JMIR Aging最新文献

{"title":"Application-Based Interventions for Family Caregivers of Older Adults: Scoping Review.","authors":"Xin Yao Lin, Francesca Falzarano, E-Shien Chang, Kristin Hon, Ruoying Zhang, Andy Hickner, Sara Czaja","doi":"10.2196/76115","DOIUrl":"10.2196/76115","url":null,"abstract":"<p><strong>Background: </strong>As the global population ages, the increasing number of individuals with chronic conditions places a growing burden on family caregivers. Behavioral interventions delivered via application-based platforms, including those on mobile phones, tablets, or the web, have emerged as a powerful tool for enhancing caregiver support.</p><p><strong>Objective: </strong>This study aims to identify and describe application-based interventions for family caregivers of older adults with chronic conditions, focusing on their designs, features, and impact on caregiver outcomes.</p><p><strong>Methods: </strong>This review is reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A search of publications from 2007 through December 20, 2022, was conducted across PsycINFO (EBSCO), MEDLINE ALL (Ovid), Embase (Ovid), Web of Science Core Collection (A&HCI, BKCI-SSH, BKCI-S, CCR-EXPANDED, ESCI, IC, CPCI-SSH, CPCI-S, SCI-EXPANDED, and SSCI; Clarivate), ACM Guide to Computing Literature (ACM Digital Library), and Engineering Village (Elsevier) using relevant keywords.</p><p><strong>Results: </strong>The database search identified 9482 studies, resulting in 290 full-text papers being assessed, and a final 49 studies were included. Forty-four unique applications were identified, demonstrating different designs and features. These studies primarily examined the impact of applications on caregiver well-being, burden, and mental health. While the majority of interventions were perceived as beneficial, several design and research limitations were noted.</p><p><strong>Conclusions: </strong>While many interventions demonstrate positive effects on caregiver outcomes, there are significant gaps in research design, evaluation, and reporting. Future studies should prioritize greater integration of self-care practices, clarity of intervention components, rigorous adherence to behavioral intervention frameworks, and greater inclusivity in participant samples.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e76115"},"PeriodicalIF":4.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228511","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":"Early-Life Experiences as Moderators of the Relationship Between Extreme Heat and Alcohol Consumption among Older Adults: Quantitative Study.","authors":"Hee Yun Lee, Su Hyun Shin, Yeon Jin Choi, Eun Young Choi, Hyunjung Ji","doi":"10.2196/76904","DOIUrl":"10.2196/76904","url":null,"abstract":"<p><strong>Background: </strong>Climate change has intensified the frequency and duration of extreme heat events worldwide, posing growing public health risks, particularly for older adults who are physiologically more susceptible to heat-related illnesses. Concurrently, alcohol consumption among older adults in the United States has risen significantly over the past 2 decades, increasing vulnerability to dehydration, cardiovascular strain, and cognitive impairment during heat exposure. Emerging evidence suggests that environmental stressors such as extreme heat may exacerbate maladaptive coping behaviors, including alcohol use; however, few studies have examined this association in aging populations. Moreover, little is known about how early-life experiences such as childhood adversity or positive parental relationships shape behavioral responses to environmental stressors later in life.</p><p><strong>Objective: </strong>This study examines the relationship between extreme heat and alcohol consumption among older Americans, emphasizing the moderating role of early-life experiences within a life course framework.</p><p><strong>Methods: </strong>Using data from individuals aged >50 years in the Health and Retirement Study (1996-2018), we analyzed the association between extreme heat exposure (>95 °F) and alcohol consumption, while examining whether early-life experiences such as parental substance abuse, law enforcement encounters, and relationships with fathers moderate this relationship.</p><p><strong>Results: </strong>Extreme heat exposure was significantly associated with increased alcohol consumption (0.21% per additional extreme heat day, P<.001). A positive father-child relationship buffered this effect, while adverse early-life experiences, including law enforcement encounters (0.08%, P<.001) and parental substance abuse (0.05%, P<.001), exacerbated it.