@Article{info:doi/10.2196/66772,
author="Liang, Bingyu
and Xu, Chen
and Wang, Bingyi
and Li, Xinyi
and Peng, Xin
and Wang, Ying
and Li, Hui
and Lu, Yong
and Shen, Xiaopei
and Ouyang, Lin
and Wu, Guohui
and Yu, Maohe
and Liu, Jiewei
and Meng, Xiaojun
and Cai, Yong
and Zou, Huachun",
title="Sexual Response Problems and Their Correlates Among Older Adults From the Sexual Well-Being (SWELL) Study in China: Multicenter Cross-Sectional Study",
journal="JMIR Aging",
year="2025",
month="May",
day="1",
volume="8",
pages="e66772",
keywords="dysfunction",
keywords="sexual health",
keywords="sexual well-being",
keywords="sexually active",
keywords="sexual activity",
keywords="well-being",
keywords="correlate",
keywords="sex partner relationship",
keywords="gerontology",
keywords="geriatrics",
keywords="older adults",
keywords="elder",
keywords="elderly",
keywords="older person",
keywords="aging",
keywords="China",
keywords="cross-sectional study",
abstract="Background: Sexual response problems among older adults are not an inevitable consequence of aging but rather a response to sexual health. However, there is a lack of recent and multicenter data on this issue in China. Objective: This study aims to assess the prevalence of sexual response problems and their correlates among older adults. Methods: A multicenter cross-sectional study on sexual well-being was conducted among individuals aged more than 50 years in China between June 2020 and December 2022. Data on sociodemographics, physical health, psychological health, and sexual response problems were collected through face-to-face interviews. We included sexually active older adults who reported either vaginal, oral, or anal sex in the past 12 months for this study. Sexual response problems included a lack of interest or enjoyment in sex; feeling anxious, having pain, or no excitement during sex; no desire or orgasms; and the lack of lubrication in sex. The stepwise logistic regression models were used to examine the correlates of sexual response problems. Results: A total of 1317 sexually active older adults (842 men, 475 women) were included. Older women reported a higher prevalence of sexual response problems than older men (52.0\% [247/475] vs 43.1\% [363/842]). Common factors associated with at least one of the sexual response problems included living in rural areas (men: adjusted odds ratio [aOR]=0.31, 95\% CI 0.22?0.43; women: aOR=0.29, 95\% CI 0.19?0.43) and abnormal BMI (aOR=men: 1.52, 95\% CI1.11?2.07; women: aOR=2.19, 95\% CI 1.47?3.28). Among older men, sleep quality (aOR=1.87, 95\% CI 1.30?2.68), emotional connection with sex partners during sexual intercourse (aOR=0.69, 95\% CI 0.50?0.96), frequently experienced fatigue (aOR=2.47, 95\% CI 1.59?3.90), anxiety (aOR=4.26, 95\% CI 1.12?21.27), and seeking professional help for sex life (aOR=1.58, 95\% CI 1.14?2.21) were associated with sexual response problems. Among older women, sexual response problems were associated with a lack of physical exercise (aOR=1.69, 95\% CI 1.13?2.54), poor sex-partner relationships (aOR=1.70, 95\% CI 1.12?2.60), and depressive symptoms (aOR=3.18, 95\% CI 1.18?10.24). Conclusions: Sexual response problems are common among older adults. These problems were associated with adverse physical health, mental health, and poor sex-partner relationships. These findings highlight the importance for health care providers to take into account the physical and psychological health of older adults, as well as the quality of their relationships with sexual partners when diagnosing and addressing sexual response problems. ",
doi="10.2196/66772",
url="https://aging.jmir.org/2025/1/e66772"
}


@Article{info:doi/10.2196/66180,
author="Shu, Sara
and Woo, P. Benjamin K.",
title="Applications of Self-Driving Vehicles in an Aging Population",
journal="JMIR Form Res",
year="2025",
month="Apr",
day="28",
volume="9",
pages="e66180",
keywords="self-driving",
keywords="driverless",
keywords="driver",
keywords="autonomous vehicles",
keywords="car",
keywords="transportation",
keywords="mobility",
keywords="travel",
keywords="vehicle",
keywords="driving",
keywords="artificial intelligence",
keywords="gerontology",
keywords="geriatric",
keywords="older",
keywords="elderly",
keywords="aging",
keywords="healthy aging",
keywords="older adult",
keywords="autonomy",
keywords="independence",
keywords="aging in place",
keywords="health equity",
doi="10.2196/66180",
url="https://formative.jmir.org/2025/1/e66180"
}


@Article{info:doi/10.2196/64115,
author="Gao, Jiamin
and Zhang, Yuying
and Jiang, Xiaqing
and Fu, Zhenjing
and Jiang, Haochen",
title="Evaluating the Effectiveness of Community-Delivered Hearing Rehabilitation and Health Education Intervention on Social Isolation and Functioning Among Chinese Adults With Hearing Impairment: Protocol for Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2025",
month="Apr",
day="28",
volume="14",
pages="e64115",
keywords="hearing impairment",
keywords="social isolation",
keywords="functioning",
keywords="community-delivered hearing interventions",
keywords="randomized controlled trial",
abstract="Background: Hearing impairment (HI) is a common sensory deficit with considerable impacts on social well-being (SWB) in adults. Evidence on the effectiveness of auditory rehabilitation and hearing health education in the social domain of health for individuals with HI is scarce. Objective: This study aims to test the feasibility and efficacy of providing free hearing aids or a combined offline and online hearing health education intervention on social isolation and functioning among Chinese adults with HI. Methods: This study is a 3-arm, single-blinded, randomized controlled trial (RCT) with a follow-up at 24 months after the baseline study. A total of 435 participants aged 18 years and older with some degree of HI will be recruited and randomly assigned to 2 intervention groups and 1 control group. Free hearing-aid provision, as well as a hearing health education program that is combined with online and offline lessons, will be implemented in 2 intervention groups, respectively. The control group will not receive any intervention. The primary outcomes include social isolation and functioning in society. The secondary outcomes include social engagement, a sense of mastery, self-efficacy, psychological resilience, chronic diseases, life satisfaction, hearing health literacy, and hearing care usage. Results: Participants were recruited for hearing tests in September 2022, during which baseline results were collected through in-person interviews. Follow-up interviews were conducted in September 2024. The primary analysis will use ANOVA, linear mixed-effects modeling, structural equation modeling, and cost-effectiveness analysis. Conclusions: The findings of this study will provide evidence for the impact and cost-effectiveness of a community-based auditory or hearing health education intervention on SWB among Chinese adults with HI, which may contribute to promoting hearing health and reducing adverse health consequences in an aging society. Trial Registration: Chinese Clinical Trial Registry ChiCTR2200062148; https://www.chictr.org.cn/showproj.html?proj=174741 International Registered Report Identifier (IRRID): DERR1-10.2196/64115 ",
doi="10.2196/64115",
url="https://www.researchprotocols.org/2025/1/e64115"
}


@Article{info:doi/10.2196/64449,
author="Gustafson Sr, H. David
and Mares, Marie-Louise
and Johnston, C. Darcie
and Curtin, J. John
and Pe-Romashko, Klaren
and Landucci, Gina",
title="Comparison of Smart Display Versus Laptop Platforms for an eHealth Intervention to Improve Functional Health for Older Adults With Multiple Chronic Conditions: Protocol for a Randomized Clinical Trial",
journal="JMIR Res Protoc",
year="2025",
month="Apr",
day="3",
volume="14",
pages="e64449",
keywords="eHealth",
keywords="aged",
keywords="geriatrics",
keywords="functional health",
keywords="multiple chronic conditions",
keywords="smart display",
keywords="smart speaker",
keywords="primary care",
keywords="quality of life",
abstract="Background: Maintaining functional health, or the ability to live independently, is a primary goal of individuals as they age, but most older adults develop chronic conditions that threaten this goal. Physical activity is a key aspect of self-care that can improve functional health, and digital interventions offering guidance on appropriate exercise can help. However, older adults with multiple morbidities may be unable to use a laptop or smartphone-based eHealth because poor vision, dexterity, mobility, or other physical challenges make typing or touch navigation difficult. A smart display platform---comprising a smart speaker plus a small visual screen---has the potential to remove these barriers because it is voice-activated. Objective: The study aims to compare usage patterns of an eHealth intervention for older adults when delivered via a voice-based smart display versus a typing-based laptop, and assess whether the smart display outperforms the laptop in improving functional health and its specific physical and mental aspects. Methods: A minimum of 356 adults aged 60 years and older with at least 5 chronic health conditions are to be recruited from primary care clinics and community organizations. Participants will be randomized 1:1 to 12 months of access to an evidence-based intervention, ElderTree, delivered on either a smart display or a touchscreen laptop, with a postintervention follow-up at 18 months. The primary outcome is differences between groups on a comprehensive measure of physical and mental functional health. Secondary outcomes are between-group differences in the subscales of functional health (eg, physical function and depression), as well as measures of health distress, loneliness, unscheduled health care, and falls. We will also examine mediators and moderators of the effects of ElderTree on both platforms. Participants will complete surveys at baseline, 6, 12, and 18 months, and ElderTree use data will be collected continuously during the intervention period in system logs. We will use linear mixed-effect models to evaluate outcomes over time, with treatment condition and time point as between-subjects factors. Separate analyses will be conducted for each outcome. Results: Recruitment began in July 2023 and was completed in May 2024, with 387 participants enrolled. The 12-month intervention period will end in May 2025; data collection will end in November 2025. Findings will be disseminated via peer-reviewed publications. Conclusions: Voice-activated digital health interventions have theoretical but untested advantages over typing-based technologies for older adults with physical limitations. As the population ages, and as multiple morbidities threaten the functional health of the majority of older adults, innovations in self-management are a matter of public health as well as individual quality of life. Trial Registration: ClinicalTrials.gov NCT05240534; https://clinicaltrials.gov/study/NCT05240534 International Registered Report Identifier (IRRID): DERR1-10.2196/64449 ",
doi="10.2196/64449",
url="https://www.researchprotocols.org/2025/1/e64449",
url="http://www.ncbi.nlm.nih.gov/pubmed/40080672"
}


@Article{info:doi/10.2196/66248,
author="Peng, Yingchun
and Zhang, Zhiying
and Zhang, Ruyi
and Zhang, Yiyao
and Wang, Runying
and Zhang, Jiaying
and Zhai, Shaoqi
and Jin, Qilin
and Zhou, Jiaojiao
and Chen, Jingjing",
title="Multidimensional Evaluation of the Process of Constructing Age-Friendly Communities Among Different Aged Community Residents in Beijing, China: Cross-Sectional Questionnaire Study",
journal="JMIR Public Health Surveill",
year="2025",
month="Mar",
day="21",
volume="11",
pages="e66248",
keywords="age-friendly",
keywords="positive living experience",
keywords="active aging",
keywords="healthy aging",
keywords="community residents",
keywords="older adults",
keywords="age-friendly communities",
keywords="multiple stakeholders",
keywords="evaluating age-friendliness",
keywords="urban and suburban areas",
abstract="Background: The World Health Organization (WHO) has made significant efforts to promote age-friendly community initiatives (AFCI) to address the challenges of population aging. Previous studies have discussed the construction of age-friendly communities (AFC) in urban cities, evaluating AFCs often rooted in the WHO's Checklist and focused on a single group, namely older adults, overlooking the role of other age groups in community development. Objective: This study aims to evaluate AFCs from multidimensional aspects, particularly the positive living experiences of older adults, summarize the deficiencies in both hardware and software aspects in the process of constructing AFCs in China, and provide some recommendations to promote AFCIs worldwide. Methods: Using a multistage sampling strategy, 470 community residents from urban and suburban areas participated in this study. A self-designed questionnaire was designed to use a standardized method to evaluate older adults' living experiences across five dimensions, including the degree of age-friendliness in the community, social support, sense of gain, sense of happiness, and sense of security. Respondents rated each dimension on a 10-point scale. This study defined community residents into 3 groups: residents younger than 45 years(Group 1: youth), those aged 45-59 years (Group 2: middle-aged), and those aged ?60 years (Group 3: old-age). Results: In this study, 382 (81.3\%) community residents were unaware of the relevant concepts of AFCs. Most participants highlighted the importance of community support and health services, followed by respect and social inclusion, and outdoor spaces and buildings. The findings showed that the highest-rated dimension was the sense of security. The mean scores for the degree of the sense of security in urban and suburban areas were 7.88 (SD 1.776) and 7.73 (SD 1.853), respectively. For Group 2, the mean scores were 7.60 (SD 2.070) and 8.03 (SD 1.662), while Group 3 had mean scores of 7.34 (SD 2.004) and 7.91 (SD 1.940). The lowest-rated dimension was social support; the mean scores for Group 1 for the degree of social support in urban and suburban areas were 7.63 (SD 1.835) and 7.48 (SD 1.918), respectively. For Group 2, the mean scores were 6.94 (SD 2.087) and 7.36 (SD 2.228), while those for Group 3 were 6.37 (SD 2.299) and 6.84 (SD 2.062). Further, there were significant differences in the scores of residents among different age groups in urban areas regarding age-friendliness (P<.001), social support, (P<.001), and sense of gain (P=.01). Conclusions: China is in the early stages of developing AFCs. We further highlight the importance of continued research on the collaboration and participation among multiple stakeholders. These outcomes have a direct and positive impact on the well?being of older adults. ",
doi="10.2196/66248",
url="https://publichealth.jmir.org/2025/1/e66248"
}


@Article{info:doi/10.2196/66061,
author="Liu, Hui
and Wang, Jieru
and Chen, Rui
and Xu, Xixing
and Pang, Mingli
and Feng, Kaiyuan
and Li, Bingsong
and Li, Qinling
and Qin, Ziwei
and Yan, Shuyi
and Ibn Ziyat, Nabila
and Kong, Fanlei",
title="Migrant-Local Differences in the Relationship Between Oral Health, Social Support, and Loneliness Among Older Adults in Weifang, China: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2025",
month="Mar",
day="13",
volume="11",
pages="e66061",
keywords="loneliness",
keywords="oral health",
keywords="social support",
keywords="migrant older adults",
keywords="local older adults",
abstract="Background: Increased aging and accelerated urbanization have led to the migration of older adults within China. Migrant older adults (MOAs) may experience physical and psychological discomfort in influx cities, and they are a vulnerable group that has emerged in the course of fast urbanization. Previous studies have confirmed the association between oral health and loneliness as well as the relationship between social support and loneliness; however, no research has been done to clarify the underlying mechanisms and the migrant-local difference between oral health, social support, and loneliness. Objective: This study aimed to test the association between oral health, social support, and loneliness among Chinese older adults, as well as the migrant-local difference on the above relationship. Methods: Multistage cluster random sampling was used to enroll a total of 1205 participants, including 613 MOAs and 592 local older adults (LOAs). Loneliness was assessed by the 6-item short-form UCLA Loneliness Scale; oral health was measured via the Chinese version Geriatric Oral Health Assessment Index (GOHAI); social support was evaluated by the Social Support Rating Scale (SSRS). Descriptive analysis, $\chi$2 tests, and t tests were conducted. Multigroup structural equation modeling (SEM) was employed to clarify the migrant-local difference on the association between oral health, social support, and loneliness among MOAs and LOAs. Results: The mean score of loneliness was 8.58 (SD 3.032) for MOAs and 8.00 (SD 2.790) for LOAs. Oral health and social support were found to be negatively related to loneliness among MOAs and LOAs; the standardized direct effects for MOAs were ?0.168 and ?0.444 (P<.001), and they were ?0.243 and ?0.392 (P<.001) for LOAs, respectively. Oral health generated a direct positive effect on social support, and the direct effect was 0.186 for MOAs (P<.001) and 0.247 for LOAs (P<.001). Conclusions: Loneliness was fairly low among older adults in Weifang, China, while MOAs showed higher loneliness than LOAs. Oral health had both direct and indirect negative effects on loneliness among MOAs and LOAs, with no significant path differences between MOAs and LOAs. Social support was found to be negatively associated with loneliness for both MOA and LOA, while the association was stronger among MOAs than LOAs. Oral health exerted a significantly positive effect on social support for both MOAs and LOAs, while no significant difference existed between them. Measures should be taken by the government, society, and families to increase social support, improve oral health, and further reduce loneliness among MOAs and LOAs. ",
doi="10.2196/66061",
url="https://publichealth.jmir.org/2025/1/e66061"
}


@Article{info:doi/10.2196/65776,
author="Wolfe, H. Brooke
and Oh, Jung Yoo
and Choung, Hyesun
and Cui, Xiaoran
and Weinzapfel, Joshua
and Cooper, Amanda R.
and Lee, Hae-Na
and Lehto, Rebecca",
title="Caregiving Artificial Intelligence Chatbot for Older Adults and Their Preferences, Well-Being, and Social Connectivity: Mixed-Method Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="13",
volume="27",
pages="e65776",
keywords="older adults",
keywords="technology use",
keywords="AI chatbots",
keywords="artificial intelligence",
keywords="well-being",
keywords="social connectedness",
keywords="mobile phone",
abstract="Background: The increasing number of older adults who are living alone poses challenges for maintaining their well-being, as they often need support with daily tasks, health care services, and social connections. However, advancements in artificial intelligence (AI) technologies have revolutionized health care and caregiving through their capacity to monitor health, provide medication and appointment reminders, and provide companionship to older adults. Nevertheless, the adaptability of these technologies for older adults is stymied by usability issues. This study explores how older adults use and adapt to AI technologies, highlighting both the persistent barriers and opportunities for potential enhancements. Objective: This study aimed to provide deeper insights into older adults' engagement with technology and AI. The technologies currently used, potential technologies desired for daily life integration, personal technology concerns faced, and overall attitudes toward technology and AI are explored. Methods: Using mixed methods, participants (N=28) completed both a semistructured interview and surveys consisting of health and well-being measures. Participants then participated in a research team--facilitated interaction with an AI chatbot, Amazon Alexa. Interview transcripts were analyzed using thematic analysis, and surveys were evaluated using descriptive statistics. Results: Participants' average age was 71 years (ranged from 65 years to 84 years). Most participants were familiar with technology use, especially using smartphones  (26/28, 93\%) and desktops and laptops (21/28, 75\%). Participants rated appointment reminders (25/28, 89\%), emergency assistance (22/28, 79\%), and health monitoring (21/28, 75\%). Participants rated appointment reminders (25/28, 89.3\%), emergency assistance (22/28, 78.6\%), and health monitoring (21/28, 75\%) as the most desirable features of AI chatbots for adoption. Digital devices were commonly used for entertainment, health management, professional productivity, and social connectivity. Participants were most interested in integrating technology into their personal lives for scheduling reminders, chore assistance, and providing care to others. Challenges in using new technology included a commitment to learning new technologies, concerns about lack of privacy, and worries about future technology dependence. Overall, older adults' attitudes coalesced into 3 orientations, which we label as technology adapters, technologically wary, and technology resisters. These results illustrate that not all older adults were resistant to technology and AI. Instead, older adults are aligned with categories on a spectrum between willing, hesitant but willing, and unwilling to use technology and AI. Researchers can use these findings by asking older adults about their orientation toward technology to facilitate the integration of new technologies with each person's comfortability and preferences. Conclusions: To ensure that AI technologies effectively support older adults, it is essential to foster an ongoing dialogue among developers, older adults, families, and their caregivers, focusing on inclusive designs to meet older adults' needs. ",
doi="10.2196/65776",
url="https://www.jmir.org/2025/1/e65776"
}


@Article{info:doi/10.2196/64352,
author="Gomes da Rocha, Carla
and von Gunten, Armin
and Vandel, Pierre
and Jopp, S. Daniela
and Ribeiro, Olga
and Verloo, Henk",
title="Building Consensus on the Relevant Criteria to Screen for Depressive Symptoms Among Near-Centenarians and Centenarians: Modified e-Delphi Study",
journal="JMIR Aging",
year="2025",
month="Mar",
day="5",
volume="8",
pages="e64352",
keywords="centenarians",
keywords="near-centenarians",
keywords="depressive symptoms",
keywords="depression diagnosis",
keywords="screening",
keywords="assessment",
keywords="e-Delphi technique",
keywords="web-based survey",
abstract="Background: The number of centenarians worldwide is expected to increase dramatically, reaching 3.4 million by 2050 and >25 million by 2100. Despite these projections, depression remains a prevalent yet underdiagnosed and undertreated condition among this population that carries significant health risks. Objective: This study aimed to identify and achieve consensus on the most representative signs and symptoms of depression in near-centenarians and centenarians (aged ?95 years) through an e-Delphi study with an international and interdisciplinary panel of experts. Ultimately, the outcomes of this study might help create a screening instrument that is specifically designed for this unique population. Methods: A modified e-Delphi study was carried out to achieve expert consensus on depressive symptoms in near-centenarians and centenarians. A panel of 28 international experts was recruited. Consensus was defined as 70\% agreement on the relevance of each item. Data were collected through a web-based questionnaire over 3 rounds. Experts rated 104 items that were divided into 24 dimensions and 80 criteria to identify the most representative signs and symptoms of depression in this age group. Results: The panel consisted of experts from various countries, including physicians with experience in old age psychiatry or geriatrics as well as nurses and psychologists. The response rate remained consistent over the rounds (20/28, 71\% to 21/28, 75\%). In total, 4 new dimensions and 8 new criteria were proposed by the experts, and consensus was reached on 86\% (24/28) of the dimensions and 80\% (70/88) of the criteria. The most consensual potentially relevant dimensions were lack of hope (21/21, 100\%), loss of interest (27/28, 96\%), lack of reactivity to pleasant events (27/28, 96\%), depressed mood (26/28, 93\%), and previous episodes of depression or diagnosed depression (19/21, 90\%). In addition, the most consensual potentially relevant criteria were despondency, gloom, and despair (25/25, 100\%); depressed (27/27, 100\%); lack of reactivity to pleasant events or circumstances (28/28, 100\%); suicidal ideation (28/28, 100\%); suicide attempt(s) (28/28, 100\%); ruminations (27/28, 96\%); recurrent thoughts of death or suicide (27/28, 96\%); feelings of worthlessness (25/26, 96\%); critical life events (20/21, 95\%); anhedonia (20/21, 95\%); loss of interest in activities (26/28, 93\%); loss of pleasure in activities (26/28, 93\%); and sadness (24/26, 92\%). Moreover, when assessing depression in very old age, the duration, number, frequency, and severity of signs and symptoms should also be considered, as evidenced by the high expert agreement. Conclusions: The classification of most elements as relevant highlights the importance of a multidimensional approach for optimal depression screening among individuals of very old age. This study offers a first step toward improving depression assessment in near-centenarians and centenarians. The development of a more adapted screening tool could improve early detection and intervention, enhancing the quality of mental health care for this population. ",
doi="10.2196/64352",
url="https://aging.jmir.org/2025/1/e64352",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053803"
}


@Article{info:doi/10.2196/65379,
author="Deng, Cheng
and Shen, Na
and Li, Guangzhou
and Zhang, Ke
and Yang, Shijun",
title="Digital Isolation and Dementia Risk in Older Adults: Longitudinal Cohort Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="19",
volume="27",
pages="e65379",
keywords="dementia",
keywords="digital isolation",
keywords="cognitive decline",
keywords="older adults",
keywords="elderly",
keywords="geriatric",
keywords="longitudinal cohort study",
keywords="cognitive impairment",
keywords="aging",
keywords="social isolation",
keywords="risk",
keywords="digital engagement",
abstract="Background: Dementia poses a significant global health challenge, characterized by progressive cognitive decline and functional impairment. With the aging global population, dementia prevalence is projected to surge, reaching an estimated 153 million cases by 2050. While the impact of traditional social isolation on dementia risk has been extensively studied, the influence of digital isolation, a phenomenon unique to the digital age, remains underexplored. Objective: This study aimed to investigate the association between digital isolation and dementia risk among older adults, hypothesizing that higher levels of digital isolation significantly increase the risk of developing dementia. Methods: We conducted a longitudinal cohort study using data from the National Health and Aging Trends Study (NHATS), analyzing 8189 participants aged 65 years and older from the 3rd (2013) to the 12th wave (2022). Digital isolation was quantified using a composite digital isolation index, derived from participants' usage of digital devices, electronic communication, internet access, and engagement in online activities. Participants were stratified into low isolation and moderate to high isolation groups. Dementia incidence was assessed using cognitive tests and proxy reports. Cox proportional hazards models were used to estimate the association between digital isolation and dementia risk, adjusting for potential confounders including sociodemographic factors, baseline health conditions, and lifestyle variables. Results: The moderate to high isolation group demonstrated a significantly elevated risk of dementia compared with the low isolation group. In the discovery cohort, the adjusted hazard ratio (HR) was 1.22 (95\% CI 1.01-1.47, P=.04), while the validation cohort showed an HR of 1.62 (95\% CI 1.27-2.08, P<.001). The pooled analysis across both cohorts revealed an adjusted HR of 1.36 (95\% CI 1.16-1.59, P<.001). Kaplan-Meier curves corroborated a higher incidence of dementia in the moderate to high isolation group. Conclusions: Our findings indicate that digital isolation is a significant risk factor for dementia among older adults. This study underscores the importance of digital engagement in mitigating dementia risk and suggests that promoting digital literacy and access to digital resources should be integral components of public health strategies aimed at dementia prevention. ",
doi="10.2196/65379",
url="https://www.jmir.org/2025/1/e65379",
url="http://www.ncbi.nlm.nih.gov/pubmed/39969956"
}


@Article{info:doi/10.2196/59023,
author="Yang, Lu
and Lynch, Chris
and Lee, Tayu John
and Oldenburg, Brian
and Haregu, Tilahun",
title="Understanding the Association Between Home Broadband Connection and Well-Being Among Middle-Aged and Older Adults in China: Nationally Representative Panel Data Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="10",
volume="27",
pages="e59023",
keywords="digital divide",
keywords="health inequity",
keywords="China",
keywords="longitudinal study",
keywords="broadband",
keywords="internet connection",
keywords="internet",
keywords="well-being",
keywords="psychosocial",
keywords="middle age",
keywords="older adult",
keywords="inequality",
keywords="digital connectivity",
keywords="logistic regression",
keywords="questionnaire",
keywords="survey",
keywords="panel data approach",
abstract="Background: Access to digital technology is among the major social determinants of health, and digital divide impacts health inequality. Yet, the impact of digital connectivity on the well-being and psychosocial outcomes in adults has not been fully studied. Objective: The aim of this study was to investigate the association of home broadband connection with health and well-being of middle-aged adults and adults older than 45 years in China. Methods: A panel data study design of the national sample of China Health and Retirement Longitudinal Study (CHARLS) was conducted in 2015, 2018, and 2020. This study included 16,185 participants older than 45 years. The associations between digital connectivity (home broadband connection), loneliness, social participation, and life satisfaction were assessed using mixed effects logistic regression models, adjusting for socioeconomic factors, behavioral factors, and locality. Broadband internet connectivity, feelings of loneliness, social participation, and satisfaction with life were measured using the self-reported CHARLS questionnaire. Results: We observed a substantial increase in digital connectivity from 29.5\% in 2015 to 59.8\% in 2020. Broadband internet connection at home was positively correlated with social participation (adjusted odds ratio [AOR] 1.34, 95\% CI 1.28-1.41) and life satisfaction (AOR 1.30, 95\% CI 1.20-1.40), after adjusting for confounding factors, while the absence of broadband internet connection was associated with increased loneliness (AOR 0.81, 95\% CI 0.77-0.86). These associations were consistent across age, gender, socioeconomic groups, and geographic areas. Conclusions: This study highlights the potential additional health benefits of digital connectivity beyond the known advantages. Our results suggest the importance of expanding broadband access to enhance social inclusion and life satisfaction. Further research is needed to understand the broader implications and digital determinants of health associated with digital connectivity. ",
doi="10.2196/59023",
url="https://www.jmir.org/2025/1/e59023"
}


