JMIR Aging最新文献

{"title":"Determinants of Medical Help-Seeking Behavior Following Case Finding of Early Cognitive Impairment: Semistructured Interview Study of Patients and Caregivers.","authors":"Shu Rong Lim, Xiaohui Xin, Gerald Choon Huat Koh, Julian Thumboo, Tau Ming Liew","doi":"10.2196/79386","DOIUrl":"10.2196/79386","url":null,"abstract":"<p><strong>Background: </strong>Timely medical follow-up after a diagnosis of cognitive impairment, such as mild cognitive impairment (MCI) or dementia, is imperative for initiating appropriate medical treatment and accessing comprehensive care management and psychosocial support. However, many community-dwelling older adults who receive a positive case-finding result default on their medical follow-up appointments. This persistent challenge undermines early detection and active case-finding efforts and increases the risk of early institutionalization. Understanding the determinants is important for developing effective interventions in community-based case-finding.</p><p><strong>Objective: </strong>This qualitative study aimed to explore the barriers and facilitators influencing medical help-seeking behavior among community-dwelling individuals in Singapore diagnosed with MCI or dementia following a positive case-finding result. The COM-B (capability, opportunity, motivation-behavior) framework of the Behavior Change Wheel (BCW) was used to systematically identify these determinants.</p><p><strong>Methods: </strong>Using maximum variation sampling based on age, gender, ethnicity, living arrangement, relationship with caregiver, prior memory concerns, and whether participants had sought medical follow-up after their cognitive impairment diagnosis, we conducted 21 unique household semistructured interviews with 26 individuals (comprising 5 participant-caregiver dyads of MCI, 6 participants diagnosed with MCI, 1 caregiver of a participant with MCI, and 9 caregivers of participants diagnosed with dementia). These participants were a subset of individuals and caregivers recruited from a community-based study validating an artificial intelligence (AI)-based dementia case-finding tool. Interviews were audio-recorded, transcribed verbatim, and analyzed using the framework analysis method. Two authors (SRL and XX) performed inductive coding before mapping to COM-B, with subsequent discussion and review by the remaining authors. The COM-B components informed the selection of the relevant intervention functions from the BCW.</p><p><strong>Results: </strong>Barriers to medical help-seeking behavior after cognitive impairment diagnosis included physical impairments, low health literacy to navigate the health care processes, inaccurate disease knowledge, complicated health care processes, inadequate physical infrastructure to navigate health care organizations, oversimplified cultural representation of dementia, perceived inaccuracy of the case-finding tool, and lay beliefs about seeking medical care when sick. Facilitators included adopting strategies to track medical appointments, a case-finding result letter as a cue for action, caregivers with profamily workplace policies, and valuing proactive medical disease management. Notably, social capital, (in)ability to recognize symptoms, and strong affective states triggered by the case-finding results were both","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e79386"},"PeriodicalIF":4.6,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Web-Based Resource to Support Driving Safety in Older Adults: Semistructured Interview and Focus Group Study.","authors":"Mollie Cahill, Ranmalee Eramudugolla, Marwin Tang, Diane Hosking, Stephen Cratchley, Michael Regan, Lesley A Ross, Jasmine Price, Kaarin J Anstey","doi":"10.2196/79630","DOIUrl":"10.2196/79630","url":null,"abstract":"<p><strong>Background: </strong>Older adults face increased crash risk due to age-related declines in cognitive, visual, and physical functioning; yet, many Australians in their 70s are continuing to drive. Web-based platforms are increasingly used to deliver health and mobility information to older adults and may support safer driving; however, existing online resources on driving safety often lack age-specific guidance, have usability limitations, and may not be designed with older adults in mind.</p><p><strong>Objective: </strong>This study aimed to explore the information needs, preferences, and experiences of older drivers and general practitioners (GPs) to inform the formative, prelaunch development of a user-centered web-based platform, Ageing Well on the Road. Interviews and focus groups were conducted to gather feedback on content, accessibility, and usability, with data collection guided by the Consolidated Framework for Implementation Research and the Technology Acceptance Model frameworks to explore implementation and technology adoption factors.