@Article{info:doi/10.2196/63280,
author="Suarez, Raphael Jethro
and Blount, Amber
and Lafontant, Kworweinski
and Park, Joon-Hyuk
and Xie, Rui
and Lighthall, Nichole
and Thiamwong, Ladda",
title="Association Between Prevention Focus and Sedentary Behavior in Older Adults: Cross-Sectional Study",
journal="Interact J Med Res",
year="2025",
month="May",
day="1",
volume="14",
pages="e63280",
keywords="accelerometry",
keywords="regulatory focus theory",
keywords="actigraph",
keywords="motivation",
keywords="physical activity",
abstract="Background: Older adults engage in increased amounts of sedentary behavior (SB), which can result in a significant decline in muscle function and overall health. An understanding of the motivational driving factors that lead older adults to engage in SB can help to create effective intervention programs. Objective: This study aimed to determine the association between prevention and promotion focus with SB in older adults, as well as compare these associations with two factors (ie, age and BMI) that are commonly known to have an association with SB among older adults. Methods: A cross-sectional analysis was conducted among 93 community-dwelling older adults with a mean age of 74.98 (SD 6.68) years. Prevention and promotion focus were both assessed using the Regulatory Focus Questionnaire. Correlation analysis was performed to determine the associations between prevention focus, promotion focus, age, and BMI with SB. Anderson-Darling tests confirmed nonnormal data distributions for all factors (except age); therefore, Spearman rank correlation was used to determine correlations between factors. Comparative analysis of significant correlations was performed using Fisher Z transformation. Results: Prevention focus had the greatest statistically significant correlation with SB ($\rho$=0.296; P=.004), followed by BMI ($\rho$=0.204; P=.049). Both age ($\rho$=0.116; P=.27) and promotion focus ($\rho$=0.002; P=.99) had statistically insignificant correlations with SB, indicating no associations. The correlation between prevention focus and SB did not significantly differ from the correlation between BMI and SB (P=.51). Conclusions: Prevention focus was found to have a weak, but significant positive association with SB in older adults. Although age and BMI have been found to have an association with SB in previous literature, age was not associated with SB in this study, while BMI had a significant but relatively weaker association with SB than that with prevention focus. However, the association found between BMI and SB did not statistically differ from the association found between prevention focus and SB. These findings suggest that older adults could be driven to engage in increased amounts of SB due to having a dominant prevention focus, which revolves around thoughts of safety and avoiding negative consequences. The recognition of this association has the potential to aid in developing intervention programs that could promote shifting from prevention to promotion focus, thereby reducing SB in older adults. Trial Registration: ClinicalTrials.gov NCT05778604; https://www.clinicaltrials.gov/study/NCT05778604 International Registered Report Identifier (IRRID): RR2-10.2196/51899 ",
doi="10.2196/63280",
url="https://www.i-jmr.org/2025/1/e63280"
}


@Article{info:doi/10.2196/65213,
author="Lee, Li-Yun
and Tung, Heng-Hsin
and Liao, George
and Liu, Su-Ju
and Chen, Zi-Yu
and Yang, Yea-Ru",
title="Multihealth Promotion Programs on Physical Health and Quality of Life in Older Adults: Quasi-Experimental Study",
journal="Interact J Med Res",
year="2025",
month="May",
day="1",
volume="14",
pages="e65213",
keywords="older adult",
keywords="body composition",
keywords="physical activity",
keywords="health promotion",
keywords="exercise",
keywords="nutrition",
keywords="diet",
keywords="well-being",
keywords="quality-of-life",
keywords="QoL",
keywords="gerontology",
keywords="geriatrics",
abstract="Background: Physical activity and appropriate nutrition are essential for older adults. Improving physical health and quality of life can lead to healthy aging. Objective: This study aims to investigate the long-term effects of multihealth promotion programs on the physical and mental health of older adults in communities. Methods: A quasi-experimental method was used to recruit 112 older adults voluntarily from a pharmacy in central Taiwan between April 2021 and February 2023. Participants were divided into an experimental group receiving a multihealth promotion program and a control group with no specific intervention. The study measured frailty, nutritional status, well-being, and quality of life using standardized tools such as the Clinical Frailty Scale (CFS), Mini-Nutritional Assessment-Short Form (MNA-SF), Well-being Scale for Elders, and the EQ-5D-3L. Data were analyzed using descriptive statistics, independent t tests, Pearson correlation, and generalized estimating equations. Results: A total of 112 participants were recruited. There were 64 (57.1\%) in the experimental group and 48 (42.9\%) in the control group. The experimental group exhibited significantly better quality of life (EQ-5D index) at weeks 12 ($\beta$=--.59; P=.01) and 24 ($\beta$=--.44; P=.04) compared to the control group. The experimental group muscle mass significantly increased at weeks 24 ($\beta$=4.29; P<.01) and 36 ($\beta$=3.03; P=.01). Upper limb strength improved significantly at weeks 12 ($\beta$=3.4; P=.04) and 36 ($\beta$=5; P=.01), while core strength showed significant gains at weeks 12 ($\beta$=4.43; P=.01) and 36 ($\beta$=6.99; P<.01). Lower limb strength increased significantly only at week 12 ($\beta$=4.15; P=.01). Overall physical performance improved significantly at weeks 12 ($\beta$=5.47; P<.01), 24 ($\beta$=5.17; P<.01), and 36 ($\beta$=8.79; P<.01). Conclusions: The study's findings highlight the practical benefits of interventions, including physical and social activities and nutritional support, in enhancing the quality of life and general physical health of older adults. This study's findings have significant implications for clinical practice. These findings can aid in the establishment of effective interventions for older adults. Trial Registration: ClinicalTrials.gov NCT05412251; https://clinicaltrials.gov/study/NCT05412251 ",
doi="10.2196/65213",
url="https://www.i-jmr.org/2025/1/e65213",
url="http://www.ncbi.nlm.nih.gov/pubmed/40310677"
}


@Article{info:doi/10.2196/63686,
author="Imani, Mahdi
and Borda, G. Miguel
and Vogrin, Sara
and Meijering, Erik
and Aarsland, Dag
and Duque, Gustavo",
title="Using Deep Learning to Perform Automatic Quantitative Measurement of Masseter and Tongue Muscles in Persons With Dementia: Cross-Sectional Study",
journal="JMIR Aging",
year="2025",
month="Mar",
day="19",
volume="8",
pages="e63686",
keywords="artificial intelligence",
keywords="machine learning",
keywords="sarcopenia",
keywords="dementia",
keywords="masseter muscle",
keywords="tongue muscle",
keywords="deep learning",
keywords="head",
keywords="tongue",
keywords="face",
keywords="magnetic resonance imaging",
keywords="MRI",
keywords="image",
keywords="imaging",
keywords="muscle",
keywords="muscles",
keywords="neural network",
keywords="aging",
keywords="gerontology",
keywords="older adults",
keywords="geriatrics",
keywords="older adult health",
abstract="Background: Sarcopenia (loss of muscle mass and strength) increases adverse outcomes risk and contributes to cognitive decline in older adults. Accurate methods to quantify muscle mass and predict adverse outcomes, particularly in older persons with dementia, are still lacking. Objective: This study's main objective was to assess the feasibility of using deep learning techniques for segmentation and quantification of musculoskeletal tissues in magnetic resonance imaging (MRI) scans of the head in patients with neurocognitive disorders. This study aimed to pave the way for using automated techniques for opportunistic detection of sarcopenia in patients with neurocognitive disorder. Methods: In a cross-sectional analysis of 53 participants, we used 7 U-Net-like deep learning models to segment 5 different tissues in head MRI images and used the Dice similarity coefficient and average symmetric surface distance as main assessment techniques to compare results. We also analyzed the relationship between BMI and muscle and fat volumes. Results: Our framework accurately quantified masseter and subcutaneous fat on the left and right sides of the head and tongue muscle (mean Dice similarity coefficient 92.4\%). A significant correlation exists between the area and volume of tongue muscle, left masseter muscle, and BMI. Conclusions: Our study demonstrates the successful application of a deep learning model to quantify muscle volumes in head MRI in patients with neurocognitive disorders. This is a promising first step toward clinically applicable artificial intelligence and deep learning methods for estimating masseter and tongue muscle and predicting adverse outcomes in this population. ",
doi="10.2196/63686",
url="https://aging.jmir.org/2025/1/e63686"
}


@Article{info:doi/10.2196/63900,
author="Abu El Kheir-Mataria, Wafa
and Mahmoud Abdelraheem, Omnia
and Chun, Sungsoo",
title="Genetic, Socioecological, and Health Determinants of Extreme Longevity in Semi-Supercentenarians and Supercentenarians: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2025",
month="Mar",
day="5",
volume="14",
pages="e63900",
keywords="supercentenarians",
keywords="semi-supercentenarians",
keywords="extreme longevity",
keywords="genetic factors",
keywords="socioecological factors",
keywords="health determinants",
keywords="aging research",
keywords="scoping review",
keywords="cognitive performance",
keywords="data collection methods",
abstract="Background: The study of supercentenarians (individuals aged 110 years or older) offers valuable insights into aging, longevity, and the factors contributing to exceptional lifespans. These individuals often exhibit extraordinary cognitive and physical performance, which can inform strategies to improve the health of the general population. Research on centenarians (individuals aged 100 years or older), semi-supercentenarians (individuals aged 105-109 years), and supercentenarians covers themes like genetic factors, microbiome, inflammation, diet, lifestyle, and psychological aspects. These studies often focus on various aspects of extreme longevity, using varied objectives and methodologies, highlighting the need for a comprehensive synthesis to map the breadth of research and identify gaps in understanding this demographic. Objective: This scoping review aims to map and synthesize existing evidence on the determinants of extreme longevity, focusing on individuals living beyond 105 years. This review seeks to categorize genetic factors associated with semi-supercentenarians and supercentenarians; explore the range of socioecological factors contributing to their longevity; and identify common themes such as health, functional capacity, cognition, mental health, behaviors, social support, quality of life, personality traits, environmental factors, and religiosity. Additionally, it aims to examine and describe the methodologies and assessment tools used in studies on extreme longevity and provide an overview of global demographic trends and patterns among supercentenarians, including geographic distribution, gender prevalence, and socioeconomic characteristics. Methods: This scoping review follows the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 guidelines and the Population, Exposure, and Outcome framework. It includes observational and interventional, quantitative and qualitative studies on supercentenarians and semi-supercentenarians. Data will be sourced from databases like Scopus, PubMed, ProQuest, PsycINFO, and The Cochrane Library. The selection process involves abstract and full-text screening by two independent reviewers, with data extraction focusing on study characteristics, participant demographics, interventions or exposures, and key findings. A thematic analysis will identify patterns across various themes Results: As of October 2, 2024, five databases were searched, yielding 844 studies. After removing duplicates, 706 studies remained. Following the first and second screening stages, 135 studies were found to be eligible. The study is expected to be completed by the end of February 2025. Conclusions: By synthesizing evidence, this study will understand the global scope of supercentenarians, describe the main themes of research interest, and identify gaps. The findings are expected to contribute significantly to the body of knowledge on longevity, informing future research and public health policies. This scoping review aims to enhance the understanding of factors promoting healthy aging and extreme longevity, benefiting broader public health initiatives. Trial Registration: PROSPERO CRD42024512298; https://tinyurl.com/4cmux7h4 ",
doi="10.2196/63900",
url="https://www.researchprotocols.org/2025/1/e63900",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053776"
}


@Article{info:doi/10.2196/65075,
author="Fan, Huimin
and Yu, Weijie
and Rong, Hongguo
and Geng, Xiaokun",
title="Associations Between Sleep Duration and Activity of Daily Living Disability Among Older Adults in China: Cross-Sectional Study",
journal="Interact J Med Res",
year="2025",
month="Mar",
day="5",
volume="14",
pages="e65075",
keywords="sleep",
keywords="sleep duration",
keywords="activities of daily living",
keywords="CHARLS",
keywords="survey",
keywords="questionnaire",
keywords="self-reported",
keywords="gerontology",
keywords="geriatric",
keywords="older adult",
keywords="elder",
keywords="elderly",
keywords="aging",
keywords="ADL",
keywords="physical function",
keywords="physical functioning",
keywords="well-being",
keywords="association",
keywords="correlation",
keywords="China Health and Retirement Longitudinal Study",
abstract="Background: China has the largest elderly population globally; the growth rate of the aged tendency of the population was higher than that of Western countries. Given the distinctions in historical, ethnic, and economic status as well as socio-cultural background, Chinese adults had different sleep patterns compared with adults in other countries. Considering the heavy disease burden caused by activities of daily living (ADL) disability, we conducted a cross-sectional analysis using data from the China Health and Retirement Longitudinal Study (CHARLS) to test the hypothesis that individuals with short and longer sleep duration are more likely to have ADL disability. Objective: ADL disability is a common condition affecting the quality of life among older people. This study aimed to explore the associations between sleep duration and ADL disability among middle-aged and older adults in China. Methods: This cross-sectional study used data from 17,607 participants from the 2018 CHARLS (from 2018 to 2020), an ongoing representative survey of adults aged 45 years or older and their spouses. Self-reported sleep duration per night was obtained from face-to-face interviews. The ADL was measured using a 6-item summary assessed with an ADL scale that included eating, dressing, getting into or out of bed, bathing, using the toilet, and continence. Multiple generalized linear regression models---adjusted for age, sex, education, marital status, tobacco and alcohol use, depression, place of residence, sensory impairment, self-reported health status, life satisfaction, daytime napping, chronic disease condition, and sample weights---were used. Results: Data were analyzed from 17,607 participants, of whom 8375 (47.6\%) were men. The mean (SD) age was 62.7 (10.0) years. Individuals with 4 hours or less (odds ratio [OR] 1.91, 95\% CI 1.60?2.27; P<.001), 5 hours (OR 1.33, 95\% CI 1.09?1.62; P=.006), 9 hours (OR 1.48, 95\% CI 1.13?1.93; P<.001), and 10 hours or more (OR 1.88, 95\% CI 1.47?2.14; P<.001) of sleep per night had a higher risk of ADL disability than those in the reference group (7 hours per night) after adjusting for several covariates. Restricted cubic splines analysis suggested a U-shaped association between sleep duration and ADL disability. When sleep duration fell below 7 hours, an increased sleep duration was associated with a significantly low risk of ADL disability, which was negatively correlated with sleep duration until it fell below 7 hours (OR 0.83, 95\% CI 0.79?0.87; P<.001). When sleep duration exceeded 7 hours, the risk of ADL disability would increase facing prolonged sleep duration (OR 1.19, 95\% CI 1.12?1.27; P<.001). ADL disability should be monitored in individuals with insufficient (?4 or 5 hours per night) or excessive (9 or ?10 hours per night) sleep duration. Conclusions:: In this study, a U-shaped association between sleep duration and ADL disability was found. Future longitudinal studies are needed to establish temporality and examine the mechanisms of the associations between sleep duration and ADL disability. ",
doi="10.2196/65075",
url="https://www.i-jmr.org/2025/1/e65075"
}


