JMIR Aging最新文献

{"title":"Uncovering Specific Navigation Patterns by Assessing User Engagement of People With Dementia and Family Caregivers With an Advance Care Planning Website: Quantitative Analysis of Web Log Data.","authors":"Charlèss Dupont, Tinne Smets, Courtney Potts, Fanny Monnet, Lara Pivodic, Aline De Vleminck, Chantal Van Audenhove, Maurice Mulvenna, Lieve Van den Block","doi":"10.2196/60652","DOIUrl":"10.2196/60652","url":null,"abstract":"<p><strong>Background: </strong>Web-based tools have gained popularity to inform and empower individuals in advance care planning. We have developed an interactive website tailored to the unique needs of people with dementia and their families to support advance care planning. This website aims to break away from the rigid pathways shown in other tools that support advance care planning, in which advance care planning is shown as a linear process from information to reflection, communication, and documentation.</p><p><strong>Objective: </strong>This study aimed to assess the website's usage by people with dementia and their family caregivers, identify distinct user engagement patterns, and visualize how users navigated the website.</p><p><strong>Methods: </strong>We analyzed the website's log data obtained from an 8-week evaluation study of the site. Interactions with the website were collected in log data files and included visited web pages or clicked-on hyperlinks. Distinct user engagement patterns were identified using K-means clustering process mining, a technique that extracts insights from log data to model and visualize workflows, was applied to visualize user pathways through the website.</p><p><strong>Results: </strong>A total of 52 participants, 21 individuals with dementia and their family caregivers as dyads and 10 family caregivers were included in the study. Throughout the 8-week study, users spent an average of 35.3 (SD 82.9) minutes over 5.5 (SD 3.4) unique days on the website. Family caregivers mostly used the website (alone or with a person with dementia) throughout the 8-week study. Only 3 people with dementia used it on their own. In total, 3 distinct engagement patterns emerged: low, moderate, and high. Low-engagement participants spent less time on the website during the 8 weeks, following a linear path from information to communication to documentation. Moderate- and high-engagement users showed more dynamic patterns, frequently navigating between information pages and communication tools to facilitate exploration of aspects related to advance care planning.</p><p><strong>Conclusions: </strong>The diverse engagement patterns underscore the need for personalized support in advance care planning and challenge the conventional linear advance care planning representations found in other web-based tools.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e60652"},"PeriodicalIF":5.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400178","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":"Assessment of Technology Readiness in Norwegian Older Adults With Long-Term Health Conditions Receiving Home Care Services: Cross-Sectional Questionnaire Study.","authors":"Sverre Bergh, Jūratė Šaltytė Benth, Lisbeth Dyrendal Høgset, Britt Rydjord, Lars Kayser","doi":"10.2196/62936","DOIUrl":"10.2196/62936","url":null,"abstract":"<p><strong>Background: </strong>With the increasing number of older adults globally, there is a constant search for new ways to organize health care services. Digital health services are promising and may reduce workload and at the same time improve patient well-being. A certain level of eHealth literacy is needed to be able to use digital health services. However, knowledge of technology readiness in this target group of older adults is unclear.</p><p><strong>Objective: </strong>The aim of this study was to understand the technology readiness level of a group of older adults who were provided home care services in order to address the present and future needs of this group in relation to the implementation of digital health care services.</p><p><strong>Methods: </strong>This quantitative cross-sectional study included 149 older adults from Norway receiving home care services. The participants completed the Readiness and Enablement Index for Health Technology (READHY) instrument, assessments of well-being (World Health Organization-Five Well-Being Index [WHO-5]), and assessments of demographic and clinical variables (sex, age, education, living situation, comorbidity, use of digital devices, and use of IT). Cluster analyses were used to group the users according to their technology readiness.