%0 Journal Article %@ 1438-8871 %I JMIR Publications %V 27 %N %P e62824 %T The Impact of the COVID-19 Pandemic on Oldest-Old Social Capital and Health and the Role of Digital Inequalities: Longitudinal Cohort Study %A Valla,Luca Guido %A Rossi,Michele %A Gaia,Alessandra %A Guaita,Antonio %A Rolandi,Elena %+ Centre for Longitudinal Studies, UCL Social Research Institute, University College London, Room 101, 55-59 Gordon Square, London, WC1H 0AL, United Kingdom, 44 02076792000, a.gaia@ucl.ac.uk %K older adults %K information and communication technology %K ICT %K ICT use %K COVID-19 %K social capital %K health %K mental health %K digital divide %D 2025 %7 9.1.2025 %9 Original Paper %J J Med Internet Res %G English %X Background: During the COVID-19 pandemic, information and communication technology (ICT) became crucial for staying connected with loved ones and accessing health services. In this scenario, disparities in ICT use may have exacerbated other forms of inequality, especially among older adults who were less familiar with technology and more vulnerable to severe COVID-19 health consequences. Objective: This study investigated changes in ICT use, psychological and physical health, and social capital before and after the pandemic among the oldest old population (aged 80 years or older after the pandemic) and explored how internet use influenced these changes. Methods: We leveraged data from the InveCe.Ab study, a population-based longitudinal cohort of people born between 1935 and 1939 and living in Abbiategrasso, a municipality on the outskirts of Milan, Italy. Participants underwent multidimensional assessment at baseline (2010) and after 2, 4, 8, and 12 years. We restricted our analysis to cohort members who participated in the last wave (ie, 2022) and who did not have a diagnosis of dementia (n=391). We used linear mixed models to assess the impact of COVID-19 and time on changes in social capital, physical and psychological health, and ICT use in a discontinuity regression design while controlling for age, sex, education, and income satisfaction. Then, we assessed the influence of internet use and its interaction with COVID-19 on these changes. Results: COVID-19 had a significant impact on social relationships (β=–4.35, 95% CI 6.38 to –2.32; P<.001), cultural activities (β=–.55, 95% CI –0.75 to –0.35; P<.001), cognitive functioning (β=–1.00, 95% CI –1.28 to –0.72; P<.001), depressive symptoms (β=.42, 95% CI 0.10-0.74; P=.009), physical health (β=.07, 95% CI 0.04-0.10; P<.001), and ICT use (β=–.11, 95% CI –0.18 to –0.03; P=.008). Internet use predicts reduced depressive symptoms (β=–.56, 95% CI –1.07 to –0.06; P=.03) over time. The interaction between internet use and COVID-19 was significant for cultural activities (β=–.73, 95% CI –1.22 to –0.24; P=.003) and cognitive functioning (β=1.36, 95% CI 0.67-2.05; P<.001). Conclusions: The pandemic had adverse effects on older adults’ health and social capital. Contrary to expectations, even ICT use dropped significantly after the pandemic. Internet users maintained higher psychological health regardless of time and COVID-19 status. However, COVID-19 was associated with a steeper decline in cognitive functioning among internet nonusers. Policy makers may develop initiatives to encourage ICT adoption among older adults or strengthen their digital skills. Trial Registration: ClinicalTrials.gov NCT01345110; https://clinicaltrials.gov/study/NCT01345110 %M 39784108 %R 10.2196/62824 %U https://www.jmir.org/2025/1/e62824 %U https://doi.org/10.2196/62824 %U http://www.ncbi.nlm.nih.gov/pubmed/39784108 %0 Journal Article %@ 2152-7202 %I JMIR Publications %V 16 %N %P e54841 %T Assessing the Quality of an Online Democratic Deliberation on COVID-19 Pandemic Triage Protocols for Access to Critical Care in an Extreme Pandemic Context: Mixed Methods Study %A Calderon Ramirez,Claudia Lucrecia %A Farmer,Yanick %A Downar,James %A Frolic,Andrea %A Opatrny,Lucie %A Poirier,Diane %A Bravo,Gina %A L'Espérance,Audrey %A Gaucher,Nathalie %A Payot,Antoine %A Dahine,Joseph %A Tanuseputro,Peter %A Rousseau,Louis-Martin %A Dumez,Vincent %A Descôteaux,Annie %A Dallaire,Clara %A Laporte,Karell %A Bouthillier,Marie-Eve %+ Université de Montréal, 2900 Bd Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada, 1 (450) 668 1010 ext 24228, marie-eve.bouthillier@umontreal.ca %K quality assessment %K online democratic deliberation %K COVID-19 triage or prioritization %K critical care %K clinical ethics %D 2024 %7 11.11.2024 %9 Original Paper %J J Particip Med %G English %X Background: Online democratic deliberation (ODD) may foster public engagement in new health strategies by providing opportunities for knowledge exchange between experts, policy makers, and the public. It can favor decision-making by generating new points of view and solutions to existing problems. Deliberation experts recommend gathering feedback from participants to optimize future implementation. However, this online modality has not been frequently evaluated. Objective: This study aims to (1) assess the quality of an ODD held in Quebec and Ontario, Canada, on the topic of COVID-19 triage protocols for access to critical care in an extreme pandemic context and (2) determine its transformative aspect according to the perceptions of participants. Methods: We conducted a simultaneous ODD in Quebec and Ontario on May 28 and June 4, 2022, with a diversified target audience not working in the health care system. We used a thematic analysis for the transcripts of the deliberation and the written comments of the participants related to the quality of the process. Participants responded to a postdeliberation questionnaire to assess the quality of the ODD and identify changes in their perspectives on COVID-19 pandemic triage protocols after the deliberation exercise. Descriptive statistics were used. An index was calculated to determine equality of participation. Results: The ODD involved 47 diverse participants from the public (n=20, 43% from Quebec and n=27, 57% from Ontario). Five themes emerged: (1) process appreciation, (2) learning experience, (3) reflecting on the common good, (4) technological aspects, and (5) transformative aspects. A total of 46 participants responded