@Article{info:doi/10.2196/63928,
author="Shin, Jinyoung
and Kweon, Jung Hyuk
and Choi, Jaekyung",
title="Assessment of Gait Parameters Using Wearable Sensors and Their Association With Muscle Mass, Strength, and Physical Performance in Korean Older Adults: Cross-Sectional Study",
journal="JMIR Form Res",
year="2025",
month="Apr",
day="10",
volume="9",
pages="e63928",
keywords="gait analysis",
keywords="sarcopenia",
keywords="wearable electronic devices",
keywords="muscle mass",
keywords="physical performance",
keywords="older adults",
keywords="geriatric",
keywords="cross-sectional study",
keywords="outpatient clinic",
keywords="Korea",
keywords="mHealth",
keywords="mobile health",
abstract="Background: Gait speed indicates the onset or decline of physical performance in sarcopenia. However, real-time measurements of other gait parameters, such as step length, stride length, step width, and support time, are limited. The advent of wearable technology has facilitated the measurement of these parameters, necessitating further investigation into their potential applications. Objective: This study aimed to investigate the relationship between gait parameters measured using wearable sensors and muscle mass, strength, and physical performance in community-dwelling older adults. Methods: In a cross-sectional study of 91 participants aged ?65 years, gait parameters, such as step count, step length, cadence, single and double support times, vertical oscillation, and instantaneous vertical loading rate (IVLR), measured using a wireless earbud device, were analyzed on the basis of the appendicular skeletal muscle mass index (SMI), calf circumference, handgrip strength, 5-time chair stand test, short physical performance battery (SPPB), and the SARC-F (strength, assistance with walking, rise from a chair, climb stairs and fall frequency) questionnaire. This study was conducted from July 10 to November 1, 2023, at an outpatient clinic of a university hospital in Seoul, Korea. Multiple regression analysis was performed to investigate independent associations after adjusting for age, sex, BMI, and comorbidities. Results: Among 91 participants (45 men and 46 women; mean age 74.1 years for men and 73.6 years for women), gait speed and vertical oscillation showed negative associations with their performance in the 5-time chair stand test (P<.001) and SARC-F and positive associations with their performance in the SPPB (P<.001). Vertical oscillations were also associated with grip strength (P=.003). Single and double support times were associated with performance in the 5-time chair stand test and SPPB (P<.001). In addition, double support time was associated with SARC-F scores (P<.001). Gait speed, support time, vertical oscillation, and IVLR showed independent associations with performance in the 5-time chair stand test and SPPB (P<.001), both related to muscle strength or physical performance. Gait speed, double support time, and vertical oscillation all had significant associations with SARC-F scores. Conclusions: This study demonstrated a significant association between gait monitoring using wearable sensors and quantitative assessments of muscle strength and physical performance in older people. Furthermore, this study substantiated the extensive applicability of diverse gait parameters in predicting sarcopenia. ",
doi="10.2196/63928",
url="https://formative.jmir.org/2025/1/e63928"
}


@Article{info:doi/10.2196/67294,
author="Jones, D. Caleb
and Wasilko, Rachel
and Zhang, Gehui
and Stone, L. Katie
and Gujral, Swathi
and Rodakowski, Juleen
and Smagula, F. Stephen",
title="Detecting Sleep/Wake Rhythm Disruption Related to Cognition in Older Adults With and Without Mild Cognitive Impairment Using the myRhythmWatch Platform: Feasibility and Correlation Study",
journal="JMIR Aging",
year="2025",
month="Apr",
day="7",
volume="8",
pages="e67294",
keywords="sleep",
keywords="sleep/wake",
keywords="circadian",
keywords="activity pattern",
keywords="dementia",
keywords="cognition",
keywords="mobile sensing",
keywords="actigraphy",
keywords="accelerometer",
abstract="Background: Consumer wearable devices could, in theory, provide sufficient accelerometer data for measuring the 24-hour sleep/wake risk factors for dementia that have been identified in prior research. To our knowledge, no prior study in older adults has demonstrated the feasibility and acceptability of accessing sufficient consumer wearable accelerometer data to compute 24-hour sleep/wake rhythm measures. Objective: We aimed to establish the feasibility of characterizing 24-hour sleep/wake rhythm measures using accelerometer data gathered from the Apple Watch in older adults with and without mild cognitive impairment (MCI), and to examine correlations of these sleep/wake rhythm measures with neuropsychological test performance. Methods: Of the 40 adults enrolled (mean [SD] age 67.2 [8.4] years; 72.5\% female), 19 had MCI and 21 had no cognitive disorder (NCD). Participants were provided devices, oriented to the study software (myRhythmWatch or myRW), and asked to use the system for a week. The primary feasibility outcome was whether participants collected enough data to assess 24-hour sleep/wake rhythm measures (ie, ?3 valid continuous days). We extracted standard nonparametric and extended-cosine based sleep/wake rhythm metrics. Neuropsychological tests gauged immediate and delayed memory (Hopkins Verbal Learning Test) as well as processing speed and set-shifting (Oral Trails Parts A and B). Results: All participants meet the primary feasibility outcome of providing sufficient data (?3 valid days) for sleep/wake rhythm measures. The mean (SD) recording length was somewhat shorter in the MCI group at 6.6 (1.2) days compared with the NCD group at 7.2 (0.6) days. Later activity onset times were associated with worse delayed memory performance ($\beta$=?.28). More fragmented rhythms were associated with worse processing speed ($\beta$=.40). Conclusions: Using the Apple Watch-based myRW system to gather raw accelerometer data is feasible in older adults with and without MCI. Sleep/wake rhythms variables generated from this system correlated with cognitive function, suggesting future studies can use this approach to evaluate novel, scalable, risk factor characterization and targeted therapy approaches. ",
doi="10.2196/67294",
url="https://aging.jmir.org/2025/1/e67294"
}