@Article{info:doi/10.2196/68163,
author="Jung, Hyein
and Lee, Hocheol
and Nam, Woo Eun",
title="Mediating Effect of Social Capital on the Association Between Digital Literacy and Life Satisfaction Among Older Adults in South Korea: Cross-Sectional Study",
journal="JMIR Form Res",
year="2025",
month="Feb",
day="6",
volume="9",
pages="e68163",
keywords="digital literacy",
keywords="digital access",
keywords="digital competency",
keywords="digital utilization",
keywords="life satisfaction",
keywords="older adults",
keywords="social capital",
keywords="mediating effect",
keywords="aging",
abstract="Background: As Korea rapidly transforms into a super-aged society, research indicates that digital literacy among older adults enhances their life satisfaction. Digital literacy refers to the ability to efficiently use digital technologies, encompassing access, competency, and utilization. It reflects the capacity to navigate and benefit from digital environments effectively. Furthermore, social capital positively influences the quality of life, and digital literacy facilitates social capital formation. However, since most studies have only focused on the direct relationship between digital literacy and life satisfaction, research on the mediating role of social capital remains limited. Objective: To analyze the effect of digital literacy on the life satisfaction of older adults in South Korea and to verify whether social capital acts as a mediating factor in this process. Methods: This descriptive cross-sectional study used data from the 2023 Report on the Digital Divide---an annual survey conducted by the Korean Ministry of Science and Information and Communications Technology. The study targeted individuals aged 65 years or older. Descriptive statistics, the Pearson correlation analyses, and the 3-step multiple regression analysis proposed by Baron and Kenny were performed. The bootstrap method was employed, and all analyses were conducted using R, version 4.4.1. Results: The study included 869 participants. Digital literacy had a significant positive effect on their life satisfaction ($\beta$=0.103; P=.008). Social capital was also positively associated with life satisfaction ($\beta$=0.337; P<.001). Mediation analysis showed that digital literacy influenced life satisfaction both directly ($\beta$=0.103; P=.006) and indirectly through social capital ($\beta$=0.037; P=.03). Bootstrapping confirmed the significance of the indirect effect ($\beta$=0.037, 95\% CI 0.005?0.070; P=.03). The total effect of digital literacy on life satisfaction was also significant ($\beta$=0.140, 95\% CI 0.058?0.230; P=.002). Conclusions: This study analyzed the association between digital literacy, social capital, and life satisfaction among older adults in Korea. We identified that social capital mediates the association between digital literacy and life satisfaction among older adults. These findings indicate that tailored digital literacy programs and support policies that promote social capital formation could help bridge the digital divide and foster social inclusion. These measures would enable older adults to access essential services, reduce social isolation, and enhance health and well-being, ultimately improving the overall quality of life. ",
doi="10.2196/68163",
url="https://formative.jmir.org/2025/1/e68163"
}


@Article{info:doi/10.2196/65399,
author="Guo, Lin
and Li, Yunwei
and Cheng, Kai
and Zhao, Ying
and Yin, Wenqiang
and Liu, Ying",
title="Impact of Internet Usage on Depression Among Older Adults: Comprehensive Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="31",
volume="27",
pages="e65399",
keywords="internet usage",
keywords="depression",
keywords="older people",
keywords="mechanism",
keywords="heterogeneity",
keywords="mobile phone",
abstract="Background: Depression is a widespread mental health issue affecting older adults globally, with substantial implications for their well-being. Although digital interventions have proven effective in high-income countries, research on the potential of internet usage to alleviate depression among older adults in high-income countries remains limited. Objective: This study aimed to examine the impact of internet usage on depression among older adults in high-income countries by developing a comprehensive theoretical framework and testing key hypotheses. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), a 2-stage instrumental variable approach was applied to address endogeneity and estimate causal relationships between internet usage and depression. Results: The findings indicate that internet usage results in a 1.41\% reduction in depression levels among older adults. This effect is mediated by four primary mechanisms: (1) enhanced social interaction, (2) increased physical activity, (3) improved intergenerational contact, and (4) expanded access to educational opportunities. A heterogeneity analysis revealed that these effects are more pronounced in urban areas, eastern regions, and regions with superior internet infrastructure. Conclusions: Internet usage plays a crucial role in alleviating depression among older adults in high-income countries, with regional variations. The findings highlight the need for targeted policy interventions to improve internet access and digital literacy, which can mitigate depression and enhance the mental health of older adults. ",
doi="10.2196/65399",
url="https://www.jmir.org/2025/1/e65399"
}


@Article{info:doi/10.2196/64763,
author="Shade, Marcia
and Yan, Changmin
and Jones, K. Valerie
and Boron, Julie",
title="Evaluating Older Adults' Engagement and Usability With AI-Driven Interventions: Randomized Pilot Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="24",
volume="9",
pages="e64763",
keywords="voice assistant",
keywords="interventions",
keywords="usability",
keywords="engagement",
keywords="personality",
keywords="older adults",
keywords="aging",
keywords="technology",
keywords="artificial intelligence",
keywords="AI",
keywords="self-management",
keywords="pilot trial",
keywords="chronic",
keywords="musculoskeletal pain",
keywords="AI assistant",
keywords="Alexa",
keywords="user experience",
keywords="digital health",
keywords="digital intervention",
keywords="mobile phone",
abstract="Background: Technologies that serve as assistants are growing more popular for entertainment and aiding in daily tasks. Artificial intelligence (AI) in these technologies could also be helpful to deliver interventions that assist older adults with symptoms or self-management. Personality traits may play a role in how older adults engage with AI technologies. To ensure the best intervention delivery, we must understand older adults' engagement with and usability of AI-driven technologies. Objective: This study aimed to describe how older adults engaged with routines facilitated by a conversational AI assistant. Methods: A randomized pilot trial was conducted for 12-weeks in adults aged 60 years or older, self-reported living alone, and having chronic musculoskeletal pain. Participants (N=50) were randomly assigned to 1 of 2 intervention groups (standard vs enhanced) to engage with routines delivered by the AI assistant Alexa (Amazon). Participants were encouraged to interact with prescribed routines twice daily (morning and evening) and as needed. Data were collected and analyzed on routine engagement characteristics and perceived usability of the AI assistant. An analysis of the participants' personality traits was conducted to describe how personality may impact engagement and usability of AI technologies as interventions. Results: The participants had a mean age of 79 years, with moderate to high levels of comfort and trust in technology, and were predominately White (48/50, 96\%) and women (44/50, 88\%). In both intervention groups, morning routines (n=62, 74\%) were initiated more frequently than evening routines (n=52, 62\%; z=?2.81, P=.005). Older adult participants in the enhanced group self-reported routine usability as good (mean 74.50, SD 11.90), and those in the standard group reported lower but acceptable usability scores (mean 66.29, SD 6.94). Higher extraversion personality trait scores predicted higher rates of routine initiation throughout the whole day and morning in both groups (standard day: B=0.47, P=.004; enhanced day: B=0.44, P=.045; standard morning: B=0.50, P=.03; enhanced morning: B=0.53, P=.02). Higher agreeableness (standard: B=0.50, P=.02; enhanced B=0.46, P=.002) and higher conscientiousness (standard: B=0.33, P=.04; enhanced: B=0.38, P=.006) personality trait scores predicted better usability scores in both groups. Conclusions: he prescribed interactive routines delivered by an AI assistant were feasible to use as interventions with older adults. Engagement and usability by older adults may be influenced by personality traits such as extraversion, agreeableness, and conscientiousness. While integrating AI-driven interventions into health care, it is important to consider these factors to promote positive outcomes. Trial Registration: ClinicalTrials.gov NCT05387447; https://clinicaltrials.gov/study/NCT05387447 ",
doi="10.2196/64763",
url="https://formative.jmir.org/2025/1/e64763"
}


@Article{info:doi/10.2196/64564,
author="Zhang, Kaili
and Huang, Bowen
and Divigalpitiya, Prasanna",
title="Identifying Community-Built Environment's Effect on Physical Activity and Depressive Symptoms Trajectories Among Middle-aged and Older Adults: Chinese National Longitudinal Study",
journal="JMIR Public Health Surveill",
year="2025",
month="Jan",
day="13",
volume="11",
pages="e64564",
keywords="community-built environment",
keywords="physical activity",
keywords="depressive symptom trajectories",
keywords="middle-aged and older adults",
keywords="latent growth curve modeling",
keywords="longitudinal study",
abstract="Background: The effects of physical activity (PA) across different domains and intensities on depressive symptoms remain inconclusive. Incorporating the community-built environment (CBE) into longitudinal analyses of PA's impact on depressive symptoms is crucial. Objective: This study aims to examine the effects of PA at different intensities---low-intensity PA (eg, walking activities) and moderate-to-vigorous-intensity PA (eg, activities requiring substantial effort and causing faster breathing or shortness of breath)---across leisure-time and occupational domains on depressive symptom trajectories among middle-aged and older adults. Additionally, it investigated how CBEs influence depressive symptoms and PA trajectories. Methods: This longitudinal study included 6865 middle-aged and older adults from the China Health and Retirement Longitudinal Survey. A CBE variable system was developed using a community questionnaire to assess attributes of the physical built environment. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Latent growth curve modeling was applied to analyze 3 waves of the cohort data (2015, 2018, and 2020) to explore the differential effects of PA on depressive symptoms and the role of the CBE. Results: In the 2015 and 2018 waves, higher low-intensity leisure-time physical activity (LTPA) was associated with lower depressive symptoms ($\beta$=--.025, P=.01 and $\beta$=--.027, P=.005, respectively). Across all waves, moderate-to-vigorous-intensity LTPA showed no significant predictive effects (P=.21 in 2015, P=.57 in 2018, and P=.85 in 2020, respectively). However, higher occupational physical activity (OPA), particularly at moderate-to-vigorous intensities, was consistently associated with higher depressive symptoms. Parallel process latent growth curve modeling revealed that the initial level of total LTPA negatively predicted the initial level of depressive symptoms ($\beta$=--.076, P=.01). OPA exhibited dual effects, positively predicting the initial level of depressive symptoms ($\beta$=.108, P<.001) but negatively predicting their upward trajectory ($\beta$=--.136, P=.009). Among CBE variables, better infrastructure conditions ($\beta$=--.082, P<.001) and greater accessibility to public facilities ($\beta$=--.036, P=.045) negatively predicted the initial level of depressive symptoms. However, greater accessibility to public facilities positively predicted the upward trajectory of depressive symptoms ($\beta$=.083, P=.04). Better infrastructure conditions ($\beta$=.100, P=.002) and greater accessibility to public transport ($\beta$=.060, P=.01) positively predicted the initial level of total LTPA. Meanwhile, better infrastructure conditions ($\beta$=--.281, P<.001) and greater accessibility to public facilities ($\beta$=--.073, P<.001) negatively predicted the initial level of total OPA. Better infrastructure conditions positively predicted the declining trajectory of total OPA ($\beta$=.100, P=.004). Conclusions: This study underscores the importance of considering the differential effects of PA across domains and intensities on depressive symptoms in public policies and guidelines. Given the influence of the environment on PA and depressive symptoms, targeted community measures should be implemented. ",
doi="10.2196/64564",
url="https://publichealth.jmir.org/2025/1/e64564",
url="http://www.ncbi.nlm.nih.gov/pubmed/39804686"
}


@Article{info:doi/10.2196/62824,
author="Valla, Guido Luca
and Rossi, Michele
and Gaia, Alessandra
and Guaita, Antonio
and Rolandi, Elena",
title="The Impact of the COVID-19 Pandemic on Oldest-Old Social Capital and Health and the Role of Digital Inequalities: Longitudinal Cohort Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="9",
volume="27",
pages="e62824",
keywords="older adults",
keywords="information and communication technology",
keywords="ICT",
keywords="ICT use",
keywords="COVID-19",
keywords="social capital",
keywords="health",
keywords="mental health",
keywords="digital divide",
abstract="Background: During the COVID-19 pandemic, information and communication technology (ICT) became crucial for staying connected with loved ones and accessing health services. In this scenario, disparities in ICT use may have exacerbated other forms of inequality, especially among older adults who were less familiar with technology and more vulnerable to severe COVID-19 health consequences. Objective: This study investigated changes in ICT use, psychological and physical health, and social capital before and after the pandemic among the oldest old population (aged 80 years or older after the pandemic) and explored how internet use influenced these changes. Methods: We leveraged data from the InveCe.Ab study, a population-based longitudinal cohort of people born between 1935 and 1939 and living in Abbiategrasso, a municipality on the outskirts of Milan, Italy. Participants underwent multidimensional assessment at baseline (2010) and after 2, 4, 8, and 12 years. We restricted our analysis to cohort members who participated in the last wave (ie, 2022) and who did not have a diagnosis of dementia (n=391). We used linear mixed models to assess the impact of COVID-19 and time on changes in social capital, physical and psychological health, and ICT use in a discontinuity regression design while controlling for age, sex, education, and income satisfaction. Then, we assessed the influence of internet use and its interaction with COVID-19 on these changes. Results: COVID-19 had a significant impact on social relationships ($\beta$=--4.35, 95\% CI 6.38 to --2.32; P<.001), cultural activities ($\beta$=--.55, 95\% CI --0.75 to --0.35; P<.001), cognitive functioning ($\beta$=--1.00, 95\% CI --1.28 to --0.72; P<.001), depressive symptoms ($\beta$=.42, 95\% CI 0.10-0.74; P=.009), physical health ($\beta$=.07, 95\% CI 0.04-0.10; P<.001), and ICT use ($\beta$=--.11, 95\% CI --0.18 to --0.03; P=.008). Internet use predicts reduced depressive symptoms ($\beta$=--.56, 95\% CI --1.07 to --0.06; P=.03) over time. The interaction between internet use and COVID-19 was significant for cultural activities ($\beta$=--.73, 95\% CI --1.22 to --0.24; P=.003) and cognitive functioning ($\beta$=1.36, 95\% CI 0.67-2.05; P<.001). Conclusions: The pandemic had adverse effects on older adults' health and social capital. Contrary to expectations, even ICT use dropped significantly after the pandemic. Internet users maintained higher psychological health regardless of time and COVID-19 status. However, COVID-19 was associated with a steeper decline in cognitive functioning among internet nonusers. Policy makers may develop initiatives to encourage ICT adoption among older adults or strengthen their digital skills. Trial Registration: ClinicalTrials.gov NCT01345110; https://clinicaltrials.gov/study/NCT01345110 ",
doi="10.2196/62824",
url="https://www.jmir.org/2025/1/e62824"
}


@Article{info:doi/10.2196/63856,
author="DeLange Martinez, Pauline
and Tancredi, Daniel
and Pavel, Misha
and Garcia, Lorena
and Young, M. Heather",
title="Adapting the Technology Acceptance Model to Examine the Use of Information Communication Technologies and Loneliness Among Low-Income, Older Asian Americans: Cross-Sectional Survey Analysis",
journal="JMIR Aging",
year="2025",
month="Jan",
day="8",
volume="8",
pages="e63856",
keywords="social isolation",
keywords="loneliness",
keywords="aged",
keywords="older adults",
keywords="Asian American",
keywords="immigrant",
keywords="vulnerable populations",
keywords="internet",
keywords="information and communication technologies",
keywords="ICTs",
keywords="digital divide",
keywords="technology acceptance model",
keywords="mobile phone",
abstract="Background: Loneliness is a significant issue among older Asian Americans, exacerbated by the COVID-19 pandemic. Older age, lower income, limited education, and immigrant status heighten loneliness risk. Information communication technologies (ICTs) have been associated with decreased loneliness among older adults. However, older Asian Americans are less likely to use ICTs, particularly if they are immigrants, have limited English proficiency, or are low income. The Technology Acceptance Model posits that perceived usefulness (PU), and perceived ease of use (PEOU) are key factors in predicting technology use. Objective: This study aimed to examine associations between PU, PEOU, ICT use, and loneliness among low-income, older Asian Americans. Methods: Cross-sectional survey data were gathered from predominately older Asian Americans in affordable senior housing (N=401). Using exploratory factor analysis and Horn parallel analysis, we examined 12 survey items to identify factors accounting for variance in ICT use. We deployed structural equation modeling to explore relationships among the latent factors and loneliness, adjusting for demographic and cognitive factors. Results: Exploratory factor analysis and Horn parallel analysis revealed 3 factors that accounted for 56.48\% (6.78/12) total variance. PEOU combined items from validated subscales of tech anxiety and comfort, accounting for a 28.44\% (3.41/12) variance. ICT use combined years of technological experience, computer, tablet, and smartphone use frequency, accounting for 15.59\% (1.87/12) variance. PU combined 2 items assessing the usefulness of technology for social connection and learning and accounted for a 12.44\% (1.49/12) variance. The 3-factor structural equation modeling revealed reasonable fit indexes ($\chi$2133=345.132; P<.001, chi-square minimum (CMIN)/df = 2595, comparative fit index (CFI)=0.93, Tucker-Lewis Index (TLI)=0.88). PEOU was positively associated with PU ($\beta$=.15; P=.01); PEOU and PU were positive predictors of ICT use (PEOU $\beta$=.26, P<.001; PU $\beta$=.18, P=.01); and ICT use was negatively associated with loneliness ($\beta$=--.28, P<.001). Demographic and health covariates also significantly influenced PU, PEOU, ICT use, and loneliness.  English proficiency and education positively predicted PEOU (r=0.25, P<.001; r=0.26, P<.001) and ICT use ($\beta$=1.66, P=.03; $\beta$=.21, P<.001), while subjective cognitive decline and Asian ethnicity were positively associated with loneliness ($\beta$=.31, P<.001; $\beta$=.25, P<.001). Conclusions: This study suggests that targeted interventions enhancing PU or PEOU could increase ICT acceptance and reduce loneliness among low-income Asian Americans. Findings also underscore the importance of considering limited English proficiency and subjective cognitive decline when designing interventions and in future research. ",
doi="10.2196/63856",
url="https://aging.jmir.org/2025/1/e63856"
}


@Article{info:doi/10.2196/60483,
author="Chadwick, Helen
and Laverty, Louise
and Finnigan, Robert
and Elias, Robert
and Farrington, Ken
and Caskey, J. Fergus
and van der Veer, N. Sabine",
title="Engagement With Digital Health Technologies Among Older People Living in Socially Deprived Areas: Qualitative Study of Influencing Factors",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="26",
volume="8",
pages="e60483",
keywords="aged",
keywords="digital health",
keywords="health equity",
keywords="intersectionality, qualitative research",
keywords="social deprivation",
abstract="Background: The potential benefits of incorporating digital technologies into health care are well documented. For example, they can improve access for patients living in remote or underresourced locations. However, despite often having the greatest health needs, people who are older or living in more socially deprived areas may be less likely to have access to these technologies and often lack the skills to use them. This puts them at risk of experiencing further health inequities. In addition, we know that digital health inequities associated with older age may be compounded by lower socioeconomic status. Yet, there is limited research on the intersectional barriers and facilitators for engagement with digital health technology by older people who are particularly marginalized. Objective: This study aimed to explore factors influencing engagement with digital health technologies among people at the intersection of being older and socially deprived. Methods: We conducted semistructured interviews with people who were 70 years or older, living in a socially deprived area, or both. Chronic kidney disease was our clinical context. We thematically analyzed interview transcripts using the Unified Theory of Acceptance and Use of Technology as a theoretical framework. Results: We interviewed 26 people. The majority were White British (n=20) and had moderate health and digital literacy levels (n=10 and n=11, respectively). A total of 13 participants were 70 years of age or older and living in a socially deprived area. Across participants, we identified 2 main themes from the interview data. The first showed that some individuals did not use digital health technologies due to a lack of engagement with digital technology in general. The second theme indicated that people felt that digital health technologies were ``not for them.'' We identified the following key engagement factors, with the first 2 particularly impacting participants who were both older and socially deprived: lack of opportunities in the workplace to become digitally proficient; lack of appropriate support from family and friends; negative perceptions of age-related social norms about technology use; and reduced intrinsic motivation to engage with digital health technology because of a perceived lack of relevant benefits. Participants on the intersection of older age and social deprivation also felt significant anxiety around using digital technology and reported a sense of distrust toward digital health care. Conclusions: We identified factors that may have a more pronounced negative impact on the health equity of older people living in socially deprived areas compared with their counterparts who only have one of these characteristics. Successful implementation of digital health interventions therefore warrants dedicated strategies for managing the digital health equity impact on this group. Future studies should further develop these strategies and investigate their effectiveness, as well as explore the influence of related characteristics, such as educational attainment and ethnicity. ",
doi="10.2196/60483",
url="https://formative.jmir.org/2024/1/e60483"
}


@Article{info:doi/10.2196/57622,
author="Probst, Freya
and Rees, Jessica
and Aslam, Zayna
and Mexia, Nikitia
and Molteni, Erika
and Matcham, Faith
and Antonelli, Michela
and Tinker, Anthea
and Shi, Yu
and Ourselin, Sebastien
and Liu, Wei",
title="Evaluating a Smart Textile Loneliness Monitoring System for Older People: Co-Design and Qualitative Focus Group Study",
journal="JMIR Aging",
year="2024",
month="Dec",
day="17",
volume="7",
pages="e57622",
keywords="loneliness",
keywords="smart textiles",
keywords="wearable technology",
keywords="health monitoring",
keywords="older people",
keywords="co-design",
keywords="design requirement",
keywords="mobile phone",
abstract="Background: Previous studies have explored how sensor technologies can assist in in the detection, recognition, and prevention of subjective loneliness. These studies have shown a correlation between physiological and behavioral sensor data and the experience of loneliness. However, little research has been conducted on the design requirements from the perspective of older people and stakeholders in technology development. The use of these technologies and infrastructural questions have been insufficiently addressed. Systems generally consist of sensors or software installed in smartphones or homes. However, no studies have attempted to use smart textiles, which are fabrics with integrated electronics. Objective: This study aims to understand the design requirements for a smart textile loneliness monitoring system from the perspectives of older people and stakeholders. Methods: We conducted co-design workshops with 5 users and 6 stakeholders to determine the design requirements for smart textile loneliness monitoring systems. We derived a preliminary product concept of the smart wearable and furniture system. Digital and physical models and a use case were evaluated in a focus group study with older people and stakeholders (n=7). Results: The results provided insights for designing systems that use smart textiles to monitor loneliness in older people and widen their use. The findings informed the general system, wearables and furniture, materials, sensor positioning, washing, sensor synchronization devices, charging, intervention, and installation and maintenance requirements. This study provided the first insight from a human-centered perspective into smart textile loneliness monitoring systems for older people. Conclusions: We recommend more research on the intervention that links to the monitored loneliness in a way that addresses different needs to ensure its usefulness and value to people. Future systems must also reflect on questions of identification of system users and the available infrastructure and life circumstances of people. We further found requirements that included user cooperation, compatibility with other worn medical devices, and long-term durability. ",
doi="10.2196/57622",
url="https://aging.jmir.org/2024/1/e57622",
url="http://www.ncbi.nlm.nih.gov/pubmed/39688889"
}


@Article{info:doi/10.2196/63907,
author="Jeon, Sangha
and Charles, Turk Susan",
title="Internet-Based Social Activities and Cognitive Functioning 2 Years Later Among Middle-Aged and Older Adults: Prospective Cohort Study",
journal="JMIR Aging",
year="2024",
month="Dec",
day="10",
volume="7",
pages="e63907",
keywords="online social interaction",
keywords="cognitive health",
keywords="age differences",
keywords="Health and Retirement Study",
keywords="social activity",
keywords="internet use",
keywords="isolation",
abstract="Background: A number of studies document the benefits of face-to-face social interactions for cognitive functioning among middle-aged and older adults. Social activities in virtual worlds may confer similar if not enhanced cognitive benefits as face-to-face social activities, given that virtual interactions require the additional cognitive tasks of learning and navigating communicative tools and technology platforms. Yet, few studies have examined whether social activities in internet-based settings may have synergistic effects on cognitive functioning beyond those of face-to-face interactions. Objective: This study examined whether internet-based social activity participation is associated with concurrent and later cognitive functioning, after adjusting for face-to-face social activity participation and sociodemographic covariates. Methods: For cross-sectional analyses, we included 3650 adults aged 50 years and older who completed questions in the 2020 Health and Retirement Study about social activity participation, including specific internet-based social activities such as emailing or accessing social networks. Cognitive functioning was measured using the standardized cognitive tasks assessing working memory, episodic memory, and attention and processing speed. The longitudinal analyses included the 2034 participants who also completed follow-up cognitive assessments in 2022. Results: Our results revealed that those with higher levels of internet-based social activity participation had higher levels of concurrent cognitive functioning than those with low levels of internet-based social activity participation, after adjusting for demographic and health-related factors and face-to-face social activity participation (b=0.44, SE 0.07; P<.001). More internet-based social activity participation also predicted better cognitive functioning 2 years later, even when adjusting for baseline cognitive functioning and other covariates (b=0.35, SE 0.09; P<.001). Conclusions: Our findings suggest that greater engagement in internet-based social activities is associated with higher levels of concurrent cognitive functioning and slower cognitive decline in middle-aged and older adults. ",
doi="10.2196/63907",
url="https://aging.jmir.org/2024/1/e63907"
}


@Article{info:doi/10.2196/58051,
author="Naud{\'e}, B{\'e}rang{\`e}re
and Rigaud, Anne-Sophie
and Pino, Maribel",
title="Investigating the Acceptability of an Interactive Television Intervention Promoting Social Links Among Older Adults Living at Home and in Care Institutions: Qualitative Interview and Questionnaire Study",
journal="JMIR Hum Factors",
year="2024",
month="Dec",
day="2",
volume="11",
pages="e58051",
keywords="interactive television",
keywords="iTV",
keywords="acceptance",
keywords="older adults",
keywords="nursing home",
keywords="residential facility",
keywords="technology acceptance model",
keywords="TAM",
keywords="mobile phone",
abstract="Background: When older adults (OAs) can no longer live independently at home, they have the option to choose from various types of geriatric care institutions, such as residential facilities or nursing homes. For several years now, thanks to the development of interactive television (iTV), social link functions have been accessible directly on televisions, tools that are already integrated into residents' rooms. The acceptance of technologies specifically targeting older users, as well as iTV, has been widely documented in the literature, incorporating factors from the innovation resistance model. Objective: This research aims to enrich the acceptance of existing models of innovation by OAs living in different settings. Methods: User tests were carried out to evaluate OAs' experiences with iTV and identify the factors involved in its acceptance. A total of 32 OAs living at home, in nursing homes, or in residential facilities in France were interviewed between November 2022 and June 2023. iTV acceptance was examined using an interview grid based on the technology acceptance model and included the following factors: intention to use, perceived usefulness, perceived ease of use, user resistance, anxiety, facilitating conditions, and user characteristics. Results: The deductive qualitative analysis based on the technology acceptance model helped to identify 33 concepts. Conclusions: This study has contributed to the literature on the acceptance of iTV by OAs living at home and in geriatric institutions, particularly by enriching existing models and proposing new avenues for reflection. ",
doi="10.2196/58051",
url="https://humanfactors.jmir.org/2024/1/e58051"
}


@Article{info:doi/10.2196/52294,
author="Pe{\~n}a, Jorge
and Koebner, Ian
and Weisman, William",
title="Using Digital Art and Attachment Priming in a Web-Based Serious Game to Reduce Pain and Social Disconnection in Individuals With Chronic Pain and Loneliness: Randomized Controlled Trial",
journal="JMIR Serious Games",
year="2024",
month="Nov",
day="27",
volume="12",
pages="e52294",
keywords="pain",
keywords="social disconnection",
keywords="loneliness",
keywords="randomized controlled trial",
keywords="art",
keywords="museums",
keywords="virtual reality",
keywords="serious games",
keywords="virtual art",
keywords="chronic pain and loneliness",
keywords="attachment",
keywords="priming",
keywords="mediation",
keywords="intervention",
keywords="cyberpsychology",
keywords="mental health",
abstract="Background: Arts engagement using virtual reality and serious games represent promising nonpharmacological self-management treatment approaches to chronic pain. This study is the first randomized controlled trial to explore the impact of a web-based serious game that simulated a visit to an art museum on pain and social disconnection among individuals living with chronic pain and loneliness. Objective: This study aimed to test the joint and separate effects of exposure to digital art and attachment figure priming on pain and social disconnection among individuals living with chronic pain and loneliness. Methods: This randomized controlled trial used a 2 (digital artwork present and absent) {\texttimes} 2 (secure attachment and avoidant attachment prime) repeated measures factorial web-based experimental design with a hanging control condition. Mediation and moderation analyses examined how feelings about the social world triggered by the artwork and frequency of museum visits impacted the effects of the interventions on pain and social disconnection. Results: The results are based on 308 participants. Mean age of the participants was 42.78 (SD 13.11; range 18-76) years, and 60.2\% (n=186) were women. Posttest pain was lower than pretest pain for the artwork present (P=.001) and absent (P=.001) conditions. Similarly, posttest pain was lower than pretest pain for the secure (P=.001) and avoidant (P=.001) attachment priming conditions. Relative to the control group, artwork present (P=.001) and absent (P=.01) conditions had decreased posttest pain. The secure (P=.001) and avoidant (P=.001) attachment priming conditions also had lower posttest pain scores relative to the control group. Moreover, social disconnection decreased from pre- to posttest for both the artwork present (P=.04) and the secure attachment priming (P=.002) conditions. Relative to the control group, posttest social disconnection was lower for the artwork present (P=.02) and secure attachment priming condition (P=.03). The artwork-secure attachment (P=.001) and artwork-avoidant attachment (P=.006) conditions had lower posttest pain scores compared with the control group. Social disconnection decreased from pre- to posttest for the artwork-secure attachment (P=.01) and no artwork-secure attachment (P=.05) conditions. Posttest social disconnection was lower for the artwork-secure attachment condition compared with the control group (P=.04). Positive feelings about the social world triggered by artwork exposure and frequency of museum visits in the last year played a mediating and moderating role in these effects. Positive feelings about the social world were associated with decreased pain (B=?.53) and social disconnection (B=?.25), and these effects operated on individuals exposed to digital artwork at low, medium, and high frequency of physical museum visits. Conclusions: Relative to a control group, visiting a web-based art museum reliably decreased pain and social disconnection among individuals living with chronic pain and loneliness. Engaging with digital artwork that triggers positive feelings about the social world may mitigate the burden of chronic pain. Trial Registration: ClinicalTrials.gov NCT05310747; https://clinicaltrials.gov/study/NCT05310747 ",
doi="10.2196/52294",
url="https://games.jmir.org/2024/1/e52294"
}


