JMIR Aging最新文献

{"title":"The Needs and Experiences of People With Early-Stage Dementia Using an Application for Cognitive and Physical Activation in Germany: Qualitative Study.","authors":"Melina Klein, Alexa von Bosse, Christophe Kunze","doi":"10.2196/62689","DOIUrl":"10.2196/62689","url":null,"abstract":"<p><strong>Background: </strong>The demand for support among people with dementia is increasing, while caregiving capacity is declining. As the trend of aging at home continues, technologies can help maintain the autonomy of people with dementia, enabling them to live independently for as long as possible. Furthermore, digital applications can have numerous positive biopsychosocial effects on the health of people with dementia, enhancing their physical, cognitive, and social functioning.</p><p><strong>Objective: </strong>This study aims to investigate the needs and experiences of people with dementia regarding a prototype tablet-based application designed to promote cognitive and physical activity.</p><p><strong>Methods: </strong>We conducted a methodical triangulation by combining semistructured interviews with people with dementia and external overt participant observation while testing a tablet-based application. A qualitative content analysis, as outlined by Kuckartz, was used to analyze the data.</p><p><strong>Results: </strong>Participants demonstrated varying levels of ability and prior experience with technology. While most were initially hesitant to use the tablet independently, they were more willing to try it after receiving encouragement. Some individuals required more assistance than others, indicating the need for individualized adjustments. Personal relevance to the content appeared to be crucial for cognitive tasks, as it helped to minimize overload for people with dementia. The participants appreciated social interaction with researchers and direct communication. Therefore, it is important to consider the role of personal support when developing and implementing technology.</p><p><strong>Conclusions: </strong>The successful implementation and use of technology requires acceptance and an effective interaction between people with dementia, technology, and caregivers or caring relatives providing personal support. The acceptance of the application was found to be less influenced by the types and presentation of tasks and more by content relevance and social interaction. Ideally, one-on-one support will be provided during use, though this requires additional time and financial resources, which are often limited in caregiving settings.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e62689"},"PeriodicalIF":5.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829621","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":"Brief Video-Delivered Intervention to Reduce Anxiety and Improve Functioning in Older Veterans: Pilot Randomized Controlled Trial.","authors":"Christine E Gould, Chalise Carlson, Julie L Wetherell, Mary K Goldstein, Lauren Anker, Sherry A Beaudreau","doi":"10.2196/56959","DOIUrl":"10.2196/56959","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Older veterans with anxiety disorders encounter multiple barriers to receiving mental health services, including transportation difficulties, physical limitations, and limited access to providers trained to work with older persons. To address both accessibility and the shortage of available providers, evidence-based treatments that can be delivered via guided self-management modalities are a potential solution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to determine the feasibility and acceptability of a randomized controlled trial of 2 guided self-management interventions. This study compared the treatment effects of these 2 interventions (relaxation and health psychoeducation) on anxiety symptom severity and functioning in older veterans with anxiety disorders. Our exploratory aims examined factors related to home practices and treatment engagement and perceptions of the practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants were randomized to one of two video-delivered interventions: (1) Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment (BREATHE)-breathing and progressive relaxation or (2) Healthy Living for Reduced Anxiety-psychoeducation about lifestyle changes. Telephone coaching calls were conducted weekly. Measures of anxiety, depression, and functioning were obtained at baseline, week 4 (end of treatment), week 8, and week 12. Participants completed a semistructured interview at week 12. Analyses included descriptive statistics to summarize measures of intervention engagement; mixed-effects models to characterize symptom change, and qualitative analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 56 participants (n=48, 86% men; n=23, 41% from ethnic or racial minority groups; mean age 71.36, SD 6.19 y) were randomized. No difference in retention between study arms was found. The Healthy Living group (29/56, 52%) completed significantly more lessons (mean 3.68, SD 0.86) than the BREATHE group (27/56, 48%; mean 2.85, SD 1.43; t&lt;sub&gt;53&lt;/sub&gt;=2.60; P=.01) but did not differ in completion of coaching calls. In the BREATHE group, greater