JMIR Aging最新文献

Background: The potential benefits of IT for the well-being of older adults have been widely anticipated. However, findings regarding the impact of internet use on depressive symptoms are inconsistent. As a result of IT's exponential growth, internet skills have supplanted internet access as the source of the digital divide.

Objective: This study evaluates the effect of internet skills on depressive symptoms through an instrumental variables (IV) approach.

Methods: Data from the China Health and Retirement Longitudinal Study's wave 4 (2018) were used. This included 16,949 community residents aged 45 years and older. To overcome the endogeneity issue, we used an IV approach.

Results: Our results reveal the emergence of a second-level digital divide, the disparity in internet skills, among Chinese middle-aged and older adults. Liner regression suggests that a 1% increase in internet skills is associated with a 0.037% decrease in depressive symptoms (β=-.037, SE 0.009), which underestimates the causal effect. As expected, internet skills are an endogenous variable (F test P value <.001). IV regressions indicate that a 1% increase in internet skills reduces 1.135% (SE 0.471) to 1.741% (SE 0.297) of depressive symptoms. These 2 IV are neither weak (F-1=16.7 and 28.5; both >10) nor endogenous (Wu-Hausman test P value of .10; >.05 or >.01).

Conclusions: Better mental health is predicted through improved and higher internet skills. Consequently, residents and policy makers in China should focus on bridging the digital divide in internet skills among middle-aged and older adults.

Background: Digital neuropsychological tools for diagnosing neurodegenerative diseases in the older population are becoming more relevant and widely adopted because of their diagnostic capabilities. In this context, explicit memory is mainly examined. The assessment of implicit memory occurs to a lesser extent. A common measure for this assessment is the serial reaction time task (SRTT).

Objective: This study aims to develop and empirically test a digital tablet-based SRTT in older participants with cognitive impairment (CoI) and healthy control (HC) participants. On the basis of the parameters of response accuracy, reaction time, and learning curve, we measure implicit learning and compare the HC and CoI groups.

Methods: A total of 45 individuals (n=27, 60% HCs and n=18, 40% participants with CoI-diagnosed by an interdisciplinary team) completed a tablet-based SRTT. They were presented with 4 blocks of stimuli in sequence and a fifth block that consisted of stimuli appearing in random order. Statistical and machine learning modeling approaches were used to investigate how healthy individuals and individuals with CoI differed in their task performance and implicit learning.

Results: Linear mixed-effects models showed that individuals with CoI had significantly higher error rates (b=-3.64, SE 0.86; z=-4.25; P<.001); higher reaction times (F_1,41=22.32; P<.001); and lower implicit learning, measured via the response increase between sequence blocks and the random block (β=-0.34; SE 0.12; t=-2.81; P=.007). Furthermore, machine learning models based on these findings were able to reliably and accurately predict whether an individual was in the HC or CoI group, with an average prediction accuracy of 77.13% (95% CI 74.67%-81.33%).

Conclusions: Our results showed that the HC and CoI groups differed substantially in their performance in the SRTT. This highlights the promising potential of implicit learning paradigms in the detection of CoI. The short testing paradigm based on these results is easy to use in clinical practice.

Background: Older adults experience a significant decline in muscle integrity and function with aging. Early detection of decreased muscle quality can pave the way for interventions to mitigate the progression of age-related physical declines. Phase angle (PhA) and impedance ratio (IR) are measures of muscle integrity, which can be assessed quickly via bioelectrical impedance analysis (BIA) and may be indicative of physical function.

Objective: This study aimed to characterize the relationships among handgrip strength (HGS), sit-to-stand (STS), BTrackS balance scores, fear of falling (evaluated using the Short Falls Efficacy Scale-International [Short FES-I]), and IR among community-dwelling older adult women classified as having a low or high PhA.

Methods: A cross-sectional analysis was conducted with 85 older women (mean age 75.0, SD 7.2 years; mean weight 71.0, SD 15.0 kg; mean height 162.6, SD 6.1 cm). To examine the influence of PhA on performance measures, participants were divided into 2 PhA groups: high (>4.1°; n=56) and low (≤4.1°; n=29). Data were nonnormative; hence, the Mann-Whitney U test was used to evaluate between-group differences, and Kendall τ coefficients were used to determine the partial correlations.

Results: The low PhA group had a significantly higher IR (mean 0.85, SD 0.03) than the high PhA group (mean 0.81, SD 0.03; r=.92; P<.001). The high PhA group had superior HGS (mean 21.4, SD 6.2 kg; P=.007; r=0.36), BTrackS balance scores (mean 26.6, SD 9.5 cm; P=.03; r=0.30), and STS scores (mean 16.0, SD 5.5; P<.001; r=0.49) than the low PhA group (mean HGS 17.6, SD 4.7 kg; mean BTrackS balance score 37.1, SD 21.1 cm; mean STS score 10.7, SD 6.2). Both PhA and IR were significantly correlated with HGS and BTrackS balance, STS, and Short FES-I scores (P<.05). However, on adjusting for the whole sample's age, only PhA was strongly correlated with HGS (τb=0.75; P=.003) and STS scores (τb=0.76; P=.002). Short FES-I scores were moderately correlated with IR (τb=0.46; P=.07) after controlling for age. No significant between-group differences were observed for height, weight, or BMI.