@Article{info:doi/10.2196/63572,
author="Walzer, Stefan
and Sch{\"o}n, Isabel
and Pfeil, Johanna
and Merz, Nicola
and Marx, Helga
and Ziegler, Sven
and Kunze, Christophe",
title="Experiences With an In-Bed Real-Time Motion Monitoring System on a Geriatric Ward: Mixed Methods Study",
journal="JMIR Form Res",
year="2025",
month="Mar",
day="4",
volume="9",
pages="e63572",
keywords="nurses",
keywords="geriatric patients",
keywords="cognitive impairment",
keywords="technology",
keywords="fall prevention",
keywords="hospital",
keywords="mixed methods",
keywords="patient",
keywords="learning process",
keywords="assessment",
keywords="autonomy",
keywords="impairment",
keywords="real-time motion",
keywords="university",
keywords="geriatric ward",
keywords="survey",
keywords="anxiety",
keywords="willingness",
keywords="patient privacy",
keywords="effectiveness",
keywords="monitoring system",
keywords="health care practice",
abstract="Background: Older adults now make up about two-thirds of hospital admissions, with up to 50\% experiencing cognitive impairments such as dementia. These patients often struggle with adherence to care plans and maintaining regular day or night cycles, presenting challenges for nurses. Hospitals are typically unprepared to manage this patient population, resulting in increased nurse workload and challenges like managing motor agitation, which can lead to falls or accidental removal of medical devices. Objective: This study aimed to (1) assess how an in-bed real-time motion monitoring system (IRMS) impacts nurses' perceptions of physical and mental stress, (2) evaluate the IRMS's effect on the care process, (3) explore ethical implications like patient autonomy and privacy, and (4) understand how nurses acquire knowledge about the technology and how this affects their assessment of the IRMS. Methods: The IRMS, which provides real-time motion monitoring and bed edge or exit information, was implemented in the geriatric ward of a university medical center. The study followed a monocentric, explorative evaluation design using a mixed methods approach. It lasted 24 weeks and had two phases. In Phase 0 (6 weeks), patients received standard care. In Phase 1 (18 weeks), the IRMS was introduced. Initial data were gathered through focus groups and participant observations during manufacturer training sessions. At the end of the intervention, a survey, a second focus group, and an interview were conducted to capture nurses' experiences. The study follows the Good Reporting of a Mixed Method Study (GRAMMS) checklist for reporting. Results: Initial training sessions with 12 participants (10 nurses and 2 physiotherapists) showed varying levels of engagement, with the second session demonstrating more optimism and interprofessional collaboration. A total of 10 questionnaires were completed (10/21, 48\%). Survey results showed that 80\% (8/10) of nurses found the IRMS valuable for assessing the quality of work, and 90\% (9/10) were willing to continue using it. The system was regarded as reliable for monitoring bed edge and exit events. Usability was positively rated, with minimal concerns about documentation burden. Focus group discussions (n=3 per session) indicated that nurses viewed the system as reliable and appreciated its role in reducing anxiety related to fall prevention. However, concerns about patient privacy and monitoring were raised. Nurses expressed a willingness to continue using the IRMS but reaffirmed their ability to care for patients without it. Conclusions: Nurses had a generally positive attitude toward the IRMS, recognizing its benefits, particularly for nighttime monitoring. Although its effectiveness in preventing falls remains inconclusive, the system helps reduce nurses' fear of falls and enhances their responsiveness. The study highlights the broader impact of the IRMS beyond fall prevention and stresses the importance of thoughtful integration into health care practice. ",
doi="10.2196/63572",
url="https://formative.jmir.org/2025/1/e63572",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053780"
}


@Article{info:doi/10.2196/64633,
author="Beverly, A. Elizabeth
and Miller, Samuel
and Love, Matthew
and Love, Carrie",
title="Feasibility of a Cinematic--Virtual Reality Program Educating Health Professional Students About the Complexity of Geriatric Care: Pilot Pre-Post Study",
journal="JMIR Aging",
year="2025",
month="Feb",
day="12",
volume="8",
pages="e64633",
keywords="virtual reality",
keywords="VR",
keywords="aging",
keywords="geriatric syndromes",
keywords="diabetes",
keywords="elder abuse and neglect",
keywords="gerontology",
keywords="geriatrics",
keywords="older",
keywords="elderly",
keywords="education",
keywords="student",
keywords="cinematic",
keywords="video",
keywords="head mounted",
keywords="feasibility",
keywords="experience",
keywords="attitude",
keywords="opinion",
keywords="perception",
keywords="elder abuse",
keywords="chronic conditions",
keywords="older adult care",
keywords="health intervention",
keywords="randomized controlled trial",
abstract="Background: The US population is aging. With this demographic shift, more older adults will be living with chronic conditions and geriatric syndromes. To prepare the next generation of health care professionals for this aging population, we need to provide training that captures the complexity of geriatric care. Objective: This pilot study aimed to assess the feasibility of the cinematic--virtual reality (cine-VR) training in the complexity of geriatric care. We measured changes in attitudes to disability, self-efficacy to identify and manage elder abuse and neglect, and empathy before and after participating in the training program. Methods: We conducted a single-arm, pretest-posttest pilot study to assess the feasibility of a cine-VR training and measure changes in attitudes to disability, self-efficacy to identify and manage elder abuse and neglect, and empathy. Health professional students from a large university in the Midwest were invited to participate in 1 of 4 cine-VR trainings. Participants completed 3 surveys before and after the cine-VR training. We performed paired t tests to examine changes in these constructs before and after the training. Results: A total of 65 health professional students participated in and completed the full cine-VR training for 100\% retention. Participants did not report any technological difficulties or adverse effects from wearing the head-mounted displays or viewing the 360-degree video. Out of the 65 participants, 48 completed the pre- and postassessments. We observed an increase in awareness of discrimination towards people with disability (t47=?3.97; P<.001). In addition, we observed significant improvements in self-efficacy to identify and manage elder abuse and neglect (t47=?3.36; P=.002). Finally, we observed an increase in participants' empathy (t47=?2.33; P=.02). Conclusions: We demonstrated that our cine-VR training program was feasible and acceptable to health professional students at our Midwestern university. Findings suggest that the cine-VR training increased awareness of discrimination towards people with disabilities, improved self-efficacy to identify and manage elder abuse and neglect, and increased empathy. Future research using a randomized controlled trial design with a larger, more diverse sample and a proper control condition is needed to confirm the effectiveness of our cine-VR training. ",
doi="10.2196/64633",
url="https://aging.jmir.org/2025/1/e64633"
}


@Article{info:doi/10.2196/58528,
author="Lee, Man-Sin Maggie
and Yeoh, Eng-kiong
and Wong, Lai-Yi Eliza
and Bai, Xue
and Yeung, Chun-Yiu Nelson
and French, Catherine
and Taddese, Henock",
title="Perceptions and Experiences of Caregiver-Employees, Employers, and Health Care Professionals With Caregiver-Friendly Workplace Policy in Hong Kong: Thematic Analysis",
journal="Interact J Med Res",
year="2025",
month="Feb",
day="10",
volume="14",
pages="e58528",
keywords="caregiver employees",
keywords="workplace",
keywords="discrimination",
keywords="dual roles",
keywords="caregiver burden",
abstract="Background: Caregiver-employees (CEs) for older adults experience a high burden to fulfill their dual roles. Caregiver-friendly workplace policy (CFWP) has been used in many countries to balance employment and caregiving duties, but it is a relatively new concept in Hong Kong. Objective: This study explored the views and experiences of CEs, employers, and health care professionals regarding CFWP (specifically for older adult caregivers) in Hong Kong. Methods: This study explored the CFWP-related views and experiences in Hong Kong using 15 in-depth interviews with purposively sampled CEs for older adults, employers, and health care professionals. Results: Two context-related themes (``lacking leadership'' and ``unfavorable culture'') were identified with thematic analysis. They explain the absence of CFWP in Hong Kong due to the lack of governmental and organizational leadership, and the additional burden experienced by CEs because of the working culture that underpins work-life separation, overprizing business interest, and unsympathetic corporate attitude. Implicit voice theory was applicable in explaining CEs' nondisclosure about their status at work due to potential risks. In addition, the two facilitation-related themes (``role struggle'' and ``inadequate support'') identified in this study exhibit how the dual role had positive and negative spillover effects on each other and the inadequacy of social welfare and health care support systems. Conclusions: We strongly recommend exploring and adopting potential CFWP in Hong Kong, considering the complexity of factors identified in this study. ",
doi="10.2196/58528",
url="https://www.i-jmr.org/2025/1/e58528"
}


@Article{info:doi/10.2196/66104,
author="Bai, Anying
and He, Shan
and Jiang, Yu
and Xu, Weihao
and Lin, Zhanyi",
title="Comparison of 3 Aging Metrics in Dual Declines to Capture All-Cause Dementia and Mortality Risk: Cohort Study",
journal="JMIR Aging",
year="2025",
month="Jan",
day="30",
volume="8",
pages="e66104",
keywords="gerontology",
keywords="geriatrics",
keywords="older adults",
keywords="older people",
keywords="aging",
keywords="motoric cognitive risk syndrome",
keywords="MCR",
keywords="physio-cognitive decline syndrome",
keywords="PCDS",
keywords="cognitive frailty",
keywords="CF",
keywords="frailty",
keywords="discrimination",
keywords="risk factors",
keywords="prediction",
keywords="dementia risk",
keywords="mortality risk",
abstract="Background: The utility of aging metrics that incorporate cognitive and physical function is not fully understood. Objective: We aim to compare the predictive capacities of 3 distinct aging metrics---motoric cognitive risk syndrome (MCR), physio-cognitive decline syndrome (PCDS), and cognitive frailty (CF)---for incident dementia and all-cause mortality among community-dwelling older adults. Methods: We used longitudinal data from waves 10-15 of the Health and Retirement Study. Cox proportional hazards regression analysis was employed to evaluate the effects of MCR, PCDS, and CF on incident all-cause dementia and mortality, controlling for socioeconomic and lifestyle factors, as well as medical comorbidities. Discrimination analysis was conducted to assess and compare the predictive accuracy of the 3 aging metrics. Results: A total of 2367 older individuals aged 65 years and older, with no baseline prevalence of dementia or disability, were ultimately included. The prevalence rates of MCR, PCDS, and CF were 5.4\%, 6.3\%, and 1.3\%, respectively. Over a decade-long follow-up period, 341 cases of dementia and 573 deaths were recorded. All 3 metrics were predictive of incident all-cause dementia and mortality when adjusting for multiple confounders, with variations in the strength of their associations (incident dementia: MCR odds ratio [OR] 1.90, 95\% CI 1.30?2.78; CF 5.06, 95\% CI 2.87?8.92; PCDS 3.35, 95\% CI 2.44?4.58; mortality: MCR 1.60, 95\% CI 1.17?2.19; CF 3.26, 95\% CI 1.99?5.33; and PCDS 1.58, 95\% CI 1.17?2.13). The C-index indicated that PCDS and MCR had the highest discriminatory accuracy for all-cause dementia and mortality, respectively. Conclusions: Despite the inherent differences among the aging metrics that integrate cognitive and physical functions, they consistently identified risks of dementia and mortality. This underscores the importance of implementing targeted preventive strategies and intervention programs based on these metrics to enhance the overall quality of life and reduce premature deaths in aging populations. ",
doi="10.2196/66104",
url="https://aging.jmir.org/2025/1/e66104"
}