baseline anxiety scores (r=-0.41; P=.03) and greater severity of medical comorbidity (r=-0.50; P=.009) were associated with fewer completed practices. There was no effect of intervention on change in total anxiety scores or functioning. For specific anxiety subtypes, Healthy Living produced a greater decline in somatic anxiety compared with BREATHE. Qualitative analyses found barriers to practicing, including difficulty setting time aside to practice, forgetting, or having other activities that interfered with BREATHE practices. Some participants described adapting their practice routine to fit their daily lives; some also used relaxation skills in everyday situations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings suggest that a larger randomized controlled trial of guided self-management approaches to treating late-life anxiety is fea","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e56959"},"PeriodicalIF":5.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802439","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":"Factors Influencing Drug Prescribing for Patients With Hospitalization History in Circulatory Disease-Patient Severity, Composite Adherence, and Physician-Patient Relationship: Retrospective Cohort Study.","authors":"Tomoyuki Takura, Hiroyoshi Yokoi, Asao Honda","doi":"10.2196/59234","DOIUrl":"10.2196/59234","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;With countries promoting generic drug prescribing, their growth may plateau, warranting further investigation into the factors influencing this trend, including physician and patient perspectives. Additional strategies may be needed to maximize the switch to generic drugs while ensuring health care system sustainability, focusing on factors beyond mere low cost. Emphasizing affordability and clarifying other prescription considerations are essential.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to provide initial insights into how patient severity, composite adherence, and physician-patient relationships impact generic switching.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used a long-term retrospective cohort design by analyzing data from a national health care database. The population included patients of all ages, primarily older adults, who required primary-to-tertiary preventive actions with a history of hospitalization for cardiovascular diseases (ICD-10 [International Statistical Classification of Diseases, Tenth Revision]) from April 2014 to March 2018 (4 years). We focused on switching to generic drugs, with temporal variations in clinical parameters as independent variables. Lifestyle factors (smoking and drinking) were also considered. Adherence was measured as a composite score comprising 11 elements. The physician-patient relationship was established based on the interval between physician change and prescription. Logistic regression analysis and propensity score matching were used, along with complementary analysis of physician-patient relationships, proportion of days covered, and adherence for a subset of the population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 48,456 patients with an average follow-up of 36.1 (SD 8.8) months. The mean age was 68.3 (SD 9.9) years; BMI, 23.4 (SD 3.4) kg/m&lt;sup&gt;2&lt;/sup&gt;; systolic blood pressure, 131.2 (SD 15) mm Hg; low-density lipoprotein cholesterol level, 116.6 (SD 29.3) mg/dL; hemoglobin A&lt;sub&gt;1c&lt;/sub&gt; (HbA&lt;sub&gt;1c&lt;/sub&gt;), 5.9% (SD 0.8%); and serum creatinine level, 0.9 (SD 0.8) mg/dL. Logistic regression analysis revealed significant associations between generic switching and systolic blood pressure (odds ratio [OR] 0.996, 95% CI 0.993-0.999), serum creatinine levels (OR 0.837, 95% CI 0.729-0.962), glutamic oxaloacetic transaminase levels (OR 0.994, 95% CI 0.990-0.997), proportion of days covered score (OR 0.959, 95% CI 0.948-0.97), and adherence score (OR 0.910, 95% CI 0.875-0.947). In addition, generic drug rates increased with improvements in the HbA&lt;sub&gt;1c&lt;/sub&gt; level band and smoking level (P&lt;.01 and P&lt;.001). The group with a superior physician-patient relationship after propensity score matching had a significantly higher rate of generic drug prescribing (51.6%, SD 15.2%) than the inferior relationship group (47.7%, SD17.7%; P&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although physicians' understanding influences the choice of generic drugs, pa","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":" ","pages":"e59234"},"PeriodicalIF":5.