JMIR Aging最新文献

{"title":"Emotional Regulation and Physiological Responses to a Cultural Heritage Virtual Reality Experience in Older Adults: Mixed Methods Study.","authors":"Yafeng Lai, Pohsun Wang","doi":"10.2196/91772","DOIUrl":"10.2196/91772","url":null,"abstract":"<p><strong>Background: </strong>Against the backdrop of global population aging, the development of low-burden and widely acceptable interventions to support emotional health in older adults has become a critical research priority. Virtual reality (VR) has been increasingly applied in medical rehabilitation and psychological interventions due to its immersive and interactive features. However, its potential as a form of digital therapy that integrates cultural content and artistic design remains underexplored, particularly with respect to the mechanisms through which such experiences facilitate emotional regulation in older populations. Empirical studies combining subjective emotional outcomes with objective physiological indicators are especially scarce.</p><p><strong>Objective: </strong>This study aimed to examine the emotional regulation effects of an artistic cultural heritage-based VR experience among older adults and to explore its underlying mechanisms by integrating subjective psychological assessments with objective physiological responses.</p><p><strong>Methods: </strong>A mixed methods experimental design was adopted using the United Nations Educational, Scientific and Cultural Organization Historic Centre of Macao as the study context. Two VR conditions were developed for comparison: (1) an artistic cultural heritage VR environment and (2) a conventional photorealistic replica VR environment. A total of 49 participants aged 60 years and older were recruited. During the VR experience, electrodermal activity (EDA) was continuously recorded to capture emotional arousal. Physiological data were triangulated with pre- and postintervention psychological questionnaires assessing emotional states, as well as semistructured interviews.</p><p><strong>Results: </strong>Compared with the realistic replication VR condition, the cultural heritage VR condition was associated with significantly higher positive affect and lower negative affect (P<.05). At the physiological level, a significant between-group difference was observed in mean normal-to-normal interval (P=.01; Cohen d=0.91), whereas no significant differences were found in EDA measures (all P>.05). EDA results showed notable interindividual variability but did not demonstrate consistent group-level effects. These findings suggest that emotional changes may be more prominently reflected in subjective experience than in physiological arousal.</p><p><strong>Conclusions: </strong>By integrating subjective and physiological measures, this study provides preliminary empirical evidence that cultural heritage VR is associated with improved emotional outcomes in older adults. The findings propose a conceptual interpretative pathway linking digital cultural experience, emotional engagement, and psychological well-being, while highlighting the importance of individual variability in physiological responses. This study contributes to the development of content- and experience-oriented approaches in di","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e91772"},"PeriodicalIF":4.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449660","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":"Performance-Based Usability of Medication Adherence Technologies Among Older Adults With Diverse Capabilities: Quantitative Study.","authors":"Bincy Baby, Ghada Elba, SooMin Park, Imra Hudani, Rishabh Sharma, Kirk Patterson, Annette McKinnon, Sara J T Guilcher, Feng Chang, Linda Lee, Catherine Burns, Dagmar Hajducek, Ryan H Griffin, Tejal Patel","doi":"10.2196/88398","DOIUrl":"10.2196/88398","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence technologies (MATs) offer innovative solutions to support older adults in managing complex medication regimens, yet usability challenges can prevent their successful use. Older adults often face cognitive, physical, sensory, motivational, and environmental barriers, which can influence how they interact with these devices. Therefore, performance-based usability testing is essential for identifying usability issues.</p><p><strong>Objective: </strong>This study aimed to evaluate the performance-based usability and user experience of 13 MATs among older adults with diverse capabilities.</p><p><strong>Methods: </strong>A prospective mixed methods design was used, with 96 participants aged 60 years and older testing smart and electronic MATs using cognitive walkthroughs and predefined usability tasks without formal training to simulate first-use conditions. This manuscript focuses specifically on the performance-based usability metrics collected as part of the mixed methods study. Validated tools, including the Self-Medication Assessment Tool (SMAT), Daily Living Tasks Dependent on Vision (DLTV), Whisper Test, Self-Efficacy for Appropriate Medication Use Scale (SEAMS), and Martin and Park Environmental Demands (MPED) Questionnaire, were used to assess individual barriers. Poisson generalized estimating equations (GEE) was used to determine predictors of unassisted task success and error rates while accounting for repeated observations.