@Article{info:doi/10.2196/63092,
author="Vagnetti, Roberto
and Camp, Nicola
and Story, Matthew
and Ait-Belaid, Khaoula
and Mitra, Suvobrata
and Fowler Davis, Sally
and Meese, Helen
and Zecca, Massimiliano
and Di Nuovo, Alessandro
and Magistro, Daniele",
title="Social Robots and Sensors for Enhanced Aging at Home: Mixed Methods Study With a Focus on Mobility and Socioeconomic Factors",
journal="JMIR Aging",
year="2024",
month="Nov",
day="25",
volume="7",
pages="e63092",
keywords="older adults",
keywords="motor difficulties",
keywords="socioeconomic status",
keywords="social assistive robots",
keywords="monitoring technologies",
keywords="mixed methods",
abstract="Background: Population aging affects society, with a profound impact on daily activities for those of a low socioeconomic status and with motor impairments. Social assistive robots (SARs) and monitoring technologies can improve older adults' well-being by assisting with and monitoring home activities. Objective: This study explored the opinions and needs of older adults, including those with motor difficulties and of a low socioeconomic status, regarding SARs and monitoring technologies at home to promote daily activities and reduce sedentary behaviors. Methods: A mixed methods approach was used, with 31 older adults divided into 3 groups: those of a low socioeconomic status, those with motor difficulties, and healthy individuals. Focus groups were conducted, and they were analyzed using thematic analysis. Perceived mental and physical well-being were assessed using the 12-Item Short Form Health Survey, and attitudes toward robots were evaluated using the Multidimensional Robot Attitude Scale. Results: The results identified 14 themes in four key areas: (1) technology use for supporting daily activities and reducing sedentary behaviors, (2) perceived barriers, (3) suggestions and preferences, and (4) actual home technology use. Lower perceived physical well-being was associated with higher levels of familiarity, interest, perceived utility, and control related to SARs. Lower perceived psychological well-being was linked to a more negative attitude, increased concerns about environmental fit, and a preference for less variety. Notably, older adults from the low--socioeconomic status group perceived less control over SARs, whereas older adults with motor difficulties expressed higher perceived utility compared to other groups, as well as higher familiarity and interest compared to the low--socioeconomic status group. Conclusions: Participants indicated that SARs and monitoring technologies could help reduce sedentary behaviors by assisting in the management of daily activities. The results are discussed in the context of these outcomes and the implementation of SARs and monitoring technologies at home. This study highlights the importance of considering the functional and socioeconomic characteristics of older adults as future users of SARs and monitoring technologies to promote widespread adoption and improve well-being within this population. ",
doi="10.2196/63092",
url="https://aging.jmir.org/2024/1/e63092"
}


@Article{info:doi/10.2196/51214,
author="Ware, Paul",
title="Social Cohesion and COVID-19: Integrative Review",
journal="Interact J Med Res",
year="2024",
month="Nov",
day="21",
volume="13",
pages="e51214",
keywords="social cohesion",
keywords="social capital",
keywords="COVID-19",
keywords="infrastructure",
keywords="tool",
keywords="social",
keywords="economic",
keywords="interpersonal",
keywords="interpersonal relationship",
keywords="emotions",
keywords="pandemic",
keywords="engagement",
keywords="health behaviors",
keywords="resilience",
keywords="emotional well-being",
keywords="well-being",
abstract="Background: Nations of considerable wealth and sophisticated health care infrastructures have experienced high rates of illness and death from COVID-19. Others with limited economic means and less developed health systems have achieved much lower burdens. To build a full understanding, an appraisal of the contribution of social relationships is necessary. Social cohesion represents a promising conceptual tool. Objective: This study aimed to examine scholarship on social cohesion during the COVID-19 pandemic: specifically, the constructions of social cohesion being deployed, the variables chosen for representation, and the effects of and on social cohesion being reported. Methods: The PubMed, Scopus, and JSTOR databases were searched for relevant journal articles and gray literature. A total of 100 studies met the inclusion criteria. Data were extracted and analyzed from these using spreadsheet software. Results: Several constructions of social cohesion were found. These concerned interpersonal relationships, sameness and difference, collective action, perceptions or emotions of group members, structures and institutions of governance, locally or culturally specific versions, and hybrid or multidimensional models. Social cohesion was reported to be influential on health outcomes, health behaviors, resilience, and emotional well-being, but there was some potential for it to drive undesirable outcomes. Scholarship reported increases or decreases in quantitative measures of social cohesion, a temporary ``rally round the flag'' effect early in the pandemic, the variable impacts of policy on social cohesion, and changing interpersonal relationships due to the pandemic conditions. There are numerous issues with the literature that reflect the well-documented limitations of popular versions of the concept. Conclusions: Social cohesion has been used to express a range of different aspects of relationships during the pandemic. It is claimed to promote better health outcomes, more engagement with positive health behaviors, and greater resilience and emotional well-being. The literature presents a range of ways in which it has been altered by the pandemic conditions. There are significant weaknesses to this body of knowledge that greatly impede its overall quality. ",
doi="10.2196/51214",
url="https://www.i-jmr.org/2024/1/e51214"
}


@Article{info:doi/10.2196/57352,
author="Wong, Ching Arkers Kwan
and Zhang, Qian Melissa
and Bayuo, Jonathan
and Chow, Sum Karen Kit
and Wong, Man Siu
and Wong, Po Bonnie
and Liu, Man Bob Chung
and Lau, Ho David Chi
and Kowatsch, Tobias",
title="The Effect of Young People--Assisted, Individualized, Motion-Based Video Games on Physical, Cognitive, and Social Frailty Among Community-Dwelling Older Adults With Frailty: Randomized Controlled Trial",
journal="JMIR Serious Games",
year="2024",
month="Nov",
day="20",
volume="12",
pages="e57352",
keywords="frailty",
keywords="gaming intervention",
keywords="motion-based",
keywords="video games",
keywords="older adults",
keywords="gerontology",
keywords="geriatrics",
keywords="randomized controlled trial",
keywords="RCT",
keywords="physical fitness",
keywords="adolescents",
keywords="young people--assisted",
keywords="eHealth literacy",
keywords="well-being",
keywords="therapists",
keywords="youth volunteers",
keywords="social support",
keywords="exergames",
keywords="gamification",
keywords="active games",
keywords="physical activity",
abstract="Background: The aging population highlights the need to maintain both physical and psychological well-being. Frailty, a multidimensional syndrome, increases vulnerability to adverse outcomes. Although physical exercise is effective, adherence among older adults with frailty is often low due to barriers. Motion-based video games (MBVGs) may enhance motivation and engagement. Objective: This study aims to evaluate the effect of individualized exercise programs that combine MBVGs, intergenerational support, and therapeutic frameworks on physical, cognitive, and social frailty outcomes in community-dwelling older adults. Methods: This randomized controlled trial was conducted from March 2022 to October 2023 across 6 community centers in Hong Kong. Participants aged 60 years and above with mild neurocognitive disorder were recruited, screened, and randomly assigned to either an intervention (n=101) or control group (n=101). The intervention included an 18-week program with 12 supervised exercise sessions utilizing motion-based technology, led by occupational therapists and assisted by youth volunteers. Data were collected at baseline (T1) and postintervention (T2), focusing on physical, cognitive, and social frailty outcomes, as well as client-related metrics. Statistical analyses were performed using SPSS, with significance set at P<.05. Results: A total of 202 participants were recruited, with a mean age of 78.8 years (SD 7.8). Both groups showed improvements in balance from T1 to T2, with a significant time effect ($\beta$=?0.63, P=.03). The intervention group demonstrated enhancements in hand strength and BMI, but no statistically significant between-group differences were observed. The intervention group also exhibited significant improvements in cognitive function ($\beta$=2.43, P<.001), while the control group's scores declined. Short-term memory improved for both groups, with no significant differences noted. Both groups experienced a reduction in depression levels, with a significant within-group effect at T2 ($\beta$=?1.16, P=.001). Improvements in social connectedness and eHealth literacy were observed in both groups, with the latter showing a significant within-group effect at T2 ($\beta$=3.56, P=.002). No significant effects were found for social isolation, physical activities, or quality of life. Conclusions: The growing aging population necessitates innovative strategies to support aging in place. Results indicated statistically significant improvements only in BMI and cognition, while other outcomes such as loneliness, balance, and eHealth literacy showed positive trends but lacked significance. Despite the limitations observed, particularly regarding the role of volunteer support and the diverse needs of community-dwelling older adults, the findings contribute to the foundation for future research aimed at enhancing biopsychosocial outcomes. Future studies should explore tailored interventions that consider individual preferences and abilities, as well as evaluate specific components of motion-based video games to optimize their effectiveness. Trial Registration: ClinicalTrials.gov NCT05267444; https://clinicaltrials.gov/study/NCT05267444 ",
doi="10.2196/57352",
url="https://games.jmir.org/2024/1/e57352"
}


@Article{info:doi/10.2196/53156,
author="Kershner, Kyle
and Morton, David
and Robison, Justin
and N'dah, Williams Kindia
and Fanning, Jason",
title="Assessing the Feasibility and Acceptability of Virtual Reality for Remote Group-Mediated Physical Activity in Older Adults: Pilot Randomized Controlled Trial",
journal="JMIR Form Res",
year="2024",
month="Nov",
day="8",
volume="8",
pages="e53156",
keywords="virtual reality",
keywords="physical activity",
keywords="videoconference",
keywords="social connection",
keywords="remote meeting",
keywords="gerontology",
keywords="physical inactivity",
keywords="at-home intervention",
keywords="descriptive statistics",
keywords="eHealth",
keywords="comorbidity",
keywords="cybersickness",
abstract="Background: Physical inactivity represents a major health concern for older adults. Most social, at-home physical activity (PA) interventions use videoconference, email, or telephone communication for program delivery. However, evidence suggests that these platforms may hinder the social connection experienced by users. Recent advancements in virtual reality (VR) suggest that it may be a rich platform for social, at-home interventions because it offers legitimate options for intervention delivery and PA. Objective: This pilot study aims to determine the feasibility and acceptability of VR compared to videoconference as a medium for remote group-mediated behavioral intervention for older adults. The information generated from this investigation will inform the use of VR as a medium for intervention delivery. Methods: Nine low-active older adults (mean age 66.8, SD 4.8 y) were randomized to a 4-week home-based, group-mediated PA intervention delivered via VR or videoconference. Feasibility (ie, the total number of sessions attended and the number of VR accesses outside of scheduled meetings) and acceptability (ie, the number of participants reporting high levels of nausea, program evaluations using Likert-style prompts with responses ranging from --5=very difficult or disconnected to 5=very easy or connected, and participant feedback on immersion and social connection) are illustrated via descriptive statistics and quotes from open-ended responses. Results: None of the participants experienced severe VR-related sickness before randomization, with a low average sickness rating of 1.6 (SD 1.6) out of 27 points. Attendance rates for group meetings were 98\% (59/60) and 96\% (46/48) for the VR and videoconference groups, respectively. Outside of scheduled meeting times, participants reported a median of 5.5 (IQR 5.3-5.8, range 0-27) VR accesses throughout the entire intervention. Program evaluations suggested that participants felt personally connected to their peers (VR group: median 3.0, IQR 2.5-3.5; videoconference group: median 3.0, IQR 2.7-3.3), found that goals were easy to accomplish (VR group: median 3.0, IQR 2.8-3.3; videoconference group: median 3.0, IQR 2.6-3.4), and had ease in finding PA options (VR group: median 4.0, IQR 3.5-4.3; videoconference group: median 2.0, IQR 1.6-2.4) and engaging in meaningful dialogue with peers (VR group: median 4.0, IQR 4.0-4.0; videoconference group: median 3.5, IQR 3.3-3.8). Open-ended responses regarding VR use indicated increased immersion experiences and intrinsic motivation for PA. Conclusions: These findings suggest that VR may be a useful medium for social PA programming in older adults, given it was found to be feasible and acceptable in this sample. Importantly, all participants indicated low levels of VR-related sickness before randomization, and both groups demonstrated very high attendance at meetings with their groups and behavioral coaches, which is promising for using VR and videoconference in future interventions. Modifications for future iterations of similar interventions are provided. Further work using larger samples and longer follow-up durations is needed. Trial Registration: ClinicalTrials.gov NCT04756245; https://www.clinicaltrials.gov/study/NCT04756245 ",
doi="10.2196/53156",
url="https://formative.jmir.org/2024/1/e53156"
}


@Article{info:doi/10.2196/52640,
author="Ch{\^a}tel, L. Bas D.
and Janssen, M. Jeroen H.
and Peeters, E. Geeske M. E.
and Corten, Rense
and Tieben, Rob
and Deen, Menno
and Hendriks, M. Elmy J.
and Olde Rikkert, M. Marcel G.",
title="Social Gaming to Decrease Loneliness in Older Adults: Recruitment Challenges and Attrition Analysis in a Digital Mixed Methods Feasibility Study",
journal="JMIR Serious Games",
year="2024",
month="Oct",
day="16",
volume="12",
pages="e52640",
keywords="loneliness",
keywords="digital health",
keywords="serious gaming",
keywords="older adults",
keywords="recruitment",
keywords="feasibility study",
abstract="Background: Digital mental health interventions could sustainably and scalably prevent and reduce loneliness in older adults. We designed an app containing 29 text-based games and a questionnaire-administering chatbot to stimulate intergenerational contact. Objective: This study aims to evaluate the feasibility of a social gaming app in reducing loneliness among older adults by evaluating recruitment strategies, data collection procedures, and gameplay activity. Methods: This mixed methods study recruited participants via newsletters, articles, and a social media campaign. We used semistructured interviews and descriptive analysis of questionnaire answers and game data to assess feasibility. Key measures included recruitment reach and efficiency, participant demographics, in-app activity, and app usability and engagement feedback. Results: The social media campaign reached 192,641 potential participants, resulting in 1363 game downloads. A total of 155 participants (aged 65 years and older: n=34, 21.9\% and aged less than 65 years: n=121, 78.1\%) provided informed consent, yielding a conversion rate of 0.08\%. The recruitment campaign focusing on distanced playful interaction had a significantly (P<.001) higher click-through rate (1.98\%) than a campaign focusing on research participation (click-through rate=0.51\%; P<.001). The overall conversion rate from advertisement exposure to research participation was 0.08\%. Participants had a mean age of 48 (SD 16) years. The 65 years and older group averaged 70 (SD 5) years, while the less 65 years group averaged 42 (SD 12) years. Additionally, 45.2\% (57/126) reported at least moderate levels of loneliness at baseline. Of the initial 554 players, 91 (16.4\%) remained active after the first week, and 32 (5.8\%) remained active for more than 90 days. Active participants tended to interact with those within their own age group, as indicated by a Pearson correlation of r=0.31 between the ages of the message sender and receiver. Interviews with 12 (48\%) participants (aged 65-79 years; female: n=12, 83\%) revealed barriers such as excessive chatbot questions and a mismatch between the target group and app design focus. Questionnaire completion rates dropped from 46\% at baseline to 10\% at follow-up. Conclusions: These findings underscore the challenges of recruitment and retention for older adults in a fully digital social gaming intervention. Effective recruitment strategies and targeted app design are crucial for engagement. Based on these insights, future interventions should focus on simplified interfaces, clear guidance for gameplay, and addressing the specific needs and preferences of older adults, thereby enhancing the effectiveness of digital mental health interventions. ",
doi="10.2196/52640",
url="https://games.jmir.org/2024/1/e52640",
url="http://www.ncbi.nlm.nih.gov/pubmed/39412863"
}


@Article{info:doi/10.2196/55761,
author="Nyamathi, Adeline
and Dutt, Nikil
and Lee, Jung-Ah
and Rahmani, M. Amir
and Rasouli, Mahkameh
and Krogh, Donna
and Krogh, Erik
and Sultzer, David
and Rashid, Humayun
and Liaqat, Hamza
and Jawad, Riyam
and Azhar, Farhan
and Ahmad, Ali
and Qamar, Bilal
and Bhatti, Yasin Taha
and Khay, Chet
and Ludlow, Jocelyn
and Gibbs, Lisa
and Rousseau, Julie
and Abbasian, Mahyar
and Song, Yutong
and Jeong, Cheonkam
and Brunswicker, Sabine",
title="Establishing the Foundations of Emotional Intelligence in Care Companion Robots to Mitigate Agitation Among High-Risk Patients With Dementia: Protocol for an Empathetic Patient-Robot Interaction Study",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="4",
volume="13",
pages="e55761",
keywords="persons with dementia",
keywords="empathy-based care companion robot",
keywords="agitation",
keywords="fall risk",
keywords="artificial intelligence",
keywords="AI",
abstract="Background: An estimated 6.7 million persons are living with dementia in the United States, a number expected to double by 2060. Persons experiencing moderate to severe dementia are 4 to 5 times more likely to fall than those without dementia, due to agitation and unsteady gait. Socially assistive robots fail to address the changing emotional states associated with agitation, and it is unclear how emotional states change, how they impact agitation and gait over time, and how social robots can best respond by showing empathy. Objective: This study aims to design and validate a foundational model of emotional intelligence for empathetic patient-robot interaction that mitigates agitation among those at the highest risk: persons experiencing moderate to severe dementia. Methods: A design science approach will be adopted to (1) collect and store granular, personal, and chronological data using Personicle (an open-source software platform developed to automatically collect data from phones and other devices), incorporating real-time visual, audio, and physiological sensing technologies in a simulation laboratory and at board and care facilities; (2) develop statistical models to understand and forecast the emotional state, agitation level, and gait pattern of persons experiencing moderate to severe dementia in real time using machine learning and artificial intelligence and Personicle; (3) design and test an empathy-focused conversation model, focused on storytelling; and (4) test and evaluate this model for a care companion robot (CCR) in the community. Results: The study was funded in October 2023. For aim 1, architecture development for Personicle data collection began with a search for existing open-source data in January 2024. A community advisory board was formed and met in December 2023 to provide feedback on the use of CCRs and provide personal stories. Full institutional review board approval was received in March 2024 to place cameras and CCRs at the sites. In March 2024, atomic marker development was begun. For aim 2, after a review of open-source data on patients with dementia, the development of an emotional classifier was begun. Data labeling was started in April 2024 and completed in June 2024 with ongoing validation. Moreover, the team established a baseline multimodal model trained and validated on healthy-person data sets, using transformer architecture in a semisupervised manner, and later retrained on the labeled data set of patients experiencing moderate to severe dementia. In April 2024, empathy alignment of large language models was initiated using prompt engineering and reinforcement learning. Conclusions: This innovative caregiving approach is designed to recognize the signs of agitation and, upon recognition, intervene with empathetic verbal communication. This proposal has the potential to have a significant impact on an emerging field of computational dementia science by reducing unnecessary agitation and falls of persons experiencing moderate to severe dementia, while reducing caregiver burden. International Registered Report Identifier (IRRID): PRR1-10.2196/55761 ",
doi="10.2196/55761",
url="https://www.researchprotocols.org/2024/1/e55761",
url="http://www.ncbi.nlm.nih.gov/pubmed/39365656"
}


@Article{info:doi/10.2196/64196,
author="Kawaguchi, Kenjiro
and Nakagomi, Atsushi
and Ide, Kazushige
and Kondo, Katsunori",
title="Effects of a Mobile App to Promote Social Participation on Older Adults: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="30",
volume="26",
pages="e64196",
keywords="gerontology",
keywords="geriatrics",
keywords="older adults",
keywords="elderly",
keywords="older people",
keywords="community dwelling older adult",
keywords="aging",
keywords="social participation",
keywords="walking",
keywords="mHealth",
keywords="apps",
keywords="smartphone",
keywords="digital health",
keywords="digital technology",
keywords="digital interventions",
keywords="physical activity",
keywords="exercise",
abstract="Background: Social participation is crucial for healthy aging, improving physical and mental health, cognitive function, and quality of life among older adults. However, social participation tends to decline with age due to factors like loss of social networks and health issues. Mobile health apps show promise in promoting healthy behaviors among older adults, but their effectiveness in increasing social participation remains understudied. Objective: This randomized controlled trial aimed to evaluate the efficacy of a mobile app called Encouragement of Social Participation (ESP, ``Shakai Sanka no Susume;'' Hitachi) in promoting social participation and physical activity among community-dwelling older adults. Methods: The study recruited 181 community-dwelling adults aged 60 years or older from 2 municipalities in Japan and through a web-based research panel. Participants were randomly assigned to either the intervention group (n=87), which used the ESP app for 12 weeks, or the control group (n=94), which used only Google Fit. The ESP app incorporated features such as self-monitoring of social participation, personalized feedback, gamification elements, and educational content. Primary outcomes were changes in social participation frequency over the previous 2 months and changes in step counts, measured at baseline and week 12. Secondary outcomes included changes in specific types of social activities and subjective well-being. Data were analyzed using analysis of covariance and linear mixed-effects models. Results: The intervention group showed a significantly greater increase in social participation frequency compared with the control group (adjusted difference 3.03; 95\% CI 0.17-5.90; P=.04). Specifically, the intervention group demonstrated higher frequencies of participation in hobbies (adjusted difference: 0.82; 95\% CI 0.01-1.63) and cultural clubs (adjusted difference 0.65; 95\% CI 0.07-1.23) compared with the control group. However, there were no significant differences in weekly step counts between the groups. Subgroup analyses suggested potentially larger effects among participants who were older than 70 years, female, had lower educational attainment, and were recruited from community settings, although only females and the lower educational attainment subgroups demonstrated 95\% CIs that did not encompass zero. Conclusions: The ESP mobile app effectively promoted social participation among community-dwelling older adults, particularly in hobbies and cultural club activities. However, it did not significantly impact physical activity levels as measured by step counts. These findings suggest that mobile apps can be valuable tools for encouraging social engagement in older populations, potentially contributing to healthy aging. Future research should focus on optimizing app features to maintain long-term engagement and exploring strategies to enhance physical activity alongside social participation. Trial Registration: University Medical Information Network Clinical Trial Registry UMIN000049045; https://center6.umin.ac.jp/cgi-open-bin/ctr\_e/ctr\_view.cgi?recptno=R000055781 ",
doi="10.2196/64196",
url="https://www.jmir.org/2024/1/e64196",
url="http://www.ncbi.nlm.nih.gov/pubmed/39348180"
}


@Article{info:doi/10.2196/41093,
author="Yoo, In-jin
and Park, Do-Hyung
and Lee, EunKyoung Othelia
and Park, Albert",
title="Investigating Older Adults' Use of a Socially Assistive Robot via Time Series Clustering and User Profiling: Descriptive Analysis Study",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="19",
volume="8",
pages="e41093",
keywords="socially assistive robot",
keywords="older adults",
keywords="robot use pattern",
keywords="time series clustering",
keywords="profiling analysis",
abstract="Background: The aging population and the shortage of geriatric care workers are major global concerns. Socially assistive robots (SARs) have the potential to address these issues, but developing SARs for various types of users is still in its infancy. Objective: This study aims to examine the characteristics and use patterns of SARs. Methods: This study analyzed log data from 64 older adults who used a SAR called Hyodol for 60 days to understand use patterns and their relationship with user characteristics. Data on user interactions, robot-assisted content use, demographics, physical and mental health, and lifestyle were collected. Time series clustering was used to group users based on use patterns, followed by profiling analysis to relate these patterns to user characteristics. Results: Overall, 4 time series clusters were created based on use patterns: helpers, friends, short-term users, and long-term users. Time series and profiling analyses revealed distinct patterns for each group. We found that older adults use SARs differently based on factors beyond demographics and health. This study demonstrates a data-driven approach to understanding user needs, and the findings can help tailor SAR interventions for specific user groups. Conclusions: This study extends our understanding of the factors associated with the long-term use of SARs for geriatric care and makes methodological contributions. ",
doi="10.2196/41093",
url="https://formative.jmir.org/2024/1/e41093"
}


@Article{info:doi/10.2196/51653,
author="Sugaya, Nagisa
and Yamamoto, Tetsuya
and Suzuki, Naho
and Uchiumi, Chigusa",
title="Loneliness and Social Isolation Factors Under the Prolonged COVID-19 Pandemic in Japan: 2-Year Longitudinal Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Sep",
day="9",
volume="10",
pages="e51653",
keywords="COVID-19",
keywords="pandemic",
keywords="loneliness",
keywords="social isolation",
keywords="longitudinal survey",
keywords="epidemiology",
keywords="mental health",
abstract="Background: Worsening loneliness and social isolation during the COVID-19 pandemic have become serious public health concerns worldwide. Despite previous research reporting persistent loneliness and social isolation under repeated emergency declarations and prolonged pandemics, long-term studies are needed to identify the actual conditions of loneliness and social isolation, and the factors that explain them. Objective: In this study, 3 web-based surveys were conducted at 1-year intervals during the 2 years after the first state of emergency to examine changes in loneliness and social isolation and the psychosocial factors associated with them in the Japanese population. Methods: The first survey (phase 1, May 11-12, 2020) was conducted at the end of the first emergency declaration period, the second survey (phase 2, June 14-20, 2021) was conducted at the end of the third emergency declaration period, and the third survey (phase 3, May 13-30, 2022) was conducted when the state of emergency had not been declared but many COVID-19--positive cases occurred during this period. We collected data on 3892 inhabitants (n=1813, 46.58\% women; age: mean 50.3, SD 13.4 y) living in the 4 prefectures where emergency declaration measures were applied in phases 1 and 2. A linear mixed model analysis was performed to examine the association between psychosocial variables as explanatory variables and loneliness scores as the dependent variable in each phase. Results: While many psychosocial and physical variables showed improvement for the 2 years, loneliness, social isolation, and the relationship with familiar people deteriorated, and the opportunities for exercise, favorite activities, and web-based interaction with familiar people decreased. Approximately half of those experiencing social isolation in phase 1 remained isolated throughout the 2-year period, and a greater number of people developed social isolation than those who were able to resolve it. The results of the linear mixed model analysis showed that most psychosocial and physical variables were related to loneliness regardless of the phase. Regarding the variables that showed a significant interaction with the phase, increased altruistic preventive behavior and a negative outlook for the future were more strongly associated with severe loneliness in phase 3 (P=.01 to <.001), while the association between fewer social networks and stronger loneliness tended to be more pronounced in phase 2. Although the interaction was not significant, the association between reduced face-to-face interaction, poorer relationships with familiar people, and increased loneliness tended to be stronger in phase 3. Conclusions: This study found that loneliness and social isolation remained unresolved throughout the long-term COVID-19 pandemic. Additionally, in the final survey phase, these issues were influenced by a broader and more complex set of factors compared to earlier phases. ",
doi="10.2196/51653",
url="https://publichealth.jmir.org/2024/1/e51653",
url="http://www.ncbi.nlm.nih.gov/pubmed/39250195"
}


@Article{info:doi/10.2196/56669,
author="Tan, Kian Cheng
and Lou, Q. Vivian W.
and Cheng, Man Clio Yuen
and He, Chu Phoebe
and Khoo, Joo Veronica Eng",
title="Improving the Social Well-Being of Single Older Adults Using the LOVOT Social Robot: Qualitative Phenomenological Study",
journal="JMIR Hum Factors",
year="2024",
month="Aug",
day="23",
volume="11",
pages="e56669",
keywords="companionship",
keywords="older adults",
keywords="social well-being",
keywords="pets",
keywords="social robots",
keywords="elderly",
keywords="wellbeing",
keywords="qualitative research",
keywords="robot",
keywords="companion",
keywords="body temperature",
keywords="development",
keywords="research design",
keywords="design",
keywords="interviews",
keywords="psychosocial support",
keywords="support",
keywords="psychosocial",
keywords="temperature regulation",
keywords="social",
keywords="care home",
keywords="aging",
keywords="ageing",
keywords="robotics",
keywords="well-being",
keywords="loneliness",
keywords="technology",
keywords="mobile phone",
abstract="Background: This study examined the social well-being of single older adults through the companionship of a social robot, LOVOT (Love+Robot; Groove X). It is designed as a companion for older adults, providing love and affection through verbal and physical interaction. We investigated older adults' perceptions of the technology and how they benefitted from interacting with LOVOT, to guide the future development of social robots. Objective: This study aimed to use a phenomenological research design to understand the participants' experiences of companionship provided by the social robot. Our research focused on (1) examining the social well-being of single older adults through the companionship of social robots and (2) understanding the perceptions of single older adults when interacting with social robots. Given the prevalence of technology use to support aging, understanding single older adults' social well-being and their perceptions of social robots is essential to guide future research on and design of social robots. Methods: A total of 5 single women, aged 60 to 75 years, participated in the study. The participants interacted independently with the robot for a week in their own homes and then participated in a poststudy interview to share their experiences. Results: In total, 4 main themes emerged from the participants' interactions with LOVOT, such as caring for a social robot, comforting presence of the social robot, meaningful connections with the social robot, and preference for LOVOT over pets. Conclusions: The results indicate that single older adults can obtain psychosocial support by interacting with LOVOT. LOVOT is easily accepted as a companion and makes single older adults feel like they have a greater sense of purpose and someone to connect with. This study suggests that social robots can provide companionship to older adults who live alone. Social robots can help alleviate loneliness by allowing single older adults to form social connections with robots as companions. These findings are particularly important given the rapid aging of the population and the increasing number of single-person households in Singapore. ",
doi="10.2196/56669",
url="https://humanfactors.jmir.org/2024/1/e56669"
}