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476666","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":"An eHealth Intervention to Improve Quality of Life, Socioemotional, and Health-Related Measures Among Older Adults With Multiple Chronic Conditions: Randomized Controlled Trial.","authors":"David H Gustafson, Marie-Louise Mares, Darcie Johnston, Olivia J Vjorn, John J Curtin, Gina Landucci, Klaren Pe-Romashko, David H Gustafson, Dhavan V Shah","doi":"10.2196/59588","DOIUrl":"10.2196/59588","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the United States, over 60% of adults aged 65 years or older have multiple chronic health conditions, with consequences that include reduced quality of life, increasingly complex but less person-centered treatment, and higher health care costs. A previous trial of ElderTree, an eHealth intervention for older adults, found socioemotional benefits for those with high rates of primary care use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study tested the effectiveness of an ElderTree intervention designed specifically for older patients with multiple chronic conditions to determine whether combining it with primary care improved socioemotional and physical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a nonblinded randomized controlled trial, 346 participants recruited from primary care clinics were assigned 1:1 to the ElderTree intervention or an attention control and were followed for 12 months. All participants were aged 65 years or older and had electronic health record diagnoses of at least three of 11 chronic conditions. Primary outcomes were mental and physical quality of life, psychological well-being (feelings of competence, connectedness, meaningfulness, and optimism), and loneliness. Tested mediators of the effects of the study arm (ElderTree vs active control) on changes in primary outcomes over time were 6-month changes in health coping, motivation, feelings of relatedness, depression, and anxiety. Tested moderators were sex, scheduled health care use, and number of chronic conditions. Data sources were surveys at baseline and 6 and 12 months comprising validated scales, and continuously collected ElderTree usage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At 12 months, 76.1% (134/176) of ElderTree participants were still using the intervention. There was a significant effect of ElderTree (vs control) on improvements over 12 months in mental quality of life (arm × timepoint interaction: b=0.76, 95% CI 0.14-1.37; P=.02; 12-month ∆d=0.15) but no such effect on the other primary outcomes of physical quality of life, psychological well-being, or loneliness. Sex moderated the effects of the study arm over time on mental quality of life (b=1.33, 95% CI 0.09-2.58; P=.04) and psychological well-being (b=1.13, 95% CI 0.13-2.12; P=.03), with stronger effects for women than men. The effect of the study arm on mental quality of life was mediated by 6-month improvements in relatedness (α=1.25, P=.04; b=0.31, P&lt;.001). Analyses of secondary and exploratory outcomes showed minimal effects of ElderTree.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Consistent with the previous iteration of ElderTree, the current iteration designed for older patients with multiple chronic conditions showed signs of improving socioemotional outcomes but no impact on physical outcomes. This may reflect the choice of chronic conditions for inclusion, which need not have impinged on patients' physical quality of life. Two ongoing trials are testing more specific vers","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e59588"},"PeriodicalIF":5.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792574","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 How Older Adults Experience semAPP, a 360° Media-Based Tool for Memory Assessment: Qualitative Study.","authors":"Francesca Bruni, Valentina Mancuso, Jonathan Panigada, Marco Stramba-Badiale, Pietro Cipresso, Elisa Pedroli","doi":"10.2196/56796","DOIUrl":"10.2196/56796","url":null,"abstract":"<p><strong>Background: </strong>Technology is already a part of our daily lives, and its influence is growing rapidly. This evolution has not spared the health care field. Nowadays, a crucial challenge is considering aspects such as design, development, and implementation, highlighting their functionality, ease of use, compatibility, performance, and safety when a new technological tool is developed. As noted in many works, the abandonment rate is usually higher when a user has a terrible experience with these instruments. It would be appropriate to incorporate the final users-whether they are patients, health care professionals, or both-in the stages of instrument design to understand their needs and preferences. Since most apps that fail did not include end users and health care professionals in the development phase, their involvement at all stages of app development may increase their commitment and improve integration, self-management, and health outcomes.</p><p><strong>Objective: </strong>This study aims (1) to develop semAPP (spatial and episodic memory assessment application), a 360° media-based tool, to assess memory in aging by simulating a real-life situation and (2) to test the usability of the app and the connected experience in an end-user population.</p><p><strong>Methods: </strong>A total of 34 older adults participated in the study: 16 (47%) healthy individuals and 18 (53%) patients with mild cognitive impairment. They used semAPP and completed qualitative and quantitative measures. The app includes 2 parts: object recognition and spatial memory tasks. During the first task, users have to navigate in an apartment freely and visit rooms, and then they must recognize the right map of the house. In the second task, users are immersed in a living room, and they have to encode and then recall some target objects, simulating a relocation. We deployed this app on an 11.2-inch iPad, and we tested its usability and the experience of users interacting with the app. We conducted descriptive analyses for both the entire sample and each subgroup; we also conducted parametric and correlation analyses to compare groups and to examine the relationship between task execution and the virtual experience, as well as the acceptance of technology.