@Article{info:doi/10.2196/59203,
author="M{\"o}llmann, Louise Henriette
and Alhammadi, Eman
and Boulghoudan, Soufian
and Kuhlmann, Julian
and Mevissen, Anica
and Olbrich, Philipp
and Rahm, Louisa
and Frohnhofen, Helmut",
title="Assessment of Geriatric Problems and Risk Factors for Delirium in Surgical Medicine: Protocol for Multidisciplinary Prospective Clinical Study",
journal="JMIR Res Protoc",
year="2025",
month="Jan",
day="22",
volume="14",
pages="e59203",
keywords="delirium",
keywords="older patients",
keywords="perioperative assessment",
keywords="age-related surgical risk factors",
keywords="geriatric assessment",
keywords="gerontology",
keywords="aging",
keywords="surgical medicine",
keywords="surgical care",
keywords="surgery",
keywords="multidisciplinary",
keywords="prospective study",
keywords="perioperative",
keywords="screening",
keywords="palliative care",
keywords="health informatics",
abstract="Background: An aging population in combination with more gentle and less stressful surgical procedures leads to an increased number of operations on older patients. This collectively raises novel challenges due to higher age heavily impacting treatment. A major problem, emerging in up to 50\% of cases, is perioperative delirium. It is thus vital to understand whether and which existing geriatric assessments are capable of reliably identifying risk factors, how high the incidence of delirium is, and whether the resulting management of these risk factors might lead to a reduced incidence of delirium. Objective: This study aimed to determine the frequency and severity of geriatric medical problems in elective patients of the Clinics of Oral and Maxillofacial Surgery, Vascular Surgery, and Orthopedics, General Surgery, and Trauma Surgery, revealing associations with the incidence of perioperative delirium regarding potential risk factors, and recording the long-term effects of geriatric problems and any perioperative delirium that might have developed later the patient's life. Methods: We performed both pre- and postoperative assessments in patients of 4 different surgical departments who are older than 70 years. Patient-validated screening instruments will be used to identify risk factors. A geriatric assessment with the content of basal and instrumental activities of daily living (basal activities of daily living [Katz index], instrumental activities of daily living [Lawton and Brody score], cognition [6-item screener and clock drawing test], mobility [de Morton Mobility Index and Sit-to-Stand test], sleep [Pittsburgh Sleep Quality Index and Insomnia Severity Index/STOP-BANG], drug therapy [polypharmacy and quality of medication, Fit For The Aged classification, and anticholinergic burden score], and pain assessment and delirium risk (Delirium Risk Assessment Tool) will be performed. Any medical problems detected will be treated according to current standards, and no intervention is planned as part of the study. In addition, a telephone follow-up will be performed 3, 6, and 12 months after discharge. Results: Recruitment started in August 2022, with 421 patients already recruited at the time of submission. Initial analyses of the data are to be published at the end of 2024 or the beginning of 2025. Conclusions: In the current study, we investigate whether the risk factors addressed in the assessment are associated with an increase in the delirium rate. The aim is then to reduce this comprehensive assessment to the central aspects to be able to conduct targeted and efficient risk screening. Trial Registration: German Clinical Trials Registry DRKS00028614; https://www.drks.de/search/de/trial/DRKS00028614 International Registered Report Identifier (IRRID): DERR1-10.2196/59203 ",
doi="10.2196/59203",
url="https://www.researchprotocols.org/2025/1/e59203",
url="http://www.ncbi.nlm.nih.gov/pubmed/39841510"
}


@Article{info:doi/10.2196/63494,
author="Cheng, Yong Huai",
title="ChatGPT's Attitude, Knowledge, and Clinical Application in Geriatrics Practice and Education: Exploratory Observational Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="3",
volume="9",
pages="e63494",
keywords="ChatGPT",
keywords="geriatrics attitude",
keywords="ageism",
keywords="geriatrics competence",
keywords="geriatric syndromes",
keywords="polypharmacy",
keywords="falls",
keywords="aging, older adults",
abstract="Background: The increasing use of ChatGPT in clinical practice and medical education necessitates the evaluation of its reliability, particularly in geriatrics. Objective: This study aimed to evaluate ChatGPT's trustworthiness in geriatrics through 3 distinct approaches: evaluating ChatGPT's geriatrics attitude, knowledge, and clinical application with 2 vignettes of geriatric syndromes (polypharmacy and falls). Methods: We used the validated University of California, Los Angeles, geriatrics attitude and knowledge instruments to evaluate ChatGPT's geriatrics attitude and knowledge and compare its performance with that of medical students, residents, and geriatrics fellows from reported results in the literature. We also evaluated ChatGPT's application to 2 vignettes of geriatric syndromes (polypharmacy and falls). Results: The mean total score on geriatrics attitude of ChatGPT was significantly lower than that of trainees (medical students, internal medicine residents, and geriatric medicine fellows; 2.7 vs 3.7 on a scale from 1-5; 1=strongly disagree; 5=strongly agree). The mean subscore on positive geriatrics attitude of ChatGPT was higher than that of the trainees (medical students, internal medicine residents, and neurologists; 4.1 vs 3.7 on a scale from 1 to 5 where a higher score means a more positive attitude toward older adults). The mean subscore on negative geriatrics attitude of ChatGPT was lower than that of the trainees and neurologists (1.8 vs 2.8 on a scale from 1 to 5 where a lower subscore means a less negative attitude toward aging). On the University of California, Los Angeles geriatrics knowledge test, ChatGPT outperformed all medical students, internal medicine residents, and geriatric medicine fellows from validated studies (14.7 vs 11.3 with a score range of --18 to +18 where +18 means that all questions were answered correctly). Regarding the polypharmacy vignette, ChatGPT not only demonstrated solid knowledge of potentially inappropriate medications but also accurately identified 7 common potentially inappropriate medications and 5 drug-drug and 3 drug-disease interactions. However, ChatGPT missed 5 drug-disease and 1 drug-drug interaction and produced 2 hallucinations. Regarding the fall vignette, ChatGPT answered 3 of 5 pretests correctly and 2 of 5 pretests partially correctly, identified 6 categories of fall risks, followed fall guidelines correctly, listed 6 key physical examinations, and recommended 6 categories of fall prevention methods. Conclusions: This study suggests that ChatGPT can be a valuable supplemental tool in geriatrics, offering reliable information with less age bias, robust geriatrics knowledge, and comprehensive recommendations for managing 2 common geriatric syndromes (polypharmacy and falls) that are consistent with evidence from guidelines, systematic reviews, and other types of studies. ChatGPT's potential as an educational and clinical resource could significantly benefit trainees, health care providers, and laypeople. Further research using GPT-4o, larger geriatrics question sets, and more geriatric syndromes is needed to expand and confirm these findings before adopting ChatGPT widely for geriatrics education and practice. ",
doi="10.2196/63494",
url="https://formative.jmir.org/2025/1/e63494",
url="http://www.ncbi.nlm.nih.gov/pubmed/39752214"
}


@Article{info:doi/10.2196/53304,
author="Banarjee, Chitra
and Choudhury, Renoa
and Park, Joon-Hyuk
and Xie, Rui
and Fukuda, David
and Stout, Jeffrey
and Thiamwong, Ladda",
title="Common Physical Performance Tests for Evaluating Health in Older Adults: Cross-Sectional Study",
journal="Interact J Med Res",
year="2024",
month="Nov",
day="29",
volume="13",
pages="e53304",
keywords="functional capacity",
keywords="physical activity",
keywords="fear of falling",
keywords="physical performance tests",
keywords="Short Physical Performance Battery",
keywords="6-minute walk test",
keywords="Incremental Shuttle Walk Test",
keywords="geriatrics",
keywords="aging",
abstract="Background: Interdisciplinary evaluation of older adults' health care is a priority in the prevention of chronic health conditions and maintenance of daily functioning. While many studies evaluate different physical performance tests (PPTs) from a retrospective view in predicting mortality or cardiopulmonary health, it remains unclear which of the commonly used PPTs is the most effective at evaluating the current health of older adults. Additionally, the time and participant burden for each PPT must be considered when planning and implementing them for clinical or research purposes. Objective: This cross-sectional study aimed to determine how elements of overall physical capacity, performance, and other nongait factors in older adults affect the results of 3 commonly used tests: the Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT), and Incremental Shuttle Walk Test (ISWT). Methods: A total of 53 community-dwelling older adults met the inclusion and exclusion criteria (mean age 77.47, SD 7.25 years; n=41, 77\% female; and n=21, 40\% Hispanic). This study evaluated older adults using 3 different PPTs including the SPPB, 6MWT, and ISWT, as well as constructed multiple linear regression models with measures of physical activity, static balance, and fear of falling (FoF). The nongait measures included 7 days of physical activity monitoring using the ActiGraph GT9X Link instrument, objective measurement of static balance using the BTrackS Balance System, and FoF using the short Fall Efficacy Scale-International. Results: The models revealed that the complete SPPB provided the most comprehensive value, as indicated by a greater R2 value (0.523), and that performance on the SPPB was predicted by both moderate to vigorous physical activity (P=.01) and FoF (P<.001). The ISWT was predicted by moderate to vigorous physical activity (P=.02), BMI (P=.02), and FoF (P=.006) and had a similar R2 value (0.517), whereas the gait component of the SPPB (P=.001) and 6MWT (P<.001) was predicted by only FoF and had lower R2 values (0.375 and 0.228, respectively). Conclusions: The results indicated the value of a multicomponent, comprehensive test, such as the SPPB, in evaluating the health of older adults. Additionally, a comparison of the 2 field walking tests (ISWT and 6MWT) further distinguished the ISWT as more responsive to overall health in older adults. In comparing these commonly used PPTs, clinicians and researchers in the field can determine and select the most optimal test to evaluate older adults in communities and research settings. ",
doi="10.2196/53304",
url="https://www.i-jmr.org/2024/1/e53304"
}


@Article{info:doi/10.2196/57050,
author="Matos Queir{\'o}s, Alcina
and von Gunten, Armin
and Rosselet Amoussou, Jo{\"e}lle
and Lima, Maria Andreia
and Martins, Manuela Maria
and Verloo, Henk",
title="Relationship Between Depression and Falls Among Nursing Home Residents: Integrative Review",
journal="Interact J Med Res",
year="2024",
month="Nov",
day="28",
volume="13",
pages="e57050",
keywords="depression",
keywords="falls",
keywords="nursing home",
keywords="nursing home resident",
keywords="cross-sectional study",
keywords="cohort study",
keywords="integrative review",
keywords="fall risk",
keywords="older adults",
abstract="Background: Depression is a highly prevalent psychopathological condition among older adults, particularly those institutionalized in nursing homes (NHs). Unfortunately, it is poorly identified and diagnosed. NH residents are twice as likely to fall as community-dwelling older adults. There is a need for more knowledge about the mechanisms and relationships between depression and falls. Objective: This study aims to identify, analyze, and synthesize research on the relationships between depression and falls among NH residents. Methods: A literature search was conducted in October 2023 in the following bibliographic databases: MEDLINE ALL Ovid, Embase, CINAHL with Full Text EBSCO, APA PsycInfo Ovid, Web of Science Core Collection, the Cochrane Database of Systematic Reviews Wiley, and ProQuest Dissertations \& Theses A\&I. Clinical trials were searched for in the Cochrane Central Register of Controlled Trials Wiley, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. Additional searches were performed using Google Scholar, the DART-Europe E-theses Portal, and backward citation tracking. The Newcastle-Ottawa Scale and the Appraisal tool for Cross-Sectional Studies were used to evaluate study quality. Results: The review included 7 quantitative studies published in 7 different countries from 3 continents; of these, 6 (86\%) were cross-sectional studies, and 1 (14\%) was a prospective cohort study. Results suggested high frequencies of depressive symptoms and falls among older adults living in NHs, and depressive symptoms were considered a risk factor for falls. The 15-item and 10-item versions of the Geriatric Depression Scale were the most commonly used measurement tools, followed by the Cornell Scale for Depression in Dementia and the Resident Assessment Instrument-Minimum Data Set 2.0. The prevalence of depression was heterogeneous, varying from 21.5\% to 47.7\% of NH residents. The studies used heterogeneous descriptions of a fall, and some considered the risk of falls, recurrent fallers, and near falls in their data. The prevalence of fallers was disparate, varying from 17.2\% to 63.1\%. Of the 7 retained studies, 6 (86\%) reported a relationship between depression and falls or the risk of falls. Among the 19 other risk factors identified in the review as being associated with falls among NH residents were a history of falls in the last 180 days, >1 fall in the past 12 months, and respiratory illnesses. Conclusions: There is a paucity of research examining falls among older adults with depressive symptoms in NHs. These findings should alert nurses to the need to consider depression as a risk factor in their work to prevent falls. More research is needed to gain a comprehensive understanding of fall risk among NH residents with depressive symptoms. International Registered Report Identifier (IRRID): RR2-10.2196/46995 ",
doi="10.2196/57050",
url="https://www.i-jmr.org/2024/1/e57050",
url="http://www.ncbi.nlm.nih.gov/pubmed/39608784"
}