</p><p><strong>Conclusions: </strong>Given the link between extreme heat and alcohol use in older adults, further longitudinal research and targeted interventions are needed to mitigate associated health risks. Strengthening positive childhood experiences may offer long-term protective effects by fostering resilience and healthier coping mechanisms that persist into later life.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e76904"},"PeriodicalIF":4.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220127","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":"Developing and Testing a Brief Mindfulness Just-in-Time Adaptive Intervention to Reduce Stress Among Caregivers of People With Dementia: Quasi-Experimental Study.","authors":"Patrick Pui Kin Kor, Alex Pak Lik Tsang, Daphne Sze Ki Cheung, Steven H Zarit, Haoran Xie, Min Qian, Kay Chen Tan, Yuanqing Zheng, Amanda Man Ying Chu, Kee Lee Chou","doi":"10.2196/87316","DOIUrl":"10.2196/87316","url":null,"abstract":"<p><strong>Background: </strong>Dementia caregiving entails chronic, fluctuating stress with downstream risks to caregivers' mental health and quality of care. Mindfulness-based interventions can reduce caregiver stress; however, moment-to-moment fluctuations in stress may limit receptivity to practice at any given time. We developed a brief mindfulness just-in-time adaptive intervention (JITAI) that aims to deliver support at the right moment by using machine learning algorithms to optimize notification timing based on receptivity to engage in brief mindfulness practices.</p><p><strong>Objective: </strong>This study aims to evaluate the feasibility, acceptability, and effectiveness of a brief mindfulness JITAI for caregivers of people with dementia on stress, depressive symptoms, caregiver burden, sleep, quality of life, and trait mindfulness.</p><p><strong>Methods: </strong>A single-arm, pretest or posttest design was adopted. A total of 120 community-dwelling caregivers were recruited to participate in the 18-day intervention, which included 4 days of psychoeducation delivered via videos and phone coaching, alongside an in-app brief, low-dose mindfulness-based stress reduction component. From days 5 to 11, prompts were delivered either by a static machine learning model trained on prior pilot data or at random times, with equal probability. From days 12 to 18, three delivery models were used with equal probability, namely static, random, and adaptive models, which updated per participant using accumulating receptivity data. Feasibility and acceptability were assessed post intervention. Standardized measures of stress, depressive symptoms, caregiver burden, positive aspects of caregiving, sleep, quality of life, and trait mindfulness were collected via phone interviews at baseline and post intervention.</p><p><strong>Results: </strong>Retention was 100%. Most participants (111/120, 92.5%) found the app easy to use, 81.7% (98/120) perceived it as helpful for stress management, and 80% (96/120) would recommend it to other caregivers. Pre-post analyses indicated significant reductions in perceived stress (P<.001), depressive symptoms (P<.001), and caregiver burden (P=.003), as well as a significant increase in positive aspects of caregiving (P<.001) and subjective sleep quality (P=.02). Health-related quality of life and trait mindfulness did not change significantly.</p><p><strong>Conclusions: </strong>A brief, smartphone-delivered mindfulness JITAI for caregivers of people with dementia was feasible and acceptable, with high retention and positive user evaluations. Pre-post findings suggest reductions in perceived stress, depressive symptoms, and caregiving burden, alongside increased positive aspects of caregiving and improved sleep, supporting the potential of adaptive, technology-enabled interventions to provide timely support to caregivers.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e87316"},"PeriodicalIF":4.6,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177028","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":"Global Trends and Research Hot Spots in Medication Regimen Simplification: Bibliometric Analysis.","authors":"Chuwen Dou, Bei Wu, Leyi Wu, An Gu, An Huang, Chen Zhang, Xichenhui Qiu, Jianlin Lou, Lina Wang","doi":"10.2196/82274","DOIUrl":"10.2196/82274","url":null,"abstract":"<p><strong>Background: </strong>Medication regimen simplification has gained increasing attention as a strategy to reduce treatment burden and improve medication use. However, the overall development, knowledge structure, and emerging themes of this field have not been systematically mapped, hindering efforts to identify clear research priorities and support strategies that facilitate the translation of simplified approaches into optimized medication management.</p><p><strong>Objective: </strong>This study aimed to examine global research trends, collaboration patterns, and research hot spots in medication regimen simplification.