Technology Adoption by Older Adults: Findings From the PRISM Trial

A Technology-Supported Psychoeducational Intervention for Older Adults and Their Families to Improve Social Isolation, Loneliness, and Intergenerational Connectedness-A Randomized Controlled Study

Information and communication technologies (ICT) provide digital tools to support and facilitate social engagement. However, the extent to which new ICTs, such as instant messaging, and training on its use, enhance intergenerational family interactions and reduce social isolation and loneliness needs further exploration. In the present study, we developed a brief psychoeducational intervention to promote older adults and their family members (N = 64) to use new technologies to increase communication with each other. With a randomized controlled trial design, we evaluated the effectiveness of the intervention in changing primarily participants' intergenerational interactions, perceived social isolation, and loneliness. Through repeated-measures analysis of variance, an overall condition by time effect was found in younger family members such that contact frequency improved in the intervention condition compared with the waitlist control condition. Using a dyadic framework, we further investigated the role of the intervention in fostering interactions among family members. Dyadic analyses showed a partner effect with contact frequency in younger adults at pre-assessment predicting contact frequency of older adults at post-assessment. This suggests that support and encouragement from younger family members could increase intergenerational interactions and technology adoption among older adults. Moreover, online phone calls served as a promising tool to enhance intergenerational communication; higher user satisfaction was associated with increased ICT use, perceived usefulness, and fewer barriers to technology. This study provides preliminary findings on the effectiveness of ICT-based interventions for engaging older adults and their family members in the use of newer technologies to promote intergenerational interactions and reduce social isolation.

Alzheimer's disease diagnosis in the metaverse

BACKGROUND AND OBJECTIVE

The importance of early diagnosis of Alzheimer's Disease (AD) is by no means negligible because no cure has been recognized for it rather than some therapies only lowering the pace of progression. The research gap reveals information on the lack of an automatic non-invasive approach toward the diagnosis of AD, in particular with the help of Virtual Reality (VR) and Artificial Intelligence. Another perspective highlights that current VR studies fail to incorporate a comprehensive range of cognitive tests and consider design notes for elderlies, leading to unreliable results.

METHODS

This paper tried to design a VR environment suitable for older adults in which three cognitive assessments namely: ADAS-Cog, Montreal Cognitive Assessment (MoCA), and Mini Mental State Exam (MMSE), are implemented. Moreover, a 3DCNN-ML model was trained based on the corresponding cognitive tests and Magnetic Resonance Imaging (MRI) with different modalities using the Alzheimer's Disease Neuroimaging Initiative 2 (ADNI2) dataset and incorporated into the application to predict if the patient suffers from AD.

RESULTS

The model has undergone three experiments with different modalities (Cognitive Scores (CS), MRI images, and CS-MRI). As for the CS-MRI experiment, the trained model achieved 97%, 95%, 95%, 96%, and 94% in terms of precision, recall, F1-score, AUC, and accuracy respectively. The considered design notes were also assessed using a new proposed questionnaire based on existing ones in terms of user experience, user interface, mechanics, in-env assistance, and VR induced symptoms and effects. The designed VR system provided an acceptable level of user experience, with participants reporting an enjoyable and immersive experience. While there were areas for improvement, including graphics and sound quality, as well as comfort issues with prolonged HMD use, the user interface and mechanics of the system were generally well-received.

CONCLUSIONS

The reported results state that our method's comprehensive analysis of 3D brain volumes and incorporation of cognitive scores enabled earlier detection of AD progression, potentially allowing for timely interventions and improved patient outcomes. The proposed integrated system provided us with promising insights for improvements in the diagnosis of AD using technologies.

Facilitators and barriers of technology adoption and social connectedness among rural older adults: a qualitative study

Background

Social disconnection is a public health concern among rural Australian older adults. While research suggests technology can enhance social wellbeing and protect against social disconnection, many older adults are not digitally literate, and little is known as to why and how technology adoption could be promoted in rural contexts. This study aimed to (1) explore the barriers and facilitators of technology adoption among rural older adults and (2) determine the potential utility of technology to promote social connectedness in the aged population. The Theoretical Domains Framework and the Behaviour Change Wheel (BCW) were employed to gain a comprehensive understanding of the digital and social behaviours of rural Australian older adults.

Methods

Semi-structured interviews were conducted with a convenience sample of 33 rural older adults aged between 65 and 87 years. Interviews were conducted over the phone, audio-recorded, and transcribed. Interview transcripts were coded and analysed using thematic analysis and the BCW.

Results

Numerous barriers and facilitators of technology adoption were identified, with the most prominent being knowledge, perceived value, perceived self-efficacy, and social support. Findings suggest that older adults' technology adoption is not simply a technical matter, but influenced by various individual, social, and environmental contexts. Consideration of these factors during development, marketing, training and implementation may facilitate technology adoption among older adults. With regard to social connectedness, several rural barriers emerged, including low population density, geographic isolation, limited community opportunities and poor public transport infrastructure.

Conclusion

Technology was consistently identified as a facilitator of the social experience, indicating that technology is a promising tool to enhance social connectedness among older adults, particularly those living in rural areas. Future research should focus on enhancing the capability, opportunity and motivation of older adults in technology adoption, with reference to the rural contexts.

Feasibility, reliability and satisfaction of (automated) capillary carcinoembryonic antigen measurements for future home-based blood sampling: the prospective CASA-I study

AIM

Follow-up for colorectal cancer (CRC) necessitates regular monitoring of carcinoembryonic antigen (CEA) at the hospital. Capillary home-based blood collection, including minimally invasive techniques such as lancet sampling or an automated upper arm device (TAP-II), has the potential to replace a significant portion of hospital-based blood sampling, thereby enhancing self-reliance and quality of life. The objectives of this study were to assess the feasibility, reliability and preference for CEA blood collection.

METHODS

Baseline venous and capillary (by lancet and TAP-II) blood samples were collected from 102 participants, including 20 CRC patients with elevated CEA levels, 60 CRC patients undergoing postoperative outpatient monitoring and 20 healthy volunteers. The second group performed capillary blood collections at home on two consecutive follow-up appointments and subsequently sent them to the hospital. Satisfaction was assessed via patient reported outcome measures on pain, burden, ease of use and preference.

RESULTS

The Pearson's correlation test of all usable samples resulted in a linear coefficient of 0.998 (95% CI 0.997-0.998) for the TAP-II method and 0.997 (95% CI 0.996-0.998) for the lancet method, both compared to venipuncture. Following the initial blood collection, 86% of the participants (n = 102) favoured the TAP-II, rating it as the least painful and burdensome option. After two home-based blood samples, the preference for the TAP-II method persisted, with 64% of the patients endorsing its use.

CONCLUSION

This study demonstrated the feasibility of home-based capillary sampling of CEA. The TAP-II blood collection is the most reliable method and is preferred by patients over venipuncture and lancet sampling.