to the questionnaire. Participants considered the quality of the ODD satisfactory in terms of process, information shared, reasoning, and videoconferencing. A total of 4 (80%) of 5 participants reported at least 1 change of perspective on some of the criteria and values discussed. Most participants reported that the online modality was accessible and user-friendly. We found low polarization when calculating equal participation. Improvements identified were measures to replace participants when unable to connect and optimization of time during discussions. Conclusions: Overall, the participants perceived the quality of ODD as satisfactory. Some participants self-reported a change of opinion after deliberation. The online modality may be an acceptable alternative for democratic deliberation but with some organizational adaptations. %M 39527811 %R 10.2196/54841 %U https://jopm.jmir.org/2024/1/e54841 %U https://doi.org/10.2196/54841 %U http://www.ncbi.nlm.nih.gov/pubmed/39527811 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e58242 %T Habit and Help—Experiences of Technology Use During the COVID-19 Pandemic: Interview Study Among Older Adults %A Kilaberia,Tina R %A Hu,Yuanyuan %A Bell,Janice F %+ Silver School of Social Work, New York University, 1 Washington Square North, Room 315, New York, NY, 10003, United States, 1 212 998 5938, tk3127@nyu.edu %K pandemic %K older people %K technology habit %K subjective experience %K acceptance of technology %D 2024 %7 18.10.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: The COVID-19 pandemic compelled older adults to engage with technology to a greater extent given emergent public health observance and home-sheltering restrictions in the United States. This study examined subjective experiences of technology use among older adults as a result of unforeseen and widespread public health guidance catalyzing their use of technology differently, more often, or in new ways. Objective: This study aimed to explore whether older adults scoring higher on the Unified Theory of Acceptance and Use of Technology questionnaire fared better in aspects of technology use, and reported better subjective experiences, in comparison with those scoring lower. Methods: A qualitative study using prevalence and thematic analyses of data from 18 older adults (mean age 79 years) in 2 groups: 9 scoring higher and 9 scoring lower on the Unified Theory of Acceptance and Use of Technology questionnaire. Results: Older adults were fairly competent technology users across both higher- and lower-scoring groups. The higher-scoring group noted greater use of technology in terms of telehealth and getting groceries and household items. Cognitive difficulty was described only among the lower-scoring group; they used technology less to get groceries and household items and to obtain health information. Qualitative themes depict the role of habit in technology use, enthusiasm about technology buttressed by the protective role of technology, challenges in technology use, and getting help regardless of technology mastery. Conclusions: Whereas the pandemic compelled older adults to alter or increase technology use, it did not change their global outlook on technology use. Older adults’ prepandemic habits of technology use and available help influenced the degree to which they made use of technology during the COVID-19 pandemic. %M 39422990 %R 10.2196/58242 %U https://formative.jmir.org/2024/1/e58242 %U https://doi.org/10.2196/58242 %U http://www.ncbi.nlm.nih.gov/pubmed/39422990 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 13 %N %P e52643 %T The Association Between Physical Distancing Behaviors to Avoid COVID-19 and Health-Related Quality of Life in Immunocompromised and Nonimmunocompromised Individuals: Patient-Informed Protocol for the Observational, Cross-Sectional EAGLE Study %A Williams,Paul %A Herring,Timothy A %A Yokota,Renata T C %A Maia,Tiago %A Venkatesan,Sudhir %A Marcus,James C %A Settergren,Gabriella %A Arnetorp,Sofie %A Lloyd,Andrew %A Severens,Johan L %A Varni,James W %A Dixon,Sharon %A Hamusankwa,Lweendo %A Powell,Philip A %A Taylor,Sylvia %A Ware Jr,John E %A Krol,Marieke %+ Global Evidence, BioPharmaceuticals Medical, AstraZeneca, Pepparedsleden 1, Gothenburg, SE-431 83, Sweden, 46 722198256, paul.williams8@astrazeneca.com %K SARS-CoV-2 %K social isolation %K patient participation %K patient-reported outcome measures %K quality of life %K immunosuppression %K respiratory tract infection %K cost of illness %K surveys and questionnaires %K protocol %D 2024 %7 13.8.2024 %9 Protocol %J JMIR Res Protoc %G English %X Background: Immunocompromised individuals are known to respond inadequately to SARS-CoV-2 vaccines, placing them at high risk of severe or fatal COVID-19. Thus, immunocompromised individuals and their caregivers may still practice varying degrees of social or physical distancing to avoid COVID-19. However, the association between physical distancing to avoid COVID-19 and quality of life has not been comprehensively evaluated in any study. Objective: We aim to measure physical distancing behaviors among immunocompromised individuals and the association between those behaviors and person-centric outcomes, including health-related quality of life (HRQoL) measures, health state utilities, anxiety and depression, and work and school productivity impairment. Methods: A patient-informed protocol was developed to conduct the EAGLE Study, a large cross-sectional, observational study, and this paper describes that protocol. EAGLE is designed to measure distancing behaviors and outcomes in immunocompromised individuals, including children (aged ≥6 mo) and their caregivers, and nonimmunocompromised adults in the United States and United Kingdom who report no receipt of passive immunization against COVID-19. We previously developed a novel self- and observer-reported instrument, the Physical Distancing Scale for COVID-19 Avoidance (PDS-C19), to measure physical distancing behavior levels cross-sectionally and retrospectively. Using an interim or a randomly selected subset of the study population, the PDS-C19 psychometric properties will be assessed, including structural validity, internal consistency, known-group validity, and