</p><p><strong>Methods: </strong>Website development was informed by a review of 26 Australian websites and consultations with stakeholders. Semistructured interviews were conducted with 7 older adults (aged >67 years; one additional participant completed only survey data) and a focus group with 10 GPs experienced in fitness to drive assessments for older drivers. Thematic analysis was used to explore participants' experiences with online driving information and feedback on content, usability, and accessibility. Formative feedback from these users directly informed content and design refinements before public launch.</p><p><strong>Results: </strong>The website addressed priority topics, including age-related health conditions affecting driving, licensing requirements, vehicle safety features, and strategies for maintaining driving confidence. Older adults valued large fonts, plain language, intuitive navigation, and trustworthy, practical advice. GPs highlighted the website's potential to support clinical discussions around driving capacity and safety. Barriers to engagement included digital literacy limitations, accessibility concerns, and uncertainty about online information credibility.</p><p><strong>Conclusions: </strong>A co-designed, web-based platform tailored to older adults and clinicians can enhance access to relevant, trustworthy information and support driving self-regulation. Involving end users in the development process is critical to optimize usability and ensure the resource aligns with their needs, highlighting the value of theory-informed, user-guided development for digital health resources.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e79630"},"PeriodicalIF":4.6,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976070","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":"Supervised and Self-Directed Technology-Based Dual-Task Exercise Training Program for Older Adults With a History of Falls: Mixed Methods Feasibility Study.","authors":"Prerna Mathur, Afroditi Stathi, Victoria A Goodyear, Taylor Krauss, Helen Thomas, Angela Cooper, Philip Kinghorn, Caroline Miller, Natalie Ives, Magdalena Chechlacz, Daisy Wilson, Laura Magill, Shin-Yi Chiou","doi":"10.2196/87577","DOIUrl":"10.2196/87577","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Older adults who have fallen are at an increased risk of future falls. Training cognitive and physical functions simultaneously, known as dual-task (DT) training, has been shown to improve mobility and reduce fall risks. With appropriate digital tools, such as smartphones and mobile apps, it is possible to deliver DT training in unsupervised, home-based settings, thereby increasing accessibility beyond the clinical environment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the feasibility and acceptability of a technology-based DT training program delivered through a blended model of supervised and self-directed sessions for older adults with a history of falls. Perspectives of health care professionals working in fall-prevention services were also explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-arm, nonrandomized feasibility study was conducted with 45 community-dwelling adults aged 65 years or older with a history of falls. Participants were recruited through primary care practices, secondary care fall-prevention services, and community outreach. The 24-week DT program, which integrated balance and strength exercises with cognitive training using a mobile app, was delivered in two phases: (1) for12 weeks, weekly 50-minute physiotherapist-led group classes in the community, and 2 additional 50-minute self-directed sessions at home, and (2) for 12 weeks, 3 weekly 50-minute self-directed sessions at home. Feasibility and acceptability were assessed through recruitment and retention rates, adherence, app usage, and self-reported satisfaction. Qualitative data were obtained from focus groups with 28 participants who completed the program and 16 health care professionals. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We recruited 45 of the target 50 participants, with most participants (n=41) recruited through community pathways; 4 were recruited via National Health Service (NHS) pathways. Adherence was 64%, with higher adherence during phase 1 (81%) than phase 2 (50%). App usage was high (95%), and self-reported program satisfaction was moderate to high. Retention at 24 weeks was 76%, and no adverse events occurred. The qualitative findings supported the program's feasibility and acceptability, emphasizing social connection and tailored exercises as key to adherence-especially in home-based sessions. Health care professionals identified community organizations and referral pathways as the most practical routes for implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A blended, technology-based DT training program is both feasible and acceptable for older adults at risk of falling and can be effectively delivered beyond clinical settings. Community-based recruitment outperformed NHS pathways, highlighting the value of community engagement. These findings support the feasibility and acceptability of a full-scale trial, w","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e87577"},"PeriodicalIF":4.