@Article{info:doi/10.2196/65292,
author="Huynh, Duong
and Sun, Kevin
and Patterson, Mary
and Hosseini Ghomi, Reza
and Huang, Bin",
title="Performance of a Digital Cognitive Assessment in Predicting Dementia Stages Delineated by the Dementia Severity Rating Scale: Retrospective Study",
journal="JMIR Aging",
year="2025",
month="Feb",
day="26",
volume="8",
pages="e65292",
keywords="stage",
keywords="severity",
keywords="progression",
keywords="correlation",
keywords="association",
keywords="cognitive impairment",
keywords="functional activities",
keywords="cognitive assessment",
keywords="BrainCheck",
keywords="dementia",
keywords="Alzheimer disease",
keywords="gerontology",
keywords="geriatric",
keywords="old",
keywords="elderly",
keywords="aging",
keywords="retrospective analysis",
keywords="digital assessment",
keywords="patient assessment",
keywords="digital cognitive assessment",
keywords="digital health",
keywords="neurodegeneration",
keywords="memory loss",
keywords="memory function",
keywords="risk factors",
abstract="Background: Dementia is characterized by impairments in an individual's cognitive and functional abilities. Digital cognitive assessments have been shown to be effective in detecting mild cognitive impairment and dementia, but whether they can stage the disease remains to be studied. Objective: In this study, we examined (1) the correlation between scores obtained from BrainCheck standard battery of cognitive assessments (BC-Assess), a digital cognitive assessment, and scores obtained from the Dementia Severity Rating Scale (DSRS), and (2) the accuracy of using the BC-Assess score to predict dementia stage delineated by the DSRS score. We also explored whether BC-Assess can be combined with information from the Katz Index of Independence in activities of daily living (ADL) to obtain enhanced accuracy. Methods: Retrospective analysis was performed on a BrainCheck dataset containing 1751 patients with dementia with different cognitive and functional assessments completed for cognitive care planning, including the DSRS, the ADL, and the BC-Assess. The patients were staged according to their DSRS total score (DSRS-TS): 982 mild (DSRS-TS 10?18), 656 moderate (DSRS-TS 19-26), and 113 severe (DSRS-TS 37-54) patients. Pearson correlation was used to assess the associations between BC-Assess overall score (BC-OS), ADL total score (ADL-TS), and DSRS-TS. Logistic regression was used to evaluate the possibility of using patients' BC-OS and ADL-TS to predict their stage. Results: We found moderate Pearson correlations between DSRS-TS and BC-OS (r=?0.53), between DSRS-TS and ADL-TS (r=?0.55), and a weak correlation between BC-OS and ADL-TS (r=0.37). Both BC-OS and ADL-TS significantly decreased with increasing severity. BC-OS demonstrated to be a good predictor of dementia stages, with an area under the receiver operating characteristic curve (ROC-AUC) of classification using logistic regression ranging from .733 to .917. When BC-Assess was combined with ADL, higher prediction accuracies were achieved, with an ROC-AUC ranging from 0.786 to 0.961. Conclusions: Our results suggest that BC-Assess could serve as an effective alternative tool to DSRS for grading dementia severity, particularly in cases where DSRS, or other global assessments, may be challenging to obtain due to logistical and time constraints. ",
doi="10.2196/65292",
url="https://aging.jmir.org/2025/1/e65292"
}


@Article{info:doi/10.2196/58261,
author="Xie, Junan
and Li, Shilin
and Song, Zhen
and Shu, Lin
and Zeng, Qing
and Huang, Guozhi
and Lin, Yihuan",
title="Functional Monitoring of Patients With Knee Osteoarthritis Based on Multidimensional Wearable Plantar Pressure Features: Cross-Sectional Study",
journal="JMIR Aging",
year="2024",
month="Nov",
day="25",
volume="7",
pages="e58261",
keywords="knee osteoarthritis",
keywords="KOA",
keywords="40-m fast-paced walk test",
keywords="40mFPWT",
keywords="timed up-and-go test",
keywords="TUGT",
keywords="timed up and go",
keywords="TUG",
keywords="functional assessment",
keywords="monitoring",
keywords="wearable",
keywords="gait",
keywords="walk test",
keywords="plantar",
keywords="knee",
keywords="joint",
keywords="arthritis",
keywords="gait analysis",
keywords="regression model",
keywords="machine learning",
abstract="Background: Patients with knee osteoarthritis (KOA) often present lower extremity motor dysfunction. However, traditional radiography is a static assessment and cannot achieve long-term dynamic functional monitoring. Plantar pressure signals have demonstrated potential applications in the diagnosis and rehabilitation monitoring of KOA. Objective: Through wearable gait analysis technology, we aim to obtain abundant gait information based on machine learning techniques to develop a simple, rapid, effective, and patient-friendly functional assessment model for the KOA rehabilitation process to provide long-term remote monitoring, which is conducive to reducing the burden of social health care system. Methods: This cross-sectional study enrolled patients diagnosed with KOA who were able to walk independently for 2 minutes. Participants were given clinically recommended functional tests, including the 40-m fast-paced walk test (40mFPWT) and timed up-and-go test (TUGT). We used a smart shoe system to gather gait pressure data from patients with KOA. The multidimensional gait features extracted from the data and physical characteristics were used to establish the KOA functional feature database for the plantar pressure measurement system. 40mFPWT and TUGT regression prediction models were trained using a series of mature machine learning algorithms. Furthermore, model stacking and average ensemble learning methods were adopted to further improve the generalization performance of the model. Mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean squared error (RMSE) were used as regression performance metrics to evaluate the results of different models. Results: A total of 92 patients with KOA were included, exhibiting varying degrees of severity as evaluated by the Kellgren and Lawrence classification. A total of 380 gait features and 4 physical characteristics were extracted to form the feature database. Effective stepwise feature selection determined optimal feature subsets of 11 variables for the 40mFPWT and 10 variables for the TUGT. Among all models, the weighted average ensemble model using 4 tree-based models had the best generalization performance in the test set, with an MAE of 2.686 seconds, MAPE of 9.602\%, and RMSE of 3.316 seconds for the prediction of the 40mFPWT and an MAE of 1.280 seconds, MAPE of 12.389\%, and RMSE of 1.905 seconds for the prediction of the TUGT. Conclusions: This wearable plantar pressure feature technique can objectively quantify indicators that reflect functional status and is promising as a new tool for long-term remote functional monitoring of patients with KOA. Future work is needed to further explore and investigate the relationship between gait characteristics and functional status with more functional tests and in larger sample cohorts. ",
doi="10.2196/58261",
url="https://aging.jmir.org/2024/1/e58261"
}