Conclusions: PhA and IR are associated with physical function and the fear of falling in older women. However, only PhA was significantly associated with physical function (HGS and STS) independent of age. Conversely, only IR was significantly associated with the fear of falling. Diminished physical function and increased IR appear to be characteristics of older women with a PhA of ≤4.1°. These findings suggest that PhA and IR measured through BIA together may serve as a valuable tool for early identification of older women at the risk of functional decline and a heightened fear of falling.

Background: The COVID-19 pandemic has accelerated the shift toward the digital provision of many public services, including health and social care, public administration, and financial and leisure services. COVID-19 services including test appointments, results, vaccination appointments and more were primarily delivered through digital channels to the public. Many social, cultural, and economic activities (appointments, ticket bookings, tax and utility payments, shopping, etc) have transitioned to web-based platforms. To use web-based public services, individuals must be digitally included. This is influenced by 3 main factors: access (whether individuals have access to the internet), ability (having the requisite skills and confidence to participate over the web), and affordability (ability to pay for infrastructure [equipment] and data packages). Many older adults, especially those aged >75 years, are still digitally excluded.

Objective: This study aims to explore the views of adults aged >75 years on accessing public services digitally.

Methods: We conducted semistructured qualitative interviews with a variety of adults aged ≥75 years residing in Greater Manchester, United Kingdom. We also interviewed community support workers. Thematic analysis was used to identify the key themes from the data.

Results: Overall, 24 older adults (mean age 81, SD 4.54 y; 14/24, 58% female; 23/24, 96% White British; and 18/24, 75% digitally engaged to some extent) and 2 support workers participated. A total of five themes were identified as key in understanding issues around motivation, engagement, and participation: (1) "initial motivation to participate digitally"-for example, maintaining social connections and gaining skills to be able to connect with family and friends; (2) "narrow use and restricted activity on the web"-undertaking limited tasks on the web and in a modified manner, for example, limited use of web-based public services and selected use of specific services, such as checking but never transferring funds during web-based banking; (3) "impact of digital participation on well-being"-choosing to go to the shops or general practitioner's surgery to get out of the house and get some exercise; (4) "the last generation?"-respondents feeling that there were generational barriers to adapting to new technology and change; and (5) "making digital accessible"-understanding the support needed to keep those engaged on the web.

Conclusions: As we transition toward greater digitalization of public services, it is crucial to incorporate the perspectives of older people. Failing to do so risks excluding them from accessing services they greatly rely on and need.

Background: Social media platforms have been effective in raising awareness of the underassessment and undertreatment of pain in dementia.

Objective: After a successful pilot campaign, we aimed to scale our pain-in-dementia knowledge mobilization pilot initiative (ie, #SeePainMoreClearly) to several social media platforms with the aid of a digital media partner. The goal of the initiative was to increase awareness of the challenges in the assessment and management of pain among people with dementia. A variety of metrics were implemented to evaluate the effort. Through this work, we endeavored to highlight key differences between our pilot initiative (which was a grassroots initiative), focusing largely on Twitter and YouTube, and the current science-media partnership. We also aimed to generate recommendations suitable for other social media campaigns related to health or aging.

Methods: Evidence-based information about pain in dementia was summarized into engaging content (eg, videos) tailored to the needs of various knowledge users (eg, health professionals, families, and policy makers). We disseminated information using Facebook (Meta Platforms), Twitter (X Corp), YouTube (Alphabet Inc), Instagram (Meta Platforms), and LinkedIn (LinkedIn Corp) and measured the success of the initiative over a 12-month period (2020 to 2021). The evaluation methods focused on web analytics and questionnaires related to social media content. Knowledge users' web responses about the initiative and semistructured interviews were analyzed using thematic analysis.

Results: During the course of the campaign, >700 posts were shared across all platforms. Web analytics showed that we drew >60,000 users from 82 countries to our resource website. Of the social media platforms used, Facebook was the most effective in reaching knowledge users (ie, over 1,300,000 users). Questionnaire responses from users were favorable; interview responses indicated that the information shared throughout the initiative increased awareness of the problem of pain in dementia and influenced respondent behavior.

Conclusions: In this investigation, we demonstrated success in directing knowledge users to a resource website with practical information that health professionals could use in patient care along with pain assessment and management information for caregivers and people living with dementia. The evaluation metrics suggested no considerable differences between our pilot campaign and broader initiative when accounting for the length of time of each initiative. The limitations of large-scale health campaigns were noted, and recommendations were outlined for other researchers aiming to leverage social media as a knowledge mobilization tool.