</p><p><strong>Results: </strong>A total of 96 participants (mean age 75.1, SD 7.7, range 61-95 y) were included, with 37.5% (36/96) male and 62.5% (60/96) female. Poisson GEE models identified significant predictors of unassisted task success rate, including cognitive score (P<.001), physical score (P<.001), vision score (P<.001), motivational score (P<.001), and lower environmental busyness (P=.049). Female sex was associated with a 9% lower success rate (P=.002). Predictors of total error rate included age (P=.02), sex (P≤.001), physical score (P≤.001), vision score (P=.004), DLTV vision score (P=.01), MPED routine score (environmental; P=.05), and interaction between physical score and sex (P=.004).</p><p><strong>Conclusions: </strong>Both device design and user characteristics strongly influence the usability of MATs. Performance-based evaluations provide actionable findings for user-centered design and selection, guiding manufacturers and health care providers toward developing and choosing accessible technologies that could improve medication adherence among older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e88398"},"PeriodicalIF":4.6,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438297","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 Novel Multisegmental Individual-Based Exercise Approach for Postural Dysfunction and Balance Impairment in Older Adults: Randomized Controlled Trial.","authors":"Filza Shoukat, Syed Shakil Ur Rehman","doi":"10.2196/78426","DOIUrl":"10.2196/78426","url":null,"abstract":"<p><strong>Background: </strong>Age-related decline in mobility and balance substantially increases the risk of falls in older adults. Evidence-based exercise programs are recommended, but their effectiveness requires further evaluation.</p><p><strong>Objective: </strong>The study aimed to find out the effectiveness of multisegmental individual-based exercise program (MIBEX) approach for postural dysfunction and balance impairment in older adults.</p><p><strong>Methods: </strong>A 2-arm, single-blinded randomized controlled trial was conducted with 113 community-dwelling adults aged 65 years or older (exercise group, n=56; control group, n=57). Participants in the intervention arm received MIBEX, while the control group received postural education via video. Outcomes included the Timed Up and Go test, tragus-to-wall test, Mini-Balance Evaluation Systems Test, and postural sway, measured at baseline and 3 postintervention time points. Between-group comparisons were analyzed using the Mann-Whitney U test with effect sizes (r) and 95% CIs.</p><p><strong>Results: </strong>Significant between-group differences were observed across all outcomes (P<.01). The exercise group showed improvements in the Timed Up and Go test (median reduction from 15, IQR 13-19 to 10, IQR 8-12 s) compared with controls (15, IQR 13-18 to 12, IQR 10-14 s), with a large effect size (r=0.65, 95% CI 0.45-0.80). Tragus-to-wall test performance improved markedly in the intervention group (median increase from 41, IQR 36-47 to 49, IQR 44-54 cm) versus controls (40, IQR 35-46 to 37, IQR 31-43 cm; r=0.52, 95% CI 0.30-0.70). Mini-Balance Evaluation Systems Test scores declined in controls but improved in the intervention group (r=0.48, 95% CI 0.25-0.66). Postural sway demonstrated moderate improvement (r=0.40, 95% CI 0.18-0.58).</p><p><strong>Conclusions: </strong>These findings indicate that the MIBEX produced significantly greater improvements in mobility, balance, and postural stability compared with usual care, highlighting its potential as an effective intervention for older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e78426"},"PeriodicalIF":4.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425048","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 Tablet Computer-Based Food Record for the Self-Assessment of Nutritional Intake in Patients Undergoing Geriatric Rehabilitation: Prospective Pilot Feasibility Study.","authors":"Julia Berndt, Patrick Elfert, Marco Eichelberg, Juergen Martin Bauer, Andreas Hein, Rebecca Diekmann","doi":"10.2196/84653","DOIUrl":"10.2196/84653","url":null,"abstract":"<p><strong>Background: </strong>Nutritional status is an influential factor for functional status and rehabilitation outcomes in patients undergoing geriatric rehabilitation. Although there is evidence for the potential of eHealth interventions in patients undergoing geriatric rehabilitation in general, the evidence for eHealth interventions with a focus on nutrition is scarce. In other target groups with older people, eHealth applications to support nutrition, such as computer-based food records, have been used successfully.</p><p><strong>Objective: </strong>Therefore, the aim of this study was to verify whether it is feasible for patients undergoing geriatric rehabilitation to independently use a tablet computer-based food record (e-food record) to document their food and beverage intake. The e-food record was developed in advance and tailored to the age- and disease-specific needs of patients undergoing geriatric rehabilitation.