</p><p><strong>Results: </strong>Both groups judged the app as an easy-to-use tool, and they were willing to use it. Moreover, the results match the idea that usability might be influenced by different factors depending on instrument and personal features, such as presentation, functionality, system performance, interactive behavior, attitudes, skills, and personality.</p><p><strong>Conclusions: </strong>The findings support the possibility of using semAPP in older patients, as well as the importance of designing and evaluating new technological tools, considering not only the general population but also the specific target ones.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e56796"},"PeriodicalIF":5.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787216","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":"Factors Affecting Clinician Readiness to Adopt Smart Home Technology for Remote Health Monitoring: Systematic Review.","authors":"Gordana Dermody, Daniel Wadsworth, Melissa Dunham, Courtney Glass, Roschelle Fritz","doi":"10.2196/64367","DOIUrl":"10.2196/64367","url":null,"abstract":"<p><strong>Background: </strong>The population of older adults worldwide continues to increase, placing higher demands on primary health care and long-term care. The costs of housing older people in care facilities have economic and societal impacts that are unsustainable without innovative solutions. Many older people wish to remain independent in their homes and age in place. Assistive technology such as health-assistive smart homes with clinician monitoring could be a widely adopted alternative to aged-care facilities in the future. While studies have found that older persons have demonstrated a readiness to adopt health-assistive smart homes, little is known about clinician readiness to adopt this technology to support older adults to age as independently as possible.</p><p><strong>Objective: </strong>The purpose of this systematic review was to identify the factors that affect clinician readiness to adopt smart home technology for remote health monitoring.</p><p><strong>Methods: </strong>This review was conducted in accordance with the Joanna Briggs Institute methodology for systematic Reviews and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for reporting.</p><p><strong>Results: </strong>Several factors affected clinicians' perspectives on their readiness to adopt smart home technology for remote health monitoring, including challenges such as patient privacy and dignity, data security, and ethical use of \"invasive\" technologies. Perceived benefits included enhancing the quality of care and outcomes.</p><p><strong>Conclusions: </strong>Clinicians, including nurses, reported both challenges and benefits of adopting smart home technology for remote health monitoring. Clear strategies and frameworks to allay fears and overcome professional concerns and misconceptions form key parts of the Readiness for Adoption Pathway proposed. The use of more rigorous scientific methods and reporting is needed to advance the state of the science.</p><p><strong>Trial registration: </strong>PROSPERO International Prospective Register of Systematic Reviews CRD42020195989; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195989.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":" ","pages":"e64367"},"PeriodicalIF":5.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627943","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":"Sentiment Dynamics Among Informal Caregivers in Web-Based Alzheimer Communities: Systematic Analysis of Emotional Support and Interaction Patterns.","authors":"Congning Ni, Qingyuan Song, Qingxia Chen, Lijun Song, Patricia Commiskey, Lauren Stratton, Bradley Malin, Zhijun Yin","doi":"10.2196/60050","DOIUrl":"10.2196/60050","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Alzheimer disease and related dementias (ADRD) are a growing global health challenge. ADRD place significant physical, emotional, and financial burdens on informal caregivers and negatively affects their well-being. Web-based social media platforms have emerged as valuable sources of peer support for these caregivers. However, there has been limited investigation into how web-based peer support might influence their mental well-being.