@Article{info:doi/10.2196/65269, author="Yang, Jun Hyo and Lee, Ji-Hyun and Lee, Wonjae", title="Factors Influencing Health Care Technology Acceptance in Older Adults Based on the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology: Meta-Analysis", journal="J Med Internet Res", year="2025", month="Mar", day="28", volume="27", pages="e65269", keywords="technology adoption", keywords="older adults", keywords="health care technology", keywords="technology acceptance model", keywords="unified theory of acceptance and use of technology", keywords="meta-analysis", abstract="Background: The technology acceptance model (TAM) and the unified theory of acceptance and use of technology (UTAUT) are widely used to examine health care technology acceptance among older adults. However, existing literature exhibits considerable heterogeneity, making it difficult to determine consistent predictors of acceptance and behavior. Objective: We aimed to (1) determine the influence of perceived usefulness (PU), perceived ease of use (PEOU), and social influence (SI) on the behavioral intention (BI) to use health care technology among older adults and (2) assess the moderating effects of age, gender, geographic region, type of health care technology, and presence of visual demonstrations. Methods: A systematic search was conducted across Google Scholar, Web of Science, Scopus, IEEE Xplore, and ProQuest databases on March 15, 2024, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Of the 1167 initially identified studies, 41 studies (11,574 participants; mean age 67.58, SD 4.76 years; and female:male ratio=2.00) met the inclusion criteria. The studies comprised 12 mobile health, 12 online or telemedicine, 9 wearable, and 8 home or institution hardware investigations, with 23 studies from Asia, 7 from Europe, 7 from African-Islamic regions, and 4 from the United States. Studies were eligible if they used the TAM or UTAUT, examined health care technology adoption among older adults, and reported zero-order correlations. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale, evaluating selection, comparability, and outcome assessment with 34\% (14/41) of studies rated as good quality and 66\% (27/41) as satisfactory. Results: Random-effects meta-analysis revealed significant positive correlations for PU-BI (r=0.607, 95\% CI 0.543-0.665; P<.001), PEOU-BI (r=0.525, 95\% CI 0.462-0.583; P<.001), and SI-BI (r=0.551, 95\% CI 0.468-0.624; P<.001). High heterogeneity was observed across studies (I{\texttwosuperior}=95.9\%, 93.6\%, and 95.3\% for PU-BI, PEOU-BI, and SI-BI, respectively). Moderator analyses revealed significant differences based on geographic region for PEOU-BI (Q=8.27; P=.04), with strongest effects in Europe (r=0.628) and weakest in African-Islamic regions (r=0.480). Technology type significantly moderated PU-BI (Q=8.08; P=.04) and SI-BI (Q=14.75; P=.002), with home or institutional hardware showing the strongest effects (PU-BI: r=0.736; SI-BI: r=0.690). Visual demonstrations significantly enhanced PU-BI (r=0.706 vs r=0.554; Q=4.24; P=.04) and SI-BI relationships (r=0.670 vs r=0.492; Q=4.38; P=.04). Age and gender showed no significant moderating effects. Conclusions: The findings indicate that PU, PEOU, and SI significantly impact the acceptance of health care technology among older adults, with heterogeneity influenced by geographic region, type of technology, and presence of visual demonstrations. This suggests that tailored strategies for different types of technology and the use of visual demonstrations are important for enhancing adoption rates. Limitations include varying definitions of older adults across studies and the use of correlation coefficients rather than controlled effect sizes. Results should therefore be interpreted within specific contexts and populations. ", doi="10.2196/65269", url="https://www.jmir.org/2025/1/e65269" } @Article{info:doi/10.2196/63900, author="Abu El Kheir-Mataria, Wafa and Mahmoud Abdelraheem, Omnia and Chun, Sungsoo", title="Genetic, Socioecological, and Health Determinants of Extreme Longevity in Semi-Supercentenarians and Supercentenarians: Protocol for a Scoping Review", journal="JMIR Res Protoc", year="2025", month="Mar", day="5", volume="14", pages="e63900", keywords="supercentenarians", keywords="semi-supercentenarians", keywords="extreme longevity", keywords="genetic factors", keywords="socioecological factors", keywords="health determinants", keywords="aging research", keywords="scoping review", keywords="cognitive performance", keywords="data collection methods", abstract="Background: The study of supercentenarians (individuals aged 110 years or older) offers valuable insights into aging, longevity, and the factors contributing to exceptional lifespans. These individuals often exhibit extraordinary cognitive and physical performance, which can inform strategies to improve the health of the general population. Research on centenarians (individuals aged 100 years or older), semi-supercentenarians (individuals aged 105-109 years), and supercentenarians covers themes like genetic factors, microbiome, inflammation, diet, lifestyle, and psychological aspects. These studies often focus on various aspects of extreme longevity, using varied objectives and methodologies, highlighting the need for a comprehensive synthesis to map the breadth of research and identify gaps in understanding this demographic. Objective: This scoping review aims to map and synthesize existing evidence on the determinants of extreme longevity, focusing on individuals living beyond 105 years. This review seeks to categorize genetic factors associated with semi-supercentenarians and supercentenarians; explore the range of socioecological factors contributing to their longevity; and identify common themes such as health, functional capacity, cognition, mental health, behaviors, social support, quality of life, personality traits, environmental factors, and religiosity. Additionally, it aims to examine and describe the methodologies and assessment tools used in studies on extreme longevity and provide an overview of global demographic trends and patterns among supercentenarians, including geographic distribution, gender prevalence, and socioeconomic characteristics. Methods: This scoping review follows the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 guidelines and the Population, Exposure, and Outcome framework. It includes observational and interventional, quantitative and qualitative studies on supercentenarians and semi-supercentenarians. Data will be sourced from databases like Scopus, PubMed, ProQuest, PsycINFO, and The Cochrane Library. The selection process involves abstract and full-text screening by two independent reviewers, with data extraction focusing on study characteristics, participant demographics, interventions or exposures, and key findings. A thematic analysis will identify patterns across various themes Results: As of October 2, 2024, five databases were searched, yielding 844 studies. After removing duplicates, 706 studies remained. Following the first and second screening stages, 135 studies were found to be eligible. The study is expected to be completed by the end of February 2025. Conclusions: By synthesizing evidence, this study will understand the global scope of supercentenarians, describe the main themes of research interest, and identify gaps. The findings are expected to contribute significantly to the body of knowledge on longevity, informing future research and public health policies. This scoping review aims to enhance the understanding of factors promoting healthy aging and extreme longevity, benefiting broader public health initiatives. Trial Registration: PROSPERO CRD42024512298; https://tinyurl.com/4cmux7h4 ", doi="10.2196/63900", url="https://www.researchprotocols.org/2025/1/e63900", url="http://www.ncbi.nlm.nih.gov/pubmed/40053776" } @Article{info:doi/10.2196/64539, author="S{\'a}nchez-Gonz{\'a}lez, Luis Juan and S{\'a}nchez-Rodr{\'i}guez, Luis Juan and Gonz{\'a}lez-Sarmiento, Rogelio and Navarro-L{\'o}pez, V{\'i}ctor and Ju{\'a}rez-Vela, Ra{\'u}l and P{\'e}rez, Jes{\'u}s and Mart{\'i}n-Vallejo, Javier", title="Effect of Physical Exercise on Telomere Length: Umbrella Review and Meta-Analysis", journal="JMIR Aging", year="2025", month="Jan", day="10", volume="8", pages="e64539", keywords="aging", keywords="chromosome", keywords="exercise", keywords="meta-analysis", keywords="telomere", keywords="telomerase", keywords="genes", keywords="genome", keywords="DNA", abstract="Background: Telomere length (TL) is a marker of cellular health and aging. Physical exercise has been associated with longer telomeres and, therefore, healthier aging. However, results supporting such effects vary across studies. Our aim was to synthesize existing evidence on the effect of different modalities and durations of physical exercise on TL. Objective: The aim of this study was to explore the needs and expectations of individuals with physical disabilities and their interventionists for the use of a virtual reality physical activity platform in a community organization. Methods: We performed an umbrella review and meta-analysis. Data sources included PubMed, Embase, Web of Science, Cochrane Library, and Scopus. We selected systematic reviews and meta-analyses of randomized and nonrandomized controlled clinical trials evaluating the effect of physical exercise on TL. Results: Our literature search retrieved 12 eligible systematic reviews, 5 of which included meta-analyses. We identified 22 distinct primary studies to estimate the overall effect size of physical exercise on TL. The overall effect size was 0.28 (95\% CI 0.118-0.439), with a heterogeneity test value Q of 43.08 (P=.003) and I{\texttwosuperior} coefficient of 51\%. The number of weeks of intervention explained part of this heterogeneity (Q\_B=8.25; P=.004), with higher effect sizes found in studies with an intervention of less than 30 weeks. Exercise modality explained additional heterogeneity within this subgroup (Q\_B=10.28, P=.02). The effect sizes were small for aerobic exercise and endurance training, and moderate for high-intensity interval training. Conclusions: Our umbrella review and meta-analysis detected a small-moderate positive effect of physical exercise on TL, which seems to be influenced by the duration and type of physical exercise. High quality studies looking into the impact of standardized, evidence-based physical exercise programs on TL are still warranted. Trial Registration: PROSPERO CRD42024500736; https://www.crd.york.ac.uk/PROSPERO/display\_record.php?RecordID=500736 ", doi="10.2196/64539", url="https://aging.jmir.org/2025/1/e64539" } @Article{info:doi/10.2196/58517, author="Zou, Ning and Xie, Bo and He, Daqing and Hilsabeck, Robin and Aguirre, Alyssa", title="mHealth Apps for Dementia Caregivers: Systematic Examination of Mobile Apps", journal="JMIR Aging", year="2024", month="Nov", day="20", volume="7", pages="e58517", keywords="dementia", keywords="informal care", keywords="mobile health applications", keywords="tailoring", keywords="information quality", keywords="mobile phone", abstract="Background: Informal caregivers of persons living with dementia are increasingly using mobile health (mHealth) apps to obtain care information. mHealth apps are seen as promising tools to better support caregivers' complex and evolving information needs. Yet, little is known about the types and quality of dementia care information that these apps provide. Is this information for caregivers individually tailored; if so, how? Objective: We aim to address the aforementioned gaps in the literature by systematically examining the types and quality of care-related information provided in publicly available apps for caregivers of persons living with dementia as well as app features used to tailor information to caregivers' information wants and situations. Methods: In September 2023, we used a multistage process to select mobile apps for caregivers of persons living with dementia. The final sample included 35 apps. We assessed (1) types of dementia care information provided in the apps, using our 3-item Alzheimer disease and related dementias daily care strategy framework, which encompasses educational information, tangible actions, and referral information; (2) quality of apps' care information, using the 11 indicators recommended by the National Library of Medicine; and (3) types of tailoring to provide personalization, feedback, and content matching, which are common tailoring strategies described in the literature. Results: Educational information was the most prevalent type of information provided (29/35 apps, 83\%), followed by information about tangible actions (18/35, 51\%) and referrals (14/35, 40\%). All apps presented their objectives clearly and avoided unrealistic or emotional claims. However, few provided information to explain whether the app's content was generated or reviewed by experts (7/35, 20\%) or how its content was selected (4/35, 11\%). Further, 6 of the 35 (17\%) apps implemented 1 type of tailoring; of them, 4 (11\%) used content matching and the other 2 (6\%) used personalization. No app used 2 types of tailoring; only 2 (6\%) used all 3 types (the third is feedback). Conclusions: Existing dementia care apps do not provide sufficient high-quality, tailored information for informal caregivers. Caregivers should exercise caution when they use dementia care apps for informational support. Future research should focus on designing dementia care apps that incorporate quality-assured, transparency-enhanced, evidence-based artificial intelligence--enabled mHealth solutions for caregivers. ", doi="10.2196/58517", url="https://aging.jmir.org/2024/1/e58517" } @Article{info:doi/10.2196/58196, author="Abhari, Shahabeddin and McMurray, Josephine and Randhawa, Tanveer and Bin Noon, Gaya and Hanjahanja-Phiri, Thokozani and McNeil, Heather and Manning, Fiona and Debergue, Patricia and Teague, Jennifer and Pelegrini Morita, Plinio", title="Exploring the Landscape of Standards and Guidelines in AgeTech Design and Development: Scoping Review and Thematic Analysis", journal="JMIR Aging", year="2024", month="Oct", day="31", volume="7", pages="e58196", keywords="aging in place", keywords="technology", keywords="gerontechnology", keywords="AgeTech", keywords="assistive technology", keywords="older adult", keywords="aging", keywords="ambient assisted living", keywords="active assisted living", abstract="Background: AgeTech (technology for older people) offers digital solutions for older adults supporting aging in place, including digital health, assistive technology, Internet of Things, medical devices, robotics, wearables, and sensors. This study underscores the critical role of standards and guidelines in ensuring the safety and effectiveness of these technologies for the health of older adults. As the aging demographic expands, the focus on robust standards becomes vital, reflecting a collective commitment to improving the overall quality of life for older individuals through thoughtful and secure technology integration. Objective: This scoping review aims to investigate the current state of standards and guidelines applied in AgeTech design and development as reported in academic literature. We explore the existing knowledge of these standards and guidelines and identify key gaps in the design and development of AgeTech guidelines and standards in scholarly publications. Methods: The literature review adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Searches were carried out across multiple databases, including Scopus, IEEE, PubMed, Web of Science, EBSCO, CINAHL, Cochrane, and Google Scholar, using a search string incorporating concepts such as ``older people,'' ``technology,'' and ``standards or guidelines.'' Alternative terms, Boolean operators, and truncation were used for comprehensive coverage in each database. The synthesis of results and data analysis involved both quantitative and qualitative methods. Results: Initially, 736 documents were identified across various databases. After applying specific inclusion and exclusion criteria and a screening process, 58 documents were selected for full-text review. The findings highlight that the most frequently addressed aspect of AgeTech standards or guidelines is related to ``design and development,'' constituting 36\% (21/58) of the literature; ``usability and user experience'' was the second most prevalent aspect, accounting for 19\% (11/58) of the documents. In contrast, ``privacy and security'' (1/58, 2\%) and ``data quality'' (1/58, 2\%) were the least addressed aspects. Similarly, ``ethics,'' ``integration and interoperability,'' ``accessibility,'' and ``acceptance or adoption'' each accounted for 3\% (2/58) of the documents. In addition, a thematic analysis