@Article{info:doi/10.2196/57651,
author="Josendal, Vik Anette
and Bergmo, Strand Trine",
title="Medication Self-Management for Home Care Users Receiving Multidose Drug Dispensing: Qualitative Interview Study",
journal="JMIR Aging",
year="2024",
month="Oct",
day="4",
volume="7",
pages="e57651",
keywords="home care",
keywords="medication management",
keywords="adherence",
keywords="self-management",
keywords="multidose drug dispensing",
keywords="Norway",
keywords="primary care",
keywords="older adults",
abstract="Background: Multidose drug dispensing (MDD) is an adherence aid where medicines are machine-dispensed in disposable unit bags, usually for a 14-day period. MDD replaces manually filled dosettes in many home care services in Norway. While evidence suggests that MDD can improve medication adherence and reduce errors, there are few studies on how patients manage MDD at home and how this affects their daily routines. Objective: The aim of the study is to identify factors influencing medication self-management behavior among MDD users living at home and explore how MDD affects medication self-management. Methods: We conducted semistructured interviews with 19 MDD users in Oslo between August 2019 and February 2020. The interviews were held at the participants' homes, and the interview transcripts were analyzed thematically. Results: All participants in the study received some form of assistance with medication management from home care services. This assistance ranged from MDD delivery every other week to actual assistance with medication administration multiple times daily. However, regardless of the level of assistance received, participants primarily managed their MDD medications themselves. Daily medication routines and knowledge about medicines varied among the participants, with some taking an active role in their medication management, while others relied on others to take responsibility. The degree of involvement seemed determined by motivation rather than capability. Conclusions: MDD can support medication self-management, but its effectiveness varies among patients. The level of medication management by MDD users is not solely determined by their actual capabilities. Factors such as interest in self-care and independence, available support, information, and cognitive capacity all play a role in determining the degree of autonomy. ",
doi="10.2196/57651",
url="https://aging.jmir.org/2024/1/e57651"
}


@Article{info:doi/10.2196/63367,
author="Liu, Lu
and Wang, Xiu-Ling
and Cheng, Nuo
and Yu, Fu-Min
and Li, Hui-Jun
and Mu, Yang
and Yuan, Yonghui
and Dong, Jia-Xin
and Wu, Yu-Dan
and Gong, Da-Xin
and Wang, Shuang
and Zhang, Guang-Wei",
title="Development Trends and Prospects of Technology-Based Solutions for Health Challenges in Aging Over the Past 25 Years: Bibliometric Analysis",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="20",
volume="26",
pages="e63367",
keywords="bibliometrics",
keywords="CiteSpace",
keywords="VOSviewer",
keywords="visualization",
keywords="aging health",
keywords="technological innovations",
keywords="tech-based",
keywords="technology-based",
keywords="technology",
keywords="health challenges",
keywords="challenges",
keywords="trends",
keywords="older adults",
keywords="older adult",
keywords="ageing",
keywords="aging",
keywords="elder",
keywords="elderly",
keywords="older person",
keywords="older people",
keywords="gerontology",
keywords="geriatric",
keywords="geriatrics",
keywords="remote",
keywords="remote monitoring",
keywords="monitoring",
keywords="surveillance",
keywords="artificial intelligence",
keywords="AI",
keywords="AI-driven",
keywords="innovation",
keywords="innovations",
keywords="health management",
keywords="telemedicine",
keywords="remote care",
abstract="Background: As the global population ages, we witness a broad scientific and technological revolution tailored to meet the health challenges of older adults. Over the past 25 years, technological innovations, ranging from advanced medical devices to user-friendly mobile apps, are transforming the way we address these challenges, offering new avenues to enhance the quality of life and well-being of the aging demographic. Objective: This study aimed to systematically review the development trends in technology for managing and caring for the health of older adults over the past 25 years and to project future development prospects. Methods: We conducted a comprehensive bibliometric analysis of literatures related to technology-based solutions for health challenges in aging, published up to March 18, 2024. The search was performed using the Web of Science Core Collection, covering a span from 1999 to 2024. Our search strategy was designed to capture a broad spectrum of terms associated with aging, health challenges specific to older adults, and technological interventions. Results: A total of 1133 publications were found in the Web of Science Core Collection. The publication trend over these 25 years showed a gradual but fluctuating increase. The United States was the most productive country and participated in international collaboration most frequently. The predominant keywords identified through this analysis included ``dementia,'' ``telemedicine,'' ``older-adults,'' ``telehealth,'' and ``care.'' The keywords with citation bursts included ``telemedicine'' and ``digital health.'' Conclusions: The scientific and technological revolution has significantly improved older adult health management, particularly in chronic disease monitoring, mobility, and social connectivity. The momentum for innovation continues to build, with future research likely to focus on predictive analytics and personalized health care solutions, further enhancing older adults' independence and quality of life. ",
doi="10.2196/63367",
url="https://www.jmir.org/2024/1/e63367",
url="http://www.ncbi.nlm.nih.gov/pubmed/39238480"
}


@Article{info:doi/10.2196/50075,
author="Xiao, Han
and Zhou, Zechen
and Ma, Yujia
and Li, Xiaoyi
and Ding, Kexin
and Dai, Xiaotong
and Chen, Dafang",
title="Association of Wearable Device--Measured Step Volume and Variability With Blood Pressure in Older Chinese Adults: Mobile-Based Longitudinal Observational Study",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="14",
volume="26",
pages="e50075",
keywords="older adults",
keywords="physical activity",
keywords="step volume",
keywords="step variability",
keywords="blood pressure",
keywords="wearable devices",
keywords="mHealth apps",
keywords="mobile health apps",
keywords="mobile phone",
abstract="Background: The paucity of evidence on longitudinal and consecutive recordings of physical activity (PA) and blood pressure (BP) under real-life conditions and their relationships is a vital research gap that needs to be addressed. Objective: This study aims to (1) investigate the short-term relationship between device-measured step volume and BP; (2) explore the joint effects of step volume and variability on BP; and (3) examine whether the association patterns between PA and BP varied across sex, hypertension status, and chronic condition status. Methods: This study used PA data of a prospective cohort of 3070 community-dwelling older adults derived from a mobile health app. Daily step counts, as a proxy of step volume, were derived from wearable devices between 2018 and 2022 and categorized into tertiles (low, medium, and high). Step variability was assessed using the SD of daily step counts. Consecutive daily step count recordings within 0 to 6 days preceding each BP measurement were analyzed. Generalized estimation equation models were used to estimate the individual and joint associations of daily step volume and variability with BP. Stratified analyses by sex, the presence of hypertension, and the number of morbidities were further conducted. Results: A total of 3070 participants, with a median age of 72 (IQR 67-77) years and 71.37\% (2191/3070) women, were included. Participants walked a median of 7580 (IQR 4972-10,653) steps and 5523 (IQR 3590-7820) meters per day for a total of 592,597 person-days of PA monitoring. Our results showed that higher levels of daily step volume were associated with lower BP (systolic BP, diastolic BP, mean arterial pressure, and pulse pressure). Compared with participants with low step volume (daily step counts <6000/d) and irregular steps, participants with high step volume (?9500/d) and regular steps showed the strongest decrease in systolic BP (--1.69 mm Hg, 95\% CI --2.2 to --1.18), while participants with medium step volume (6000/d to <9500/d) and regular steps were associated with the lowest diastolic BP (--1.067 mm Hg, 95\% CI --1.379 to --0.755). Subgroup analyses indicated generally greater effects on women, individuals with normal BP, and those with only 1 chronic disease, but the effect pattern was varied and heterogeneous between participants with different characteristics. Conclusions: Increased step volume demonstrated a substantial protective effect on BP among older adults with chronic conditions. Furthermore, the beneficial association between step volume and BP was enhanced by regular steps, suggesting potential synergistic protective effects of both increased step volume and step regularity. Targeting both step volume and variability through PA interventions may yield greater benefits in BP control, particularly among participants with hypertension and a higher chronic disease burden. ",
doi="10.2196/50075",
url="https://www.jmir.org/2024/1/e50075"
}