@Article{info:doi/10.2196/52883,
author="Wiita, Farah
and Ho, K. Aileen
and Weinstein, Netta",
title="Web-Based Intervention Using Self-Compassionate Writing to Induce Positive Mood in Family Caregivers of Older Adults: Quantitative Study",
journal="JMIR Form Res",
year="2024",
month="Nov",
day="21",
volume="8",
pages="e52883",
keywords="self-compassion",
keywords="caregivers",
keywords="mindfulness",
keywords="intervention",
keywords="writing",
keywords="experimental",
abstract="Background: Caregiver burden can impact the mental health of family caregivers, but self-compassion may help reduce this impact. Brief self-compassion interventions have been shown to be useful but have not been tested in family caregivers of older adults. Objective: This study aimed to test the effects of a brief self-compassion intervention and its components (self-kindness, common humanity, and mindfulness) on mental well-being and mood when reflecting on difficult family caregiving experiences. Methods: British caregivers were recruited through a web-based panel. Three experimental studies manipulated the self-compassion intervention. In study 1 (n=206) and study 2 (n=224), participants wrote about a difficult caregiving experience while focusing on 1 self-compassion component (self-kindness, common humanity, or mindfulness). In study 3 (n=222) participants focused on all components. Self-compassion, serenity, guilt, and sadness were measured. Results: In studies 1 and 2, condition effects showed mindfulness unexpectedly lowered mood. Inconsistent and modest benefits to affect were achieved by engagement in self-kindness and common humanity in study 1 (guilt [lowered]: P=.02 and sadness [lowered]: P=.04; serenity [nonsignificantly raised]: P=.20) and also in study 2 (sadness [nonsignificantly lowered]: P=.23 and guilt [nonsignificantly lowered]: P=.26; serenity [raised]: P=.33); significant benefits for self-compassion and mood were found in study 3 (serenity [raised]: P=.01, kindness [raised]: P=.003, and common humanity [raised]: P?.001; guilt [lowered]: P<.001 and sadness [lowered]: P?.001). More intensive efforts should be made to promote self-compassion in caregivers of older adults, with caution advised when relying primarily on mindfulness approaches. Conclusions: Self-compassionate writing may be beneficial for family caregivers, but more intensive interventions are needed. Further research is needed to determine the optimal dosage and content for achieving the greatest effects. ",
doi="10.2196/52883",
url="https://formative.jmir.org/2024/1/e52883"
}


@Article{info:doi/10.2196/64248,
author="Mira, Joaqu{\'i}n Jos{\'e}
and Garc{\'i}a-Torres, Daniel
and Bonell-Guerrero, Mar Mar{\'i}a del
and C{\'a}ceres-Sevilla, Isabel Ana
and Ramirez-Sanz, Martina
and Mart{\'i}nez-Lleo, Rosa
and Carratal{\'a}, Concepci{\'o}n",
title="Patient Profile and Cost Savings of Long-Term Care in a Spanish Hospital: Retrospective Observational Study",
journal="Interact J Med Res",
year="2024",
month="Nov",
day="19",
volume="13",
pages="e64248",
keywords="chronicity",
keywords="length of stay",
keywords="hospital",
keywords="chronic",
keywords="long-term care",
keywords="demographics",
keywords="gerontology",
keywords="Hospitals for Acute and Chronic Long-Term Extended Stay",
keywords="HACLES",
keywords="healthcare economics",
keywords="cost savings",
abstract="Background: Long-term care hospitals have been considered an efficient response to the health care needs of an increasingly aging population. These centers are expected to contribute to better hospital bed management and more personalized care for patients needing continuous care. The evaluation of their outcomes is necessary after a sufficient period to assess their impact. Hospitals for Acute and Chronic Long-Term Extended Stay (HACLES) emerged in Spain in the late 20th century as a response to the aging population and the increase in chronic diseases. Objective: This study aimed to analyze the profile of patients treated in a HACLES, particularly analyzing gender differences, and evaluate the cost savings associated with using these centers. Methods: A retrospective study was conducted based on data from patients 65 years old or older admitted to a HACLES between 2022 and 2023. Gender, age, household cohabitation data, diagnosis and comorbidity, daily medication intake, and degree of dependency were obtained to describe the profile of patients who attended the HACLES. Data coded in SIA-Abucasis (version 37.00.03; Conseller{\'i}a Sanitat, Generalitat Valenciana; a digital medical record system used in the Valencian region) were reviewed, and descriptive statistics and comparison tests were used. The direct cost savings of HACLES admissions were calculated by comparing the daily cost of a general hospital bed with that of a HACLES bed. Results: Data from 123 patients with a mean age of 77 years were analyzed. Most (n=81, 65.9\%) had a cohabiting family member as their primary caregiver. Palliative care was the most frequent reason for admission (n=75, 61\%). The mortality rate (odds ratio [OR] 61.8, 95\% CI 53.2-70.5) was similar between men and women (OR 54.1, 95\% CI 47.8-71.5 vs OR 59.7, 95\% CI 42.2-66.0; P=.23). The cognitive assessment, using the Pfeiffer scale, improved at discharge (mean 3.2, SD 3.2 vs mean 2.5, SD 3.1; P=.003). The length of stay was significantly larger for patients who returned home compared with patients discharged to other facilities (mean 89.8, SD 58.2 versus mean 33.1, SD 43.1 days; P<.001). The direct cost savings were estimated at US \$42,614,846 per 1000 admissions. Conclusions: Patients typically treated in HACLES are older, with a high level of cognitive impairment and physical dependency, and a significant proportion are in palliative care, highlighting the importance of adapting care to the individual needs of the admitted patients. The HACLES model contributes to the sustainability of the public health system. ",
doi="10.2196/64248",
url="https://www.i-jmr.org/2024/1/e64248"
}


@Article{info:doi/10.2196/56522,
author="Claes, Anke
and De Mesel, Annelien
and Struyf, Thomas
and Verborgt, Olivier
and Struyf, Filip",
title="Factors Influencing Outcome After Shoulder Arthroplasty (FINOSA Study): Protocol of a Prospective Longitudinal Study With Randomized Group Allocation",
journal="JMIR Res Protoc",
year="2024",
month="Nov",
day="18",
volume="13",
pages="e56522",
keywords="shoulder arthroplasty",
keywords="influencing factors",
keywords="rehabilitation",
keywords="arthroplasty",
keywords="shoulder",
keywords="FINOSA-study",
keywords="evidence based",
keywords="post-operative rehabilitation",
keywords="rehabilitation protocols",
keywords="shoulder pain",
keywords="clinical outcomes",
keywords="geriatrics",
keywords="longitudinal study",
keywords="shoulder dysfunction",
abstract="Background: There is an increasing need for evidence-based postoperative rehabilitation strategies to optimize patient outcome. Knowledge of potential prognostic factors could steer the development of rehabilitation protocols and could result in better treatment outcomes and higher patient satisfaction. Objective: This study aimed to investigate which potential prognostic factors predict baseline shoulder pain and function and its evolution in the first 2 years following surgery, in patients with total shoulder arthroplasty. The secondary objective is to investigate which potential prognostic factors predict baseline quality of life and its evolution in the first two years following surgery. Methods: To reach the aims of this project, a prospective longitudinal study, running from January 2020 to March 2025, will be carried out with a follow-up of 48 months. Patients will be randomized based on sling wear. We will study factors such as shoulder function, patient expectations, psychosocial factors, lifestyle factors, sling wear, soft tissue integrity, and physiotherapy treatment. Test moments will take place preoperatively, at 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Descriptive statistics will be used to describe the patient population characteristics. Based on literature review, expert opinion, and univariate analyses, potential prognostic factors will be chosen as covariates. A mixed regression model for repeated measures will be used to assess both the evolution of the Shoulder Pain and Disability Index within persons from baseline over time and the differences in evolution between participants. Correlation analyses will be used to investigate associations between the other outcome measures such as the Constant and Murley Score, shoulder range of motion, shoulder muscle strength, and proprioception, and the primary outcome measure, the Shoulder Pain and Disability Index score. Potential prognostic factors not included in the model will be presented in a descriptive manner. Results: Data collection started in January 2020. In April 2023 the sample size was reached. Data collection will end in April 2025. Analyses will follow when data collection is completed. Conclusions: Knowledge of potential prognostic factors will have implications toward better rehabilitation strategies of patients after total shoulder arthroplasty. Trial Registration: ClinicalTrials.gov NCT04258267; https://clinicaltrials.gov/study/NCT04258267 International Registered Report Identifier (IRRID): DERR1-10.2196/56522 ",
doi="10.2196/56522",
url="https://www.researchprotocols.org/2024/1/e56522"
}


@Article{info:doi/10.2196/58186,
author="Mundada, Pallavi
and Makhija, Deepa
and Mata, Sunita
and Kachare, Kalpana
and Manathottathil, Aparna
and Sharma, Abha
and Rao, Sekhara Bhogavalli Chandra
and Rana, Rakesh
and Tripathi, Arunabh
and Rana, Kiran
and Joshi, Vandana
and Raturi, Ashish
and Singh, Anukampa
and Srikanth, N.
and Acharya, Rabinarayan",
title="Effectiveness of Ayush Rasayana A and B on the Quality of Life of Older Adults: Protocol for a Cluster Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Nov",
day="11",
volume="13",
pages="e58186",
keywords="Ayush Rasayana A",
keywords="Ayush Rasayana B",
keywords="cluster-randomized trial",
keywords="geriatrics",
keywords="Ayurveda",
keywords="quality of life",
keywords="complementary and alternative medicine",
abstract="Background: With advancing age among older adults, the associated debilities increase, indicating a deteriorating health status as there is a gradual loss of muscle mass, strength, and functionality. Ayush Rasayana A and B are coded Ayurvedic medicines developed from herbal extracts. This study has been planned to prevent debilitating conditions and improve the quality of life (QOL) in older adults. Objective: This study aimed to assess the effectiveness of Ayush Rasayana A and B on the QOL, quality of sleep, and functionality of older adults, along with the tolerability of the intervention. Methods: This was a multicenter, open-label, cluster randomized controlled trial conducted with 720 participants aged 60 to 75 years. The participants were divided into 2 groups (intervention and control), with both receiving Ayurvedic ancillary treatment for 3 months. The intervention group additionally received 10 g of Ayush Rasayana A orally once daily at bedtime for 6 days, followed by 1.5 g of Ayush Rasayana B orally twice daily before food for the remaining 84 days. The assessment criteria included the Older People's Quality of Life Questionnaire Brief, Katz Index of Independence in Activities of Daily Living, Pittsburgh Sleep Quality Index, Five Times Sit-to-Stand Test, and shoulder and scapular movements. Any change in hematological and biochemical parameters and occurrence of treatment-emergent adverse events were also assessed during the study period. Results: The recruitment of the participants started in December 2023, and the final follow-up was completed in April 2024. Out of the total 720 enrolled participants, 686 (95.3\%) completed the study up to the last follow-up. Conclusions: This study may provide evidence-based data to establish preventive treatment protocols for enhancing the QOL and functionality among older adults. The study results may also be helpful for the planning of interdisciplinary health policies for improving the health conditions of different populations International Registered Report Identifier (IRRID): DERR1-10.2196/58186 ",
doi="10.2196/58186",
url="https://www.researchprotocols.org/2024/1/e58186"
}


@Article{info:doi/10.2196/58466,
author="Lin, Yu-Chun
and Yan, Huang-Ting
and Lin, Chih-Hsueh
and Chang, Hen-Hong",
title="Identifying and Estimating Frailty Phenotypes by Vocal Biomarkers: Cross-Sectional Study",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="8",
volume="26",
pages="e58466",
keywords="frailty phenotypes",
keywords="older adults",
keywords="successful aging",
keywords="vocal biomarkers",
keywords="frailty",
keywords="phenotype",
keywords="vocal biomarker",
keywords="cross-sectional",
keywords="gerontology",
keywords="geriatrics",
keywords="older adult",
keywords="Taiwan",
keywords="energy-based",
keywords="hybrid-based",
keywords="sarcopenia",
abstract="Background: Researchers have developed a variety of indices to assess frailty. Recent research indicates that the human voice reflects frailty status. Frailty phenotypes are seldom discussed in the literature on the aging voice. Objective: This study aims to examine potential phenotypes of frail older adults and determine their correlation with vocal biomarkers. Methods: Participants aged ?60 years who visited the geriatric outpatient clinic of a teaching hospital in central Taiwan between 2020 and 2021 were recruited. We identified 4 frailty phenotypes: energy-based frailty, sarcopenia-based frailty, hybrid-based frailty--energy, and hybrid-based frailty--sarcopenia. Participants were asked to pronounce a sustained vowel ``/a/'' for approximately 1 second. The speech signals were digitized and analyzed. Four voice parameters---the average number of zero crossings (A1), variations in local peaks and valleys (A2), variations in first and second formant frequencies (A3), and spectral energy ratio (A4)---were used for analyzing changes in voice. Logistic regression was used to elucidate the prediction model. Results: Among 277 older adults, an increase in A1 values was associated with a lower likelihood of energy-based frailty (odds ratio [OR] 0.81, 95\% CI 0.68-0.96), whereas an increase in A2 values resulted in a higher likelihood of sarcopenia-based frailty (OR 1.34, 95\% CI 1.18-1.52). Respondents with larger A3 and A4 values had a higher likelihood of hybrid-based frailty--sarcopenia (OR 1.03, 95\% CI 1.002-1.06) and hybrid-based frailty--energy (OR 1.43, 95\% CI 1.02-2.01), respectively. Conclusions: Vocal biomarkers might be potentially useful in estimating frailty phenotypes. Clinicians can use 2 crucial acoustic parameters, namely A1 and A2, to diagnose a frailty phenotype that is associated with insufficient energy or reduced muscle function. The assessment of A3 and A4 involves a complex frailty phenotype. ",
doi="10.2196/58466",
url="https://www.jmir.org/2024/1/e58466"
}