Preparing the Younger Generation for an Aging Society: Strategies, Challenges, and Opportunities

The global demographic landscape is experiencing a monumental shift as populations age, driven by advances in healthcare and declining birth rates. This transition underscores the need to prepare the younger generation to navigate and contribute effectively to an aging society. This manuscript comprehensively reviews strategies to equip younger generations with the requisite knowledge, skills, and empathy to support an aging population. This study identifies critical challenges and opportunities in fostering intergenerational solidarity and understanding through an extensive analysis of existing literature and innovative educational programs. The review highlights the importance of early education, community engagement, and policy interventions in bridging the generational divide. Additionally, it explores the role of technology and digital media in facilitating awareness and empathy among young people. Key findings suggest that incorporating aging-related content into educational curricula, promoting volunteerism, and implementing supportive policies can significantly enhance the younger generation's readiness to support an aging society. The manuscript concludes with recommendations for future research and practical steps for educators, policymakers, and community leaders to foster a more inclusive and age-friendly environment. By preparing the younger generation today, we can build a more cohesive and supportive society for tomorrow.

Internet use and loneliness among older Chinese adults

OBJECTIVES

This study examined the association between Internet use and loneliness among Chinese older adults (aged 60+) over a two-year period using nationally representative survey data from China.

METHODS

Using data from the 2016 and 2018 waves of the China Longitudinal Ageing Social Survey (N = 8,059), we estimated difference-in-differences regression models to assess the association between Internet use and levels of loneliness over time.

RESULTS

Compared to Internet non-users, Chinese older adults who were new Internet users, as well as those who were continuous Internet users, reported lower levels of loneliness over time (B = -0.21, p < 0.001 and B = -0.16, p < 0.001, respectively). Conversely, those Chinese older adults who used the Internet in wave 1 but then disengaged from using the Internet in wave 2 demonstrated an upward trend in loneliness over time, similar to Internet non-users (the estimate of difference-in-differences was non-significant for the comparison between disengaged-users and non-users: B = -0.03, p = 0.42).

CONCLUSION

This study provided new evidence to support the potential benefits of Internet use for reducing the risk of loneliness among Chinese older adults. The findings suggested that supporting current Internet users to remain digitally engaged is as important as encouraging Internet non-users to cross the digital divide.

Ageism and the digital divide in Switzerland during COVID-19: Lessons for the post-pandemic world

The COVID-19 pandemic erupted in early 2020. The Swiss Federal Council implemented a semi-lockdown in March 2020, asking people, particularly older adults, to stay at home to limit the transmission of the disease and to use digital tools to maintain their social relations and activities. This study inquired how older adults confronting precarity experienced these restrictions, how digital tools functioned in this context, and what learning could therefore be imbibed for the post-pandemic era. We conducted semi-structured telephone interviews with adults aged between 66 and 90 years living in a rural and mountainous Swiss region. The obtained data were subsequently thematically analyzed. The results revealed that the respondents experienced ageism during the semi-lockdown and reported limited or non-existent opportunities to use digital tools to maintain online social contact. This predicament increased their sense of loneliness and amplified their feelings of rejection by the outside world. These observations elucidate the need for the enhancement of non-ageist social support for older people, including individuals with limited social and material resources. We advocate the adoption of innovative initiatives in the post-pandemic era to better include precarious older people in our localities and neighborhoods.

The mediating role of ICT learning confidence and technostress between executive functions and digital skills

Having good digital skills is essential today, yet little is known about the cognitive factors that influence the development of these skills. Given the importance of executive functions (EFs) in adapting to environmental changes and acquiring skills, EFs might contribute to acquiring digital skills too. EFs might also influence people's approach toward ICTs and affect digital skills through emotional variables. Therefore, here, we tested whether cognitive control and flexibility are connected to computer and smartphone skills through emotional factors (learning confidence, stress, and attitude). A total of 269 participants (56 males, M = 30 years) filled out our survey which included questionnaires on demographic variables (age, education, and socioeconomic status), ICT motivation, digital skills, EFs, and technology-related emotional factors. EFs were also investigated through two performance-based measures. We used generalized linear models and structural equation modeling to test the associations between these variables. The results showed that smartphone skills were positively associated with self-reported cognitive flexibility through ICT learning confidence and technology-induced stress. Self-reported cognitive control and age were connected to smartphone skills directly. Self-reported cognitive flexibility was also associated with computer skills through ICT learning confidence. In addition, performance-based cognitive control and the level of education were directly linked to computer skills. These results may provide guidance to support digital skills and create digital skill training.

Technology Use Among Older Adults and Their Caregivers: Cross-Sectional Survey Study

Background

Informal caregivers are called upon to provide substantial care, but more needs to be known about technology use among older adult and caregiver dyads.

Objective

This study described technology use among older adults and their caregivers, explored potential correlates of technology use, and highlighted implications for practice.

Methods

A cross-sectional survey was conducted among unpaid caregivers of older adults (n=486). Primary outcomes were self-reported technology (devices and functions) use among caregivers and their oldest care recipient. The concordance of technology use among caregivers and care recipients was also examined. Multivariable regression models were conducted separately for caregivers and care recipients.

Results

Greater proportions of caregivers used all examined technologies, except for the medication alerts or tracking function, than care recipients. Caregivers used an average of 3.4 devices and 4.2 functions, compared to 1.8 devices and 1.6 functions used by their care recipients. Among caregivers, younger age, higher income, and higher education were associated with more technology use (P<.05). Among care recipients, younger age, not having cognitive dysfunction, and caregiver's technology use were associated with more technology use (P<.05).

Conclusions

Understanding technology use patterns and device adoption across diverse caregiver and care recipient populations is increasingly important for enhancing geriatric care. Findings can guide recommendations about appropriate technology interventions and help providers communicate and share information more effectively with patients and their caregivers.

Assessment of a digital intervention program with Holocaust survivors

OBJECTIVE

This study evaluated a digital intervention program with aging Holocaust survivors. Participants received a tablet device and were coupled with a volunteer who assisted them to use the tablet. The study aimed to assess which characteristics of the Holocaust survivors are linked with more frequent use of digital communication at the end of the program.

METHODS

Information was collected by telephone interviews with 91 survivors before and 54 after participating in the program. We combined this data with digital usage data from the tablets. Regression models examined the characteristics of Holocaust survivors that were related to higher frequency of using digital communication technologies during the intervention.

RESULTS

The Holocaust survivors expressed high satisfaction with the program. They increased their frequency of using digital communication technologies-text correspondence and video chats with friends and family. Regressions showed that Holocaust survivors who reported increased digital communication were characterized at the start of the intervention by having fewer post-traumatic stress symptoms, higher levels of flourishing (reflecting a more meaningful life and higher well-being), being lonelier, and were also more satisfied with the program at follow-up.

CONCLUSION

The pilot program benefited the aging Holocaust survivors. Further programs should be developed to increase the digital communication of vulnerable older populations, such as trauma survivors.

Older and fearing new technologies? The relationship between older adults' technophobia and subjective age

OBJECTIVE

This article aimed to identify different technophobia subgroups of older adults and examine the associations between these distinct subgroups and the subjective age.

METHODS

A sample of 728 retired older adults over the age of 55 was recruited in China. Latent profile analysis was conducted to identify technophobia subgroups using three indicators: techno-anxiety, techno-paranoia and privacy concerns. Analysis of Variance was applied to determine whether a relationship exists between the identified technophobic subgroups and subjective ages (Feel-age, Look-age, Do-age and Interests-age).

RESULT

Four technophobia types were identified: 'low-technophobia' (24.59%), 'high-privacy concerns' (26.48%), 'medium-technophobia' (28.38%), and 'high-technophobia' (20.55%). Privacy concerns play a major role in the profiles of older adults who belong to the profiles of 'high-privacy concerns' and 'high-technophobia' (47.03%). A series of ANOVAs showed that older adults in the 'low-technophobia' were more likely to be younger subjective ages of the feel-age and interest-age.

