@Article{info:doi/10.2196/25779,
author="Daly, R. Jessica
and Depp, Colin
and Graham, A. Sarah
and Jeste, V. Dilip
and Kim, Ho-Cheol
and Lee, E. Ellen
and Nebeker, Camille",
title="Health Impacts of the Stay-at-Home Order on Community-Dwelling Older Adults and How Technologies May Help: Focus Group Study",
journal="JMIR Aging",
year="2021",
month="Mar",
day="22",
volume="4",
number="1",
pages="e25779",
keywords="aging",
keywords="quarantine",
keywords="mental health",
keywords="physical health",
keywords="social isolation",
keywords="COVID-19 pandemic",
keywords="continued care senior housing community",
keywords="CCSHC",
keywords="qualitative research",
keywords="videoconferencing",
keywords="older adults",
keywords="gerontechnology",
keywords="loneliness",
keywords="housing for the elderly",
keywords="independent living",
abstract="Background: As of March 2021, in the USA, the COVID-19 pandemic has resulted in over 500,000 deaths, with a majority being people over 65 years of age. Since the start of the pandemic in March 2020, preventive measures, including lockdowns, social isolation, quarantine, and social distancing, have been implemented to reduce viral spread. These measures, while effective for risk prevention, may contribute to increased social isolation and loneliness among older adults and negatively impact their mental and physical health. Objective: This study aimed to assess the impact of the COVID-19 pandemic and the resulting ``Stay-at-Home'' order on the mental and physical health of older adults and to explore ways to safely increase social connectedness among them. Methods: This qualitative study involved older adults living in a Continued Care Senior Housing Community (CCSHC) in southern California, USA. Four 90-minute focus groups were convened using the Zoom Video Communications platform during May 2020, involving 21 CCSHC residents. Participants were asked to describe how they were managing during the ``stay-at-home'' mandate that was implemented in March 2020, including its impact on their physical and mental health. Transcripts of each focus group were analyzed using qualitative methods. Results: Four themes emerged from the qualitative data: (1) impact of the quarantine on health and well-being, (2) communication innovation and technology use, (3) effective ways of coping with the quarantine, and (4) improving access to technology and training. Participants reported a threat to their mental and physical health directly tied to the quarantine and exacerbated by social isolation and decreased physical activity. Technology was identified as a lifeline for many who are socially isolated from their friends and family. Conclusions: Our study findings suggest that technology access, connectivity, and literacy are potential game-changers to supporting the mental and physical health of older adults and must be prioritized for future research. ",
doi="10.2196/25779",
url="https://aging.jmir.org/2021/1/e25779",
url="http://www.ncbi.nlm.nih.gov/pubmed/33690146"
}


@Article{info:doi/10.2196/23384,
author="Cyr, Andr{\'e}e-Ann
and Romero, Kristoffer
and Galin-Corini, Laura",
title="Web-Based Cognitive Testing of Older Adults in Person Versus at Home: Within-Subjects Comparison Study",
journal="JMIR Aging",
year="2021",
month="Feb",
day="1",
volume="4",
number="1",
pages="e23384",
keywords="web-based testing",
keywords="aging",
keywords="cognition",
keywords="neuropsychology",
keywords="mobile phone",
abstract="Background: Web-based research allows cognitive psychologists to collect high-quality data from a diverse pool of participants with fewer resources. However, web-based testing presents unique challenges for researchers and clinicians working with aging populations. Older adults may be less familiar with computer usage than their younger peers, leading to differences in performance when completing web-based tasks in their home versus in the laboratory under the supervision of an experimenter. Objective: This study aimed to use a within-subjects design to compare the performance of healthy older adults on computerized cognitive tasks completed at home and in the laboratory. Familiarity and attitudes surrounding computer use were also examined. Methods: In total, 32 community-dwelling healthy adults aged above 65 years completed computerized versions of the word-color Stroop task, paired associates learning, and verbal and matrix reasoning in 2 testing environments: at home (unsupervised) and in the laboratory (supervised). The paper-and-pencil neuropsychological versions of these tasks were also administered, along with questionnaires examining computer attitudes and