identified qualitative themes that warrant further exploration of variables. Conclusions: This study investigated the available knowledge regarding standards and guidelines in AgeTech design and development to evaluate their current status in academic literature. The substantial focus on assistive technologies and ambient assisted living technologies confirmed their vital role in AgeTech. The findings provide valuable insights for interested parties and point to prioritized areas for further development and research in the AgeTech domain. ", doi="10.2196/58196", url="https://aging.jmir.org/2024/1/e58196" } @Article{info:doi/10.2196/58629, author="Trainum, Katie and Liu, Jiaying and Hauser, Elliott and Xie, Bo", title="Nursing Staff's Perspectives of Care Robots for Assisted Living Facilities: Systematic Literature Review", journal="JMIR Aging", year="2024", month="Sep", day="16", volume="7", pages="e58629", keywords="robots", keywords="nursing staff", keywords="nursing home", keywords="senior living", keywords="systematic review", keywords="aging", keywords="older adults", keywords="gerontology", keywords="participatory design", keywords="user needs", keywords="nurses", keywords="nursing", keywords="retirement", keywords="long-term care", keywords="geriatrics", keywords="elderly", keywords="older people", keywords="syntheses", keywords="review methods", keywords="review methodology", keywords="searches", keywords="searching", keywords="systematic", keywords="experiences", keywords="attitudes", keywords="opinions", keywords="perceptions", keywords="perspectives", keywords="preferences", keywords="needs", keywords="preference", abstract="Background: Care robots have been proposed in response to nursing shortages in assisted living facilities (ALFs) and the growing population of older adults. While the use of care robots may improve the general health and well-being of older adults, their introduction changes the work of nursing staff fundamentally, and it has implications for the entire health care system. In developing such technology, it is important to include end users, but so far, the nursing staff's perspectives have largely been ignored. Objective: This study aims to examine the literature on nursing staff's attitudes, needs, and preferences related to the use of care robots in ALFs, in order to discover gaps in the literature and guide future research. Methods: This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 protocol. On May 12, 2023, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, the IEEE Xplore Digital Library, and the ACM Digital Library using predetermined search terms. Included publications, written in English, focused on the predevelopment phase, in which information was gathered on nursing staff's attitudes, needs, and preferences regarding care robots for ALFs. Publications were excluded if they did not provide peer-reviewed empirical data. The studies' findings were summarized, coded, and analyzed into major themes using thematic analysis and narrative synthesis. Their quality was assessed using McGill University's Mixed Methods Appraisal Tool and the Joanna Briggs Institute's critical appraisal tools. Results: The final sample included 15 studies. Most of the studies (n=11, 73\%) were rated as good quality; however, there was a general lack of reporting on important methodological decisions and sample characteristics. Nursing staff desired care robots that could assist with physically demanding tasks and reduce their workload but had mixed feelings on whether robots could or should assist with social tasks. In addition, nursing staff are concerned about the ethics of care robots, as well as about their safety, accessibility, and operability. The nursing staff's culture, qualification, and role in the facility may influence their perspectives of care robots. The studies lacked theory-driven designs and large sample sizes. Eight (53\%) studies mentioned using a participatory design approach, but a lack of established criteria for what constitutes participatory design leads to varying degrees of methodological quality. Conclusions: There was consensus among nursing staff that care robots should serve as nursing assistants to reduce workload. Whether robots could or should assist with social tasks remains a question. Further research is needed to mitigate nursing staff's concerns and understand the socioecological factors that influence their perspectives of care robots and their adoption in ALFs. In addition, theory-driven and large sample size study designs are necessary, as well as work to develop clear criteria for related participatory design research. ", doi="10.2196/58629", url="https://aging.jmir.org/2024/1/e58629" } @Article{info:doi/10.2196/55257, author="Wong, Yi Karen Lok and Hung, Lillian and Wong, Joey and Park, Juyoung and Alfares, Hadil and Zhao, Yong and Mousavinejad, Abdolhossein and Soni, Albin and Zhao, Hui", title="Adoption of Artificial Intelligence--Enabled Robots in Long-Term Care Homes by Health Care Providers: Scoping Review", journal="JMIR Aging", year="2024", month="Aug", day="27", volume="7", pages="e55257", keywords="artificial intelligence", keywords="robot", keywords="long-term care home", keywords="health care provider", keywords="scoping review", keywords="person-centered care", abstract="Background: Long-term care (LTC) homes face the challenges of increasing care needs of residents and a shortage of health care providers. Literature suggests that artificial intelligence (AI)--enabled robots may solve such challenges and support person-centered care. There is a dearth of literature exploring the perspectives of health care providers, which are crucial to implementing AI-enabled robots. Objective: This scoping review aims to explore this scant body of literature to answer two questions: (1) what barriers do health care providers perceive in adopting AI-enabled robots in LTC homes? (2) What strategies can be taken to overcome these barriers to the adoption of AI-enabled robots in LTC homes? Methods: We are a team consisting of 3 researchers, 2 health care providers, 2 research trainees, and 1 older adult partner with diverse disciplines in nursing, social work, engineering, and medicine. Referring to the Joanna Briggs Institute methodology, our team searched databases (CINAHL, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google Scholar) for peer-reviewed and gray literature, screened the literature, and extracted the data. We analyzed the data as a team. We compared our findings with the Person-Centered Practice Framework and Consolidated Framework for Implementation Research to further our understanding of the findings. Results: This review includes 33 articles that met the inclusion criteria. We identified three barriers to AI-enabled robot adoption: (1) perceived technical complexity and limitation; (2) negative impact, doubted usefulness, and ethical concerns; and (3) resource limitations. Strategies to mitigate these barriers were also explored: (1) accommodate the various needs of residents and health care providers, (2) increase the understanding of the benefits of using robots, (3) review and overcome the safety issues, and (4) boost interest in the use of robots and provide training. Conclusions: Previous literature suggested using AI-enabled robots to resolve the challenges of increasing care needs and staff shortages in LTC. Yet, our findings show that health care providers might not use robots because of different considerations. The implication is that the voices of health care providers need to be included in using robots. International Registered Report Identifier (IRRID): RR2-doi:10.1136/bmjopen-2023-075278 ", doi="10.2196/55257", url="https://aging.jmir.org/2024/1/e55257", url="http://www.ncbi.nlm.nih.gov/pubmed/39190455" } @Article{info:doi/10.2196/53038, author="Kokorelias, Marie Kristina and McMurray, Josephine and Chu, Charlene and Astell, Arlene and Grigorovich, Alisa and Kontos, Pia and Babineau, Jessica and Bytautas, Jessica and Ahuja, Ashley and Iaboni, Andrea", title="Technology-Enabled Recreation and Leisure Programs and Activities for Older Adults With Cognitive Impairment: Rapid Scoping Review", journal="JMIR Neurotech", year="2024", month="Aug", day="8", volume="3", pages="e53038", keywords="scoping review", keywords="review methods", keywords="review methodology", keywords="knowledge synthesis", keywords="synthesis", keywords="syntheses", keywords="scoping", keywords="rapid review", keywords="rapid reviews", keywords="gerontology", keywords="geriatric", keywords="geriatrics", keywords="older adult", keywords="older adults", keywords="elder", keywords="elderly", keywords="older person", keywords="older people", keywords="ageing", keywords="aging", keywords="gerontechnology", keywords="technology", keywords="recreation", keywords="recreational", keywords="leisure", keywords="hobby", keywords="hobbies", keywords="cognitive", keywords="MCI", keywords="Alzheimer", keywords="dementia", keywords="digital health", abstract="Background: Recreational and leisure activities significantly contribute to the well-being of older adults, positively impacting physical, cognitive, and mental health. However, limited mobility and cognitive decline often impede access to these activities, particularly for individuals living with dementia. With the increasing availability of digital technologies, there is a rising interest in using technology to deliver recreation and leisure activities for cognitively impaired individuals, acknowledging its potential to provide diverse experiences. The COVID-19 pandemic further highlighted the need for virtual program delivery, especially for individuals in long-term care settings, leading to the development of tools like the Dementia Isolation Toolkit aimed at supporting compassionate isolation. To better support future implementations of the DIT, our rapid scoping review explores evidence-based, technology-enabled recreation programs for older adults with cognitive impairments, which promote well-being. Objective: We conducted a rapid scoping review of published peer-reviewed literature to answer the following research question: What recreation and leisure programs or activities are being delivered using technology to adults living with dementia or another form of cognitive impairment? Methods: In total, 6 databases were searched by an Information Specialist. Single reviewers performed title or abstract review, full-text screening, data extraction, and study characteristic summarization. Results: A total of 92 documents representing 94 studies were identified. The review identified a variety of technology-enabled delivery methods, including robots, gaming consoles, tablets, televisions, and computers, used to engage participants in recreational and leisure activities. These technologies impacted mood, cognition, functional activity, and overall well-being among older adults with cognitive impairments. Activities for socializing were the most common, leveraging technologies such as social robots and virtual companions, while relaxation methods used virtual reality and digital reminiscence therapy. However, challenges included technological complexity and potential distress during reminiscing activities, prompting recommendations for diversified research settings, and increased sample sizes to comprehensively understand technology's impact on leisure among this demographic. Conclusions: The findings suggest that technology-enabled recreational activities, such as socializing, relaxation and self-awareness activities, music and dance, exergaming, and art, can positively impact the mood and overall well-being of older adults with cognitive impairment. Future research should embrace a more inclusive approach, integrating design, diverse settings, and a broader sample of older adults to develop technology-driven leisure activities tailored to their unique needs and promote their effective use. ", doi="10.2196/53038", url="https://neuro.jmir.org/2024/1/e53038" } @Article{info:doi/10.2196/58174, author="Shi, Beibei and Li, Guangkai and Wu, Shuang and Ge, Hongli and Zhang, Xianliang and Chen, Si and Pan, Yang and He, Qiang", title="Assessing the Effectiveness of eHealth Interventions to Manage Multiple Lifestyle Risk Behaviors Among Older Adults: Systematic Review and Meta-Analysis", journal="J Med Internet Res", year="2024", month="Jul", day="31", volume="26", pages="e58174", keywords="eHealth", keywords="lifestyle risk behaviors", keywords="older adults", keywords="multiple health behavior change", keywords="mobile phone", abstract="Background: Developing adverse lifestyle behaviors increases the risk of a variety of chronic age-related diseases, including cardiovascular disease, obesity, and Alzheimer disease. There is limited evidence regarding the effectiveness of eHealth-based multiple health behavior change (MHBC) interventions to manage lifestyle risk behaviors. Objective: The purpose of this systematic evaluation was to assess the effectiveness of eHealth MHBC interventions in changing ?2 major lifestyle risk behaviors in people aged ?50 years. Methods: The literature search was conducted in 6 electronic databases---PubMed, Embase, Web of Science, Scopus, Cochrane Library, and SPORTDiscus---from inception to May 1, 2024. Eligible studies were randomized controlled trials of eHealth interventions targeting ?2 of 6 behaviors of interest: alcohol use, smoking, diet, physical activity (PA), sedentary behavior, and sleep. Results: A total of 34 articles with 35 studies were included. eHealth-based MHBC interventions significantly increased smoking cessation rates (odds ratio 2.09, 95\% CI 1.62-2.70; P<.001), fruit intake (standardized mean difference [SMD] 0.18, 95\% CI 0.04-0.32; P=.01), vegetable intake (SMD 0.17, 95\% CI 0.05-0.28; P=.003), self-reported total PA (SMD 0.22, 95\% CI 0.02-0.43; P=.03), and objectively measured moderate to vigorous PA (SMD 0.25, 95\% CI 0.09-0.41; P=.002); in addition, the interventions decreased fat intake (SMD --0.23, 95\% CI --0.33 to --0.13; P<.001). No effects were observed for alcohol use, sedentary behavior, or sleep. A sensitivity analysis was conducted to test the robustness of the pooled results. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. Conclusions: eHealth-based MHBC interventions may be a promising strategy to increase PA, improve diet, and reduce smoking among older adults. However, the effect sizes were small. Further high-quality, older adult--oriented research is needed to develop eHealth interventions that can change multiple behaviors. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42023444418; https://www.crd.york.ac.uk/prospero/display\_record.php?ID=CRD42023444418 ", doi="10.2196/58174", url="https://www.jmir.org/2024/1/e58174" } @Article{info:doi/10.2196/53564, author="Chu, Charlene and Donato-Woodger, Simon and Khan, S. Shehroz and Shi, Tianyu and Leslie, Kathleen and Abbasgholizadeh-Rahimi, Samira and Nyrup, Rune and Grenier, Amanda", title="Strategies to Mitigate Age-Related Bias in Machine Learning: Scoping Review", journal="JMIR Aging", year="2024", month="Mar", day="22", volume="7", pages="e53564", keywords="age", keywords="ageing", keywords="ageism", keywords="aging", keywords="algorithm", keywords="algorithmic bias", keywords="artificial intelligence", keywords="bias", keywords="digital ageism", keywords="elder", keywords="elderly", keywords="geriatric", keywords="gerontology", keywords="machine learning", keywords="older adult", keywords="older people", keywords="older person", keywords="review methodology", keywords="review methods", keywords="scoping", keywords="search", keywords="searching", keywords="synthesis", abstract="Background: Research suggests that digital ageism, that is, age-related bias, is present in the development and deployment of machine learning (ML) models. Despite the recognition of the importance of this problem, there is a lack of research that specifically examines the strategies used to mitigate age-related bias in ML models and the effectiveness of these strategies. Objective: To address this gap, we conducted a scoping review of mitigation strategies to reduce age-related bias in ML. Methods: We followed a scoping review methodology framework developed by Arksey and O'Malley. The search was developed in conjunction with an information specialist and conducted in 6 electronic databases (IEEE Xplore, Scopus, Web of Science, CINAHL, EMBASE, and the ACM digital library), as well as 2 additional gray literature databases (OpenGrey and Grey Literature Report). Results: We identified 8 publications that attempted to mitigate age-related bias in ML approaches. Age-related bias was introduced primarily due to a lack of representation of older adults in the data. Efforts to mitigate bias were categorized into one of three approaches: (1) creating a more balanced data set, (2) augmenting and supplementing their data, and (3) modifying the algorithm directly to achieve a more balanced result. Conclusions: Identifying and mitigating related biases in ML models is critical to fostering fairness, equity, inclusion, and social benefits. Our analysis underscores the ongoing need for rigorous research and the development of effective mitigation approaches to address digital ageism, ensuring that ML systems are used in a way that upholds the interests of all individuals. Trial Registration: Open Science Framework AMG5P; https://osf.io/amg5p ", doi="10.2196/53564", url="https://aging.jmir.org/2024/1/e53564", url="http://www.ncbi.nlm.nih.gov/pubmed/38517459" } @Article{info:doi/10.2196/55198, author="Bannigan, Katrina and Larkan, Jade Nicole and Meurgue, Rogelia Emmanuelle Renee and Sze, Hin Jason Chun", title="Characteristics of Occupational Therapy Interventions to Promote Healthy Aging: Protocol for a Scoping Review", journal="JMIR Res Protoc", year="2024", month="Mar", day="18", volume="13", pages="e55198", keywords="healthy aging", keywords="interventions", keywords="occupational therapy", keywords="public health", keywords="scoping review", keywords="intervention", keywords="aging", keywords="lifestyle change", keywords="aging population", keywords="well-being", keywords="occupation-based approach", keywords="occupational therapists", keywords="older people", abstract="Background: Healthy aging is a pressing public health priority. Focusing on what people do every day may be a meaningful approach to lifestyle change, suggesting a need for occupation therapy interventions to promote healthy aging. A preliminary database search was conducted, and no current or underway systematic or scoping reviews on the topic were identified. Developing an overview of studies of occupational therapy interventions to promote healthy aging is a necessary first step to understanding the existing knowledge and increasing the impact of future interventions. This scoping review will build on previously conducted reviews. Objective: This scoping review will identify the following: (1) what occupational therapy interventions exist for promoting healthy aging in community-dwelling adults? and (2) what are the intervention characteristics, their evaluated outcome, and the impact observed? Methods: This protocol was reviewed by 2 occupational therapists as part of a patient and public involvement consultation. The review will consider all studies and publications of occupational therapy focused on promoting healthy aging in community-dwelling adults who are aged 18 years and older. Databases to be searched are AMED, CINAHL, Cochrane Library, Embase, JBI EBP database, MEDLINE, OAlster, PsycINFO, PsycArticles, ProQuest Dissertations \& Theses, ProQuest nursing and allied health source, PubMed, and Science Direct. Studies published in any language will be included. Titles and abstracts will be screened against the inclusion criteria using Covidence (Veritas Health Innovation). Potentially relevant studies will be retrieved in full and assessed against the inclusion criteria. No date limiters will be used. Study selection will be completed by 2 independent reviewers. Data will be extracted using a data extraction tool, including descriptive characteristics of the participants including age, sex, and socioeconomic status. Data will be charted using the TIDieR (Template for Intervention Description and Replication) checklist in alignment with the review objectives. The scoping review will be reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) statement. Results: The research began in October 2023, and the results are expected to be published in 2024. Conclusions: This scoping review will produce valuable information about occupation-based interventions to promote healthy aging to support the development of an occupational therapy intervention. Trial Registration: Open Science Framework 5k36d; https://osf.io/5k36d/ International Registered Report Identifier (IRRID): DERR1-10.2196/55198 ", doi="10.2196/55198", url="https://www.researchprotocols.org/2024/1/e55198", url="http://www.ncbi.nlm.nih.gov/pubmed/38498043" } @Article{info:doi/10.2196/48292, author="Kirby, Pippa and Lai, Helen and Horrocks, Sophie and Harrison, Matthew and Wilson, Danielle and Daniels, Sarah and Calvo, A. Rafael and Sharp, J. David and Alexander, M. Caroline", title="Patient and Public Involvement in Technology-Related Dementia Research: Scoping Review", journal="JMIR Aging", year="2024", month="Mar", day="4", volume="7", pages="e48292", keywords="dementia", keywords="technology", keywords="patient and public involvement and engagement", keywords="co-design", keywords="coproduction", abstract="Background: Technology-related research on people with dementia and their carers often aims to enable people to remain living at home for longer and prevent unnecessary hospital admissions. To develop person-centered, effective, and ethical research, patient and public involvement (PPI) is necessary, although it may be perceived as more difficult with this cohort. With recent and rapid expansions in health and care--related technology, this review explored how and with what impact collaborations between researchers and stakeholders such as people with dementia and their carers have taken place. Objective: This review aims to describe approaches to PPI used to date in technology-related dementia research, along with the barriers and facilitators and impact of PPI in this area. Methods: A scoping review of literature related to dementia, technology, and PPI was conducted using MEDLINE, PsycINFO, Embase, and CINAHL. Papers were screened for inclusion by 2 authors. Data were then extracted using a predesigned data extraction table by the same 2 authors. A third author supported the resolution of any conflicts at each stage. Barriers to and facilitators of undertaking PPI were then examined and themed. Results: The search yielded 1694 papers, with 31 (1.83\%) being analyzed after screening. Most (21/31, 68\%) did not make clear distinctions between activities undertaken as PPI and those undertaken by research participants, and as such, their involvement did not fit easily into the National Institute for Health and Care Research definition of PPI. Most of this mixed involvement focused on reviewing or evaluating technology prototypes. A range of approaches were described, most typically using focus groups or co-design workshops. In total, 29\% (9/31) described involvement at multiple stages throughout the research cycle, sometimes with evidence of sharing decision-making power. Some (23/31, 74\%) commented on barriers to or facilitators of effective PPI. The challenges identified often regarded issues of working with people with significant cognitive impairments and pressures on time and resources. Where reported, the impact of PPI was largely reported as positive, including the experiences for patient and public partners, the impact on research quality, and the learning experience it provided for researchers. Only 4 (13\%) papers used formal methods for evaluating impact. Conclusions: Researchers often involve people with dementia and other stakeholders in technology research. At present, involvement is often limited in scope despite aspirations for high levels of involvement and partnership working. Involving people with dementia, their carers, and other stakeholders can have a positive impact on research, patient and public partners, and researchers. Wider reporting of methods and facilitative strategies along with more formalized methods for recording and reporting on meaningful impact would be helpful so that all those involved---researchers, patients, and other stakeholders---can learn how we can best conduct research together. ", doi="10.2196/48292", url="https://aging.jmir.org/2024/1/e48292", url="http://www.ncbi.nlm.nih.gov/pubmed/38437014" } @Article{info:doi/10.2196/51544, author="Bauernschmidt, Dorothee and Wittmann, Janina and Hirt, Julian and Meyer, Gabriele and Bieber, Anja", title="The Implementation Success of Technology-Based Counseling in Dementia Care: Scoping Review", journal="JMIR Aging", year="2024", month="Jan", day="25", volume="7", pages="e51544", keywords="implementation success", keywords="implementation outcomes", keywords="counseling", keywords="technology", keywords="dementia", abstract="Background: Implementing technology-based counseling as a complex intervention in dementia care poses challenges such as adaptation to stakeholders' needs and limited resources. While studies have examined the effectiveness of technology-based counseling, its successful implementation remains largely unexplored. Objective: We aimed to review the knowledge about the implementation success of technology-based counseling interventions for people with dementia and their informal caregivers. Methods: We conducted a scoping review and systematically searched CINAHL, the Cochrane Library including the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and Web of Science Core Collection databases (April 2021) in combination with citation searching and web searching (November 2021). Studies reporting on technology-based counseling interventions for people with dementia or their informal caregivers were included, irrespective of the design. We used the conceptual framework for implementation outcomes to operationalize implementation success and applied the outcomes acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability as categories to inform data extraction. We identified dimensions within the categories and synthesized results narratively and graphically. Results: We included 52 publications reporting on 27 technology-based counseling interventions. The studies were conducted in 9 countries and published between 1993 and 2021. As the design of the included studies varied, the number of participants and the type of data reported varied as well. The intervention programs were heterogeneous and ranged from single counseling interventions (such as helpline services) to counseling as part of a multicomponent program. Telephone, email, videoconferencing, social media (respectively chats), and web-based platforms were used for delivering counseling. We found data on appropriateness for all interventions and data on acceptability for most interventions, describing aspects such as consumer-perceived usefulness and helpfulness of services, as well as satisfaction. Information on the other categories of adoption, feasibility, fidelity, implementation cost, penetration, and sustainability was fragmented. Conclusions: The scope and depth of information on conceptual categories of the implementation success of technology-based counseling for people with dementia and informal caregivers varied. The data only partially covered the concept of implementation success, which highlights the need for a systematic evaluation accompanying the implementation. The application of theoretical approaches for implementation and adherence to the framework for developing and evaluating complex interventions are required to promote the implementation of complex interventions and to comprehensively assess implementation success. Trial Registration: PROSPERO CRD42021245473; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=245473 ", doi="10.2196/51544", url="https://aging.jmir.org/2024/1/e51544", url="http://www.ncbi.nlm.nih.gov/pubmed/38271050" } @Article{info:doi/10.2196/42437, author="Han, Eunkyung and Kharrazi, Hadi and Shi, Leiyu", title="Identifying Predictors of Nursing Home Admission by Using Electronic Health Records and Administrative Data: Scoping Review", journal="JMIR Aging", year="2023", month="Nov", day="20", volume="6", pages="e42437", keywords="prediction model", keywords="nursing home admission", keywords="electronic health record", keywords="EHR", keywords="administrative claims data", keywords="administrative data", keywords="claims data", keywords="health record", keywords="medical record", keywords="long-term care", keywords="nursing home", keywords="elder care", keywords="geriatric", keywords="gerontology", keywords="machine learning", keywords="PRISMA", keywords="scoping review", keywords="search strategy", keywords="aging", keywords="older adult", abstract="Background: Among older adults, nursing home admissions (NHAs) are considered a significant adverse outcome and have been extensively studied. Although the volume and significance of electronic data sources are expanding, it is unclear what predictors of NHA have been systematically identified in the literature via electronic health records (EHRs) and administrative data. Objective: This study synthesizes findings of recent literature on identifying predictors of NHA that are collected from administrative data or EHRs. Methods: The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines were used for study selection. The PubMed and CINAHL databases were used to retrieve the studies. Articles published between January 1, 2012, and March 31, 2023, were included. Results: A total of 34 papers were selected for final inclusion in this review. In addition to NHA, all-cause mortality, hospitalization, and rehospitalization were frequently used as outcome measures. The most frequently used models for predicting NHAs were Cox proportional hazards models (studies: n=12, 35\%), logistic regression models (studies: n=9, 26\%), and a combination of both (studies: n=6, 18\%). Several predictors were used in the NHA prediction models, which were further categorized into sociodemographic, caregiver support, health status, health use, and social service use factors. Only 5 (15\%) studies used a validated frailty measure in their NHA prediction models. Conclusions: NHA prediction tools based on EHRs or administrative data may assist clinicians, patients, and policy makers in making informed decisions and allocating public health resources. More research is needed to assess the value of various predictors and data sources in predicting NHAs and validating NHA prediction models externally. ", doi="10.2196/42437", url="https://aging.jmir.org/2023/1/e42437" } @Article{info:doi/10.2196/42274, author="Siette, Joyce and Dodds, Laura and Sharifi, Fariba and Nguyen, Amy and Baysari, Melissa and Seaman, Karla and Raban, Magdalena and Wabe, Nasir and Westbrook, Johanna", title="Usability and Acceptability of Clinical Dashboards in Aged Care: Systematic Review", journal="JMIR Aging", year="2023", month="Jun", day="19", volume="6", pages="e42274", keywords="dashboard", keywords="visualization", keywords="usability", keywords="acceptability", keywords="user interface design", keywords="health information technology", keywords="aged care", keywords="clinical", keywords="database", keywords="development", abstract="Background: The use of clinical dashboards in aged care systems to support performance review and improve outcomes for older adults receiving care is increasing. Objective: Our aim was to explore evidence from studies of the acceptability and usability of clinical dashboards including their visual features and functionalities in aged care settings. Methods: A systematic review was conducted using 5 databases (MEDLINE, Embase, PsycINFO, Cochrane Library, and CINAHL) from inception to April 2022. Studies were included in the review if they were conducted in aged care environments (home-based community care, retirement villages, and long-term care) and reported a usability or acceptability evaluation of a clinical dashboard for use in aged care environments, including specific dashboard visual features (eg, a qualitative summary of individual user experience or metrics from a usability scale). Two researchers independently reviewed the articles and extracted the data. Data synthesis was performed via narrative review, and the risk of bias was measured using the Mixed Methods Appraisal Tool. Results: In total, 14 articles reporting on 12 dashboards were included. The quality of the articles varied. There was considerable heterogeneity in implementation setting (home care 8/14, 57\%), dashboard user groups (health professionals 9/14, 64\%), and sample size (range 3-292). Dashboard features included a visual representation of information (eg, medical condition prevalence), analytic capability (eg, predictive), and others (eg, stakeholder communication). Dashboard usability was mixed (4 dashboards rated as high), and dashboard acceptability was high for 9 dashboards. Most users considered dashboards to be informative, relevant, and functional, highlighting the use and intention of using this resource in the future. Dashboards that had the presence of one or more of these features (bar charts, radio buttons, checkboxes or other symbols, interactive displays, and reporting