@Article{info:doi/10.2196/41549,
author="Arnaert, Antonia
and Sumbly, Pia
and da Costa, Daniel
and Liu, Yuxin
and Debe, Zoumanan
and Charbonneau, Sylvain",
title="Acceptance of the Apple Watch Series 6 for Telemonitoring of Older Adults With Chronic Obstructive Pulmonary Disease: Qualitative Descriptive Study Part 1",
journal="JMIR Aging",
year="2023",
month="Dec",
day="26",
volume="6",
pages="e41549",
keywords="Apple Watch",
keywords="chronic obstructive pulmonary disease",
keywords="digital health",
keywords="older adults",
keywords="qualitative descriptive",
keywords="technology acceptance",
keywords="telemonitoring",
abstract="Background: The Apple Watch is not a medical device per se; it is a smart wearable device that is increasingly being used for health monitoring. Evidence exists that the Apple Watch Series 6 can reliably measure blood oxygen saturation (SpO2) in patients with chronic obstructive pulmonary disease under controlled circumstances. Objective: This study aimed to better understand older adults' acceptance of the Watch as a part of telemonitoring, even with these advancements. Methods: This study conducted content analysis on data collected from 10 older adults with chronic obstructive pulmonary disease who consented to wear the Watch. Results: Using the Extended Unified Theory of Acceptance and Use of Technology model, results showed that participants experienced potential health benefits; however, the inability of the Watch to reliably measure SpO2 when in respiratory distress was concerning. Participants' level of tech savviness varied, which caused some fear and frustration at the start, yet all felt supported by family and would have explored more features if they owned the Watch. All agreed that the Watch is mainly a medical tool and not a gadget. Conclusions: To conclude, although the Watch may enhance their physical health and well-being, results indicated that participants are more likely to accept the Watch if it ultimately proves to be useful when experiencing respiratory distress. ",
doi="10.2196/41549",
url="https://aging.jmir.org/2023/1/e41549",
url="http://www.ncbi.nlm.nih.gov/pubmed/38147371"
}


@Article{info:doi/10.2196/43777,
author="David, B. Michael C.
and Kolanko, Magdalena
and Del Giovane, Martina
and Lai, Helen
and True, Jessica
and Beal, Emily
and Li, M. Lucia
and Nilforooshan, Ramin
and Barnaghi, Payam
and Malhotra, A. Paresh
and Rostill, Helen
and Wingfield, David
and Wilson, Danielle
and Daniels, Sarah
and Sharp, J. David
and Scott, Gregory",
title="Remote Monitoring of Physiology in People Living With Dementia: An Observational Cohort Study",
journal="JMIR Aging",
year="2023",
month="Mar",
day="9",
volume="6",
pages="e43777",
keywords="dementia",
keywords="remote monitoring",
keywords="physiology",
keywords="Internet of Things",
keywords="alerts",
keywords="monitoring",
keywords="technology",
keywords="detection",
keywords="blood pressure",
keywords="support",
keywords="feasibility",
keywords="system",
keywords="quality of life",
abstract="Background: Internet of Things (IoT) technology enables physiological measurements to be recorded at home from people living with dementia and monitored remotely. However, measurements from people with dementia in this context have not been previously studied. We report on the distribution of physiological measurements from 82 people with dementia over approximately 2 years. Objective: Our objective was to characterize the physiology of people with dementia when measured in the context of their own homes. We also wanted to explore the possible use of an alerts-based system for detecting health deterioration and discuss the potential applications and limitations of this kind of system. Methods: We performed a longitudinal community-based cohort study of people with dementia using ``Minder,'' our IoT remote monitoring platform. All people with dementia received a blood pressure machine for systolic and diastolic blood pressure, a pulse oximeter measuring oxygen saturation and heart rate, body weight scales, and a thermometer, and were asked to use each device once a day at any time. Timings, distributions, and abnormalities in measurements were examined, including the rate of significant abnormalities (``alerts'') defined by various standardized criteria. We used our own study criteria for alerts and compared them with the National Early Warning Score 2 criteria. Results: A total of 82 people with dementia, with a mean age of 80.4 (SD 7.8) years, recorded 147,203 measurements over 958,000 participant-hours. The median percentage of days when any participant took any measurements (ie, any device) was 56.2\% (IQR 33.2\%-83.7\%, range 2.3\%-100\%). Reassuringly, engagement of people with dementia with the system did not wane with time, reflected in there being no change in the weekly number of measurements with respect to time (1-sample t-test on slopes of linear fit, P=.45). A total of 45\% of people with dementia met criteria for hypertension. People with dementia with $\alpha$-synuclein--related dementia had lower systolic blood pressure; 30\% had clinically significant weight loss. Depending on the criteria used, 3.03\%-9.46\% of measurements generated alerts, at 0.066-0.233 per day per person with dementia. We also report 4 case studies, highlighting the potential benefits and challenges of remote physiological monitoring in people with dementia. These include case studies of people with dementia developing acute infections and one of a person with dementia developing symptomatic bradycardia while taking donepezil. Conclusions: We present findings from a study of the physiology of people with dementia recorded remotely on a large scale. People with dementia and their carers showed acceptable compliance throughout, supporting the feasibility of the system. Our findings inform the development of technologies, care pathways, and policies for IoT-based remote monitoring. We show how IoT-based monitoring could improve the management of acute and chronic comorbidities in this clinically vulnerable group. Future randomized trials are required to establish if a system like this has measurable long-term benefits on health and quality of life outcomes. ",
doi="10.2196/43777",
url="https://aging.jmir.org/2023/1/e43777",
url="http://www.ncbi.nlm.nih.gov/pubmed/36892931"
}