@Article{info:doi/10.2196/59818,
author="Wu, Yuting
and Gong, Cong
and Pi, Lifang
and Zheng, Meixin
and Liu, Weifang
and Wang, Yamei",
title="Interrelationships Among Individual Factors, Family Factors, and Quality of Life in Older Chinese Adults: Cross-Sectional Study Using Structural Equation Modeling",
journal="JMIR Aging",
year="2024",
month="Oct",
day="28",
volume="7",
pages="e59818",
keywords="quality of life",
keywords="older adults",
keywords="individual factor",
keywords="family factor",
keywords="structural equation modeling (SEM)",
abstract="Background: China's rapidly aging population necessitates effective strategies for ensuring older adults' quality of life (QOL). While individual factors (IF) and family factors (FF) are known to influence QOL, existing research often examines these factors in isolation or focuses on specific subpopulations, overlooking potential interactions and mediating pathways. Objective: This study aims to examine both direct and indirect pathways connecting IF and FF to older adults' QOL, focusing on the mediating roles of health risks (HR) and health care service demand (HSD). Methods: This study uses structural equation modeling (SEM) to analyze cross-sectional data from 8600 older participants in the 2015 China Health and Retirement Longitudinal Study (CHARLS), a nationally representative study using a multistage probability proportional to size sampling method. Results: Among the 8600 participants, the majority (5586/8502, 65.7\%) were aged 60-70 years, with a near-equal distribution of males and females at around 50\%. The average PCS score was 76.77, while the MCS score averaged 59.70. Both IF ($\beta$=0.165, P<.001) and FF ($\beta$=0.189, P<.001) had a direct positive effect on QOL. Furthermore, the indirect effects of IF ($\beta$=0.186, P<.001) and FF ($\beta$=0.211, P<.001) through HR and HSD were also significant. In the direct model, IF and FF had a greater impact on MCS ($\beta$=0.841) than on PCS ($\beta$=0.639). However, after including the 2 mediating factors, HR and HSD, the influence of IF and FF on MCS ($\beta$=0.739) became consistent with that on PCS ($\beta$=0.728). Subgroup analyses revealed that the direct effect of IF on QOL was significant in the 60-70 age group ($\beta$=0.151, P<.001) but not in those over 70 years old ($\beta$=0.122, P=.074). Comorbidity status significantly influenced the pathway from HR to HSD, with older adults having 2 or more chronic diseases ($\beta$=0.363) showing a greater impact compared to those with fewer than 2 chronic diseases ($\beta$=0.358). Conclusions: Both IF (education, per capita disposable income, and endowment insurance) and FF (satisfaction with a spouse and children) directly impact the QOL in older people. Meanwhile, IF and FF have equal influence on QOL through the mediating role of HR and HSD. Recognizing the interplay among these factors is crucial for targeted interventions to enhance the well-being of older adults in China. ",
doi="10.2196/59818",
url="https://aging.jmir.org/2024/1/e59818"
}


@Article{info:doi/10.2196/49975,
author="Corr{\^e}a, Laura
and J{\'u}dice, Andr{\'e}
and Scoz, Robson
and Machado, Vanessa
and Mendes, Jo{\~a}o Jos{\'e}
and Proen{\c{c}}a, Lu{\'i}s
and Botelho, Jo{\~a}o
and Ferreira, Luciano",
title="Portuguese Version of the Oral Frailty Index-8: Instrument Validation Study",
journal="Interact J Med Res",
year="2024",
month="Oct",
day="28",
volume="13",
pages="e49975",
keywords="oral frailty",
keywords="oral health",
keywords="functional disability",
keywords="frailty",
keywords="aging",
keywords="dentistry",
keywords="confirmatory factor analysis",
keywords="psychometric validity",
keywords="questionnaire development",
abstract="Background: The concept of oral frailty has gained scientific and clinical relevance in recent years, and early detection can facilitate timely intervention to manage its progression. The Oral Frailty Index-8 (OFI-8) was developed to assess community-dwelling older adults at risk for oral frailty. Objective: This study aims to investigate the psychometric validity of the OFI-8 in the Portuguese population, named the Portuguese version of the OFI-8 (OFI-8-PT), which may serve as a reference for future studies related to longevity and oral function. Methods: This study included 2 main phases, involving patients aged 60 years or older, Portuguese speakers, and those who consented to participate in the study. First, the researchers translated and cross-culturally adapted the original questionnaire to make it suitable for native Portuguese speakers. The translated tool was then assessed for psychometric validation, which consisted of test-retest reliability, internal consistency, construct validity, and sex invariance measurement. Results: A total of 159 older adults participated in the baseline survey, with almost equal numbers of male (n=79, 49.7\%) and female participants (n=80, 50.3\%). The OFI-8-PT demonstrated good reliability (Cronbach $\alpha$=0.95) and construct validity (goodness-of-fit index=0.96; comparative fit index=0.85; and root mean square error of approximation=0.05, 90\% CI 0.00-0.09). The study found sex invariance, indicating that the OFI-8-PT is equally valid for male and female participants, and the tested-retest reliability of the OFI-8-PT was good, indicating consistent results over time. Conclusions: The OFI-8-PT showed psychometric validity and good reliability to be used in the Portuguese population. ",
doi="10.2196/49975",
url="https://www.i-jmr.org/2024/1/e49975",
url="http://www.ncbi.nlm.nih.gov/pubmed/39466299"
}


@Article{info:doi/10.2196/59428,
author="Berian, R. Julia
and Schwarze, L. Margaret
and Werner, E. Nicole
and Mahoney, E. Jane
and Shah, N. Manish",
title="Using Systems Engineering and Implementation Science to Design an Implementation Package for Preoperative Comprehensive Geriatric Assessment Among Older Adults Having Major Abdominal Surgery: Protocol for a 3-Phase Study",
journal="JMIR Res Protoc",
year="2024",
month="Sep",
day="9",
volume="13",
pages="e59428",
keywords="systems engineering",
keywords="participatory design",
keywords="user-centered design",
keywords="implementation science",
keywords="surgery",
keywords="aging research",
keywords="randomized controlled trial",
abstract="Background: Older Americans, a growing segment of the population, have an increasing need for surgical services, and they experience a disproportionate burden of postoperative complications compared to their younger counterparts. A preoperative comprehensive geriatric assessment (pCGA) is recommended to reduce risk and improve surgical care delivery for this population, which has been identified as vulnerable. The pCGA optimizes multiple chronic conditions and factors commonly overlooked in routine preoperative planning, including physical function, polypharmacy, nutrition, cognition, mental health, and social and environmental support. The pCGA has been shown to decrease postoperative morbidity, mortality, and length of stay in a variety of surgical specialties. Although national guidelines recommend the use of the pCGA, a paucity of strategic guidance for implementation limits its uptake to a few academic medical centers. By applying implementation science and human factors engineering methods, this study will provide the necessary evidence to optimize the implementation of the pCGA in a variety of health care settings. Objective: The purpose of this paper is to describe the study protocol to design an adaptable, user-centered pCGA implementation package for use among older adults before major abdominal surgery. Methods: This protocol uses systems engineering methods to develop, tailor, and pilot-test a user-centered pCGA implementation package, which can be adapted to community-based hospitals in preparation for a multisite implementation trial. The protocol is based upon the National Institutes of Health Stage Model for Behavioral Intervention Development and aligns with the goal to develop behavioral interventions with an eye to real-world implementation. In phase 1, we will use observation and interviews to map the pCGA process and identify system-based barriers and facilitators to its use among older adults undergoing major abdominal surgery. In phase 2, we will apply user-centered design methods, engaging health care providers, patients, and caregivers to co-design a pCGA implementation package. This package will be applicable to a diverse population of older patients undergoing major abdominal surgery at a large academic hospital and an affiliate community site. In phase 3, we will pilot-test and refine the pCGA implementation package in preparation for a future randomized controlled implementation-effectiveness trial. We anticipate that this study will take approximately 60 months (April 2023-March 2028). Results: This study protocol will generate (1) a detailed process map of the pCGA; (2) an adaptable, user-centered pCGA implementation package ready for feasibility testing in a pilot trial; and (3) preliminary pilot data on the implementation and effectiveness of the package. We anticipate that these data will serve as the basis for future multisite hybrid implementation-effectiveness clinical trials of the pCGA in older adults undergoing major abdominal surgery. Conclusions: The expected results of this study will contribute to improving perioperative care processes for older adults before major abdominal surgery. International Registered Report Identifier (IRRID): DERR1-10.2196/59428 ",
doi="10.2196/59428",
url="https://www.researchprotocols.org/2024/1/e59428"
}


@Article{info:doi/10.2196/49688,
author="Fu, Liping
and Liu, Caiping
and Dong, Yongqing
and Ma, Xiaodong
and Cai, Quanling
and Li, Dongli
and Di, Kaisheng",
title="Mediating Effects of Information Access on Internet Use and Multidimensional Health Among Middle-Aged and Older Adults: Nationwide Cross-Sectional Study",
journal="J Med Internet Res",
year="2024",
month="Sep",
day="9",
volume="26",
pages="e49688",
keywords="internet use",
keywords="health",
keywords="middle-aged and older adults",
keywords="information access",
keywords="mediation analysis",
abstract="Background: With the exacerbation of population aging, the health issues of middle-aged and older adults have increasingly become a focus of attention. The widespread use of the internet has created conditions for promoting the health of this demographic. However, little is known about the effects of information access in promoting the relationship between internet use and the health of middle-aged and older adults. Objective: This study aims to examine the relationship between internet use and multidimensional health in middle-aged and older adults, as well as the mediating effect of information access. Moreover, this study will explore the relationship between other dimensions of internet use (purposes and frequency) and health. Methods: Data were sourced from the China General Social Survey conducted in 2018. Health outcomes, including self-rated, physical, and mental health, were assessed using the 5-level self-rated health scale, the 5-level basic activities of daily living scale, and the 5-level depression scale, respectively. The ordinal logistic regression model was used to examine the relationship between internet use and health among middle-aged and older adults. Additionally, the Karlson-Holm-Breen decomposition method was used to examine the mediation effect of information access. To address endogeneity issues, the two-stage least squares approach was applied. Results: In our sample, nearly half (n=3036, 46.3\%) of the respondents use the internet. Regression analyses revealed that internet use was positively associated with self-rated health (odds ratio [OR] 1.55, 95\% CI 1.39-1.74; P<.001), physical health (OR 1.39, 95\% CI 1.25-1.56; P<.001), and mental health (OR 1.33, 95\% CI 1.19-1.49; P<.001) of middle-aged and older adults. Various dimensions of internet use positively contribute to health. In addition, information access significantly mediated the relationship between internet use and self-rated health ($\beta$=.28, 95\% CI 0.23-0.32), physical health ($\beta$=.40, 95\% CI 0.35-0.45), and mental health ($\beta$=.16, 95\% CI 0.11-0.20). Furthermore, there were significant differences in the relationship between internet use and health among advantaged and disadvantaged groups. Conclusions: The study showed that different dimensions of internet use are associated with better self-rated health, better physical health, and better mental health in middle-aged and older adults. Information access mediates the relationship between internet use and health. This result emphasizes the significance of promoting internet access as a means to enhance the health of middle-aged and older adults in China. ",
doi="10.2196/49688",
url="https://www.jmir.org/2024/1/e49688"
}


@Article{info:doi/10.2196/53513,
author="Gualtieri, Lisa
and Rigby, Mathilda
and Wang, Deelia
and Mann, Elaine",
title="Medication Management Strategies to Support Medication Adherence: Interview Study With Older Adults",
journal="Interact J Med Res",
year="2024",
month="Aug",
day="13",
volume="13",
pages="e53513",
keywords="home medication management",
keywords="medication adherence",
keywords="prescription drugs",
keywords="adherence devices",
keywords="adherence apps",
keywords="pill cases",
keywords="aging in place",
keywords="independent living",
keywords="aging",
keywords="medication",
keywords="older adults",
keywords="prescription",
keywords="interview",
keywords="interview design",
keywords="design",
keywords="app",
keywords="mobile phone",
abstract="Background: Home medication management has been insufficiently studied, including the factors that impact the development and effectiveness of adherence strategies under both routine and anomalous circumstances. Older adults are a particularly important population to study due to the greater likelihood of taking medication in combination with the desire to ``age in place.'' Objective: This interview study aims to understand how older adults develop medication management strategies, identify when and why such strategies succeed or fail, learn more about how older adults think about their medication, and explore interventions that increase medication adherence. Methods: This study used a qualitative, semistructured interview design to elicit older adults' experiences with home medication management. Overall, 22 participants aged ?50 years taking 1 to 3 prescription medications were recruited and interviewed. Interview responses were recorded, and thematic, qualitative analysis was performed by reviewing recordings and identifying recurring patterns and themes. Responses were systematically coded, which not only facilitated the identification of these themes but also allowed us to quantify the prevalence of behaviors and perceptions, providing a robust understanding of medication management and medication adherence. Results: Participants reported developing home medication management strategies on their own, with none of the participants receiving guidance from health care providers and 59\% (13/22) of the participants using trial and error. The strategies developed by study participants were all unique and generally encompassed prescription medication and vitamins or supplements, with no demarcation between what was prescribed or recommended by a physician and what they selected independently. Participants thought about their medications by their chemical name (10/22, 45\%), by the appearance of the pill (8/22, 36\%), by the medication's purpose (2/22, 9\%), or by the medication's generic name (2/22, 9\%). Pill cases (17/22, 77\%) were more popular than prescription bottles (5/22, 23\%) for storage of daily medication. Most participants (19/22, 86\%) stored their pill cases or prescription bottles in visible locations in the home, and those using pill cases varied in their refill routines. Participants used ?2 routines or objects as triggers to take their medication. Nonadherence was associated with a disruption to their routine. Finally, only 14\% (3/22) of the participants used a time-based reminder or alarm, and none of the participants used a medication adherence device or app. Conclusions: Participants in our study varied considerably in their home medication management strategies and developed unique routines to remember to take their medication as well as to refill their pill cases. To reduce trial and error in establishing a strategy, there are opportunities for physicians and pharmacists to provide adherence guidance to older adults. To minimize the impact of disruptions on adherence, there are opportunities to develop more durable strategies and to design aids to medication adherence that leverage established daily routines. ",
doi="10.2196/53513",
url="https://www.i-jmr.org/2024/1/e53513",
url="http://www.ncbi.nlm.nih.gov/pubmed/39137021"
}