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13183345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976029","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":"Digital Handwriting Kinematics and Physical Performance According to Pentagon-Copy Performance in Community-Dwelling Older Adults: Cross-Sectional Study.","authors":"Pau Ferrer-Ramos, Marcos Faundez-Zanuy, Noemí Serra-Payá, Manuel Vicente Garnacho-Castaño, Montserrat Girabent-Farrés","doi":"10.2196/85074","DOIUrl":"10.2196/85074","url":null,"abstract":"<p><strong>Background: </strong>Cognitive decline in older adults is often accompanied by subtle motor alterations. Digital handwriting analysis has emerged as a promising noninvasive approach for detecting these changes, but its usefulness in community-based settings remains unclear.</p><p><strong>Objective: </strong>This study aims to examine the association of handwriting kinematics and physical performance measures with pentagon-copy performance classification in community-dwelling older adults.</p><p><strong>Methods: </strong>This cross-sectional study included 174 community-dwelling adults aged 60 years or older (mean age 73.9, SD 6.1 years; 108/174, 62% women). Participants completed 10 digital handwriting tasks and a battery of physical performance tests assessing strength, balance, gait, and cardiorespiratory fitness. Group classification was based on pentagon-copy performance and categorized as normal (93/174, 53% participants) or altered (81/174, 46% participants). Adjusted linear regression models included group as the main predictor and age and sex as covariates. Multiple comparisons were controlled using the Benjamini-Hochberg false discovery rate.</p><p><strong>Results: </strong>After adjustment for age, sex, and multiple comparisons, selected handwriting variables remained significantly associated with altered pentagon-copy performance, whereas no physical performance variables remained statistically significant. The most consistent differences were observed in cognitive effort and mechanical tasks, where participants with altered pentagon-copy performance showed longer contact time (β=526.8 ms; P<.001) and time on air (β=1111.5 ms; P<.001), together with lower mean writing pressure (β=-2058.8 au; P=.003). Overall, group differences were more consistently detected in handwriting-derived variables than in conventional physical performance outcomes after adjusted analyses.</p><p><strong>Conclusions: </strong>Selected digital handwriting variables, particularly temporal measures, were more consistently associated with altered pentagon-copy performance than physical performance outcomes. These findings suggest that digital handwriting analysis may represent a sensitive complementary approach for exploring subtle functional differences in community-based settings.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e85074"},"PeriodicalIF":4.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964836","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":"Leveraging Multimodal Large Language Models for Fall Risk Reduction in Older Adults in the Home: Proposed Model Design.","authors":"Justin Do, Vivaswat Suresh, Lily Zhang, Bharvi M Chavre, Jeremy Cha, Robert Pugliese","doi":"10.2196/77591","DOIUrl":"10.2196/77591","url":null,"abstract":"<p><strong>Unlabelled: </strong>This research letter proposes a novel model design leveraging natively multimodal large language models to identify fall risks and generate visualizations of recommended home environmental modifications, aiming to improve the accessibility and impact of personalized fall prevention advice for older adults. Through a pilot rating study, this work demonstrates that multimodal large language models can generate safe and actionable advice to reduce fall risk in lived spaces of older adults, and also generate realistic edits based on original images. While this concept needs further testing and clinical comparison, it highlights a promising avenue for further innovation of fall prevention tactics.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e77591"},"PeriodicalIF":4.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934148","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":"Self-Identified Age Cohorts and Personal Experience Sharing in Pseudonymous Online Spaces: Natural Language Processing Analysis of Reddit.","authors":"Ern Chern Khor, Moon Choi","doi":"10.2196/90103","DOIUrl":"10.2196/90103","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;While older adults' social media use has been widely studied for its instrumental benefits, such as accessing health information or maintaining family ties, research has largely focused on identity-based platforms that mirror offline social networks, leaving pseudonymous, interest-driven environments such as Reddit underexplored. Although older adults actively participate in these spaces to share personal narratives and engage beyond their existing social roles, the literature has yet to center their own voices, with most existing work focusing on caregivers or younger users discussing older adults rather than older adults speaking for themselves.