@Article{info:doi/10.2196/58263,
author="Bravata, Dena
and Russell, Daniel
and Fellows, Annette
and Goldman, Ron
and Pace, Elizabeth",
title="Digitally Enabled Peer Support and Social Health Platform for Vulnerable Adults With Loneliness and Symptomatic Mental Illness: Cohort Analysis",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="24",
volume="8",
pages="e58263",
keywords="peer support",
keywords="social isolation",
keywords="loneliness",
keywords="depression",
keywords="depressive",
keywords="mental health",
keywords="anxiety",
keywords="quality of life",
keywords="isolation",
keywords="isolated",
keywords="online support",
keywords="digital health",
keywords="vulnerable",
keywords="race",
keywords="racial ethnic",
keywords="ethnicity",
keywords="gender",
keywords="socioeconomic",
keywords="demographic",
doi="10.2196/58263",
url="https://formative.jmir.org/2024/1/e58263",
url="http://www.ncbi.nlm.nih.gov/pubmed/38941568"
}


@Article{info:doi/10.2196/56714,
author="Mills, Marie Christine
and Boyar, Liza
and O'Flaherty, A. Jessica
and Keller, H. Heather",
title="Social Factors Associated With Nutrition Risk in Community-Dwelling Older Adults in High-Income Countries: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2024",
month="Jun",
day="25",
volume="13",
pages="e56714",
keywords="community",
keywords="malnutrition risk",
keywords="nutrition risk",
keywords="older adults",
keywords="social factors",
keywords="geriatric",
keywords="geriatrics",
keywords="malnutrition",
keywords="community-dwelling",
keywords="older adult",
keywords="elderly",
keywords="HIC",
keywords="high-income countries",
keywords="diet",
keywords="dietary intake",
keywords="nutritional status",
keywords="Canada",
keywords="nutritional risk",
keywords="social",
keywords="intervention",
keywords="public health",
keywords="community-based intervention",
keywords="health promotion",
abstract="Background: In high-income countries (HICs), between 65\% and 70\% of community-dwelling adults aged 65 and older are at high nutrition risk. Nutrition risk is the risk of poor dietary intake and nutritional status. Consequences of high nutrition risk include frailty, hospitalization, death, and reduced quality of life. Social factors (such as social support and commensality) are known to influence eating behavior in later life; however, to the authors' knowledge, no reviews have been conducted examining how these social factors are associated with nutrition risk specifically. Objective: The objective of this scoping review is to understand the extent and type of evidence concerning the relationship between social factors and nutrition risk among community-dwelling older adults in HICs and to identify social interventions that address nutrition risk in community-dwelling older adults in HICs. Methods: This review will follow the scoping review methodology as outlined by the JBI Manual for Evidence Synthesis and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The search will include MEDLINE (Ovid), CINAHL, PsycINFO, and Web of Science. There will be no date limits placed on the search. However, only resources available in English will be included. EndNote (Clarivate Analytics) and Covidence (Veritas Health Innovation Ltd) will be used for reference management and removal of duplicate studies. Articles will be screened, and data will be extracted by at least 2 independent reviewers using Covidence. Data to be extracted will include study characteristics (country, methods, aims, design, and dates), participant characteristics (population description, inclusion and exclusion criteria, recruitment method, total number of participants, and demographics), how nutrition risk was measured (including the tool used to measure nutrition risk), social factors or interventions examined (including how these were measured or determined), the relationship between nutrition risk and the social factors examined, and the details of social interventions designed to address nutrition risk. Results: The scoping review was started in October 2023 and will be finalized by August 2024. The findings will describe the social factors commonly examined in the nutrition risk literature, the relationship between these social factors and nutrition risk, the social factors that have an impact on nutrition risk, and social interventions designed to address nutrition risk. The results of the extracted data will be presented in the form of a narrative summary with accompanying tables. Conclusions: Given the high prevalence of nutrition risk in community-dwelling older adults in HICs and the negative consequences of nutrition risk, it is essential to understand the social factors associated with nutrition risk. The results of the review are anticipated to aid in identifying individuals who should be screened proactively for nutrition risk and inform programs, policies, and interventions designed to reduce the prevalence of nutrition risk. International Registered Report Identifier (IRRID): DERR1-10.2196/56714 ",
doi="10.2196/56714",
url="https://www.researchprotocols.org/2024/1/e56714",
url="http://www.ncbi.nlm.nih.gov/pubmed/38696645"
}


@Article{info:doi/10.2196/51675,
author="Miller, Soederberg Lisa M.
and Callegari, A. Rachel
and Abah, Theresa
and Fann, Helen",
title="Digital Literacy Training for Low-Income Older Adults Through Undergraduate Community-Engaged Learning: Single-Group Pretest-Posttest Study",
journal="JMIR Aging",
year="2024",
month="May",
day="14",
volume="7",
pages="e51675",
keywords="community-engaged learning",
keywords="digital divide",
keywords="underserved older adults",
keywords="digital literacy training",
keywords="intergenerational programs",
abstract="Background: Digital technology is a social determinant of health that affects older people's ability to engage in health maintenance and disease prevention activities; connect with family and friends; and, more generally, age in place. Unfortunately, disparities in technology adoption and use exist among older adults compared with other age groups and are even greater among low-income older adults. Objective: In this study, we described the development and implementation of a digital literacy training program designed with the dual goals of training low-income older adults in the community and teaching students about aging using a community-engaged learning (CEL) approach. Methods: The training program was embedded within a 10-week CEL course that paired undergraduates (N=27) with low-income older adults (n=18) for 8 weeks of digital literacy training. Older adults and students met weekly at the local senior center for the training. Students also met in the classroom weekly to learn about aging and how to use design thinking to train their older adult trainees. Both older adults and students completed pre- and posttraining surveys. Results: Older adults demonstrated increased digital literacy skills and confidence in the use of digital technology. Loneliness did not change from pre to postassessment measurements; however, older adults showed improvements in their attitudes toward their own aging and expressed enthusiasm for the training program. Although students' fear of older adults did not change, their comfort in working with older adults increased. Importantly, older adults and students expressed positive feelings about the trainee-trainer relationship that they formed during the training program. Conclusions: A CEL approach that brings together students and low-income older adults in the community has a strong potential to reduce the digital divide experienced by underserved older adults. Additional work is needed to explore the efficacy and scalability of this approach in terms of older adults' digital literacy as well as other potential benefits to both older and younger adults. ",
doi="10.2196/51675",
url="https://aging.jmir.org/2024/1/e51675",
url="http://www.ncbi.nlm.nih.gov/pubmed/38599620"
}


@Article{info:doi/10.2196/52292,
author="Lu, Yinn Si
and Yoon, Sungwon
and Yee, Qi Wan
and Heng Wen Ngiam, Nerice
and Ng, Yi Kennedy Yao
and Low, Leng Lian",
title="Experiences of a Community-Based Digital Intervention Among Older People Living in a Low-Income Neighborhood: Qualitative Study",
journal="JMIR Aging",
year="2024",
month="Apr",
day="25",
volume="7",
pages="e52292",
keywords="digital divide",
keywords="digital learning",
keywords="smartphones",
keywords="social gerontology",
keywords="older adults",
keywords="COVID-19 pandemic",
keywords="technology adoption",
abstract="Background: Older adults worldwide experienced heightened risks of depression, anxiety, loneliness, and poor mental well-being during the COVID-19 pandemic. During this period, digital technology emerged as a means to mitigate social isolation and enhance social connectedness among older adults. However, older adults' behaviors and attitudes toward the adoption and use of digital technology are heterogeneous and shaped by factors such as age, income, and education. Few empirical studies have examined how older adults experiencing social and economic disadvantages perceive the learning of digital tools. Objective: This study aims to examine the motivations, experiences, and perceptions toward a community-based digital intervention among older adults residing in public rental flats in a low-income neighborhood. Specifically, we explored how their attitudes and behaviors toward learning the use of smartphones are shaped by their experiences related to age and socioeconomic challenges. Methods: This study adopted a qualitative methodology. Between December 2020 and March 2021, we conducted semistructured in-depth interviews with 19 participants aged ?60 years who had completed the community-based digital intervention. We asked participants questions about the challenges encountered amid the pandemic, their perceived benefits of and difficulties with smartphone use, and their experiences with participating in the intervention. All interviews were audio recorded and analyzed using a reflexive thematic approach. Results: Although older learners stated varying levels of motivation to learn, most expressed ambivalence about the perceived utility and relevance of the smartphone to their current needs and priorities. While participants valued the social interaction with volunteers and the personalized learning model of the digital intervention, they also articulated barriers such as age-related cognitive and physical limitations and language and illiteracy that hindered their sustained use of these digital devices. Most importantly, the internalization of ageist stereotypes of being less worthy learners and the perception of smartphone use as being in the realm of the privileged other further reduced self-efficacy and interest in learning. Conclusions: To improve learning and sustained use of smartphones for older adults with low income, it is essential to explore avenues that render digital tools pertinent to their daily lives, such as creating opportunities for social connections and relationship building. Future studies should investigate the relationships between older adults' social, economic, and health marginality and their ability to access digital technologies. We recommend that the design and implementation of digital interventions should prioritize catering to the needs and preferences of various segments of older adults, while working to bridge rather than perpetuate the digital divide. ",
doi="10.2196/52292",
url="https://aging.jmir.org/2024/1/e52292",
url="http://www.ncbi.nlm.nih.gov/pubmed/38662423"
}


@Article{info:doi/10.2196/47943,
author="Zarling, Amie
and Kim, Joseph
and Russell, Daniel
and Cutrona, Carolyn",
title="Increasing Older Adults' Social Connectedness: Development and Implementation of a Web-Assisted Acceptance and Commitment Therapy--Based Intervention",
journal="JMIR Aging",
year="2024",
month="Apr",
day="22",
volume="7",
pages="e47943",
keywords="acceptance and commitment therapy",
keywords="psychotherapy",
keywords="loneliness",
keywords="technology",
keywords="lonely",
keywords="older adults",
keywords="older adult",
keywords="gerontology",
keywords="geriatric",
keywords="geriatrics",
keywords="emotion regulation",
keywords="mental health",
keywords="elder",
keywords="elderly",
keywords="isolation",
keywords="aging",
keywords="mHealth",
keywords="digital health",
keywords="digital mental health",
keywords="online health",
keywords="online support",
keywords="eHealth",
keywords="internet",
keywords="depression",
doi="10.2196/47943",
url="https://aging.jmir.org/2024/1/e47943"
}


@Article{info:doi/10.2196/50534,
author="Marziali, Alessandra Rachele
and Franceschetti, Claudia
and Dinculescu, Adrian
and Nistorescu, Alexandru
and Krist{\'a}ly, Mircea Dominic
and Mo?oi, Alexandru Adrian
and Broekx, Ronny
and Marin, Mihaela
and Vizitiu, Cristian
and Moraru, Sorin-Aurel
and Rossi, Lorena
and Di Rosa, Mirko",
title="Reducing Loneliness and Social Isolation of Older Adults Through Voice Assistants: Literature Review and Bibliometric Analysis",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="18",
volume="26",
pages="e50534",
keywords="voice assistant",
keywords="loneliness",
keywords="social isolation",
keywords="older adults",
keywords="literature review",
keywords="bibliometric analysis",
keywords="mobile phone",
abstract="Background: Loneliness and social isolation are major public health concerns for older adults, with severe mental and physical health consequences. New technologies may have a great impact in providing support to the daily lives of older adults and addressing the many challenges they face. In this scenario, technologies based on voice assistants (VAs) are of great interest and potential benefit in reducing loneliness and social isolation in this population, because they could overcome existing barriers with other digital technologies through easier and more natural human-computer interaction. Objective: This study aims to investigate the use of VAs to reduce loneliness and social isolation of older adults by performing a systematic literature review and a bibliometric cluster mapping analysis. Methods: We searched PubMed, Embase, and Scopus databases for articles that were published in the last 6 years, related to the following main topics: voice interface, VA, older adults, isolation, and loneliness. A total of 40 articles were found, of which 16 (40\%) were included in this review. The included articles were then assessed through a qualitative scoring method and summarized. Finally, a bibliometric analysis was conducted using VOSviewer software (Leiden University's Centre for Science and Technology Studies). Results: Of the 16 articles included in the review, only 2 (13\%) were considered of poor methodological quality, whereas 9 (56\%) were of medium quality and 5 (31\%) were of high quality. Finally, through bibliometric analysis, 221 keywords were extracted, of which 36 (16\%) were selected. The most important keywords, by number of occurrences and by total link strength; results of the analysis with the Association Strength normalization method; and default values were then presented. The final bibliometric network consisted of 36 selected keywords, which were grouped into 3 clusters related to 3 main topics (ie, VA use for social isolation among older adults, the significance of age in the context of loneliness, and the impact of sex factors on well-being). For most of the selected articles, the effect of VA on social isolation and loneliness of older adults was a minor theme. However, more investigations were done on user experience, obtaining preliminary positive results. Conclusions: Most articles on the use of VAs by older adults to reduce social isolation and loneliness focus on usability, acceptability, or user experience. Nevertheless, studies directly addressing the impact that using a VA has on the social isolation and loneliness of older adults find positive and promising results and provide important information for future research, interventions, and policy development in the field of geriatric care and technology. ",
doi="10.2196/50534",
url="https://www.jmir.org/2024/1/e50534",
url="http://www.ncbi.nlm.nih.gov/pubmed/38498039"
}


@Article{info:doi/10.2196/49462,
author="Chou, Ya-Hsin
and Lin, Chemin
and Lee, Shwu-Hua
and Lee, Yen-Fen
and Cheng, Li-Chen",
title="User-Friendly Chatbot to Mitigate the Psychological Stress of Older Adults During the COVID-19 Pandemic: Development and Usability Study",
journal="JMIR Form Res",
year="2024",
month="Mar",
day="13",
volume="8",
pages="e49462",
keywords="geriatric psychiatry",
keywords="mental health",
keywords="loneliness",
keywords="chatbot",
keywords="user experience",
keywords="health promotion",
keywords="older adults",
keywords="technology-assisted interventions",
keywords="pandemic",
keywords="lonely",
keywords="gerontology",
keywords="elderly",
keywords="develop",
keywords="design",
keywords="development",
keywords="conversational agent",
keywords="geriatric",
keywords="geriatrics",
keywords="psychiatry",
abstract="Background: To safeguard the most vulnerable individuals during the COVID-19 pandemic, numerous governments enforced measures such as stay-at-home orders, social distancing, and self-isolation. These social restrictions had a particularly negative effect on older adults, as they are more vulnerable and experience increased loneliness, which has various adverse effects, including increasing the risk of mental health problems and mortality. Chatbots can potentially reduce loneliness and provide companionship during a pandemic. However, existing chatbots do not cater to the specific needs of older adult populations. Objective: We aimed to develop a user-friendly chatbot tailored to the specific needs of older adults with anxiety or depressive disorders during the COVID-19 pandemic and to examine their perspectives on mental health chatbot use. The primary research objective was to investigate whether chatbots can mitigate the psychological stress of older adults during COVID-19. Methods: Participants were older adults belonging to two age groups (?65 years and <65 years) from a psychiatric outpatient department who had been diagnosed with depressive or anxiety disorders by certified psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) criteria. The participants were required to use mobile phones, have internet access, and possess literacy skills. The chatbot's content includes monitoring and tracking health data and providing health information. Participants had access to the chatbot for at least 4 weeks. Self-report questionnaires for loneliness, depression, and anxiety were administered before and after chatbot use. The participants also rated their attitudes toward the chatbot. Results: A total of 35 participants (mean age 65.21, SD 7.51 years) were enrolled in the trial, comprising 74\% (n=26) female and 26\% (n=9) male participants. The participants demonstrated a high utilization rate during the intervention, with over 82\% engaging with the chatbot daily. Loneliness significantly improved in the older group ?65 years. This group also responded positively to the chatbot, as evidenced by changes in University of California Los Angeles Loneliness Scale scores, suggesting that this demographic can derive benefits from chatbot interaction. Conversely, the younger group, <65 years, exhibited no significant changes in loneliness after the intervention. Both the older and younger age groups provided good scores in relation to chatbot design with respect to usability (mean scores of 6.33 and 6.05, respectively) and satisfaction (mean scores of 5.33 and 5.15, respectively), rated on a 7-point Likert scale. Conclusions: The chatbot interface was found to be user-friendly and demonstrated promising results among participants 65 years and older who were receiving care at psychiatric outpatient clinics and experiencing relatively stable symptoms of depression and anxiety. The chatbot not only provided caring companionship but also showed the potential to alleviate loneliness during the challenging circumstances of a pandemic. ",
doi="10.2196/49462",
url="https://formative.jmir.org/2024/1/e49462",
url="http://www.ncbi.nlm.nih.gov/pubmed/38477965"
}


@Article{info:doi/10.2196/43999,
author="Fritz, Johanna
and von Heideken W{\aa}gert, Petra
and Gusdal, K. Annelie
and Johansson-Pajala, Rose-Marie
and Eklund, Caroline",
title="Determinants of Implementing an Information and Communication Technology Tool for Social Interaction Among Older People: Qualitative Content Analysis of Social Services Personnel Perspectives",
journal="JMIR Aging",
year="2024",
month="Feb",
day="26",
volume="7",
pages="e43999",
keywords="information and communication technology",
keywords="implementation",
keywords="determinants",
keywords="social isolation",
keywords="loneliness",
keywords="organization",
keywords="digitalization",
keywords="facilitators",
keywords="barriers",
keywords="older people",
abstract="Background: Older people are particularly vulnerable to social isolation and loneliness, which can lead to ill-health, both mentally and physically. Information and communication technology (ICT) can supplement health and social care and improve health among the vulnerable, older adult population. When ICT is used specifically for communication with others, it is associated with reduced loneliness in older populations. Research is sparse on how the implementation of ICT, used specifically for communication among older people in social services, can be performed. It is recommended to consider the determinants of implementation, that is, barriers to and facilitators of implementation. Determinants related to older people using ICT tools are reported in several studies. To the best of our knowledge, studies investigating the determinants related to the social services perspective are lacking. Objective: This study aims to explore the determinants of implementing the Fik@ room, a new, co-designed, and research-based ICT tool for social interaction among older people, from a social services personnel perspective. Methods: This study used an exploratory, qualitative design. An ICT tool called the Fik@ room was tested in an intervention study conducted in 2021 in 2 medium-sized municipalities in Sweden. Informants in this study were municipal social services personnel with experience of implementing this specific ICT tool in social services. We conducted a participatory workshop consisting of 2 parts, with 9 informants divided into 2 groups. We analyzed the data using qualitative content analysis with an inductive approach. Results: The results included 7 categories of determinants for implementing the ICT tool. Being able to introduce the ICT tool in an appropriate manner concerns the personnel's options for introducing and supporting the ICT tool, including their competencies in using digital equipment. Organizational structure concerns a structure for communication within the organization. Leadership concerns engagement and enthusiasm as driving forces for implementation. The digital maturity of the social services personnel concerns the personnel's skills and attitudes toward using digital equipment. Resources concern time and money. IT support concerns accessibility, and legal liability concerns possibilities to fulfill legal responsibilities. Conclusions: The results show that implementation involves an entire organization at varying degrees. Regardless of how much each level within the organization comes into direct contact with the ICT tool, all levels need to be involved to create the necessary conditions for successful implementation. The prerequisites for the implementation of an ICT tool will probably change depending on the digital maturity of future generations. As this study only included 9 informants, the results should be handled with care. The study was performed during the COVID-19 pandemic, which has probably affected the results. ",
doi="10.2196/43999",
url="https://aging.jmir.org/2024/1/e43999",
url="http://www.ncbi.nlm.nih.gov/pubmed/38407955"
}


@Article{info:doi/10.2196/47908,
author="Sen, Keya
and Laheji, Nida
and Ramamonjiarivelo, Zo
and Renick, Cecil
and Osborne, Randall
and Beauvais, Brad",
title="Examining the Effect of Contactless Intergenerational Befriending Intervention on Social Isolation Among Older Adults and Students' Attitude Toward Companionship: Content Analysis",
journal="JMIR Aging",
year="2024",
month="Jan",
day="30",
volume="7",
pages="e47908",
keywords="intergenerational befriending",
keywords="social isolation",
keywords="boredom",
keywords="contactless socialization",
keywords="service learning",
keywords="internal motivation",
keywords="mobile phone",
abstract="Background: Intergenerational friendship, a mechanism of social support, is an effective intervention to reduce the increasing risk of social isolation (SI) and develop companionship in the older adult population. The COVID-19 pandemic provided a unique opportunity to examine the psychosocial intervention of befriending via technology use as a primary form of contactless socialization. Objective: The study aims to explore the effectiveness of the befriending intervention through a contactless, intergenerational service-learning project on older adult emotions, especially boredom and loneliness as the key attributes of SI, and on students' attitude toward companionship. Methods: During the months of January to April 2022 , undergraduate students enrolled in a health administration course with a special focus on culture were asked to be involved in a contactless, intergenerational service-learning project (n=46). In this study, contactless intervention meant communication using the telephone and apps such as FaceTime and Zoom. Students were paired with older adults to have at least a 30-minute weekly conversation, for 8 weeks, via telephone or an internet-based app such as FaceTime. Students were asked to write a half-page diary after each interaction and a 1-page reflection at the end of the fourth week and at the end of the service-learning project. At the completion of the project, the researchers also surveyed the older adults to assess the impact of the project using a 5-item open-ended questionnaire. Following a heuristic approach and content analysis, student artifacts (110,970 words; 118-page, single-spaced Microsoft Word document) and the older adult surveys were analyzed using MAXQDA, (VERBI GmbH). Qualitative data were extracted to assess the impact of service learning on SI by measuring the attributes of boredom and loneliness among 46 older adults. Students' attitudes toward companionship were also assessed using data from their diaries and reflections. Results: Overall, three major constructs were identified: (1) meaningful engagement, defined as feeling safe, having increased confidence, and having reduced boredom; (2) internal motivation to participate in the weekly interaction, defined as discussion about daily life experience, level of happiness, and ability to exert personal control over the situation; and (3) intergenerational befriending, defined as perceived benefits from the friendly nature of the interaction, ability to comfortably connect with students, and positive feeling and attitude toward the student. Conclusions: The contactless, intergenerational befriending intervention reduced boredom and loneliness among older adults and enhanced positive attitude and confidence among university students. Students helped older adults to develop digital skills for the use of apps and social media. Older adults showed interest in the intervention and shared their daily life experiences with the students, which helped to reduce the gap between generations. Findings indicate the effectiveness of an intergenerational service-learning intervention on SI reduction and increased positive attitude among college students. ",
doi="10.2196/47908",
url="https://aging.jmir.org/2024/1/e47908",
url="http://www.ncbi.nlm.nih.gov/pubmed/38175944"
}


@Article{info:doi/10.2196/49253,
author="Pang, Mingli
and Wang, Jieru
and Zhao, Mingyue
and Chen, Rui
and Liu, Hui
and Xu, Xixing
and Li, Shixue
and Kong, Fanlei",
title="The Migrant-Local Difference in the Relationship Between Social Support, Sleep Disturbance, and Loneliness Among Older Adults in China: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Jan",
day="9",
volume="10",
pages="e49253",
keywords="loneliness",
keywords="social support",
keywords="sleep disturbance",
keywords="older adults",
keywords="migrant-local difference",
keywords="structural equation modeling",
abstract="Background: Driven by the accelerated aging of the population of China, the number of older adults has increased rapidly in the country. Meanwhile, following children, migrant older adults (MOA) have emerged as a vulnerable group in the process of fast urbanization. Existed studies have illustrated the association between social support and loneliness and the relationship between sleep disturbance and loneliness; however, the underlying mechanisms and the migrant-local difference in the association between social support, sleep disturbance, and loneliness have not been identified. Objective: This study aimed to clarify the migrant-local difference in the relationship between social support, sleep disturbance, and loneliness in older adults in China. Methods: Multistage cluster random sampling was used to select participants: 1205 older adults (n=613, 50.9\%, MOA and n=592, 49.1\%, local older adults [LOA]) were selected in Weifang City, China, in August 2021. Loneliness was assessed with the 6-item short-form University of California, Los Angeles Loneliness Scale, social support was evaluated with the Social Support Rating Scale, and sleep disturbance was measured with the Pittsburgh Sleep Quality Index. The chi-square test, t test, and structural equation modeling (SEM) were adopted to explore the migrant-local difference between social support, sleep disturbance, and loneliness among the MOA and LOA. Results: The mean score of loneliness was 8.58 (SD 3.03) for the MOA and 8.00 (SD 2.79) for the LOA. SEM analysis showed that social support exerts a direct negative effect on both sleep disturbance (standardized coefficient=--0.24 in the MOA and --0.20 in the LOA) and loneliness (standardized coefficient=--0.44 in the MOA and --0.40 in the LOA), while sleep disturbance generates a direct positive effect on loneliness (standardized coefficient=0.13 in the MOA and 0.22 in the LOA). Conclusions: Both MOA and LOA have a low level of loneliness, but the MOA show higher loneliness than the LOA. There is a negative correlation between social support and loneliness as well as between social support and sleep disturbance among the MOA and LOA (MOA>LOA), while loneliness is positively associated with sleep disturbance in both populations (MOA<LOA). Measures should be taken by the government, society, and families to increase social support, decrease sleep disturbance, and further reduce the loneliness among older adults, especially the MOA. ",
doi="10.2196/49253",
url="https://publichealth.jmir.org/2024/1/e49253",
url="http://www.ncbi.nlm.nih.gov/pubmed/38194253"
}


@Article{info:doi/10.2196/48031,
author="Tanner, Alexandra
and Urech, Andreas
and Schulze, Hartmut
and Manser, Tanja",
title="Older Adults' Engagement and Mood During Robot-Assisted Group Activities in Nursing Homes: Development and Observational Pilot Study",
journal="JMIR Rehabil Assist Technol",
year="2023",
month="Dec",
day="25",
volume="10",
pages="e48031",
keywords="human-robot interaction",
keywords="social robot",
keywords="nursing home",
keywords="observational research",
keywords="group activity",
keywords="observational",
keywords="pilot study",
keywords="robot",
keywords="engagement",
keywords="mood",
keywords="well-being",
keywords="cognitive",
keywords="elderly",
keywords="nursing",
keywords="aging",
abstract="Background: Promoting the well-being of older adults in an aging society requires new solutions. One resource might be the use of social robots for group activities that promote physical and cognitive stimulation. Engaging in a robot-assisted group activity may help in the slowdown of physical and cognitive decline in older adults. Currently, our knowledge is limited on whether older adults engage in group activities with humanlike social robots and whether they experience a positive affect while doing so. Both are necessary preconditions to achieve the intended effects of a group activity. Objective: Our pilot study has 2 aims. First, we aimed to develop and pilot an observational coding scheme for robot-assisted group activities because self-report data on engagement and mood of nursing home residents are often difficult to obtain, and the existing observation instruments do have limitations. Second, we aimed to investigate older adults' engagement and mood during robot-assisted group activities in 4 different nursing care homes in the German-speaking part of Switzerland. Methods: We developed an observation system, inspired by existing tools, for a structured observation of engagement and mood of older adults during a robot-assisted group activity. In this study, 85 older adult residents from 4 different care homes in Switzerland participated in 5 robot-assisted group activity sessions, and they were observed using our developed system. The data were collected in the form of video clips that were assessed by 2 raters regarding engagement (direction of gaze, posture as well as body expression, and activity) and mood (positive and negative affects). Both variables were rated on a 5-point rating scale. Results: Our pilot study findings show that the engagement and mood of older adults can be assessed reliably by using the proposed observational coding scheme. Most participants actively engaged in robot-assisted group activities (mean 4.19, SD 0.47; median 4.0). The variables used to measure engagement were direction of gaze (mean 4.65, SD 0.49; median 5.0), posture and body expression (mean 4.03, SD 0.71; median 4.0), and activity (mean 3.90, SD 0.65; median 4.0). Further, we observed mainly positive affects in this group. Almost no negative affect was observed (mean 1.13, SD 0.20; median 1.0), while the positive affect (mean 3.22, SD 0.55; median 3.2) was high. Conclusions: The developed observational coding system can be used and further developed in future studies on robot-assisted group activities in the nursing home context and potentially in other settings. Additionally, our pilot study indicates that cognitive and physical stimulation of older adults can be promoted by social robots in a group setting. This finding encourages future technological development and improvement of social robots and points to the potential of observational research to systematically evaluate such developments. ",
doi="10.2196/48031",
url="https://rehab.jmir.org/2023/1/e48031",
url="http://www.ncbi.nlm.nih.gov/pubmed/38145484"
}