convergent validity. Associations (correlations) will be assessed between the PDS-C19 and validated HRQoL-related measures and utilities. Structural equation modeling and regression will be used to assess these associations, adjusting for potential confounders. Participant recruitment and data collection took place from December 2022 to June 2023 using direct-to-patient channels, including panels, clinician referral, patient advocacy groups, and social media, with immunocompromising diagnosis confirmation collected and assessed for a randomly selected 25% of immunocompromised participants. The planned total sample size is 3718 participants and participant-caregiver pairs. Results will be reported by immunocompromised status, immunocompromising condition category, country, age group, and other subgroups. Results: All data analyses and reporting were planned to be completed by December 2023. Results are planned to be submitted for publication in peer-reviewed journals in 2024-2025. Conclusions: This study will quantify immunocompromised individuals’ physical distancing behaviors to avoid COVID-19 and their association with HRQoL as well as health state utilities. International Registered Report Identifier (IRRID): RR1-10.2196/52643 %M 39137022 %R 10.2196/52643 %U https://www.researchprotocols.org/2024/1/e52643 %U https://doi.org/10.2196/52643 %U http://www.ncbi.nlm.nih.gov/pubmed/39137022 %0 Journal Article %@ 2369-2960 %I JMIR Publications %V 10 %N %P e51891 %T National and Regional Trends in the Prevalence of Hypertension in South Korea Amid the Pandemic, 2009-2022: Nationwide Study of Over 3 Million Individuals %A Lee,Hyeri %A Kim,Minji %A Woo,Selin %A Park,Jaeyu %A Kim,Hyeon Jin %A Kwon,Rosie %A Koyanagi,Ai %A Smith,Lee %A Kim,Min Seo %A López Sánchez,Guillermo F %A Dragioti,Elena %A Lee,Jinseok %A Lee,Hayeon %A Rahmati,Masoud %A Rhee,Sang Youl %A Lee,Jun Hyuk %A Woo,Ho Geol %A Yon,Dong Keon %+ Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea, 82 2 961 0680, yonkkang@gmail.com %K COVID-19 %K pandemic %K Korea %K hypertension %K HPN %K high blood pressure %K prevalence %K national trends %K regional trends %K nationwide study %K socioeconomic %K trends %K participant %K population based %K cross-sectional study %K treatment %D 2024 %7 30.7.2024 %9 Original Paper %J JMIR Public Health Surveill %G English %X Background: Understanding the association between hypertension prevalence and socioeconomic and behavioral variables during a pandemic is essential, and this analysis should extend beyond short-term trends. Objective: This study aims to examine long-term trends in the prevalence of participants diagnosed with and receiving treatment for hypertension, using data collected by a nationally representative survey from 2009 to 2022, which includes the COVID-19 pandemic era. Methods: A nationwide, population-based, cross-sectional study used data collected from the South Korea Community Health Survey between 2009 and 2022. The study sample comprised 3,208,710 Korean adults over a period of 14 years. We aimed to assess trends in the prevalence of participants diagnosed with and receiving treatment for hypertension in the national population from 2009 to 2022, with a specific focus on the COVID-19 pandemic, using weighted linear regression models. Results: Among the included 3,072,546 Korean adults, 794,239 (25.85%) were aged 19-39 years, 1,179,388 (38.38%) were aged 40-59 years; 948,097 (30.86%) were aged 60-79 years, and 150,822 (4.91%) were aged 80 years or older. A total of 1,426,379 (46.42%) were men; 761,896 (24.80%) and 712,264 (23.18%) were diagnosed with and received treatment for hypertension, respectively. Although the overall prevalence over the 14-year period increased, the upward trends of patients diagnosed with and receiving treatment for hypertension decreased during the COVID-19 pandemic era compared with the prepandemic era (β difference for trend during vs before the pandemic –.101, 95% CI –0.107 to –0.094 vs –.133, 95% CI –0.140 to –0.127). Notably, the trends in prevalence during the pandemic were less pronounced in subgroups of older adults (≥60 years old) and individuals with higher alcohol consumption (≥5 days/month). Conclusions: This nationwide representative study found that the national prevalence of participants diagnosed with and receiving treatment for hypertension increased during the prepandemic era. However, there was a marked decrease in these trends during the prepandemic era, compared with the pandemic era, particularly among specific subgroups at increased risk of negative outcomes. Future studies are needed to evaluate the factors associated with changes in the prevalence of hypertension during the COVID-19 pandemic. %M 39078683 %R 10.2196/51891 %U https://publichealth.jmir.org/2024/1/e51891 %U https://doi.org/10.2196/51891 %U http://www.ncbi.nlm.nih.gov/pubmed/39078683 %0 Journal Article %@ 2369-2960 %I %V 10 %N %P e37625 %T A Novel Web-Based Application for Influenza and COVID-19 Outbreak Detection and Response in Residential Aged Care Facilities %A Hsiao,Kai Hsun %A Quinn,Emma %A Johnstone,Travers %A Gomez,Maria %A Ingleton,Andrew %A Parasuraman,Arun %A Najjar,Zeina %A Gupta,Leena %K web application %K digital health %K communicable disease control %K outbreak %K surveillance %K influenza %K aged care %K aged care homes %D 2024 %7 24.6.2024 %9 %J JMIR Public Health Surveill %G English %X The use of innovative digital health technologies in public health is expanding quickly, including the use of these tools in outbreak response. The translation of a digital health innovation into effective public health practice is a complex process requiring diverse enablers across the people, process, and technology domains. This paper describes a novel web-based application that was designed and implemented by a district-level public health authority to assist residential aged care facilities in influenza and COVID-19 outbreak detection and response. It discusses some of the challenges, enablers, and key lessons learned in designing and implementing such a novel application from the perspectives of the public health practitioners (the authors) that undertook this project. %R 10.2196/37625 %U https://publichealth.jmir.org/2024/1/e37625 %U https://doi.org/10.2196/37625 %0 Journal Article %@ 2561-7605 %I JMIR Publications %V 6 %N %P e43185 %T Use of a Data Repository to Identify Delirium as a Presenting Symptom of COVID-19 Infection in Hospitalized Adults: Cross-Sectional Cohort Pilot Study %A Solberg,Laurence M %A Duckworth,Laurie J %A Dunn,Elizabeth M %A Dickinson,Theresa %A Magoc,Tanja %A Snigurska,Urszula A %A Ser,Sarah E %A Celso,Brian %A Bailey,Meghan %A Bowen,Courtney %A Radhakrishnan,Nila %A Patel,Chirag R %A Lucero,Robert %A Bjarnadottir,Ragnhildur I %+ Geriatrics Research, Education, and Clinical Center, North Florida/South Georgia Veterans Health System, Veterans Health Administration, 1601 South West Archer Road, GRECC-182, Gainesville, FL, 32608, United States, 1 3525486000 ext 105033, lmsolberg@ufl.edu %K COVID-19 %K delirium %K neurocognitive disorder %K data repository %K adults %K pilot study %K symptom %K electronic health record %K viral infection %K clinical %K patient %K research %K diagnosis %K disorder %K memory %K covid %K memory loss %K old %K old age %D 2023 %7 30.11.2023 %9 Original Paper %J JMIR Aging %G English %X Background: Delirium, an acute confusional state highlighted by inattention, has been reported to occur in 10% to 50% of patients with COVID-19. People hospitalized with COVID-19 have been noted to present with or develop delirium and neurocognitive disorders. Caring for patients with delirium is associated with more burden for nurses, clinicians, and caregivers. Using information in electronic health record data to recognize delirium and possibly COVID-19 could lead to earlier treatment of the underlying viral infection and improve outcomes in clinical and health care systems cost per patient. Clinical data repositories can further support rapid discovery through cohort identification tools, such as the Informatics for Integrating Biology and the Bedside tool. Objective: The specific aim of this research was to investigate delirium in hospitalized older adults as a possible presenting symptom in COVID-19 using a data repository to identify neurocognitive disorders with a novel group of International Classification of Diseases, Tenth Revision (ICD-10) codes. Methods: We analyzed data from 2 catchment areas with different demographics. The first catchment area (7 counties in the North-Central Florida) is predominantly rural while the second (1 county in North Florida) is predominantly urban. The Integrating Biology and the Bedside data repository was queried for patients with COVID-19 admitted to inpatient units via the emergency department (ED) within the health center from April 1, 2020, and April 1, 2022. Patients with COVID-19 were identified by having a positive COVID-19 laboratory test or a diagnosis code of U07.1. We identified neurocognitive disorders as delirium or encephalopathy, using ICD-10 codes. Results: Less than one-third (1437/4828, 29.8%) of patients with COVID-19 were diagnosed with a co-occurring neurocognitive disorder. A neurocognitive disorder was present on admission for 15.8% (762/4828) of all patients with COVID-19 admitted through the ED. Among patients with both COVID-19 and a neurocognitive disorder, 56.9% (817/1437) were aged ≥65 years, a significantly higher proportion than those with no neurocognitive disorder (P<.001). The proportion of patients aged <65 years was significantly higher among patients diagnosed with encephalopathy only than patients diagnosed with delirium only and both delirium and encephalopathy (P<.001). Most (1272/4828, 26.3%) patients with COVID-19 admitted through the ED during our study period were admitted during the Delta variant peak. Conclusions: The data collected demonstrated that an increased number of older patients with neurocognitive disorder present on admission were infected with COVID-19. Knowing that delirium increases the staffing, nursing care needs, hospital resources used, and the length of stay as previously noted, identifying delirium early may benefit hospital administration when planning for newly anticipated COVID-19 surges. A robust and accessible data repository, such as the one used in this study, can provide invaluable support to clinicians and clinical administrators in such resource reallocation and clinical decision-making. %M 37910448 %R 10.2196/43185 %U https://aging.jmir.org/2023/1/e43185 %U https://doi.org/10.2196/43185 %U http://www.ncbi.nlm.nih.gov/pubmed/37910448 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e49817 %T Demographic, Clinical, and Quality of Life Profiles of Older People With Diabetes During the COVID-19 Pandemic: Cross-Sectional Study %A Sousa,Fabianne %A de Araujo,Lucianne Nascimento %A de Oliveira,Tainá Sayuri Onuma %A Gomes,Mateus Cunha %A Ferreira,Glenda %A Aben-Athar,Cintia %A da Silva,Silvio Eder Dias %A Cruz Ramos,Aline MP %A Rodrigues,Diego Pereira %+ Nursing School, Federal University of Para, Rua Agusto Correa 1 S/N, Belém, 66075-110, Brazil, 55 91 981219404, fabiannesousa@hotmail.com %K aged %K diabetes mellitus %K COVID-19 %K cross-sectional study %K quality of life %K long COVID-19 %K diabetic %K older people %D 2023 %7 16.11.2023 %9 Original Paper %J JMIR Form Res %G English %X Background: Diabetes mellitus, one of the main diseases that affects the Brazilian population older than 60 years, is defined as a divergent group of metabolic disorders that present a high level of glycemia (hyperglycemia), causing damage to various organs and systems of the body, including the heart, kidneys, eyes, and nervous system. It is believed that in 2025, in Brazil alone, there will be more than 18.5 million individuals diagnosed with diabetes mellitus. Therefore, it is important to know the individuals’ quality of life in the context of life and culture. Objective: This study aimed to assess the demographic, clinical, and quality of life profiles of older adults with diabetes during the COVID-19 pandemic in a university hospital complex in the northern Amazon region. Methods: We conducted a cross-sectional, exploratory, noninterventional, descriptive, and analytical study using a nonrandom sample of 54 older people diagnosed with diabetes mellitus at the geriatrics outpatient clinic of the medium and high complexity university