@Article{info:doi/10.2196/19641,
author="Itoh, Sakiko
and Tan, Hwee-Pink
and Kudo, Kenichi
and Ogata, Yasuko",
title="Comparison of the Mental Burden on Nursing Care Providers With and Without Mat-Type Sleep State Sensors at a Nursing Home in Tokyo, Japan: Quasi-Experimental Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="23",
volume="5",
number="1",
pages="e19641",
keywords="long-term care",
keywords="caregiver burden",
keywords="nursing homes",
keywords="aged",
keywords="information technology",
keywords="sensors",
abstract="Background: Increasing need for nursing care has led to the increased burden on formal caregivers, with those in nursing homes having to deal with exhausting labor. Although research activities on the use of internet of things devices to support nursing care for older adults exist, there is limited evidence on the effectiveness of these interventions among formal caregivers in nursing homes. Objective: This study aims to investigate whether mat-type sleep state sensors for supporting nursing care can reduce the mental burden of formal caregivers in a nursing home. Methods: This was a quasi-experimental study at a nursing home in Tokyo, Japan. The study participants were formal caregivers who cared for residents in private rooms on the fourth and fifth floors of the nursing home. In the intervention group, formal caregivers took care of residents who used sleep state sensors on the fourth floor of the nursing home. The sleep state sensors were mat types and designed to detect body motion such as the frequency of toss and turning and to measure heartbeat and respiration. One sensor was placed on a bed in a private room. When body motion is detected, the information is instantly displayed on a monitor at a staff station. In addition, the mental condition of the formal caregivers was measured using a validated self-reported outcome measure---the Profile of Mood States (POMS), Short-Form, 2nd edition. Formal caregivers in both groups received the POMS at baseline, midpoint (week 4), and endpoint (week 8) to identify changes in these domains. The primary outcome was the difference in total mood disturbance (TMD) of the POMS at baseline and week 8. Results: Of the 22 eligible formal caregivers, 12 (intervention group) utilized sleep state sensors for 8 weeks. The remaining 10 formal caregivers (control group) provided nursing care as usual. As for the primary outcome of the difference between TMD at baseline and week 8, TMD in the intervention group improved by --3.67 versus 4.70 in the control group, resulting in a mean difference of --8.37 (95\% CI --32.02 to 15.29; P=.48) in favor of the intervention. Conclusions: The present 8-week study showed that sleep state sensing for elderly residents might not be associated with reduced mental burdens on formal caregivers in nursing homes. ",
doi="10.2196/19641",
url="https://aging.jmir.org/2022/1/e19641",
url="http://www.ncbi.nlm.nih.gov/pubmed/35319474"
}


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


@Article{info:doi/10.2196/32957,
author="Kim, Sunyoung
and Yao, Willow
and Du, Xiaotong",
title="Exploring Older Adults' Adoption and Use of a Tablet Computer During COVID-19: Longitudinal Qualitative Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="8",
volume="5",
number="1",
pages="e32957",
keywords="older adults",
keywords="tablet computer",
keywords="technology acceptance",
keywords="mental model",
keywords="longitudinal study",
keywords="COVID-19",
abstract="Background: As mobile computing technology evolves, such as smartphones and tablet computers, it increasingly offers features that may be particularly beneficial to older adults. However, the digital divide exists, and many older adults have been shown to have difficulty using these devices. The COVID-19 pandemic has magnified how much older adults need but are excluded from having access to technologies to meet essential daily needs and overcome physical distancing restrictions. Objective: This study sought to understand how older adults who had never used a tablet computer learn to use it, what they want to use it for, and what barriers they experience as they continue to use it during social isolation caused by the COVID-19 pandemic. Methods: We conducted a series of semistructured interviews with eight people aged 65 years and older for 16 weeks, investigating older novice users' adoption and use of a tablet computer during the nationwide lockdown due to COVID-19. Results: Participants were gradually yet successfully accustomed to using a tablet computer to serve various daily needs, including entertainment, social connectedness, and information-seeking. However, this success was not achieved through developing sufficient digital skills but rather by applying the methods they were already familiar with in its operation, such as taking and referring to instruction notes. Conclusions: Our findings imply that older adults without digital literacy can still benefit from a digital device for quality of later life if proper traditional methods they are already familiar with are offered in its use. ",
doi="10.2196/32957",
url="https://aging.jmir.org/2022/1/e32957",
url="http://www.ncbi.nlm.nih.gov/pubmed/35134747"
}