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Integrating a life course perspective with the concept of subjective age cohort, this study examines how Reddit users who explicitly self-identify as being in their 50s, 60s, or 70s engage in self-expression and personal experience sharing within pseudonymous online spaces.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using data collected via the Reddit application programming interface, this study analyzed posts and comments from 848 self-identified older Reddit users, including 488 future older adults in their 50s (57.5%) and 360 current older adults in their 60s and 70s (42.5%) identified through age-based flairs in the subreddit r/AskOldPeople. A fine-tuned large language model (BLOOM-560m; F&lt;sub&gt;1&lt;/sub&gt;-score=0.96) classified 4,055,275 sentences into three personal experience domains: (1) health and wellness, (2) personal relationships and identity, and (3) professional and financial life. Chi-square analysis compared domain distributions across age groups. BERTopic topic modeling identified thematic patterns within each domain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 569,107 personal experience sentences identified, personal relationships and identity comprised the largest share (n=268,212, 47.1%), followed by professional and financial (n=186,768, 32.8%) and health and wellness (n=114,127, 20.1%). Chi-square analysis revealed significant between-group differences (χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;2&lt;/sub&gt;=34.7; P&lt;.001): current older adults shared proportionally more about health and wellness, whereas future older adults shared more about relationships and identity. Topic modeling further revealed qualitatively distinct emphases within each domain. Future older adults' posts frequently discussed menopause, depression, and friendships, while current older adults more frequently addressed chronic illness, aging, and financial security. Both groups used pseudonymity to disclose sensitive or stigmatized topics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates that older adults' personal experience sharing on pseudonymous platforms is shaped by the simultaneous interplay of life course stage, age cohort background, and platform affordances, rather than by any single factor. Pseudonymous environments such as Reddit enable disclosures of health vulnerabilities,","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e90103"},"PeriodicalIF":4.6,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876036","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 Between Loneliness, eHealth Literacy, and Quality of Life Among Chinese Older Adults: Cross-Sectional Study.","authors":"Shouchuang Zhang, Jiayi Li, Jia Tang, Weiyan Jian, Qing Liu, Jing Guo","doi":"10.2196/88600","DOIUrl":"10.2196/88600","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a growing public health challenge among older adults and is associated with a wide range of adverse health outcomes. The role of eHealth literacy in shaping the relationship between loneliness and quality of life remains unclear.</p><p><strong>Objective: </strong>This study aimed to examine the contributing role of eHealth literacy in moderating the associations between loneliness and quality of life among older adults.</p><p><strong>Methods: </strong>A community-based survey was conducted in 2025 among older adults aged 60 years or older living in northwestern China. A total of 2110 participants were included. Multiple linear regression and interaction models were used to assess associations and moderating effects. Sensitivity analyses were conducted by replacing the outcome variable with depressive symptoms and by performing stratified analyses to assess the robustness of the primary interaction findings.</p><p><strong>Results: </strong>Loneliness showed a consistent negative association with quality of life (β=-0.83, 95% CI -1.18 to -0.49; P<.001). Higher overall eHealth literacy was associated with better quality of life (β=0.41, 95% CI 0.35-0.47; P<.001). Interaction models indicated that higher eHealth literacy was associated with a steeper negative association between loneliness and quality of life (β=-0.04, 95% CI -0.08 to -0.002; P=.04). Sensitivity analyses produced similar results across alternative outcomes and subgroups.</p><p><strong>Conclusions: </strong>Higher loneliness was related to a poorer quality of life. Higher eHealth literacy was associated with a steeper negative association between loneliness and quality of life. These findings suggest that eHealth literacy may function as a double-edged sword in later life. Future research is needed to clarify the underlying mechanisms and to examine how digital health competencies interact with psychosocial vulnerability in shaping older adults' well-being.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e88600"},"PeriodicalIF":4.