CONCLUSION

The majority of Chinese older adults do not suffer from high levels of technophobia, but do concerns about privacy issues. It also pointed out the younger subjective age might have a protective effect on older adults with technophobia. Future technophobia interventions should better focus on breaking the age stereotype of technology on older adults.

Multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): study protocol for a multicenter randomized controlled trial

BACKGROUND

Geriatric rehabilitation aims to maintain the functional reserves of older adults in order to optimize social participation and prevent disability. After discharge from inpatient geriatric rehabilitation, patients are at high risk for decreased physical capacity, increased vulnerability, and limitations in mobility. As a result, ageing in place becomes uncertain for a plethora of patients after discharge from geriatric rehabilitation and effective strategies to prevent physical decline are required. Collaboration between different health-care providers is essential to improve continuity of care after discharge from inpatient geriatric rehabilitation. The aim of this study is to evaluate the effectiveness of a multi-professional home-based intervention program (GeRas) to improve functional capacity and social participation in older persons after discharge from inpatient geriatric rehabilitation.

METHODS

The study is a multicenter, three-arm, randomized controlled trial with a three-month intervention period. Two hundred and seventy community-dwelling older people receiving inpatient geriatric rehabilitation will be randomized with a 1:1:1 ratio to one of the parallel intervention groups (conventional IG or tablet IG) or the control group (CG). The participants of both IGs will receive a home-based physical exercise program supervised by physical therapists, a nutritional recommendation by a physician, and social counseling by social workers of the health insurance company. The collaboration between the health-care providers and management of participants will be realized within a cloud environment based on a telemedicine platform and supported by multi-professional case conferences. The CG will receive usual care, two short handouts on general health-related topics, and facultative lifestyle counseling with general recommendations for a healthy diet and active ageing. The primary outcomes will be the physical capacity measured by the Short Physical Performance Battery and social participation assessed by the modified Reintegration to Normal Living Index, three months after discharge.

DISCUSSION

The GeRas program is designed to improve the collaboration between health-care providers in the transition from inpatient geriatric rehabilitation to outpatient settings. Compared to usual care, it is expected to improve physical capacity and participation in geriatric patients after discharge from inpatient geriatric rehabilitation.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS00029559). Registered on October 05, 2022.

Internet Use in Very Old Age: The Role of the Social Context and Individual Characteristics

The social context plays an important role in very old age. However, little is known about its relationship with internet use, whereas individual characteristics (e.g., sociodemographic variables, and health status) are better studied. Still, representative studies for the oldest old are missing. Therefore, this study analyzes the relationship between social context variables and individual characteristics with internet use in a representative sample of oldest old from North Rhine-Westphalia, Germany (N = 1,862; Mage = 85.43, SDage = 4.15). Descriptive statistics reveal differences between oldest old onliners and offliners regarding their social context and individual characteristics. Logistic regression analyses show that the significant role of the social context (family and living situation, social contacts and activities) diminishes after adding individual characteristics to the model, which appear to be significantly related to internet use. The results indicate an association of social context variables and individual characteristics with internet use in very old age.

Associations between perceived usefulness and willingness to use smart healthcare devices among Chinese older adults: The multiple mediating effect of technology interactivity and technology anxiety

Objective

This study aims to explore the mediating roles of technological interactivity and technological anxiety in the relationship between perceived usefulness and the willingness to use a smart health device to provide insight into the decision-making process of older adults in relation to the adoption of smart devices.

Methods

A cross-sectional survey was conducted in Jiangsu, China involving 552 older adults. The study utilized structural equation modeling (SEM) to analyze the relationship between the independent variable 'perceived usefulness' and the dependent variable 'willingness to use.' It also examined the multiple mediating effects of technological interactivity and technological anxiety between the independent and dependent variables.

Results

The results indicate that the direct effect of perceived usefulness on willingness to use was insignificant. However, technological interactivity completely mediated the relationship between perceived usefulness and willingness to use. Additionally, technological interactivity and technological anxiety were found to have a serial mediating effect on the impact of perceived usefulness on willingness to use smart healthcare devices.

Conclusions

These findings suggest that increasing older adults' intention to use smart healthcare devices requires not only raising awareness of their usefulness, but also addressing technological anxiety and enhancing the interactivity of these devices to improve the overall user experience.

Consumer Perspectives on the Adoption of a Prehabilitation Multimodal Online Program for Patients Undergoing Cancer Surgery

This study aimed to explore patients' perspectives on the adoption of a prehabilitation multimodal online program. Patients recovering from gastrointestinal cancer surgery at a tertiary hospital between October 2021 and November 2022 were invited to participate. An e-Health program including intensity exercises, nutrition and psychological counselling was used. Patients were instructed to navigate the e-Health program over 24 h using an iPad and then complete the study survey. Patients' characteristics, use of technology, views and minimal expected outcomes from a preoperative online program were collected. Of the 30 patients included, most were female, most reported confidence in the use of technology, most considered the online program safe and most agreed it would be beneficial for their health. "Poor preoperative health" and "lack of motivation and encouragement" were identified as the main barriers to the uptake of a preoperative online program, while program 'simplicity' and perceived 'benefits' were the main facilitators. Significant improvement in postoperative outcomes is perceived to influence patients' willingness to participate in a preoperative multimodal e-Health program. Gastrointestinal cancer patients perceived the adoption of a preoperative multimodal e-Health application as safe to be performed at home and of potential benefit to their health. A range of patient's characteristics, barriers and facilitators to the uptake of an online program were identified. These should be considered in future preoperative multimodal online programs to enhance patient experience, adherence and efficacy. The safety and efficacy of the online prehabilitation program will need to be determined in a larger randomized controlled trial.

The Relationship Between Internet Use for Social Purposes, Loneliness, and Depressive Symptoms Among the Oldest Old

The internet enables communication with social partners and has been found to be related to higher psychological well-being among older adults. Using data from the representative German North Rhine-Westphalia 80+ (NRW80+) study (n = 1,698, Mage = 84.86), we conducted linear regression and mediation analyses to compare levels of loneliness and depressive symptoms of onliners using the internet for social or other purposes with offliners. Oldest old onliners used the internet mostly for social purposes, and this type of internet use was related to a significantly lower level of loneliness and fewer depressive symptoms compared to offliners. The mediation analysis revealed that internet use for social purposes was related to lower levels of loneliness, which in turn was associated with a lower number of depressive symptoms. The findings suggest that internet use for social purposes may help the oldest old to reduce feelings of loneliness and depressive symptoms.

"It's Another Feather in My Hat"-Exploring Factors Influencing the Adoption of Apps With People Living With Dementia

INTRODUCTION

With the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing adoption of mobile applications for people living with dementia.

METHODS

The recruitment of participants was facilitated through a dementia advocacy group of people living with dementia. A focus group design was applied to elicit discussion and to explore divergent views on the topic. The data was analysed using thematic analysis.

FINDINGS

The 15 individuals who participated in this study comprised of seven women and eight men within the age range of 60-90 years. This study reports key findings pertaining to the views and experiences of using mobile apps. Data analysis revealed the following four distinct themes; (Theme 1: Living with dementia)-"That's the difficulty there even with apps or anything else." (Theme 2: Motivation)- "It makes me feel good. I feel a little with it [laughs], that its not all gone in there" (Theme 3: Fears and Concerns)- "Can somebody else get into your personal memories?" (Theme 4- Support)- "So it's important that we have that support". Together these themes encapsulate the most influential aspects, as highlighted by the participants influencing the acceptance and adoption of apps.

