs, PSW trainees, and paid care companions from 3 recruitment sites were invited to access the Dementia Foundations Program, a 4-hour self-paced web-based program composed of 4 courses, for up to 6 weeks. Usability, usefulness, and satisfaction were assessed using surveys after each course and following the program. Dementia knowledge and attitudes were measured using the Dementia Knowledge Assessment Scale and the Dementia Attitudes Scale, with differences between baseline and postprogram scores analyzed using repeated measures ANOVA.</p><p><strong>Results: </strong>Participants reported high levels of satisfaction with the program. Of the 50 participants, 46 (92%) agreed that the web-based training met their expectations, 47 (94%) agreed that the training covered a broad range of topics and was not missing any important content, and 49 (98%) agreed that the web-based training would benefit them. There was a significant postprogram improvement in dementia knowledge as measured by the Dementia Knowledge Assessment Scale, with an average 30% improvement across all cohorts. Dementia Attitudes Scale scores were also significantly improved postprogram across all cohorts.</p><p><strong>Conclusions: </strong>This pilot study in PSWs, PSW trainees, and unregulated care companions demonstrated high satisfaction levels with the web-based Dementia Foundations Program. There were substantial improvements in knowledge and small improvements in attitudes for participants, and it was perceived as a useful tool that complemented their existing education and training. The Dementia Foundations Program is a user-friendly and effective e-learning program, which can be conveniently scaled and spread to enhance unregulated care provider dementia education.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e67889"},"PeriodicalIF":4.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683327","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":"Multimodal Detection of Agitation in People With Dementia in Clinical Settings: Observational Pilot Study.","authors":"Abeer Badawi, Somayya Elmoghazy, Samira Choudhury, Sara Elgazzar, Khalid Elgazzar, Amer M Burhan","doi":"10.2196/68156","DOIUrl":"10.2196/68156","url":null,"abstract":"<p><strong>Background: </strong>Dementia is a progressive neurodegenerative condition that affects millions worldwide, often accompanied by agitation and aggression (AA), which contribute to patient distress and increased health care burden. Existing assessment methods for AA rely heavily on caregiver reporting, introducing subjectivity and inconsistency.</p><p><strong>Objective: </strong>This study proposes a novel, multimodal system for predicting AA episodes in individuals with severe dementia, integrating wearable sensor data and privacy-preserving video analytics.</p><p><strong>Methods: </strong>A pilot study involving 10 participants was conducted at Ontario Shores Mental Health Institute. The system combines digital biomarkers collected from the EmbracePlus (Empatica Inc) wristband with video-based behavioral monitoring. Facial features in video frames were anonymized using a masking tool, and a deep learning model was used for AA detection. To determine optimal performance, various machine learning and deep learning models were evaluated for both wearable and video data streams.</p><p><strong>Results: </strong>The Extra Trees model achieved up to 99% accuracy for personalized wristband data, while the multilayer perceptron model performed best in general models with 98% accuracy. For video analysis, the gated recurrent unit model achieved 95% accuracy and 99% area under the curve, and the long short-term memory model demonstrated superior response time for real-time use. Importantly, the system predicted AA episodes at least 6 minutes in advance in all participants based on wearable data.</p><p><strong>Conclusions: </strong>The findings demonstrate the system's potential to autonomously and accurately detect and predict AA events in real-time. This approach represents a significant advancement in the proactive management of behavioral symptoms in dementia care.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e68156"},"PeriodicalIF":4.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643720","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":"Development and Validation of a Rule-Based Natural Language Processing Algorithm to Identify Falls in Inpatient Records of Older Adults: Retrospective Analysis.","authors":"Xing Xing Qian, Pui Hing Chau, Daniel Y T Fong, Mandy Ho, Jean Woo","doi":"10.2196/65195","DOIUrl":"10.2196/65195","url":null,"abstract":"<p><strong>Background: </strong>In order to address fall underestimation by the International Classification of Diseases (ICD) in clinical settings, information from clinical notes could be incorporated via natural language processing (NLP) as a possible solution. However, its application to inpatient notes has not been fully investigated.