@Article{info:doi/10.2196/58635,
author="Lang, Yan
and Chen, Kay-Yut
and Zhou, Yuan
and Kosmari, Ludmila
and Daniel, Kathryn
and Gurses, Ayse
and Young, Richard
and Arbaje, Alicia
and Xiao, Yan",
title="Perception of Medication Safety--Related Behaviors Among Different Age Groups: Web-Based Cross-Sectional Study",
journal="Interact J Med Res",
year="2024",
month="Aug",
day="12",
volume="13",
pages="e58635",
keywords="medication safety",
keywords="patient engagement",
keywords="aged adults",
keywords="survey",
keywords="Amazon Mechanical Turk",
keywords="medication",
keywords="engagement",
keywords="older adults",
keywords="elderly",
keywords="safety",
keywords="United States",
keywords="USA",
keywords="crowdsourcing",
keywords="community",
keywords="patient portal",
keywords="primary care",
keywords="medications",
keywords="safety behavior",
keywords="younger adults",
keywords="age",
keywords="correlation",
keywords="statistical test",
abstract="Background: Previous research and safety advocacy groups have proposed various behaviors for older adults to actively engage in medication safety. However, little is known about how older adults perceive the importance and reasonableness of these behaviors in ambulatory settings. Objective: This study aimed to assess older adults' perceptions of the importance and reasonableness of 8 medication safety behaviors in ambulatory settings and compare their responses with those of younger adults. Methods: We conducted a survey of 1222 adults in the United States using crowdsourcing to evaluate patient behaviors that may enhance medication safety in community settings. A total of 8 safety behaviors were identified based on the literature, such as bringing medications to office visits, confirming medications at home, managing medication refills, using patient portals, organizing medications, checking medications, getting help, and knowing medications. Respondents were asked about their perception of the importance and reasonableness of these behaviors on a 5-point Likert rating scale in the context of collaboration with primary care providers. We assessed the relative ranking of behaviors in terms of importance and reasonableness and examined the association between these dimensions across age groups using statistical tests. Results: Of 1222 adult participants, 125 (10.2\%) were aged 65 years or older. Most participants were White, college-educated, and had chronic conditions. Older adults rated all 8 behaviors significantly higher in both importance and reasonableness than did younger adults (P<.001 for combined behaviors). Confirming medications ranked highest in importance (mean score=3.78) for both age groups while knowing medications ranked highest in reasonableness (mean score=3.68). Using patient portals was ranked lowest in importance (mean score=3.53) and reasonableness (mean score=3.49). There was a significant correlation between the perceived importance and reasonableness of the identified behaviors, with coefficients ranging from 0.436 to 0.543 (all P<.001). Conclusions: Older adults perceived the identified safety behaviors as more important and reasonable than younger adults. However, both age groups considered a behavior highly recommended by professionals as the least important and reasonable. Patient engagement strategies, common and specific to age groups, should be considered to improve medication safety in ambulatory settings. ",
doi="10.2196/58635",
url="https://www.i-jmr.org/2024/1/e58635"
}


@Article{info:doi/10.2196/60009,
author="Yoon, Seolah
and Jeong, Innhee
and Kim, Ivy Jennifer
and Hong, Dahye
and Kang, Bada",
title="Correlates of Mild Behavioral Impairment in Older Adults: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2024",
month="Jul",
day="29",
volume="13",
pages="e60009",
keywords="mild behavioral impairment",
keywords="older adults",
keywords="mild cognitive impairment",
keywords="subjective cognitive decline",
keywords="behavioral symptoms",
keywords="scoping review",
keywords="protocol",
keywords="elderly",
keywords="behavioral impairment",
keywords="cognitive",
keywords="cognitive decline",
keywords="scoping review protocol",
keywords="older adult",
keywords="neuropsychological",
keywords="impairment",
keywords="behavioral",
keywords="behavior",
abstract="Background: Understanding mild behavioral impairment, a relatively recent notion in neuropsychological studies, provides significant insights into early behavioral indicators of cognitive decline and predicts the onset of dementia in older adults. Although the importance of understanding mild behavioral impairment is acknowledged, comprehensive reviews of its correlates with older adults are limited. Objective: This scoping review aims to identify the impact of mild behavioral impairment on health outcomes in older adults and the factors associated with mild behavioral impairment. Methods: The review will adhere to the Joanna Briggs Institute's methodological principles for scoping reviews. We will include studies focusing mainly on mild behavioral impairment in older adults, with the literature on this topic being limited to the period from 2003 to the present. Other clinical diagnoses, such as cognitive impairment, Parkinson disease, and multiple sclerosis, will not be included. We will use databases including PubMed (MEDLINE), CINAHL, Web of Science, Embase, PsycINFO, Cochrane, and Scopus for relevant articles published in English. Both gray literature and peer-reviewed articles will be considered during screening. Three independent reviewers will extract data using a predefined data extraction tool. Extracted data will be presented using tables, figures, and a narrative summary aligned with review questions, accompanied by an analysis of study characteristics and categorization of mild behavioral impairment correlates. Results: The results will be presented as a descriptive summary, structured according to the associated factors related to mild behavioral impairment, and the health outcomes. Additionally, the data on study characteristics will be presented in tabular format. An exploratory search was conducted in July 2023 to establish a comprehensive search strategy, and iterative refinements to the scoping review protocol and formalization of methods were completed. A follow-up search is planned for May 2024, with the aim of submitting the findings for publication in peer-reviewed journals. Conclusions: To our knowledge, this would be the first study to map the literature on the health-related factors and outcomes of mild behavioral impairment. The findings will support the development of interventions to prevent the occurrence of mild behavioral impairment and mitigate the negative outcomes of mild behavioral impairment. International Registered Report Identifier (IRRID): DERR1-10.2196/60009 ",
doi="10.2196/60009",
url="https://www.researchprotocols.org/2024/1/e60009"
}


@Article{info:doi/10.2196/47729,
author="Balki, Eric
and Hayes, Niall
and Holland, Carol",
title="The Indirect Impact of Educational Attainment as a Distal Resource for Older Adults on Loneliness, Social Isolation, Psychological Resilience, and Technology Use During the COVID-19 Pandemic: Cross-Sectional Quantitative Study",
journal="JMIR Aging",
year="2023",
month="Nov",
day="24",
volume="6",
pages="e47729",
keywords="pandemic",
keywords="educational attainment",
keywords="isolation",
keywords="loneliness",
keywords="socioemotional needs",
keywords="social engagement",
keywords="technology use",
keywords="older adults",
keywords="psychological resilience",
abstract="Background: During the COVID-19 pandemic, government-mandated social distancing prevented the spread of the disease but potentially exacerbated social isolation and loneliness for older people, especially those already vulnerable to isolation. Older adults may have been able to draw from their personal resources such as psychological resilience (PR) and technology use (TU) to combat such effects. Educational attainment (EA) or early-life EA may potentially shape later-life personal resources and their impact on the effects of the pandemic lockdown on outcomes such as loneliness. The developmental adaptation model allows for the supposition that social isolation, TU, and PR may be affected by early EA in older adults. Objective: This study examined the indirect impact of EA on pandemic-linked loneliness in a sample of older adults. The developmental adaptation model was used as the conceptual framework to view EA as a distal influence on loneliness, social isolation, PR, and TU. We hypothesized that EA would predict TU and PR and have a moderating impact on social isolation and loneliness. We also hypothesized that PR and TU would mediate the effect of EA on loneliness. Methods: This was a cross-sectional observational study, in which data were gathered from 92 older adults aged ?65 years in the United Kingdom from March 2020 to June 2021, when the country was under various pandemic-linked social mobility restrictions. The data captured demographic information including age, gender, ethnicity, and the highest degree of education achieved. The University of California Los Angeles Loneliness Scale, Connor--Davidson Resilience Scale, Lubben Social Network Index, and Technology Experience Questionnaire were used as standardized measures. Pearson correlation, moderation, and mediation regression analyses were conducted to investigate the hypotheses. Results: We found a higher prevalence of loneliness in older adults than in prepandemic norms. EA was correlated with greater TU and PR and moderated the impact of social isolation on loneliness. PR mediated and TU partially mediated the relationship between EA and loneliness. Conclusions: Early-life EA was confirmed as a distal resource for older adults and played an indirect role in affecting loneliness levels during the pandemic. It has an impact on present-day personal resources, such as PR and TU, which affect loneliness and also moderate the impact of social isolation on loneliness. Policymakers should be aware that older adults with low levels of EA may be more vulnerable to the harmful impacts of loneliness when isolated by choice. ",
doi="10.2196/47729",
url="https://aging.jmir.org/2023/1/e47729",
url="http://www.ncbi.nlm.nih.gov/pubmed/37999938"
}


@Article{info:doi/10.2196/47568,
author="Schmidt, M. Steven
and Iwarsson, Susanne
and Hansson, {\AA}sa
and Dahlgren, David
and Kyl{\'e}n, Maya",
title="Homeownership While Aging---How Health and Economic Factors Incentivize or Disincentivize Relocation: Protocol for a Mixed Methods Project",
journal="JMIR Res Protoc",
year="2023",
month="Jul",
day="10",
volume="12",
pages="e47568",
keywords="housing market",
keywords="aging-in-place",
keywords="housing policy",
keywords="healthy aging",
keywords="mobility",
keywords="housing preferences",
abstract="Background: Many factors influence housing choices among older adults, but far from all have been identified. There is little systematic analysis that has included economic factors and virtually no knowledge about the interplay among perceived costs of moving, health status, and the mobility rate of older homeowners. It is currently unclear whether economic factors influence older adults' willingness to move, and the effects of economic policies on their actual behavior in the housing market are largely unknown. Objective: The overarching objective of the AGE-HERE project is to develop knowledge of the relationship between health and economic factors that incentivize or disincentivize relocation during the process of aging. Methods: This project uses a mixed methods convergent design across 4 studies. The initial quantitative register study and subsequent qualitative focus group study will nurture the evidence base and the development of a national survey. The final study will synthesize and integrate the results of the entire project. Results: Ethical approval for the register study (DNR 2022-04626-01) and focus group study (DNR 2023-01887-01) has been obtained. As of July 2023, data analyses (register study) and data collection (focus group study) are currently being conducted. The first paper based on the register data is expected to be submitted after the summer of 2023. Three meetings have been held with the nonacademic reference group. The qualitative data will be analyzed in the autumn. Based on the results of these studies, a survey questionnaire will be developed and distributed nationally during the spring of 2024, followed by data analyses in the autumn. Finally, the results from all studies will be synthesized in 2025. Conclusions: Results from AGE-HERE will add to the knowledge base for research on aging, health, and housing and can play a critical role in guiding future policy decisions aiming to balance the housing market. Such developments may lower related social costs and support older adults to maintain active, independent, and healthy lives. International Registered Report Identifier (IRRID): DERR1-10.2196/47568 ",
doi="10.2196/47568",
url="https://www.researchprotocols.org/2023/1/e47568",
url="http://www.ncbi.nlm.nih.gov/pubmed/37428548"
}


@Article{info:doi/10.2196/46014,
author="Wang, Jingjing
and Liang, Yiqing
and Cao, Songmei
and Cai, Peixuan
and Fan, Yimeng",
title="Application of Artificial Intelligence in Geriatric Care: Bibliometric Analysis",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="23",
volume="25",
pages="e46014",
keywords="artificial intelligence",
keywords="older adults",
keywords="geriatric care",
keywords="bibliometric analysis",
abstract="Background: Artificial intelligence (AI) can improve the health and well-being of older adults and has the potential to assist and improve nursing care. In recent years, research in this area has been increasing. Therefore, it is necessary to understand the status of development and main research hotspots and identify the main contributors and their relationships in the application of AI in geriatric care via bibliometric analysis. Objective: Using bibliometric analysis, this study aims to examine the current research hotspots and collaborative networks in the application of AI in geriatric care over the past 23 years. Methods: The Web of Science Core Collection database was used as a source. All publications from inception to August 2022 were downloaded. The external characteristics of the publications were summarized through HistCite and the Web of Science. Keywords and collaborative networks were analyzed using VOSviewers and Citespace. Results: We obtained a total of 230 publications. The works originated in 499 institutions in 39 countries, were published in 124 journals, and were written by 1216 authors. Publications increased sharply from 2014 to 2022, accounting for 90.87\% (209/230) of all publications. The United States and the International Journal of Social Robotics had the highest number of publications on this topic. The 1216 authors were divided into 5 main clusters. Among the 230 publications, 4 clusters were modeled, including Alzheimer disease, aged care, acceptance, and the surveillance and treatment of diseases. Machine learning, deep learning, and rehabilitation had also become recent research hotspots. Conclusions: Research on the application of AI in geriatric care has developed rapidly. The development of research and cooperation among countries/regions and institutions are limited. In the future, strengthening the cooperation and communication between different countries/regions and institutions may further drive this field's development. This study provides researchers with the information necessary to understand the current state, collaborative networks, and main research hotspots of the field. In addition, our results suggest a series of recommendations for future research. ",
doi="10.2196/46014",
url="https://www.jmir.org/2023/1/e46014",
url="http://www.ncbi.nlm.nih.gov/pubmed/37351923"
}