@Article{info:doi/10.2196/47729,
author="Balki, Eric
and Hayes, Niall
and Holland, Carol",
title="The Indirect Impact of Educational Attainment as a Distal Resource for Older Adults on Loneliness, Social Isolation, Psychological Resilience, and Technology Use During the COVID-19 Pandemic: Cross-Sectional Quantitative Study",
journal="JMIR Aging",
year="2023",
month="Nov",
day="24",
volume="6",
pages="e47729",
keywords="pandemic",
keywords="educational attainment",
keywords="isolation",
keywords="loneliness",
keywords="socioemotional needs",
keywords="social engagement",
keywords="technology use",
keywords="older adults",
keywords="psychological resilience",
abstract="Background: During the COVID-19 pandemic, government-mandated social distancing prevented the spread of the disease but potentially exacerbated social isolation and loneliness for older people, especially those already vulnerable to isolation. Older adults may have been able to draw from their personal resources such as psychological resilience (PR) and technology use (TU) to combat such effects. Educational attainment (EA) or early-life EA may potentially shape later-life personal resources and their impact on the effects of the pandemic lockdown on outcomes such as loneliness. The developmental adaptation model allows for the supposition that social isolation, TU, and PR may be affected by early EA in older adults. Objective: This study examined the indirect impact of EA on pandemic-linked loneliness in a sample of older adults. The developmental adaptation model was used as the conceptual framework to view EA as a distal influence on loneliness, social isolation, PR, and TU. We hypothesized that EA would predict TU and PR and have a moderating impact on social isolation and loneliness. We also hypothesized that PR and TU would mediate the effect of EA on loneliness. Methods: This was a cross-sectional observational study, in which data were gathered from 92 older adults aged ?65 years in the United Kingdom from March 2020 to June 2021, when the country was under various pandemic-linked social mobility restrictions. The data captured demographic information including age, gender, ethnicity, and the highest degree of education achieved. The University of California Los Angeles Loneliness Scale, Connor--Davidson Resilience Scale, Lubben Social Network Index, and Technology Experience Questionnaire were used as standardized measures. Pearson correlation, moderation, and mediation regression analyses were conducted to investigate the hypotheses. Results: We found a higher prevalence of loneliness in older adults than in prepandemic norms. EA was correlated with greater TU and PR and moderated the impact of social isolation on loneliness. PR mediated and TU partially mediated the relationship between EA and loneliness. Conclusions: Early-life EA was confirmed as a distal resource for older adults and played an indirect role in affecting loneliness levels during the pandemic. It has an impact on present-day personal resources, such as PR and TU, which affect loneliness and also moderate the impact of social isolation on loneliness. Policymakers should be aware that older adults with low levels of EA may be more vulnerable to the harmful impacts of loneliness when isolated by choice. ",
doi="10.2196/47729",
url="https://aging.jmir.org/2023/1/e47729",
url="http://www.ncbi.nlm.nih.gov/pubmed/37999938"
}


@Article{info:doi/10.2196/45173,
author="Janssen, Jeroen
and Ch{\^a}tel, Bas
and Den Heijer, Nora
and Tieben, Rob
and Deen, Menno
and Corten, Rense
and Peeters, Geeske
and Olde Rikkert, Marcel",
title="A Digital Gaming Intervention to Strengthen the Social Networks of Older Dutch Adults: Mixed Methods Process Evaluation of a Digitally Conducted Randomized Controlled Trial",
journal="JMIR Form Res",
year="2023",
month="Oct",
day="20",
volume="7",
pages="e45173",
keywords="eHealth",
keywords="gerontology",
keywords="loneliness",
keywords="mixed methods",
keywords="mobile games",
keywords="qualitative research",
keywords="serious games",
abstract="Background: Digital loneliness interventions for older adults are promising, yet conclusive evidence is lacking due to a lack of randomized controlled trials (RCTs) and difficulties with recruitment. Process evaluation of performed RCTs is essential to inform future interventions. Still, it is rarely carried out, resulting in an overly optimistic view of the impact of eHealth interventions on loneliness in older adults and options to conduct such research entirely remotely. Objective: We describe a mixed methods process evaluation of a digitally conducted RCT assessing the effectiveness of a mobile social gaming app to facilitate meaningful social interactions in older adults. Methods: We analyzed the questionnaire and game data of the RCT participants to evaluate recruitment and onboarding, intervention adherence, and intervention acceptability. The RCT participants were allocated either to the main group of older adults (aged 65 years or older) or the side group (aged between 18 and 64 years). The side group used networking to play with the older adults. We also conducted 6 post-RCT evaluation interviews and 1 focus group with a total of 4 RCT participants and 5 welfare organization representatives that aided in RCT recruitment. Results: In total, 371 people aged 18 years or older signed up for the RCT, of which 64\% (238/371) were aged 65 years or older. Of the total sample, 20\% (76/371) installed the app and signed informed consent, showing a large dropout during onboarding. The high number of questions was a relevant barrier for participants. Both questionnaire and gameplay adherence were low. Participants indicated that the games elicited contact and a feeling of togetherness and proposed challenging and competitive games with increasing difficulty levels. They suggested focusing on enjoying the games rather than administering questionnaires. Conclusions: Conducting a remote digital trial of a social gaming intervention for older adults is a great challenge. Remote recruitment and informed consent acquisition may often not result in sufficient participation. Personal engagement with fellow participants and researchers might be essential for adherence and enjoyment. Future digital gaming interventions should start with small-scale studies with in-person contact, repeated instructions, and fewer questionnaires. ",
doi="10.2196/45173",
url="https://formative.jmir.org/2023/1/e45173",
url="http://www.ncbi.nlm.nih.gov/pubmed/37862093"
}


@Article{info:doi/10.2196/51129,
author="Kokorelias, Marie Kristina
and Grigorovich, Alisa
and Harris, T. Maurita
and Rehman, Umair
and Ritchie, Louise
and Levy, AnneMarie
and Denecke, Kerstin
and McMurray, Josephine",
title="Coadaptation Between Smart Technologies and Older Adults Over Time: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2023",
month="Oct",
day="9",
volume="12",
pages="e51129",
keywords="scoping review",
keywords="review methods",
keywords="review methodology",
keywords="knowledge synthesis",
keywords="scoping",
keywords="coadaptation",
keywords="older adults",
keywords="older adult",
keywords="gerontechnology",
keywords="technology",
keywords="smart technology",
keywords="smart technologies",
keywords="smart",
keywords="geriatrics",
keywords="elderly",
keywords="elder",
keywords="geriatric",
keywords="scoping literature review",
keywords="protocol",
keywords="internet of things",
keywords="IoT",
keywords="ageing",
keywords="aging",
keywords="PRISMA-ScR",
keywords="user-centered design",
abstract="Background: The Internet of Things (IoT) has gained significant attention due to advancements in technology and has potential applications in meeting the needs of an aging population. Smart technologies, a subset of IoT, can support older adults in aging in place, promoting independent living and improving their quality of life. However, there is a lack of research on how older adults and smart technologies coadapt over time to maximize their benefits and sustain adoption. Objective: We will aim to comprehensively review and analyze the existing scientific literature pertaining to the coadaptation between smart technologies and older adults. The primary focus will be to investigate the extent and nature of this coadaptation process and explore how older adults and technology coevolve over time to enhance older adults' experience with technology. Methods: This scoping review will follow the methodology outlined in the Joanna Briggs Institute Reviewer's Manual and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews) guidelines for reporting. Peer-reviewed articles will be searched in databases like Ovid MEDLINE, OVID Embase, PEDro, OVID PsycINFO, EBSCO CINAHL, the Cochrane Library, Scopus, IEEE Xplore, Web of Science, and Global Index Medicus. The research team will create a data extraction form covering study characteristics, participant characteristics, underlying models and frameworks, research findings, implications for technology coadaptation, and any identified study limitations. A directed content analysis approach will be used, incorporating the Selection, Optimization, and Compensation framework and Sex- and Gender-Based Analysis Plus theoretical framework. Results: The results of this study are expected in January 2024. Conclusions: This scoping review endeavors to present a thorough overview of the available evidence concerning how smart technologies interact with older adults over an extended period. The insights gained from this review will lay the groundwork for a research program that explores how older adults adapt to and use smart technologies throughout their lives, ultimately leading to improved user satisfaction and experience and facilitating aging in place with tailored support and user-centered design principles. International Registered Report Identifier (IRRID): PRR1-10.2196/51129 ",
doi="10.2196/51129",
url="https://www.researchprotocols.org/2023/1/e51129",
url="http://www.ncbi.nlm.nih.gov/pubmed/37812466"
}


@Article{info:doi/10.2196/46753,
author="Beogo, Idrissa
and Sia, Drissa
and Collin, Stephanie
and Phaelle Gedeon, Andi
and Louism{\'e}, Micha{\"e}l-Christopher
and Ramd{\'e}, Jean
and Gagnon, Marie-Pierre
and Tchouaket Nguemeleu, Eric",
title="Strengthening Social Capital to Address Isolation and Loneliness in Long-Term Care Facilities During the COVID-19 Pandemic: Systematic Review of Research on Information and Communication Technologies",
journal="JMIR Aging",
year="2023",
month="Aug",
day="14",
volume="6",
pages="e46753",
keywords="information and communication technology",
keywords="ICT",
keywords="long-term care facilities",
keywords="COVID-19",
keywords="social isolation",
keywords="loneliness",
keywords="pandemic",
keywords="implementation sciences",
keywords="protocol",
keywords="nursing home",
keywords="mobile phone",
abstract="Background: The COVID-19 pandemic has disproportionately and severely affected older adults, namely those living in long-term care facilities (LTCFs). Aside from experiencing high mortality rates, survivors were critically concerned by social isolation and loneliness (SIL). To address this serious public health concern and stay connected with LTCF residents, information and communication technology (ICT) platforms (eg, video calls) were used as an alternative to maintaining social interactions amid the visiting restriction policy. Objective: This paper aimed to synthesize the effects of ICT-related communication interventions using SMS text messaging or chat, video, voice mail, or photo to address SIL in LTCF residents during the COVID-19 pandemic. Methods: In total, 2793 references published in English and French in 2019 and onward were obtained from 10 relevant databases: PsycINFO-Ovid, Ovid-MEDLINE, CINAHL-EBSCO, Cochrane Library, Web of Science, Scopus, DirectScience, Communication \& Mass Media Complete, IEEE Xplore, and ACM Digital Library. A 2-person screening approach was used, and the studies were screened independently and blindly. A narrative synthesis was performed to interpret the results of the included studies, and their quality was appraised. Results: In total, 4 studies were included in the review. ICT-related applications were used to ensure connectedness to address SIL. ICT interventions consisted mainly of videoconferencing, intergroup video call sessions between residents, and chatting (SMS text messages and phone calls). Roughly 3 classes of mediating ICT tools were used: video calls using software applications (eg, Skype); robot systems embedding video telephones; and ordinary telecommunication such as telephone, internet, social media platforms, and videoconferencing. This review has included the role of humanoid robots in LTCFs as an innovation avenue because of their multipurpose use (eg, communication tools and remotely operable). Conclusions: Remote social capitalization through ICT applications has become an avenue to reduce SIL among LTCF residents. This review examined a social connection approach that will remain relevant and even be fostered after the COVID-19 pandemic. As families remain the main stakeholders of LTCFs, this study's findings could inform policy makers and frontline managers to better shape programs and initiatives to prevent or reduce SIL in LTCFs. International Registered Report Identifier (IRRID): RR2-10.2196/36269 ",
doi="10.2196/46753",
url="https://aging.jmir.org/2023/1/e46753",
url="http://www.ncbi.nlm.nih.gov/pubmed/37578824"
}


@Article{info:doi/10.2196/43612,
author="Wang, Jing
and Kwan, Patrick
and Zhang, Gong
and Shen, Mingwang
and Piccenna, Loretta
and O'Brien, J. Terence
and Zhang, Lei",
title="A Multidimensional Assessment of Activities of Daily Living, Mental Status, Communication, and Social Abilities Among Older Adults in Shenzhen, China: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Aug",
day="10",
volume="9",
pages="e43612",
keywords="older adults",
keywords="ability assessment",
keywords="activities of daily living",
keywords="mental status",
keywords="sensory and communication",
keywords="social participation",
abstract="Background: China is facing a rapidly expanding aging population. Insights into the health status of older adults are of great significance for health resource allocation and health care provision to this population. Objective: With the goal of providing a comprehensive understanding of the health status of older adults and to inform potential interventions, we investigated the level of disability and identified risk factors associated with disability among the older population (aged ?60 years) living in China. Methods: A total of 8467 older adults living in the Chinese city of Shenzhen were enrolled in this cross-sectional study. We used a multidimensional ability assessment survey, which assessed their activities of daily living (ADL; including eating, bathing, grooming, dressing, defecation control, urination control, using a toilet unaided, transfer, flat-ground walking, stair activity), mental status (including cognitive function, aggressive behavior, depression symptoms), sensory and communication (including consciousness level, vision, hearing, communication), and social participation (including living, working, time/space orientation, distinguish persons, social communication) abilities. The impact of demographic risk factors on ability levels was analyzed using ordinal logistic regression. The correlations between the four dimensions of ability mentioned above were analyzed using Spearman correlation analysis. Results: A total of 7766 participants were effectively assessed. The participants' average age was 70.64 (SD 8.46) years comprising 56.53\% females. The overall ability level was classified as mildly, moderately, and severely impaired for 27.57\% (n=2141), 2.83\% (n=220), and 4.28\% (n=332) of the 7766 participants, respectively. With increasing age, the proportion of impaired participants increased from 17.62\% (365/2071) in the age group 60-64 years to 91.3\% (253/277) in the age group above 90 years (P<.001), corresponding to an approximate 10\% rise for every 5-year age increment. The odds of having more severe overall ability impairment in females was 1.15 times that in males (odds ratio [OR] 1.15, 95\% CI 1.04-1.28). Participants who were divorced or widowed had a higher risk of more severe overall ability impairment than those currently married (OR 1.98, 95\% CI 1.68-2.33). Participants living with nonrelatives had an increased risk of more severe overall ability impairment than those living alone (OR 2.38, 95\% CI 1.46-3.91). Higher education level was a protective factor of overall ability impairment (college degree or above: OR 0.32, 95\% CI 0.24-0.42). The four dimensions of ability assessed were significantly correlated; a low score for ADL was significantly correlated with poorer mental status, sensory and communication, and social participation (all P<.001). Conclusions: The proportion of disability among Chinese older adults increases with age, being female, having lower education levels, being divorced or widowed, and living with nonrelatives. Impairment in ADL ability is significantly correlated with poor mental status, social participation, and sensory and communication abilities. A holistic approach to improving the health of the older population is recommended in China. ",
doi="10.2196/43612",
url="https://publichealth.jmir.org/2023/1/e43612",
url="http://www.ncbi.nlm.nih.gov/pubmed/37561566"
}


@Article{info:doi/10.2196/45677,
author="Guo, Lan
and Wang, Wanxin
and Shi, Jingman
and Zheng, Xinyu
and Hua, Yilin
and Lu, Ciyong",
title="Evaluation of Social Isolation Trajectories and Incident Cardiovascular Disease Among Middle-Aged and Older Adults in China: National Cohort Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Jun",
day="30",
volume="9",
pages="e45677",
keywords="social isolation trajectories",
keywords="cardiovascular disease",
keywords="CVD",
keywords="cohort study",
keywords="middle-aged and older adults",
keywords="China",
keywords="social isolation",
abstract="Background: Although the association between social isolation and the risk of subsequent cardiovascular disease (CVD) is well documented, most studies have only assessed social isolation at a single time point, and few studies have considered the association using repeatedly measured social isolation. Objective: This study aimed to examine the association between social isolation trajectories and incident CVD in a large cohort of middle-aged and older adults. Methods: This study used data from 4 waves (wave 1, wave 2, wave 3, and wave 4) of the China Health and Retirement Longitudinal Study. We defined the exposure period as from June 2011 to September 2015 (from wave 1 to wave 3) and the follow-up period as from September 2015 to March 2019 (wave 4). On the basis of the inclusion and exclusion criteria, our final analytic sample included 8422 individuals who had no CVD in the China Health and Retirement Longitudinal Study in waves 1 to 3 and were fully followed up in wave 4. Social isolation was ascertained using an extensively used questionnaire at 3 consecutive, biennial time points from waves 1 to 3, and individuals were assigned to 3 predefined social isolation trajectories based on their scores at each wave (consistently low, fluctuating, and consistently high). Incident CVD included self-reported physician-diagnosed heart disease and stroke combined. Cox proportional hazard models estimated the associations of social isolation trajectories with risks of incident CVD, adjusting for demographics, health behaviors, and health conditions. Results: Of the 8422 participants (mean age 59.76, SD 10.33 years at baseline), 4219 (50.09\%) were male. Most of the participants (5267/8422, 62.54\%) had consistently low social isolation over time and 16.62\% (1400/8422) of the participants had consistently high social isolation over the exposure period. During the 4-year follow-up, 746 incident CVDs occurred (heart disease: 450 cases and stroke: 336 cases). Compared with individuals with consistently low social isolation, those with fluctuating social isolation (adjusted hazard ratio 1.27, 95\% CI 1.01-1.59) and consistently high social isolation (adjusted hazard ratio 1.45, 95\% CI 1.13-1.85) had higher risks for incident CVD after adjusting for demographics (ie, age, sex, residence, and educational level), health behaviors (ie, smoking status and drinking status), and health conditions (ie, BMI; history of diabetes, hypertension, dyslipidemia, chronic kidney disease; use of diabetes medications, hypertension medications, and lipid-lowering therapy; and depressive symptoms scores). Conclusions: In this cohort study, middle-aged and older adults with fluctuating and consistently high social isolation exposure had higher risks of the onset of CVD than those without the exposure. The findings suggest that routine social isolation screenings and efforts to improve social connectedness merit increased attention for preventing CVD among middle-aged and older adults. ",
doi="10.2196/45677",
url="https://publichealth.jmir.org/2023/1/e45677",
url="http://www.ncbi.nlm.nih.gov/pubmed/37389914"
}


@Article{info:doi/10.2196/45231,
author="Budak, Beliz K{\"u}bra
and Laporte Uribe, Franziska
and Meiland, Franka
and Felding, Anna Simone
and Teupen, Sonja
and Bergmann, Michael Johannes
and Mueller-Widmer, Rene
and Roes, Martina",
title="Implementing Active Assisted Living Technology in the Long-term Care of People Living With Dementia to Address Loneliness: European Survey",
journal="JMIR Aging",
year="2023",
month="Jun",
day="14",
volume="6",
pages="e45231",
keywords="loneliness",
keywords="social isolation",
keywords="active assisted living technology",
keywords="long-term care",
keywords="dementia",
keywords="Alzheimer",
keywords="implementation",
keywords="CFIR",
abstract="Background: In the lives of people with dementia, loneliness is an important issue with psychological and physical consequences. Active assisted living (AAL) technology has been gaining visibility in the care of persons living with dementia, including addressing loneliness. However, to the best of our knowledge, there is a lack of evidence concerning the factors influencing the implementation of AAL technology within the context of dementia, loneliness, and long-term care (LTC). Objective: We aimed to identify the familiarity with AAL technology that is promising for addressing loneliness in persons living with dementia in LTC in Europe and the factors influencing AAL technology implementation. Methods: A web-based survey was developed based on findings from our previous literature review. The Consolidated Framework for Implementation Research guided the development and analysis of the survey. Participants included 24 representatives of Alzheimer Europe member associations from 15 European countries. The data were analyzed using basic statistical methods (descriptive statistics). Results: The baby seal robot Paro was reported to be the most familiar AAL technology by 19 of 24 participants addressing loneliness in people with dementia living in LTC. Participants from Norway (n=2) reported familiarity with 14 AAL technologies, and participants from Serbia (n=1) reported zero familiarity. It seems that countries that invest less in LTC facilities are familiar with fewer AAL technologies. At the same time, these countries report a more positive attitude toward AAL technology, express a higher need for it, and see more advantages than disadvantages than those countries that invest more in LTC. However, a country's investment in LTC facilities does not seem to be linked to other implementation aspects such as costs, planning, and the impact of infrastructure. Conclusions: Implementation of AAL technology to address loneliness in dementia seems to be linked to familiarity with the technology in a country as well as national investment in LTC facilities. This survey confirms the literature on higher investment countries' critical stance in regard to AAL technology implementation to address loneliness in persons living with dementia living in LTC. Further research is needed to clarify the potential reasons why familiarity with more AAL technology does not seem to be directly linked with acceptance, positive attitude, or satisfaction with AAL technology addressing loneliness in persons living with dementia. ",
doi="10.2196/45231",
url="https://aging.jmir.org/2023/1/e45231",
url="http://www.ncbi.nlm.nih.gov/pubmed/37314840"
}


@Article{info:doi/10.2196/41938,
author="Tahir, Sahar
and Abdulrazak, Bessam
and Baillargeon, Dany
and Girard, Catherine
and Provencher, V{\'e}ronique",
title="Adapting Transportation Planning e-Tools to Older Adults' Needs: Scoping Review",
journal="JMIR Aging",
year="2023",
month="May",
day="16",
volume="6",
pages="e41938",
keywords="active aging, transportation",
keywords="e-tool",
keywords="user-centered",
keywords="review",
keywords="Canadian mobility experience",
abstract="Background: Aging is often accompanied by a decrease in physical and sensory capacities and financial resources, which makes travel and the use of public transport a big challenge for older adults. These mobility limitations may prevent them from going out for groceries, medical appointments, or entertainment, which increases the risk of social isolation. A key element in helping older adults to maintain healthy aging and social engagement is to foster autonomy, freedom, and active mobility. A transportation planning e-tool can provide older adults with information about transport and trip options. There are many transportation planning e-tools, but little is known about whether and how their characteristics and functionalities address older adults' needs and preferences. Objective: This study aims to map existing transportation e-tools and identify gaps to be filled in order to match their functionalities with older adults' needs and preferences. Methods: A scoping review of existing transportation planning e-tools was conducted based on the approach developed by Arksey and O'Malley. A search in the scientific literature (Academic Search Complete, MEDLINE, CINAHL, SocINDEX, and ERIC) as well as gray literature (TRID Database, Google Scholar, Proquest, Google Play, etc) was conducted in June 2020 and updated 3 times; in September 2021, December 2021, and May 2022. After the studies were selected, a comparative analysis was performed by 2 evaluators; an occupational therapy student and a computer science student. These e-tools were analyzed with respect to some characteristics (eg, tool's development status, target customers, and geographic coverage) as well as 10 functionalities (time autonomy, walkability, crowd avoidance, incline avoidance, weather consideration, dark avoidance, winter obstacles avoidance, amenities inclusion, taxi driver's information, and support affordance) that we defined based on older adults' needs and preferences (mainly Canadians). These needs were identified from a literature review and confirmed by workshops (focus groups). Results: The scientific and gray literature search yielded 463 sources, and 42 transportation e-tools were included. None of the e-tools reviewed addresses all 10 functionalities. More specifically, functionalities such as dark avoidance and support affordance were not addressed by any of the included e-tools. Conclusions: Most of the e-tools currently available to plan trips do not address older adults' needs and preferences. The results of this scoping review helped fill this gap by identifying functionalities to include in transportation planning e-tools designed to promote active aging. The findings of this study highlight the need to use a multicriteria optimization algorithm to address older adults' mobility needs and preferences. International Registered Report Identifier (IRRID): RR2-10.2196/33894 ",
doi="10.2196/41938",
url="https://aging.jmir.org/2023/1/e41938",
url="http://www.ncbi.nlm.nih.gov/pubmed/37191985"
}


@Article{info:doi/10.2196/40785,
author="Lee, Rebecca Abigail
and Csipke, Emese
and Yates, Lauren
and Moniz-Cook, Esme
and McDermott, Orii
and Taylor, Steven
and Stephens, Michael
and Kelleher, Daniel
and Orrell, Martin",
title="A Web-Based Self-management App for Living Well With Dementia: User-Centered Development Study",
journal="JMIR Hum Factors",
year="2023",
month="Feb",
day="24",
volume="10",
pages="e40785",
keywords="dementia",
keywords="self-management",
keywords="independence",
keywords="quality of life",
keywords="web-based",
keywords="website",
keywords="psychosocial",
abstract="Background: Self-management, autonomy, and quality of life are key constructs in enabling people to live well with dementia. This population often becomes isolated following diagnosis, but it is important for them to feel encouraged to maintain their daily activities and stay socially active. Promoting Independence in Dementia (PRIDE) fosters social inclusion and greater dementia self-management through an interactive handbook. Objective: This study aimed to develop a paper-based PRIDE manual on a web-based platform. Methods: Two overarching stages were used to create the web-based version of PRIDE. The first was Preliminary Development, which encompassed tendering, preliminary development work, consultations, beta version of the website, user testing and consultation on beta version, and production of the final web-based prototype. The second stage was Development of the Final PRIDE App, which included 2 sprints and further user testing. Results: Through a lengthy development process, modifications were made to app areas such as the log-in process, content layout, and aesthetic appearance. Feedback from the target population was incorporated into the process to achieve a dementia-friendly product. The finished PRIDE app has defined areas for reading dementia-related topics, creating activity plans, and logging these completed activities. Conclusions: The PRIDE app has evolved from its initial prototype into a more dementia-friendly and usable program that is suitable for further testing. The finished version will be tested in a reach, effectiveness, adoption, implementation, and maintenance study, with its potential reach, effectiveness, and adoption explored. Feedback gathered during the reach, effectiveness, adoption, implementation, and maintenance study will lead to any further developments in the app to increase its applicability to the target audience and usability. ",
doi="10.2196/40785",
url="https://humanfactors.jmir.org/2023/1/e40785",
url="http://www.ncbi.nlm.nih.gov/pubmed/36826978"
}


@Article{info:doi/10.2196/38593,
author="Lemaire, C{\'e}lia
and Humbert, Christophe
and Sueur, C{\'e}dric
and Racin, C{\'e}line",
title="Use of Digital Technologies to Maintain Older Adults' Social Ties During Visitation Restrictions in Long-Term Care Facilities: Scoping Review",
journal="JMIR Aging",
year="2023",
month="Feb",
day="10",
volume="6",
pages="e38593",
keywords="social isolation",
keywords="COVID-19 pandemic",
keywords="remote care",
keywords="nursing homes",
keywords="social ties",
keywords="digital devices",
keywords="older adults",
abstract="Background: Digital technologies were implemented to address the disruption of long-term care facility residents' socialization needs during the COVID-19 pandemic. A literature review regarding this topic is needed to inform public policy, facility managers, family caregivers, and nurses and allied health professionals involved in mediating the use of digital devices for residents' social ties. Objective: Our study outlines key concepts, methodologies, results, issues, and gaps in articles published during pandemic-related visitation restrictions. Methods: Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) protocol, a scoping review was conducted by searching 3 database aggregator platforms (EBSCO, ProQuest, and PubMed) for studies published in peer-reviewed journals from early 2020 to the end of June 2021, when the most stringent restrictions were in place. We included qualitative and quantitative studies, reviews, commentaries, viewpoints, and letters to the editors in French or English focusing on digital technologies aiming to support the social contact of residents in long-term care facilities during pandemic-related visitation restrictions. Results: Among 763 screened articles, 29 met our selection criteria. For each study, we characterized the (1) authors, title, and date of the publication; (2) country of the first author; (3) research fields; (4) article type; and (5) type of technology mentioned. The analysis distinguished 3 main themes emerging from the literature: (1) impact and expectations of remote social contact on the physical and mental health and well-being of the residents (n=12), (2) with whom or what the social contact took place (n=17), and (3) limitations and barriers to significant social contact related to digital technologies (n=14). The results first underlined the highly positive impact expected by the authors of the digital technologies on health and quality of life of residents of long-term care facilities. Second, they highlighted the plurality of ties to consider, since social contact takes place not only with family caregivers to maintain contact but also for other purposes (end-of-life videoconferences) and with other types of contact (eg, with staff and robots). Third, they exposed the limitations and barriers to significant contact using digital technologies and outlined the required conditions to enable them. Conclusions: The review demonstrated the opportunities and risks outlined by the literature about the implementation of digital technologies to support remote social contact. It showed the plurality of ties to consider and revealed the need to evaluate the positive impact of remote contact from the residents' perspectives. Therefore, to go beyond the risk of digital solutionism, there is a need for studies considering the holistic impact on health regarding the implementation of digital technologies, including the meaning residents give to interpersonal exchanges and the organizational constraints. Trial Registration: OSF Registries osf.io/yhpx3; https://osf.io/yhpx3 ",
doi="10.2196/38593",
url="https://aging.jmir.org/2023/1/e38593",
url="http://www.ncbi.nlm.nih.gov/pubmed/36599164"
}