CONCLUSION

This paper explores the barriers and facilitators to app acceptance and adoption. This includes the importance of "feel good moments" and positive experiences, challenges associated with living with dementia, the importance of ongoing support, and security of the user's information. This study adds to what is already known by capturing the views and experiences of people living with dementia in relation to the factors influencing the adoption of apps.

Evaluating the Acceptability and Appropriateness of the Augmented Reality Home Assessment Tool (ARHAT): Qualitative Descriptive Study

Background

The Augmented Reality Home Assessment Tool (ARHAT) is a mobile app developed to provide rapid, highly accurate assessments of the home environment. It uses 3D-capture technologies to help people identify and address functional limitations and environmental barriers.

Objective

This study was conducted to gain stakeholder feedback on the acceptability and appropriateness of the ARHAT for identifying and addressing barriers within home environments.

Methods

A qualitative descriptive study was conducted because it allows for variability when obtaining data and seeks to understand stakeholders' insights on an understudied phenomenon. Each stakeholder group (occupational therapists, housing professionals, and aging adult and caregiver "dyads") participated in a 60-minute, web-based focus group via a secure Zoom platform. Focus group data were analyzed by 2 trained qualitative research team members using a framework method for analysis.

Results

A total of 19 stakeholders, aged from 18 to 85+ years, were included in the study. Of the occupational therapists (n=5, 26%), housing professionals (n=3, 16%), and dyads (n=11, 58%), a total of 32% (n=6) were male and 68% (n=13) were female, with most living in the Midwestern United States (n=10, 53%). The focus group data demonstrate the acceptability and appropriateness of the workflow, style, measurement tools, and impact of the ARHAT. All stakeholders stated that they could see the ARHAT being used at many different levels and by any population. Dyads specifically mentioned that the ARHAT would allow them to do forward planning and made them think of home modifications in a new light.

Conclusions

Stakeholders found the ARHAT to be acceptable and appropriate for identifying and addressing functional limitations and barriers in the home environment. This study highlights the importance of considering the workflow, style, measurement tools, and potential impact of home assessment technology early in the developmental process.

Smartphone- and Paper-Based Delivery of Balance Intervention for Older Adults Are Equally Effective, Enjoyable, and of High Fidelity: A Randomized Controlled Trial

Home-based rehabilitation programs for older adults have demonstrated effectiveness, desirability, and reduced burden. However, the feasibility and effectiveness of balance-intervention training delivered through traditional paper-versus novel smartphone-based methods is unknown. Therefore, the purpose of this study was to evaluate if a home-based balance-intervention program could equally improve balance performance when delivered via smartphone or paper among adults over the age of 65. A total of 31 older adults were randomized into either a paper or phone group and completed a 4-week asynchronous self-guided balance intervention across 12 sessions for approximately 30 min per session. Baseline, 4-week, and 8-week walking and standing balance evaluations were performed, with exercise duration and adherence recorded. Additional self-reported measures were collected regarding the enjoyment, usability, difficulty, and length of the exercise program. Twenty-nine participants completed the balance program and three assessments, with no group differences found for any outcome measure. Older adults demonstrated an approximately 0.06 m/s faster gait velocity and modified balance strategies during walking and standing conditions following the intervention protocol. Participants further self-reported similar enjoyment, difficulty, and exercise effectiveness. Results of this study demonstrated the potential to safely deliver home-based interventions as well as the feasibility and effectiveness of delivering balance intervention through a smartphone-based application.

The impact of older adult care policy mixes on the construction of senior centers

The problem of an aging population is becoming increasingly serious, and the establishment of senior centers helps to promote the physical health and mental health of the older adult, a key factor in achieving the high-quality development of the old-age security industry. The government has issued a number of policies to promote the establishment and development of senior centers. However, more and more older adult care policy mixes have gradually shown the phenomenon of poor policy connection, confusing standards, and even mutually exclusive content, resulting in many problems in the construction of policy-driven senior centers. Therefore, based on the overall perspective of the older adult care policy mix, this paper uses the GMM method to explore the impact of the comprehensiveness, balance, and consistency of older adult care policy tool portfolios issued by Chinese government agencies on the construction of senior centers in China. The empirical analysis results show that a comprehensive and consistent policy mix can promote the establishment of senior centers, while the balance of the policy mix will inhibit the establishment of senior centers. This paper analyzes the impact of older adult care policy on the construction of senior centers from the perspective of the policy mix, which helps to clarify the different policy effects produced by different policy mix characteristics and provides feasible policy suggestions for the government to formulate more reasonable and effective policies.

Emerging roles of telemedicine in dementia treatment and care

Dementia is a neurological disorder that affects memory, thinking, orientation, and other important functions of the brain; telemedicine is a part of the healthcare delivery system involving diagnosis and consultation over telecommunications devices such as mobile phones and computers. In this review, we assessed the impact, accessibility, and possible improvements in telemedicine in dementia treatment. Regarding the use of telemedicine in the treatment, we evaluated its impact on the management of the disease (i.e., diagnosis and follow-up). We also evaluated studies on the current improvements and accessibility of telemedicine in dementia treatment. The review findings showed that it is effective in diagnosing patients, monitoring their progress during treatment, and providing caregiver support. However, studies have revealed a lack of accessibility and improvement in telemedicine among the elderly, particularly in West African countries. Finally, lasting solutions were provided to address the problems in the review permanently.

Older Adults and New Technology: Mapping Review of the Factors Associated With Older Adults' Intention to Adopt Digital Technologies

BACKGROUND

Ongoing advancements in digital solutions support older adults' healthy aging and well-being. However, a unified synthesis of sociodemographic, cognitive, attitudinal, emotional, and environmental factors that influence older adults' intention to use these new digital technologies is still lacking. Understanding the salient factors that influence older adults' intention to use digital technologies will help to ensure that technology is developed appropriately and contextually. This understanding is also likely to contribute to developing technology acceptance models specifically for the aging generation, by reorganizing principles and constructing objectivity criteria for future research studies.

OBJECTIVE

This review aims to identify the key factors associated with older adults' intention to use digital technologies and to provide a comprehensive conceptual framework to describe the relationships between these key factors and older adults' intention to use digital technologies.

METHODS

A mapping review was conducted using 9 databases from inception to November 2022. Articles were selected for review if they had an evaluative component of older adults' intention to use digital technologies. Three researchers independently reviewed the articles and extracted the data. Data synthesis was performed via narrative review and quality appraisal was measured using 3 different tools based on each article's study design.

RESULTS

We identified a total of 59 articles investigating older adults' intention to use digital technologies. The majority (40/59, 68%) of articles did not use an existing framework or model for technology acceptance. Studies mostly adopted a quantitative research design (27/59, 46%). We found 119 unique factors reported to influence older adults' intention to use digital technologies. These were categorized into 6 distinct themes: Demographics and Health Status, Emotional Awareness and Needs, Knowledge and Perception, Motivation, Social Influencers, and Technology Functional Features.