@Article{info:doi/10.2196/37648,
author="Xue, Qun
and Zhang, Xuewu
and Liu, Rong
and Guan, Xiaoqin
and Li, Guocheng
and Zhao, Linhai
and Wang, Qian
and Wang, Debin
and Shen, Xingrong",
title="Differentiated Effects and Determinants of Home Blood Pressure Telemonitoring: Three-Year Cohort Study in Jieshou, Anhui, China",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="11",
volume="24",
number="10",
pages="e37648",
keywords="blood pressure",
keywords="home telemonitoring",
keywords="effect",
keywords="influence factors",
keywords="China",
abstract="Background: Home blood pressure telemonitoring (HBPT) is witnessing rapid diffusion worldwide. Contemporary studies documented mainly short-term (6-12 months) effects of HBPT, and there are limited data about its uptake. Objective: The aim of this study was to explore the 3-year use and determinants of HBPT, and the interactions with systolic and diastolic blood pressure (SBP/DBP) and overall blood pressure (BP) control rate. Methods: HBPT records were obtained from a 3-year cohort of 5658 patients with hypertension in Jieshou, Anhui, China, and data from a structured household survey of a random sample (n=3005) of the cohort. The data analysis comprised (1) timeline trajectories of the rates of monthly active HBPT and mean SBP/DBP for overall and subgroups of patients with varied start-month SBP/DBP; and (2) multivariable linear, logistic, and percentile regression analyses using SBP/DBP, BP control rate, and yearly times of HBPT as the dependent variable, respectively. Results: HBPT was followed by mixed changes in mean monthly SBP/DBP for varied patient groups. The magnitude of changes ranged from --43 to +39 mmHg for SBP and from --27 to +15 mmHg for DBP. The monthly rates of active HBPT all exhibited a rapid and then gradually slower decline. When controlled for commonly reported confounders, times of HBPT in the last year were found to have decreasing correlation coefficients for SBP/DBP (from 0.16 to --0.35 and from 0.11 to --0.35, respectively) and for BP control rate (from 0.53 to --0.62). Conclusions: HBPT had major and ``target-converging'' effects on SBP/DBP. The magnitude of changes was much greater than commonly reported. BP, variation in BP, and time were the most important determinants of HBPT uptake. Age, education, duration of hypertension, family history, and diagnosis of hypertension complications were also linked to the uptake but at weaker strength. There is a clear need for differentiated thinking over the application and assessment of HBPT, and for identifying and correcting/leveraging potential outdated/new opportunities or beliefs. ",
doi="10.2196/37648",
url="https://www.jmir.org/2022/10/e37648",
url="http://www.ncbi.nlm.nih.gov/pubmed/36114000"
}


@Article{info:doi/10.2196/34606,
author="Gooch, Daniel
and Mehta, Vikram
and Stuart, Avelie
and Katz, Dmitri
and Bennasar, Mohamed
and Levine, Mark
and Bandara, Arosha
and Nuseibeh, Bashar
and Bennaceur, Amel
and Price, Blaine",
title="Designing Tangibles to Support Emotion Logging for Older Adults: Development and Usability Study",
journal="JMIR Hum Factors",
year="2022",
month="Apr",
day="27",
volume="9",
number="2",
pages="e34606",
keywords="older adults",
keywords="health",
keywords="emotion",
keywords="affect",
keywords="well-being",
keywords="tangible interaction",
keywords="TUI",
abstract="Background: The global population is aging, leading to shifts in health care needs. In addition to developing technology to support physical health, there is an increasing recognition of the need to consider how technology can support emotional health. This raises the question of how to design devices that older adults can interact with to log their emotions. Objective: We designed and developed 2 novel tangible devices, inspired by existing paper-based scales of emotions. The findings from a field trial of these devices with older adults are reported. Methods: Using interviews, field deployment, and fixed logging tasks, we assessed the developed devices. Results: Our results demonstrate that the tangible devices provided data comparable with standardized psychological scales of emotion. The participants developed their own patterns of use around the devices, and their experience of using the devices uncovered a variety of design considerations. We discuss the difficulty of customizing devices for specific user needs while logging data comparable to psychological scales of emotion. We also highlight the value of reflecting on sparse emotional data. Conclusions: Our work demonstrates the potential for tangible emotional logging devices. It also supports further research on whether such devices can support the emotional health of older adults by encouraging reflection of their emotional state. ",
doi="10.2196/34606",
url="https://humanfactors.jmir.org/2022/2/e34606",
url="http://www.ncbi.nlm.nih.gov/pubmed/35475781"
}


@Article{info:doi/10.2196/37282,
author="Jacobson, Natasha
and Lithgow, Brian
and Jafari Jozani, Mohammad
and Moussavi, Zahra",
title="The Effect of Transcranial Alternating Current Stimulation With Cognitive Training on Executive Brain Function in Individuals With Dementia: Protocol for a Crossover Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2022",
month="Apr",
day="27",
volume="11",
number="4",
pages="e37282",
keywords="transcranial alternating current stimulation",
keywords="Alzheimer disease",
keywords="cognitive impairment",
keywords="double blind",
keywords="treatment",
keywords="placebo-controlled",
keywords="randomized",
keywords="crossover",
keywords="dementia",
keywords="cognitive",
abstract="Background: Although memory and cognitive declines are associated with normal brain aging, they may also be precursors to dementia. Objective: We aim to offer a novel approach to prevent or slow the progress of neurodegenerative dementia, or plausibly, improve the cognitive functions of individuals with dementia. Methods: We will recruit and enroll 75 participants (older than 50 years old with either mild cognitive impairment or probable early or moderate dementia) for this double-blind randomized controlled study to estimate the efficacy of active transcranial alternating current stimulation with cognitive treatment (in comparison with sham transcranial alternating current stimulation). This will be a crossover study; a cycle consists of sham or active treatment for a period of 4 weeks (5 days per week, in two 30-minute sessions with a half-hour break in between), and participants are randomized into 2 groups, with stratification by age, sex, and cognitive level (measured with the Montreal Cognitive Assessment). Outcomes will be assessed before and after each treatment cycle. The primary outcomes are changes in Wechsler Memory Scale Older Adult Battery and Alzheimer Disease Assessment Scale scores. Secondary outcomes are changes in performance on tests of frontal lobe functioning (verbal fluency), neuropsychiatric symptoms (Neuropsychiatric Inventory Questionnaire), mood changes (Montgomery-{\AA}sberg Depression Rating Scale), and short-term recall (visual 1-back task). Exploratory outcome measures will also be assessed: static and dynamic vestibular response using electrovestibulography, neuronal changes using functional near-infrared spectroscopy, and change in spatial orientation using virtual reality navigation. Results: As of February 10, 2022, the study is ongoing: 7 patients have been screened, and all were deemed eligible for and enrolled in the study; 4 participants have completed baseline assessments. Conclusions: We anticipate that transcranial alternating current stimulation will be a well-tolerated treatment, with no serious side effects and with considerable short- and long-term cognitive improvements. Trial Registration: Clinicaltrials.gov NCT05203523; https://clinicaltrials.gov/show/NCT05203523 International Registered Report Identifier (IRRID): DERR1-10.2196/37282 ",
doi="10.2196/37282",
url="https://www.researchprotocols.org/2022/4/e37282",
url="http://www.ncbi.nlm.nih.gov/pubmed/35475789"
}