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to examine the dynamics of sentiment scores, a major indicator of mental well-being, among informal ADRD caregivers, specifically how their sentiment changes as they participate in caregiving experience discussions within 2 ADRD web-based communities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We collected data from 2 large web-based ADRD caregiving communities, ALZConnected (from November 2011 to August 2022) and TalkingPoint (from March 2003 to November 2022). Using the Valence Aware Dictionary for Sentiment Reasoning and Linguistic Inquiry and Word Count, we calculated sentiment scores for each post and evaluated how the initial sentiment score of a topic initiator evolves within a discussion thread. Structured topic modeling and regression analysis were used to identify the primary topics consistently associated with sentiment changes within these threads. We investigated longitudinal sentiment trends to identify patterns of sentimental stability or enhancement due to prolonged engagement in web-based communities by plotting linear interpolation lines of the sentiment values of each individual user.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The ALZConnected dataset comprised 532,992 posts, consisting of 57,641 topic threads and 475,351 comments. The TalkingPoint dataset was composed of 846,344 posts, consisting of 81,068 topic threads and 765,276 comments. Our research revealed that topic initiators experienced a notable increase in sentiment as they engaged in subsequent discussions within their threads, with a significant uptick in positivity in the short term. This phenomenon is part of a broader trend of steadily rising positive sentiment among ADRD caregivers. Using structured topic modeling, we cataloged a diverse range of topics that included both emotional aspects, such as family emotions, and practical concerns, such as diagnosis and treatment and everyday care practices. We observed that sentiment scores were positively aligned with discussions about family and daily routines life (coefficient=3.53; P&lt;.001), while topics related to illness (coefficient=-1.37; P&lt;.001) and caregiving facilities (coefficient=-1.98; P&lt;.001) tended to correlate with lower sentiment scores. This evidence highlights the significant impact that both the time of participation and the posting content have on the sentiment changes of caregivers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study identifies sentiment changes among informal ADRD caregivers through their inter","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e60050"},"PeriodicalIF":5.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773161","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":"Evaluating the Prognostic and Clinical Validity of the Fall Risk Score Derived From an AI-Based mHealth App for Fall Prevention: Retrospective Real-World Data Analysis.","authors":"Sónia A Alves, Steffen Temme, Seyedamirhosein Motamedi, Marie Kura, Sebastian Weber, Johannes Zeichen, Wolfgang Pommer, André Baumgart","doi":"10.2196/55681","DOIUrl":"10.2196/55681","url":null,"abstract":"<p><strong>Background: </strong>Falls pose a significant public health concern, with increasing occurrence due to the aging population, and they are associated with high mortality rates and risks such as multimorbidity and frailty. Falls not only lead to physical injuries but also have detrimental psychological and social consequences, negatively impacting quality of life. Identifying individuals at high risk for falls is crucial, particularly for those aged ≥60 years and living in residential care settings; current professional guidelines favor personalized, multifactorial fall risk assessment approaches for effective fall prevention.</p><p><strong>Objective: </strong>This study aimed to explore the prognostic validity of the Fall Risk Score (FRS), a multifactorial-based metric to assess fall risk (using longitudinal real-world data), and establish the clinical relevance of the FRS by identifying threshold values and the minimum clinically important differences.</p><p><strong>Methods: </strong>This retrospective cohort study involved 617 older adults (857 observations: 615 of women, 242 of men; mean age 83.3, SD 8.7 years; mean gait speed 0.49, SD 0.19 m/s; 622 using walking aids) residing in German residential care facilities and used the LINDERA mobile health app for fall risk assessment. The study focused on the association between FRS at the initial assessment (T1) and the normalized number of falls at follow-up (T2). A quadratic regression model and Spearman correlation analysis were utilized to analyze the data, supported by descriptive statistics and subgroup analyses.</p><p><strong>Results: </strong>The quadratic model exhibited the lowest root mean square error (0.015), and Spearman correlation analysis revealed that a higher FRS at T1 was linked to an increased number of falls at T2 (ρ=0.960, P<.001). Subgroups revealed significant strong correlations between FRS at T1 and falls at T2, particularly for older adults with slower gait speeds (ρ=0.954, P<.001) and those using walking aids (ρ=0.955, P<.001). Threshold values revealed that an FRS of 45%, 32%, and 24% corresponded to the expectation of a fall within 6, 12, and 24 months, respectively. Distribution-based minimum clinically important difference values were established, providing ranges for small, medium, and large effect sizes for FRS changes.</p><p><strong>Conclusions: </strong>The FRS exhibits good prognostic validity for predicting future falls, particularly in specific subgroups. The findings support a stratified fall risk assessment approach and emphasize the significance of early and personalized intervention. This study contributes to the knowledge base on fall risk, despite limitations such as demographic focus and potential assessment interval variability.