capabilities) were found to be highly acceptable. Conclusions: A comprehensive summary of clinical dashboards used in aged care is provided to inform future dashboard development, testing, and implementation. Further research is required to optimize visualization features, usability, and acceptability of dashboards in aged care. ", doi="10.2196/42274", url="https://aging.jmir.org/2023/1/e42274", url="http://www.ncbi.nlm.nih.gov/pubmed/37335599" } @Article{info:doi/10.2196/46976, author="Shade, Marcia and Kovaleva, Mariya and Harp, Kimberly and Martin-Hammond, Aqueasha", title="Older Adults' Pain Outcomes After mHealth Interventions: Scoping Review", journal="JMIR Aging", year="2023", month="May", day="31", volume="6", pages="e46976", keywords="mHealth", keywords="older adults", keywords="pain", keywords="self-management", keywords="pain management", keywords="mobile health", keywords="musculoskeletal pain", keywords="scoping review", keywords="pain outcomes", keywords="mobile phone", abstract="Background: Pain is prevalent and poorly managed in older adults. Although pain self-management strategies are helpful, adoption and access are limited; thus, technology provides an opportunity for intervention delivery. Mobile health (mHealth) is feasible to use in older adults; however, we have yet to understand the effect of mHealth pain self-management interventions on pain outcomes in older adults. Objective: The purpose of this scoping review is to examine the characteristics of mHealth interventions and their efficacy on pain outcomes in older adults with musculoskeletal pain. Methods: With the assistance of a medical librarian, keywords and subject headings were generated, including but not limited to mobile health application, mHealth, digital, pain, pain management, and older. A search was conducted for papers in journal databases, including PubMed, Embase, CINAHL, Scopus, and IEEE Xplore, between 2000 and 2022. Papers were screened according to predetermined inclusion and exclusion criteria, and reference lists were reviewed for additional paper inclusion. Three authors appraised the methodology of papers independently, then collaboratively to synthesize the evidence. Results: Six publications were included in the scoping review. The design and methodology ranged widely from pilot studies to a comparative effectiveness trial. Older participants in the studies reported a variety of musculoskeletal conditions. Delivery of the mHealth pain self-management interventions incorporated mobile devices, such as a smartphone or tablet. Most mHealth-delivered interventions were multicomponent and incorporated elements of in-person and telephone access to an interventionist. The findings suggested mHealth interventions may reduce pain intensity; however, pain interference and other pain-related conditions did not have a statistically significant reduction. Conclusions: Research that has explored mHealth for pain self-management is beginning to move beyond feasibility. The few experimental studies conducted in older adults are heterogeneous, and the interventions are mostly multicomponent. It is premature to conclude the interventions' significant effect on pain or pain-related symptoms. As technology continues to integrate into health care, more experimental research is warranted to examine the efficacy of mHealth interventions on a variety of pain outcomes in older adults. ", doi="10.2196/46976", url="https://aging.jmir.org/2023/1/e46976", url="http://www.ncbi.nlm.nih.gov/pubmed/37256667" } @Article{info:doi/10.2196/47152, author="Yu, Ying and Xiao, Lily and Ullah, Shahid and Meyer, Claudia and Wang, Jing and Pot, Margriet Anne and Shifaza, Fathimath", title="The Experiences of Informal Caregivers of People With Dementia in Web-Based Psychoeducation Programs: Systematic Review and Metasynthesis", journal="JMIR Aging", year="2023", month="May", day="29", volume="6", pages="e47152", keywords="informal caregivers", keywords="dementia", keywords="psychoeducation", keywords="online", keywords="web based", keywords="qualitative research", keywords="systematic review", keywords="metasynthesis", abstract="Background: Informal caregivers of people living with dementia experience a higher level of physical and mental stress compared with other types of caregivers. Psychoeducation programs are viewed as beneficial for building caregivers' knowledge and skills and for decreasing caregiver stress. Objective: This review aimed to synthesize the experiences and perceptions of informal caregivers of people with dementia when participating in web-based psychoeducation programs and the factors that enable and impede informal caregivers' engagement in web-based psychoeducation programs. Methods: This review followed the Joanna Briggs Institute protocol of systematic review and meta-aggregation of qualitative studies. We searched 4 English databases, 4 Chinese databases, and 1 Arabic database in July 2021. Results: A total of 9 studies written in English were included in this review. From these studies, 87 findings were extracted and grouped into 20 categories. These categories were further synthesized into 5 findings: web-based learning as an empowering experience, peer support, satisfactory and unsatisfactory program content, satisfactory and unsatisfactory technical design, and challenges encountered in web-based learning. Conclusions: High-quality and carefully designed web-based psychoeducation programs offered positive experiences for informal caregivers of people living with dementia. To meet broader caregiver education and support needs, program developers should consider information quality and relevancy, the support offered, individual needs, flexibility in delivery, and connectedness between peers and program facilitators. ", doi="10.2196/47152", url="https://aging.jmir.org/2023/1/e47152", url="http://www.ncbi.nlm.nih.gov/pubmed/37247218" } @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/10.2196/40460, author="Zhang, Yichi and Leuk, Siew-Pin Jessie and Teo, Wei-Peng", title="Domains, Feasibility, Effectiveness, Cost, and Acceptability of Telehealth in Aging Care: Scoping Review of Systematic Reviews", journal="JMIR Aging", year="2023", month="Apr", day="18", volume="6", pages="e40460", keywords="telehealth", keywords="telemedicine", keywords="telecare", keywords="telemonitoring", keywords="aging care", keywords="health care access", keywords="scoping review", keywords="digital health", keywords="mobile health", keywords="mHealth", keywords="eHealth", abstract="Background: Aging is becoming a major global challenge. Compared with younger adults, the older population has greater health needs but faces inadequate access to appropriate, affordable, and high-quality health care. Telehealth can remove geographic and time boundaries, as well as enabling socially isolated and physically homebound people to access a wider range of care options. The impacts of different telehealth interventions in terms of their effectiveness, cost, and acceptability in aging care are still unclear. Objective: This scoping review of systematic reviews aimed to provide an overview of the domains of telehealth implemented in aging care; synthesize evidence of telehealth's feasibility, effectiveness, cost benefits, and acceptability in the context of aging care; identify gaps in the literature; and determine the priorities for future research. Methods: Guided by the methodological framework of the Joanna Briggs Institute, we reviewed systematic reviews concerning all types of telehealth interventions involving direct communication between older users and health care providers. In total, 5 major electronic databases, PubMed, Embase (Ovid), Cochrane Library, CINAHL, and PsycINFO (EBSCO), were searched on September 16, 2021, and an updated search was performed on April 28, 2022, across the same databases as well as the first 10 pages of the Google search. Results: A total of 29 systematic reviews, including 1 post hoc subanalysis of a previously published large Cochrane systematic review with meta-analysis, were included. Telehealth has been adopted in various domains in aging care, such as cardiovascular diseases, mental health, cognitive impairment, prefrailty and frailty, chronic diseases, and oral health, and it seems to be a promising, feasible, effective, cost-effective, and acceptable alternative to usual care in selected domains. However, it should be noted that the generalizability of the results might be limited, and further studies with larger sample sizes, more rigorous designs, adequate reporting, and more consistently defined outcomes and methodologies are needed. The factors affecting telehealth use among older adults have been categorized into individual, interpersonal, technological, system, and policy levels, which could help direct collaborative efforts toward improving the security, accessibility, and affordability of telehealth as well as better prepare the older population for digital inclusion. Conclusions: Although telehealth remains in its infancy and there is a lack of high-quality studies to rigorously prove the feasibility, effectiveness, cost benefit, and acceptability of telehealth, mounting evidence has indicated that it could play a promising complementary role in the care of the aging population. ", doi="10.2196/40460", url="https://aging.jmir.org/2023/1/e40460", url="http://www.ncbi.nlm.nih.gov/pubmed/37071459" } @Article{info:doi/10.2196/41187, author="Korenhof, A. Sophie and Fang, Yuan and Luo, Jie and van der Cammen, M. Tischa J. and Raat, Hein and van Grieken, Amy", title="Monitoring the Well-being of Older People by Energy Usage Patterns: Systematic Review of the Literature and Evidence Synthesis", journal="JMIR Aging", year="2023", month="Mar", day="31", volume="6", pages="e41187", keywords="smart energy meter", keywords="healthy aging", keywords="activities of daily living", keywords="independent living", keywords="monitoring", keywords="older adults", keywords="devices", keywords="risk", keywords="well-being", keywords="effectiveness", keywords="design", keywords="safety", abstract="Background: Due to the aging population, there is a need for monitoring well-being and safety while living independently. A low-intrusive monitoring system is based on a person's use of energy or water. Objective: The study's objective was to provide a systematic overview of studies that monitor the health and well-being of older people using energy (eg, electricity and gas) and water usage data and study the outcomes on health and well-being. Methods: CENTRAL, Embase, MEDLINE (Ovid), Scopus, Web of Science, and Google Scholar were searched systematically from inception until November 8, 2021. The inclusion criteria were that the study had to be published in English, have full-text availability, target independent-living people aged 60 years and older from the general population, have an observational design, and assess the outcomes of a monitoring system based on energy (ie, electricity, gas, or water) usage on well-being and safety. The quality of the studies was assessed by the QualSyst systematic review tool. Results: The search strategy identified 2920 articles. The majority of studies focused on the technical algorithms underlying energy usage data and related sensors. One study was included in this review. This study reported that the smart energy meter data monitoring system was considered unobtrusive and was well accepted by the older people and professionals involved. Energy usage in a household acted as a unique signature and therefore provided useful insight into well-being and safety. This study lacked statistical power due to the small number of participants and the low number of observed events. In addition, the quality of the study was rated as low. Conclusions: This review identified only 1 study that evaluated the impact of an energy usage monitoring system on the well-being and safety of older people. The absence of reliable evidence impedes any definitive guidance or recommendations for practice. Because this emerging field has not yet been studied thoroughly, many questions remain open for further research. Future studies should focus on the further development of a monitoring system and the evaluation of the implementation and outcomes of these systems. Trial Registration: PROSPERO CRD42022245713; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=245713 ", doi="10.2196/41187", url="https://aging.jmir.org/2023/1/e41187", url="http://www.ncbi.nlm.nih.gov/pubmed/37000477" } @Article{info:doi/10.2196/42652, author="Trainum, Katie and Tunis, Rachel and Xie, Bo and Hauser, Elliott", title="Robots in Assisted Living Facilities: Scoping Review", journal="JMIR Aging", year="2023", month="Mar", day="6", volume="6", pages="e42652", keywords="robotics", keywords="long-term care", keywords="nursing home", keywords="residential care", keywords="scoping review", keywords="review method", keywords="robot", keywords="aging", keywords="elder", keywords="older adult", keywords="gerontology", keywords="geriatric", keywords="senior living", abstract="Background: Various technological interventions have been proposed and studied to address the growing demand for care of residents in assisted living facilities, in which a preexisting shortage of professional caregivers has been exacerbated by the COVID-19 pandemic. Care robots are one such intervention with the potential to improve both the care of older adults and the work life of their professional caregivers. However, concerns about efficacy, ethics, and best practices in the applications of robotic technologies in care settings remain. Objective: This scoping review aimed to examine the literature on robots used in assisted living facilities and identify gaps in the literature to guide future research. Methods: On February 12, 2022, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) protocol, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, IEEE Xplore digital library, and ACM Digital Library using predetermined search terms. Publications were included if they were written in English and focused on the use of robotics in assisted living facilities. Publications were excluded if they did not provide peer-reviewed empirical data, focused on user needs, or developed an instrument to study human-robot interaction. The study findings were then summarized, coded, and analyzed using the Patterns, Advances, Gaps, Evidence for practice, and Research recommendations framework. Results: The final sample included 73 publications from 69 unique studies on the use of robots in assisted living facilities. The findings of studies on older adults were mixed, with some studies suggesting positive impacts of robots, some expressing concerns about robots and barriers to their use, and others being inconclusive. Although many therapeutic benefits of care robots have been identified, methodological limitations have weakened the internal and external validity of the findings of these studies. Few studies (18/69, 26\%) considered the context of care: most studies (48/69, 70\%) collected data only on recipients of care, 15 studies collected data on staff, and 3 studies collected data on relatives or visitors. Theory-driven, longitudinal, and large sample size study designs were rare. Across the authors' disciplines, a lack of consistency in methodological quality and reporting makes it difficult to synthesize and assess research on care robotics. Conclusions: The findings of this study call for more systematic research on the feasibility and efficacy of robots in assisted living facilities. In particular, there is a dearth of research on how robots may change geriatric care and the work environment within assisted living facilities. To maximize the benefits and minimize the consequences for older adults and caregivers, future research will require interdisciplinary collaboration among health sciences, computer science, and engineering as well as agreement on methodological standards. ", doi="10.2196/42652", url="https://aging.jmir.org/2023/1/e42652", url="http://www.ncbi.nlm.nih.gov/pubmed/36877560" } @Article{info:doi/10.2196/31812, author="Khadjesari, Zarnie and Houghton, Julie and Brown, J. Tracey and Jopling, Helena and Stevenson, Fiona and Lynch, Jennifer", title="Contextual Factors That Impact the Implementation of Patient Portals With a Focus on Older People in Acute Care Hospitals: Scoping Review", journal="JMIR Aging", year="2023", month="Feb", day="3", volume="6", pages="e31812", keywords="patient portal", keywords="tethered personal health records", keywords="acute care hospitals", keywords="implementation", keywords="scoping review", abstract="Background: Older people are the highest users of health services but are less likely to use a patient portal than younger people. Objective: This scoping