@Article{info:doi/10.2196/31552,
author="Albers, A. Elizabeth
and Mikal, Jude
and Millenbah, Ashley
and Finlay, Jessica
and Jutkowitz, Eric
and Mitchell, Lauren
and Horn, Brenna
and Gaugler, E. Joseph",
title="The Use of Technology Among Persons With Memory Concerns and Their Caregivers in the United States During the COVID-19 Pandemic: Qualitative Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="17",
volume="5",
number="1",
pages="e31552",
keywords="social isolation",
keywords="dementia",
keywords="caregiving - informal",
keywords="aging in place",
keywords="caregivers",
keywords="aging",
keywords="elderly",
keywords="pandemic",
keywords="COVID-19",
keywords="mental health",
keywords="technology use",
keywords="health technology",
abstract="Background: Stay-at-home orders and other public health measures designed to mitigate the spread of COVID-19 have increased isolation among persons with memory concerns (PWMCs: individuals diagnosed with cognitive impairment or Alzheimer disease or related dementias). The pandemic has also exacerbated challenges for family members who care for PWMCs. Although technology has demonstrated the potential to improve the social connections and mental health of PWMCs and their family caregivers (CGs), previous research shows that older adults may be reluctant to adopt new technologies. Objective: We aimed to understand why and how some PWMCs and their CGs altered their use of mainstream technology, such as smartphones and fitness trackers, and assistive technology to adapt to lifestyle changes (eg, increased isolation) during the COVID-19 pandemic. Methods: Using data collected in 20 qualitative interviews from June to August 2020 with 20 PWMCs and family CG dyads, we assessed changes in and barriers to everyday technology use following the implementation of COVID-19 mitigation strategies in the United States. Zoom videoconferencing was utilized to conduct the interviews to protect the health of the participants who were primarily older adults. Results: Using qualitative thematic analysis, we identified 3 themes that explained motivations for using technology during a pandemic: (1) maintaining social connections, (2) alleviating boredom, and (3) increasing CG respite. Results further revealed lingering barriers to PWMC and CG adoption of technologies, including: (1) PWMC dependence upon CGs, (2) low technological literacy, and (3) limitations of existing technology. Conclusions: This in-depth investigation suggests that technology can provide PWMCs with more independence and offer CGs relief from CG burden during periods of prolonged isolation. ",
doi="10.2196/31552",
url="https://aging.jmir.org/2022/1/e31552",
url="http://www.ncbi.nlm.nih.gov/pubmed/35134748"
}


@Article{info:doi/10.2196/15413,
author="Egan, J. Kieren
and Clark, Patricia
and Deen, Zahid
and Paputa Dutu, Carmen
and Wilson, Graham
and McCann, Lisa
and Lennon, Marilyn
and Maguire, Roma",
title="Understanding Current Needs and Future Expectations of Informal Caregivers for Technology to Support Health and Well-being: National Survey Study",
journal="JMIR Aging",
year="2022",
month="Jan",
day="27",
volume="5",
number="1",
pages="e15413",
keywords="caregiving",
keywords="technology",
keywords="health",
keywords="well-being",
keywords="digital health",
keywords="co-design",
keywords="mobile phone",
abstract="Background: There are approximately 6.5 million informal (unpaid) caregivers in the United Kingdom. Each caregiver plays a critical role in the society, supporting the health and well-being of those who are ill, disabled, or older and who need frequent support. Digital technologies are becoming a ubiquitous part of everyday life for many, but little is known about the real-world impact of technology for those in a caring role, including the abilities of technologies to address the mental and physical impacts of caregiving. Objective: This study aims to understand the current and future technology use of caregivers, including digital technologies used to care for themselves and the person they look after. Methods: We codeveloped a wide range of questions with caregivers and care professionals and delivered this survey both on the web and in paper format (eg, using social networks such as Twitter alongside in-person events). Questions were focused on providing care and looking after caregiver health and well-being. Analyses focused on both quantitative outcomes (frequency counts and Likert questions) and explored free text entries (thematic analysis). Results: From 356 respondents, we identified that caregivers were receptive to, and largely positive about current and future use of technology both for their own care and their caring role (eg, checking in from distance). There were notable concerns, including the risk that technology could replace human contact. We identified several key areas for future work, including communication with health and social care professionals, and the potential for technology to help caregivers with their own health. We also identified several stakeholders (eg, care workers, pharmacy staff, and general practitioners) who could act as suitable points for technology signposting and support. Conclusions: Caregivers are a transient, often difficult to reach population, and this work has collated a large body of knowledge across a diverse group of individuals. Many caregivers, like the rest of society, are realizing the benefits of using everyday technology to help deliver care. It is clear that there is already a high level of dependency on technologies, where future expectations will grow. However, many barriers to digital technology use remain, including a lack of ongoing technology support. Preventive measures linked to technology that can help look after a caregiver's own health appear acceptable, particularly for communicative tools. This collated caregiver knowledge is a call for all stakeholders---academics, policy makers, and practitioners---to take note of these specific challenges, and to ensure that caregiver voices are both heard and fully integrated within the emerging digital health agenda. ",
doi="10.2196/15413",
url="https://aging.jmir.org/2022/1/e15413",
url="http://www.ncbi.nlm.nih.gov/pubmed/35084339"
}