@Article{info:doi/10.2196/39848,
author="Phang, Kie Jie
and Kwan, Heng Yu
and Yoon, Sungwon
and Goh, Hendra
and Yee, Qi Wan
and Tan, Seng Chuen
and Low, Leng Lian",
title="Digital Intergenerational Program to Reduce Loneliness and Social Isolation Among Older Adults: Realist Review",
journal="JMIR Aging",
year="2023",
month="Jan",
day="4",
volume="6",
pages="e39848",
keywords="aged",
keywords="loneliness",
keywords="older people",
keywords="review",
keywords="social isolation",
abstract="Background: There is a compelling need for an innovative and creative approach to promote social connectedness among older adults to optimize their well-being and quality of life. One possible solution may be through a digital intergenerational program. Objective: This realist review aimed to identify existing digital intergenerational programs that were used to reduce loneliness or social isolation among older adults and analyze them in terms of strategy, context, mechanisms, and outcomes. Methods: We performed a realist review with an extensive search of published and gray literature. For scholarly literature, we searched PubMed, Embase, CINAHL, PsycINFO (Ovid), and Social Sciences Citation Index databases for articles published between January 2000 to August 2020. A grey literature search was performed using the Google search engine, and the search was completed in May 2021. We included programs that evaluated digital intergenerational programs for older adults, which described outcomes of loneliness or social isolation. We included quantitative, mixed methods, and qualitative studies, as well as relevant theoretical papers, policy documents, and implementation documents. The studies were appraised based on their relevance and rigor. We synthesized the available evidence from the literature into Strategy-Context-Mechanism-Outcome (S-C-M-O) configurations to better understand what, when, and how programs work. Results: A total of 31 documents reporting 27 digital intergenerational programs were reviewed. Our final results identified 4 S-C-M-O configurations. For S-C-M-O configuration 1, we found that for community-dwelling older adults, provision of access to and training in digital technology may increase older adults' self-efficacy in digital devices and therefore increase the use of digital communication with family. In S-C-M-O configuration 2, digital psychosocial support and educational interventions from nurses were found to be useful in reducing loneliness among community-dwelling older adults. In S-C-M-O configuration 3, a video call with a student or family was found to reduce loneliness among older adults residing in long-term residential care facilities. Finally, for S-C-M-O configuration 4, we found that behavioral activation provided through videoconferencing by a lay coach may be useful in reducing loneliness among older adults who are lonely. However, as almost half (11/27, 41\%) of the included programs only reported quantitative results, this review focused on screening the discussion section of publications to identify author opinions or any qualitative information to elucidate the mechanisms of how programs work. Conclusions: This review identified the key strategy, context, and mechanism influencing the success of programs that promote intergenerational interaction through digital means. This review revealed that different strategies should be adopted for different groups of older adults (eg, older adults who are lonely, older adults who reside in long-term residential care facilities, and community-dwelling older adults). The S-C-M-O configurations should be considered when designing and implementing digital intergenerational programs for older adults. ",
doi="10.2196/39848",
url="https://aging.jmir.org/2023/1/e39848",
url="http://www.ncbi.nlm.nih.gov/pubmed/36598801"
}


@Article{info:doi/10.2196/37617,
author="Mills, Marie Christine
and Parniak, Simone
and Hand, Carri
and McGrath, Colleen
and Laliberte Rudman, Debbie
and Chislett, Cassandra
and Giberson, Mariah
and White, Lauren
and DePaul, Vincent
and Donnelly, Catherine",
title="The Impact of a Naturally Occurring Retirement Community Supportive Services Program on Older Adult Participants' Social Networks: Semistructured Interview Study",
journal="JMIR Aging",
year="2022",
month="Nov",
day="21",
volume="5",
number="4",
pages="e37617",
keywords="aging in place",
keywords="naturally occurring retirement communities",
keywords="social networks",
keywords="social networking",
keywords="social capital",
keywords="aged",
abstract="Background: Most older adults want to age in place, in their homes and communities. However, this can be challenging for many, frequently owing to lack of supports that allow for aging in place. Naturally occurring retirement community supportive services programs (NORC-SSPs) offer an approach to help older adults age in place. Although qualitative studies have examined the experiences of NORC-SSP participants, little is known about how participation in NORC-SSP programming affects participants' social networks. Objective: This study aimed to explore the experiences of 13 NORC-SSP residents who participated in Oasis Senior Supportive Living (Oasis) and how participating in NORC-SSP programming, specifically based on the Oasis model, influenced their social networks. Methods: Participants were recruited, using convenience sampling, from 4 naturally occurring retirement communities (NORCs) in Ontario, Canada. All participants (13/13, 100\%) had participated in Oasis programming. Semistructured qualitative interviews were conducted with participants. Social network theory informed the interview guide and thematic analysis. Results: In total, 13 participants (n=12, 92\% women and n=1, 8\% men) were interviewed. These participants were from 4 different NORCs where Oasis had been implemented, comprising 2 midrise apartment buildings, 1 low-rise apartment building, and 1 mobile home community. Overall, 3 main themes were identified from the interviews with Oasis participants: expansion and deepening of social networks, Oasis activities (something to do, someone to do it with), and self-reported impact of Oasis on mental health and well-being (feeling and coping with life better). Participants noted that Oasis provided them with opportunities to meet new people and broaden their social networks, both within and outside their NORCs. They also indicated that Oasis provided them with meaningful ways to spend their time, including opportunities to socialize and try new activities. Participants stated that participating in Oasis helped to alleviate loneliness and improved their quality of life. They noted that Oasis provided them with a reason to get up in the morning. However, the experiences described by participants may not be reflective of all Oasis members. Those who had positive experiences may have been more likely to agree to be interviewed. Conclusions: On the basis of the participants' interviews, Oasis is an effective aging-in-place model that has been successfully implemented in low-rise apartment buildings, midrise apartment buildings, and mobile home communities. Participating in Oasis allowed participants to expand their social networks and improve their mental health and well-being. Therefore, NORCs may offer an ideal opportunity to build strong communities that provide deep, meaningful social connections that expand social networks. NORC-SSPs, such as Oasis, can support healthy aging and allow older adults to age in place. ",
doi="10.2196/37617",
url="https://aging.jmir.org/2022/4/e37617",
url="http://www.ncbi.nlm.nih.gov/pubmed/36409533"
}


@Article{info:doi/10.2196/40125,
author="Balki, Eric
and Hayes, Niall
and Holland, Carol",
title="Effectiveness of Technology Interventions in Addressing Social Isolation, Connectedness, and Loneliness in Older Adults: Systematic Umbrella Review",
journal="JMIR Aging",
year="2022",
month="Oct",
day="24",
volume="5",
number="4",
pages="e40125",
keywords="information and communications technology",
keywords="interventions",
keywords="loneliness",
keywords="older adults",
keywords="social connectedness",
keywords="social isolation",
keywords="technology interventions",
abstract="Background: The global population of older adults (aged >60 years) is expected to triple to 2 billion by 2050. Proportionate rises in older adults affected by loneliness and social isolation (or social connectedness) are expected. Rapid deployability and social changes have increased the availability of technological devices, creating new opportunities for older adults. Objective: This study aimed to identify, synthesize, and critically appraise the effectiveness of technology interventions improving social connectedness in older adults by assessing the quality of reviews, common observations, and derivable themes. Methods: Following the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), 4 databases (PsycINFO, PubMed, Embase, and MEDLINE) were searched between February 2020 and March 2022. We identified reviews with adults aged ?50 years in community and residential settings, reporting outcomes related to the impact of technologies on social disconnectedness with inclusion criteria based on the population, intervention, context, outcomes, and study schema---review-type articles (systematic, meta-analyses, integrative, and scoping)---and with digital interventions included. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to measure the strength of outcome recommendations including the risk of bias. The reviews covered 326 primary studies with 79,538 participants. Findings were extracted, synthesized, and organized according to emerging themes. Results: Overall, 972 publications met the initial search criteria, and 24 met our inclusion criteria. Revised Assessment of Multiple Systematic Reviews was used to assess the quality of the analysis. Eligible reviews (3/24, 12\%) were excluded because of their low Revised Assessment of Multiple Systematic Reviews scores (<22). The included reviews were dedicated to information and communications technology (ICT; 11/24, 46\%), videoconferencing (4/24, 17\%), computer or internet training (3/24, 12\%), telecare (2/24, 8\%), social networking sites (2/24, 8\%), and robotics (2/27, 8\%). Although technology was found to improve social connectedness, its effectiveness depended on study design and is improved by shorter durations, longer training times, and the facilitation of existing relationships. ICT and videoconferencing showed the best results, followed by computer training. Social networking sites achieved mixed results. Robotics and augmented reality showed promising results but lacked sufficient data for informed conclusions. The overall quality of the studies based on GRADE was medium low to very low. Conclusions: Technology interventions can improve social connectedness in older adults. The specific effectiveness rates favor ICT and videoconferencing, but with limited evidence, as indicated by low GRADE ratings. Future intervention and study design guidelines should carefully assess the methodological quality of studies and the overall certainty of specific outcome measures. The lack of randomized controlled trials in underlying primary studies (<28\%) and suboptimal methodologies limited our findings. Robotics and augmented or virtual reality warrant further research. Low GRADE scores highlight the need for high-quality research in these areas. Trial Registration: PROSPERO CRD42022363475; https://tinyurl.com/mdd6zds ",
doi="10.2196/40125",
url="https://aging.jmir.org/2022/4/e40125",
url="http://www.ncbi.nlm.nih.gov/pubmed/36279155"
}


@Article{info:doi/10.2196/35425,
author="Gerritzen, Vera Esther
and Lee, Rebecca Abigail
and McDermott, Orii
and Coulson, Neil
and Orrell, Martin",
title="Online Peer Support for People With Parkinson Disease: Narrative Synthesis Systematic Review",
journal="JMIR Aging",
year="2022",
month="Jul",
day="27",
volume="5",
number="3",
pages="e35425",
keywords="Parkinson disease",
keywords="web-based health community",
keywords="online peer support",
keywords="narrative synthesis",
keywords="systematic review",
abstract="Background: Parkinson disease (PD) significantly impacts the lives of people with the diagnosis and their families. In addition to the physical symptoms, living with PD also has an emotional impact. This can result in withdrawal from social roles, increasing the risk for social isolation and loneliness. Peer support is a way to stay socially connected, share experiences, and learn new coping skills. Peer support can be provided both in person and on the internet. Some of the advantages of online peer support are that it overcomes geographical barriers and provides a form of anonymity; moreover, support can be readily available when needed. However, the psychosocial impact of PD is still underresearched, and there is no systematic synthesis of online peer support for people with PD. Objective: This review aims to explore the benefits and challenges of online peer support and identify successful elements of online peer support for people with PD. Methods: The method selected for this systematic review is narrative synthesis. A total of 6 databases were systematically searched in April 2020 for articles published between 1989 and 2020. The quality of the included studies was assessed using the Critical Appraisal Skills Programme qualitative research checklist and the Downs and Black quality checklist. Results: A total of 10,987 unique articles were identified through a systematic database search. Of these 10,987 articles, 8 (0.07\%) were included in this review. Of the 8 studies, 5 (63\%) were of good or high quality, 2 (25\%) were of medium or fair quality, and 1 (13\%) study was of poor quality. Web-based platforms included discussion forums, a web-based virtual world, and Facebook groups. Most papers reported on text-based communication. The included studies reported on sharing social support and personal experiences. Successful elements included increasing similarity between members and offering the opportunity to directly ask questions to a physician. Challenges included members leaving without a warning and PD symptoms hindering the use of technology. Conclusions: Peer support can improve social support and help people with PD in living meaningful and satisfying lives. Peer support is unique and cannot be replaced by family members, friends, or health care professionals. Online peer support can be a solution for those who do not have access to an in-person support group or whose PD symptoms restrict them from travelling. However, research on the personal experiences of those who engage in online peer support and potential barriers in accessing it remains limited. Future research could use qualitative methods to explore these fields further. ",
doi="10.2196/35425",
url="https://aging.jmir.org/2022/3/e35425",
url="http://www.ncbi.nlm.nih.gov/pubmed/35896025"
}


@Article{info:doi/10.2196/38896,
author="Lee, Hocheol
and Chung, Ah Min
and Kim, Hyeji
and Nam, Woo Eun",
title="The Effect of Cognitive Function Health Care Using Artificial Intelligence Robots for Older Adults: Systematic Review and Meta-analysis",
journal="JMIR Aging",
year="2022",
month="Jun",
day="28",
volume="5",
number="2",
pages="e38896",
keywords="older adult population",
keywords="older adults",
keywords="cognition",
keywords="cognitive function",
keywords="artificial intelligence",
keywords="socially assistive robots",
keywords="AI SAR",
keywords="social prescription",
keywords="dementia",
keywords="social support",
keywords="aging",
keywords="caregiver",
keywords="caregiving",
keywords="meta-analysis",
keywords="review",
keywords="Cochrane collaboration",
keywords="assistive robot",
keywords="assistive technology",
abstract="Background: With rapidly aging populations in most parts of the world, it is only natural that the need for caregivers for older adults is going to increase in the near future. Therefore, most technologically proficient countries are in the process of using artificial intelligence (AI) to build socially assistive robots (SAR) to play the role of caregivers in enhancing interaction and social participation among older adults. Objective: This study aimed to examine the effect of intervention through AI SAR on the cognitive function of older adults through a systematic literature review. Methods: We conducted a meta-analysis of the various existing studies on the effect of AI SAR on the cognitive function of older adults to standardize the results and clarify the effect of each method and indicator. Cochrane collaboration and the systematic literature review flow of PRISMA (Preferred Reporting Item Systematic Reviews and Meta-Analyses) were used on original, peer-reviewed studies published from January 2010 to March 2022. The search words were derived by combining keywords including Population, Intervention, and Outcome---according to the Population, Intervention, Comparison, Outcome, Time, Setting, and Study Design principle---for the question ``What is the effect of AI SAR on the cognitive function of older adults in comparison with a control group?'' (Population: adults aged ?65 years; Intervention: AI SAR; Comparison: comparison group; Outcome: popular function; and Study Design: prospective study). For any study, if one condition among subjects, intervention, comparison, or study design was different from those indicated, the study was excluded from the literature review. Results: In total, 9 studies were selected (6 randomized controlled trials and 3 quasi-experimental design studies) for the meta-analysis. Publication bias was examined using the contour-enhanced funnel plot method to confirm the reliability and validity of the 9 studies. The meta-analysis revealed that the average effect size of AI SAR was shown to be Hedges g=0.43 (95\% CI --0.04 to 0.90), indicating that AI SAR are effective in reducing the Mini Mental State Examination scale, which reflects cognitive function. Conclusions: The 9 studies that were analyzed used SAR in the form of animals, robots, and humans. Among them, AI SAR in anthropomorphic form were able to improve cognitive function more effectively. The development and expansion of AI SAR programs to various functions including health notification, play therapy, counseling service, conversation, and dementia prevention programs are expected to improve the quality of care for older adults and prevent the overload of caregivers. AI SAR can be considered a representative, digital, and social prescription program and a nonpharmacological intervention program that communicates with older adults 24 hours a day. Despite its effectiveness, ethical issues, the digital literacy needs of older adults, social awareness and reliability, and technological advancement pose challenges in implementing AI SAR. Future research should include bigger sample sizes, pre-post studies, as well as studies using an older adult control group. ",
doi="10.2196/38896",
url="https://aging.jmir.org/2022/2/e38896",
url="http://www.ncbi.nlm.nih.gov/pubmed/35672268"
}


@Article{info:doi/10.2196/34793,
author="Savage, D. Rachel
and Di Nicolo, Sophia
and Wu, Wei
and Li, Joyce
and Lawson, Andrea
and Grieve, Jim
and Goel, Vivek
and Rochon, A. Paula",
title="The Factors Associated With Nonuse of Social Media or Video Communications to Connect With Friends and Family During the COVID-19 Pandemic in Older Adults: Web-Based Survey Study",
journal="JMIR Aging",
year="2022",
month="Jun",
day="6",
volume="5",
number="2",
pages="e34793",
keywords="digital technology",
keywords="loneliness",
keywords="older adults",
keywords="COVID-19",
keywords="elderly",
keywords="lonely",
keywords="mental health",
keywords="factor",
keywords="usage",
keywords="social media",
keywords="video",
keywords="communication",
keywords="connection",
keywords="connect",
keywords="family",
keywords="friend",
keywords="age",
keywords="support",
abstract="Background: Digital technologies have enabled social connection during prolonged periods of physical distancing and travel restrictions throughout the COVID-19 pandemic. These solutions may exclude older adults, who are at higher risk for social isolation, loneliness, and severe outcomes if infected with SARS-CoV-2. Objective: This study investigated factors associated with nonuse of social media or video communications to connect with friends and family among older adults during the pandemic's first wave. Methods: A web-based, cross-sectional survey was administered to members of a national retired educators' organization based in Ontario, Canada, between May 6 and 19, 2020. Respondents (N=4879) were asked about their use of social networking websites or apps to communicate with friends and family, their internet connection and smartphone access, loneliness, and sociodemographic characteristics. Factors associated with nonuse were evaluated using multivariable logistic regression. A thematic analysis was performed on open-ended survey responses that described experiences with technology and virtual connection. Results: Overall, 15.4\% (751/4868) of respondents did not use social networking websites or apps. After adjustment, male gender (odds ratio [OR] 1.60, 95\% CI 1.33-1.92), advanced age (OR 1.88, 95\% CI 1.38-2.55), living alone (OR 1.68, 95\% CI 1.39-2.02), poorer health (OR 1.33, 95\% CI 1.04-1.71), and lower social support (OR 1.44, 95\% CI 1.20-1.71) increased the odds of nonuse. The reliability of internet connection and access to a smartphone also predicted nonuse. Many respondents viewed these technologies as beneficial, especially for maintaining pre--COVID-19 social contacts and routines, despite preferences for in-person connection. Conclusions: Several factors including advanced age, living alone, and low social support increased the odds of nonuse of social media in older adults to communicate with friends and family during COVID-19's first wave. Our findings identified socially vulnerable subgroups who may benefit from intervention (eg, improved access, digital literacy, and telephone outreach) to improve social connection. ",
doi="10.2196/34793",
url="https://aging.jmir.org/2022/2/e34793",
url="http://www.ncbi.nlm.nih.gov/pubmed/35344502"
}


@Article{info:doi/10.2196/33856,
author="Muurling, Marijn
and Reus, M. Lianne
and de Boer, Casper
and Wessels, C. Sterre
and Jagesar, R. Raj
and Vorstman, S. Jacob A.
and Kas, H. Martien J.
and Visser, Jelle Pieter",
title="Assessment of Social Behavior Using a Passive Monitoring App in Cognitively Normal and Cognitively Impaired Older Adults: Observational Study",
journal="JMIR Aging",
year="2022",
month="May",
day="20",
volume="5",
number="2",
pages="e33856",
keywords="passive monitoring",
keywords="smartphone app",
keywords="cognitive impairment",
keywords="social behavior",
keywords="dementia",
keywords="mHealth",
keywords="mobile app",
keywords="cognitive",
keywords="mental health",
keywords="social withdrawal",
keywords="well-being",
abstract="Background: In people with cognitive impairment, loss of social interactions has a major impact on well-being. Therefore, patients would benefit from early detection of symptoms of social withdrawal. Current measurement techniques such as questionnaires are subjective and rely on recall, in contradiction to smartphone apps, which measure social behavior passively and objectively. Objective: This study uses the remote monitoring smartphone app Behapp to assess social behavior, and aims to investigate (1) the association between social behavior, demographic characteristics, and neuropsychiatric symptoms in cognitively normal (CN) older adults, and (2) if social behavior is altered in cognitively impaired (CI) participants. In addition, we explored in a subset of individuals the association between Behapp outcomes and neuropsychiatric symptoms. Methods: CN, subjective cognitive decline (SCD), and CI older adults installed the Behapp app on their own Android smartphone for 7 to 42 days. CI participants had a clinical diagnosis of mild cognitive impairment (MCI) or Alzheimer-type dementia. The app continuously measured communication events, app use and location. Neuropsychiatric Inventory (NPI) total scores were available for 20 SCD and 22 CI participants. Linear models were used to assess group differences on Behapp outcomes and to assess the association of Behapp outcomes with the NPI. Results: We included CN (n=209), SCD (n=55) and CI (n=22) participants. Older cognitively normal participants called less frequently and made less use of apps (P<.05). No sex effects were found. Compared to the CN and SCD groups, CI individuals called less unique contacts ($\beta$=--0.7 [SE 0.29], P=.049) and contacted the same contacts relatively more often ($\beta$=0.8 [SE 0.25], P=.004). They also made less use of apps ($\beta$=--0.83 [SE 0.25], P=.004). Higher total NPI scores were associated with further traveling ($\beta$=0.042 [SE 0.015], P=.03). Conclusions: CI individuals show reduced social activity, especially those activities that are related to repeated and unique behavior, as measured by the smartphone app Behapp. Neuropsychiatric symptoms seemed only marginally associated with social behavior as measured with Behapp. This research shows that the Behapp app is able to objectively and passively measure altered social behavior in a cognitively impaired population. ",
doi="10.2196/33856",
url="https://aging.jmir.org/2022/2/e33856",
url="http://www.ncbi.nlm.nih.gov/pubmed/35594063"
}


@Article{info:doi/10.2196/34577,
author="Parniak, Simone
and DePaul, G. Vincent
and Frymire, Clare
and DePaul, Samuel
and Donnelly, Catherine",
title="Naturally Occurring Retirement Communities: Scoping Review",
journal="JMIR Aging",
year="2022",
month="Apr",
day="14",
volume="5",
number="2",
pages="e34577",
keywords="naturally occurring retirement communities",
keywords="NORC",
keywords="NORC supportive service programs",
keywords="aging in place",
keywords="older adults",
keywords="scoping review",
abstract="Background: As Canada's population ages, there is a need to explore community-based solutions to support older adults. Naturally occurring retirement communities (NORCs), defined in 1986 as buildings or areas not specifically designed for, but which attract, older adults and associated NORC supportive service programs (NORC-SSPs) have been described as potential resources to support aging in place. Though the body of literature on NORCs has been growing since the 1980s, no synthesis of this work has been conducted to date. Objective: The goal of this scoping review is to highlight the current state of NORC literature to inform future research and offer a summarized description of NORCs and how they have supported, and can support, older adults to age in place. Methods: Using a published framework, a scoping review was conducted by searching 13 databases from earliest date of coverage to January 2022. We included English peer- and non--peer-reviewed scholarly journal publications that described, critiqued, reflected on, or researched NORCs. Aging-in-place literature with little to no mention of NORCs was excluded, as were studies that recruited participants from NORCs but did not connect findings to the setting. A qualitative content analysis of the literature was conducted, guided by a conceptual framework, to examine the promise of NORC programs to promote aging in place. Results: From 787 publications, we included 64 (8.1\%) articles. All publications were North American, and nearly half used a descriptive research approach (31/64, 48\%). A little more than half provided a specific definition of a NORC (33/64, 52\%); of these, 13 (39\%) used the 1986 definition; yet, there were discrepancies in the defined proportions of older adults that constitute a NORC (eg, 40\% or 50\%). Of the 64 articles, 6 (9\%) described processes for identifying NORCs and 39 (61\%) specifically described NORC-SSPs and included both external partnerships with organizations for service delivery (33/39, 85\%) and internal resources such as staff, volunteers, or neighbors. Identified key components of a NORC-SSP included activities fostering social relationships (25/64, 39\%) and access to resources and services (26/64, 41\%). Sustainability and funding of NORC-SSPs were described (27/64, 42\%), particularly as challenges to success. Initial outcomes, including self-efficacy (6/64, 9\%) and increased access to social and health supports (14/64, 22\%) were cited; however, long-term outcomes were lacking. Conclusions: This review synthesizes the NORC literature to date and demonstrates that NORC-SSPs have potential as an alternative model of supporting aging in place. Longitudinal research exploring the impacts of both NORCs and NORC-SSPs on older adult health and well-being is recommended. Future research should also explore ways to improve the sustainability of NORC-SSPs. ",
doi="10.2196/34577",
url="https://aging.jmir.org/2022/2/e34577",
url="http://www.ncbi.nlm.nih.gov/pubmed/35436204"
}


@Article{info:doi/10.2196/31162,
author="Waycott, Jenny
and Zhao, Wei
and Kelly, M. Ryan
and Robertson, Elena",
title="Technology-Mediated Enrichment in Aged Care: Survey and Interview Study",
journal="JMIR Aging",
year="2022",
month="Apr",
day="12",
volume="5",
number="2",
pages="e31162",
keywords="aged care",
keywords="older adults",
keywords="technology",
keywords="social enrichment",
keywords="virtual reality",
keywords="robots",
keywords="videoconferencing",
keywords="care providers",
abstract="Background: Digital technologies such as virtual reality (VR), humanoid robots, and digital companion pets have the potential to provide social and emotional enrichment for people living in aged care. However, there is currently limited knowledge about how technologies are being used to provide enrichment, what benefits they provide, and what challenges arise when deploying these technologies in aged care settings. Objective: This study aims to investigate how digital technologies are being used for social and emotional enrichment in the Australian aged care industry and identify the benefits and challenges of using technology for enrichment in aged care. Methods: A web-based survey (N=20) was distributed among people working in the Australian aged care sector. The survey collected information about the types of technologies being deployed and their perceived value. The survey was followed by semistructured interviews (N=12) with aged care workers and technology developers to investigate their experiences of deploying technologies with older adults living in aged care. Survey data were analyzed using summary descriptive statistics and categorizing open-ended text responses. Interview data were analyzed using reflexive thematic analysis. Results: The survey revealed that a range of commercial technologies, such as VR, tablet devices, and mobile phones, are being used in aged care to support social activities and provide entertainment. Respondents had differing views about the value of emerging technologies, such as VR, social robots, and robot pets, but were more united in their views about the value of videoconferencing. Interviews revealed 4 types of technology-mediated enrichment experiences: enhancing social engagement, virtually leaving the care home, reconnecting with personal interests, and providing entertainment and distraction. Our analysis identified 5 barriers: resource constraints, the need to select appropriate devices and apps, client challenges, limited staff and organizational support, and family resistance. Conclusions: This study demonstrates that technologies can be used in aged care to create personally meaningful enrichment experiences for aged care clients. To maximize the effectiveness of technology-mediated enrichment, we argue that a person-centered care approach is crucial. Although enrichment experiences can be created using available technologies, they must be carefully selected and co-deployed with aged care clients. However, significant changes may be required within organizations to allow caregivers to facilitate individual technology-based activities for enrichment. ",
doi="10.2196/31162",
url="https://aging.jmir.org/2022/2/e31162",
url="http://www.ncbi.nlm.nih.gov/pubmed/34975014"
}


@Article{info:doi/10.2196/34221,
author="Thangavel, Gomathi
and Memedi, Mevludin
and Hedstr{\"o}m, Karin",
title="Customized Information and Communication Technology for Reducing Social Isolation and Loneliness Among Older Adults: Scoping Review",
journal="JMIR Ment Health",
year="2022",
month="Mar",
day="7",
volume="9",
number="3",
pages="e34221",
keywords="social isolation",
keywords="loneliness",
keywords="review",
keywords="ICT",
keywords="older adults",
keywords="customization",
keywords="mobile phone",
abstract="Background: Advancements in science and various technologies have resulted in people having access to better health care, a good quality of life, and better economic situations, enabling humans to live longer than ever before. Research shows that the problems of loneliness and social isolation are common among older adults, affecting psychological and physical health. Information and communication technology (ICT) plays an important role in alleviating social isolation and loneliness. Objective: The aim of this review is to explore ICT solutions for reducing social isolation or loneliness among older adults, the purpose of ICT solutions, and the evaluation focus of these solutions. This study particularly focuses on customized ICT solutions that either are designed from scratch or are modifications of existing off-the-shelf products that cater to the needs of older adults. Methods: A scoping literature review was conducted. A search across 7 databases, including ScienceDirect, Association for Computing Machinery, PubMed, IEEE Xplore, PsycINFO, Scopus, and Web of Science, was performed, targeting ICT solutions for reducing and managing social isolation and loneliness among older adults. Articles published in English from 2010 to 2020 were extracted and analyzed. Results: From the review of 39 articles, we identified 5 different purposes of customized ICT solutions focusing on reducing social isolation and loneliness. These were social communication, social participation, a sense of belonging, companionship, and feelings of being seen. The mapping of purposes of ICT solutions with problems found among older adults indicates that increasing social communication and social participation can help reduce social isolation problems, whereas fulfilling emotional relationships and feeling valued can reduce feelings of loneliness. In terms of customized ICT solution types, we found the following seven different categories: social network, messaging services, video chat, virtual spaces or classrooms with messaging capabilities, robotics, games, and content creation and management. Most of the included studies (30/39, 77\%) evaluated the usability and acceptance aspects, and few studies (11/39, 28\%) focused on loneliness or social isolation outcomes. Conclusions: This review highlights the importance of discussing and managing social isolation and loneliness as different but related concepts and emphasizes the need for future research to use suitable outcome measures for evaluating ICT solutions based on the problem. Even though a wide range of customized ICT solutions have been developed, future studies need to explore the recent emerging technologies, such as the Internet of Things and augmented or virtual reality, to tackle social isolation and loneliness among older adults. Furthermore, future studies should consider evaluating social isolation or loneliness while developing customized ICT solutions to provide more robust data on the effectiveness of the solutions. ",
doi="10.2196/34221",
url="https://mental.jmir.org/2022/3/e34221",
url="http://www.ncbi.nlm.nih.gov/pubmed/35254273"
}