@Article{info:doi/10.2196/42577,
author="Gu{\'e}nette, Line
and Kr{\"o}ger, Edeltraut
and Bonnan, Dylan
and Maheu, Anne
and Morin, Mich{\`e}le
and B{\'e}langer, Laurianne
and Vedel, Isabelle
and Wilchesky, Machelle
and Sirois, Caroline
and Durand, Etienne
and Couturier, Yves
and Sourial, Nadia
and Dallaire, Cl{\'e}mence",
title="Reorganizing Pharmaceutical Care in Family Medicine Groups for Older Adults With or at Risk of Major Neurocognitive Disorders: Protocol for a Mixed Methods Study",
journal="JMIR Res Protoc",
year="2022",
month="Nov",
day="17",
volume="11",
number="11",
pages="e42577",
keywords="primary care",
keywords="older adults",
keywords="neurocognitive disorders",
keywords="pharmaceutical care",
keywords="mixed method study",
abstract="Background: The latest global figures show that 55 million persons lived with major neurocognitive disorders (MNCDs) worldwide in 2021. In Quebec, Canada, most of these older adults are cared for by family physicians in interdisciplinary primary care clinics such as family medicine groups (FMG). When a person has a MNCD, taking potentially inappropriate medications or polypharmacy (5 different medications or more) increases their vulnerability to serious adverse events. With the recent arrival of pharmacists working in FMGs and their expanded scope of practice and autonomy, new possibilities for optimizing older adults' pharmacotherapy are opening. Objective: This project aims to evaluate the impact of involving these pharmacists in the care trajectory of older adults living with MNCD, in an interdisciplinary collaboration with the FMG team, as well as home care nurses and physicians. Pharmacists will provide medication reviews, interventions, and recommendations to improve the pharmacotherapy and support offered to these patients and their caregivers. Methods: This 2-step mixed methods study will include a quasi-experimental controlled trial (step 1) and semistructured interviews (step 2). Older adults undergoing cognitive assessment, recently diagnosed with MNCD, or receiving care for this at home will be identified and recruited in FMGs in 2 Quebec regions. FMGs implementing the intervention will involve pharmacists in these patients' care trajectory. Training and regular mentoring will be offered to these FMGs, especially to pharmacists. In control FMGs, no FMG pharmacist will be involved with these patients, and usual care will be provided. Results: Medication use (including appropriateness) and burden, satisfaction of care received, and quality of life will be assessed at study beginning and after 6 months of follow-up and compared between groups. At the end of the intervention study, we will conduct semistructured interviews with FMG care team members (pharmacists, nurses, and physicians) who have experienced the intervention. We will ask about the feasibility of integrating the intervention into practice and their satisfaction with and their perception of the intervention's impacts for older adults and their families. We will assess the effect of improved pharmaceutical care for older adults with or at risk of MNCDs through the involvement of FMG pharmacists and a reorganization of pharmaceutical care. Conclusions: The inclusion of pharmacists in interdisciplinary care teams is recent and rising, strengthened by more substantial pharmacist practice roles. Results will inform the processes required to successfully involve pharmacists and implement developed tools and procedures transposable to other care settings to improve patient care. Trial Registration: ClinicalTrials.gov NCT04889794; https://clinicaltrials.gov/ct2/show/NCT04889794 International Registered Report Identifier (IRRID): DERR1-10.2196/42577 ",
doi="10.2196/42577",
url="https://www.researchprotocols.org/2022/11/e42577",
url="http://www.ncbi.nlm.nih.gov/pubmed/36264995"
}


@Article{info:doi/10.2196/37315,
author="Lavoie, Audrey
and Dub{\'e}, V{\'e}ronique",
title="Web-Based Interventions to Promote Healthy Lifestyles for Older Adults: Scoping Review",
journal="Interact J Med Res",
year="2022",
month="Aug",
day="23",
volume="11",
number="2",
pages="e37315",
keywords="aged",
keywords="behavior change",
keywords="components",
keywords="effects",
keywords="healthy lifestyle",
keywords="web-based intervention",
abstract="Background: With the aging of the population and rising rates of chronic diseases, web-based interventions could be considered to support older adults in adopting healthy lifestyles. To date, published knowledge syntheses have focused on quantitative studies among older adults aged ?50 years. However, those aged ?65 years may have different needs to be met by these interventions because of the biological and physiological changes associated with aging, and qualitative studies could help advance knowledge in this field. Objective: The objective of this scoping review is to explore the extent of the literature on web-based interventions aimed at promoting healthy lifestyles among people aged ?65 years. Methods: A scoping review was conducted based on the framework proposed by Levac et al. Six databases (ie, MEDLINE, CINAHL, PsycINFO, Web of Science, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Library) and gray literature (ie, Google Scholar and OpenGrey) were searched. The final search was conducted on June 23, 2021. The studies were selected by 2 persons (AL and ML) independently. The included studies were systematic reviews and qualitative and quantitative studies focusing on web-based interventions to promote healthy lifestyles in people aged ?65 years that were published in French or English between 1990 and 2021. Data were extracted in a table and synthesized based on the conceptualization of web-based interventions (ie, according to the use parameters, behavior change techniques, delivery modes, and theories). A thematic analysis was performed. Results: In total, 20 articles were included in this review, which represents studies focused on 11 distinct interventions. All of the interventions (11/11, 100\%) aimed to promote physical activity among older adults. The number of intervention sessions varied from 5 to 16, with a frequency from daily to once every 2 weeks. Diverse delivery modes such as electronic diary, video, and phone call were found. The most used behavior change techniques were instruction, feedback, and self-monitoring. Few interventions (6/11, 55\%) were based on a theory. A favorable trend was observed in increasing physical activity, and 5 themes emerged that appeared to be central to behavior change among older adults: motivation, support, tailoring, barriers, and perceptions. Conclusions: This scoping review provides a better understanding of the components of web-based interventions and their outcomes on the healthy lifestyles of people aged ?65 years. These findings could provide important guidance for the design and development of future web-based interventions in this field. Further research is needed to continue the development and evaluation of innovative and accessible interventions to promote healthy lifestyles among older adults. International Registered Report Identifier (IRRID): RR2-10.2196/23207 ",
doi="10.2196/37315",
url="https://www.i-jmr.org/2022/2/e37315",
url="http://www.ncbi.nlm.nih.gov/pubmed/35998024"
}


@Article{info:doi/10.2196/36269,
author="Beogo, Idrissa
and Sia, Drissa
and Tchouaket Nguemeleu, Eric
and Zhao, Junqiang
and Gagnon, Marie-Pierre
and Etowa, Josephine",
title="Strengthening Social Capital to Address Isolation and Loneliness in Long-term Care Facilities During the COVID-19 Pandemic: Protocol for a Systematic Review of Research on Information and Communication Technologies",
journal="JMIR Res Protoc",
year="2022",
month="Mar",
day="24",
volume="11",
number="3",
pages="e36269",
keywords="ICT, long-term care facilities, COVID-19, social isolation, loneliness, pandemic, implementation sciences, protocol",
keywords="nursing home",
keywords="long-term care",
keywords="mental health",
keywords="aging",
keywords="older adults",
keywords="virtual communication",
keywords="virtual care",
keywords="information technology",
keywords="healthcare",
keywords="healthcare sector",
keywords="health care",
abstract="Background: The COVID-19 pandemic has had the greatest impact in long-term care facilities (LTCFs) by disproportionately harming older adults and heightening social isolation and loneliness (SIL). Living in close quarters with others and in need of around-the-clock assistance, interactions with older adults, which were previously in person, have been replaced by virtual chatting using information and communication technologies (ICTs). ICT applications such as FaceTime, Zoom, and Microsoft Teams video chatting have been overwhelmingly used by families to maintain residents' social capital and subsequently reduce their SIL. Objective: Because of the lack of substantive knowledge on this ever-increasing form of social communication, this systematic review intends to synthesize the effects of ICT interventions to address SIL among residents in LTCFs during the COVID-19 period. Methods: We will include studies published in Chinese, English, and French from December 2019 onwards. Beyond the traditional search strategy approach, 4 of the 12 electronic databases to be queried will be in Chinese. We will include quantitative and intervention studies as well as qualitative and mixed methods designs. Using a 2-person approach, the principal investigator and one author will blindly screen eligible articles, extract data, and assess risk of bias. In order to improve the first round of screening, a pilot-tested algorithm will be used. Disagreements will be resolved through discussion with a third author. Results will be presented as structured summaries of the included studies. We plan to conduct a meta-analysis if sufficient data are available. Results: A total of 1803 articles have been retrieved to date. Queries of the Chinese databases are ongoing. The systematic review and subsequent manuscript will be completed by the fall of 2022. Conclusions: ICT applications have become a promising avenue to reduce SIL by providing a way to maintain communication between LTCF residents and their families and will certainly remain in the post--COVID-19 period. This review will investigate and describe context-pertinent and high-quality programs and initiatives to inform, at the macro level, policy makers and researchers, frontline managers, and families. These methods will remain relevant in the post--COVID-19 era. International Registered Report Identifier (IRRID): DERR1-10.2196/36269 ",
doi="10.2196/36269",
url="https://www.researchprotocols.org/2022/3/e36269",
url="http://www.ncbi.nlm.nih.gov/pubmed/35275841"
}


@Article{info:doi/10.2196/26871,
author="Gomes, Antunes Lu{\'i}s
and Greg{\'o}rio, Jo{\~a}o Maria
and Iakovleva, A. Tatiana
and Sousa, de Rute Dinis
and Bessant, John
and Oliveira, Pedro
and Branco, C. Jaime
and Canh{\~a}o, Helena
and Rodrigues, Maria Ana",
title="A Home-Based eHealth Intervention for an Older Adult Population With Food Insecurity: Feasibility and Acceptability Study",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="31",
volume="23",
number="8",
pages="e26871",
keywords="food insecurity",
keywords="eHealth",
keywords="television app",
keywords="elderly people",
keywords="vulnerable population",
keywords="cognitive behavioral strategy",
keywords="health innovation",
keywords="multidisciplinary program",
abstract="Background: Food insecurity is a global public health challenge, affecting predominately the most vulnerable people in society, including older adults. For this population, eHealth interventions represent an opportunity for promoting healthy lifestyle habits, thus mitigating the consequences of food insecurity. However, before their widespread dissemination, it is essential to evaluate the feasibility and acceptability of these interventions among end users. Objective: This study aims to explore the feasibility and acceptability of a home-based eHealth intervention focused on improving dietary and physical activity through an interactive television (TV) app among older adults with food insecurity. Methods: A pilot noncontrolled quasi-experimental study was designed with baseline and 3-month follow-up assessments. Older adult participants with food insecurity were recruited from 17 primary health care centers in Portugal. A home-based intervention program using an interactive TV app aimed at promoting healthy lifestyle behaviors was implemented over 12 weeks. Primary outcomes were feasibility (self-reported use and interest in eHealth) and acceptability (affective attitude, burden, ethicality, perceived effectiveness, and self-efficacy), which were evaluated using a structured questionnaire with a 7-point Likert scale. Secondary outcomes were changes in food insecurity (Household Food Insecurity Scale), quality of life (European Quality of Life Questionnaire with five dimensions and three levels and Functional Assessment of Chronic Illness Therapy-Fatigue), physical function (Health Assessment Questionnaire, Elderly Mobility Scale, grip strength, and regularity of exercise), and nutritional status (adherence to the Mediterranean diet). Results: A sample of 31 older adult individuals with food insecurity was enrolled in the 12-week intervention program with no dropouts. A total of 10 participants self-reported low use of the TV app. After the intervention, participants were significantly more interested in using eHealth to improve food insecurity (baseline median 1.0, IQR 3.0; 3-month median 5.0, IQR 5.0; P=.01) and for other purposes (baseline median 1.0, IQR 2.0; 3-month median 6.0, IQR 2.0; P=.03). High levels of acceptability were found both before and after (median range 7.0-7.0, IQR 2.0-0.0 and 5.0-7.0, IQR 2.0-2.0, respectively) the intervention, with no significant changes for most constructs. Clinically, there was a reduction of 40\% in food insecurity (P=.001), decreased fatigue (mean ?3.82, SD 8.27; P=.02), and improved physical function (Health Assessment Questionnaire: mean ?0.22, SD 0.38; P=.01; Elderly Mobility Scale: mean ?1.50, SD 1.08; P=.01; regularity of exercise: baseline 10/31, 32\%; 3 months 18/31, 58\%; P=.02). No differences were found for the European Quality of Life Questionnaire with five dimensions and three levels, grip strength, or adherence to the Mediterranean diet. Conclusions: The home-based eHealth intervention was feasible and highly acceptable by participants, thus supporting a future full-scale trial. The intervention program not only reduced the proportion of older adults with food insecurity but also improved participants' fatigue and physical function. International Registered Report Identifier (IRRID): RR2-10.2196/resprot.6626 ",
doi="10.2196/26871",
url="https://www.jmir.org/2021/8/e26871",
url="http://www.ncbi.nlm.nih.gov/pubmed/34463638"
}