@Article{info:doi/10.2196/32516,
author="Gilson, Aaron
and Gassman, Michele
and Dodds, Debby
and Lombardo, Robin
and Ford II, H. James
and Potteiger, Michael",
title="Refining a Digital Therapeutic Platform for Home Care Agencies in Dementia Care to Elicit Stakeholder Feedback: Focus Group Study With Stakeholders",
journal="JMIR Aging",
year="2022",
month="Mar",
day="2",
volume="5",
number="1",
pages="e32516",
keywords="dementia",
keywords="technology",
keywords="mobile app",
keywords="home care",
keywords="focus groups",
keywords="qualitative research",
keywords="digital therapeutics",
keywords="value-based care",
keywords="aging in place",
keywords="caregiving",
abstract="Background: Persons living with dementia require increasing levels of care, and the care model has evolved. The Centers for Medicare and Medicaid Services is transitioning long-term care services from institutional care to home- or community-based services, including reimbursement for nonclinical services. Although home care companies are positioned to handle this transition, they need innovative solutions to address the special challenges posed by caring for persons living with dementia. To live at home longer, these persons require support from formal caregivers (FCGs; ie, paid professionals), who often lack knowledge of their personal histories and have high turnover, or informal caregivers (eg, family or friends), who may have difficulty coping with behavioral and psychological symptoms of dementia. The Generation Connect platform was developed to support these individuals and their formal and informal caregivers. In preliminary studies, the platform improved mood and influenced caregiver satisfaction. To enhance platform effectiveness, Generation Connect received a grant from the National Institutes of Health Small Business Innovation Research to improve clinical outcomes, reduce health care costs, and lower out-of-pocket costs for persons living with dementia who receive care through home care agencies. Objective: This study aims to evaluate information elicited from a series of stakeholder focus groups to understand existing processes, needs, barriers, and goals for the use of the Generation Connect platform by home care agencies and formal and informal caregivers. Methods: A series of focus groups were conducted with home care agency corporate leadership, home care agency franchise owners, home care agency FCGs, and informal caregivers of persons living with dementia. The qualitative approach allowed for unrestricted idea generation that best informed the platform development to enable home care providers to differentiate their dementia care services, involve informal caregivers, improve FCG well-being, and extend the ability of persons living with dementia to age in place. Using the Technology-Enabled Caregiving in the Home framework, an inductive and iterative content analysis was conducted to identify thematic categories from the transcripts. Results: Overall, 39 participants participated across the 6 stakeholder focus groups. The following five overarching themes were identified: technology related; care services; data, documentation, and outcomes; cost, finance, and resources; and resources for caregivers. Within each theme, the most frequent subthemes were identified. Exemplar stakeholder group statements provided support for each of the identified themes. Conclusions: The focus group results will inform the further development of the Generation Connect platform to reduce the burden of caregiving for persons living with dementia, evaluate changes in cognition, preserve functional independence, and promote caregiver engagement between these individuals. The next step is to evaluate the effectiveness of the revised platform in the National Institutes of Health Small Business Innovation Research phase 2 clinical trial to assess the efficacy of its evidence-based interventions and market viability. ",
doi="10.2196/32516",
url="https://aging.jmir.org/2022/1/e32516",
url="http://www.ncbi.nlm.nih.gov/pubmed/35234657"
}


@Article{info:doi/10.2196/27355,
author="Hu, Lu
and Trinh-Shevrin, Chau
and Islam, Nadia
and Wu, Bei
and Cao, Shimin
and Freeman, Jincong
and Sevick, Ann Mary",
title="Mobile Device Ownership, Current Use, and Interest in Mobile Health Interventions Among Low-Income Older Chinese Immigrants With Type 2 Diabetes: Cross-sectional Survey Study",
journal="JMIR Aging",
year="2022",
month="Feb",
day="2",
volume="5",
number="1",
pages="e27355",
keywords="technology use",
keywords="Chinese immigrants",
keywords="type 2 diabetes",
keywords="mHealth",
keywords="health disparities",
keywords="immigrant health",
keywords="diabetes",
keywords="mobile health",
keywords="intervention",
keywords="smartphone",
keywords="immigrant",
abstract="Background: Chinese immigrants suffer a disproportionately high type 2 diabetes (T2D) burden and tend to have poorly controlled disease. Mobile health (mHealth) interventions have been shown to increase access to care and improve chronic disease management in minority populations. However, such interventions have not been developed for or tested in Chinese immigrants with T2D. Objective: This study aims to examine mobile device ownership, current use, and interest in mHealth interventions among Chinese immigrants with T2D. Methods: In a cross-sectional survey, Chinese immigrants with T2D were recruited from Chinese community centers in New York City. Sociodemographic characteristics, mobile device ownership, current use of social media software applications, current use of technology for health-related purposes, and interest in using mHealth for T2D management were assessed. Surveys were administered face-to-face by bilingual study staff in the participant's preferred language. Descriptive statistics were used to characterize the study sample and summarize technology use. Results: The sample (N=91) was predominantly female (n=57, 63\%), married (n=68, 75\%), and had a high school education or less (n=58, 64\%); most participants had an annual household income of less than US \$25,000 (n=63, 69\%) and had limited English proficiency (n=78, 86\%). The sample had a mean age of 70 (SD 11) years. Almost all (90/91, 99\%) participants had a mobile device (eg, basic cell phones, smart devices), and the majority (n=83, 91\%) reported owning a smart device (eg, smartphone or tablet). WeChat was the most commonly used social media platform (65/91, 71\%). When asked about their top source for diabetes-related information, 63 of the 91 participants (69\%) reported health care providers, followed by 13 who reported the internet (14\%), and 10 who reported family, friends, and coworkers (11\%). Less than one-quarter (21/91, 23\%) of the sample reported using the internet to search for diabetes-related information in the past 12 months. About one-third of the sample (34/91, 37\%) reported that they had watched a health-related video on their cell phone or computer in the past 12 months. The majority (69/91, 76\%) of participants reported interest in receiving an mHealth intervention in the future to help with T2D management. Conclusions: Despite high mobile device ownership, the current use of technology for health-related issues remained low in older Chinese immigrants with T2D. Given the strong interest in future mHealth interventions and high levels of social media use (eg, WeChat), future studies should consider how to leverage these existing low-cost platforms and deliver tailored mHealth interventions to this fast-growing minority group. ",
doi="10.2196/27355",
url="https://aging.jmir.org/2022/1/e27355",
url="http://www.ncbi.nlm.nih.gov/pubmed/35107426"
}