@Article{info:doi/10.2196/32085,
author="McLaren, Ruth
and Smith, F. Paul
and Lord, Sue
and Kaur, Kamal Preet
and Zheng, Yiwen
and Taylor, Denise",
title="Noisy Galvanic Vestibular Stimulation Combined With a Multisensory Balance Program?in Older Adults With Moderate to High Fall Risk: Protocol for a Feasibility Study for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2021",
month="Oct",
day="5",
volume="10",
number="10",
pages="e32085",
keywords="older adult",
keywords="balance",
keywords="rehabilitation",
keywords="noisy galvanic vestibular stimulation",
keywords="nGVS",
keywords="brain stimulation",
abstract="Background: Reduced mobility and falls are common among older adults. Balance retraining programs are effective in reducing falls and in improving balance and mobility. Noisy galvanic vestibular stimulation is a low-level electrical stimulation used to reduce the threshold for the firing of vestibular neurons via a mechanism of stochastic resonance. Objective: This study aims to determine the feasibility of using noisy galvanic vestibular stimulation to augment a balance training program for older adults at risk of falls. We hypothesize that noisy galvanic vestibular stimulation will enhance the effects of balance retraining in older adults at risk of falls Methods: In this 3-armed randomized controlled trial, community dwelling older adults at risk of falling will be randomly assigned to a noisy galvanic vestibular stimulation plus balance program (noisy galvanic vestibular stimulation group), sham plus balance program (sham group), or a no treatment group (control). Participants will attend the exercise group twice a week for 8 weeks with assessment of balance and gait pretreatment, posttreatment, and at 3 months postintervention. Primary outcome measures include postural sway, measured by center of pressure velocity, area and root mean square, and gait parameters such as speed, step width, step variability, and double support time. Spatial memory will also be measured using the triangle completion task and the 4 Mountains Test. Results: Recruitment began in November 2020. Data collection and analysis are expected to be completed by December 2022. Conclusions: This study will evaluate the feasibility of using noisy galvanic vestibular stimulation alongside balance retraining in older adults at risk of falls and will inform the design of a fully powered randomized controlled trial. Trial Registration: New Zealand Clinical Trials Registry (ACTRN12620001172998); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379944 International Registered Report Identifier (IRRID): DERR1-10.2196/32085 ",
doi="10.2196/32085",
url="https://www.researchprotocols.org/2021/10/e32085",
url="http://www.ncbi.nlm.nih.gov/pubmed/34609323"
}


@Article{info:doi/10.2196/24553,
author="Rouzaud Laborde, Charlotte
and Cenko, Erta
and Mardini, T. Mamoun
and Nerella, Subhash
and Kheirkhahan, Matin
and Ranka, Sanjay
and Fillingim, B. Roger
and Corbett, B. Duane
and Weber, Eric
and Rashidi, Parisa
and Manini, Todd",
title="Satisfaction, Usability, and Compliance With the Use of Smartwatches for Ecological Momentary Assessment of Knee Osteoarthritis Symptoms in Older Adults: Usability Study",
journal="JMIR Aging",
year="2021",
month="Jul",
day="14",
volume="4",
number="3",
pages="e24553",
keywords="ehealth",
keywords="mobile health",
keywords="ecological momentary assessment",
keywords="real-time online assessment and mobility monitor",
keywords="ROAMM",
keywords="older adults",
keywords="compliance",
keywords="personal satisfaction",
keywords="usability",
keywords="smartwatch",
keywords="knee osteoarthritis",
keywords="pain",
keywords="fatigue",
keywords="wearable electronic device",
keywords="mobile application",
abstract="Background: Smartwatches enable physicians to monitor symptoms in patients with knee osteoarthritis, their behavior, and their environment. Older adults experience fluctuations in their pain and related symptoms (mood, fatigue, and sleep quality) that smartwatches are ideally suited to capture remotely in a convenient manner. Objective: The aim of this study was to evaluate satisfaction, usability, and compliance using the real-time, online assessment and mobility monitoring (ROAMM) mobile app designed for smartwatches for individuals with knee osteoarthritis. Methods: Participants (N=28; mean age 73.2, SD 5.5 years; 70\% female) with reported knee osteoarthritis were asked to wear a smartwatch with the ROAMM app installed. They were prompted to report their prior night's sleep quality in the morning, followed by ecological momentary assessments (EMAs) of their pain, fatigue, mood, and activity in the morning, afternoon, and evening. Satisfaction, comfort, and usability were evaluated using a standardized questionnaire. Compliance with regard to answering EMAs was calculated after excluding time when the watch was not being worn for technical reasons (eg, while charging). Results: A majority of participants reported that the text displayed was large enough to read (22/26, 85\%), and all participants found it easy to enter ratings using the smartwatch. Approximately half of the participants found the smartwatch to be comfortable (14/26, 54\%) and would consider wearing it as their personal watch (11/24, 46\%). Most participants were satisfied with its battery charging system (20/26, 77\%). A majority of participants (19/26, 73\%) expressed their willingness to use the ROAMM app for a 1-year research study. The overall EMA compliance rate was 83\% (2505/3036 responses). The compliance rate was lower among those not regularly wearing a wristwatch (10/26, 88\% vs 16/26, 71\%) and among those who found the text too small to read (4/26, 86\% vs 22/26, 60\%). Conclusions: Older adults with knee osteoarthritis positively rated the ROAMM smartwatch app and were generally satisfied with the device. The high compliance rates coupled with the willingness to participate in a long-term study suggest that the ROAMM app is a viable approach to remotely collecting health symptoms and behaviors for both research and clinical endeavors. ",
doi="10.2196/24553",
url="https://aging.jmir.org/2021/3/e24553",
url="http://www.ncbi.nlm.nih.gov/pubmed/34259638"
}