CONCLUSIONS

Given the importance of global demographic change toward an aging society, there is surprisingly limited research on the factors that influence older adults' intention to use digital technologies. Our identification of the key factors across different types of digital technology and models supports the future integration of a comprehensive perspective encompassing environmental, psychological, and social determinants for older adults' intention to use digital technologies.

Improvement Opportunities for PAINReportIt® Delivered on a Wireless Tablet: Rated by Black Older Men With Low Back Pain

Health care professionals and researchers can implement technology to improve older adults' acceptability of providing health information and to better include older adults in sharing information with health providers. However, older adults' engagement with technology remains low. This study focused on 60 Black older men (mean age = 70 years, SD = 6 years) with low back pain who completed the 13-item Computer Acceptability Scale after using the PAINReportIt® software on an Apple iPad®. On average, the sample found it acceptable to use PAINReportIt® software to share their pain or discomfort but that this was no replacement for oral dialogue with their health care provider. These findings contribute valuable information about the acceptability of using technology and indicate potential opportunities to improve PAINReportIt® software. Community interventions with acceptable tablet devices can offer new insight into collecting pain or discomfort data in populations with low presence in clinical research studies. [Research in Gerontological Nursing, 16(3), 108-114.].

Using Immersive Virtual Reality to Enhance Social Interaction Among Older Adults: A Cross-Site Investigation

Background and Objectives

Virtual reality (VR) applications are increasingly being targeted toward older adults as a means to maintain physical and cognitive skills and to connect with others, especially during the coronavirus disease 2019 era. Our knowledge about how older adults interact with VR is limited, however, since this is an emerging area and the related research literature is still rather slim. The current study focused specifically on older adults' reactions to a social-VR environment, examining participant's views about the possibility of meaningful interactions in this format, the impacts of social-VR immersion on mood and attitude, and features of the VR environment that affected these outcomes.

Research Design and Methods

The researchers designed a novel social-VR environment with features intended to prompt conversation and collaborative problem-solving among older adults. Participants were recruited from 3 diverse geographic locations (Tallahassee, FL; Ithaca, NY; and New York City, NY), and were randomly assigned to a partner from one of the other sites for social-VR interaction. The sample consisted of 36 individuals aged 60 and older.

Results

Reactions to the social VR were quite positive. Older adults reported high levels of engagement in the environment and perceived the social VR to be enjoyable and usable. Perceived spatial presence was found to be a central driver of positive outcomes. A majority of the participants indicated a willingness to reconnect with their VR partner in the future. The data also identified important areas for improvement that were of concern to older adults, such as the use of more realistic avatars, larger controllers more suited to aging hands, and more time for training/familiarization.

Discussion and Implications

Overall, these findings suggest that VR can be an effective format for social engagement among older adults.

Attitudes related to technology for active and healthy aging in a national multigenerational survey

Research is needed to understand attitudes toward and adoption of the broad range of technologies available to support active and healthy aging in different generations. The present article gives an overview of the GenerationTech survey and sample, and describes attitudes and acceptance related to technology in general and as a means to support active and healthy aging. A national survey was conducted with a random sample (n = 2,121) including men and women from three generations (30-39, 50-59 and 70-79-year-olds) in Sweden. The generations shared some attitudes toward and acceptance of technologies for active and healthy aging. However, what kind of technologies are preferred to support active and healthy aging and the reasons for using certain technologies differed by generation. The findings could help guide the development and implementation of technologies for active and healthy aging throughout the aging process.

Predicting Older Adults' Continued Computer Use After Initial Adoption

Background and Objectives

Sustained computer and internet use have the potential to help older adults in various aspects of their lives, making predicting sustained use a critical goal. However, some factors related to adoption and use (e.g., computer attitudes) change over time and with experience. To understand these dynamics, the current study modeled changes in constructs related to computer use after initial computer adoption and examined whether these changes predict continued use.

Research Design and Methods

We used data from the computer arm (N = 150, MAge = 76.15) of a 12-month field trial examining the potential benefits of computer use in older adults. Individual differences identified in the technology acceptance literature (perceived usefulness, ease of use, computer interest, computer self-efficacy, computer anxiety, quality of life, social isolation, and social support) were measured before (baseline), during (Month 6), and after the intervention (post-test). Univariate and bivariate latent change score models examined changes in each predictor and their potential causal relationship with use.

Results

Results demonstrated large interindividual differences in the change patterns of individual difference factors examined. Changes in perceived usefulness, perceived ease of use, computer interest, computer self-efficacy, and computer anxiety were correlated with but not predictive of change in use.

Discussion and Implications

Our findings demonstrate the limitation of popular constructs in technology acceptance literature in predicting continued use and point out important gaps in knowledge to be targeted in future investigations.

Changes in Internet use patterns among older adults in England from before to after the outbreak of the COVID-19 pandemic

The COVID-19 pandemic brought about an increased reliance on the Internet for various daily activities. Given the known digital divide, it is important to understand whether older adults changed their Internet use patterns, but current evidence is limited to cross-sectional studies. This study documents changes in frequency and types of Internet use among older adults from before to shortly after the outbreak of the COVID-19 pandemic (2018/2019 to June/July 2020), and the factors predicting regular use during these early days of the pandemic. Using data on 6,840 adults aged 50 + from the nationally representative English Longitudinal Study of Ageing, we apply longitudinal fixed-effects models to examine within-individual changes in Internet use behaviour. There was no change in the likelihood of daily Internet use between 2018/2019 and June/July 2020, despite the increased digitalisation of services over the pandemic. Daily use in June/July 2020 was negatively related to age, neighbourhood deprivation, and loneliness, and positively related to partnership status, education, employment, income, and organisation membership. Using the Internet for making calls and getting information about Government services increased, which was important given the social restrictions and overall uncertainty. However, Internet use for finding health-related information decreased. As the world moves towards digital alternatives post-pandemic, it is important to continually ensure older adults are not at risk of exclusion.

Life after lockdown: The experiences of older adults in a contactless digital world

Introduction

The digital response to the Coronavirus (COVID-19) pandemic and its effects on the lives of older adults has been well-documented, but less is known about how they experienced the post-lockdown re-emergence into a relatively contactless digital society.

Methods

We report the findings from a qualitative survey (n = 93) and subsequent interviews (n = 9) with older adults aged 50+, where they describe their struggles with some of the newly implemented digital interactions. These struggles cover a range of settings but include using contactless payments, QR codes and apps to facilitate transactions in cafes, bars, and restaurants.

Results

A thematic analysis of our data revealed the intrinsic (e.g. digital literacy) and extrinsic (e.g. malfunctioning technology) factors that limited social inclusion for these participants, and that sometimes even led to moments of public humiliation.

Discussion

Our findings shed light on some of the motivational factors that underpin the age-related digital divide, whilst also highlighting the role of self-directed agism in limiting motivations to learn new digital routines.

Tackling Loneliness and Isolation in Older Adults With Virtual Reality: How do We Move Forward?

Current trends in gerontology conceptualize Virtual Reality (VR) as a tool for rehabilitation, lauding its potential for cognitive rehabilitation or as an intervention to reduce cognitive function decline. However, we must take a critical stance and identify not just the potential positive impact, but also how things may go wrong without appropriate guidelines, and the need for careful design around the interaction affordances of the technology. We conducted co-discovery and co-design workshops involving expert stakeholders and older adults (N = 25) over a period of 6 months, involving practical activities including user personas and focus groups to understand the complexities of loneliness and identify possible solutions with VR. Based on our findings we focus our argument on two key factors in the conceptualization of loneliness: spaces, and activities which may take place within said spaces. We present our reconceptualization of VR as a tool for group activities instead of passive consumption of content and make suggestions to the community for reducing feelings of loneliness with VR.