familiarity. The order of testing environments was counterbalanced across participants. Results: Analyses of variance conducted on scores from the computerized cognitive tasks revealed no significant effect of the testing environment and no correlation with computer familiarity or attitudes. These null effects were confirmed with follow-up Bayesian analyses. Moreover, performance on the computerized tasks correlated positively with performance on their paper-and-pencil equivalents. Conclusions: Our findings show comparable performance on computerized cognitive tasks in at-home and laboratory testing environments. These findings have implications for researchers and clinicians wishing to harness web-based testing to collect meaningful data from older adult populations. ",
doi="10.2196/23384",
url="http://aging.jmir.org/2021/1/e23384/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33522972"
}


@Article{info:doi/10.2196/18164,
author="Abrantes, Diogo
and Teles, Soraia
and Tavares de Sousa, Rita
and Freitas, Alberto
and Vieira-Marques, Pedro
and Ferreira, Ana",
title="A Multipurpose Platform for Ambient Assisted Living (ActiveAdvice): Usability Study",
journal="JMIR Aging",
year="2021",
month="Mar",
day="1",
volume="4",
number="1",
pages="e18164",
keywords="aging",
keywords="ambient assisted living",
keywords="elderly",
keywords="usability testing",
keywords="user-centered design",
abstract="Background: Aging of the global population is slowly paving the way for new markets for care products and services. The desire of older people to maintain their independence while remaining at home is boosting the development of ambient assisted living (AAL) solutions. Lack of user awareness of AAL solutions paired with an insufficient use of user-centered and participatory design approaches in the development of these products has hindered the uptake of these solutions by end users. Objective: This study aims to describe the usability and users' experiences within a novel platform, ActiveAdvice, aimed at offering advice and a holistic market overview of AAL products and services. Methods: Usability tests were performed on the developed platform among identified prospective end users, with 32 older adults and informal carers from 4 European countries being part of the user tests. The usability and appeal of the web interface design, information flow, and information architecture were analyzed by collecting both objective and subjective measures. These would include pretest and posttest surveys, along with a series of think-aloud tasks to be performed within the platform. Results: The outcomes suggest that the ActiveAdvice platform's objectives and functionalities are mostly aligned with the needs and expectations of end users, who demonstrated interest in using it, stressing its purpose along with its simple and intuitive interaction. Task completion rates were high, and participants had good satisfaction rates when navigating the platform. However, the tests still advocate for an improved design at some points and better disclosure of information. Conclusions: Our findings shed light on a few peculiarities of interface design, information architecture, user needs, and preferred functionalities, which should be applied to future developments of similar platforms with related services. The AAL field could benefit from tools supporting the dissemination of available AAL solutions and how they can improve one's quality of life. These tools may benefit not only older adults but also caregivers, business owners, and governmental employees. ",
doi="10.2196/18164",
url="https://aging.jmir.org/2021/1/e18164",
url="http://www.ncbi.nlm.nih.gov/pubmed/33646134"
}


@Article{info:doi/10.2196/21629,
author="Christie, Liane Hannah
and Boots, Maria Lizzy Mitzy
and Tange, Johannes Huibert
and Verhey, Josef Frans Rochus
and de Vugt, Elizabeth Marjolein",
title="Implementations of Evidence-Based eHealth Interventions for Caregivers of People With Dementia in Municipality Contexts (Myinlife and Partner in Balance): Evaluation Study",
journal="JMIR Aging",
year="2021",
month="Feb",
day="5",
volume="4",
number="1",
pages="e21629",
keywords="eHealth",
keywords="mHealth",
keywords="implementation science",
keywords="dementia",
keywords="caregiving",
keywords="municipality",