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted to characterize the research landscape of medication regimen simplification. Publications from the Web of Science Core Collection (January 1, 2005, to December 31, 2025) were analyzed using Microsoft Excel 365, VOSviewer, CiteSpace, and Bibliometrix in R for publication trends, countries and regions, institutions, authors, cocited references, keyword co-occurrence, clustering, and thematic evolution.</p><p><strong>Results: </strong>A total of 468 publications were included in this bibliometric analysis. Annual publication output showed an upward trend, although fluctuations occurred across years. The United States ranked first in publication output and total citations, and Monash University was the most productive institution. Collaboration was concentrated in a limited number of country, institutional, and author clusters, with the strongest international links between North America and Europe. Cocitation and keyword analyses showed that the field evolved from a focus on HIV-related regimen optimization and medication adherence to broader themes in chronic disease management, including type 2 diabetes, heart failure, long-term care, and medication regimen complexity.</p><p><strong>Conclusions: </strong>Research on medication regimen simplification has grown over time, but collaboration remains relatively concentrated. Current hot spots center on its use in specific disease settings and on medication complexity and adherence, whereas recent trends highlight real-world implementation. Future research should further examine the long-term impact and sustainability of simplification strategies.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e82274"},"PeriodicalIF":4.6,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057379","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":"Assigning Article-Level Themes in Bibliometric Analysis: Mode-Based Mapping Approach Using JMIR Aging Publications.","authors":"Sam Yu-Chieh Ho, Kang-Ting Tsai","doi":"10.2196/79906","DOIUrl":"10.2196/79906","url":null,"abstract":"<p><strong>Background: </strong>Although clustering techniques are commonly used in bibliometric analysis to identify research themes, few studies systematically assign these themes back to individual articles. This gap limits the interpretability of findings and hinders granular, article-level longitudinal analysis.</p><p><strong>Objective: </strong>This study introduces the Theme Assignment Algorithm for Articles (TAAA), a data-driven framework designed to map clustered themes to individual publications. We demonstrate its utility by identifying dominant research patterns and thematic shifts within JMIR Aging.</p><p><strong>Methods: </strong>TAAA was applied to 434 JMIR Aging articles published between 2020 and 2025. Keywords were harvested from 3 sources: Web of Science Core Collection (WoSCC) Keywords Plus, author-provided keywords, and abstract-derived terms. These were grouped into thematic clusters using the \"following leader clustering algorithm\". The TAAA, implemented via R and a web-based application, determined each article's primary theme using a statistical model to create a discrete article-level variable. Core themes were identified via h-index computation. Analytical visualization included Kano and Sankey diagrams, alongside volcano plots and heatmaps. The framework's robustness was further tested by applying a \"differentially expressed genes\" analogy to map \"unknown\" core metadata across \"known\" pre/post publication stages using Cohen kappa as the extent of mapping power.</p><p><strong>Results: </strong>Analysis across the 3 keyword sources yielded 9, 7, and 9 core themes, respectively. The most prominent themes identified were HEALTH (39.4%), OLDER ADULTS (43.1%), and DEMENTIA (25.3%). Notably, DEMENTIA emerged as a consistent core theme across all sources and visual layers, validating the TAAA's ability to capture cross-source thematic coherence. The adaptation of dual heatmaps demonstrated the algorithm's capacity for comparative bibliometric mapping in JMIR Aging. A mapping precision of 0.33 provided quantitative evidence of a 2-stage publication pattern, though the separation between stages was not strictly confined to predefined time intervals.</p><p><strong>Conclusions: </strong>The TAAA framework provides a replicable, scalable, and interpretable method for article-level thematic assignment. Its ability to uncover consistent research patterns-specifically the dominance of dementia-related studies in JMIR Aging-demonstrates its value for bibliometricians and its potential adaptability to other domains, such as bioinformatics-inspired meta-analyses.