</p><p><strong>Methods: </strong>This prospective pilot study investigated the general feasibility of an e-food record in older adults (≥70 y) in a geriatric rehabilitation center in Germany. It was tested whether the e-food record could be independently used by the participants over 3 days. Furthermore, the usability of the e-food record was assessed by the System Usability Scale (0-100 points) after usage. To compare nutritional data, the participants recorded their consumption of food and beverages by the e-food record and by a 24-hour recall for the same time period, and the mean difference was calculated as follows: the value of the 24-hour recall minus the value of the e-food record. As the study was characterized as a pilot, the data analysis was descriptive.</p><p><strong>Results: </strong>Seventeen out of 25 patients (n=6, 35.3% female, mean age 79.5, SD 3.7 y) maintained the e-food record independently over the study period. The mean System Usability Scale score of the e-food record was 76.0 (SD 11.3) points. Datasets of 9 out of 17 participants (n=5, 55.6% female, mean age 78.2, SD 2.9 y) were analyzed in terms of nutritional data. Mean differences in energy, protein, and fluid intake by the 24-hour recall compared to the e-food record were 4.9 (SD 10.2) kcal/kg body weight (bw), 0.1 (SD 0.3) g/kg bw, and 4.9 (SD 9.4) g/kg bw, respectively.</p><p><strong>Conclusions: </strong>The use of an e-food record is generally feasible for patients undergoing geriatric rehabilitation characterized by low technical experience, high mean age, and a high rate of functional impairment. Lower intake levels were observed for the e-food record compared to the 24-hour recall with regard to energy, protein, and fluid intake. Aspects for further development of the e-food record were identified to enable evaluation on a larger sample. Following successful evaluation, the e-food record could be used within nutrition therapy in the future to increase the efficiency of the nutritional therapy process.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e84653"},"PeriodicalIF":4.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425059","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":"Smart Speaker-Based Applications to Support Social Connectedness in Older Adult Residents in Affordable Housing: User-Centered Design Study.","authors":"Jane Chung, Natalie Mansion, Tracey Gendron, Rachel E Wood, George Demiris","doi":"10.2196/90053","DOIUrl":"10.2196/90053","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Older adults in affordable housing face heightened risks of social isolation and loneliness due to limited social networks, transportation barriers, chronic conditions, and inadequate technology access. Smart speakers offer potential for enhancing social connectedness in this underserved population, yet technology interventions are rarely designed with meaningful input from older adults themselves. User-centered design (UCD) approaches can address this gap by engaging end users throughout the development process to ensure technology solutions align with their needs and living contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to engage older adults in affordable housing in an iterative UCD process to develop prototype scenarios for smart speaker-based applications that promote social connectedness while addressing safety, community-building, and wellness needs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a 3-stage UCD study with 29 older adults (mean age 70, SD 6.8 years; 23/29, 79% African American; 20/29, 69% high school education or less) living alone in affordable housing between April 2021 and April 2022. Stage 1 included 5 focus groups (n=25) combining needs assessment discussions with rapid brainstorming activities. Stage 2 involved research team synthesis of focus group transcripts and brainstorming data to create a Design Strategies Map, development of initial prototype scenarios, 5 evaluation focus groups (n=18) to gather feedback, and iterative scenario refinement. Stage 3 comprised 4 validation focus groups (n=17) to assess refined scenarios and identify implementation recommendations. Participants included both smart speaker users (n=13) and nonusers (n=16). Data were analyzed using thematic analysis for needs assessment, content analysis for brainstorming ideas and feedback, and matrix analysis for systematic comparison across scenarios.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants generated 153 ideas for smart speaker use, with Health and Safety and Daily Assistance being the most frequent categories. Analysis revealed that social connection needs were inseparable from safety concerns related to living alone. Through iterative co-design, we developed 7 prototype scenarios across 4 functional categories: Checking-In (peer and management safety verification with privacy controls), Social Companion (conversational artificial intelligence-based companionship and emotional support), Community Involvement (virtual bulletin boards and activity coordination), and Wellness Check (system-initiated monitoring of activity and behavioral patterns as health indicators with user-controlled interventions). Participants emphasized requirements for personalization, opt-in/opt-out controls, \"Do-Not-Disturb\" functionality, and safeguards preventing replacement of human connection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Older adults in affordable housing engaged in technology design and provided valuable insights","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e90053"},"PeriodicalIF":4.