abstract="Background: Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context in which to implement these interventions due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in 8 municipalities in the Euregion Meuse-Rhine. Partner in Balance is a blended care, 8-week, self-management intervention intervention designed to aid caregivers of people with dementia in adapting to their new roles that is delivered through coaches in participating health care organizations who are trained to use it to offer online support to their clients. Myinlife is an eHealth/mHealth intervention integrated into the Dutch Alzheimer's Association website and available from the App Store or Google Play, designed to help caregivers of people with dementia use their social network to better organize care and share positive (caregiving) experiences. Objective: This study's objectives were to evaluate the success of the implementation of Myinlife and Partner in Balance and investigate determinants of their successful implementation in the municipality context. Methods: This study collected eHealth use data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials based on the measurement instrument for determinants of implementation (MIDI). These data from multiple sources and perspectives were integrated and analyzed to form a total picture of the determinants (barriers and facilitators to implementation in the municipality context). Results: The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, 3 municipalities planned to continue the implementation of  Partner in Balance, while none planned to continue the implementation of Myinlife. The 2 Partner in Balance municipalities that did not consider the implementation to be successful viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and target groups. Successful implementations were linked to implementer self-efficacy and sense of ownership, which seemed to be absent in unsuccessful implementations. Conclusions: The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols as part of standard implementation materials for municipalities and organizations implementing Myinlife and Partner in Balance. ",
doi="10.2196/21629",
url="http://aging.jmir.org/2021/1/e21629/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33544085"
}


@Article{info:doi/10.2196/24965,
author="Ramirez, Magaly
and Duran, C. Miriana
and Pabiniak, J. Chester
and Hansen, E. Kelly
and Kelley, Ann
and Ralston, D. James
and McCurry, M. Susan
and Teri, Linda
and Penfold, B. Robert",
title="Family Caregiver Needs and Preferences for Virtual Training to Manage Behavioral and Psychological Symptoms of Dementia: Interview Study",
journal="JMIR Aging",
year="2021",
month="Feb",
day="10",
volume="4",
number="1",
pages="e24965",
keywords="dementia",
keywords="Alzheimer disease",
keywords="behavioral symptoms",
keywords="caregivers",
keywords="internet-based intervention",
keywords="education",
keywords="behavior",
keywords="symptom",
keywords="psychology",
keywords="qualitative",
keywords="caregiver",
keywords="intervention",
keywords="training",
keywords="virtual care",
keywords="digital health",
abstract="Background: Behavioral and psychological symptoms of dementia (BPSD) are associated with increased stress, burden, and depression among family caregivers of people with dementia. STAR-Caregivers Virtual Training and Follow-up (STAR-VTF) is adapted from an evidence-based, in-person program that trains family caregivers to manage BPSD. We used a human-centered design approach to obtain feedback from family caregivers about STAR-VTF. The program will be evaluated using a pragmatic randomized trial. Objective: The objective of the study was to understand the needs of family caregivers for improving BPSD management and the extent to which caregivers perceived that STAR-VTF could address those needs. Methods: Between July and September 2019, we conducted 15 semistructured interviews with family caregivers of people with dementia who receive care at Kaiser Permanente Washington in the Seattle metropolitan area. We identified participants from electronic health records, primarily based on a prescription for antipsychotic medication for the person with dementia (a proxy for caregivers dealing with BPSD). We showed caregivers low-fidelity prototypes of STAR-VTF online self-directed materials and verbally described potential design elements. We obtained caregiver feedback on these elements, focusing on their needs and preferences and perceived barriers to using STAR-VTF. We used a hybrid approach of inductive and deductive coding and aggregated codes to develop themes. Results: The idea of a virtual training program for learning to manage BPSD appealed to caregivers. They said health care providers did not provide adequate education in the early disease stages about the personality and behavior symptoms that can affect people with dementia. Caregivers found it unexpected and frustrating when the person with dementia began experiencing BPSD, symptoms