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e79906"},"PeriodicalIF":4.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057335","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":"Subsequent Hypertension's Mediation of the Association Between Sleep Duration Trajectories and New-Onset Cardiovascular Disease: Population-Based Cohort Study.","authors":"Hongwei Liu, Minghui Wu, Minheng Zhang, Jian Pan, Haiyan Wu, Haixia Fan","doi":"10.2196/78914","DOIUrl":"10.2196/78914","url":null,"abstract":"<p><strong>Background: </strong>Prior research has rarely explored the link between sleep duration trajectories and cardiovascular disease (CVD) either in cross-sectional or longitudinal data.</p><p><strong>Objective: </strong>We aimed to analyze the relationship between sleep duration trajectories and the incidence of CVD.</p><p><strong>Methods: </strong>Data from 5603 participants in the China Health and Retirement Longitudinal Study (CHARLS) were used in the analysis. Sleep duration was self-reported at multiple time points, and group-based trajectory modeling identified distinct patterns of total and nocturnal sleep duration over time. To investigate the link among sleep duration trajectories and CVD, Cox proportional hazards models, restricted cubic splines, and mediation analyses were used, with sensitivity analyses ensuring the results' robustness.</p><p><strong>Results: </strong>Four sleep duration trajectories were identified, including steady high, inverted U-shaped, steady low, and U-shaped. In fully adjusted models, an inverted U-shaped sleep trajectory was associated with a 34% higher risk of hypertension compared with the steady high group (total sleep: hazard ratio [HR]=1.34, 95% CI 1.07-1.69; P=.01). Notably, the inverted U-shaped sleep trajectory showed a 110% increased stroke risk during nocturnal periods compared to the steady high group (nocturnal sleep: HR=2.10, 95% CI 1.08-4.05; P=.03). The findings remained consistent across a range of sensitivity analyses. Hypertension was identified as a partial mediator of the association between sleep instability and stroke risk.</p><p><strong>Conclusions: </strong>The findings indicate that an inverted U-shaped sleep pattern is associated with increased cardiovascular risk, partially mediated by hypertension, highlighting sleep stability as a potential preventive target.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e78914"},"PeriodicalIF":4.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057320","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":"Developing Customized Personas to Capture Intrinsic Capacity Profiles and Digital Monitoring Intentions in Older Adults: Mixed Methods Study.","authors":"Zehui Xuan, Yirou Niu, Ruifu Kang, Qian Xiao, Shuai Jin, Jie Zhao, Yanling Wang, Hong Chang","doi":"10.2196/82867","DOIUrl":"10.2196/82867","url":null,"abstract":"<p><strong>Background: </strong>Integrated Care for Older People (ICOPE), focused on monitoring and optimizing the intrinsic capacity (IC) of older adults, is a new model of geriatric care that is currently being accelerated globally. Digital health technologies are recommended for longitudinal IC monitoring to provide precise and timely interventions. However, little is known about the psychological intentions of engaging in digital monitoring of IC according to the profile heterogeneity of IC among older adults.</p><p><strong>Objective: </strong>This study aims to map a set of customized personas to capture the profiles of IC and match psychological intentions that support personalized digital IC monitoring.</p><p><strong>Methods: </strong>An explanatory sequential mixed methods study was conducted at 16 sites in Beijing, China. Older adults aged ≥60 years (n=481) were selected to complete the quantitative survey. Latent profile analysis, descriptive statistics, and logistic regression analyses were performed to cluster subgroups using Mplus (Muthén & Muthén) and SPSS (IBM Corp). A subsample of participants from each profile (n=25) was purposively sampled for semistructured interviews. An inductive-deductive content analysis was used to identify similar attributes and to affirm the personas gradually. A joint statistical and thematic visualization method was used to integrate the customized personas.</p><p><strong>Results: </strong>Three profiles of IC patterns emerged: \"multisubdomain decline-IC imbalance group,\" \"multisubdomain moderate-sensory deficit group,\" and \"multisubdomain robust-whole balance group.