@Article{info:doi/10.2196/32442,
author="Schuster, M. Amy
and Cotten, R. Shelia",
title="COVID-19's Influence on Information and Communication Technologies in Long-Term Care: Results From a Web-Based Survey With Long-Term Care Administrators",
journal="JMIR Aging",
year="2022",
month="Jan",
day="12",
volume="5",
number="1",
pages="e32442",
keywords="COVID-19",
keywords="pandemic",
keywords="socioemotional needs",
keywords="long-term care",
keywords="nursing home facility",
keywords="assisted living facility",
keywords="elderly",
keywords="older adults",
keywords="information and communication technologies",
keywords="support",
keywords="emotion",
keywords="needs",
keywords="access",
keywords="connection",
keywords="communication",
keywords="engagement",
abstract="Background: The prevalence of COVID-19 in the United States led to mandated lockdowns for long-term care (LTC) facilities, resulting in loss of in-person contact with social ties for LTC residents. Though information and communication technologies (ICTs) can be used by LTC residents to support their socioemotional needs, residents must have access to ICTs to use them. Objective: This study explored ICT access and use in LTC facilities and how LTC facilities adapted to try to enhance social connections for their residents during the COVID-19 pandemic. Methods: LTC administrators in South Carolina (United States) were invited to complete a web-based survey exploring ICT access and use in LTC facilities and whether access and use changed as a result of the COVID-19 pandemic. Results: LTC administrators (N=70, 12 nursing homes [NHs], and 58 assisted living facilities [ALFs]) completed the web-based survey. Since March 2020, a total of 53\% (37/70) of the LTC facilities have purchased ICTs for residents' use. ICTs have mainly been used for videoconferencing with family members (31/36, 86\%), friends (25/36, 69\%), and health care providers (26/36, 72\%). NHs were 10.23 times more likely to purchase ICTs for residents' use during the COVID-19 pandemic than ALFs (odds ratio 11.23, 95\% CI 1.12-113.02; P=.04). Benefits of ICT use included residents feeling connected to their family members, friends, and other residents. Barriers to ICT use included staff not having time to assist residents with using the technology, nonfunctional technology, and residents who do not want to share technology. Conclusions: Our results suggest that over half of the LTC facilities in this study were able to acquire ICTs for their residents to use during the COVID-19 pandemic. Additional research is needed to explore how residents adapted to using the ICTs and whether LTC facilities developed and adopted technology integration plans, which could help them be prepared for future situations that may affect LTC residents' engagement and communication opportunities, such as another pandemic. ",
doi="10.2196/32442",
url="https://aging.jmir.org/2022/1/e32442",
url="http://www.ncbi.nlm.nih.gov/pubmed/34878989"
}


@Article{info:doi/10.2196/29623,
author="Cristiano, Alessia
and Musteata, Stela
and De Silvestri, Sara
and Bellandi, Valerio
and Ceravolo, Paolo
and Cesari, Matteo
and Azzolino, Domenico
and Sanna, Alberto
and Trojaniello, Diana",
title="Older Adults' and Clinicians' Perspectives on a Smart Health Platform for the Aging Population: Design and Evaluation Study",
journal="JMIR Aging",
year="2022",
month="Feb",
day="28",
volume="5",
number="1",
pages="e29623",
keywords="smart health",
keywords="remote monitoring",
keywords="requirement elicitation",
keywords="older population",
keywords="age-related chronic conditions",
keywords="healthy aging",
keywords="Internet of Things",
keywords="mobile phone",
abstract="Background: Over recent years, interest in the development of smart health technologies aimed at supporting independent living for older populations has increased. The integration of innovative technologies, such as the Internet of Things, wearable technologies, artificial intelligence, and ambient-assisted living applications, represents a valuable solution for this scope. Designing such an integrated system requires addressing several aspects (eg, equipment selection, data management, analytics, costs, and users' needs) and involving different areas of expertise (eg, medical science, service design, biomedical and computer engineering). Objective: The objective of this study is 2-fold; we aimed to design the functionalities of a smart health platform addressing 5 chronic conditions prevalent in the older population (ie, hearing loss, cardiovascular diseases, cognitive impairments, mental health problems, and balance disorders) by considering both older adults' and clinicians' perspectives and to evaluate the identified smart health platform functionalities with a small group of older adults. Methods: Overall, 24 older adults (aged >65 years) and 118 clinicians were interviewed through focus group activities and web-based questionnaires to elicit the smart health platform requirements. Considering the elicited requirements, the main functionalities of smart health platform were designed. Then, a focus group involving 6 older adults was conducted to evaluate the proposed solution in terms of usefulness, credibility, desirability, and learnability. Results: Eight main functionalities were identified and assessed---cognitive training and hearing training (usefulness: 6/6, 100\%; credibility: 6/6, 100\%; desirability: 6/6, 100\%; learnability: 6/6, 100\%), monitoring of physiological parameters (usefulness: 6/6, 100\%; credibility: 6/6, 100\%; desirability: 6/6, 100\%; learnability: 5/6, 83\%), physical training (usefulness: 6/6, 100\%; credibility: 6/6, 100\%; desirability: 5/6, 83\%; learnability: 2/6, 33\%), psychoeducational intervention (usefulness: 6/6, 100\%; credibility: 6/6, 100\%; desirability: 4/6, 67\%; learnability: 2/6, 33\%), mood monitoring (usefulness: 4/6, 67\%; credibility: 4/6, 67\%; desirability: 3/6, 50\%; learnability: 5/6, 50\%), diet plan (usefulness: 5/6, 83\%; credibility: 4/6, 67\%; desirability: 1/6, 17\%; learnability: 2/6, 33\%), and environment monitoring and adjustment (usefulness: 1/6, 17\%; credibility: 1/6, 17\%; desirability: 0/6, 0\%; learnability: 0/6, 0\%). Most of them were highly appreciated by older participants, with the only exception being environment monitoring and adjustment. The results showed that the proposed functionalities met the needs and expectations of users (eg, improved self-management of patients' disease and enhanced patient safety). However, some aspects need to be addressed (eg, technical and privacy issues). Conclusions: The presented smart health platform functionalities seem to be able to meet older adults' needs and desires to enhance their self-awareness and self-management of their medical condition, encourage healthy and independent living, and provide evidence-based support for clinicians' decision-making. Further research with a larger and more heterogeneous pool of stakeholders in terms of demographics and clinical conditions is needed to assess system acceptability and overall user experience in free-living conditions. ",
doi="10.2196/29623",
url="https://aging.jmir.org/2022/1/e29623",
url="http://www.ncbi.nlm.nih.gov/pubmed/35225818"
}