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e55681"},"PeriodicalIF":5.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781424","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 the Perspectives of Older Adults Living With HIV on Virtual Care: Qualitative Study.","authors":"Kristina M Kokorelias, Dean Valentine, Erica M Dove, Paige Brown, Stuart McKinlay, Christine L Sheppard, Hardeep Singh, Andrew D Eaton, Laura Jamieson, Marina B Wasilewski, Alice Zhabokritsky, Ashley Flanagan, Reham Abdelhalim, Rahel Zewude, Rabea Parpia, Sharon Walmsley, Luxey Sirisegaram","doi":"10.2196/65730","DOIUrl":"10.2196/65730","url":null,"abstract":"<p><strong>Background: </strong>As the population of individuals with HIV ages rapidly due to advancements in antiretroviral therapy, virtual care has become an increasingly vital component in managing their complex health needs. However, little is known about perceptions of virtual care among older adults living with HIV.</p><p><strong>Objective: </strong>This study aimed to understand the perceptions of older adults living with HIV regarding virtual care.</p><p><strong>Methods: </strong>Using an interpretive, qualitative, descriptive methodology, semistructured interviews were conducted with 14 diverse older adults living with HIV. The participants lived in Ontario, Canada, self-identified as HIV-positive, and were aged 50 years or older. Efforts were made to recruit individuals with varying experience with virtual health care. Reflexive thematic analysis was conducted with the interview transcripts to identify prevalent themes.</p><p><strong>Results: </strong>The identified themes included (1) the importance of relationships in virtual care for older adults living with HIV; (2) privacy and confidentiality in virtual care; and (3) challenges and solutions related to access and technological barriers in virtual care. These themes highlight the perceptions of diverse older adults living with HIV concerning virtual care, emphasizing the fundamental role of trust, privacy, and technology access.</p><p><strong>Conclusions: </strong>By embracing the unique perspectives and experiences of this population, we can work toward building more inclusive and responsive health care systems that meet the needs of all individuals, regardless of age, HIV status, or other intersecting identities.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e65730"},"PeriodicalIF":5.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773240","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":"In-Home Positioning for Remote Home Health Monitoring in Older Adults: Systematic Review.","authors":"Andrew Chan, Joanne Cai, Linna Qian, Brendan Coutts, Steven Phan, Geoff Gregson, Michael Lipsett, Adriana M Ríos Rincón","doi":"10.2196/57320","DOIUrl":"10.2196/57320","url":null,"abstract":"<p><strong>Background: </strong>With the growing proportion of Canadians aged >65 years, smart home and health monitoring technologies may help older adults manage chronic disease and support aging in place. Localization technologies have been used to support the management of frailty and dementia by detecting activities in the home.</p><p><strong>Objective: </strong>This systematic review aims to summarize the clinical evidence for in-home localization technologies, review the acceptability of monitoring, and summarize the range of technologies being used for in-home localization.</p><p><strong>Methods: </strong>The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology was followed. MEDLINE, Embase, CINAHL, and Scopus were searched with 2 reviewers performing screening, extractions, and quality assessments.</p><p><strong>Results: </strong>A total of 1935 articles were found, with 36 technology-focused articles and 10 articles that reported on patient outcomes being included. From moderate- to high-quality studies, 2 studies reported mixed results on identifying mild cognitive dementia or frailty, while 4 studies reported mixed results on the acceptability of localization technology. Technologies included ambient sensors; Bluetooth- or Wi-Fi-received signal strength; localizer tags using radio frequency identification, ultra-wideband, Zigbee, or GPS; and inertial measurement units with localizer tags.</p><p><strong>Conclusions: </strong>The clinical utility of localization remains mixed, with in-home sensors not being able to differentiate between older adults with healthy cognition and older adults with mild cognitive impairment. However, frailty was detectable using in-home sensors. Acceptability is moderately positive, particularly with ambient sensors. Localization technologies can achieve room detection accuracies up to 92% and linear accuracies of up to 5-20 cm that may be promising for future clinical applications.</p><p><strong>Trial registration: </strong>PROSPERO CRD42022339845; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=339845.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e57320"},"PeriodicalIF":5.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773252","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}