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413283","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 Identification of Mobility Limitations in Community-Dwelling Middle-Aged and Older Adults: Development of a Prediction Model Based on a Prospective Cohort.","authors":"Alberto Conde Freniche, Wei Hu, Mo Chen, Dantong Wang, Denis Breuillé, Yu-Ming Chen","doi":"10.2196/77187","DOIUrl":"10.2196/77187","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;With the aging of the global population, preventing the onset of mobility limitations is considered a worldwide public health priority.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop a predictive model for incident early mobility limitations (EMLs) in late middle-aged and older adults, based on a simple functional test and modifiable lifestyle factors to facilitate a home-based self-assessment of early mobility decline and promote lifestyle intervention strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Our study population was community dwellers aged 45 years and above who participated in the second and fourth waves of the Guangzhou Nutrition and Health Study. The included participants were healthy, nonfrail adults reporting no limitations in activities of daily living at baseline. At the 6-year follow-up, participants with poor physical performance (walking speed &lt;1 m/s or handgrip strength &lt;28 kg for males and &lt;18 kg for females) or reporting some difficulty in walking and/or climbing stairs were classified as experiencing EMLs. Least absolute shrinkage and selection operator (LASSO) was used to identify predictors from various factors, and 6 machine learning models were trained and evaluated for EML prediction, using bootstrap-based techniques to address class imbalance. Predictive ability was quantified using the area under the receiver operating characteristic curve (AUC). Variable importance analysis was used to identify key predictors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1344 participants were included in the analysis, of which 206 (15.33%) developed EMLs after a median follow-up of 6.67 (IQR 5.91-7.26) years. Those who developed EMLs were older, had a higher BMI, a lower alternate Mediterranean diet score, and poorer performance in the sit-to-stand (STS) test, as well as lower estimated muscle power from the STS at baseline. The final models included 6 out of 9 predictors: age, sex, BMI, alternate Mediterranean diet score, STS power, and dietary calcium intake. Four machine learning models (logistic regression, LASSO, support vector machine, and neural network) achieved an acceptable AUC value (≥0.70) or slightly below in the testing dataset, with the neural network performing the best (AUC 0.70, 95% CI 0.63-0.77). Curve analysis showed positive net benefits for LASSO and logistic regression. Bootstrapping did not improve classification performance. Advanced age, lower adherence to Mediterranean diet, lower muscle power estimated from STS test, and higher BMI at baseline emerged as the most important predictors of EMLs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study shows that EMLs in Chinese adults aged 45 years and older can be predicted using easy-to-obtain physical performance measures, age, sex, BMI, and specific nutritional factors. The combination of prediction models and variable importance analysis provides valuable insights for the early identification and intervention of EMLs. Mor","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e77187"},"PeriodicalIF":4.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876001","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":"Response Time Dynamics From Noncognitive Ordinal Ecological Momentary Assessment as a Proxy for Symptom Change in Geriatric Depression: Longitudinal Observational Study.","authors":"Jooho Lee, Jeehang Lee, Sehwan Park, Gangho Do, Jihye Noh, Sangjoon Moon, Kyungmi Chung, Sang Joon Son, Jin Young Park","doi":"10.2196/83891","DOIUrl":"10.2196/83891","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Depressive symptoms in older adults are amplified by social isolation and limited access to clinic-based mental health care. Ecological momentary assessment (EMA) enables remote self-monitoring and unobtrusively captures response times (RTs), which may serve as indicators of psychomotor and cognitive functioning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study investigated the use of EMA-based RT dynamics for predicting symptom change and profiling potential responders for repeated self-monitoring in late-life depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Forty-nine community-dwelling adults aged 65 years or older (mean age 70.7, SD 5.8 years; female: 35; male: 14) with a history of major depressive disorder received case management incorporating daily EMA. Participants provided self-reports of mood, appetite, sleep quality, and general well-being. Preassessment and postassessment included the 15-item Short Geriatric Depression Scale (GDS-15), the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), the 9-item Patient Health Questionnaire, and the Beck