</p><p><strong>Results: </strong>The mean participant age was 78.6 (SD 8.0) years, and 55.7% (83/149) were women. There was good consistency within the assumed READHY scales (Cronbach α=.61-.91). The participants were grouped into 4 clusters, which differed in terms of READHY scores, demographic variables, and the use of IT in daily life. Participants in cluster 1 (n=40) had the highest scores on the READHY scales, were younger, had a larger proportion of men, had higher education, and had better access to digital devices and IT. Participants in cluster 4 (n=16) scored the lowest on eHealth literacy knowledge. Participants in cluster 1 had relatively high levels of eHealth literacy knowledge and were expected to benefit from digital health services, while participants in cluster 4 had the lowest level of eHealth literacy and would not easily be able to start using digital health services.</p><p><strong>Conclusions: </strong>The technology readiness level varied in our cohort of Norwegian participants receiving home care. Not all elderly people have the eHealth literacy to fully benefit from digital health services. Participants in cluster 4 (n=16) had the lowest scores in the eHealth Literacy Questionnaire scales in the READHY instrument and should be offered nondigital services or would need extensive management support. The demographic differences between the 4 clusters may inform stakeholders about which older people need the most training and support to take advantage of digital health care services.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e62936"},"PeriodicalIF":5.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365148","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":"Implications of Public Disclosure of Personal Information in a Mobile Alert App for People Living With Dementia Who Go Missing: Qualitative Descriptive Study.","authors":"Adebusola Adekoya, Christine Daum, Noelannah Neubauer, Antonio Miguel-Cruz, Lili Liu","doi":"10.2196/64847","DOIUrl":"10.2196/64847","url":null,"abstract":"<p><strong>Background: </strong>People living with dementia are at risk of getting lost and going missing due to memory loss, confusion, and disorientation. Missing person incidents involving people living with dementia are increasing. Alert systems such as Community ASAP can promote community engagement in locating missing persons with dementia and aid in search and rescue efforts. However, the implications of public disclosure of personal information such as name, age, sex, and physical description within such alert systems have yet to be explored.</p><p><strong>Objective: </strong>This study aimed to identify and discuss the implications of public disclosure of personal information in Community ASAP for people living with dementia at risk of going missing.</p><p><strong>Methods: </strong>This study used a qualitative descriptive research design drawing from naturalistic inquiry. A total of 19 participants including people living with dementia, care partners, first responders, and service providers were recruited from Ontario, Alberta, and British Columbia, Canada. Semistructured interviews were used to explore participants' perspectives on the perceived implications of the release of personal information when using Community ASAP. NVivo (version 12) was used to manage data, and conventional content analysis was conducted to identify key themes of the implications of public disclosure of personal information in Community ASAP.</p><p><strong>Results: </strong>In total, 10/19 (53%) of the participants were women and 9/19 (47%) were men. Of the 19 participants, 3 (16%) were people living with dementia, 5 (26%) were care partners, 4 (21%) were first responders, and 7 (37%) were service providers. In total, 4 key themes were identified as implications of public disclosure of personal information in Community ASAP: right to autonomy, safety versus privacy, informed and knowledgeable consent, and stigmatization. Participants discussed how the public disclosure of personal information in Community ASAP could undermine a person's choice not to be found and contribute to stigmatization. Participants emphasized a need to balance safety and privacy concerns. Informed and knowledgeable consent is important when using an alert system to locate missing persons with dementia.</p><p><strong>Conclusions: </strong>Community ASAP can promote community engagement in locating missing persons with dementia. However, the public disclosure of personal information in alert systems has implications. Users' right to autonomy, a balance between safety and privacy, informed and knowledgeable consent, and risks of stigmatization are perceived impacts of disclosure of personal information in alert systems.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e64847"},"PeriodicalIF":5.