</p><p><strong>Objective: </strong>This study aims to develop and validate a rule-based NLP algorithm to identify falls based on inpatient admission notes from older patients.</p><p><strong>Methods: </strong>This retrospective study used 12-year electronic inpatient records of patients aged ≥65 years from public hospitals in Hong Kong. A random sample of 1000 patients was drawn to develop the NLP algorithm. Manual review was the gold standard for assessing the algorithm's performance, with sensitivity, specificity, precision, and F1-score calculated at the record, episode, and patient levels. In addition, the study compared the number of falls identified by ICD codes and clinical notes independently and combined.</p><p><strong>Results: </strong>Our rule-based NLP algorithm showed excellent performance, with a sensitivity, specificity, precision, and F1-score of 93.3%, 99.0%, 87.5%, and 0.903 at the record and episode levels, and 92.9%, 98.3%, 89.7%, and 0.912 at the patient level. The combined identification strategy using ICD codes and the NLP method provided the most comprehensive capture of fall-related episodes and fallers.</p><p><strong>Conclusions: </strong>The NLP method proved efficient and accurate in detecting falls from clinical notes in inpatient episodes. For comprehensive capture of fall episodes and fallers, we recommend the combined use of the NLP algorithm and ICD codes, which should be applied in future fall epidemiology studies and clinical practice for identifying high-risk groups of fall interventions.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e65195"},"PeriodicalIF":5.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592503","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":"Design of a Mobile App and a Clinical Trial Management System for Cognitive Health and Dementia Risk Reduction: User-Centered Design Approach.","authors":"Hannes Hilberger, Bianca Buchgraber-Schnalzer, Simone Huber, Theresa Weitlaner, Markus Bödenler, Alara Abaci, Jeroen Bruinsma, Ana Diaz, Anna Giulia Guazzarini, Jenni Lehtisalo, Seungjune Lee, Vasileios Loukas, Francesca Mangialasche, Patrizia Mecocci, Tiia Ngandu, Anna Rosenberg, Elisabeth Stögmann, Konsta Valkonen, Elena Uhlik, Helena Untersteiner, Laura Kneß, Helmut Ahammer, Sten Hanke","doi":"10.2196/66660","DOIUrl":"10.2196/66660","url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of dementia is a major concern, with approximately 45% of cases linked to 14 modifiable risk factors. The European project LETHE aims to develop a personalized digital intervention model to delay or prevent cognitive decline through risk factor management.</p><p><strong>Objective: </strong>The objective of our study was to design a clinical trial platform for older individuals at risk of cognitive decline, including a mobile app for study participants and a clinical trial management system (CTMS) for health professionals.</p><p><strong>Methods: </strong>Using a user-centered design approach, workshops and feedback rounds involved potential participants representing the target group and professionals. The LETHE app's usability was assessed among 156 older adults enrolled in a 2-year multinational randomized controlled trial evaluating the feasibility of a digitally supported lifestyle program for dementia risk reduction. The randomized controlled trial is currently ongoing; the System Usability Scale (SUS) was administered 1 month after baseline to map first user experiences. Feedback on the LETHE CTMS was collected from 21 users.</p><p><strong>Results: </strong>Of the 78 participants in the trial intervention group, 66 (85%) provided responses for the mobile app, with a median SUS score of 70 (IQR 55-82). Within the control group, 73% (57/78) of responses were received, with a median SUS score of 73 (IQR 63-90). For the CTMS, we received 71% (15/21) of responses, and the feedback was mostly positive. A ranking of the features that could be considered beyond state of the art showed that the integration of personalized activities (mean 2.23, SD 1.17) and real-time appointments (mean 2.46, SD 1.51) were considered the most novel ones.</p><p><strong>Conclusions: </strong>The LETHE app and CTMS were developed to support a personalized digital intervention method within a study involving 156 participants. Limitations include participants having digital literacy and internet access, potentially impacting the generalizability of the findings. Despite these limitations, positive feedback and high usability scores suggest promising potential for the LETHE app and CTMS in supporting personalized interventions to prevent cognitive decline in older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66660"},"PeriodicalIF":5.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555217","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}