The association between information and communication technologies, loneliness and social connectedness: A scoping review

Older adults are at a higher risk of loneliness, compared to other demographics. The use of Internet Communication and Technologies (ICTs) among older adults is steadily increasing and given ICTs provide a means of enhancing social connectedness suggests they may have positive effects on reducing loneliness. Therefore, the aim of this scoping review was to examine the research that explores how ICTs may be implicated in mitigating loneliness and increasing social connectedness among older adults. After the examination of 54 articles, we identified three major themes within the literature: (1) ICTs were associated with a reduction in loneliness and increase in wellbeing. (2) ICTs promoted social connectedness by facilitating conversations. (3) Factors such as training, self-efficacy, self-esteem, autonomy, and the design/features, or affordances, of ICTs contribute toward the associations between ICT use and wellbeing. The heterogeneity of methodologies, statistical reporting, the small sample sizes of interventional and observational studies, and the diversity of the experimental contexts underline the challenges of quantitative research in this field and highlights the necessity of tailoring ICT interventions to the needs and contexts of the older users.

Acceptance of digital health services among older adults: Findings on perceived usefulness, self-efficacy, privacy concerns, ICT knowledge, and support seeking

Background

Over the last decade, the rapid advancements in information and communication technologies (ICTs) have also driven the development of digital health services and applications. Older adults could particularly benefit from these technologies, but they still have less access to the Internet and less competence in using it. Based on the empirical literature on technology acceptance among older adults, this study examines the relations of perceived usefulness, self-efficacy, privacy concerns, ICT knowledge, and support seeking (family, informal, formal/institutional) with older adults' intention to adopt new digital health services.

Methods

The study included 478 older adults who participated in an online or paper/pencil questionnaire (M = 70.1 years, SD = 7.8; 38% male). Sociodemographic characteristics, subjective health status, and variables related to technology acceptance were assessed.

Results

Latent structural equation modeling revealed that higher perceived usefulness, higher self-efficacy regarding digital health technologies, and lower privacy concerns contributed to a higher intention to use digital health services among older adults. Contrary to our expectations, general ICT knowledge was not a significant predictor. Older adults who reported seeking more support regarding technology problems from family members and formal/institutional settings also reported higher usage intentions, whereas informal support was not as relevant. Furthermore, higher age was associated with higher perceived usefulness and lower self-efficacy.

Discussion

Future studies should further explore mediating factors for intention and actual use of digital health services and develop educational programs including follow-up assessments.

Understanding older adults' attitudes toward mobile and wearable technologies to support health and cognition

The use of technology to facilitate remote patient monitoring and virtual care is desirable due to the challenges of providing healthcare during the COVID-19 pandemic and the need for more efficient and effective methods to care for the expanding older adult population. Further, the collection and sharing of patient generated health data (PGHD) through these technologies holds promise with respect to improving outcomes and reducing the cost of care by facilitating the early detection and treatment of cognitive and health problems. Despite the potential benefits of these technologies, their promise might be hampered by low rates of acceptance and adoption among older adults. In an online survey, we assessed community-dwelling older adults' (N = 92) attitudes towards the use of wearable and mobile technologies for (1) predicting cognitive decline, (2) assisting with adherence to healthy activities, and (3) collecting self-report data to understand current and predict future health states. Participants generally agreed hypothetical technology solutions would be useful (M = 4.20, SD = 0.70 on a 1-5 agreement scale; 5 = "strongly agree"), that they were interested in learning more about these technologies (M = 4.04, SD = 0.74), and that they would be willing to adopt these technologies (M = 3.83, SD = 0.93), though attitudes varied. Although participants were generally positive toward these technologies, they were relatively neutral in terms of their agreement that privacy of generated data was a concern (M = 2.92, SD = 1.02). Privacy concerns were associated with lower interest and willingness to adopt. More positive general technology attitudes and higher mobile device proficiency were associated with greater acceptance and willingness to adopt these technologies. Finally, poorer self-rated health was related to negative attitudes toward these technologies. These findings highlight barriers and potential targets for intervention to increase uptake of these and similar technologies among older adults who may be reluctant to adopt remote monitoring technologies.

How Telemedicine Can Improve the Quality of Care for Patients with Alzheimer's Disease and Related Dementias? A Narrative Review

Background and Objectives: Dementia affects more than 55 million patients worldwide, with a significant societal, economic, and psychological impact. However, many patients with Alzheimer's disease (AD) and other related dementias have limited access to effective and individualized treatment. Care provision for dementia is often unequal, fragmented, and inefficient. The COVID-19 pandemic accelerated telemedicine use, which holds promising potential for addressing this important gap. In this narrative review, we aim to analyze and discuss how telemedicine can improve the quality of healthcare for AD and related dementias in a structured manner, based on the seven dimensions of healthcare quality defined by the World Health Organization (WHO), 2018: effectiveness, safety, people-centeredness, timeliness, equitability, integrated care, and efficiency. Materials and Methods: MEDLINE and Scopus databases were searched for peer-reviewed articles investigating the role of telemedicine in the quality of care for patients with dementia. A narrative synthesis was based on the seven WHO dimensions. Results: Most studies indicate that telemedicine is a valuable tool for AD and related dementias: it can improve effectiveness (better access to specialized care, accurate diagnosis, evidence-based treatment, avoidance of preventable hospitalizations), timeliness (reduction of waiting times and unnecessary transportation), patient-centeredness (personalized care for needs and values), safety (appropriate treatment, reduction of infection risk),integrated care (interdisciplinary approach through several dementia-related services), efficiency (mainly cost-effectiveness) and equitability (overcoming geographical barriers, cultural diversities). However, digital illiteracy, legal and organizational issues, as well as limited awareness, are significant potential barriers. Conclusions: Telemedicine may significantly improve all aspects of the quality of care for patients with dementia. However, future longitudinal studies with control groups including participants of a wide educational level spectrum will aid in our deeper understanding of the real impact of telemedicine in quality care for this population.

Extended Family Caregivers for Persons Living With Dementia

Despite changes in the structure of contemporary families, little is known about extended family members-siblings, grandchildren, nieces/nephews, stepkin-who are primary caregivers for a relative living with dementia. Information about these caregivers is needed to help ensure their needs are understood by providers in health care and social service settings. The focus of this research was on the care situations of extended family caregivers and the impact of caregiving on their health and well-being. In Study 1, data from the National Study of Caregiving were used to describe the experiences of 107 extended family caregivers. In Study 2, case study techniques elicited additional information about the experiences of 10 extended family caregivers. Collectively, these caregivers provide care with little or no formal support and occasional help from a small informal network. Caregiving affected their physical and emotional health, depending on the strength of the relationship between the caregiver and the person living with dementia and the type of care provided. Findings contribute new knowledge about extended family caregivers and highlight the important role extended family dementia caregivers play and the challenges they face.