@Article{info:doi/10.2196/17299,
author="Ferguson, Caleb
and Inglis, C. Sally
and Breen, P. Paul
and Gargiulo, D. Gaetano
and Byiers, Victoria
and Macdonald, S. Peter
and Hickman, D. Louise",
title="Clinician Perspectives on the Design and Application of Wearable Cardiac Technologies for Older Adults: Qualitative Study",
journal="JMIR Aging",
year="2020",
month="Jun",
day="18",
volume="3",
number="1",
pages="e17299",
keywords="technology",
keywords="arrhythmia",
keywords="monitoring",
keywords="older people",
keywords="cardiology",
keywords="qualitative",
keywords="wearable",
abstract="Background: New wearable devices (for example, AliveCor or Zio patch) offer promise in detecting arrhythmia and monitoring cardiac health status, among other clinically useful parameters in older adults. However, the clinical utility and usability from the perspectives of clinicians is largely unexplored. Objective: This study aimed to explore clinician perspectives on the use of wearable cardiac monitoring technology for older adults. Methods: A descriptive qualitative study was conducted using semistructured focus group interviews. Clinicians were recruited through purposive sampling of physicians, nurses, and allied health staff working in 3 tertiary-level hospitals. Verbatim transcripts were analyzed using thematic content analysis to identify themes. Results: Clinicians representing physicians, nurses, and allied health staff working in 3 tertiary-level hospitals completed 4 focus group interviews between May 2019 and July 2019. There were 50 participants (28 men and 22 women), including cardiologists, geriatricians, nurses, and allied health staff. The focus groups generated the following 3 overarching, interrelated themes: (1) the current state of play, understanding the perceived challenges of patient cardiac monitoring in hospitals, (2) priorities in cardiac monitoring, what parameters new technologies should measure, and (3) cardiac monitoring of the future, ``the ideal device.'' Conclusions: There remain pitfalls related to the design of wearable cardiac technology for older adults that present clinical challenges. These pitfalls and challenges likely negatively impact the uptake of wearable cardiac monitoring in routine clinical care. Partnering with clinicians and patients in the co-design of new wearable cardiac monitoring technologies is critical to optimize the use of these devices and their uptake in clinical care. ",
doi="10.2196/17299",
url="http://aging.jmir.org/2020/1/e17299/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32554377"
}


@Article{info:doi/10.2196/18073,
author="Patel, Tejal
and Ivo, Jessica
and Faisal, Sadaf
and McDougall, Aidan
and Carducci, Jillian
and Pritchard, Sarah
and Chang, Feng",
title="A Prospective Study of Usability and Workload of Electronic Medication Adherence Products by Older Adults, Caregivers, and Health Care Providers",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="2",
volume="22",
number="6",
pages="e18073",
keywords="electronic medication adherence",
keywords="usability",
keywords="workload",
keywords="geriatrics",
keywords="older adults",
keywords="mobile phone",
abstract="Background: A decreased capacity to self-manage medications results in nonadherence, medication errors, and drug-related problems in older adults. Previous research identified 80 electronic medication adherence products available to assist patients with self-management of medications. Unfortunately, the usability and workload of these products are unknown. Objective: This study aimed to examine the usability and workload of a sample of electronic medication adherence products. Methods: In a prospective, mixed methods study, a sample of older adults, health care professionals, and caregivers tested the usability and workload of 21 electronic medication adherence products. Each participant tested 5 products, one at a time, after which they completed the system usability scale (SUS) and NASA-task load index (NASA-TLX), instruments that measure the usability and workload involved in using a product. Higher SUS scores indicate more user-friendliness, whereas lower NASA-TLX raw scores indicate less workload when using a product. Results: Electronic medication adherence products required a mean of 12.7 steps (range 5-20) for the appropriate use and took, on average, 15.19 min to complete the setup tasks (range 1-56). Participants were able to complete all steps without assistance 55.3\% of the time (103 out of the 186 tests were completed by 39 participants; range 0\%-100\%). The mean SUS and NASA-TLX raw scores were 52.8 (SD 28.7; range 0-100) and 50.0 (SD 25.7; range 4.2-99.2), respectively, revealing significant variability among the electronic medication adherence products. The most user-friendly products were found to be TimerCap travel size (mean 78.67, SD 15.57; P=.03) and eNNOVEA Weekly Planner with Advanced Auto Reminder (mean 78.13, SD 14.13; P=.049) as compared with MedReady 1700 automated medication dispenser (mean 28.63, SD 21.24). Similarly, MedReady (72.92, SD 18.69) was found to be significantly more work intensive when compared with TimerCap (29.35, SD 20.35; P=.03), e-pill MedGlider home medication management system (28.43, SD 20.80; P=.02), and eNNOVEA (28.65, SD 14.97; P=.03). The e-pill MedTime Station automatic pill dispenser with tipper (71.77, SD 21.98) had significantly more workload than TimerCap (P=.04), MedGlider (P=.03), and eNNOVEA (P=.04). Conclusions: This study demonstrated that variability exists in the usability and workload of different electronic medication adherence products among older adults, caregivers, and clinicians. With few studies having investigated the usability and workload of electronic medication adherence products, no benchmarks exist to compare the usability and workload of these products. However, our study highlights the need to assess the usability and workload of different products marketed to assist with medication taking and provides guidance to clinicians regarding electronic medication adherence product recommendations for their patients. Future development of electronic medication adherence products should ensure that the target populations of patients are able to use these products adequately to improve medication management. ",
doi="10.2196/18073",
url="https://www.jmir.org/2020/6/e18073",
url="http://www.ncbi.nlm.nih.gov/pubmed/32348292"
}