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406205","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 a Combined Zumba and Video Game-Based Cognitive Intervention on Cognitive Function Among Older Adults in Klang Valley, Malaysia: Semirandomized Trial.","authors":"Yook Chin Chia, Sharifah Nadhira Syed Annuar, Jactty Chew, Yunli Lee, Wei-Gene Lim, Wei Zern Yip, Kristin-Ann Leong Zhe Mun, Michael Jenkins","doi":"10.2196/88479","DOIUrl":"10.2196/88479","url":null,"abstract":"<p><strong>Background: </strong>Age-related cognitive decline can threaten independence in older adults, creating an urgent need for effective and practical preventive strategies. Nonpharmacological approaches such as physical activity, cognitive stimulation, and combined programs show promise, but their comparative effectiveness and the specific cognitive domains they influence are not yet clearly established.</p><p><strong>Objective: </strong>This study evaluated the effects of 3 nonpharmacological interventions. These consisted of a physical activity program using Zumba, a video game-based cognitive stimulation program, and a combined physical and cognitive program. The aim was to determine their effects on global cognition and specific cognitive domains in community-dwelling older adults in the Klang Valley of Malaysia. A secondary objective was to examine the influence of adherence on cognitive outcomes.</p><p><strong>Methods: </strong>A total of 96 participants (median age 69 y, IQR 65-72 y; n=63, 65.6% female) were assigned to 4 groups: physical (n=12), cognitive (n=23), combined (n=43), and control (n=18). Global cognitive performance was measured using the Montreal Cognitive Assessment at baseline and postintervention. Mixed ANOVA examined time and time × group effects. Additional nonparametric analyses (Kruskal-Wallis, Mann-Whitney U, Wilcoxon signed rank tests) were conducted under intention-to-treat and per-protocol (PP) frameworks. Adherence was defined as attending 50% or more of scheduled sessions, with PP analyses reclassifying participants accordingly.</p><p><strong>Results: </strong>Global cognition improved significantly over time across all groups (time main effect: F1,92=7.03, P=.008; time × group interaction: F3,92=0.57, P=.64). PP analyses showed moderate gains for participants attending 50% or more of cognitive sessions (r=0.46) and larger gains for those adhering to the combined intervention (r=0.66), with median Montreal Cognitive Assessment scores increasing by approximately 2 points in both adherent groups. Subdomain analyses indicated improvements in language (all groups), visuospatial function (combined group), and orientation (cognitive group).</p><p><strong>Conclusions: </strong>All intervention types were associated with improvements in cognitive performance over time, with comparable gains across groups. Participants who achieved at least moderate adherence (≥50%) to the cognitive or combined interventions demonstrated larger and more consistent within-group effect sizes, highlighting the importance of sustained engagement. These findings support the feasibility and potential cognitive benefits of structured, multimodal nonpharmacological interventions for community-dwelling older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e88479"},"PeriodicalIF":4.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382477","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 Adoption of Smartwatches by Older Adults in Bangladesh: User Study.","authors":"Fariah Mahzabeen, Fazlea Rabby, Neazmul Mowla, Sadia Afra Ibnat","doi":"10.2196/76404","DOIUrl":"10.2196/76404","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Wearables such as smartwatches can support point-of-care health management for older adults while reducing pressure on health care systems as aging populations grow. Although many studies emphasize technical accuracy, user-centered research on smartwatch adoption among older adults remains limited, particularly in low- and middle-income countries, such as Bangladesh.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated real-world usability, acceptance, and adoption of smartwatches among socioeconomically diverse older adults (aged ≥60 y) in a low- and middle-income country context. It examined how age, education, socioeconomic background, and cultural perceptions influence user experience, and identified barriers and facilitators related to comfort, usability, and long-term engagement. It also explored health-related features that older adults perceived as missing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants were recruited from older adult communities with diverse socioeconomic and educational backgrounds, and received a commercially available smartwatch. A mixed methods, 3-phase longitudinal design was conducted, including a short-term survey (n=27), 3 long-term survey data points (n=19, 18, and 18), and 2 focus group interviews (n=13 and 12). Quantitative analyses included paired t tests across longitudinal data points and chi-square tests for distributional associations, complemented by thematic qualitative analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Comfort improved substantially over time, with participants rating the smartwatch as very comfortable, increasing from 26% (5/19) at baseline to 80% (16/20) at final follow-up. Heart rate monitoring remained the most frequently used feature, rising from 68.42% (13/19) to 75% (15/20). Paired t tests showed no significant longitudinal changes in daily usage (t5=0.00 to 0.22, P=.83 to ≥.99), comfort (t4=-0.07 to 0.30, P=.78 to .95), most liked features (t8=-0.63 to 0.51, P=.30 to .62), or clarity of instructions (t2=0.00 to 0.19, P=.87 to ≥.99). Significant increases were observed in feature usage (data point [DP] 2 vs DP3: t8=-4.16, P&lt;.001; DP1 vs DP3: t8=-2.53, P=.03) and perceived difficulty of use (DP2 vs DP3: t8=-4.29, P&lt;.001; DP1 vs DP3: t8=-2.31, P=.05). Chi-square analyses indicated a significant association between study phase and clarity of instructions (χ24=10.3, P=.03), with a trend for comfort (χ²8=13.8, P=.08); other usability dimensions were non-significant (χ²16=7.1 to 17.5, P=.35 to .97). Socioeconomic differences emerged in data-sharing preferences, with higher socioeconomic participants favoring continuous sharing and lower socioeconomic participants preferring emergency-only sharing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Older adults can adapt to wearable health technologies when given adequate time and support, regardless of education level. Preferences for a limited set of essential health features and faster adoption among participants with lower ","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e76404"},"PeriodicalIF":4.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362715","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":"Associations of Solid Fuel Use and Circadian Rhythm Syndrome With Physical Function and Muscle Strength in Middle-Aged and Older Adults: Nationwide Cohort Study in China.","authors":"Haochen Wang, Pengsen Mou, Donghao Liu, Ze Zhao, Wenzheng Chen, Yuxin Yao, Haoyan Shi, Jiaxin Guan, Jing Dong, Yingliang Wei","doi":"10.2196/78352","DOIUrl":"10.2196/78352","url":null,"abstract":"<p><strong>Background: </strong>The relationships among circadian rhythm syndrome, physical function, and muscle strength remain unclear.</p><p><strong>Objective: </strong>This study aimed to demonstrate the separate and combined deleterious effects of solid fuel use and circadian rhythm syndrome on physical function and muscle strength.</p><p><strong>Methods: </strong>We used data from the China Health and Retirement Longitudinal Study cohort. The study population consisted of participants who underwent comprehensive assessments of metabolism, circadian rhythm, indoor air pollution, physical function, and muscle strength at the initial evaluation. Muscle strength was assessed using repeated grip strength measurements, and physical function was assessed using a composite score of muscle strength, physical performance, and balance. Circadian rhythm syndrome was derived from the 5 diagnostic components of metabolic syndrome combined with sleep duration and depression. Logistic regression and linear mixed models were used to assess the relationships among solid fuel use, circadian rhythm syndrome, physical function, and muscle strength. Furthermore, we analyzed the mediating role of circadian rhythm syndrome and its combined effect with solid fuel use on physical function and muscle strength.</p><p><strong>Results: </strong>A total of 7934 participants were included in the study, most of whom used solid fuels. Solid fuel use was positively associated with circadian rhythm syndrome (odds ratio [OR] 1.078, 95% CI 1.031-1.125; P<.05). Circadian rhythm syndrome was found to be a significant risk factor for impairment of physical function (β=-0.475; P<.05) and muscle strength (β=-0.304; P<.05). Participants who used solid fuels and had circadian rhythm syndrome needed to pay more attention to changes in physical function (β=-0.698; P<.05) and muscle strength (β=-0.332; P<.05). A significant interaction was observed between solid fuel use and circadian rhythm syndrome on physical function (P_interaction=.03) and muscle strength (P_interaction=.02). Circadian rhythm syndrome partially mediated the association between solid fuel use and physical function, accounting for 2.51% of the total effect.</p><p><strong>Conclusions: </strong>Circadian rhythm syndrome exacerbates the adverse effects of solid fuel use on physical function and muscle strength. Fuel cleanliness and regular work and rest habits are crucial for the health of middle-aged and older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e78352"},"PeriodicalIF":4.