they felt unprepared to manage. Accordingly, caregivers expressed a strong desire for the health care organization to offer programs such as STAR-VTF much sooner. Caregivers had already put considerable effort into problem solving challenging behaviors. They anticipated deriving less value from STAR-VTF at that point. Nonetheless, many were interested in the virtual aspect of the training due to the convenience of receiving help from home and the perception that help from a virtual program would be timelier than traditional service modalities (eg, face to face). Given caregivers' limited time, they suggested dividing the STAR-VTF content into chunks to review as time permitted. Caregivers were interested in having a STAR-VTF provider for additional support in managing challenging behaviors. Caregivers reported a preference for having the same coach for the program duration. Conclusions: Caregivers we interviewed would likely accept a virtual training program such as STAR-VTF to obtain information about BPSD and receive help managing it. Family caregivers anticipated deriving more value if STAR-VTF was offered earlier in the disease course. ",
doi="10.2196/24965",
url="http://aging.jmir.org/2021/1/e24965/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33565984"
}


@Article{info:doi/10.2196/23381,
author="Vollmer Dahlke, Deborah
and Lee, Shinduk
and Smith, Lee Matthew
and Shubert, Tiffany
and Popovich, Stephen
and Ory, G. Marcia",
title="Attitudes Toward Technology and Use of Fall Alert Wearables in Caregiving: Survey Study",
journal="JMIR Aging",
year="2021",
month="Jan",
day="27",
volume="4",
number="1",
pages="e23381",
keywords="wearables",
keywords="falls alert technology",
keywords="falls",
keywords="caregivers",
keywords="care recipients",
abstract="Background: Wearable technology for fall alerts among older adult care recipients is one of the more frequently studied areas of technology, given the concerning consequences of falls among this population. Falls are quite prevalent in later life. While there is a growing amount of literature on older adults' acceptance of technology, less is known about how caregivers' attitudes toward technology can impact care recipients' use of such technology. Objective: The objective of our study was to examine associations between caregivers' attitudes toward technology for caregiving and care recipients' use of fall alert wearables. Methods: This study examined data collected with an online survey from 626 caregivers for adults 50 years and older. Adapted from the technology acceptance model, a structural equation model tested the following prespecified hypotheses: (1) higher perceived usefulness of technologies for caregiving would predict higher perceived value of and greater interest in technologies for caregiving; (2) higher perceived value of technologies for caregiving would predict greater interest in technologies for caregiving; and (3) greater interest in technologies for caregiving would predict greater use of fall alert wearables among care recipients. Additionally, we included demographic factors (eg, caregivers' and care recipients' ages) and caregiving context (eg, caregiver type and caregiving situation) as important predictors of care recipients' use of fall alert wearables. Results: Of 626 total respondents, 548 (87.5\%) with all valid responses were included in this study. Among care recipients, 28\% used fall alert wearables. The final model had a good to fair model fit: a confirmatory factor index of 0.93, a standardized root mean square residual of 0.049, and root mean square error of approximation of 0.066. Caregivers' perceived usefulness of technology was positively associated with their attitudes toward using technology in caregiving (b=.70, P<.001) and interest in using technology for caregiving (b=.22, P=.003). Greater perceived value of using technology in caregiving predicted greater interest in using technology for caregiving (b=.65, P<.001). Greater interest in using technology for caregiving was associated with greater likelihood of care recipients using fall alert wearables (b=.27, P<.001). The caregiver type had the strongest inverse relationship with care recipients' use of fall alert wearables (unpaid vs paid caregiver) (b=--.33, P<.001). Conclusions: This study underscores the importance of caregivers' attitudes in care recipients' technology use for falls management. Raising awareness and improving perception about technologies for caregiving may help caregivers and care recipients adopt and better utilize technologies that can promote independence and enhance safety. ",
doi="10.2196/23381",