@Article{info:doi/10.2196/24015,
author="Kraaijkamp, M. Jules J.
and van Dam van Isselt, F. El{\'e}onore
and Persoon, Anke
and Versluis, Anke
and Chavannes, H. Niels
and Achterberg, P. Wilco",
title="eHealth in Geriatric Rehabilitation: Systematic Review of Effectiveness, Feasibility, and Usability",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="19",
volume="23",
number="8",
pages="e24015",
keywords="geriatric rehabilitation",
keywords="eHealth",
keywords="mHealth",
keywords="digital health",
keywords="effectiveness",
keywords="feasibility",
keywords="usability",
keywords="systematic review",
abstract="Background: eHealth has the potential to improve outcomes such as physical activity or balance in older adults receiving geriatric rehabilitation. However, several challenges such as scarce evidence on effectiveness, feasibility, and usability hinder the successful implementation of eHealth in geriatric rehabilitation. Objective: The aim of this systematic review was to assess evidence on the effectiveness, feasibility, and usability of eHealth interventions in older adults in geriatric rehabilitation. Methods: We searched 7 databases for randomized controlled trials, nonrandomized studies, quantitative descriptive studies, qualitative research, and mixed methods studies that applied eHealth interventions during geriatric rehabilitation. Included studies investigated a combination of effectiveness, usability, and feasibility of eHealth in older patients who received geriatric rehabilitation, with a mean age of ?70 years. Quality was assessed using the Mixed Methods Appraisal Tool and a narrative synthesis was conducted using a harvest plot. Results: In total, 40 studies were selected, with clinical heterogeneity across studies. Of 40 studies, 15 studies (38\%) found eHealth was at least as effective as non-eHealth interventions (56\% of the 27 studies with a control group), 11 studies (41\%) found eHealth interventions were more effective than non-eHealth interventions, and 1 study (4\%) reported beneficial outcomes in favor of the non-eHealth interventions. Of 17 studies, 16 (94\%) concluded that eHealth was feasible. However, high exclusion rates were reported in 7 studies of 40 (18\%). Of 40 studies, 4 (10\%) included outcomes related to usability and indicated that there were certain aging-related barriers to cognitive ability, physical ability, or perception, which led to difficulties in using eHealth. Conclusions: eHealth can potentially improve rehabilitation outcomes for older patients receiving geriatric rehabilitation. Simple eHealth interventions were more likely to be feasible for older patients receiving geriatric rehabilitation, especially, in combination with another non-eHealth intervention. However, a lack of evidence on usability might hamper the implementation of eHealth. eHealth applications in geriatric rehabilitation show promise, but more research is required, including research with a focus on usability and participation. ",
doi="10.2196/24015",
url="https://www.jmir.org/2021/8/e24015",
url="http://www.ncbi.nlm.nih.gov/pubmed/34420918"
}


@Article{info:doi/10.2196/25607,
author="Stephens, Alastair
and Rudd, Hannah
and Stephens, Emilia
and Ward, Jayne",
title="Secondary Prevention of Hip Fragility Fractures During the COVID-19 Pandemic: Service Evaluation of ``MRS BAD BONES''",
journal="JMIR Aging",
year="2020",
month="Dec",
day="22",
volume="3",
number="2",
pages="e25607",
keywords="osteoporosis",
keywords="fragility fracture",
keywords="guideline",
keywords="mnemonic",
keywords="acronym",
keywords="COVID-19",
keywords="bone",
keywords="morbidity",
keywords="mortality",
keywords="fracture",
keywords="elderly",
keywords="older adults",
keywords="geriatrics",
keywords="audit",
keywords="prevention",
abstract="Background: Management of osteoporosis is an important consideration for patients with femoral neck fractures due to the morbidity and mortality it poses. The input of orthogeriatric teams is invaluable in coordinating secondary fragility fracture prevention. The COVID-19 pandemic resulted in the rapid restructuring of health care teams and led to the redeployment of orthogeriatricians. Objective: This study aimed to determine the impact COVID-19 had on the secondary prevention of fragility fractures among patients with femoral neck fractures, and to optimize management in this population. Methods: A retrospective audit was conducted of patients with femoral neck fractures before and after the lockdown in response to the COVID-19 pandemic in the United Kingdom. A reaudit was conducted following the development of our new mnemonic, ``MRS BAD BONES,'' which addressed key factors in the assessment and management of osteoporosis: medication review, rheumatology/renal advice, smoking cessation; blood tests, alcohol limits, DEXA (dual energy X-ray absorptiometry) scan; bone-sparing medications, orthogeriatric review, nutrition, exercise, supplements. The Fisher exact test was used for comparison analyses between each phase. Results: Data for 50 patients were available in each phase. The orthogeriatric team reviewed 88\% (n=44) of patients prelockdown, which fell to 0\% due to redeployment, before recovering to 38\% (n=19) in the postintervention period. The lockdown brought a significant drop in the prescription of vitamin D/calcium supplements from 81.6\% (n=40) to 58.0\% (n=29) (P=.02); of bone-sparing medications from 60.7\% (n=17) to 18.2\% (n=4) (P=.004), and DEXA scan requests from 40.1\% (n=9) to 3.6\% (n=1) (P=.003). Following the implementation of our mnemonic, there was a significant increase in the prescription of vitamin D/calcium supplements to 85.7\% (n=42) (P=.003), bone-sparing medications to 72.4\% (n=21) (P<.001), and DEXA scan requests to 60\% (n=12) (P<.001). Conclusions: The redeployment of the orthogeriatric team, due to the COVID-19 pandemic, impacted the secondary prevention of fragility fractures in the study population. The ``MRS BAD BONES'' mnemonic significantly improved management and could be used in a wider setting. ",
doi="10.2196/25607",
url="https://aging.jmir.org/2020/2/e25607",
url="http://www.ncbi.nlm.nih.gov/pubmed/33326412"
}


@Article{info:doi/10.2196/18169,
author="Backman, Chantal
and Harley, Anne
and Kuziemsky, Craig
and Mercer, Jay
and Peyton, Liam",
title="MyPath to Home Web-Based Application for the Geriatric Rehabilitation Program at Bruy{\`e}re Continuing Care: User-Centered Design and Feasibility Testing Study",
journal="JMIR Form Res",
year="2020",
month="Sep",
day="14",
volume="4",
number="9",
pages="e18169",
keywords="geriatric rehabilitation",
keywords="care transition",
keywords="technology",
keywords="hip fracture",
abstract="Background: When older adults return home from geriatric rehabilitation in a hospital, remembering the plethora of medical advice and medical instructions provided can be overwhelming for them and for their caregivers. Objective: The overall objective was to develop and test the feasibility of a novel web-based application called MyPath to Home that can be used to manage the personalized needs of geriatric rehabilitation patients during their transition from the hospital to home. Methods: This study involved (1) co-designing a patient- and clinician-tailored web-based application and (2) testing the feasibility of the application to manage the needs of geriatric rehabilitation patients when leaving the hospital. In phase 1, we followed a user-centered design process integrated with the modern agile software development methodology to iteratively co-design the application. The approach consisted of three cycles in which we engaged patients, caregivers, and clinicians to design a series of prototypes (cycles 1-3). In phase 2, we conducted a single-arm feasibility pilot test of MyPath to Home. Baseline and follow-up surveys, as well as select semistructured interviews were conducted. Results: In phase 1, semistructured interviews and talk-aloud sessions were conducted with patients/caregivers (n=5) and clinicians (n=17) to design the application. In phase 2, patients (n=30), caregivers (n=18), and clinicians (n=20) received access to use the application. Patients and their caregivers were asked to complete baseline and follow-up surveys. A total of 91\% (21/23) of patients would recommend this application to other patients. In addition, clinicians (n=6) and patients/caregivers (n=6) were interviewed to obtain further details on the value of the web-based application with respect to engaging patients and facilitating communication and sharing of information with the health care team. Conclusions: We were successful at designing the MyPath to Home prototype for patients and their caregivers to engage with their clinicians during the transition from geriatric rehabilitation to home. Further work is needed to increase the uptake and usage by clinicians, and determine if this translates to meaningful changes in clinical and functional outcomes. International Registered Report Identifier (IRRID): RR2-10.2196/11031 ",
doi="10.2196/18169",
url="http://formative.jmir.org/2020/9/e18169/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32924953"
}


@Article{info:doi/10.2196/16700,
author="G Bianchi, Mara
and Santos, Andre
and Cordioli, Eduardo",
title="Benefits of Teledermatology for Geriatric Patients: Population-Based Cross-Sectional Study",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="21",
volume="22",
number="4",
pages="e16700",
keywords="access to and use of services",
keywords="decision making",
keywords="epidemiology",
keywords="economics",
keywords="health care systems and management (telehealth)",
keywords="management",
keywords="technology",
keywords="teledermatology",
keywords="geriatric population",
abstract="Background: Teledermatology is a health care tool that has been increasingly used around the world, mostly because dermatology has an emphasis on visual diagnosis. Many studies have shown that access to specialized care improves using teledermatology, which provides accurate diagnosis and reduces the time taken for treatment, with high patient satisfaction. As the population around the world grows old, there will be even more demand for dermatologists in years to come. It is essential to know which are the most prevalent skin conditions in the primary care population and if they can be addressed through teledermatology. Objective: Our main goal was to evaluate the proportion of lesions in individuals aged 60 years and older that could be managed using teledermatology in conjunction with primary care physicians. Second, we aimed to assess the most frequent skin lesions, the most common treatments provided to patients, and the distribution and causes of referrals made by the teledermatologists. Methods: This was a retrospective cohort study from July 2017 to July 2018 in S{\~a}o Paulo, Brazil. We included 6633 individuals aged 60 years and older who presented with 12,770 skin lesions. Teledermatologists had three options to refer patients: (1) to undergo biopsy directly, (2) to an in-person dermatologist visit, and (3) back to the primary care physician with the most probable diagnosis and treatment. Results: Teledermatology managed 66.66\% (8408/12614) of dermatoses with the primary care physician without the need for an in-presence visit; 27.10\% (3419/12614) were referred to dermatologists, and 6.24\% (787/12614) directly to biopsy. The most frequent diseases were seborrheic keratosis, solar lentigo, onychomycosis, melanocytic nevus, benign neoplasms, actinic keratosis, epidermoid cyst, xerosis, leucoderma, and wart, with significant differences between sexes. Malignant tumors increased with age and were the leading cause for biopsies, while infectious skin conditions and pigmentary disorders decreased. Emollient was the most frequent treatment prescribed, in 31.88\% (909/2856) of the cases. Conclusions: Teledermatology helped to treat 67\% of the dermatoses of older individuals, addressing cases of minor complexity quickly and conveniently together with the primary care physician, thus optimizing dermatological appointments for the most severe, surgical, or complex diseases. Teledermatology does not aim to replace a face-to-face visit with the dermatologist; however, it might help to democratize dermatological treatment access for patients and decrease health care expenses. ",
doi="10.2196/16700",
url="http://www.jmir.org/2020/4/e16700/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32314966"
}


@Article{info:doi/10.2196/12781,
author="Tsuda, Kenji
and Higuchi, Asaka
and Yokoyama, Emi
and Kosugi, Kazuhiro
and Komatsu, Tsunehiko
and Kami, Masahiro
and Tanimoto, Tetsuya",
title="Physician Decision-Making Patterns and Family Presence: Cross-Sectional Online Survey Study in Japan",
journal="Interact J Med Res",
year="2019",
month="Sep",
day="06",
volume="8",
number="3",
pages="e12781",
keywords="physician decision making",
keywords="family",
keywords="cross-sectional study",
keywords="cardiopulmonary resuscitation",
keywords="artificial ventilation",
abstract="Background: Due to a low birth rate and an aging population, Japan faces an increase in the number of elderly people without children living in single households. These elderly without a spouse and/or children encounter a lack of caregivers because most sources of care for the elderly in Japan are not provided by private agencies but by family members. However, family caregivers not only help with daily living but are also key participants in treatment decision making. The effect of family absence on treatment decision making has not been elucidated, although more elderly people will not have family members to make surrogate decisions on their behalf. Objective: The aim is to understand the influence of family absence on treatment decision making by physicians through a cross-sectional online survey with three hypothetical vignettes of patients. Methods: We conducted a cross-sectional online survey among Japanese physicians using three hypothetical vignettes. The first vignette was about a 65-year-old man with alcoholic liver cirrhosis and the second was about a 78-year-old woman with dementia, both of whom developed pneumonia with consciousness disturbance. The third vignette was about a 70-year-old woman with necrosis of her lower limb. Participants were randomly assigned to either of the two versions of the questionnaires---with family or without family---but methods were identical otherwise. Participants chose yes or no responses to questions about whether they would perform the presented medical procedures. Results: Among 1112 physicians, 454 (40.8\%) completed the survey; there were no significant differences in the baseline characteristics between groups. Significantly fewer physicians had a willingness to perform dialysis (odds ratio [OR] 0.55, 95\% CI 0.34-0.80; P=.002) and artificial ventilation (OR 0.51, 95\% CI 0.35-0.75; P<.001) for a patient from vignette 1 without family. In vignette 2, fewer physicians were willing to perform artificial ventilation (OR 0.59, 95\% CI 0.39-0.90; P=.02). In vignette 3, significantly fewer physicians showed willingness to perform wound treatment (OR 0.51, 95\% CI 0.31-0.84; P=.007), surgery (OR 0.35, 95\% CI 0.22-0.57; P<.001), blood transfusion (OR 0.45, 95\% CI 0.31-0.66; P<.001), vasopressor (OR 0.49, 95\% CI 0.34-0.72; P<.001), dialysis (OR 0.38, 95\% CI 0.24-0.59; P<.001), artificial ventilation (OR 0.25, 95\% CI 0.15-0.40; P<.001), and chest compression (OR 0.29, 95\% CI 0.18-0.47; P<.001) for a patient without family. Conclusions: Elderly patients may have treatments withheld because of the absence of family, highlighting the potential importance of advance care planning in the era of an aging society with a declining birth rate. ",
doi="10.2196/12781",
url="http://www.i-jmr.org/2019/3/e12781/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31493327"
}