\" The distribution of latent profiles was influenced by age, education, monthly per capita household income, self-rated health, and number of chronic diseases, while positively impacting older adults' functional ability. The following customized personas were captured regarding established themes: \"affects my mood-anxious evader,\" characterized by avoidance and anxiety, low digital interest, and perceived social isolation; \"capitalize on what comes-accommodative adopter,\" pragmatically oriented toward disease detection, with moderate digital openness but limited self-efficacy; and \"more autonomy-active improver,\" who exhibited proactive engagement, high digital literacy, and motivation rooted in self-management and social participation.</p><p><strong>Conclusions: </strong>This study is the first to integrate latent profile analysis with customized qualitative personas to link the heterogeneity of IC with the psychological intentions underlying digital monitoring. The resulting personas model provides an actionable framework for tailoring digital IC monitoring strategies in community-based integrated care. The findings emphasize the need to align monitoring approaches with older adults' IC characteristics, psychological readiness, digital literacy, and social support to enhance engagement in digital IC monitoring.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e82867"},"PeriodicalIF":4.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044060","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":"e-Counseling for Fall Prevention in Older Adults: Scoping Review.","authors":"Lina Safarina, Cecep Eli Kosasih, Iqbal Pramukti, Nucki Nursjamsi","doi":"10.2196/78444","DOIUrl":"10.2196/78444","url":null,"abstract":"<p><strong>Background: </strong>Falls are a major contributor to injury, disability, and mortality among older adults worldwide. Digital health-based e-counseling has emerged as a scalable strategy to support fall prevention by addressing physical, behavioral, and cognitive risk factors.</p><p><strong>Objective: </strong>This scoping review aimed to map the scope, characteristics, and outcomes of e-counseling interventions for fall prevention among adults aged 60 years or older.</p><p><strong>Methods: </strong>Guided by Arksey and O'Malley's framework and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews), we searched PubMed, ScienceDirect, CINAHL, and ProQuest for studies published between January 2019 and May 2025. Eligible studies evaluated digital or telehealth-based counseling interventions for fall prevention. Data were synthesized descriptively, and methodological quality was appraised using the Mixed Methods Appraisal Tool.</p><p><strong>Results: </strong>A total of 13 studies were included, comprising randomized controlled trials, feasibility studies, qualitative research, and retrospective cohorts conducted across Asia, Europe, and North America. e-Counseling modalities included virtual reality, mobile health application, teleconsultations, and wearable-triggered feedback systems. Reported outcomes included reductions in fall incidence ranging from 15% to 90.9%, improvements in balance and mobility, increased fall risk awareness, and enhanced self-efficacy. Interventions incorporating cultural tailoring and digital literacy support demonstrated higher engagement and adherence.</p><p><strong>Conclusions: </strong>e-Counseling appears to be a promising and scalable approach for fall prevention in older adults, with benefits across physical and behavioral domains. Future research should focus on long-term effectiveness, equitable access in low- and middle-income settings, and integration into routine health care systems.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e78444"},"PeriodicalIF":4.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036181","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":"Speech Recognition-Based Dietary Assessment Tool for Older Adults: Validation and Usability Study.","authors":"Yoonjee Sung, Soyoung Jung, Hae Jin Kang, So Young Moon, Jee Hyang Jeong, Seong Hye Choi, Eun-Hye Lee, Yoo Kyung Park","doi":"10.2196/81336","DOIUrl":"10.2196/81336","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As populations age globally, accurate and feasible dietary assessment for older adults has become increasingly important. South Korea has already become an \"aged society,\" with over 14.2% of its population being aged 65 years and older, and is projected to become one of the world's most rapidly super-aged societies by 2050, with more than 40% of its population in this age group. Similarly, the Asia-Pacific region is experiencing accelerated population aging, with 10 countries classified as \"aging societies\" (&gt;7% aged ≥65 years), 5 as \"aged societies\" (&gt;14%), and 11 as \"super-aged societies\" (&gt;21%) in 2025. Despite the growing need for accurate dietary monitoring in this demographic, nutritional assessment remains challenging due to limitations of conventional methods, compounded by cognitive