The effect of sub-epidermal moisture on pressure injury prevention strategies and incidence of pressure injuries: A feasibility pilot randomised controlled trial

AIM

Sub-epidermal moisture scanning (SEMS) is a novel point-of-care technology that measures localised oedema and detects early tissue damage that may develop into a pressure injury (PI). It provides objective data that may assist PI prevention (PIP) decision making. This study aimed to determine the feasibility of undertaking a definitive randomised controlled trial (RCT) to test the effectiveness of SEMS.

MATERIALS AND METHODS

This pilot RCT recruited medical and surgical patients at risk of developing a PI in one Australian hospital. All participants received routine PIP care and daily visual skin assessment to determine the presence of a PI. The intervention group also received daily SEMS. Clinical staff were told if the sub-epidermal moisture (SEM) value was abnormal but were not given advice for PIP. Blinding of patients, care staff and outcome assessors was not practical. Feasibility outcomes included recruitment, retention, intervention fidelity, and patient outcomes.

RESULTS

Of 1185 patients screened prior to eligibility, 950 were excluded (80%); 235 were then assessed for eligibility and 160 met the inclusion criteria (68.1%); 100 were recruited (70.0%) and randomised and 99 completed the trial (intervention n = 50; control n = 49) with one person withdrawn due to inappropriate recruitment (100% retention). Of the 657 expected SEMS observations, 598 were completed (91% intervention fidelity). Only 34 of 454 (7.4%) patient outcome data points were missing.

CONCLUSIONS

Most feasibility criteria were met, indicating a definitive trial to assess the effectiveness of SEMS in a medical-surgical patient population is realistic. However, recruitment may be resource intensive and require specific strategies.

Assisted Relaxation Therapy for Insomnia in Older Adults With Mild Cognitive Impairment: A Pilot Study

Insomnia symptoms are prevalent in older adults with mild cognitive impairment (MCI) and can pose treatment challenges. We tested the feasibility, acceptability, and preliminary efficacy of assisted relaxation therapy (ART) to improve insomnia symptoms in community-dwelling older adults with MCI. In this pilot RCT, 25 participants were assigned to intervention or control groups for 2 weeks. The final sample (n = 20) consisted of all Black, primarily female (70%) older adults (mean age 69.10; SD = 7.45) with mean Montreal Cognitive Assessment scores of 21.10 (SD = 2.49). Recruitment was timely; attrition was low (80%). Participants were able to use ART (average use 7.00; SD = 5.07 days). Participants in the ART group improved on Insomnia Severity Index (ISI) (- 7.10; 95% CI [-11.63, -2.55]; p = .004) compared to baseline. There were clinically meaningful mean change scores on ISI for the intervention group compared to the control (- 7.10 vs. - 4.33). Results provide justification for testing ART in a fully powered clinical trial.

Stakeholder Perspectives on Implementation of Smart Speakers for Aging in Place in Low-Income Senior Housing: A Qualitative Study

In the current study, a smart speakers-based system (Amazon^® Echo Dot device, a safety pendant, and facility tailored functionalities) for supporting aging in place was implemented in one low-income senior housing property. We aimed to explore perceived benefits, concerns, and expectations about this system among three stakeholder groups (older adults, housing staff, and technology developers) to identify facilitators of and barriers to system implementation. A qualitative analysis of individual interviews using inductive coding methods was performed to identify emerging themes. All stakeholder groups perceived smart speakers as valuable for convenience in daily living and safety. Older adults and system developers identified user difficulty with setting up functions they wanted to use, suggesting the need for user-centered technology support. There were differences in priorities for smart speaker use among three stakeholder groups. This work contributes to the identification of factors affecting smart speaker adoption and use among low-income older adults who often have limited technology experience and support. [Journal of Gerontological Nursing, 48(10), 33-39.].

Online Exercise Programming Among Older Adults: A Scoping Review

Online exercise programming may promote physical activity while at home, but little is known about its use among older adults. Using the Arksey and O'Malley framework, we describe the nature and extent of the research pertaining to the use of online exercise programming among adults 65 years of age and older. We ran two separate searches (January 2005-September 2020 and October 2020-October 2021), yielding 17 articles that met our inclusion criteria. A total of 1,767 participants (69% female) ranging from 65 to 94 years of age were included. Most studies delivered the online programs asynchronously. The majority of studies assessed the feasibility of online programs, with 14 studies investigating health-related outcomes such as physical, psychological, and social health. Future research should explore perceptions and experiences of online exercise programming among older adults and the mechanisms by which it impacts physical, psychological, social, and behavioral outcomes.

The Effects of a Digital Well-being Intervention on Older Adults: Retrospective Analysis of Real-world User Data

BACKGROUND

Digital interventions have been shown to be effective for a variety of mental health disorders and problems. However, few studies have examined the effects of digital interventions in older adults; therefore, little is known about how older adults engage with or benefit from these interventions. Given that adoption rates for technology among people aged ≥65 years remain substantially lower than in the general population and that approximately 20% of older adults are affected by mental health disorders, research exploring whether older adults will use and benefit from digital interventions is needed.

OBJECTIVE

This study aimed to examine the extent to which older adults engaged with a digital well-being intervention (Happify) and whether engaging with this program led to improvements in both subjective well-being and anxiety symptoms.

METHODS

In this retrospective analysis, we analyzed data from 375 real-world Happify users aged ≥65 years who signed up for the platform between January 1, 2019, and December 23, 2021. Changes in well-being and anxiety symptoms across 42 to 182 days were assessed using responses to the in-app assessment, which users were prompted to take every 2 weeks, and were compared among users who engaged with the program at the recommended level (ie, 2 or more activities per week) or below the recommended level.

RESULTS

In all, 30% (113/375) of the sample engaged with the platform at the recommended level (ie, completed an average of 2 or more activities per week), and overall, users completed an average of 43.35 (SD 87.80) activities, ranging from 1 to 786, between their first and last assessment. Users were also active on the platform for an average of 19.36 (SD 27.16) days, ranging from 1 to 152 days. Moreover, older adults who engaged at the recommended level experienced significantly greater improvements in subjective well-being (P=.002) and anxiety symptoms (P<.001) relative to those who completed fewer activities.

CONCLUSIONS

These data provide preliminary evidence that older adults engage with and benefit from digital well-being interventions. We believe that these findings highlight the importance of considering older adult populations in digital health research. More research is needed to understand potential barriers to using digital interventions among older adults and whether digital interventions should be modified to account for this population's particular needs (eg, ensuring that the intervention is accessible using a variety of devices). However, these results are an important step in demonstrating the feasibility of such interventions in a population that is assumed to be less inclined toward digital approaches.

Preliminary User Evaluation of a Physical Activity Smartphone App for Older Adults

Objectives

Mobile health (mHealth) delivered through smartphone apps is a viable means of improving health behaviors. Technologies can be strengthened and made more age-inclusive by involving older adults as co-designers, resulting in more accessible and effective products. This study's purpose is to describe preliminary acceptability and feasibility of a physical activity (PA) app tailored to underactive older people.

Methods

Moving Up is a multi-feature app designed to increase PA and reduce sedentary behaviors in underactive older adults. The suite houses a core activity tracker and three add-on features that target correlates of inactivity: sedentary behavior, stereotypes about aging, and PA knowledge and routines. Three groups of 4-5 older adult smartphone owners were provided with and oriented to the Moving Up app activity tracker and one add-on feature. Participants beta-tested the app for two weeks, after which each cohort reconvened to discuss experiences, make recommendations for app improvements, and complete a usability questionnaire on their assigned feature.