url="http://aging.jmir.org/2021/1/e23381/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33502320"
}


@Article{info:doi/10.2196/24092,
author="McLean, Bianca
and Hossain, Nazia
and Donison, Valentina
and Gray, Mikaela
and Durbano, Sara
and Haase, Kristen
and Alibhai, Husayn Shabbir Muhammad
and Puts, Martine",
title="Providing Medical Information to Older Adults in a Web-Based Environment: Systematic Review",
journal="JMIR Aging",
year="2021",
month="Feb",
day="9",
volume="4",
number="1",
pages="e24092",
keywords="eHealth",
keywords="systematic review",
keywords="geriatric assessment",
keywords="geriatric oncology",
abstract="Background: Cancer is a disease that predominantly affects older adults, and several organizations recommend the completion of a geriatric assessment to help with cancer treatment decision-making. Owing to a shortage of geriatric teams and the vast number of older adults diagnosed with cancer each year, a web-based geriatric assessment may improve access to geriatric assessment for older adults. We systematically reviewed the literature to obtain the latest evidence for the design of our web-based geriatric assessment tool Comprehensive Health Assessment for My Plan. Objective: This review aimed to probe the following questions: what is the impact of providing health test results to older adults in a web-based environment without the presence of a health care provider for patient-centered outcomes, including satisfaction, perceived harm, empowerment, quality of life, and health care use (eg, hospitalization, physician visits, emergency room visits, and costs), and what recommendations do older adults and developers have for designing future apps or websites for older adults? Methods: This systematic review was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) statement. Studies were limited to publications in English that examined a web-based tool that provided test results to older adults (aged ?65 years) without the presence of a health care provider. A health sciences librarian performed the search on November 29, 2019, on the following electronic databases: MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Library. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool Version 2018. The findings are summarized narratively and in tabular format. Results: A total of 26,898 titles and abstracts were screened by 2 independent reviewers, of which 94 studies were selected for a full-text review, and 9 studies were included in this review. There were only 2 randomized controlled trials of high quality that explored the effects of receiving health care results on the web via eHealth tools for older adults or provided evidence-based recommendations for designing such tools. Older adults were generally satisfied with receiving screening results via eHealth tools, and several studies suggested that receiving health screening results electronically improved participants' quality of life. However, user interfaces that were not designed with older adults in mind and older adults' lack of confidence in navigating eHealth tools proved challenging to eHealth uptake and use. All 9 studies included in this systematic review made recommendations on how to design eHealth tools that are intuitive and useful for older adults. Conclusions: eHealth tools should incorporate specific elements to ensure usability for older adults. However, more research is required to fully elucidate the impact of receiving screening and results via eHealth tools without the presence of a health care provider for patient-centered outcomes in this target population. ",
doi="10.2196/24092",
url="https://aging.jmir.org/2021/1/e24092",
url="http://www.ncbi.nlm.nih.gov/pubmed/33560228"
}


@Article{info:doi/10.2196/23826,
author="Han, Madeline
and Tan, Yi Xin
and Lee, Rachael
and Lee, Kyu Jeong
and Mahendran, Rathi",
title="Impact of Social Media on Health-Related Outcomes Among Older Adults in Singapore: Qualitative Study",
journal="JMIR Aging",
year="2021",
month="Feb",
day="17",
volume="4",
number="1",
pages="e23826",
keywords="aging",
keywords="social media",
keywords="health",
keywords="qualitative research",
keywords="communication",
keywords="mobile phone",