@Article{info:doi/10.2196/35221,
author="Yu, Ellie
and Hagens, Simon",
title="Socioeconomic Disparities in the Demand for and Use of Virtual Visits Among Senior Adults During the COVID-19 Pandemic: Cross-sectional Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="22",
volume="5",
number="1",
pages="e35221",
keywords="virtual care",
keywords="virtual visit",
keywords="COVID-19",
keywords="survey",
keywords="virtual care demand",
keywords="virtual care use",
keywords="older adults",
keywords="elderly care",
keywords="aging",
keywords="digital health",
keywords="pandemic",
abstract="Background: The COVID-19 pandemic has limited the provision of in-person care and accelerated the need for virtual care. Older adults (65+ years) were 1 of the highest user groups of in-person health care services prior to the pandemic. Social distancing guidelines and high rates of mortality from coronavirus infections among older adults made receiving in-person health care services challenging for older adults. The provision of virtual care technologies can help to ensure continuity of care and provide essential health care services during the pandemic to those at high risk of contracting the COVID-19 coronavirus, including older adults. It is also essential to understand and address potential socioeconomic, demographic, and health disparities in the demand for and use of virtual care technologies among older adults. Objective: The objective of this study is to investigate socioeconomic disparities in the demand for and use of virtual visits during the COVID-19 pandemic among older adults in Canada. Methods: A cross-sectional web survey was conducted with 12,052 Canadians over the age of 16 years, selected from Leger's L{\'e}ger Opinion panel from July 14 to August 6, 2021. Associations between socioeconomic factors and the demand for and use of virtual visits were tested using $\chi$2 tests and logistic regression models for telephone visits, video visits, and secure messaging. Weighting was applied using the 2016 census reference variables to render a representative sample of the Canadian population. Results: A total of 2303 older adults were surveyed. Older adults expressed the highest demand for and use of telephone visits, following by video visits and secure messaging. eHealth literacy was positively associated with the use of all 3 virtual care modalities. Higher income was negatively associated with the use of video visits (odds ratio [OR] 0.65, 95\% CI 0.428-0.974, P=.03). Having no private insurance coverage was negatively associated with use of secure messaging (OR 0.73, 95\% CI 0.539-0.983, P=.04), but living in a rural community (OR 0.172, 95\% CI 1.12-2.645, P=.01) and being born outside of Canada (OR 0.150, 95\% CI 1.041-2.173, P=.03) were positively associated with the use of secure messaging. Higher education (OR 0.078, 95\% CI 0.633-0.97, P=.02) and being non-White (OR=0.054, 95\% CI 0.312-0.92, P=.02) were negatively associated with the use of the telephone. Conclusions: This study found that compared to video visits and secure messaging, the demand for and use of telephone visits were more prevalent among older adults during the pandemic. The gaps between the demand for and use of video and secure messaging services remain substantial. Our results highlight socioeconomic disparities among older adults that could potentially explain this trend. Lower income and a lower education level may act as barriers for older adults in acquiring the skills and technologies necessary to use more complex solutions, such as video and secure messaging. In addition, higher eHealth literacy was found to be critical for older adults to successfully navigate all types of virtual visit technologies. ",
doi="10.2196/35221",
url="https://aging.jmir.org/2022/1/e35221",
url="http://www.ncbi.nlm.nih.gov/pubmed/35134746"
}