hospital in the western Brazilian Amazon between 2020 and 2022. We used 3 instruments, namely, a sociodemographic questionnaire, a clinical conditions questionnaire, and Diabetes-39. Qualitative data were described using absolute and relative frequencies. The Kolmogorov-Smirnov normality test was applied, and the z test was used for inferential analysis. SPSS software (version 27) was used for data analysis, and the significance level was 5%. Results: Of the 54 interviewees, the majority were women, married, retired, and had a good quality of life. Of these, 48.1% (n=26) were infected by COVID-19, 61.5% (n=16) of whom progressed to long COVID, presenting with fatigue or muscle weakness. As for the quality of life, the “social overload” (P<.001) and “sexual functioning” (P<.001) dimensions had with low scores compared to the “energy and mobility” (P=.005), “diabetes control” (P<.001), and “anxiety and worry” (P<.001) dimensions. Quality of life was negatively impacted in the “anxiety and worry” dimension. Among those affected by COVID-19, most progressed to long COVID; however, there was a lack of data on this theme in the population of older people with diabetes. Conclusions: The majority of interviewees progressed to long COVID, with their quality of life negatively impacted in the “anxiety and worry” dimension, reflecting that health actions prioritizing mental health should be implemented by health professionals. %M 37971795 %R 10.2196/49817 %U https://formative.jmir.org/2023/1/e49817 %U https://doi.org/10.2196/49817 %U http://www.ncbi.nlm.nih.gov/pubmed/37971795 %0 Journal Article %@ 2561-7605 %I JMIR Publications %V 6 %N %P e42517 %T Older Adults’ Trust and Distrust in COVID-19 Public Health Information: Qualitative Critical Incident Study %A Shiroma,Kristina %A Zimmerman,Tara %A Xie,Bo %A Fleischmann,Kenneth R %A Rich,Kate %A Lee,Min Kyung %A Verma,Nitin %A Jia,Chenyan %+ School of Information, The University of Texas at Austin, 1616 Guadalupe St, Suite 5.202, Austin, TX, 78701, United States, 1 5124713821, kristinashiroma@utexas.edu %K health information %K information-seeking behavior %K COVID-19 %K qualitative research methods %K communication %K media and networks %K aging %K older adults %K elderly population %K mass media %K public health information %K trust %D 2023 %7 9.11.2023 %9 Original Paper %J JMIR Aging %G English %X Background: The COVID-19 infodemic has imposed a disproportionate burden on older adults who face increased challenges in accessing and assessing public health information, but little is known about factors influencing older adults’ trust in public health information during COVID-19. Objective: This study aims to identify sources that older adults turn to for trusted COVID-19 public health information and factors that influence their trust. In addition, we explore the relationship between public health information sources and trust factors. Methods: Adults aged 65 years or older (N=30; mean age 71.6, SD 5.57; range 65-84 years) were recruited using Prime Panels. Semistructured phone interviews, guided by critical incident technique, were conducted in October and November 2020. Participants were asked about their sources of COVID-19 public health information, the trustworthiness of that information, and factors influencing their trust. Interview data were examined with thematic analysis. Results: Mass media, known individuals, and the internet were the older adults’ main sources for COVID-19 public health information. Although they used social media for entertainment and personal communication, the older adults actively avoided accessing or sharing COVID-19 information on social media. Factors influencing their trust in COVID-19 public health information included confirmation bias, personal research, resigned acceptance, and personal relevance. Conclusions: These findings shed light on older adults’ use of information sources and their criteria for evaluating the trustworthiness of public health information during a pandemic. They have implications for the future development of effective public health communication, policies, and interventions for older adults during health crises. %M 37856774 %R 10.2196/42517 %U https://aging.jmir.org/2023/1/e42517 %U https://doi.org/10.2196/42517 %U http://www.ncbi.nlm.nih.gov/pubmed/37856774 %0 Journal Article %@ 2561-7605 %I JMIR Publications %V 6 %N %P e42707 %T COVID-19 Infodemic and Impacts on the Mental Health of Older People: Cross-sectional Multicenter Survey Study %A Braz,Patricia Rodrigues %A Moreira,Tiago Ricardo %A Ribeiro,Andréia Queiroz %A de Faria,Luciane Ribeiro %A Carbogim,Fabio da Costa %A Püschel,Vilanice Alves de Araújo %A Fhon,Jack Roberto Silva %A Freitas,Eduarda Rezende %A Pinto,Ione Carvalho %A Zacharias,Fabiana Costa Machado %A Cruz,Gylce Eloisa Cabreira Panitz %A Machado,Richardson Miranda %A Santana,Rosimere Ferreira %A de Souza,Priscilla Alfradique %A Bitencourt,Graziele Ribeiro %A Bulgarelli,Alexandre Favero %A Cavalcante,Ricardo Bezerra %+ Universidade Federal de Juiz de Fora, Campus Universitário, Rua José Lourenço Kelmer, s/n - São Pedro, Juiz de Fora - MG, 36036-900, Brazil, 55 32 85033443, ricardo.cavalcante@ufjf.br %K information dissemination %K health communication %K COVID-19 %K COVID-19 pandemic %K public health %K health of older people %K mental health %D 2023 %7 17.5.2023 %9 Original Paper %J JMIR Aging %G English %X Background: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary “infodemic” that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people’s reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. Objective: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). Methods: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. Results: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that “some” social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. Conclusions: Older people, especially women, were often exposed to COVID-19–related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care. %M 37195762 %R 10.2196/42707 %U https://aging.jmir.org/2023/1/e42707 %U https://doi.org/10.2196/42707 %U http://www.ncbi.nlm.nih.gov/pubmed/37195762 %0 Journal Article %@ 2561-7605 %I JMIR Publications %V 6 %N %P e41692 %T Pandemic-Related