abstract="Background: The worldwide spread of digitalization has led to the harnessing of technology to improve health outcomes. Paying attention to older adults' social needs via social media is one way to promote healthy aging. Although 56\% of older adults are smartphone users, little is known about their use patterns of social media. Objective: This exploratory study aims to determine the experiences of social media apps' use among older adults in Singapore and understand their perceptions of its impact on health-related outcomes. Methods: This study used a qualitative research design with an interpretative approach. Using maximum variation purposive sampling, normal aging older adults (N=16) who were aged between 60 and 80 years and experienced in the use of internet-enabled technology were recruited from an existing community study. Semistructured, in-depth interviews were conducted. Employing a thematic analysis, interviews were transcribed verbatim and analyzed for codes inductively. Results: The following themes and subthemes were identified as key moderators of older adults' experiences on social media apps: (1) personal attitudes: participants were encouraged to use social media due to the increased accessibility, which enabled the ease of contact, but perceptions that the quality of interactions was compromised and its associated risks reduced their use; and (2) social influences: the desire to bond with co-users and the availability of support increased use. In addition, use of social media apps was perceived to positively impact health through its ability to keep older adults cognitively engaged, improve health communication, and increase social connectedness. However, opinions remained mixed on older adults' vulnerability to social media addiction. Conclusions: Personal and social contexts determine older adults' social media use. This study's findings provide practical insights into how social media can be deployed to improve health-related outcomes in older adults. ",
doi="10.2196/23826",
url="http://aging.jmir.org/2021/1/e23826/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33595437"
}


@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"
}


@Article{info:doi/10.2196/23313,
author="Portenhauser, A. Alexandra
and Terhorst, Yannik
and Schultchen, Dana
and Sander, B. Lasse
and Denkinger, D. Michael
and Stach, Michael
and Waldherr, Natalie
and Dallmeier, Dhayana
and Baumeister, Harald
and Messner, Eva-Maria",
title="Mobile Apps for Older Adults: Systematic Search and Evaluation Within Online Stores",
journal="JMIR Aging",
year="2021",
month="Feb",
day="19",
volume="4",
number="1",
pages="e23313",
keywords="mHealth",
keywords="MARS",
keywords="MARS-G",
keywords="older adults",
keywords="mobile apps",
keywords="apps",
keywords="aging",
abstract="Background: Through the increasingly aging population, the health care system is confronted with various challenges such as expanding health care costs. To manage these challenges, mobile apps may represent a cost-effective and low-threshold approach to support older adults. Objective: This systematic review aimed to evaluate the quality, characteristics, as well as privacy and security measures of mobile apps for older adults in the European commercial app stores. Methods: In the European Google Play and App Store, a web crawler systematically searched for mobile apps for older adults. The identified mobile apps were evaluated by two independent reviewers using the German version of the Mobile Application Rating Scale. A correlation between the user star rating and overall rating was calculated. An exploratory regression analysis was conducted to determine whether the obligation to pay fees predicted overall quality. Results: In total, 83 of 1217 identified mobile apps were included in the analysis. Generally, the mobile apps for older adults were of moderate quality (mean 3.22 [SD 0.68]). Four mobile apps (5\%) were evidence-based; 49\% (41/83) had no security measures. The user star rating correlated significantly positively with the overall rating (r=.30, P=.01). Obligation to pay fees could not predict overall quality. Conclusions: There is an extensive quality range within mobile apps for older adults, indicating deficits in terms of information quality, data protection, and security precautions, as well as a lack of evidence-based approaches. Central databases are needed to identify high-quality mobile apps. ",
doi="10.2196/23313",
url="https://aging.jmir.org/2021/1/e23313",
url="http://www.ncbi.nlm.nih.gov/pubmed/33605884"
}


@Article{info:doi/10.2196/26340,
author="Mansbach, E. William
and Mace, A. Ryan
and Tanner, A. Melissa",
title="A New Tool for Detecting COVID-19 Psychological Burden Among Postacute and Long-term Care Residents (Mood-5 Scale): Observational Study",
journal="JMIR Aging",
year="2021",
month="Mar",
day="10",
volume="4",
number="1",
pages="e26340",
keywords="nursing homes",
keywords="long-term care",
keywords="COVID-19",
keywords="depression",
keywords="stress",
keywords="coping",
keywords="burden",
keywords="mental health",