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365522","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":"Predictive Validity of Hospital-Associated Complications of Older People Identified Using Diagnosis Procedure Combination Data From an Acute Care Hospital in Japan: Observational Study.","authors":"Seigo Mitsutake, Tatsuro Ishizaki, Shohei Yano, Takumi Hirata, Kae Ito, Ko Furuta, Yoshitomo Shimazaki, Hideki Ito, Alison Mudge, Kenji Toba","doi":"10.2196/68267","DOIUrl":"10.2196/68267","url":null,"abstract":"<p><strong>Background: </strong>A composite outcome of hospital-associated complications of older people (HAC-OP; comprising functional decline, delirium, incontinence, falls, and pressure injuries) has been proposed as an outcome measure reflecting quality of acute hospital care. Estimating HAC-OP from routinely collected administrative data could facilitate the rapid and standardized evaluation of interventions in the clinical setting, thereby supporting the development, improvement, and wider implementation of effective interventions.</p><p><strong>Objective: </strong>This study aimed to create a Diagnosis Procedure Combination (DPC) data version of the HAC-OP measure (HAC-OP-DPC) and demonstrate its predictive validity by assessing its associations with hospital length of stay (LOS) and discharge destination.</p><p><strong>Methods: </strong>This retrospective cohort study acquired DPC data (routinely collected administrative data) from a general acute care hospital in Tokyo, Japan. We included data from index hospitalizations for patients aged ≥65 years hospitalized for ≥3 days and discharged between July 2016 and March 2021. HAC-OP-DPC were identified using diagnostic codes for functional decline, incontinence, delirium, pressure injury, and falls occurring during the index hospitalization. Generalized linear regression models were used to examine the associations between HAC-OP-DPC and LOS, and logistic regression models were used to examine the associations between HAC-OP-DPC and discharge to other hospitals and long-term care facilities (LTCFs).</p><p><strong>Results: </strong>Among 15,278 patients, 3610 (23.6%) patients had coding evidence of one or more HAC-OP-DPC (1: 18.8% and ≥2: 4.8%). Using \"no HAC-OP-DPC\" as the reference category, the analysis showed a significant and graded association with longer LOS (adjusted risk ratio for patients with one HAC-OP-DPC 1.29, 95% CI 1.25-1.33; adjusted risk ratio for ≥2 HAC-OP-DPC 1.97, 95% CI 1.87-2.08), discharge to another hospital (adjusted odds ratio [AOR] for one HAC-OP-DPC 2.36, 95% CI 2.10-2.65; AOR for ≥2 HAC-OP-DPC 6.96, 95% CI 5.81-8.35), and discharge to LTCFs (AOR for one HAC-OP-DPC 1.35, 95% CI 1.09-1.67; AOR for ≥2 HAC-OP-DPC 1.68, 95% CI 1.18-2.39). Each individual HAC-OP was also significantly associated with longer LOS and discharge to another hospital, but only delirium was associated with discharge to LTCF.</p><p><strong>Conclusions: </strong>This study demonstrated the predictive validity of the HAC-OP-DPC measure for longer LOS and discharge to other hospitals and LTCFs. To attain a more robust understanding of these relationships, additional studies are needed to verify our findings in other hospitals and regions. The clinical implementation of HAC-OP-DPC, which is identified using routinely collected administrative data, could support the evaluation of integrated interventions aimed at optimizing inpatient care for older adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e68267"},"PeriodicalIF":5.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365524","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":"Revisits, Readmission, and Mortality From Emergency Department Admissions for Older Adults With Vague Presentations: Longitudinal Observational Study.","authors":"Sebastian Alejandro Alvarez Avendano, Amy Cochran, Valerie Odeh Couvertier, Brian Patterson, Manish Shah, Gabriel Zayas-Caban","doi":"10.2196/55929","DOIUrl":"10.2196/55929","url":null,"abstract":"<p><strong>Background: </strong>Older adults (65 years and older) often present to the emergency department (ED) with an unclear need for hospitalization, leading to potentially harmful and costly care. This underscores the importance of measuring the trade-off between admission and discharge for these patients in terms of patient outcomes.</p><p><strong>Objective: </strong>This study aimed to measure the relationship between disposition decisions and 3-day, 9-day, and 30-day revisits, readmission, and mortality, using causal inference methods that adjust for potential measured and unmeasured confounding.