Changes in Technology Use Among a Sample of Previously Hospitalized Older Adult New Yorkers: Observational Study %A Drazich,Brittany F %A Lee,Ji Won %A Bowles,Kathryn H %A Taylor,Janiece L %A Shah,Shivani %A Resnick,Barbara %A Kim,Nayeon %A Szanton,Sarah L %+ School of Nursing, University of Maryland, 655 W Lombard St, Baltimore, MD, 21201, United States, 1 410 706 0501, brittdrazich@gmail.com %K older adults %K technology %K COVID-19 %K well-being %K elderly population %K technology use %K physical disability %K virtual health %K social interaction %K digital gaming %K digital learning %D 2023 %7 29.3.2023 %9 Original Paper %J JMIR Aging %G English %X Background: The COVID-19 pandemic increased the importance of technology for all Americans, including older adults. Although a few studies have indicated that older adults might have increased their technology use during the COVID-19 pandemic, further research is needed to confirm these findings, especially among different populations, and using validated surveys. In particular, research on changes in technology use among previously hospitalized community-dwelling older adults, especially those with physical disability, is needed because older adults with multimorbidity and hospital associated deconditioning were a population greatly impacted by COVID-19 and related distancing measures. Obtaining knowledge regarding previously hospitalized older adults’ technology use, before and during the pandemic, could inform the appropriateness of technology-based interventions for vulnerable older adults. Objective: In this paper, we 1) described changes in older adult technology-based communication, technology-based phone use, and technology-based gaming during the COVID-19 pandemic, compared to before the COVID-19 pandemic and 2) tested whether technology use moderated the association between changes in in-person visits and well-being, controlling for covariates. Methods: Between December 2020 and January 2021 we conducted a telephone-based objective survey with 60 previously hospitalized older New Yorkers with physical disability. We measured technology-based communication through three questions pulled from the National Health and Aging Trends Study COVID-19 Questionnaire. We measured technology-based smart phone use and technology-based video gaming through the Media Technology Usage and Attitudes Scale. We used paired t tests and interaction models to analyze survey data. Results: This sample of previously hospitalized older adults with physical disability consisted of 60 participants, 63.3% of whom identified as female, 50.0% of whom identified as White, and 63.8% of whom reported an annual income of $25,000 or less. This sample had not had physical contact (such as friendly hug or kiss) for a median of 60 days and had not left their home for a median of 2 days. The majority of older adults from this study reported using the internet, owning smart phones, and nearly half learned a new technology during the pandemic. During the pandemic, this sample of older adults significantly increased their technology-based communication (mean difference=.74, P=.003), smart phone use (mean difference=2.9, P=.016), and technology-based gaming (mean difference=.52, P=.030). However, this technology use during the pandemic did not moderate the association between changes in in-person visits and well-being, controlling for covariates. Conclusions: These study findings suggest that previously hospitalized older adults with physical disability are open to using or learning technology, but that technology use might not be able to replace in-person social interactions. Future research might explore the specific components of in-person visits that are missing in virtual interactions, and if they could be replicated in the virtual environment, or through other means. %M 36881528 %R 10.2196/41692 %U https://aging.jmir.org/2023/1/e41692 %U https://doi.org/10.2196/41692 %U http://www.ncbi.nlm.nih.gov/pubmed/36881528 %0 Journal Article %@ 2561-7605 %I JMIR Publications %V 6 %N %P e42223 %T The Changes in Levels and Barriers of Physical Activity Among Community-Dwelling Older Adults During and After the Fifth Wave of COVID-19 Outbreak in Hong Kong: Repeated Random Telephone Surveys %A Wang,Zixin %A Fang,Yuan %A Chan,Paul Shing-Fong %A Yu,Fuk Yuen %A Sun,Fenghua %+ Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Room 508, School of Public Health, Prince of Wales Hospital, Ngan Shing St, Sha Tin, Hong Kong, Hong Kong, 852 22528740, wangzx@cuhk.edu.hk %K COVID-19 %K physical activity %K older adults %K barriers %K changes %K repeated random telephone survey %K China %K aging %K elderly population %K community-dwelling older adults %K health promotion %K telehealth %D 2023 %7 23.1.2023 %9 Original Paper %J JMIR Aging %G English %X Background: COVID-19 has had an impact on physical activity (PA) among older adults; however, it is unclear whether this effect would be long-lasting, and there is a dearth of studies assessing the changes in barriers to performing PA among older adults before and after entering the “postpandemic era.” Objective: The aim of this study was to compare the levels and barriers of PA among a random sample of community-dwelling older adults recruited during (February to April 2022) and after the fifth wave of the COVID-19 outbreak (May to July 2022) in Hong Kong. In addition, we investigated factors associated with a low PA level among participants recruited at different time points. Methods: This study involved two rounds of random telephone surveys. Participants were community-dwelling Chinese-speaking individuals aged 65 years or above and having a Hong Kong ID card. Household telephone numbers were randomly selected from the most updated telephone directories. Experienced interviewers carried out telephone interviews between 6 PM and 10 PM on weekdays and between 2 PM and 9 PM on Saturdays to avoid undersampling of working individuals. We called 3900 and 3840 households in the first and second round, respectively; for each round, 640 and 625 households had an eligible older adult and 395 and 370 completed the telephone survey, respectively. Results: As compared to participants in the first round, fewer