review aimed to identify and synthesize the literature on contextual factors that impact the implementation of patient portals in acute care hospitals and among older people. Methods: A scoping review was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The following databases were searched from 2010 to June 2020: MEDLINE and Embase via the Ovid platform, CINAHL and PsycINFO via the EBSCO platform, and the Cochrane Library. Eligible reviews were published in English; focused on the implementation of tethered patient portals; included patients, health care professionals, managers, and budget holders; and aimed at identifying the contextual factors (ie, barriers and facilitators) that impact the implementation of patient portals. Review titles and abstracts and full-text publications were screened in duplicate. The study characteristics were charted by one author and checked for accuracy by a second author. The NASSS (Non-adoption, Abandonment, Scale-up, Spread, and Sustainability) framework was used to synthesize the findings. Results: In total, 10 systematic reviews published between 2015 and 2020 were included in the study. Of these, 3 (30\%) reviews addressed patient portals in acute care hospitals, and 2 (20\%) reviews addressed the implementation of patient portals among older people in multiple settings (including acute care hospitals). To maximize the inclusion of the literature on patient portal implementation, we also included 5 reviews of systematic reviews that examined patient portals in multiple care settings (including acute care hospitals). Contextual factors influencing patient portal implementation tended to cluster in specific NASSS domains, namely the condition, technology, and value proposition. Certain aspects within these domains received more coverage than others, such as sociocultural factors and comorbidities, the usability and functionality aspects of the technology, and the demand-side value. There are gaps in the literature pertinent to the consideration of the provision of patient portals for older people in acute care hospitals, including the lack of consideration of the diversity of older adults and their needs, the question of interoperability between systems (likely to be important where care involves multiple services), the involvement of lay caregivers, and looking beyond short-term implementation to ways in which portal use can be sustained. Conclusions: We identified important contextual factors that impact patient portal implementation and key gaps in the literature. Future research should focus on evaluating strategies that address disparities in use and promote engagement with patient portals among older people in acute care settings. ", doi="10.2196/31812", url="https://aging.jmir.org/2023/1/e31812", url="http://www.ncbi.nlm.nih.gov/pubmed/36735321" } @Article{info:doi/10.2196/37785, author="Wegener, Kauffeldt Emilie and Bergsch{\"o}ld, M. Jenny and Whitmore, Carly and Winters, Marjolein and Kayser, Lars", title="Involving Older People With Frailty or Impairment in the Design Process of Digital Health Technologies to Enable Aging in Place: Scoping Review", journal="JMIR Hum Factors", year="2023", month="Jan", day="27", volume="10", pages="e37785", keywords="eHealth", keywords="cognitive decline", keywords="frail", keywords="aging", keywords="cocreation", keywords="user involvement", keywords="mobile phone", abstract="Background: With an increase in life expectancy globally, the focus on digital health technologies that can enhance physical and mental health among older people with frailty and impairment has increased. Similarly, research interest in how digital health technology can promote well-being and self-management of health in older age has increased, including an increased focus on methods for designing digital health technologies that meet the various medical, psychological, and social needs of older population. Despite the increased focus, there remains a necessity to further understand the needs of this population group to ensure uptake and to avoid introduction of additional challenges when introducing technologies, for example, because of poor technological design. The scope is limited to digital health technologies meant to enable older people with frailty and impairment to age in place. Objective: In this study, we aimed to explore how older people with frailty and impairment are involved in various parts of the design processes of digital health technologies and identify gaps or neglected steps in a user-involving design process. This included a focus on recruitment strategies, contributions, and methods used to address the perspectives, needs, and desires of older people with frailty and impairment in the development of digital health technologies. Methods: A scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting from February 2021 to April 2021. Literature searches were conducted in PubMed, Scopus, Embase, and IEEE using a search string covering the concepts of health technology, older people, frailty and impairment, user-centered design, and self-management. Results: In total, 1891 studies were imported for screening from the initial search. A total of 22 studies were included in this review after full-text screening and manual search. Invitation through partners was the most reported recruitment strategy to involve older people with frailty and impairment in the design process of digital health technologies. Furthermore, they were commonly involved in the final evaluation of the development process. Three main gaps identified were the use of outreach approaches to recruit older people with frailty and impairment in the design process of digital health technologies, description of the value of involvement and outcome of the contribution of participants, and knowledge regarding involvement in all parts of the design process. Conclusions: Although there is literature on methods for involving older people with frailty and impairment in the design of digital health technology, there is little methodological dialogue on the nuances of how different methods for involvement relate to and shape the outcome of the development process. ", doi="10.2196/37785", url="https://humanfactors.jmir.org/2023/1/e37785", url="http://www.ncbi.nlm.nih.gov/pubmed/36705959" } @Article{info:doi/10.2196/43564, author="Khalili-Mahani, Najmeh and Sawchuk, Kim", title="Double-Bind of Recruitment of Older Adults Into Studies of Successful Aging via Assistive Information and Communication Technologies: Mapping Review", journal="JMIR Aging", year="2022", month="Dec", day="23", volume="5", number="4", pages="e43564", keywords="information and communication technologies", keywords="successful aging", keywords="healthy aging", keywords="independent living", keywords="agism", keywords="research methods", keywords="double-bind theory", keywords="mobile phone", abstract="Background: Two fields of research and development targeting the needs of the aging population of the world are flourishing, successful aging and assistive information and communication technologies (A-ICTs). The risks of ageist stereotypes emerging from how we communicate in both discourses are long known. This raises questions about whether using specific age criteria in the context of ``aging deficits'' can bias participation in, or compliance with, the research process by older adults who try to avoid age-related stigma. Objective: This study aimed to examine subject recruitment, study designs (based on age >65 years criteria), as well as discourses in research objectives and conclusions in health research on affordances of A-ICTs for older adults. Methods: A systematic mapping approach was used to characterize rationales, methods, stated objectives, and expected outcomes of studies indexed in PubMed and retrieved through the search logic ([``Older Adults'' OR Seniors OR Elderly] AND [ICT OR gerontechnology OR ``Assistive Technology'')] AND (``Healthy Aging'' OR ``Successful Aging'' OR ``healthy ageing'' OR ``successful ageing''). Inclusion criteria were as follows: the study should have recruited older participants (aged >65 years), been qualitative or quantitative research, and involved the introduction of at least one A-ICT for health-related improvements. Exclusion criteria were as follows: reviews, viewpoints, surveys, or studies that used information and communication technology for data collection instead of lifestyle interventions. Content, thematic, and discourse analyses were used to map the study characteristics and synthesize results with respect to the research question. Results: Of 180 studies that passed the search logic, 31 (17.2\%) satisfied the inclusion criteria (6 randomized controlled trials, 4 purely quantitative studies, 9 focus groups, 2 observational studies, and 10 mixed methods studies). In all but one case, recruitment was pragmatic and nonrandom. Thematic analysis of rationales revealed a high likelihood of emphasis on the burdens of aging, such as rising costs of care (12/31, 39\%) and age-related deficits (14/31, 45\%). The objectives of the research fell under 4 categories: promotion of physical activity, acceptance and feasibility of robots and remote health monitoring systems, risk detection, and the future of A-ICTs in health care for older adults. Qualitative studies were more attentive to the nonageist research guidelines. Heterogeneity in the study results (both qualitative and quantitative) was not related to age but to individual agency, acceptance, and adherence. A combination of research strategies (participatory, longitudinal, playful, flexible, and need-based designs) proved successful in characterizing variations in study outcomes. Studies that documented recruitment dynamics revealed that fear of stigma was a factor that biased participants' engagement. Conclusions: This review indicates that age is not an informative criterion for recruitment and retention of participants. Charting the dynamics of adoption of, and interaction with, A-ICTs is critical for advancing research and technology development. ", doi="10.2196/43564", url="https://aging.jmir.org/2022/4/e43564", url="http://www.ncbi.nlm.nih.gov/pubmed/36563033" } @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/10.2196/34872, author="Hechinger, Mareike and Hentschel, Diana and Aumer, Christine and Rester, Christian", title="A Conceptual Model of Experiences With Digital Technologies in Aging in Place: Qualitative Systematic Review and Meta-synthesis", journal="JMIR Aging", year="2022", month="Sep", day="9", volume="5", number="3", pages="e34872", keywords="older adults", keywords="old age", keywords="assistive device", keywords="aging in place", keywords="home modification", keywords="independent living", keywords="telemedicine", keywords="assistive technology", keywords="ambient assisted living", keywords="assisted living", keywords="community living", keywords="chronic disease", keywords="chronic condition", keywords="chronic illness", keywords="elder", keywords="older adult", keywords="systematic review", keywords="meta-synthesis", keywords="digital technology", keywords="mobile phone", abstract="Background: Older adults with chronic illnesses or dependency on care who strive to age in place need support and care depending on their illness. Digital technology has enabled the possibility of supporting older adults in their wishes to age in place. However, current studies have mainly focused on the solitary evaluation of individual technologies or on evaluating technologies for specific illnesses. Objective: This study aimed to synthesize research on the experiences of older people from the Western culture with chronic illnesses or care needs and their families with digital technology for aging in place. From the meta-synthesis, a model was derived that can be useful for the development of assistive devices in old age and that can support health care providers and professionals in their work with affected individuals. Methods: A systematic review and qualitative meta-synthesis was performed using an inductive approach, as proposed by Sandelowski and Barroso. We performed a systematic literature search in 6 databases from 2000 to 2019, with an update in 2021 and, in addition, conducted a hand search in 2 databases, relevant journals, and reference lists. The results of each study were analyzed using initial and axial coding, followed by theoretical coding. A conceptual model was derived. Results: A total of 7776 articles were identified. Articles were screened independently by 2 authors based on the eligibility criteria. Finally, of the 7776 studies, 18 (0.23\%) were included in the meta-synthesis. The derived conceptual model describes older adults with chronic illnesses or dependency on care and their family members in an individual process of reflection and decision-making, starting with the use of a digital device. Older adults live in times of change. They experience stable and unstable times of illness as they are part of a changing digital world. Hence, older adults and their families consider digital technology a solution to their current situation. As they become familiar with a specific digital technology, they refine their needs and demands, gain confidence in its use, and note its advantages and disadvantages. They weigh hopes, needs, demands, and experiences in a process of reflection to decide on convenience and inconvenience. Independent of their decision, they achieve peace of mind either with or without digital technology. This process can restart repeatedly during the illness trajectory of older adults. Conclusions: This study promotes a differentiated understanding of older adults' experiences with digital technology. The conceptual model can be useful for the development of assistive technology in old age. Moreover, it can guide health care professionals in their work with older adults and their families to provide individual counseling to find the appropriate digital technology for their respective situations. ", doi="10.2196/34872", url="https://aging.jmir.org/2022/3/e34872", url="http://www.ncbi.nlm.nih.gov/pubmed/36083625" } @Article{info:doi/10.2196/37753, author="Kim, Yesol and Hong, Soomin and Choi, Mona", title="Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials", journal="J Med Internet Res", year="2022", month="Sep", day="6", volume="24", number="9", pages="e37753", keywords="effectiveness", keywords="serious game", keywords="exergaming", keywords="video games", keywords="virtual reality", keywords="depression", keywords="older adults", keywords="systematic review", keywords="meta-analysis", keywords="mobile phone", abstract="Background: Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. Objective: This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. Methods: A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. Results: A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD ?0.54, 95\% CI ?0.79 to ?0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD ?0.61, 95\% CI ?0.95 to ?0.26; P<.001) than in hospital settings (SMD ?0.46, 95\% CI ?0.85 to ?0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD ?0.60, 95\% CI ?0.95 to ?0.25; P<.001) and games for both (SMD ?0.73, 95\% CI ?1.29 to ?0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. Conclusions: Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. Trial Registration: PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5 ", doi="10.2196/37753", url="https://www.jmir.org/2022/9/e37753", url="http://www.ncbi.nlm.nih.gov/pubmed/36066964" } @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/10.2196/31691, author="Chowdhury, Diya and Baiocco-Romano, Leonardo and Sacco, Veronica and El Hajj, Karen and Stolee, Paul", title="Cultural Competence Interventions for Health Care Providers Working With Racialized Foreign-born Older Adults: Protocol for a Systematic Review", journal="JMIR Res Protoc", year="2022", month="Jul", day="26", volume="11", number="7", pages="e31691", keywords="cultural competence", keywords="racialized older adults", keywords="person-centered care", keywords="immigrants", keywords="health systems interventions", abstract="Background: Integrating culturally competent approaches in the provision of health care services is recognized as a promising strategy for improving health outcomes for racially and ethnically diverse populations. Person-centered care, which ensures patient values guide care delivery, necessitates cultural competence of health care providers to reduce racial/ethnic health disparities. Previous work has focused on interventions to improve cultural competence among health care workers generally; however, little investigation has been undertaken regarding current practices focused on racialized foreign-born older adults. Objective: We seek to synthesize evidence from existing