@Article{info:doi/10.2196/33118,
author="Wu, Xi Vivien
and Dong, Yanhong
and Tan, Choo Poh
and Gan, Peiying
and Zhang, Di
and Chi, Yuchen
and Chao, Ting Felicia Fang
and Lu, Jinhua
and Teo, Dennis Boon Heng
and Tan, Qian Yue",
title="Development of a Community-Based e-Health Program for Older Adults With Chronic Diseases: Pilot Pre-Post Study",
journal="JMIR Aging",
year="2022",
month="Jan",
day="17",
volume="5",
number="1",
pages="e33118",
keywords="eHealth",
keywords="self-management",
keywords="older adults",
keywords="chronic disease",
keywords="community care",
keywords="elderly",
keywords="community",
keywords="innovation",
keywords="development",
keywords="pilot",
keywords="evaluation",
keywords="health literacy",
keywords="empowerment",
keywords="feasibility",
keywords="engagement",
abstract="Background: Chronic diseases may impact older adults' health outcomes, health care costs, and quality of life. Self-management is expected to encourage individuals to make autonomous decisions, adhere to treatment plans, deal with emotional and social consequences, and provide choices for healthy lifestyle. New eHealth solutions significantly increase the health literacy and empower patients in self-management of chronic conditions. Objective: This study aims to develop a Community-Based e-Health Program (CeHP) for older adults with chronic diseases and conduct a pilot evaluation. Methods: A pilot study with a 2-group pre- and posttest repeated measures design was adopted. Community-dwelling older adults with chronic diseases were recruited from senior activity centers in Singapore. A systematic 3-step process of developing CeHP was coupled with a smart-device application. The development of the CeHP intervention consists of theoretical framework, client-centric participatory action research process, content validity assessment, and pilot testing. Self-reported survey questionnaires and health outcomes were measured before and after the CeHP. The instruments used were the Self-care of Chronic Illness Inventory (SCCII), Healthy Aging Instrument (HAI), Short-Form Health Literacy Scale, 12 Items (HLS-SF 12), Patient Empowerment Scale (PES), and Social Support Questionnaire, 6 items. The following health outcomes were measured: Montreal Cognitive Assessment, Symbol Digit Modalities Test, total cholesterol (TC), high-density lipoproteins, low-density lipoproteins/very-low-density lipoproteins (LDL/VLDL), fasting glucose, glycated hemoglobin (HbA1c), and BMI. Results: The CeHP consists of health education, monitoring, and an advisory system for older adults to manage their chronic conditions. It is an 8-week intensive program, including face-to-face and eHealth (Care4Senior App) sessions. Care4Senior App covers health education topics focusing on the management of hypertension, hyperlipidemia, and diabetes, brain health, healthy diet, lifestyle modification, medication adherence, exercise, and mindfulness practice. Content validity assessment indicated that the content of the CeHP is valid, with a content validity index (CVI) ranging 0.86-1 and a scale-CVI of 1. Eight participants in the CeHP group and 4 in the control group completed both baseline and post intervention assessments. Participants in the CeHP group showed improvements in fasting glucose, HbA1c, TC, LDL/VLDL, BMI, SCCII indices (Maintenance, Monitoring, and Management), HAI, and PES scores post intervention, although these changes were not significant. For the participants in the control group, the scores for SCCII (management and confidence) and HLS-SF 12 decreased post intervention. Conclusions: The CeHP is feasible, and it engages and empowers community-dwelling older adults to manage their chronic conditions. The rigorous process of program development and pilot evaluation provided valid evidence to expand the CeHP to a larger-scale implementation to encourage self-management, reduce debilitating complications of poorly controlled chronic diseases, promote healthy longevity and social support, and reduce health care costs. ",
doi="10.2196/33118",
url="https://aging.jmir.org/2022/1/e33118",
url="http://www.ncbi.nlm.nih.gov/pubmed/35037882"
}


@Article{info:doi/10.2196/30388,
author="Hudson, Georgie
and Jansli, M. Sonja
and Erturk, Sinan
and Morris, Daniel
and Odoi, M. Clarissa
and Clayton-Turner, Angela
and Bray, Vanessa
and Yourston, Gill
and Clouden, Doreen
and Proudfoot, David
and Cornwall, Andrew
and Waldron, Claire
and Wykes, Til
and Jilka, Sagar",
title="Investigation of Carers' Perspectives of Dementia Misconceptions on Twitter: Focus Group Study",
journal="JMIR Aging",
year="2022",
month="Jan",
day="24",
volume="5",
number="1",
pages="e30388",
keywords="patient and public involvement",
keywords="dementia",
keywords="co-production",
keywords="misconceptions",
keywords="stigma",
keywords="Twitter",
keywords="social media",
keywords="Alzheimer's Disease",
abstract="Background: Dementia misconceptions on social media are common, with negative effects on people with the condition, their carers, and those who know them. This study codeveloped a thematic framework with carers to understand the forms these misconceptions take on Twitter. Objective: The aim of this study is to identify and analyze types of dementia conversations on Twitter using participatory methods. Methods: A total of 3 focus groups with dementia carers were held to develop a framework of dementia misconceptions based on their experiences. Dementia-related tweets were collected from Twitter's official application programming interface using neutral and negative search terms defined by the literature and by carers (N=48,211). A sample of these tweets was selected with equal numbers of neutral and negative words (n=1497), which was validated in individual ratings by carers. We then used the framework to analyze, in detail, a sample of carer-rated negative tweets (n=863). Results: A total of 25.94\% (12,507/48,211) of our tweet corpus contained negative search terms about dementia. The carers' framework had 3 negative and 3 neutral categories. Our thematic analysis of carer-rated negative tweets found 9 themes, including the use of weaponizing language to insult politicians (469/863, 54.3\%), using dehumanizing or outdated words or statements about members of the public (n=143, 16.6\%), unfounded claims about the cures or causes of dementia (n=11, 1.3\%), or providing armchair diagnoses of dementia (n=21, 2.4\%). Conclusions: This is the first study to use participatory methods to develop a framework that identifies dementia misconceptions on Twitter. We show that misconceptions and stigmatizing language are not rare. They manifest through minimizing and underestimating language. Web-based campaigns aiming to reduce discrimination and stigma about dementia could target those who use negative vocabulary and reduce the misconceptions that are being propagated, thus improving general awareness. ",
doi="10.2196/30388",
url="https://aging.jmir.org/2022/1/e30388",
url="http://www.ncbi.nlm.nih.gov/pubmed/35072637"
}