burden, functional decline, and low literacy. Although various technology-based solutions, including web-based, scanner-based, and mobile tools, have been introduced, challenges related to usability, accuracy, and cost remain unresolved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the validity and usability of a speech-based dietary assessment tool as a potential alternative to a traditional pen-and-paper food diary among older adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a randomized crossover study, adults aged ≥65 years (n=18) completed 2 nonconsecutive 3-day dietary assessment periods using both a speech-recording (SR) method and a food diary (FD). Mean daily nutrient intakes were compared between methods, and agreement was examined using Bland-Altman plots. Usability was assessed after each method using the System Usability Scale (SUS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mean daily intakes estimated by SR and FD were similar in magnitude across most nutrients. The paired mean difference in energy intake (FD-SR) was 38.38 (95% CI -176.63 to 253.40) kcal. Across nutrients, mean differences were generally small, and most 95% CIs included zero, indicating limited evidence of a large systematic difference at the group level. The correlation coefficient between SR and FD ranged from 0.178 to 0.907 depending on the nutrient assessed, though CIs were often wide (eg, energy intake; Pearson r=0.52, 95% CI 0.05-0.81). Bland-Altman analyses for energy and macronutrients show mean differences close to zero, although substantial individual-level variability was observed. Cholesterol demonstrated greater dispersion and possible proportional bias at higher intake levels. Mean SUS scores were 66.25 for FD and 72.78 for SR, with a paired mean difference (FD-SR) of -6.53 (95% CI -11.75 to -1.30), indicating higher usability ratings for the SR method on average.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings suggest that in older adults, the speech recognition method-produced dietary intake estimates may be a feasible approach with broadly comparable nutrient intake levels to written food diaries and modestly higher usability","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e81336"},"PeriodicalIF":4.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13211599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036275","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":"Combining Subjective Perceptions and Objective Behavioral Metrics With the Elderly Digital Twin System: Quantitative Usability Study.","authors":"Ziaullah Momand, Pornchai Mongkolnam, Debajyoti Pal, Siam Yamsaengsung","doi":"10.2196/91873","DOIUrl":"10.2196/91873","url":null,"abstract":"<p><strong>Background: </strong>The growing aging population has increased the need for technologies that support informal caregivers in home-based older adult care. Digital twin (DT) systems offer promising capabilities; yet, their effectiveness depends on usability, an aspect still insufficiently evaluated among caregivers.</p><p><strong>Objective: </strong>This study aimed to assess the usability of an older adult care DT system using a dual-method evaluation that integrates subjective and objective behavioral performance.</p><p><strong>Methods: </strong>Fifty caregivers participated in a usability assessment combining the System Usability Scale (SUS) and detailed system activity log analytics. Log-based measures included task completion, time on task, errors, and abandonment rate. A composite user engagement score was computed and analyzed for correlation and predictive association with SUS ratings. Engagement clusters were also explored.</p><p><strong>Results: </strong>Caregivers reported an excellent mean SUS score of 80.45. System logs showed a 94.08% task completion rate, 2.66% abandonment, and an average task duration of 89.16 seconds. User engagement score demonstrated significant correlations with SUS (r=0.626, ρ=0.552; P<.001) and significantly predicted usability in regression analysis (β=52.94, R²=0.392; P<.001). Engagement-based clustering identified high-, medium-, and low-tier user groups, each exhibiting distinct usability patterns.</p><p><strong>Conclusions: </strong>Integrating subjective usability ratings with objective behavioral metrics provides a rigorous and comprehensive approach to evaluating DT systems for older adult care. The findings highlight strong usability of the system and offer actionable insights for refining caregiver support technologies.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e91873"},"PeriodicalIF":4.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13207158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036213","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}