</p><p><strong>Methods: </strong>A longitudinal observational study (n=3591) was conducted using electronic health records from a large tertiary teaching hospital with an ED between January 1, 2014 and September 27, 2018. The sample consisted of older adult patients with 1 of 6 presentations with significant variability in admission: falls, weakness, syncope, urinary tract infection, pneumonia, and cellulitis. The exposure under consideration was the ED disposition decision (admission to the hospital or discharge). Nine outcome variables were considered: ED revisits, hospital readmission, and mortality within 3, 9, and 30 days of being discharged from either the hospital for admitted patients or the ED for discharged patients.</p><p><strong>Results: </strong>Admission was estimated to significantly decrease the risk of an ED revisit after discharge (30-day window: -6.4%, 95% CI -7.8 to -5.0), while significantly increasing the risk of hospital readmission (30-day window: 5.8%, 95% CI 5.0 to 6.5) and mortality (30-day window: 1.0%, 95% CI 0.4 to 1.6). Admission was found to be especially adverse for patients with weakness and pneumonia, and relatively less adverse for older adult patients with falls and syncope.</p><p><strong>Conclusions: </strong>Admission may not be the safe option for older adults with gray area presentations, and while revisits and readmissions are commonly used to evaluate the quality of care in the ED, their divergence suggests that caution should be used when interpreting either in isolation.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e55929"},"PeriodicalIF":5.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365836","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 Older Adults' Lives Through Positive Aging Perception, Quality-of-Life Enhancement, and Social Support to Drive Acceptance and Readiness Toward Indoor Assistive Technology: Cross-Sectional Study.","authors":"Ka Po Wong, Pei-Lee Teh, Weng Marc Lim, Shaun Wen Huey Lee","doi":"10.2196/59665","DOIUrl":"10.2196/59665","url":null,"abstract":"<p><strong>Background: </strong>The growing aging population faces increasing mobility limitations, highlighting the need for assistive technologies as potential solutions. These technologies support the independence and well-being of older adults and individuals with mobility challenges. Indoor mobility is essential for daily activities and significantly impacts their lives. Limited indoor mobility can reduce quality of life and heighten the risk of falls.</p><p><strong>Objective: </strong>This study explores how positive aging perceptions, quality-of-life enhancements, and social support influence the acceptance and readiness of indoor assistive technologies among older adults.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a gerontechnology laboratory, requiring participants to visit the facility in person. Each 60-minute session included demonstrations of various indoor assistive technologies and the completion of a questionnaire. The assistive technologies showcased encompassed a wide range of devices. Participants' positive aging perceptions, quality-of-life enhancements, social support, technology acceptance, and readiness were measured using validated scales. Data were analyzed with AMOS (version 28; IBM Corp) and SPSS (version 28; IBM Corp), using structural equation modeling and multivariate analysis of covariance to assess the effects of predictors while controlling for demographic factors.</p><p><strong>Results: </strong>A total of 104 older adults aged 60 years and older participated, with a mean age of 67.92 (SD 5.68) years. Structural equation modeling indicated that positive aging perception has a significant influence on older adults' control beliefs (P=.095), comfort (P=.047), and confidence (P<.001) in gerontechnology. Multivariate analysis revealed significant combined effects of quality-of-life enhancement (P=.01) and social support (P=.03) on technology acceptance and readiness, wherein quality-of-life enhancement (P=.001) and social support (P=.008) negatively impacted security perception. Among demographic variables, educational level significantly impacted gerontechnology confidence (P=.004) while ethnicity influenced optimism (P=.003).</p><p><strong>Conclusions: </strong>This study sheds light on key factors affecting older adults' acceptance and readiness to adopt indoor assistive technologies. Findings highlight the importance of fostering positive aging perceptions through these technologies. Addressing issues related to control beliefs, comfort, and confidence in gerontechnology is essential to enhance technology acceptance and readiness among older adults. Future research should investigate the underlying mechanisms and create targeted interventions to support successful technology adoption in this population.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e59665"},"PeriodicalIF":5.