@Article{info:doi/10.2196/13757,
author="Graham, Anne Sarah
and Jeste, V. Dilip
and Lee, E. Ellen
and Wu, Tsung-Chin
and Tu, Xin
and Kim, Ho-Cheol
and Depp, A. Colin",
title="Associations Between Heart Rate Variability Measured With a Wrist-Worn Sensor and Older Adults' Physical Function: Observational Study",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Oct",
day="23",
volume="7",
number="10",
pages="e13757",
keywords="wearable technology",
keywords="aging",
keywords="electrocardiogram",
keywords="geriatric assessment",
abstract="Background: Heart rate variability (HRV), or variation in beat-to-beat intervals of the heart, is a quantitative measure of autonomic regulation of the cardiovascular system. Low HRV derived from electrocardiogram (ECG) recordings is reported to be related to physical frailty in older adults. Recent advances in wearable technology offer opportunities to more easily integrate monitoring of HRV into regular clinical geriatric health assessments. However, signals obtained from ECG versus wearable photoplethysmography (PPG) devices are different, and a critical first step preceding their widespread use is to determine whether HRV metrics derived from PPG devices also relate to older adults' physical function. Objective: This study aimed to investigate associations between HRV measured with a wrist-worn PPG device, the Empatica E4 sensor, and validated clinical measures of both objective and self-reported physical function in a cohort of older adults living independently within a continuing care senior housing community. Our primary hypothesis was that lower HRV would be associated with lower physical function. In addition, we expected that HRV would explain a significant proportion of variance in measures of physical health status. Methods: We evaluated 77 participants from an ongoing study of older adults aged between 65 and 95 years. The assessments encompassed a thorough examination of domains typically included in a geriatric health evaluation. We collected HRV data with the Empatica E4 device and examined bivariate correlations between HRV quantified with the triangular index (HRV TI) and 3 widely used and validated measures of physical functioning---the Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), and Medical Outcomes Study Short Form 36 (SF-36) physical composite scores. We further investigated the additional predictive power of HRV TI on physical health status, as characterized by SF-36 physical composite scores and Cumulative Illness Rating Scale for Geriatrics (CIRS-G) scores, using generalized estimating equation regression analyses with backward elimination. Results: We observed significant associations of HRV TI with SPPB (n=52; Spearman $\rho$=0.41; P=.003), TUG (n=51; $\rho$=?0.40; P=.004), SF-36 physical composite scores (n=49; $\rho$=0.37; P=.009), and CIRS-G scores (n=52, $\rho$=?0.43; P=.001). In addition, the HRV TI explained a significant proportion of variance in SF-36 physical composite scores (R2=0.28 vs 0.11 without HRV) and CIRS-G scores (R2=0.33 vs 0.17 without HRV). Conclusions: The HRV TI measured with a relatively novel wrist-worn PPG device was related to both objective (SPPB and TUG) and self-reported (SF-36 physical composite) measures of physical function. In addition, the HRV TI explained additional variance in self-reported physical function and cumulative illness severity beyond traditionally measured aspects of physical health. Future steps include longitudinal tracking of changes in both HRV and physical function, which will add important insights regarding the predictive value of HRV as a biomarker of physical health in older adults. ",
doi="10.2196/13757",
url="http://mhealth.jmir.org/2019/10/e13757/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31647469"
}


@Article{info:doi/10.2196/11057,
author="Plante, B. Timothy
and O'Kelly, C. Anna
and Urrea, Bruno
and Macfarlane, T. Zane
and Appel, J. Lawrence
and Miller III, R. Edgar
and Blumenthal, S. Roger
and Martin, S. Seth",
title="Auralife Instant Blood Pressure App in Measuring Resting Heart Rate: Validation Study",
journal="JMIR Biomed Eng",
year="2018",
month="Nov",
day="21",
volume="3",
number="1",
pages="e11057",
keywords="mHealth",
keywords="digital health",
keywords="heart rate",
keywords="validation study",
keywords="photoplethysmography",
keywords="medical informatics",
keywords="mobile phones",
abstract="Background: mHealth apps that measure heart rate using pulse photoplethysmography (PPG) are classified as class II (moderate-risk) Food and Drug Administration devices; therefore, these devices need clinical validation prior to public release. The Auralife Instant Blood Pressure app (AuraLife IBP app) is an mHealth app that measures blood pressure inaccurately based on a previous validation study. Its ability to measure heart rate has not been previously reported. Objective: The objective of our study was to assess the accuracy and precision of the AuraLife IBP app in measuring heart rate. Methods: We enrolled 85 adults from ambulatory clinics. Two measurements were obtained using the AuraLife IBP app, and 2 other measurements were achieved with a oscillometric device. The order of devices was randomized. Accuracy was assessed by calculating the relative and absolute mean differences between heart rate measurements obtained using each AuraLife IBP app and an average of both standard heart rate measurements. Precision was assessed by calculating the relative and absolute mean differences between individual measurements in the pair for each device. Results: The relative and absolute mean (SD) differences between the devices were 1.1 (3.5) and 2.8 (2.4) beats per minute (BPM), respectively. Meanwhile, the within-device relative and absolute mean differences, respectively, were <0.1 (2.2) and 1.7 (1.4) BPM for the standard device and ?0.1 (3.2) and 2.2 (2.3) BPM for the AuraLife IBP app. Conclusions: The AuraLife IBP app had a high degree of accuracy and precision in the measurement of heart rate. This supports the use of PPG technology in smartphones for monitoring resting heart rate. ",
doi="10.2196/11057",
url="http://biomedeng.jmir.org/2018/1/e11057/"
}


@Article{info:doi/10.2196/10975,
author="Albrecht, Lauren
and Wood, W. Peter
and Fradette, Miriam
and McAlister, A. Finlay
and Rabi, Doreen
and Boulanger, Pierre
and Padwal, Raj",
title="Usability and Acceptability of a Home Blood Pressure Telemonitoring Device Among Community-Dwelling Senior Citizens With Hypertension: Qualitative Study",
journal="JMIR Aging",
year="2018",
month="Jul",
day="24",
volume="1",
number="2",
pages="e10975",
keywords="blood pressure",
keywords="telemonitoring",
keywords="community-dwelling",
keywords="qualitative",
abstract="Background: Hypertension is a major cause of cardiovascular disease in older individuals. To ensure that blood pressure (BP) levels are within the optimal range, accurate BP monitoring is required. Contemporary hypertension clinical practice guidelines strongly endorse the use of home BP measurement as a preferred method of BP monitoring for individuals with hypertension. The benefits of home BP monitoring may be optimized when measurements are telemonitored to care providers; however, this may be challenging for older individuals with less technological capabilities. Objective: The objective of this qualitative study was to examine the usability and acceptability of a home BP telemonitoring device among senior citizens. Methods: We conducted a qualitative descriptive study. Following a 1-week period of device use, individual, semistructured interviews were conducted. Interview audio recordings were anonymized, de-identified, and transcribed verbatim. We performed thematic analysis on interview transcripts. Results: Seven senior citizens participated in the usability testing of the home BP telemonitoring device. Participants comprised females (n=4) and males (n=3) with a mean age of 86 years (range, 70-95 years). Overall, eight main themes were identified from the interviews: (1) positive features of the device; (2) difficulties or problems with the device; (3) device was simple to use; (4) comments about wireless capability and components; (5) would recommend device to someone else; (6) would use device in future; (7) suggestions for improving the device; and (8) assistance to use device. Additional subthemes were also identified. Conclusions: Overall, the home BP telemonitoring device had very good usability and acceptability among community-dwelling senior citizens with hypertension. To enhance its long-term use, few improvements were noted that may mitigate some of the relatively minor challenges encountered by the target population. ",
doi="10.2196/10975",
url="http://aging.jmir.org/2018/2/e10975/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518242"
}