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354069","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":"Use of Wearable Technology for Measuring and Characterizing Sedentary Behavior in People With Mild Cognitive Impairment and Dementia: Systematic Review.","authors":"Jenny L Wales, Chloe Hinchliffe, Ryan Stanley Falck, Silvia Del Din, Alison J Yarnall, Ríona Mc Ardle","doi":"10.2196/85361","DOIUrl":"10.2196/85361","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sedentary behavior (SB) is a critical, modifiable risk factor for adverse health outcomes. Evidence suggests that SB is higher among individuals with cognitive impairment relative to their cognitively healthy peers. However, the nature and extent of SB across cognitive impairments remains unclear, largely due to the reliance on self-report data and the lack of synthesized evidence from more accurate methodology, such as wearable devices. Wearable device-based methodologies offer a reliable means of capturing SB in real-world settings, circumventing the recall bias inherent to self-report methods. Continuous remote monitoring of SB, via wearable devices, may provide nuanced insights important for understanding SB's contribution to cognitive impairment and health consequences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This review aims to synthesize evidence on the volume, patterns, and variability of SB across cognitive impairment and critically appraise the wearable device-based methodology used to capture SB in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched 5 databases (Embase, MEDLINE, PsycInfo, Scopus, and Web of Science) up to January 2025 for peer-reviewed English-language studies using wearable devices to measure SB in community-dwelling or aged residential care residents aged 50 years or older with cognitive impairment (PROSPERO: CRD42024616523). Study quality was assessed using an adapted version of the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data were extracted on SB outcomes (eg, volume, pattern, and variability) and methodological characteristics (eg, device type, placement, SB classification/processing, and its corresponding validation).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 2824 screened records, 17 studies (2016-2025) were included. Most studies (n=11, 65%) were of \"good\" quality (scoring ≥5 on bias assessment). Synthesis revealed inconsistent evidence for differences in SB volume across cognitive impairment. However, individuals with dementia consistently exhibited a unique SB pattern, engaging in significantly fewer but longer sedentary bouts than other forms of cognitive impairment and cognitively intact controls. All (n=17, 100%) studies used volume metrics to describe SB, followed by pattern metrics (n=7, 41%); only 1 study reported on SB variability. Methodological appraisal found significant heterogeneity: 13 different device models across 6 body placements were used. Most studies quantified SB using count-based thresholds (counts per minute), which were largely unvalidated in cognitively impaired or older adult populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This review found that participants with dementia consistently exhibited a unique pattern of SB compared to other forms of cognitive impairment and healthy controls, while","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e85361"},"PeriodicalIF":4.6,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333365","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":"Patient Satisfaction With Telehealth Visits in Rural Compared With Urban Communities: Single-Center Study.","authors":"Corrin Hepburn, Karolina Krawczyk, Cara Joyce, Jonah Rubin","doi":"10.2196/85018","DOIUrl":"10.2196/85018","url":null,"abstract":"<p><strong>Background: </strong>Studies performed in urban communities with access to technology suggest high patient satisfaction with telehealth. While virtual visits can increase the reach of clinical practice in rural communities, technological barriers may reduce patient satisfaction.</p><p><strong>Objective: </strong>This study aimed to compare satisfaction with telehealth visits between patients living in rural and urban communities.</p><p><strong>Methods: </strong>A telephone survey was developed and administered to hepatology patients seen at outpatient clinics from March 2020 through March 2021. Patient characteristics and survey responses were compared by urban and rural location as defined by the census tract based on zip code using univariable and multivariable logistic regression.</p><p><strong>Results: </strong>Of 400 patients, 164 (41%) completed the survey. Compared with urban patients, rural patients had twice the transportation time to clinic (mean 59, SD 35 vs mean 30, SD 15 min) and were more likely to cancel due to transportation issues (21/48, 46% vs 15/116, 13%). Rural patients reported less proficiency with technology and more technical difficulties, including an inability to log on to the portal or access the camera or microphone (35/48, 75% vs 29/116, 25%) and less comfort with their devices (26/48, 54% vs 10/116, 9%). Overall, urban patients were more likely to prefer telehealth (adjusted odds ratio 5.20, 95% CI 2.15-13.7) and were more satisfied with telehealth vs in-person visits than rural patients (72/116, 62.1% vs 10/48, 20.8%).</p><p><strong>Conclusions: </strong>Rural patients reported more technical challenges with telehealth and more transportation issues than urban patients but favored in-person hepatology visits. Urban patients were more satisfied with telehealth visits compared with in-person visits. Research is needed to improve telehealth delivery and satisfaction for rural patients.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e85018"},"PeriodicalIF":4.6,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319548","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}