@Article{info:doi/10.2196/29224,
author="Koh, Qi Wei
and Whelan, Sally
and Heins, Pascale
and Casey, Dympna
and Toomey, Elaine
and Dr{\"o}es, Rose-Marie",
title="The Usability and Impact of a Low-Cost Pet Robot for Older Adults and People With Dementia: Qualitative Content Analysis of User Experiences and Perceptions on Consumer Websites",
journal="JMIR Aging",
year="2022",
month="Feb",
day="22",
volume="5",
number="1",
pages="e29224",
keywords="social robot",
keywords="pet robots",
keywords="low-cost robot",
keywords="dementia",
keywords="older adults",
keywords="qualitative research",
keywords="qualitative content analysis",
abstract="Background: Worldwide, populations are aging exponentially. Older adults and people with dementia are especially at risk of social isolation and loneliness. Social robots, including robotic pets, have had positive impacts on older adults and people with dementia by providing companionship, improving mood, reducing agitation, and facilitating social interaction. Nevertheless, the issue of affordability can hinder technology access. The Joy for All (JfA) robotic pets have showed promise as examples of low-cost alternatives. However, there has been no research that investigated the usability and impact of such low-cost robotic pets based on perceptions and experiences of its use with older adults and people with dementia. Objective: The aim of our study was to explore the usability and impact of the JfA robotic cat, as an example of a low-cost robot, based on perceptions and experiences of using the JfA cat for older adults and people with dementia. Methods: We used a novel methodology of analyzing a large volume of information that was uploaded by reviewers of the JfA cat onto online consumer review sites. Data were collected from 15 consumer websites. This provided a total of 2445 reviews. Next, all reviews were screened. A total of 1327 reviews that contained information about use of the JfA cat for older adults or people with dementia were included for analysis. These were reviews that contained terms relating to ``older adults,'' ``dementia,'' and ``institutional care'' and were published in the English language. Descriptive statistics was used to characterize available demographic information, and textual data were qualitatively analyzed using inductive content analysis. Results: Most reviews were derived from consumer sites in the United States, and most reviewers were family members of users (ie, older adults and people with dementia). Based on the qualitative content analysis, 5 key themes were generated: prior expectations, perceptions, meaningful activities, impacts, and practicalities. Reviewers had prior expectations of the JfA cat, which included circumstantial reasons that prompted them to purchase this technology. Their perceptions evolved after using the technology, where most reported positive perceptions about their appearance and interactivity. The use of the robot provided opportunities for users to care for it and incorporate it into their routine. Finally, reviewers also shared information about the impacts of device and practicalities related to its use. Conclusions: This study provides useful knowledge about the usability and impact of a low-cost pet robot, based on experiences and perceptions of its use. These findings can help researchers, robot developers, and clinicians understand the viability of using low-cost robotic pets to benefit older adults and people with dementia. Future research should consider evaluating design preferences for robotic pets, and compare the effects of low-cost robotic pets with other more technologically advanced robotic pets. ",
doi="10.2196/29224",
url="https://aging.jmir.org/2022/1/e29224",
url="http://www.ncbi.nlm.nih.gov/pubmed/35191844"
}


@Article{info:doi/10.2196/20466,
author="Silva, Patr{\'i}cia
and Delerue Matos, Alice
and Martinez-Pecino, Roberto",
title="The Contribution of the Internet to Reducing Social Isolation in Individuals Aged 50 Years and Older: Quantitative Study of Data From the Survey of Health, Ageing and Retirement in Europe",
journal="J Med Internet Res",
year="2022",
month="Jan",
day="3",
volume="24",
number="1",
pages="e20466",
keywords="social isolation",
keywords="internet",
keywords="50+ individuals",
keywords="e-inclusion",
keywords="SHARE",
abstract="Background: Social isolation has a negative impact on the quality of life of older people; therefore, studies have focused on identifying its sociodemographic, economic, and health determinants. In view of the growing importance of the internet as a means of communication, it is essential to assess whether internet use interferes with social isolation. Objective: This study specifically aims to clarify the relationship between internet use and social isolation of individuals aged ?50 years, for which other surveys present contradictory results. Methods: We performed logistic regression analysis with social isolation as the dependent variable, internet use as the interest variable, and several other sociodemographic, economic, and health characteristics of the individuals as control variables. The sample size was 67,173 individuals aged 50 years and older from 17 European countries (Portugal, Greece, Italy, Spain, Denmark, Sweden, Austria, Belgium, France, Germany, Switzerland, Luxemburg, Poland, Czech Republic, Slovenia, Estonia, and Croatia) plus Israel, who were interviewed in the Survey of Health, Ageing and Retirement in Europe (SHARE), wave 6. Results: The results show that countries differ in the level of social isolation and rate of internet use by individuals aged 50 years and older. They also evidence that in most of the countries analyzed, social isolation of internet users was lower compared to that of nonusers after controlling for a set of sociodemographic, economic, and health characteristics of the individuals that have been previously described in the literature as determinants of social isolation. Indeed, on average, although 31.4\% of individuals in the nonuser group experienced high social isolation, only 12.9\% of individuals who used the internet experienced this condition. Conclusions: Internet users show lower social isolation. This result underlines the importance of promoting e-inclusion in Europe as a way to counter social isolation of individuals aged 50 years and older. ",
doi="10.2196/20466",
url="https://www.jmir.org/2022/1/e20466",
url="http://www.ncbi.nlm.nih.gov/pubmed/34982040"
}


@Article{info:doi/10.2196/28022,
author="Latikka, Rita
and Rubio-Hern{\'a}ndez, Rosana
and Lohan, Simona Elena
and Rantala, Juho
and Nieto Fern{\'a}ndez, Fernando
and Laitinen, Arto
and Oksanen, Atte",
title="Older Adults' Loneliness, Social Isolation, and Physical Information and Communication Technology in the Era of Ambient Assisted Living: A Systematic Literature Review",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="30",
volume="23",
number="12",
pages="e28022",
keywords="loneliness",
keywords="social isolation",
keywords="older adults",
keywords="physical information and communication technology",
keywords="systematic literature review",
abstract="Background: Loneliness and social isolation can have severe effects on human health and well-being. Partial solutions to combat these circumstances in demographically aging societies have been sought from the field of information and communication technology (ICT). Objective: This systematic literature review investigates the research conducted on older adults' loneliness and social isolation, and physical ICTs, namely robots, wearables, and smart homes, in the era of ambient assisted living (AAL). The aim is to gain insight into how technology can help overcome loneliness and social isolation other than by fostering social communication with people and what the main open-ended challenges according to the reviewed studies are. Methods: The data were collected from 7 bibliographic databases. A preliminary search resulted in 1271 entries that were screened based on predefined inclusion criteria. The characteristics of the selected studies were coded, and the results were summarized to answer our research questions. Results: The final data set consisted of 23 empirical studies. We found out that ICT solutions such as smart homes can help detect and predict loneliness and social isolation, and technologies such as robotic pets and some other social robots can help alleviate loneliness to some extent. The main open-ended challenges across studies relate to the need for more robust study samples and study designs. Further, the reviewed studies report technology- and topic-specific open-ended challenges. Conclusions: Technology can help assess older adults' loneliness and social isolation, and alleviate loneliness without direct interaction with other people. The results are highly relevant in the COVID-19 era, where various social restrictions have been introduced all over the world, and the amount of research literature in this regard has increased recently. ",
doi="10.2196/28022",
url="https://www.jmir.org/2021/12/e28022",
url="http://www.ncbi.nlm.nih.gov/pubmed/34967760"
}


@Article{info:doi/10.2196/31586,
author="Loveys, Kate
and Sagar, Mark
and Pickering, Isabella
and Broadbent, Elizabeth",
title="A Digital Human for Delivering a Remote Loneliness and Stress Intervention to At-Risk Younger and Older Adults During the COVID-19 Pandemic: Randomized Pilot Trial",
journal="JMIR Ment Health",
year="2021",
month="Nov",
day="8",
volume="8",
number="11",
pages="e31586",
keywords="COVID-19",
keywords="loneliness",
keywords="stress",
keywords="well-being",
keywords="eHealth",
keywords="digital human",
keywords="conversational agent",
keywords="older adults",
keywords="chronic illness",
abstract="Background: Loneliness is a growing public health issue that has been exacerbated in vulnerable groups during the COVID-19 pandemic. Computer agents are capable of delivering psychological therapies through the internet; however, there is limited research on their acceptability to date. Objective: The objectives of this study were to evaluate (1) the feasibility and acceptability of a remote loneliness and stress intervention with digital human delivery to at-risk adults and (2) the feasibility of the study methods in preparation for a randomized controlled trial. Methods: A parallel randomized pilot trial with a mixed design was conducted. Participants were adults aged 18 to 69 years with an underlying medical condition or aged 70 years or older with a Mini-Mental State Examination score of >24 (ie, at greater risk of developing severe COVID-19). Participants took part from their place of residence (independent living retirement village, 20; community dwelling, 7; nursing home, 3). Participants were randomly allocated to the intervention or waitlist control group that received the intervention 1 week later. The intervention involved completing cognitive behavioral and positive psychology exercises with a digital human facilitator on a website for at least 15 minutes per day over 1 week. The exercises targeted loneliness, stress, and psychological well-being. Feasibility was evaluated using dropout rates and behavioral observation data. Acceptability was evaluated from behavioral engagement data, the Friendship Questionnaire (adapted), self-report items, and qualitative questions. Psychological measures were administered to evaluate the feasibility of the trial methods and included the UCLA Loneliness Scale, the 4-item Perceived Stress Scale, a 1-item COVID-19 distress measure, the Flourishing Scale, and the Scale of Positive and Negative Experiences. Results: The study recruited 30 participants (15 per group). Participants were 22 older adults and 8 younger adults with a health condition. Six participants dropped out of the study. Thus, the data of 24 participants were analyzed (intervention group, 12; waitlist group, 12). The digital human intervention and trial methods were generally found to be feasible and acceptable in younger and older adults living independently, based on intervention completion, and behavioral, qualitative, and some self-report data. The intervention and trial methods were less feasible to nursing home residents who required caregiver assistance. Acceptability could be improved with additional content, tailoring to the population, and changes to the digital human's design. Conclusions: Digital humans are a promising and novel technological solution for providing at-risk adults with access to remote psychological support during the COVID-19 pandemic. Research should further examine design techniques to improve their acceptability in this application and investigate intervention effectiveness in a randomized controlled trial. Trial Registration: Australia New Zealand Clinical Trials Registry ACTRN12620000786998; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380113 ",
doi="10.2196/31586",
url="https://mental.jmir.org/2021/11/e31586",
url="http://www.ncbi.nlm.nih.gov/pubmed/34596572"
}


@Article{info:doi/10.2196/23471,
author="Chiu, Ching-Ju
and Hsieh, Shiuan
and Li, Chia-Wei",
title="Needs and Preferences of Middle-Aged and Older Adults in Taiwan for Companion Robots and Pets: Survey Study",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="11",
volume="23",
number="6",
pages="e23471",
keywords="middle-aged adults",
keywords="older adults",
keywords="companionship demand",
keywords="robot",
keywords="pet",
keywords="acceptance",
abstract="Background: In recent years, robots have been considered a new tech industry that can be used to solve the shortage in human resources in the field of health care. Also, animal-assisted therapy has been used to provide assistance, companionship, and interaction among the elderly and has been shown to have a positive impact on their emotional and psychological well-being. Both pets and robots can provide dynamic communication and positive interaction patterns. However, preferences for middle-aged and older adults in this regard are not clear. Objective: This study explored the degree of acceptance of robots and pets as partners in later life and to determine the needs and preferences of elderly individuals related to companion robots. Methods: A total of 273 middle-aged and older adults aged ?45 years and living in the community were invited to answer a structured questionnaire after watching a companion robot video. Sociodemographic data, physical health status and activities, experience with technology, eHealth literacy, and acceptance and attitude toward robots and pets were recorded and analyzed using multinomial logistic regression analysis. Results: Age, level of education, type of dwelling, occupation, retirement status, number of comorbidities, experience with pets, experience using apps, and eHealth literacy were significantly associated with acceptance of robots and pets. Middle-aged and older women preferred robots with an animal-like appearance, while men preferred robots that resembled a human adult. In terms of robot functions, participants preferred a companion robot with dancing, singing, storytelling, or news-reporting functions. Participants' marital status and whether or not they lived alone affected their preference of functions in the companion robot. Conclusions: Findings from this study inform the development of social robots with regard to their appearance and functions to address loneliness in later life in fast-aging societies. ",
doi="10.2196/23471",
url="https://www.jmir.org/2021/6/e23471/",
url="http://www.ncbi.nlm.nih.gov/pubmed/34347621"
}


@Article{info:doi/10.2196/24712,
author="Shah, Sarwar Syed Ghulam
and Nogueras, David
and van Woerden, Cornelis Hugo
and Kiparoglou, Vasiliki",
title="Evaluation of the Effectiveness of Digital Technology Interventions to Reduce Loneliness in Older Adults: Systematic Review and Meta-analysis",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="4",
volume="23",
number="6",
pages="e24712",
keywords="loneliness",
keywords="older people",
keywords="digital technology",
keywords="effectiveness",
keywords="efficacy",
keywords="evidence",
keywords="systematic review",
keywords="meta-analysis",
abstract="Background: Loneliness is a serious public health issue, and its burden is increasing in many countries. Loneliness affects social, physical, and mental health, and it is associated with multimorbidity and premature mortality. In addition to social interventions, a range of digital technology interventions (DTIs) are being used to tackle loneliness. However, there is limited evidence on the effectiveness of DTIs in reducing loneliness, especially in adults. The effectiveness of DTIs in reducing loneliness needs to be systematically assessed. Objective: The objective of this study is to assess the effectiveness of DTIs in reducing loneliness in older adults. Methods: We conducted electronic searches in PubMed, MEDLINE, CINAHL, Embase, and Web of Science for empirical studies published in English from January 1, 2010, to July 31, 2019. The study selection criteria included interventional studies that used any type of DTIs to reduce loneliness in adults (aged ?18 years) with a minimum intervention duration of 3 months and follow-up measurements at least 3 months after the intervention. Two researchers independently screened articles and extracted data using the PICO (participant, intervention, comparator, and outcome) framework. The primary outcome measure was loneliness. Loneliness scores in both the intervention and control groups at baseline and at follow-up at 3, 4, 6, and 12 months after the intervention were extracted. Data were analyzed via narrative synthesis and meta-analysis using RevMan (The Cochrane Collaboration) software. Results: A total of 6 studies were selected from 4939 screened articles. These studies included 1 before and after study and 5 clinical trials (4 randomized clinical trials and 1 quasi-experimental study). All of these studies enrolled a total of 646 participants (men: n=154, 23.8\%; women: n=427, 66.1\%; no gender information: n=65, 10.1\%) with an average age of 73-78 years (SD 6-11). Five clinical trials were included in the meta-analysis, and by using the random effects model, standardized mean differences (SMDs) were calculated for each trial and pooled across studies at the 3-, 4-, and 6-month follow-ups. The overall effect estimates showed no statistically significant difference in the effectiveness of DTIs compared with that of usual care or non-DTIs at follow-up at 3 months (SMD 0.02; 95\% CI ?0.36 to 0.40; P=.92), 4 months (SMD ?1.11; 95\% CI ?2.60 to 0.38; P=.14), and 6 months (SMD ?0.11; 95\% CI ?0.54 to 0.32; P=.61). The quality of evidence was very low to moderate in these trials. Conclusions: Our meta-analysis shows no evidence supporting the effectiveness of DTIs in reducing loneliness in older adults. Future research may consider randomized controlled trials with larger sample sizes and longer durations for both the interventions and follow-ups. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2019-032455 ",
doi="10.2196/24712",
url="https://www.jmir.org/2021/6/e24712",
url="http://www.ncbi.nlm.nih.gov/pubmed/34085942"
}


@Article{info:doi/10.2196/25876,
author="Rosenblum, Sara
and Cohen Elimelech, Ortal",
title="Gender Differences in State Anxiety Related to Daily Function Among Older Adults During the COVID-19 Pandemic: Questionnaire Study",
journal="JMIR Aging",
year="2021",
month="Jun",
day="3",
volume="4",
number="2",
pages="e25876",
keywords="COVID-19",
keywords="coronavirus",
keywords="anxiety",
keywords="cognition",
keywords="aging",
keywords="eHealth",
keywords="online data",
abstract="Background: The COVID-19 pandemic poses a challenge to people's day-to-day functioning and emotional and physical health, especially among older adults. Objective: The aim of this study is to analyze gender differences in state anxiety, daily functional self-actualization, and functional cognition as well as the relationships among those factors in older adults during the COVID-19 pandemic lockdown. Methods: We collected data on the web from a sample of 204 people (102 men and 102 women) aged 60 years and older. In addition to a demographic questionnaire, we used the State-Trait Personality Inventory to assess state anxiety, the Daily Functional Actualization questionnaire to evaluate daily functional self-actualization, and the Daily Living Questionnaire to measure functional cognition. Results: Significant gender differences were found for state anxiety (t202=?2.36, P=.02); daily functional self-actualization (t202=2.15, P=.03); and the functional cognition components: complex tasks (Z=?3.07, P=.002); cognitive symptoms that might be interfering (Z=?2.15, P=.028); executive functions (Z=?2.21, P=.024); and executive function monitoring (Z=?2.21, P=.027). Significant medium correlations were found between both state anxiety level and daily functional self-actualization (r=?0.62, P<.001) and functional cognition (r=0.37-0.40, P<.001). Gender predicted 3\% of the variance in state anxiety level, while daily functional self-actualization predicted 41\% and complex activities (Daily Living Questionnaire) predicted an additional 3\% (F3,200=58.01, P<.001). Conclusions: In older adults, anxiety is associated with cognitive decline, which may harm daily functional abilities and lead to social isolation, loneliness, and decreased well-being. Self-awareness and knowledge of gender differences and relationships between common available resources of daily functional self-actualization and functional cognition with anxiety may be strengthening factors in crisis periods such as the COVID-19 pandemic. ",
doi="10.2196/25876",
url="https://aging.jmir.org/2021/2/e25876",
url="http://www.ncbi.nlm.nih.gov/pubmed/33939623"
}


@Article{info:doi/10.2196/23591,
author="Anderberg, Peter
and Abrahamsson, Linda
and Berglund, Sanmartin Johan",
title="An Instrument for Measuring Social Participation to Examine Older Adults' Use of the Internet as a Social Platform: Development and Validation Study",
journal="JMIR Aging",
year="2021",
month="May",
day="17",
volume="4",
number="2",
pages="e23591",
keywords="internet",
keywords="older people",
keywords="social participation",
keywords="aging",
keywords="instrument",
keywords="elderly",
keywords="social platform",
keywords="perception",
keywords="connectedness",
abstract="Background: Older people's use of the internet is increasingly coming into focus with the demographic changes of a growing older population. Research reports several benefits of older people's internet use and highlights problems such as various forms of inequality in use within the group. There is a need for consistent measurements to follow the development and use of the internet in this group and to be able to compare groups both within and between countries, as well as follow the changes over time. Objective: The aim of this study was to create an instrument to measure an older person's perception of the benefits of their online social participation, unconnected to specific applications and services. The instrument to measure internet social participation proposed in this paper builds on social participation factors and is a multidimensional construct incorporating both social relations and societal connectedness. Methods: A short instrument for measuring social participation over the internet was created. An exploratory factor analysis (EFA) was conducted in a random selection of persons aged 65 years or older (n=193) on 10 initial items. Further validation was made by confirmatory factor analysis (CFA) in the remaining group (n=193). Results: A 1-factor solution for the social internet score was decided upon after exploratory factor analysis (EFA; based on a random sample of half the data set). None of the questionnaire items were excluded based on the EFA, as they all had high loadings, the lowest being 0.61. The Cronbach $\alpha$ coefficient was .92. The 1-factor solution explained 55\% of the variance. CFA was performed and included all 10 questionnaire items in a 1-factor solution. Indices of goodness of fit of the model showed room for improvement. Removal of 4 questions in a stepwise procedure resulted in a 6-item model ($\chi$26=13.985; $\chi$2/degrees of freedom=1.554; comparative fit index=0.992; root mean square error of approximation=0.054; standardized root mean square residual=0.025). Conclusions: The proposed instrument can be used to measure digital social participation and coherence with society. The factor analysis is based on a sufficient sample of the general population of older adults in Sweden, and overall the instrument performed as expected. ",
doi="10.2196/23591",
url="https://aging.jmir.org/2021/2/e23591",
url="http://www.ncbi.nlm.nih.gov/pubmed/33999004"
}


@Article{info:doi/10.2196/21864,
author="Cosco, D. Theodore
and Fortuna, Karen
and Wister, Andrew
and Riadi, Indira
and Wagner, Kevin
and Sixsmith, Andrew",
title="COVID-19, Social Isolation, and Mental Health Among Older Adults: A Digital Catch-22",
journal="J Med Internet Res",
year="2021",
month="May",
day="6",
volume="23",
number="5",
pages="e21864",
keywords="social isolation",
keywords="mental health",
keywords="COVID-19",
keywords="technology",
keywords="older adult",
keywords="psychology",
keywords="digital health",
doi="10.2196/21864",
url="https://www.jmir.org/2021/5/e21864",
url="http://www.ncbi.nlm.nih.gov/pubmed/33891557"
}


@Article{info:doi/10.2196/28010,
author="Haase, R. Kristen
and Cosco, Theodore
and Kervin, Lucy
and Riadi, Indira
and O'Connell, E. Megan",
title="Older Adults' Experiences With Using Technology for Socialization During the COVID-19 Pandemic: Cross-sectional Survey Study",
journal="JMIR Aging",
year="2021",
month="Apr",
day="23",
volume="4",
number="2",
pages="e28010",
keywords="older adults",
keywords="social isolation",
keywords="COVID-19",
keywords="technology use",
keywords="eHealth",
abstract="Background: Technology use has become the most critical approach to maintaining social connectedness during the COVID-19 pandemic. Older adults (aged >65 years) are perceived as the most physiologically susceptible population to developing COVID-19 and are at risk of secondary mental health challenges related to the social isolation that has been imposed by virus containment strategies. To mitigate concerns regarding sampling bias, we analyzed a random sample of older adults to understand the uptake and acceptance of technologies that support socialization during the pandemic. Objective: We aimed to conduct a population-based assessment of the barriers and facilitators to engaging in the use of technology for web-based socialization among older adults in the Canadian province of British Columbia during the COVID-19 pandemic. Methods: We conducted a cross-sectional, population-based, regionally representative survey by using the random-digit dialing method to reach participants aged >65 years who live in British Columbia. Data were analyzed using SPSS (IBM Corporation), and open-text responses were analyzed via thematic analysis. Results: Respondents included 400 older adults aged an average of 72 years, and 63.7\% (n=255) of respondents were female. Most respondents (n=358, 89.5\%) were aware of how to use technology to connect with others, and slightly more than half of the respondents (n=224, 56\%) reported that, since the beginning of the pandemic, they used technology differently to connect with others during the pandemic. Additionally, 55.9\% (n=223) of respondents reported that they adopted new technology since the beginning of the pandemic. Older adults reported the following key barriers to using technology: (1) a lack of access (including finance-, knowledge-, and age-related issues); (2) a lack of interest (including a preference for telephones and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults also reported the following facilitators: (1) a knowledge of technologies (from self-teaching or external courses); (2) reliance on others (family, friends, and general internet searches); (3) technology accessibility (including appropriate environments, user-friendly technology, and clear instructions); and (4) social motivation (everyone else is doing it). Conclusions: Much data on older adults' use of technology are limited by sampling biases, but this study, which used a random sampling method, demonstrated that older adults used technology to mitigate social isolation during the pandemic. Web-based socialization is the most promising method for mitigating potential mental health effects that are related to virus containment strategies. Providing telephone training; creating task lists; and implementing the facilitators described by participants, such as facilitated socialization activities, are important strategies for addressing barriers, and these strategies can be implemented during and beyond the pandemic to bolster the mental health needs of older adults. ",
doi="10.2196/28010",
url="https://aging.jmir.org/2021/2/e28010",
url="http://www.ncbi.nlm.nih.gov/pubmed/33739929"
}


@Article{info:doi/10.2196/21275,
author="Hwang, Juwon
and Toma, L. Catalina
and Chen, Junhan
and Shah, V. Dhavan
and Gustafson, David
and Mares, Marie-Louise",
title="Effects of Web-Based Social Connectedness on Older Adults' Depressive Symptoms: A Two-Wave Cross-Lagged Panel Study",
journal="J Med Internet Res",
year="2021",
month="Jan",
day="13",
volume="23",
number="1",
pages="e21275",
keywords="depressive symptoms",
keywords="older adults",
keywords="web-based intervention",
keywords="online social support",
keywords="patient health questionnaire",
keywords="longitudinal survey",
keywords="mobile phone",
abstract="Background: Depressive symptoms are the most prevalent mental health concern among older adults (possibly heightened during the COVID-19 pandemic), which raises questions about how such symptoms can be lowered in this population. Existing research shows that offline social connectedness is a protective factor against depression in older adults; however, it is unknown whether web-based social connectedness can have similar effects. Objective: This study investigates whether social connectedness on a support website protects older adults against depressive symptoms over the course of a year, above and beyond the protective effect of offline social connectedness. The secondary aim is to determine whether older adults with increased depressive symptoms are more likely to engage in social connectedness on this website. Thus, we examine depressive symptoms as both an outcome and predictor of web-based social connectedness to fully understand the chain of causality among these variables. Finally, we compare web-based social connectedness with offline social connectedness in their ability to lower depressive symptoms among older adults. Methods: A total of 197 adults aged 65 years or older were given access to a social support website, where they were able to communicate with each other via a discussion forum for a year. Participants' social connectedness on the web-based platform, conceptualized as message production and consumption, was measured using behavioral log data as the number of messages participants wrote and read, respectively, during the first 6 months (t1) and the following 6 months (t2) of the study. Participants self-reported their offline social connectedness as the number of people in their support networks, and they reported their depressive symptoms using the Patient Health Questionnaire-8 both at baseline (t1) and at 12-month follow-up (t2). To ascertain the flow of causality between these variables, we employed a cross-lagged panel design, in which all variables were measured at t1 and t2. Results: After controlling for the effect of offline support networks at t1, web-based message consumption at t1 decreased older adults' depressive symptoms at t2 ($\beta$=?.11; P=.02), but web-based message production at t1 did not impact t2 depressive symptoms ($\beta$=.12; P=.34). Web-based message consumption had a larger effect ($\beta$=?.11; P=.02) than offline support networks ($\beta$=?.08; P=.03) in reducing older adults' depressive symptoms over time. Higher baseline depressive symptoms did not predict increased web-based message consumption ($\beta$=.12; P=.36) or production ($\beta$=.02; P=.43) over time. Conclusions: The more messages older adults read on the web-based forum for the first 6 months of the study, the less depressed they felt at the 1-year follow-up, above and beyond the availability of offline support networks at baseline. This pinpoints the substantial potential of web-based communication to combat depressive symptoms in this vulnerable population. International Registered Report Identifier (IRRID): RR2-10.1186/s13063-015-0713-2 ",
doi="10.2196/21275",
url="http://www.jmir.org/2021/1/e21275/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33439143"
}


@Article{info:doi/10.2196/22339,
author="Aubourg, Timoth{\'e}e
and Demongeot, Jacques
and Vuillerme, Nicolas",
title="Gaining Insights Into the Estimation of the Circadian Rhythms of Social Activity in Older Adults From Their Telephone Call Activity With Statistical Learning: Observational Study",
journal="J Med Internet Res",
year="2021",
month="Jan",
day="8",
volume="23",
number="1",
pages="e22339",
keywords="circadian rhythms",
keywords="phone call detail records",
keywords="older population",
keywords="statistics",
keywords="machine learning",
abstract="Background: Understanding the social mechanisms of the circadian rhythms of activity represents a major issue in better managing the mechanisms of age-related diseases occurring over time in the elderly population. The automated analysis of call detail records (CDRs) provided by modern phone technologies can help meet  such an objective. At this stage, however, whether and how the circadian rhythms of telephone call activity can be automatically and properly modeled in the elderly population remains to be established. Objective: Our goal for this study is to address whether and how the circadian rhythms of social activity observed through  telephone calls could be automatically modeled in older adults. Methods: We analyzed a 12-month data set of outgoing telephone CDRs of 26 adults older than 65 years of age. We designed a statistical learning modeling approach adapted for exploratory analysis. First, Gaussian mixture models (GMMs) were calculated to automatically model each participant's circadian rhythm of telephone call activity. Second, k-means clustering was used for grouping participants into distinct groups depending on the characteristics of their personal GMMs. Results: The results showed the existence of specific structures of telephone call activity in the daily social activity of older adults. At the individual level, GMMs allowed the identification of personal habits, such as morningness-eveningness for making calls. At the population level, k-means clustering allowed the structuring of these individual habits into specific morningness or eveningness clusters. Conclusions: These findings support the potential of phone technologies and statistical learning approaches to automatically provide personalized and precise information on the social rhythms of telephone call activity of older individuals. Futures studies could integrate such digital insights with other sources of data to complete assessments of the circadian rhythms of activity in elderly populations. ",
doi="10.2196/22339",
url="http://www.jmir.org/2021/1/e22339/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33416502"
}