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256920","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":"Effectiveness of a Dyadic Technology-Enhanced Home-Based Horticultural Therapy on Psychosocial Well-Being Among People With Dementia and Their Family Caregivers: Multimethods Pilot Study.","authors":"Patrick Pui Kin Kor, Justina Yat Wa Liu, Arkers Kwan Ching Wong, Alex Pak Lik Tsang, Han Zhi Tan, Daphne Sze Ki Cheung, Humphrey Kwong Wai Leung, Frances Kam Yuet Wong","doi":"10.2196/66017","DOIUrl":"10.2196/66017","url":null,"abstract":"<p><strong>Background: </strong>Horticultural therapy (HT) has been proposed to be an effective intervention for improving the psychosocial well-being of people with dementia and their caregivers. However, constraints such as limited land space in high-density cities, unstable weather, and lack of gardening experience may hamper the delivery of HT to people with dementia and their caregivers.</p><p><strong>Objective: </strong>This pilot study aimed to examine the feasibility and preliminary effects of a technology-enhanced home-based HT for people with dementia and their caregivers using a hydroponic indoor growing system.</p><p><strong>Methods: </strong>A single-group pre-post design was adopted. A total of 37 dyads of people with dementia and their caregivers participated in 3 weekly face-to-face sessions, followed by 8 weeks of home-based horticultural activities. Outcomes were measured at baseline and postintervention (at week 11), including feasibility outcomes, cognitive function, neuropsychiatric symptoms, and happiness levels of people with dementia. Caregivers' outcomes included positive aspects of caregiving, perceived stress levels, depressive symptoms, caregiver distress, and happiness levels. Semistructured focus group interviews were conducted with the caregivers to further explore their horticultural experience.</p><p><strong>Results: </strong>Intervention feasibility was established with a completion rate of 83.78% and an attrition rate of 2.63% (n=1). Significant improvements were detected in caregiver distress (P<.05) and the happiness level of people with dementia (P<.01). The qualitative findings indicated that HT improved the psychological well-being of both people with dementia and caregivers, enhanced the relationships between caregivers and people with dementia, expanded the caregivers' social networks, and enhanced the autobiographical memory of people with dementia.</p><p><strong>Conclusions: </strong>This pilot study provides evidence on the feasibility of using a hydroponic indoor grower to conduct home-based HT for people with dementia and their caregivers. The findings suggest positive effects on the psychological well-being of both people with dementia and their caregivers. Caregivers reported potential positive effects of HT on the autobiographical memory retrieval of people with dementia. Due to the pilot nature of this study, a control group was not employed. Therefore, large-scale randomized controlled trials are encouraged to further confirm the effectiveness of the intervention.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05577975; https://clinicaltrials.gov/study/NCT05577975.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66017"},"PeriodicalIF":5.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190785","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 Subjective Cognitive Concerns With Performance on Mobile App-Based Cognitive Assessment in Cognitively Normal Older Adults: Observational Study.","authors":"Caroline O Nester, Alyssa N De Vito, Sarah Prieto, Zachary J Kunicki, Jennifer Strenger, Karra D Harrington, Nelson Roque, Martin J Sliwinski, Laura A Rabin, Louisa I Thompson","doi":"10.2196/64033","DOIUrl":"10.2196/64033","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive concerns (SCCs) may be among the earliest clinical symptoms of dementia. There is growing interest in applying a mobile app-based cognitive assessment to remotely screen for cognitive status in preclinical dementia, but the relationship between SCC and relevant mobile assessment metrics is uncertain.</p><p><strong>Objective: </strong>This study aimed to characterize the relationship between SCC and adherence, satisfaction, and performance on mobile app assessments in cognitively unimpaired older adults.