@Article{info:doi/10.2196/35677,
author="Bacsu, Juanita-Dawne
and Fraser, Sarah
and Chasteen, L. Alison
and Cammer, Allison
and Grewal, S. Karl
and Bechard, E. Lauren
and Bethell, Jennifer
and Green, Shoshana
and McGilton, S. Katherine
and Morgan, Debra
and O'Rourke, M. Hannah
and Poole, Lisa
and Spiteri, J. Raymond
and O'Connell, E. Megan",
title="Using Twitter to Examine Stigma Against People With Dementia During COVID-19: Infodemiology Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="31",
volume="5",
number="1",
pages="e35677",
keywords="coronavirus 2019",
keywords="social media",
keywords="stigma",
keywords="dementia",
keywords="ageism",
keywords="COVID-19",
keywords="Twitter",
keywords="bias",
keywords="infodemiology",
keywords="attention",
keywords="risk",
keywords="impact",
keywords="misinformation",
keywords="belief",
keywords="cognition",
keywords="cognitive impairment",
abstract="Background: During the pandemic, there has been significant social media attention focused on the increased COVID-19 risks and impacts for people with dementia and their care partners. However, these messages can perpetuate misconceptions, false information, and stigma. Objective: This study used Twitter data to understand stigma against people with dementia propagated during the COVID-19 pandemic. Methods: We collected 1743 stigma-related tweets using the GetOldTweets application in Python from February 15 to September 7, 2020. Thematic analysis was used to analyze the tweets. Results: Based on our analysis, 4 main themes were identified: (1) ageism and devaluing the lives of people with dementia, (2) misinformation and false beliefs about dementia and COVID-19, (3) dementia used as an insult for political ridicule, and (4) challenging stigma against dementia. Social media has been used to spread stigma, but it can also be used to challenge negative beliefs, stereotypes, and false information. Conclusions: Dementia education and awareness campaigns are urgently needed on social media to address COVID-19-related stigma. When stigmatizing discourse on dementia is widely shared and consumed amongst the public, it has public health implications. How we talk about dementia shapes how policymakers, clinicians, and the public value the lives of people with dementia. Stigma perpetuates misinformation, pejorative language, and patronizing attitudes that can lead to discriminatory actions, such as the limited provision of lifesaving supports and health services for people with dementia during the pandemic. COVID-19 policies and public health messages should focus on precautions and preventive measures rather than labeling specific population groups. ",
doi="10.2196/35677",
url="https://aging.jmir.org/2022/1/e35677",
url="http://www.ncbi.nlm.nih.gov/pubmed/35290197"
}


@Article{info:doi/10.2196/32683,
author="Dimet-Wiley, Andrea
and Golovko, George
and Watowich, J. Stanley",
title="One-Year Postfracture Mortality Rate in Older Adults With Hip Fractures Relative to Other Lower Extremity Fractures: Retrospective Cohort Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="16",
volume="5",
number="1",
pages="e32683",
keywords="hip",
keywords="fracture",
keywords="mortality",
keywords="aging",
keywords="older adults",
keywords="elderly",
keywords="mortality risk",
keywords="electronic health record",
keywords="EHR",
keywords="survival probability",
keywords="postfracture mortality rate",
keywords="fall",
keywords="bone",
keywords="injury",
keywords="dementia",
keywords="diabetes",
keywords="type 2 diabetes",
keywords="trauma",
keywords="treatment",
keywords="comorbidity",
keywords="mobility",
abstract="Background: Hip fracture in older adults is tied to increased mortality risk. Deconvolution of the mortality risk specific to hip fracture from that of various other fracture types has not been performed in recent hip fracture studies but is critical to determining current unmet needs for therapeutic intervention. Objective: This study examined whether hip fracture increases the 1-year postfracture mortality rate relative to several other fracture types and determined whether dementia or type 2 diabetes (T2D) exacerbates postfracture mortality risk. Methods: TriNetX Diamond Network data were used to identify patients with a single event of fracture of the hip, the upper humerus, or several regions near and distal to the hip occurring from 60 to 89 years of age from 2010 to 2019. Propensity score matching, Kaplan-Meier, and hazard ratio analyses were performed for all fracture groupings relative to hip fracture. One-year postfracture mortality rates in elderly populations with dementia or T2D were established. Results: One-year mortality rates following hip fracture consistently exceeded all other lower extremity fracture groupings as well as the upper humerus. Survival probabilities were significantly lower in the hip fracture groups, even after propensity score matching was performed on cohorts for a variety of broad categories of characteristics. Dementia in younger elderly cohorts acted synergistically with hip fracture to exacerbate the 1-year mortality risk. T2D did not exacerbate the 1-year mortality risk beyond mere additive effects. Conclusions: Elderly patients with hip fracture have a significantly decreased survival probability. Greatly increased 1-year mortality rates following hip fracture may arise from differences in bone quality, bone density, trauma, concomitant fractures, postfracture treatments or diagnoses, restoration of prefracture mobility, or a combination thereof. The synergistic effect of dementia may suggest detrimental mechanistic or behavioral combinations for these 2 comorbidities. Renewed efforts should focus on modulating the mechanisms behind this heightened mortality risk, with particular attention to mobility and comorbid dementia. ",
doi="10.2196/32683",
url="https://aging.jmir.org/2022/1/e32683",
url="http://www.ncbi.nlm.nih.gov/pubmed/35293865"
}