Anxiety Inventory. RTs were cleaned with an asymmetric IQR rule, z standardized within-person × response level, and modeled with exponential decay curves over successive EMA trials. The efficacy of EMA-adjunctive care was evaluated using pre-post comparisons of symptom scales. We then examined associations between RT-derived features and symptom change using correlational analyses. Finally, Bayesian multilevel modeling was applied to assess the clinical relevance of RT dynamics, including group differences in adaptation patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Older adults at risk for depression showed significant symptom reductions over the 4-week EMA-adjunctive care period across all 4 psychological scales (CESD-R: mean Δ 11.5; rank-biserial r=0.78; GDS-15: mean Δ 2.14, Cohen d=0.76), alongside high EMA adherence (&gt;90%). In correlational analyses, descriptive EMA score metrics and raw RTs showed modest, symptom-specific associations with symptom change (ΔCESD-R: |r|≈0.29; Δ9-item Patient Health Questionnaire: |r|≈0.32; ΔBeck Anxiety Inventory: |r|≈0.35) but were not significantly related to change in geriatric depression (ΔGDS-15: |r|≈0.24). In contrast, exponential-decay model parameters derived from standardized RT were significantly associated with geriatric depressive symptom change (Δ GDS-15), with the strongest effects observed for the feeling item (eg, decay rate θb: r=-0.398, asymptote θc: r=-0.321). Bayesian multilevel modeling further indicated that EMA-adjunctive care responders showed faster RT adaptation than nonresponders (median decay-rate ratio≈4.9, 95% credible interval 1.44-14.31), whereas differences in postadaptation RT levels were smaller and uncertain (median postadaptation RT ratio≈1.25, 95% credible interval 0.95-1.58). Sensitivity analyses showed consistent decay-rate effects across alternative specifications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Concl","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e83891"},"PeriodicalIF":4.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Multisensory Integration Training on Postural Stability Characteristics and Fall Risk in Older Adults: Systematic Review and Meta-Analysis.","authors":"Chaoyu Guo, Lulu Yin, Peng Chen, Jianglong Zhan, Zhongqi Yu, Teck Cheng Tan, Yaru Wei, Yixue Gong, Menghan Xu, Van Minh Le, Lin Wang","doi":"10.2196/80345","DOIUrl":"10.2196/80345","url":null,"abstract":"<p><strong>Background: </strong>The risk of falls escalates with advancing age, a consequence of the concomitant degeneration of multiple physiological systems, altered sensory processing capabilities, and reduced postural control. Multisensory integration (MSI) training has been demonstrated to enhance the brain's processing of multisensory information. However, existing studies show considerable variability in intervention duration and training modalities, limiting comparability across studies and contributing to inconsistent findings.</p><p><strong>Objective: </strong>This study aimed to systematically evaluate the effectiveness of MSI training on postural stability and fall risk in healthy older adults and provide an evidence base for clinical practice.</p><p><strong>Methods: </strong>Databases including PubMed, Embase, and Cochrane Library were searched by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The methodological quality of the included randomized controlled trials was assessed using the Cochrane risk of bias tool, and publication bias was evaluated through funnel plots. Meta-analyses using R packages quantified effects via standardized mean differences (SMDs) and 95% CIs, with fixed or random effects models selected based on heterogeneity (I²). Subgroup analyses explored age, intervention duration, and type.</p><p><strong>Results: </strong>A total of 14 randomized controlled trials were included in the meta-analysis. Results showed that MSI training significantly reduced center of pressure displacement in the anterior-to-posterior displacement (SMD -1.64, 95% CI -2.78 to -0.49, P<.001) and center of pressure displacement in the medio-to-lateral displacement (SMD -1.37, 95% CI -2.68 to -0.07, P<.001). In terms of postural stability, MSI training significantly improved Berg Balance Scale scores (SMD 3.42, 95% CI 2.41 to 4.44, P=.006). In terms of fall risk, MSI training significantly reduced the time to complete the timed up and go test, and intervention type significantly moderated this effect (SMD -1.43, 95% CI -2.36 to -0.50, P<.001). Additionally, MSI training reduced the risk of falls (SMD -1.27, 95% CI -2.03 to -0.52, P<.001).</p><p><strong>Conclusions: </strong>In conclusion, MSI training is an effective intervention for enhancing static and dynamic postural control and reducing fall risk in healthy older adults, suggesting a beneficial effect on postural stability and fall-related outcomes.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"9 ","pages":"e80345"},"PeriodicalIF":4.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843846","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}