literature in the field to gain a comprehensive understanding of interventions to improve the cultural competence of health professionals who care for racialized foreign-born older adults. The aim of this paper is to outline a protocol for a systematic review of available published evidence. Methods: Our protocol will follow the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses--Protocols) for systematic review protocols. We will conduct a systematic search for relevant studies from four electronic databases that focus on health and social sciences (PubMed, CINAHL, Scopus, and Cochrane Database). After selecting relevant papers using the inclusion and exclusion criteria, data will be extracted, analyzed, and synthesized to yield recommendations for practice and for future research. Results: The systematic review is currently at the search phase where authors are refining the search strings for the selected databases; the search strings will be finalized by July 2022. We anticipate the systematic review to be completed by December 2022. Conclusions: This study will inform the future development and implementation of interventions to support culturally competent, person-centered care of racialized foreign-born older adults. Trial Registration: PROSPERO CRD42021259979; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=259979 International Registered Report Identifier (IRRID): PRR1-10.2196/31691 ", doi="10.2196/31691", url="https://www.researchprotocols.org/2022/7/e31691", url="http://www.ncbi.nlm.nih.gov/pubmed/35881433" } @Article{info:doi/10.2196/33085, author="Garnett, Anna and Northwood, Melissa and Ting, Justine and Sangrar, Ruheena", title="mHealth Interventions to Support Caregivers of Older Adults: Equity-Focused Systematic Review", journal="JMIR Aging", year="2022", month="Jul", day="8", volume="5", number="3", pages="e33085", keywords="caregivers", keywords="older adults", keywords="mobile health", keywords="social determinants of health", keywords="intervention", keywords="mobile phone", abstract="Background: Informal caregivers, hereafter referred to as caregivers, provide support to older adults so that they can age safely at home. The decision to become a caregiver can be influenced by individual factors, such as personal choice, or societal factors such as social determinants of health, including household income, employment status, and culture-specific gender roles. Over time, caregivers' health can be negatively affected by their caregiving roles. Although programs exist to support caregivers, the availability and appropriateness of services do not match caregivers' expressed needs. Research suggests that supportive interventions offered through mobile health (mHealth) technologies have the potential to increase caregivers' access to supportive services. However, a knowledge gap remains regarding the extent to which social determinants of health are considered in the design, implementation, and evaluation of mHealth interventions intended to support the caregivers of older adults. Objective: This study aimed to conduct a systematic review to determine how health equity is considered in the design, implementation, and evaluation of mHealth interventions for caregivers of older adults using Cochrane Equity's PROGRESS-Plus (place of residence, race, ethnicity, culture, language, occupation, gender, religion, education, social capital, socioeconomic status--plus age, disability, and sexual orientation) framework and synthesize evidence of the impacts of the identified caregiver-focused mHealth interventions. Methods: A systematic review was conducted using 5 databases. Articles published between January 2010 and June 2021 were included if they evaluated or explored the impact of mHealth interventions on the health and well-being of informal caregivers of older adults. mHealth interventions were defined as supportive services, for example, education, that caregivers of older adults accessed via mobile or wireless devices. Results: In total, 28 articles met the inclusion criteria and were included in the review. The interventions evaluated sought to connect caregivers with services, facilitate caregiving, and promote caregivers' health and well-being. The PROGRESS-Plus framework factors were mainly considered in the results, discussion, and limitations sections of the included studies. Some PROGRESS-Plus factors such as sexual orientation, religion, and occupation, received little to no consideration across any phase of the intervention design, implementation, or evaluation. Overall, the findings of this review suggest that mHealth interventions were positively received by study participants. Such interventions have the potential to reduce caregiver burden and positively affect caregivers' physical and mental health while supporting them as caregivers. The study findings highlight the importance of making support available to help facilitate caregivers' use of mHealth interventions, as well as in the use of appropriate language and text. Conclusions: The successful uptake and spread of mHealth interventions to support caregivers of older adults will depend on creating opportunities for the inclusive involvement of a broad range of stakeholders at all stages of design, implementation, and evaluation. ", doi="10.2196/33085", url="https://aging.jmir.org/2022/3/e33085", url="http://www.ncbi.nlm.nih.gov/pubmed/35616514" } @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/10.2196/33211, author="Chu, H. Charlene and Leslie, Kathleen and Shi, Jiamin and Nyrup, Rune and Bianchi, Andria and Khan, S. Shehroz and Rahimi, Abbasgholizadeh Samira and Lyn, Alexandra and Grenier, Amanda", title="Ageism and Artificial Intelligence: Protocol for a Scoping Review", journal="JMIR Res Protoc", year="2022", month="Jun", day="9", volume="11", number="6", pages="e33211", keywords="artificial intelligence", keywords="ageism", keywords="age-related biases", keywords="gerontology", keywords="algorithms", keywords="search strategy", keywords="health database", keywords="human rights", keywords="ethics", abstract="Background: Artificial intelligence (AI) has emerged as a major driver of technological development in the 21st century, yet little attention has been paid to algorithmic biases toward older adults. Objective: This paper documents the search strategy and process for a scoping review exploring how age-related bias is encoded or amplified in AI systems as well as the corresponding legal and ethical implications. Methods: The scoping review follows a 6-stage methodology framework developed by Arksey and O'Malley. The search strategy has been established in 6 databases. We will investigate the legal implications of ageism in AI by searching grey literature databases, targeted websites, and popular search engines and using an iterative search strategy. Studies meet the inclusion criteria if they are in English, peer-reviewed, available electronically in full text, and meet one of the following two additional criteria: (1) include ``bias'' related to AI in any application (eg, facial recognition) and (2) discuss bias related to the concept of old age or ageism. At least two reviewers will independently conduct the title, abstract, and full-text screening. Search results will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guideline. We will chart data on a structured form and conduct a thematic analysis to highlight the societal, legal, and ethical implications reported in the literature. Results: The database searches resulted in 7595 records when the searches were piloted in November 2021. The scoping review will be completed by December 2022. Conclusions: The findings will provide interdisciplinary insights into the extent of age-related bias in AI systems. The results will contribute foundational knowledge that can encourage multisectoral cooperation to ensure that AI is developed and deployed in a manner consistent with ethical values and human rights legislation as it relates to an older and aging population. We will publish the review findings in peer-reviewed journals and disseminate the key results with stakeholders via workshops and webinars. Trial Registration: OSF Registries AMG5P; https://osf.io/amg5p International Registered Report Identifier (IRRID): DERR1-10.2196/33211 ", doi="10.2196/33211", url="https://www.researchprotocols.org/2022/6/e33211", url="http://www.ncbi.nlm.nih.gov/pubmed/35679118" } @Article{info:doi/10.2196/35929, author="Singh, Hardeep and Tang, Terence and Steele Gray, Carolyn and Kokorelias, Kristina and Thombs, Rachel and Plett, Donna and Heffernan, Matthew and Jarach, M. Carlotta and Armas, Alana and Law, Susan and Cunningham, V. Heather and Nie, Xin Jason and Ellen, E. Moriah and Thavorn, Kednapa and Nelson, LA Michelle", title="Recommendations for the Design and Delivery of Transitions-Focused Digital Health Interventions: Rapid Review", journal="JMIR Aging", year="2022", month="May", day="19", volume="5", number="2", pages="e35929", keywords="transitions", keywords="health", keywords="medical informatics", keywords="aged", keywords="mobile phone", abstract="Background: Older adults experience a high risk of adverse events during hospital-to-home transitions. Implementation barriers have prevented widespread clinical uptake of the various digital health technologies that aim to support hospital-to-home transitions. Objective: To guide the development of a digital health intervention to support transitions from hospital to home (the Digital Bridge intervention), the specific objectives of this review were to describe the various roles and functions of health care providers supporting hospital-to-home transitions for older adults, allowing future technologies to be more targeted to support their work; describe the types of digital health interventions used to facilitate the transition from hospital to home for older adults and elucidate how these interventions support the roles and functions of providers; describe the lessons learned from the design and implementation of these interventions; and identify opportunities to improve the fit between technology and provider functions within the Digital Bridge intervention and other transition-focused digital health interventions. Methods: This 2-phase rapid review involved a selective review of providers' roles and their functions during hospital-to-home transitions (phase 1) and a structured literature review on digital health interventions used to support older adults' hospital-to-home transitions (phase 2). During the analysis, the technology functions identified in phase 2 were linked to the provider roles and functions identified in phase 1. Results: In phase 1, various provider roles were identified that facilitated hospital-to-home transitions, including navigation-specific roles and the roles of nurses and physicians. The key transition functions performed by providers were related to the 3 categories of continuity of care (ie, informational, management, and relational continuity). Phase 2, included articles (n=142) that reported digital health interventions targeting various medical conditions or groups. Most digital health interventions supported management continuity (eg, follow-up, assessment, and monitoring of patients' status after hospital discharge), whereas informational and relational continuity were the least supported. The lessons learned from the interventions were categorized into technology- and research-related challenges and opportunities and informed several recommendations to guide the design of transition-focused digital health interventions. Conclusions: This review highlights the need for Digital Bridge and other digital health interventions to align the design and delivery of digital health interventions with provider functions, design and test interventions with older adults, and examine multilevel outcomes. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2020-045596 ", doi="10.2196/35929", url="https://aging.jmir.org/2022/2/e35929", url="http://www.ncbi.nlm.nih.gov/pubmed/35587874" } @Article{info:doi/10.2196/35224, author="Ho, Ying Ka and Cheung, Mang Po and Cheng, Wing Tap and Suen, Yin Wing and Ho, Ying Hiu and Cheung, Ki Daphne Sze", title="Virtual Reality Intervention for Managing Apathy in People With Cognitive Impairment: Systematic Review", journal="JMIR Aging", year="2022", month="May", day="11", volume="5", number="2", pages="e35224", keywords="virtual reality", keywords="apathy", keywords="cognitive impairment", keywords="dementia", keywords="systematic review", abstract="Background: Apathy is common in people with cognitive impairment. It leads to different consequences, such as more severe cognitive deficits, rapid functional decline, and decreased quality of life. Virtual reality (VR) interventions are increasingly being used to manage apathy in individuals with cognitive impairment. However, reports of VR interventions are scattered across studies, which has hindered the development and use of the interventions. Objective: This study aimed to systematically review existing evidence on the use of VR interventions for managing apathy in people with cognitive impairment with regard to the effectiveness, contents, and implementation of the interventions. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. The PubMed, Embase, CINAHL, and PsycINFO databases were systematically searched for experimental studies published up to March 13, 2022, that reported the effects of VR interventions on apathy in older adults with cognitive impairment. Hand searching and citation chasing were conducted. The results of the included studies were synthesized by using a narrative synthesis. Their quality was appraised by using the Effective Public Health Practice Project quality assessment tool. However, because the VR interventions varied in duration, content, and implementation across studies, a meta-analysis was not conducted. Results: A total of 22 studies were identified from the databases, of which 6 (27\%) met the inclusion criteria. Of these 6 studies, 2 (33\%) were randomized controlled trials, 1 (17\%) was a controlled clinical trial, and 3 (50\%) were quasi-experimental studies. Individual studies showed significant improvement in apathy and yielded within-group medium to large effect sizes. The level of immersion ranged from low to high. Minor adverse effects were reported. The VR content mostly included natural scenes, followed by city views and game-based activities. A background soundtrack was often used with natural scenes. Most (5/6, 83\%) of the studies were conducted in a residential care setting and were implemented by health care professionals or researchers. Safety precautions were taken in most (5/6, 83\%) of the studies. Conclusions: Although preliminary evidence shows that VR interventions may be effective and feasible for alleviating apathy in people with cognitive impairment, the methodological limitations in the included studies make it difficult to reach a firm conclusion on these points. The implementation of the interventions was highlighted and discussed. More rigorous studies are encouraged. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021268289; https://www.crd.york.ac.uk/prospero/display\_record.php?ID=CRD42021268289 ", doi="10.2196/35224", url="https://aging.jmir.org/2022/2/e35224", url="http://www.ncbi.nlm.nih.gov/pubmed/35544317" } @Article{info:doi/10.2196/35925, author="Kokorelias, Marie Kristina and Nelson, LA Michelle and Tang, Terence and Steele Gray, Carolyn and Ellen, Moriah and Plett, Donna and Jarach, Micaela Carlotta and Xin Nie, Jason and Thavorn, Kednapa and Singh, Hardeep", title="Inclusion of Older Adults in Digital Health Technologies to Support Hospital-to-Home Transitions: Secondary Analysis of a Rapid Review and Equity-Informed Recommendations", journal="JMIR Aging", year="2022", month="Apr", day="27", volume="5", number="2", pages="e35925", keywords="older adults", keywords="digital technology", keywords="transitions", keywords="older adult population", keywords="digital health", keywords="Digital Hospital", keywords="health intervention", keywords="aging", keywords="gender diversity", keywords="home transition", keywords="epidemiology", abstract="Background: Digital health technologies have been proposed to support hospital-to-home transition for older adults. The COVID-19 pandemic and the associated physical distancing guidelines have propelled a shift toward digital health technologies. However, the characteristics of older adults who participated in digital health research interventions to support hospital-to-home transitions remain unclear. This information is needed to assess whether current digital health interventions are generalizable to the needs of the broader older adult population. Objective: This rapid review of the existing literature aimed to identify the characteristics of the populations targeted by studies testing the implementation of digital health interventions designed to support hospital-to-home transitions, identify the characteristics of the samples included in studies testing digital health interventions used to support hospital-to-home transitions, and create recommendations for enhancing the diversity of samples within future hospital-to-home digital health interventions. Methods: A rapid review methodology based on scoping review guidelines by Arksey and O'Malley was developed. A search for peer-reviewed literature published between 2010 and 2021 on digital health solutions that support hospital-to-home transitions for older adults was conducted using MEDLINE, Embase, and CINAHL databases. The data were analyzed using descriptive statistics and qualitative content analysis. The Sex- and Gender-Based Analysis Plus lens theoretically guided the study design, analysis, and interpretation. Results: A total of 34 studies met the inclusion criteria. Our findings indicate that many groups of older adults were excluded from these interventions and remain understudied. Specifically, the oldest old and those living with cognitive impairments were excluded from the studies included in this review. In addition, very few studies have described the characteristics related to gender diversity, education, race, ethnicity, and culture. None of the studies commented on the sexual orientation of the participants. Conclusions: This is the first review, to our knowledge, that has mapped the literature focusing on the inclusion of older adults in digital hospital-to-home interventions. The findings suggest that the literature on digital health interventions tends to operationalize older adults as a homogenous group, ignoring the heterogeneity in older age definitions. Inconsistency in the literature surrounding the characteristics of the included participants suggests a need for further study to better understand how digital technologies to support hospital-to-home transitions can be inclusive. ", doi="10.2196/35925", url="https://aging.jmir.org/2022/2/e35925", url="http://www.ncbi.nlm.nih.gov/pubmed/35475971" } @Article{info:doi/10.2196/32473, author="Boumans, Roel and van de Sande, Yana and Thill, Serge and Bosse, Tibor", title="Voice-Enabled Intelligent Virtual Agents for People With Amnesia: Systematic Review", journal="JMIR Aging", year="2022", month="Apr", day="25", volume="5", number="2", pages="e32473", keywords="intelligent virtual agent", keywords="amnesia", keywords="dementia", keywords="Alzheimer", keywords="systematic review", keywords="mobile phone", abstract="Background: Older adults often have increasing memory problems (amnesia), and approximately 50 million people worldwide have dementia. This syndrome gradually affects a patient over a period of 10-20 years. Intelligent virtual agents may support people with amnesia. Objective: This study aims to identify state-of-the-art experimental studies with virtual agents on a screen capable of verbal dialogues with a target group of older adults with amnesia. Methods: We conducted a systematic search of PubMed, SCOPUS, Microsoft Academic, Google Scholar, Web of Science, and CrossRef on virtual agent and amnesia on papers that describe such experiments. Search criteria were (Virtual Agent OR Virtual Assistant OR Virtual Human OR Conversational Agent OR Virtual Coach OR Chatbot) AND (Amnesia OR Dementia OR Alzheimer OR Mild Cognitive Impairment). Risk of bias was evaluated using the QualSyst tool (University of Alberta), which scores 14 study quality items. Eligible studies are reported in a table including country, study design type, target sample size, controls, study aims, experiment population, intervention details, results, and an image of the agent. Results: A total of 8 studies was included in this meta-analysis. The average number of participants in the studies was 20 (SD 12). The verbal interactions were generally short. The usability was generally reported to be positive. The human utterance was seen in 7 (88\%) out of 8 studies based on short words or phrases that were predefined in the agent's speech recognition algorithm. The average study quality score was 0.69 (SD 0.08) on a scale of 0 to 1. Conclusions: The number of experimental studies on talking about virtual agents that support people with memory problems is still small. The details on the verbal interaction are limited, which makes it difficult to assess the quality of the interaction and the possible effects of confounding parameters. In addition, the derivation of the aggregated data was difficult. Further research with extended and prolonged dialogues is required. ", doi="10.2196/32473", url="https://aging.jmir.org/2022/2/e32473", url="http://www.ncbi.nlm.nih.gov/pubmed/35468084" } @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/10.2196/31916, author="Fotteler, Liselotte Marina and M{\"u}hlbauer, Viktoria and Brefka, Simone and Mayer, Sarah and Kohn, Brigitte and Holl, Felix and Swoboda, Walter and Gaugisch, Petra and Risch, Beate and Denkinger, Michael and Dallmeier, Dhayana", title="The Effectiveness of Assistive Technologies for Older Adults and the Influence of Frailty: Systematic Literature Review of Randomized Controlled Trials", journal="JMIR Aging", year="2022", month="Apr", day="4", volume="5", number="2", pages="e31916", keywords="assistive technology", keywords="older adults", keywords="systematic review", keywords="frailty", abstract="Background: The use of assistive technologies (ATs) to support older people has been fueled by the demographic change and technological progress in many countries. These devices are designed to assist seniors, enable independent living at home or in residential facilities, and improve quality of life by addressing age-related difficulties. Objective: We aimed to evaluate the effectiveness of ATs on relevant outcomes with a focus on frail older adults. Methods: A systematic literature review of randomized controlled trials evaluating ATs was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Ovid Medline, PsycINFO, SocIndex, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Register of Controlled Trials), and IEEEXplore databases were searched from January 1, 2009, to March 15, 2019. ATs were included when aiming to support the domains autonomy, communication, or safety of older people with a mean age ?65 years. Trials performed within a laboratory setting were excluded. Studies were retrospectively categorized according to the physical frailty status of participants. Results: A total of 19 trials with a high level of heterogeneity were included in the analysis. Six device categories were identified: mobility, personal disease management, medication, mental support, hearing, and vision. Eight trials showed significant effectiveness in all or some of the primary outcome measures. Personal disease management devices seem to be the most effective, with four out of five studies showing significant improvement of disease-related outcomes. Frailty could only be assessed for seven trials. Studies including participants with significant or severe impairment showed no effectiveness. Conclusions: Different ATs show some promising results in well-functioning but not in frail older adults, suggesting that the evaluated ATs might not (yet) be suitable for this subgroup. The uncertainty of the effectiveness of ATs and the lack of high-quality research for many promising supportive devices were confirmed in this systematic review. Large studies, also including frail older adults, and clear standards are needed in the future to guide professionals, older users, and their relatives. Trial Registration: PROSPERO CRD42019130249; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=130249 ", doi="10.2196/31916", url="https://aging.jmir.org/2022/2/e31916", url="http://www.ncbi.nlm.nih.gov/pubmed/35377322" } @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/10.2196/25251, author="Zaman, Bin Sojib and Khan, Kabir Raihan and Evans, G. Roger and Thrift, G. Amanda and Maddison, Ralph and Islam, Shariful Sheikh Mohammed", title="Exploring Barriers to and Enablers of the Adoption of Information and Communication Technology for the Care of Older Adults With Chronic Diseases: Scoping Review", journal="JMIR Aging", year="2022", month="Jan", day="7", volume="5", number="1", pages="e25251", keywords="older adults", keywords="gerontechnology", keywords="usability challenges", keywords="chronic disease", keywords="information technology", keywords="mobile phone", abstract="Background: Information and communication technology (ICT) offers considerable potential for supporting older adults in managing their health, including chronic diseases. However, there are mixed opinions about the benefits and effectiveness of ICT interventions for older adults with chronic diseases. Objective: We aim to map the use of ICT interventions in health care and identified barriers to and enablers of its use among older adults with chronic disease. Methods: A scoping review was conducted using 5 databases (Ovid MEDLINE, Embase, Scopus, PsycINFO, and ProQuest) to identify eligible articles from January 2000 to July 2020. Publications incorporating the use of ICT interventions, otherwise known as eHealth, such as mobile health, telehealth and telemedicine, decision support systems, electronic health records, and remote monitoring in people aged ?55 years with chronic diseases were included. We conducted a strengths, weaknesses, opportunities, and threats framework analysis to explore the implied enablers of and barriers to the use of ICT interventions. Results: Of the 1149 identified articles, 31 (2.7\%; n=4185 participants) met the inclusion criteria. Of the 31 articles, 5 (16\%) mentioned the use of various eHealth interventions. A range of technologies was reported, including mobile health (8/31, 26\%), telehealth (7/31, 23\%), electronic health record (2/31, 6\%), and mixed ICT interventions (14/31, 45\%). Various chronic diseases affecting older adults were identified, including congestive heart failure (9/31, 29\%), diabetes (7/31, 23\%), chronic respiratory disease (6/31, 19\%), and mental health disorders (8/31, 26\%). ICT interventions were all designed to help people self-manage chronic diseases and demonstrated positive effects. However, patient-related and health care provider--related challenges, in integrating ICT interventions in routine practice, were identified. Barriers to using ICT interventions in older adults included knowledge gaps, a lack of willingness to adopt new skills, and reluctance to use technologies. Implementation challenges related to ICT interventions such as slow internet connectivity and lack of an appropriate reimbursement policy were reported. Advantages of using ICT interventions include their nonpharmacological nature, provision of health education, encouragement for continued physical activity, and maintenance of a healthy diet. Participants reported that the use of ICT was a fun and effective way of increasing their motivation and supporting self-management tasks. It gave them reassurance and peace of mind by promoting a sense of security and reducing anxiety. Conclusions: ICT interventions have the potential to support the care of older adults with chronic diseases. However, they have not been effectively integrated with routine health care. There is a need to improve awareness and education about ICT interventions among those who could benefit from them, including older adults, caregivers, and health care providers. More sustainable funding is required to promote the adoption of ICT interventions. We recommend involving clinicians and caregivers at the time of designing ICT interventions. ", doi="10.2196/25251", url="https://aging.jmir.org/2022/1/e25251", url="http://www.ncbi.nlm.nih.gov/pubmed/34994695" } @Article{info:doi/10.2196/25200, author="Tremblay, Zo{\"e} and Mumbere, David and Laurin, Danielle and Sirois, Caroline and Furrer, Daniela and Poisblaud, Lise and Carmichael, Pierre-Hugues and Farrell, Barbara and Tourigny, Andr{\'e} and Giguere, Anik and Vedel, Isabelle and Morais, Jos{\'e} and Kr{\"o}ger, Edeltraut", title="Health Impacts and Characteristics of Deprescribing Interventions in Older Adults: Protocol for a Systematic Review and Meta-analysis", journal="JMIR Res Protoc", year="2021", month="Dec", day="9", volume="10", number="12", pages="e25200", keywords="deprescribing", keywords="older adult", keywords="aging", keywords="medication use", keywords="inappropriate prescribing", keywords="potentially inappropriate medication", keywords="polypharmacy", keywords="comorbidity", keywords="multimorbidity", keywords="systematic review", abstract="Background: Deprescribing, a relatively recent concept, has been proposed as a promising solution to the growing issues of polypharmacy and use of medications of questionable benefit among older adults. However, little is known about the health outcomes of deprescribing interventions. Objective: This paper presents the protocol of a study that aims to contribute to the knowledge on deprescribing by addressing two specific objectives: (1) describe the impact of deprescribing in adults ?60 years on health outcomes or quality of life; and (2) determine the characteristics of effective interventions in deprescribing. Methods: Primary studies targeting three concepts (older adults, deprescribing, and health or quality of life outcomes) will be included in the review. The search will be performed using key international databases (MEDLINE, EMBASE, CINAHL, Ageline, PsycInfo), and a special effort will be made to identify gray literature. Two reviewers will independently screen the articles, extract the information, and evaluate the quality of the selected studies. If methodologically feasible, meta-analyses will be performed for groups of intervention studies reporting on deprescribing interventions for similar medications, used for similar or identical indications, and reporting on similar outcomes (eg, benzodiazepines used against insomnia and studies reporting on quality of sleep or quality of life). Alternatively, the results will be presented in bottom-line statements (objective 1) and a matrix outlining effective interventions (objective 2). Results: The knowledge synthesis may be limited by the availability of high-quality clinical trials on deprescribing and their outcomes in older adults. Additionally, analyses will likely be affected by studies on the deprescribing of different types of molecules within the same indication (eg, different pharmacological classes and medications to treat hypertension) and different measures of health and quality of life outcomes for the same indication. Nevertheless, we expect the review to identify which deprescribing interventions lead to improved health outcomes among seniors and which of their characteristics contribute to these outcomes. Conclusions: This systematic review will contribute to a better understanding of the health outcomes of deprescribing interventions among seniors. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42015020866; https://www.crd.york.ac.uk/prospero/display\_record.php?ID=CRD42015020866 International Registered Report Identifier (IRRID): PRR1-10.2196/25200 ", doi="10.2196/25200", url="https://www.researchprotocols.org/2021/12/e25200", url="http://www.ncbi.nlm.nih.gov/pubmed/34889771" } @Article{info:doi/10.2196/25887, author="Kunonga, Patience Tafadzwa and Spiers, Frances Gemma and Beyer, R. Fiona and Hanratty, Barbara and Boulton, Elisabeth and Hall, Alex and Bower, Peter and Todd, Chris and Craig, Dawn", title="Effects of Digital Technologies on Older People's Access to Health and Social Care: Umbrella Review", journal="J Med Internet Res", year="2021", month="Nov", day="24", volume="23", number="11", pages="e25887", keywords="digital health", keywords="social care", keywords="access", keywords="older adults", keywords="review of reviews", keywords="umbrella review", abstract="Background: The 2020 COVID-19 pandemic prompted the rapid implementation of new and existing digital technologies to facilitate access to health and care services during physical distancing. Older people may be disadvantaged in that regard if they are unable to use or have access to smartphones, tablets, computers, or other technologies. Objective: In this study, we synthesized evidence on the impact of digital technologies on older adults' access to health and social services. Methods: We conducted an umbrella review of systematic reviews published from January 2000 to October 2019 using comprehensive searches of 6 databases. We looked for reviews in a population of adults aged ?65 years in any setting, reporting outcomes related to the impact of technologies on access to health and social care services. Results: A total of 7 systematic reviews met the inclusion criteria, providing data from 77 randomized controlled trials and 50 observational studies. All of them synthesized findings from low-quality primary studies, 2 of which used robust review methods. Most of the reviews focused on digital technologies to facilitate remote delivery of care, including consultations and therapy. No studies examined technologies used for first contact access to care, such as online appointment scheduling. Overall, we found no reviews of technology to facilitate first contact access to health and social care such as online appointment booking systems for older populations. Conclusions: The impact of digital technologies on equitable access to services for older people is unclear. Research is urgently needed in order to understand the positive and negative consequences of digital technologies on health care access and to identify the groups most vulnerable to exclusion. ", doi="10.2196/25887", url="https://www.jmir.org/2021/11/e25887", url="http://www.ncbi.nlm.nih.gov/pubmed/34821564" } @Article{info:doi/10.2196/30841, author="Bastoni, Sofia and Wrede, Christian and da Silva, Cristina Marcia and Sanderman, Robbert and Gaggioli, Andrea and Braakman-Jansen, Annemarie and van Gemert-Pijnen, Lisette", title="Factors Influencing Implementation of eHealth Technologies to Support Informal Dementia Care: Umbrella Review", journal="JMIR Aging", year="2021", month="Oct", day="8", volume="4", number="4", pages="e30841", keywords="eHealth", keywords="assistive technologies", keywords="dementia", keywords="informal care", keywords="home care", keywords="implementation", abstract="Background: The worldwide increase in community-dwelling people with dementia underscores the need for innovative eHealth technologies that aim to provide support to both patients and their informal caregivers in the home setting. However, sustainable implementation of eHealth technologies within this target group can be difficult. Objective: The goal of this study was to gain a thorough understanding of why it is often difficult to implement eHealth technologies in practice, even though numerous technologies are designed to support people with dementia and their informal caregivers at home. In particular, our study aimed to (1) provide an overview of technologies that have been used and studied in the context of informal dementia care and (2) explore factors influencing the implementation of these technologies. Methods: Following an umbrella review design, five different databases were searched (PubMed, PsycINFO, Medline, Scopus, and Cochrane) for (systematic) reviews. Among 2205 reviews retrieved, 21 were included in our analysis based on our screening and selection procedure. A combination of deductive and inductive thematic analyses was performed, using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework for organizing the findings. Results: We identified technologies designed to be used ``by informal caregivers,'' ``by people with dementia,'' and ``with people with dementia.'' Within those groups, most of the represented technologies included, respectively: (i) devices for in-home monitoring of lifestyle, health, and safety; (ii) technologies for supporting memory, orientation, and day structure; and (iii) technologies to facilitate communication between the informal caregiver and person with dementia. Most of the identified factors influencing implementation related to the condition of dementia, characteristics of the technology, expected/perceived value of users, and characteristics of the informal caregiver. Considerably less information has been reported on factors related to the implementing organization and technology supplier, wider institutional and sociocultural context of policy and regulations, and continued adaptation of technology over time. Conclusions: Our study offers a comprehensive overview of eHealth technologies in the context of informal dementia care and contributes to gaining a better understanding of a broad range of factors influencing their implementation. Our results uncovered a knowledge gap regarding success factors for implementation related to the organizational and broader context and continuous adaptation over the long term. Although future research is needed, the current findings can help researchers and stakeholders in improving the development and implementation of eHealth technologies to support informal dementia care. ", doi="10.2196/30841", url="https://aging.jmir.org/2021/4/e30841", url="http://www.ncbi.nlm.nih.gov/pubmed/34623314" } @Article{info:doi/10.2196/27862, author="Sharma, Nikita and Brinke, Klein Jeroen and Gemert-Pijnen, Van J. E. W. C. and Braakman-Jansen, A. L. M.", title="Implementation of Unobtrusive Sensing Systems for Older Adult Care: Scoping Review", journal="JMIR Aging", year="2021", month="Oct", day="6", volume="4", number="4", pages="e27862", keywords="elderly care", keywords="unobtrusive", keywords="sensing system", keywords="caregiving", keywords="implementation", keywords="mobile phone", keywords="older adults", abstract="Background: The continuous growth of the older adult population will have implications for the organization of health and social care. Potentially, in-home monitoring unobtrusive sensing systems (USSs) can be used to support formal or informal caregivers of older adults, as they can monitor deviant physical and physiological behavior changes. Most existing USSs are not specific to older adult care. Hence, to facilitate the implementation of existing USSs in older adult care, it is important to know which USSs would be more suitable for older adults. Objective: This scoping review aims to examine the literature to identify current USSs for monitoring human activities and behaviors and assess their implementation readiness for older adult care. Methods: We conducted a structured search in the Scopus, Web of Science, and ACM Digital Library databases. Predefined inclusion criteria included studies on unobtrusive sensor-based technology; experimental in nature; aimed at monitoring human social, emotional, physical, and physiological behavior; having the potential to be scalable in in-home care; and having at least 5 adults as participants. Using these criteria, we screened studies by title, abstract, and full text. A deductive thematic analysis based on the Proctor implementation framework along with an additional outcome of external validity was applied to the included studies to identify the factors contributing to successful implementation. Finally, the identified factors were used to report the implementation readiness of the included studies for older adult care. Results: In this review, 52 studies were included. Deductive analysis using the implementation framework by Proctor resulted in six factors that can contribute to the successful implementation of USSs in older adult care: study settings, age of participants, activities monitored, sensor setup, sensing technology used, and usefulness of USSs. These factors were associated with the implementation outcomes as follows: study settings and age of participants contributed to external validity, sensor setup contributed to acceptability, usefulness of USSs contributed to adoption, activities monitored contributed to appropriateness, and sensing technology used contributed to implementation cost. Furthermore, the implementation assessment of the included 52 studies showed that none of the studies addressed all the identified factors. This assessment was useful in highlighting studies that have addressed multiple factors; thus, these studies represent a step ahead in the implementation process. Conclusions: This review is the first to scope state-of-the-art USSs suitable for older adult care. Although the included 52 USS studies fulfilled the basic criteria to be suitable for older adult care, systems leveraging radio frequency technology in a no-contact sensor setup for monitoring life risk or health wellness activities are more suitable for older adult care. Finally, this review has extended the discussion about unobtrusiveness as a property of systems that cannot be measured in binary because it varies greatly with user perception and context. ", doi="10.2196/27862", url="https://aging.jmir.org/2021/4/e27862", url="http://www.ncbi.nlm.nih.gov/pubmed/34612822" } @Article{info:doi/10.2196/27972, author="Nishchyk, Anna and Chen, Weiqin and Pripp, Hugo Are and Bergland, Astrid", title="The Effect of Mixed Reality Technologies for Falls Prevention Among Older Adults: Systematic Review and Meta-analysis", journal="JMIR Aging", year="2021", month="Jun", day="30", volume="4", number="2", pages="e27972", keywords="falls", keywords="fall prevention", keywords="mixed reality", keywords="augmented reality", keywords="virtual reality", keywords="physical exercise", abstract="Background: Falling is one of the most common and serious age-related issues, and falls can significantly impair the quality of life of older adults. Approximately one-third of people over 65 experience a fall annually. Previous research has shown that physical exercise could help reduce falls among older adults and improve their health. However, older adults often find it challenging to follow and adhere to physical exercise programs. Interventions using mixed reality (MR) technology could help address these issues. MR combines artificial augmented computer-generated elements with the real world. It has frequently been used for training and rehabilitation purposes. Objective: The aim of this systematic literature review and meta-analysis was to investigate the use of the full spectrum of MR technologies for fall prevention intervention and summarize evidence of the effectiveness of this approach. Methods: In our qualitative synthesis, we analyzed a number of features of the selected studies, including aim, type of exercise, technology used for intervention, study sample size, participant demographics and history of falls, study design, involvement of health professionals or caregivers, duration and frequency of the intervention, study outcome measures, and results of the study. To systematically assess the results of the selected studies and identify the common effect of MR interventions, a meta-analysis was performed. Results: Seven databases were searched, and the initial search yielded 5838 results. With the considered inclusion and exclusion criteria, 21 studies were included in the qualitative synthesis and 12 were included in meta-analysis. The majority of studies demonstrated a positive effect of an MR intervention on fall risk factors among older participants. The meta-analysis demonstrated a statistically significant difference in Berg Balance Scale score between the intervention and control groups (ES: 0.564; 95\% CI 0.246-0.882; P<.001) with heterogeneity statistics of I2=54.9\% and Q=17.74 (P=.02), and a statistical difference in Timed Up and Go test scores between the intervention and control groups (ES: 0.318; 95\% CI 0.025-0.662; P<.001) with heterogeneity statistics of I2=77.6\% and Q=44.63 (P<.001). The corresponding funnel plot and the Egger test for small-study effects (P=.76 and P=.11 for Berg Balance Scale and Timed Up and Go, respectively) indicate that a minor publication bias in the studies might be present in the Berg Balance Scale results. Conclusions: The literature review and meta-analysis demonstrate that the use of MR interventions can have a positive effect on physical functions in the elderly. MR has the potential to help older users perform physical exercises that could improve their health conditions. However, more research on the effect of MR fall prevention interventions should be conducted with special focus given to MR usability issues. ", doi="10.2196/27972", url="https://aging.jmir.org/2021/2/e27972", url="http://www.ncbi.nlm.nih.gov/pubmed/34255643" } @Article{info:doi/10.2196/26474, author="Lebrasseur, Audrey and Fortin-B{\'e}dard, No{\'e}mie and Lettre, Josiane and Raymond, Emilie and Bussi{\`e}res, Eve-Line and Lapierre, Nolwenn and Faieta, Julie and Vincent, Claude and Duchesne, Louise and Ouellet, Marie-Christine and Gagnon, Eric and Tourigny, Andr{\'e} and Lamontagne, Marie-{\`E}ve and Routhier, Fran{\c{c}}ois", title="Impact of the COVID-19 Pandemic on Older Adults: Rapid Review", journal="JMIR Aging", year="2021", month="Apr", day="12", volume="4", number="2", pages="e26474", keywords="COVID-19", keywords="impact", keywords="rapid review", keywords="older adults", keywords="aged individuals", keywords="review", abstract="Background: The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. Objective: This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. Methods: A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework--Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. Results: A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7\%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. Conclusions: Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers. ", doi="10.2196/26474", url="https://aging.jmir.org/2021/2/e26474", url="http://www.ncbi.nlm.nih.gov/pubmed/33720839" } @Article{info:doi/10.2196/25307, author="Palmdorf, Sarah and Stark, Lea Anna and Nadolny, Stephan and Elia{\ss}, Gerrit and Karlheim, Christoph and Kreisel, H. Stefan and Gruschka, Tristan and Trompetter, Eva and Dockweiler, Christoph", title="Technology-Assisted Home Care for People With Dementia and Their Relatives: Scoping Review", journal="JMIR Aging", year="2021", month="Jan", day="20", volume="4", number="1", pages="e25307", keywords="dementia", keywords="home care", keywords="assistive technologies", keywords="scoping review", abstract="Background: Assistive technologies for people with dementia and their relatives have the potential to ensure, improve, and facilitate home care and thereby enhance the health of the people caring or being cared for. The number and diversity of technologies and research have continuously increased over the past few decades. As a result, the research field has become complex. Objective: The goal of this scoping review was to provide an overview of the research on technology-assisted home care for people with dementia and their relatives in order to guide further research and technology development. Methods: A scoping review was conducted following a published framework and by searching 4 databases (MEDLINE, CINAHL, PsycInfo, and CENTRAL) for studies published between 2013 and 2018. We included qualitative and quantitative studies in English or German focusing on technologies that support people with dementia or their informal carers in the home care setting. Studies that targeted exclusively people with mild cognitive impairment, delirium, or health professionals were excluded as well as studies that solely consisted of assessments without implication for the people with dementia or their relatives and prototype developments. We mapped the research field regarding study design, study aim, setting, sample size, technology type, and technology aim, and we report relative and absolute frequencies. Results: From an initial 5328 records, we included 175 studies. We identified a variety of technology types including computers, telephones, smartphones, televisions, gaming consoles, monitoring devices, ambient assisted living, and robots. Assistive technologies were most commonly used by people with dementia (77/175, 44.0\%), followed by relatives (68/175, 38.9\%), and both target groups (30/175, 17.1\%). Their most frequent goals were to enable or improve care, provide therapy, or positively influence symptoms of people with dementia (eg, disorientation). The greatest proportions of studies were case studies and case series (72/175, 41.1\%) and randomized controlled trials (44/175, 25.1\%). The majority of studies reported small sample sizes of between 1 and 50 participants (122/175, 69.7\%). Furthermore, most of the studies analyzed the effectiveness (85/233, 36.5\%) of the technology, while others targeted feasibility or usability or were explorative. Conclusions: This review demonstrated the variety of technologies that support people with dementia and their relatives in the home care setting. Whereas this diversity provides the opportunity for needs-oriented technical solutions that fit individual care arrangements, it complicates the choice of the right technology. Therefore, research on the users' informational needs is required. Moreover, there is a need for larger studies on the technologies' effectiveness that could contribute to a higher acceptance and thus to a transition of technologies from research into the daily lives of people with dementia and their relatives. ", doi="10.2196/25307", url="http://aging.jmir.org/2021/1/e25307/", url="http://www.ncbi.nlm.nih.gov/pubmed/33470935" }