keywords="elderly",
keywords="older adults",
keywords="risk",
keywords="telehealth",
keywords="self-assessment",
keywords="scale",
keywords="mood",
abstract="Background: Older adults are at high risk for developing serious somatic and psychological symptoms associated with COVID-19. Currently available instruments may not be sensitive to the concerns about COVID-19 in postacute and long-term care and their applications in telehealth remain to be clarified. Objective: We investigated the psychometric properties of the Mood-5 Scale (M5) as a rapid self-assessment of the COVID-19 psychological burden among postacute and long-term care residents. Methods: Residents (N=131), aged 50 years and above, from 20 postacute and long-term care facilities in Maryland, USA, were evaluated in-person or via telehealth (43/131, 32.8\%) across a 4-week period (May 11 to June 5, 2020) during the COVID-19 pandemic. The COVID-19 psychological burden experienced by the residents was rated by geriatric psychologists who independently reviewed their clinical documentation. Psychometric analyses were performed on the M5 in relation to psychological tests, COVID-19 psychological burden, and diagnostic data collected during the evaluation. Results: The M5 demonstrated acceptable internal consistency (Cronbach $\alpha$=.77). M5 scores were not confounded by demographic variables or telehealth administration (P>.08). Convergent validity for the M5 was established via positive associations with anxiety (r=0.56, P<.001) and depressive (r=0.49, P<.001) symptoms. An M5 cutoff score of 3 demonstrated strong sensitivity (0.92) and adequate specificity (0.75) for identifying COVID-19 psychological distress among postacute and long-term care residents (area under the curve of 0.89, positive predictive value=0.79, negative predictive value=0.91). Conclusions: The M5 is a reliable and valid tool for self-assessment of mood that can help identify postacute and long-term care residents with significant psychological burden associated with COVID-19. It can be completed in less than 1 minute and is appropriate for use in both in-person and virtual visits. ",
doi="10.2196/26340",
url="https://aging.jmir.org/2021/1/e26340",
url="http://www.ncbi.nlm.nih.gov/pubmed/33640866"
}


@Article{info:doi/10.2196/21461,
author="LaMonica, M. Haley
and Davenport, A. Tracey
and Roberts, E. Anna
and Hickie, B. Ian",
title="Understanding Technology Preferences and Requirements for Health Information Technologies Designed to Improve and Maintain the Mental Health and Well-Being of Older Adults: Participatory Design Study",
journal="JMIR Aging",
year="2021",
month="Jan",
day="6",
volume="4",
number="1",
pages="e21461",
keywords="aging",
keywords="mental health",
keywords="technology",
keywords="mobile phone",
keywords="community-based participatory research",
keywords="health care reform",
keywords="stakeholder participation",
abstract="Background: Worldwide, the population is aging rapidly; therefore, there is a growing interest in strategies to support and maintain health and well-being in later life. Although familiarity with technology and digital literacy are increasing among this group, some older adults still lack confidence in their ability to use web-based technologies. In addition, age-related changes in cognition, vision, hearing, and perception may be barriers to adoption and highlight the need for digital tools developed specifically to meet the unique needs of older adults. Objective: The aim of this study is to understand the use of technology by older adults in general and identify the potential barriers to and facilitators of the adoption of health information technologies (HITs) to support the health and well-being of older adults to facilitate implementation and promote user uptake. In addition, this study aims to co-design and configure the InnoWell Platform, a digital tool designed to facilitate better outcomes for people seeking mental health services, to meet the needs of adults 50 years and older and their supportive others (eg, family members, caregivers) to ensure the accessibility, engagement, and appropriateness of the technology. Methods: Participants were adults 50 years and older and those who self-identified as a supportive other (eg, family member, caregiver). Participants were invited to participate in a 3-hour participatory design workshop using a variety of methods, including prompted discussion, creation of descriptive artifacts, and group-based development of user journeys. Results: Four participatory design workshops were conducted, including a total of 21 participants, each attending a single workshop. Technology