</p><p><strong>Methods: </strong>Participants (N=122; Meanage=68.85 [SD 4.93] years; Meaneducation=16.85 [SD 2.39] years; female: n=82, 66.7%; White:n=106, 86.2%) completed 8 assessment days using Mobile Monitoring of Cognitive Change (M2C2), an app-based testing platform, with brief daily sessions within morning, afternoon, and evening time windows (24 total testing sessions). M2C2 includes digital working memory, processing speed, and episodic memory tasks. Participants provided feedback about their satisfaction and motivation related to M2C2 upon study completion. SCC was assessed using the Cognitive Function Instrument. Regression analyses evaluated the association between SCC and adherence, satisfaction, and performance on M2C2, controlling for age, sex, depression, and loneliness. Linear-mixed effects models evaluated whether SCC predicted M2C2 subtest performance over the 8-day testing period, controlling for covariates.</p><p><strong>Results: </strong>SCC was not associated with app satisfaction or protocol motivation, but it was significantly associated with lower rates of protocol adherence (ß=-.20, P=.37, 95% CI -.65 to -.02). Higher SCC endorsement significantly predicted worse overall episodic memory performance (ß=-.20, P=.02, 95% CI -.02 to -.01), but not working memory or processing speed. There was a main effect of SCC on working memory performance at day 1 (estimate=-1.05, SE=0.47, P=.03) and a significant interaction between SCC and working memory over the 8-day period (estimate=0.05, SE=0.02, P=.03), such that SCC was associated with initially worse, then progressively better working memory performance.</p><p><strong>Conclusions: </strong>SCCs are associated with worse overall memory performance on mobile app assessments, patterns of cognitive inefficiency (variable working memory), and mildly diminished adherence across an 8-day assessment period. Findings suggest that mobile app assessments may be sensitive to subtle cognitive changes, with important implications for early detection and treatment for individuals at risk for dementia.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e64033"},"PeriodicalIF":5.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190784","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":"Comparison of 3 Aging Metrics in Dual Declines to Capture All-Cause Dementia and Mortality Risk: Cohort Study.","authors":"Anying Bai, Shan He, Yu Jiang, Weihao Xu, Zhanyi Lin","doi":"10.2196/66104","DOIUrl":"10.2196/66104","url":null,"abstract":"<p><strong>Background: </strong>The utility of aging metrics that incorporate cognitive and physical function is not fully understood.</p><p><strong>Objective: </strong>We aim to compare the predictive capacities of 3 distinct aging metrics-motoric cognitive risk syndrome (MCR), physio-cognitive decline syndrome (PCDS), and cognitive frailty (CF)-for incident dementia and all-cause mortality among community-dwelling older adults.</p><p><strong>Methods: </strong>We used longitudinal data from waves 10-15 of the Health and Retirement Study. Cox proportional hazards regression analysis was employed to evaluate the effects of MCR, PCDS, and CF on incident all-cause dementia and mortality, controlling for socioeconomic and lifestyle factors, as well as medical comorbidities. Discrimination analysis was conducted to assess and compare the predictive accuracy of the 3 aging metrics.</p><p><strong>Results: </strong>A total of 2367 older individuals aged 65 years and older, with no baseline prevalence of dementia or disability, were ultimately included. The prevalence rates of MCR, PCDS, and CF were 5.4%, 6.3%, and 1.3%, respectively. Over a decade-long follow-up period, 341 cases of dementia and 573 deaths were recorded. All 3 metrics were predictive of incident all-cause dementia and mortality when adjusting for multiple confounders, with variations in the strength of their associations (incident dementia: MCR odds ratio [OR] 1.90, 95% CI 1.30-2.78; CF 5.06, 95% CI 2.87-8.92; PCDS 3.35, 95% CI 2.44-4.58; mortality: MCR 1.60, 95% CI 1.17-2.19; CF 3.26, 95% CI 1.99-5.33; and PCDS 1.58, 95% CI 1.17-2.13). The C-index indicated that PCDS and MCR had the highest discriminatory accuracy for all-cause dementia and mortality, respectively.</p><p><strong>Conclusions: </strong>Despite the inherent differences among the aging metrics that integrate cognitive and physical functions, they consistently identified risks of dementia and mortality. This underscores the importance of implementing targeted preventive strategies and intervention programs based on these metrics to enhance the overall quality of life and reduce premature deaths in aging populations.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e66104"},"PeriodicalIF":5.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Randomized Controlled Trial.","authors":"Yanhong Xie, Shanshan Shen, Caixia Liu, Hong Hong, Huilan Guan, Jingmei Zhang, Wanqi Yu","doi":"10.2196/69493","DOIUrl":"10.2196/69493","url":null,"abstract":"","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e69493"},"PeriodicalIF":5.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060834","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}