participants indicated a low level of PA in the second round (28.6% vs 45.9%, P<.001). Participants in the second round had higher metabolic equivalent of tasks-minutes/week (median 1707.5 vs 840, P<.001) and minutes of moderate-to-vigorous PA per week (median 240 vs 105, P<.001) than those in the first round. After adjustment for significant background characteristics, participants who perceived a lack of physical capacity to perform PA (first round: adjusted odds ratio [AOR] 3.34, P=.001; second round: 2.92, P=.002) and believed that PA would cause pain and discomfort (first round: AOR 2.04, P=.02; second round: 2.82, P=.001) were more likely to have a low level of PA in both rounds. Lack of time (AOR 4.19, P=.01) and concern about COVID-19 infection during PA (AOR 1.73, P=.02) were associated with a low level of PA among participants in the first round, but not in the second round. A perceived lack of space and facility to perform PA at home (AOR 2.03, P=.02) and unable to find people to do PA with (AOR 1.80, P=.04) were associated with a low PA level in the second round, but not in the first round. Conclusions: The level of PA increased significantly among older adults after Hong Kong entered the “postpandemic era.” Different factors influenced older adults’ PA level during and after the fifth wave of the COVID-19 outbreak. Regular monitoring of the PA level and its associated factors should be conducted to guide health promotion and policy-making. %M 36599172 %R 10.2196/42223 %U https://aging.jmir.org/2023/1/e42223 %U https://doi.org/10.2196/42223 %U http://www.ncbi.nlm.nih.gov/pubmed/36599172 %0 Journal Article %@ 2291-9694 %I JMIR Publications %V 10 %N 3 %P e32949 %T Disease-Course Adapting Machine Learning Prognostication Models in Elderly Patients Critically Ill With COVID-19: Multicenter Cohort Study With External Validation %A Jung,Christian %A Mamandipoor,Behrooz %A Fjølner,Jesper %A Bruno,Raphael Romano %A Wernly,Bernhard %A Artigas,Antonio %A Bollen Pinto,Bernardo %A Schefold,Joerg C %A Wolff,Georg %A Kelm,Malte %A Beil,Michael %A Sviri,Sigal %A van Heerden,Peter V %A Szczeklik,Wojciech %A Czuczwar,Miroslaw %A Elhadi,Muhammed %A Joannidis,Michael %A Oeyen,Sandra %A Zafeiridis,Tilemachos %A Marsh,Brian %A Andersen,Finn H %A Moreno,Rui %A Cecconi,Maurizio %A Leaver,Susannah %A De Lange,Dylan W %A Guidet,Bertrand %A Flaatten,Hans %A Osmani,Venet %+ Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Moorenstraße 5, Duesseldorf, 40225, Germany, 49 2118118800, christian.jung@med.uni-duesseldorf.de %K machine-based learning %K outcome prediction %K COVID-19 %K pandemic %K machine learning %K prediction models %K clinical informatics %K patient data %K elderly population %D 2022 %7 31.3.2022 %9 Original Paper %J JMIR Med Inform %G English %X Background: The COVID-19 pandemic caused by SARS-CoV-2 is challenging health care systems globally. The disease disproportionately affects the elderly population, both in terms of disease severity and mortality risk. Objective: The aim of this study was to evaluate machine learning–based prognostication models for critically ill elderly COVID-19 patients, which dynamically incorporated multifaceted clinical information on evolution of the disease. Methods: This multicenter cohort study (COVIP study) obtained patient data from 151 intensive care units (ICUs) from 26 countries. Different models based on the Sequential Organ Failure Assessment (SOFA) score, logistic regression (LR), random forest (RF), and extreme gradient boosting (XGB) were derived as baseline models that included admission variables only. We subsequently included clinical events and time-to-event as additional variables to derive the final models using the same algorithms and compared their performance with that of the baseline group. Furthermore, we derived baseline and final models on a European patient cohort, which were externally validated on a non-European cohort that included Asian, African, and US patients. Results: In total, 1432 elderly (≥70 years old) COVID-19–positive patients admitted to an ICU were included for analysis. Of these, 809 (56.49%) patients survived up to 30 days after admission. The average length of stay was 21.6 (SD 18.2) days. Final models that incorporated clinical events and time-to-event information provided superior performance (area under the receiver operating characteristic curve of 0.81; 95% CI 0.804-0.811), with respect to both the baseline models that used admission variables only and conventional ICU prediction models (SOFA score, P<.001). The average precision increased from 0.65 (95% CI 0.650-0.655) to 0.77 (95% CI 0.759-0.770). Conclusions: Integrating important clinical events and time-to-event information led to a superior accuracy of 30-day mortality prediction compared with models based on the admission information and conventional ICU prediction models. This study shows that machine-learning models provide additional information and may support complex decision-making in critically ill elderly COVID-19 patients. Trial Registration: ClinicalTrials.gov NCT04321265; https://clinicaltrials.gov/ct2/show/NCT04321265 %M 35099394 %R 10.2196/32949 %U https://medinform.jmir.org/2022/3/e32949 %U https://doi.org/10.2196/32949 %U http://www.ncbi.nlm.nih.gov/pubmed/35099394 %0 Journal Article %@ 2561-7605 %I JMIR Publications %V 5 %N 1 %P e32957 %T Exploring Older Adults’ Adoption and Use of a Tablet Computer During COVID-19: Longitudinal Qualitative Study %A Kim,Sunyoung %A Yao,Willow %A Du,Xiaotong %+ School of Communication and Information, Rutgers University, 4 Huntington Street, New Brunswick, NJ, 08901, United States, 1 8489327585, sunyoung.kim@rutgers.edu %K older adults %K tablet computer %K technology acceptance %K mental model %K longitudinal study %K COVID-19 %D 2022 %7 8.3.2022 %9 Original Paper %J JMIR Aging %G English %X 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. %M 35134747 %R 10.2196/32957 %U https://aging.jmir.org/2022/1/e32957 %U https://doi.org/10.2196/32957 %U http://www.ncbi.nlm.nih.gov/pubmed/35134747 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 10 %N 9 %P e30802 %T Co-Development of a Web-Based Hub (eSocial-hub) to Combat Social Isolation and Loneliness in Francophone