@Article{info:doi/10.2196/21845,
author="Sacco, Guillaume
and Ll{\'e}onart, S{\'e}bastien
and Simon, Romain
and Noublanche, Fr{\'e}d{\'e}ric
and Annweiler, C{\'e}dric
and ",
title="Communication Technology Preferences of Hospitalized and Institutionalized Frail Older Adults During COVID-19 Confinement: Cross-Sectional Survey Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Sep",
day="18",
volume="8",
number="9",
pages="e21845",
keywords="video communication",
keywords="telephone",
keywords="older adults",
keywords="nursing home",
keywords="hospital",
keywords="confinement",
keywords="elderly",
keywords="COVID-19",
keywords="communication",
keywords="technology",
keywords="social isolation",
keywords="loneliness",
abstract="Background: Technological communication methods such as telephone calls and video calls can help prevent social isolation and loneliness in frail older adults during confinement. Objective: Our objectives were to determine which virtual communication method (ie, telephone call or video call) was preferred by confined older hospital patients and nursing home residents and the variables influencing this preference. Methods: The TOVID (Telephony Or Videophony for Isolated elDerly) study was a cross-sectional study that was designed to examine the preference between telephone calls and video calls among frail older adults who were either hospitalized in a geriatric acute care unit or institutionalized in a long-term care and nursing home during the COVID-19 confinement period. Results: A total of 132 older people were surveyed between March 25 and May 11, 2020 (mean age 88.2 years, SD 6.2); 79 (59.8\%) were women. Patients hospitalized in the geriatric acute care unit were more able to establish communication independently than residents institutionalized in the long-term care and nursing home (P=.03) and were more satisfied with their communication experiences (P=.02). Overall, older people tended to favor telephone calls (73/132, 55.3\%) over video calls (59/132, 44.7\%); however, their satisfaction degree was similar regardless of the chosen method (P=.1), with no effect of age (P=.97) or gender (P=.2). In the geriatric acute care unit, the satisfaction degrees were similar for telephone calls (40/41, 98\%) and video calls (33/38, 87\%) in older patients (P=.10). Conversely, in the long-term care and nursing home, residents were more satisfied with the use of video calls to communicate with their relatives (14/15, 93\%) versus the use of telephone calls (6/12, 50\%; P=.02). Conclusions: Older people confined to health care settings were able to complete telephone calls more independently than video calls, and they tended to use telephone calls more often than video calls. The satisfaction degrees were similar with both modalities and even greater with video calls among long-term care and nursing home residents when they were given assistance to establish communication. Trial Registration: ClinicalTrials.gov NCT04333849: https://www.clinicaltrials.gov/ct2/show/NCT04333849. ",
doi="10.2196/21845",
url="http://mhealth.jmir.org/2020/9/e21845/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32896832"
}


@Article{info:doi/10.2196/17586,
author="Chen, T. Annie
and Slattery, Krystal
and Tomasino, N. Kathryn
and Rubanovich, Kseniya Caryn
and Bardsley, R. Leland
and Mohr, C. David",
title="Challenges and Benefits of an Internet-Based Intervention With a Peer Support Component for Older Adults With Depression: Qualitative Analysis of Textual Data",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="16",
volume="22",
number="6",
pages="e17586",
keywords="aged",
keywords="depression",
keywords="internet",
keywords="peer group",
keywords="social support",
keywords="qualitative research",
abstract="Background: Technological interventions provide many opportunities for improving the health and quality of life of older adults. However, interaction with new technologies can also cause frustration. Although these themes have been explored in extant research, much remains to be learned with regard to how the challenges of aging and technology use and the experiences of participating in a social and learning environment are interrelated. Objective: This study aimed to perform a qualitative analysis of data collected from MoodTech, a pilot study of an internet-based intervention with a peer support component for older adults with symptoms of depression, to better understand the participants' experience of using technological interventions, including the challenges and benefits that they experienced over the course of these interventions. Methods: We employed an inductive qualitative analysis method based on grounded theory methodology and interpretative phenomenological analysis to analyze participant textual data. These textual data were of 3 main types: (1) assignments in which participants challenged their negative thoughts, (2) status updates, and (3) comments in the peer support component of the intervention. Results: We have presented the results through 3 main themes: (1) the challenges of aging as seen through the participants' comments, (2) the difficulties experienced by the participants in using MoodTech, and (3) the benefits they derived from participating. Conclusions: This paper offers several contributions concerning study participants' experiences with internet-based cognitive behavioral therapy (iCBT) interventions with a peer support component and design considerations for developing complex technological interventions that support the challenges participants experience due to aging and cognitive difficulties. First, technical issues encountered by older adults within the context of the intervention can interact with and exacerbate the insecurities they experience in life, and it is important to consider how intervention components might be designed to mitigate these issues. Second, peer support can be employed as a mechanism to facilitate communication, support, and collaborative problem solving among participants in an intervention. The insights from this paper can inform the design of iCBT interventions for older adults. ",
doi="10.2196/17586",
url="https://www.jmir.org/2020/6/e17586",
url="http://www.ncbi.nlm.nih.gov/pubmed/32543448"
}


@Article{info:doi/10.2196/18398,
author="Neil-Sztramko, E. Sarah
and Coletta, Giulia
and Dobbins, Maureen
and Marr, Sharon",
title="Impact of the AGE-ON Tablet Training Program on Social Isolation, Loneliness, and Attitudes Toward Technology in Older Adults: Single-Group Pre-Post Study",
journal="JMIR Aging",
year="2020",
month="Apr",
day="20",
volume="3",
number="1",
pages="e18398",
keywords="technology",
keywords="older adults",
keywords="tablet training",
keywords="education",
abstract="Background: The internet and technology can help older adults connect with family and friends. However, many older adults face obstacles to internet and technology use, such as lack of knowledge or self-efficacy. Objective: The purpose of this study was to explore the impact of the AGE-ON tablet training program on social isolation, loneliness, and quality of life. Methods: Adults aged >60 years took part in a series of 6 weekly workshops covering the basic features of a tablet. Before and after the program, social isolation, loneliness, social support, and quality of life were assessed. In addition, data on current tablet use and attitudes toward technology use were collected. Satisfaction with the program was also assessed at the end of the study using 6 Likert scale questions. Results: The participants (N=32; mean age 76.3, SD 8.6 years) were predominantly female (n=20, 63\%) and retired (n=30, 94\%). The participants reported that they were highly satisfied with the program. After completing the program, no differences in social isolation, loneliness, social support, or quality of life were found. Frequency of tablet use increased and the attitudes of the participants toward technology improved. Conclusions: The AGE-ON program resulted in increased tablet use frequency and may improve comfort and attitudes toward tablet use among older adults. This program may assist older adults in overcoming obstacles to internet and technology use to better connect with family and friends; however, further work targeting older adults who are socially isolated or at risk of social isolation is needed to more fully understand whether tablet training programs are beneficial in this population. Trial Registration: ClinicalTrials.gov NCT03472729; https://clinicaltrials.gov/ct2/show/NCT03472729 ",
doi="10.2196/18398",
url="http://aging.jmir.org/2020/1/e18398/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32310146"
}


@Article{info:doi/10.2196/13440,
author="Bott, Nicholas
and Wexler, Sharon
and Drury, Lin
and Pollak, Chava
and Wang, Victor
and Scher, Kathleen
and Narducci, Sharon",
title="A Protocol-Driven, Bedside Digital Conversational Agent to Support Nurse Teams and Mitigate Risks of Hospitalization in Older Adults: Case Control Pre-Post Study",
journal="J Med Internet Res",
year="2019",
month="Oct",
day="17",
volume="21",
number="10",
pages="e13440",
keywords="digital health",
keywords="older adults",
keywords="loneliness",
keywords="delirium",
keywords="falls",
keywords="embodied conversational agent",
keywords="chatbot",
keywords="relational agent",
keywords="information and communication technology",
abstract="Background: Hospitalized older adults often experience isolation and disorientation while receiving care, placing them at risk for many inpatient complications, including loneliness, depression, delirium, and falls. Embodied conversational agents (ECAs) are technological entities that can interact with people through spoken conversation. Some ECAs are also relational agents, which build and maintain socioemotional relationships with people across multiple interactions. This study utilized a novel form of relational ECA, provided by Care Coach (care.coach, inc): an animated animal avatar on a tablet device, monitored and controlled by live health advocates. The ECA implemented algorithm-based clinical protocols for hospitalized older adults, such as reorienting patients to mitigate delirium risk, eliciting toileting needs to prevent falls, and engaging patients in social interaction to facilitate social engagement. Previous pilot studies of the Care Coach avatar have demonstrated the ECA's usability and efficacy in home-dwelling older adults. Further study among hospitalized older adults in a larger experimental trial is needed to demonstrate its effectiveness. Objective: The aim of the study was to examine the effect of a human-in-the-loop, protocol-driven relational ECA on loneliness, depression, delirium, and falls among diverse hospitalized older adults. Methods: This was a clinical trial of 95 adults over the age of 65 years, hospitalized at an inner-city community hospital. Intervention participants received an avatar for the duration of their hospital stay; participants on a control unit received a daily 15-min visit from a nursing student. Measures of loneliness (3-item University of California, Los Angeles Loneliness Scale), depression (15-item Geriatric Depression Scale), and delirium (confusion assessment method) were administered upon study enrollment and before discharge. Results: Participants who received the avatar during hospitalization had lower frequency of delirium at discharge (P<.001), reported fewer symptoms of loneliness (P=.01), and experienced fewer falls than control participants. There were no significant differences in self-reported depressive symptoms. Conclusions: The study findings validate the use of human-in-the-loop, relational ECAs among diverse hospitalized older adults. ",
doi="10.2196/13440",
url="http://www.jmir.org/2019/10/e13440/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31625949"
}


@Article{info:doi/10.2196/14112,
author="Zaine, Isabela
and Frohlich, Mark David
and Rodrigues, Hora Kamila Rios Da
and Cunha, Rodrigues Bruna Carolina
and Orlando, Fernando Alex
and Scalco, Fernandes Leonardo
and Pimentel, Campos Maria Da Gra{\c{c}}a",
title="Promoting Social Connection and Deepening Relations Among Older Adults: Design and Qualitative Evaluation of Media Parcels",
journal="J Med Internet Res",
year="2019",
month="Oct",
day="3",
volume="21",
number="10",
pages="e14112",
keywords="social interaction",
keywords="interpersonal relations",
keywords="communication",
keywords="intervention",
keywords="experience sampling",
keywords="mobile apps",
keywords="photography",
keywords="video-audio media",
keywords="elderly",
abstract="Background: Being socially connected is related to well-being, and one way of avoiding social isolation is to deepen existing relationships. Even though existing relationships can be reinforced by regular and meaningful communication, state-of-the-art communication technologies alone do not increase the quality of social connections. Thus, there is a need for the involvement of a trained human facilitator in a network of older adults, preferably for a short period, to promote the deepening of their relationships. Objective: This study aimed to evaluate the hypothesis that a human-facilitated, media-sharing social networking system can improve social connection in a small group of older people, who are more vulnerable to social isolation than most, and deepen their relationships over a period of a few weeks. Methods: We conducted the design and evaluation of Media Parcels, a novel human-facilitated social networking system. Media Parcels is based on the metaphor of a facilitator collecting and delivering parcels in the physical mail. Extending the metaphor, the system supports a facilitator in designing time-based dialogue requesting parcels from participants that bring out their memories and feelings, in collecting the parcels, wrapping them in annotations that communicate the corresponding requests, and delivering the wrapped parcel to a target person. Qualitative evaluation was carried out in two trials with a group of three people each, one with family members (children and father; aged 55, 56, and 82 years old) and the other with a group of friends (aged 72, 72, and 74 years old), over two  weeks. In each trial, data were collected in three interviews (pre-, mid-, and posttrial) and via system logging. Results: Collected data indicate positive social effects for deepening and developing relationships. The parcel metaphor was easily understood and the computational system was readily adopted. Preferences with regard to media production or consumption varied among participants. In the family group, children preferred receiving media parcels (because of their sentimental value) to producing them, whereas the father enjoyed both. In the friendship group, preferences varied: one friend enjoyed both producing and receiving, while the other two preferred one over the other. In general, participants reported a preference for the production of items of a certain type depending on the associated content. Apart from having a strong engagement with the system, participants reported feeling closer to each other than usual. Conclusions: For both groups, Media Parcels was effective in promoting media sharing and social connections, resulting in the deepening of existing relationships. Its design informs researchers who are attempting to promote social connection in older adults. ",
doi="10.2196/14112",
url="https://www.jmir.org/2019/10/e14112",
url="http://www.ncbi.nlm.nih.gov/pubmed/31584001"
}


@Article{info:doi/10.2196/10857,
author="Litchman, L. Michelle
and Edelman, S. Linda",
title="Perceptions of the Diabetes Online Community's Credibility, Social Capital, and Help and Harm: Cross-Sectional Comparison Between Baby Boomers and Younger Adults",
journal="JMIR Aging",
year="2019",
month="Sep",
day="26",
volume="2",
number="2",
pages="e10857",
keywords="diabetes mellitus",
keywords="online social networking",
keywords="social capital",
keywords="trust",
keywords="social media",
keywords="older adult",
abstract="Background: The use of online health communities such as the diabetes online community (DOC) is growing. Individuals who engage in the DOC are able to interact with peers who have the same medical condition. It is not known if older adults are perceiving the DOC differently compared with younger adults. Objective: The purpose of this study was to explore and understand how the DOC is perceived in terms of social capital, source credibility, and help and harm. The findings from this study will shed light on how users of different age groups (baby boomers and younger adult counterparts) perceive DOC use. Methods: This study represents a subset of participants from a larger study of DOC users. Baby boomers and younger adults with diabetes were recruited from the DOC to participate in a cross-sectional survey. Demographics, electronic health use (reasons to join the DOC, DOC intensity, DOC engagement, internet social capital, and help or harm from the DOC), source credibility, health-related quality of life, and diabetes self-care data were collected. We examined the differences between baby boomer and younger adult responses. Results: The participants included baby boomers (N=76) and younger adult counterparts (N=102). Participants scored their diabetes health care team (mean 33.5 [SD 8]) significantly higher than the DOC (mean 32 [SD 6.4]) with regard to competence (P<.05) and trustworthiness (diabetes health care team mean 36.3 [SD 7.1]; DOC mean 33.6 [SD 6.2]; P<.001). High bonding and bridging social capital correlated with high DOC intensity (r=.629; P<.001 and r=.676; P<.001, respectively) and high DOC engagement (r=.474; P<.01 and r=.507; P?.01, respectively). The greater majority (69.8\%) reported the DOC as being helpful, and 1.8\% reported that the DOC had caused minor harm. Baby boomers perceived DOC credibility, social capital, help, and harm similarly to their younger adult counterparts. Conclusions: Baby boomers are using and perceiving the DOC similarly to younger adults. DOC users find the DOC to be credible; however, they scored their health care team higher with regard to competence and trustworthiness. The DOC is beneficial with low risk and may augment current diabetes care. ",
doi="10.2196/10857",
url="https://aging.jmir.org/2019/2/e10857/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31573907"
}


@Article{info:doi/10.2196/12496,
author="Lewis, H. Zakkoyya
and Swartz, C. Maria
and Martinez, Eloisa
and Lyons, J. Elizabeth",
title="Social Support Patterns of Middle-Aged and Older Adults Within a Physical Activity App: Secondary Mixed Method Analysis",
journal="JMIR Aging",
year="2019",
month="Aug",
day="23",
volume="2",
number="2",
pages="e12496",
keywords="social support",
keywords="aged",
keywords="middle aged",
keywords="physical activity",
keywords="technology",
keywords="fitness tracker",
abstract="Background: Physical activity (PA) is critical for maintaining independence and delaying mobility disability in aging adults. However, 27 to 44\% of older adults in the United States are meeting the recommended PA level. Activity trackers are proving to be a promising tool to promote PA adherence through activity tracking and enhanced social interaction features. Although social support has been known to be an influential behavior change technique to promote PA, how middle-aged and older adults use the social interaction feature of mobile apps to provide virtual support to promote PA engagement remains mostly underexplored. Objective: This study aimed to describe the social support patterns of middle-aged and older adults using a mobile app as part of a behavioral PA intervention. Methods: Data from 35 participants (mean age 61.66 [SD 6] years) in a 12-week, home-based activity intervention were used for this secondary mixed method analysis. Participants were provided with a Jawbone Up24 activity monitor and an Apple iPad Mini installed with the UP app to facilitate self-monitoring and social interaction. All participants were given an anonymous account and encouraged to interact with other participants using the app. Social support features included comments and likes. Thematic coding was used to identify the type of social support provided within the UP app and characterize the levels of engagement from users. Participants were categorized as superusers or contributors, and passive participants were categorized as lurkers based on the literature. Results: Over the 12-week intervention, participants provided a total of 3153 likes and 1759 comments. Most participants (n=25) were contributors, with 4 categorized as superusers and 6 categorized as lurkers. Comments were coded as emotional support, informational support, instrumental support, self-talk, and other, with emotional support being the most prevalent type. Conclusions: Our cohort of middle-aged and older adults was willing to use the social network feature in an activity app to communicate with anonymous peers. Most of our participants were contributors. In addition, the social support provided through the activity app followed social support constructs. In sum, PA apps are a promising tool for delivering virtual social support to enhance PA engagement and have the potential to make a widespread impact on PA promotion. Trial Registration: ClinicalTrials.gov NCT01869348; https://clinicaltrials.gov/ct2/show/NCT01869348 ",
doi="10.2196/12496",
url="http://aging.jmir.org/2019/2/e12496/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518281"
}


@Article{info:doi/10.2196/13638,
author="Bouwman, Tamara
and van Tilburg, Theo
and Aartsen, Marja",
title="Attrition in an Online Loneliness Intervention for Adults Aged 50 Years and Older: Survival Analysis",
journal="JMIR Aging",
year="2019",
month="Jul",
day="24",
volume="2",
number="2",
pages="e13638",
keywords="online intervention",
keywords="loneliness",
keywords="attrition",
keywords="coping",
keywords="engagement",
keywords="older adults",
abstract="Background: Online interventions can be as effective as in-person interventions. However, attrition in online intervention is high and potentially biases the results. More importantly, high attrition rates might reduce the effectiveness of online interventions. Therefore, it is important to discover the extent to which factors affect adherence to online interventions. The setting for this study is the online Friendship Enrichment Program, a loneliness intervention for adults aged 50 years and older. Objective: This study examined the contribution of severity of loneliness, coping preference, activating content, and engagement in attrition within an online intervention. Methods: Data were collected from 352 participants in an online loneliness intervention for Dutch people aged 50 years and older. Attrition was defined as not completing all 10 intervention lessons. The number of completed lessons was assessed through the management system of the intervention. We tested 4 hypotheses on attrition by applying survival analysis (Cox regression). Results: Of the 352 participants who subscribed to the intervention, 46 never started the introduction. The remaining 306 participants were divided into 2 categories: 73 participants who did not start the lessons of the intervention and 233 who started the lessons of the intervention. Results of the survival analysis (n=233) showed that active coping preference (hazard ratio [HR]=0.73), activating content (HR=0.71), and 2 indicators of engagement (HR=0.94 and HR=0.79) lowered attrition. Severity of loneliness was not related to attrition. Conclusions: To reduce attrition, developers of online (loneliness) interventions may focus on stimulating active behavior within the intervention. ",
doi="10.2196/13638",
url="http://aging.jmir.org/2019/2/e13638/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518268"
}


@Article{info:doi/10.2196/13378,
author="McCarron, R. Hayley
and Zmora, Rachel
and Gaugler, E. Joseph",
title="A Web-Based Mobile App With a Smartwatch to Support Social Engagement in Persons With Memory Loss: Pilot Randomized Controlled Trial",
journal="JMIR Aging",
year="2019",
month="Jun",
day="18",
volume="2",
number="1",
pages="e13378",
keywords="Alzheimer disease",
keywords="dementia",
keywords="social support",
keywords="quality of life",
keywords="well-being",
keywords="technology",
keywords="social engagement",
keywords="facial recognition",
keywords="smartwatch",
abstract="Background: It is estimated that the number of individuals living with dementia worldwide will increase from 50 million in 2017 to 152 million by 2050. Assistive technology has been recognized as a promising tool to improve the lives of persons living with memory loss and their caregivers. The use of assistive technology in dementia care is expanding, although it is most often intended to manage care and promote safety. There is a lack of assistive technology designed to aid persons with memory loss in participating in meaningful activities. The Social Support Aid (SSA) is a mobile phone-based app that employs facial recognition software. It was designed to assist persons with memory loss remember the names and relationships of the people they interact with to promote social engagement. Objective: This study uses a pilot randomized controlled trial (RCT) design to evaluate the SSA. The objectives were to ascertain (1) the feasibility and utility of the SSA, (2) whether the outcomes of SSA use suggest potential benefits for persons living with memory loss and their care partners, and (3) how study design components could inform subsequent RCTs. Methods: Persons with memory loss were randomized to the SSA (n=20) or the usual care control group (n=28). Quantitative data were collected at three timepoints (baseline, 3 months, and 6 months). Participants in the intervention group participated in qualitative interviews following completion of their 6-month survey. Results: Participant eligibility, willingness to be randomized, and retention were not barriers to conducting a full-scale RCT; however, recruitment strategies should be addressed before doing so. Feasibility and utility scores indicated that participants felt neutral about the technology. Use of the SSA was not significantly associated with changes in quality of social interactions or quality of life measures over the 6 months of follow-up (P>.05). The qualitative analysis revealed three themes that described how and why the SSA worked or not: (1) outcomes, (2) reasons why it was or was not useful, and (3) recommendations. Conclusions: There is a need to develop effective assistive technology that improves the quality of life of persons with memory loss. Assistive technology that allows persons living with memory loss to maintain some level of autonomy should be a priority for future research. This study suggests reasons why the SSA facial recognition software did not appear to improve the quality of social interaction and quality of life of people with memory loss. Results also provide recommendations for future assistive technology development and evaluation. Trial Registration: ClinicalTrials.gov NCT03645694; https://clinicaltrials.gov/ct2/show/NCT03645694 (Archived by WebCite at http://www.webcitation.org/78dcVZIqq) ",
doi="10.2196/13378",
url="http://aging.jmir.org/2019/1/e13378/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518270"
}


@Article{info:doi/10.2196/12616,
author="Guruge, Sepali
and Sidani, Souraya
and Wang, Lu
and Sethi, Bharati
and Spitzer, Denise
and Walton-Roberts, Margaret
and Hyman, Ilene",
title="Understanding Social Network and Support for Older Immigrants in Ontario, Canada: Protocol for a Mixed-Methods Study",
journal="JMIR Aging",
year="2019",
month="Mar",
day="04",
volume="2",
number="1",
pages="e12616",
keywords="geographic information system",
keywords="immigrants",
keywords="social network",
keywords="social support",
abstract="Background: Older adults are the fastest growing age group worldwide and in Canada. Immigrants represent a significant proportion of older Canadians. Social isolation is common among older adults and has many negative consequences, including limited community and civic participation, increased income insecurity, and increased risk of elder abuse. Additional factors such as the social, cultural, and economic changes that accompany migration, language differences, racism, and ageism heighten older immigrants' vulnerability to social isolation. Objective: This mixed-methods sequential (qualitative-quantitative) study seeks to clarify older immigrants' social needs, networks, and support and how these shape their capacity, resilience, and independence in aging well in Ontario. Methods: Theoretically, our research is informed by an intersectionality perspective and an ecological model, allowing us to critically examine the complexity surrounding multiple dimensions of social identity (eg, gender and immigration) and how these interrelate at the micro (individual and family), meso (community), and macro (societal) levels in diverse geographical settings. Methodologically, the project is guided by a collaborative, community-based, mixed-methods approach to engaging a range of stakeholders in Toronto, Ottawa, Waterloo, and London in generating knowledge. The 4 settings were strategically chosen for their diversity in the level of urbanization, size of community, and the number of immigrants and immigrant-serving organizations. Interviews will be conducted in Arabic, Mandarin, and Spanish with older women, older men, family members, community leaders, and service providers. The study protocol has received ethics approval from the 4 participating universities. Results: Quantitative and qualitative data collection is ongoing. The project is funded by the Social Sciences and Humanities Council of Canada. Conclusions: Comparative analyses of qualitative and quantitative data within and across sites will provide insights about common and unique factors that contribute to the well-being of older immigrants in different regions of Ontario. Given the comprehensive approach to incorporating local knowledge and expert contributions from multilevel stakeholders, the empirical and theoretical findings will be highly relevant to our community partners, help facilitate practice change, and improve the well-being of older men and women in immigrant communities. International Registered Report Identifier (IRRID): DERR1-10.2196/12616 ",
doi="10.2196/12616",
url="http://aging.jmir.org/2019/1/e12616/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518267"
}


@Article{info:doi/10.2196/10486,
author="Li, Jinhui
and Erdt, Mojisola
and Chen, Luxi
and Cao, Yuanyuan
and Lee, Shan-Qi
and Theng, Yin-Leng",
title="The Social Effects of Exergames on Older Adults: Systematic Review and Metric Analysis",
journal="J Med Internet Res",
year="2018",
month="Jun",
day="28",
volume="20",
number="6",
pages="e10486",
keywords="active video games",
keywords="psychosocial well-being",
keywords="ageing",
keywords="literature review",
keywords="citation analysis",
abstract="Background: Recently, many studies have been conducted to investigate the effects of exergames on the social well-being of older adults. Objective: The aim of this paper is to synthesize existing studies and provide an overall picture on the social effects of exergames on older adults. Methods: A comprehensive literature search with inclusive criteria was conducted in major social science bibliographic databases. The characteristics of exergames, participants, methodology, as well as outcome measurements were extracted from the relevant studies included in the review. The bibliometric and altmetric outreach of the included studies were also investigated. Results: A total of 10 studies were included in the review, with 8 studies having used the Nintendo Wii platform. Most of the studies recruited healthy older adults from local communities or senior activity centers. Three groups of social-related outcomes have been identified, including emotion-related, behavior-related, and attitude-related outcomes. A metric analysis has shown that the emotion-related and behavior-related outcomes received high attention from both the academic community and social media platforms. Conclusions: Overall, the majority of exergame studies demonstrated promising results for enhanced social well-being, such as reduction of loneliness, increased social connection, and positive attitudes towards others. The paper also provided implications for health care researchers and exergame designers. ",
doi="10.2196/10486",
url="http://www.jmir.org/2018/6/e10486/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29954727"
}


@Article{info:doi/10.2196/10649,
author="Lewis, Amir Jakeem
and Gee, M. Perry
and Ho, Lynn Chia-Ling
and Miller, Soederberg Lisa M.",
title="Understanding Why Older Adults With Type 2 Diabetes Join Diabetes Online Communities: Semantic Network Analyses",
journal="JMIR Aging",
year="2018",
month="Jun",
day="28",
volume="1",
number="1",
pages="e10649",
keywords="online community",
keywords="diabetes",
keywords="health information",
keywords="health support",
keywords="chronic health difficulty",
keywords="self-management",
keywords="social support",
abstract="Background: As individuals age, chronic health difficulties may disrupt physical and social well-being. Individuals can turn to online communities to interact with similar peers, which may help buffer negative effects resulting from health difficulties. Objective: This study investigated the reasons that older adults join a diabetes online community to better understand the specific resources that are being sought. Methods: We used semantic network analyses to categorize the reasons participants provided for joining a community during the sign-up process. Results: The most frequent reasons for joining were to seek information about their health condition, to help with self-management of health difficulties, for feelings of informational and social support, and for having a community with whom to share. Women were more likely to go online for sharing and companionship as well as for information and social support reasons, whereas men were more likely to go online for general information and self-management reasons. Conclusions: This study shows the reasons older adults seek to join a diabetes online community: for increased information and support regarding chronic health difficulties. Practitioners may want to consider ways to promote access to online communities among their older patients as a source of health information and a resource to provide a sense of community. ",
doi="10.2196/10649",
url="http://aging.jmir.org/2018/1/e10649/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518243"
}