use was prevalent, with a preference indicated for smartphones and computers. Factors facilitating the adoption of HITs included personalization of content and functionality to meet and be responsive to a consumer's needs, access to up-to-date information from reputable sources, and integration with standard care practices to support the relationship with health professionals. Concerns regarding data privacy and security were the primary barriers to the use of technology to support mental health and well-being. Conclusions: Although HITs have the potential to improve access to cost-effective and low-intensity interventions at scale for improving and maintaining mental health and well-being, several strategies may improve the uptake and efficacy of technologies by the older adult community, including the use of co-design methodologies to ensure usability, acceptability, and appropriateness of the technology; support in using and understanding the clinical applications of the technology by a digital navigator; and ready availability of education and training materials. ",
doi="10.2196/21461",
url="https://aging.jmir.org/2021/1/e21461",
url="http://www.ncbi.nlm.nih.gov/pubmed/33404509"
}


@Article{info:doi/10.2196/19859,
author="Kim, Ben
and Hunt, Miranda
and Muscedere, John
and Maslove, M. David
and Lee, Joon",
title="Using Consumer-Grade Physical Activity Trackers to Measure Frailty Transitions in Older Critical Care Survivors: Exploratory Observational Study",
journal="JMIR Aging",
year="2021",
month="Feb",
day="23",
volume="4",
number="1",
pages="e19859",
keywords="frailty",
keywords="frail elderly",
keywords="wearable electronic devices",
keywords="fitness trackers",
keywords="activity trackers",
keywords="heart rate",
keywords="sleep monitoring",
keywords="critical care outcomes",
abstract="Background: Critical illness has been suggested as a sentinel event for frailty development in at-risk older adults. Frail critical illness survivors are affected by increased adverse health outcomes, but monitoring the recovery after intensive care unit (ICU) discharge is challenging. Clinicians and funders of health care systems envision an increased role of wearable devices in monitoring clinically relevant measures, as sensor technology is advancing rapidly. The use of wearable devices has also generated great interest among older patients, and they are the fastest growing group of consumer-grade wearable device users. Recent research studies indicate that consumer-grade wearable devices offer the possibility of measuring frailty. Objective: This study aims to examine the data collected from wearable devices for the progression of frailty among critical illness survivors. Methods: An observational study was conducted with 12 older survivors of critical illness from Kingston General Hospital in Canada. Frailty was measured using the Clinical Frailty Scale (CFS) at ICU admission, hospital discharge, and 4-week follow-up. A wearable device was worn between hospital discharge and 4-week follow-up. The wearable device collected data on step count, physical activity, sleep, and heart rate (HR). Patient assessments were reviewed, including the severity of illness, cognition level, delirium, activities of daily living, and comorbidity. Results: The CFS scores increased significantly following critical illness compared with the pre-ICU frailty level (P=.02; d=?0.53). Survivors who were frail over the 4-week follow-up period had significantly lower daily step counts than survivors who were not frail (P=.02; d=1.81). There was no difference in sleep and HR measures. Daily step count was strongly correlated with the CFS at 4-week follow-up (r=?0.72; P=.04). The average HR was strongly correlated with the CFS at hospital discharge (r=?0.72; P=.046). The HR SD was strongly correlated (r=0.78; P=.02) with the change in CFS from ICU admission to 4-week follow-up. No association was found between the CFS and sleep measures. The pattern of increasing step count over the 4-week follow-up period was correlated with worsening of frailty (r=.62; P=.03). Conclusions: This study demonstrated an association between frailty and data generated from a consumer-grade wearable device. Daily step count and HR showed a strong association with the frailty progression of the survivors of critical illness over time. Understanding this association could unlock a new avenue for clinicians to monitor and identify a vulnerable subset of the older adult population that might benefit from an early intervention. ",
doi="10.2196/19859",
url="https://aging.jmir.org/2021/1/e19859",
url="http://www.ncbi.nlm.nih.gov/pubmed/33620323"
}