and Anglophone Older People in the Linguistic Minority Context (Quebec, Manitoba, and New Brunswick): Protocol for a Mixed Methods Interventional Study %A Beogo,Idrissa %A Ramdé,Jean %A Nguemeleu Tchouaket,Eric %A Sia,Drissa %A Bationo,Nebila Jean-Claude %A Collin,Stephanie %A Anne,Abdoulaye %A Gagnon,Marie-Pierre %+ École des sciences infirmières, Faculté des sciences de la santé, Université d'Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada, 1 6135625432, ibeogo@uottawa.ca %K older people %K nursing facility %K nursing home %K long-term care home %K linguistic minority %K digital health %K COVID-19 %K social isolation %K loneliness %K older adults %K development %K isolation %K minority %K community %D 2021 %7 15.9.2021 %9 Protocol %J JMIR Res Protoc %G English %X Background: The first wave of the COVID-19 pandemic has severely hit Canadian nursing facilities (81% of deaths). To this toll, public health measures (eg, visitation restriction) have subsequently deepened the social isolation and loneliness of residents in nursing facilities (NFs), especially those in linguistic minority settings: Anglophone institutions in Quebec and Francophone institutions outside Quebec. However, very few COVID-19 initiatives targeting these populations specifically have been documented. Given the limited number of NFs serving linguistic minorities in Canadian populations, families and loved ones often live far from these facilities, sometimes even in other provinces. This context places the digital solutions as particularly relevant for the present COVID-19 pandemic as well as in the post–COVID-19 era. Objective: This project aims to co-develop a virtual community of practice through a web-based platform (eSocial-hub) to combat social isolation and loneliness among the older people in linguistic minority settings in Canada. Methods: An interventional study using a sequential mixed methods design will be conducted. Four purposely selected NFs will be included, 2 among facilities in Manitoba and 2 in New Brunswick; and 2 Anglophone NFs in Quebec will serve as knowledge users. The development of eSocial-hub will include an experimental 4-month phase involving the following end users: (1) older people (n=3 per NF), (2) families of the participating older people (n=3 per NF), and (3) frontline staff (nurse and health care aid; n=2 per NF). Results: Activities and solutions aiming at reducing social isolation and loneliness will be implemented and then evaluated with the project stakeholders, and the best practices generated. The assessment will be conducted using indicators derived from the 5 domains of the Consolidated Framework for Implementation Research. The project will be led by an interdisciplinary team and will involve a multisectoral partnership. Conclusions: The project will develop a promising and generalizable solution that uses virtual technology to help reduce social isolation and loneliness among the older people. International Registered Report Identifier (IRRID): PRR1-10.2196/30802 %M 34464326 %R 10.2196/30802 %U https://www.researchprotocols.org/2021/9/e30802 %U https://doi.org/10.2196/30802 %U http://www.ncbi.nlm.nih.gov/pubmed/34464326 %0 Journal Article %@ 2561-7605 %I JMIR Publications %V 4 %N 3 %P e28989 %T A Sociodemographic Profile of Mask Use During the COVID-19 Outbreak Among Young and Elderly Individuals in Brazil: Online Survey Study %A Vancini,Rodrigo L %A Camargo-Neto,Luiz %A Andrade,Marilia S %A de Lira,Claudio A %A dos Santos,Rafaela G %A Nikolaidis,Pantelis T %A Knechtle,Beat %A Piacezzi,Luiz HV %A Teixeira-Lopes,Maria CB %A Assayag-Batista,Ruth E %A Pinto-Okuno,Meiry F %A Vancini-Campanharo,Cássia R %+ Institute of Primary Care, University of Zurich, Pestalozzistrasse 24, Zürich, 8091, Switzerland, 41 44 255 98 55, beat.knechtle@hispeed.ch %K aging %K older adults %K COVID-19 %K pandemic %K sociodemographic profile %K face mask %K social media %K online media %K adolescents %D 2021 %7 14.9.2021 %9 Original Paper %J JMIR Aging %G English %X Background: Sociodemographic variables may impact decision making regarding safety measures. The use and selection of adequate face masks is a safety and health measure that could help minimize the spread of COVID-19 infection. Objective: This study aims to examine sociodemographic variables and factors relating to COVID-19 that could impact decision making or the choice to use or not use face masks in the prevention and care of a possible COVID-19 infection among a large sample of younger and older Brazilian people. Methods: An online survey composed of 14 closed-ended questions about sociodemographic variables and COVID-19 was used. A total of 2673 participants consisted of Brazilian people (aged ≥18 years) from different states of Brazil and were grouped according to age (≤59 years and ≥60 years). To compare the variables of interest (associated with wearing a face mask or not), chi-square and likelihood ratio tests were used (with P<.05 being significant). Results: Most of the participants in both groups were women from the southeast region who had postgraduate degrees. Approximately 61% (1452/2378) of individuals aged ≤59 years and 67.8% (200/295) of those aged ≥60 years were not health professionals. In the group aged ≤59 years, 83.4% (1983/2378) did not show COVID-19 signs and symptoms, and 97.3% (2314/2378) were not diagnosed with COVID-19. In the older adult group, 92.5% (273/295) did not show signs and symptoms of COVID-19, and 98.3% (290/295) were not diagnosed with the disease. The majority of the participants in both groups reported using face masks, and their decision to use face masks was influenced by the level of education and their occupation as a health professional. Conclusions: Younger and older adults have worn face masks during the COVID-19 outbreak. It is difficult to measure how much of a positive impact this attitude, habit, and behavior could have on the degree of infection and spread of the disease. However, it can be a positive indicator of adherence to the population’s security and safety measures during the pandemic. %M 34253508 %R 10.2196/28989 %U https://aging.jmir.org/2021/3/e28989 %U https://doi.org/10.2196/28989 %U http://www.ncbi.nlm.nih.gov/pubmed/34253508