@Article{info:doi/10.2196/32075,
author="Nwosu, Callistus Amara
and McGlinchey, Tamsin
and Sanders, Justin
and Stanley, Sarah
and Palfrey, Jennifer
and Lubbers, Patrick
and Chapman, Laura
and Finucane, Anne
and Mason, Stephen",
title="Identification of Digital Health Priorities for Palliative Care Research: Modified Delphi Study",
journal="JMIR Aging",
year="2022",
month="Mar",
day="21",
volume="5",
number="1",
pages="e32075",
keywords="palliative care",
keywords="terminal care",
keywords="supportive care",
keywords="quality of life",
keywords="symptom management",
keywords="digital health",
keywords="technology",
abstract="Background: Developments in digital health have the potential to transform the delivery of health and social care to help citizens manage their health. Currently, there is a lack of consensus about digital health research priorities in palliative care and a lack of theories about how these technologies might improve care outcomes. Therefore, it is important for health care leaders to identify innovations to ensure that an increasingly frail population has appropriate access to palliative care services. Consequently, it is important to articulate research priorities as the first step in determining how finite resources should be allocated to a field saturated with rapidly developing innovation. Objective: The aim of this study is to identify research priority areas for digital health in palliative care. Methods: We selected digital health trends, most relevant to palliative care, from a list of emerging trends reported by a leading institute of quantitative futurists. We conducted 2 rounds of the Delphi questionnaire, followed by a consensus meeting and public engagement workshop to establish a final consensus on research priorities for digital technology in palliative care. We used the views of public representatives to gain their perspectives on the agreed priorities. Results: A total of 103 experts (representing 11 countries) participated in the first Delphi round. Of the 103 experts, 55 (53.3\%) participated in the second round. The final consensus meetings were attended by 10.7\% (11/103) of the experts. We identified 16 priority areas, which involved many applications of technologies, including care for patients and caregivers, self-management and reporting of diseases, education and training, communication, care coordination, and research methodology. We summarized the priority areas into eight topics: big data, mobile devices, telehealth and telemedicine, virtual reality, artificial intelligence, smart home, biotechnology, and digital legacy. Conclusions: The priorities identified in this study represent a wide range of important emerging areas in the fields of digital health, personalized medicine, and data science. Human-centered design and robust governance systems should be considered in future research. It is important that the risks of using these technologies in palliative care are properly addressed to ensure that these tools are used meaningfully, wisely, and safely and do not cause unintentional harm. ",
doi="10.2196/32075",
url="https://aging.jmir.org/2022/1/e32075",
url="http://www.ncbi.nlm.nih.gov/pubmed/35311674"
}


@Article{info:doi/10.2196/28333,
author="Ferrario, Andrea
and Luo, Minxia
and Polsinelli, J. Angelina
and Moseley, A. Suzanne
and Mehl, R. Matthias
and Yordanova, Kristina
and Martin, Mike
and Demiray, Burcu",
title="Predicting Working Memory in Healthy Older Adults Using Real-Life Language and Social Context Information: A Machine Learning Approach",
journal="JMIR Aging",
year="2022",
month="Mar",
day="8",
volume="5",
number="1",
pages="e28333",
keywords="cognitive aging",
keywords="language complexity",
keywords="social context",
keywords="machine learning",
keywords="natural language processing",
keywords="Electronically Activated Recorder (EAR)",
keywords="behavioral indicators",
abstract="Background: Language use and social interactions have demonstrated a close relationship with cognitive measures. It is important to improve the understanding of language use and behavioral indicators from social context to study the early prediction of cognitive decline among healthy populations of older adults. Objective: This study aimed at predicting an important cognitive ability, working memory, of 98 healthy older adults participating in a 4-day-long naturalistic observation study. We used linguistic measures, part-of-speech (POS) tags, and social context information extracted from 7450 real-life audio recordings of their everyday conversations. Methods: The methods in this study comprise (1) the generation of linguistic measures, representing idea density, vocabulary richness, and grammatical complexity, as well as POS tags with natural language processing (NLP) from the transcripts of real-life conversations and (2) the training of machine learning models to predict working memory using linguistic measures, POS tags, and social context information. We measured working memory using (1) the Keep Track test, (2) the Consonant Updating test, and (3) a composite score based on the Keep Track and Consonant Updating tests. We trained machine learning models using random forest, extreme gradient boosting, and light gradient boosting machine algorithms, implementing repeated cross-validation with different numbers of folds and repeats and recursive feature elimination to avoid overfitting. Results: For all three prediction routines, models comprising linguistic measures, POS tags, and social context information improved the baseline performance on the validation folds. The best model for the Keep Track prediction routine comprised linguistic measures, POS tags, and social context variables. The best models for prediction of the Consonant Updating score and the composite working memory score comprised POS tags only. Conclusions: The results suggest that machine learning and NLP may support the prediction of working memory using, in particular, linguistic measures and social context information extracted from the everyday conversations of healthy older adults. Our findings may support the design of an early warning system to be used in longitudinal studies that collects cognitive ability scores and records real-life conversations unobtrusively. This system may support the timely detection of early cognitive decline. In particular, the use of a privacy-sensitive passive monitoring technology would allow for the design of a program of interventions to enable strategies and treatments to decrease or avoid early cognitive decline. ",
doi="10.2196/28333",
url="https://aging.jmir.org/2022/1/e28333",
url="http://www.ncbi.nlm.nih.gov/pubmed/35258457"
}


@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"
}