Results

Thirteen participants (median age, 71 years; iOS users, n=8; females, n=12) completed the beta-testing period and returned for follow-up. Reported usability was moderate across the features. Sentiments about app content and general impressions were mainly positive, although users made several recommendations for app improvements such as more individualized messaging and timely notifications.

Conclusions

A PA app for older adults demonstrated generally good usability and acceptability. Integrating the impressions and recommendations from older adults into the design of mHealth tools will enhance overall usability and likelihood to positively influence PA behaviors long-term.

Advances in Psychotherapy for Older Adults Using Video-to-Home Treatment

Providing telemental health services to older adults has become especially important during the COVID-19 pandemic. Video-to-home (VTH) treatment is an effective treatment modality; research shows that older adults are open to using VTH. However, there are unique barriers to using VTH with older adults. Barriers include access to technology, acceptance of technology, and physical and cognitive limitations. Additional concerns include establishing rapport with older patients and the policy and ethical concerns surrounding the use of VTH. Methods of addressing these barriers have been developed, and more research is needed to develop evidence-based VTH practice.

How Age and Gender Affect the Opinions of Computing Students Regarding Computer Usage and Design Needs

This study aimed to understand the perceptions of young computing science students about women and older people with regard to their computer literacy and how this may affect the design of computer-based systems. Based on photos, participants were asked how likely they thought the person depicted would be to use desktop computers, laptops and smartphones, and how much expertise they thought they would have with each technology. Furthermore, in order to see what impact this could have on systems being developed, we asked what design aspects would be important for the depicted person and whether they thought an adapted technology would be required. This study is based on an existing questionnaire, which was translated into German and extended to explore what impact this may have on system design. The results draw on 200 questionnaires from students in the first year of their Information and Communications Technology (ICT) studies at an Austrian university of applied sciences. Quantitative methods were used to determine if the perceptions varied significantly based on the age and gender of the people depicted. Qualitative analysis was used to evaluate the design aspects mentioned. The results show that there are biases against both older people and women with respect to their perceived expertise with computers. This is also reflected in the design aspects thought to be important for the different cohorts. This is crucial as future systems will be designed by the participants, and these biases may influence whether future systems meet the needs and wishes of all groups or increase the digital divide.

Translational Potential of High-Resistance Inspiratory Muscle Strength Training

Age-associated cardiovascular (CV) dysfunction increases the risk for CV diseases. Aerobic exercise training can improve CV function, but only a minority of adults meet aerobic exercise guidelines. High-resistance inspiratory muscle strength training is a time-efficient lifestyle intervention that may promote adherence and improve CV function. However, further investigation is needed to translate inspiratory muscle strength training into the public health domain.

Factors influencing the intention to use assistive technologies by older adults

Society is ageing at an unprecedented pace worldwide creating implications for the health and social care. Gerontechnology has been recognized as a solution that increases and supports the independency and well-being of older adults at home. This article aims to identify the most critical success factors effecting the adoption of an assistive gerontechnology by older adults in Poland. The object of the authors' interest was Rudy robot, an AI-enabled mobile solution helping users remain physically healthy, mentally sharp, and socially connected. The data was collected among Polish citizens using the CATI technique between November and December 2020. The number of returned questionnaires amounted to 824. The authors used Generalized Least Squares (GLS) of Structural Equation Modelling (GLS-SEM) to verify the hypotheses. The obtained results confirmed statistically significant relationships between the variables of perceived usefulness of Rudy robot and attitude reflecting the willingness to use this technology, as well as between perceived ease of use and perceived usefulness of robot. However, relationship between perceived ease of use and inclination to use this technology in the future was not statistically significant. The conducted research confirmed that the functionality of the analysed Rudy robot for older-adult care positively influences their intension to use it in the future for their own needs or family members. The obtained results confirmed usefulness of robots as assistive technology helping older adults.

Older Adults and Smart Technology: Facilitators and Barriers to Use

Smart technologies (e.g., smartphones, smart security technologies, digital home assistants) have advanced over the years and will continue to do so. There are various benefits to using these technologies in one's life, such as an increase in productivity through automation and self-monitoring one's health. Older adults particularly may benefit from smart technologies to support their everyday activities and compensate for age related changes. In this study, we explored the experiences and attitudes of eighty older adults including those who had prior experience and those who had never used (or perhaps never heard of) smart technologies through an online survey. We assessed their general opinions toward using smart technology and explored what facilitated or hindered their use. Older adults rated the facilitators to use for each smart technology differently, with few commonalities between the order of the most agreed upon facilitators. However, older adults' opinions were consistent across each technology about their ignorance of technological features and cost of the smart technology, which could be potential barriers to use. Among those who had never used one of the smart technologies, privacy was the most commonly endorsed concern. The results from this study support the understanding of key considerations when developing and deploying smart technologies for older adults.

Testing a Model of Human Spatial Navigation Attitudes towards Global Navigation Satellite Systems

Global navigation satellite systems (GNSS) can provide better data quality for different purposes; however, some age groups might lie outside its use. Understanding the barriers to its adoption is of interest in different fields. This work aims at developing a measurement instrument of the adoption attitudes towards this technology and examining the relationship of variables such as age and gender. A UTAUT model was tested on 350 participants. The main results can be summarised as follows: (i) the proposed GNSS scale on human spatial navigation attitudes towards geopositioning technology showed optimal psychometric properties; (ii) although statistically significant differences were found in the Wayfinding Questionnaire (WQ) between men and women, these did not reach the level of statistical significance for the scores on attitudes towards GNSS; (iii) by testing a model on human spatial navigation attitudes towards geopositioning technology, it was possible to show a higher relationship with age in women.

Health Professionals’ Experience Using an Azure Voice-Bot to Examine Cognitive Impairment (WAY2AGE)

Virtual Assistants (VA) are a new groundbreaking tool for screening cognitive impairment by healthcare professionals. By providing the volume of data needed in healthcare guidance, better treatment monitoring and optimization of costs are expected. One of the first steps in the development of these items is the experience of the healthcare professionals in their use. The general goal of the current project, WAY2AGE, is to examine healthcare professionals’ experience in using an Azure voice-bot for screening cognitive impairment. In this way, back-end services, such as the ChatBot, Speech Service and databases, are provided by the cloud platform Azure (Paas) for a pilot study. Most of the underlying scripts are implemented in Python, Net, JavaScript and open software. A sample of 30 healthcare workers volunteered to participate by answering a list of question in a survey set-up, following the example provided in the previous literature. Based on the current results, WAY2AGE was evaluated very positively in several categories. The main challenge of WAY2AGE is the articulation problems of some older people, which can lead to errors in the transcription of audio to text that will be addressed in the second phase. Following an analysis of the perception of a group of thirty health professionals on its usability, potential limitations and opportunities for future research are discussed.

Quality of Mobile Apps for Care Partners of People With Alzheimer Disease and Related Dementias: Mobile App Rating Scale Evaluation

Background

Over 11 million care partners in the United States who provide care to people living with Alzheimer disease and related dementias (ADRD) cite persistent and pervasive unmet needs related to their caregiving role. The proliferation of mobile apps for care partners has the potential to meet care partners’ needs, but the quality of apps is unknown.

Objective

This study aims to evaluate the quality of publicly available apps for care partners of people living with ADRD and identify design features of low- and high-quality apps to guide future research and user-centered app development.

Methods

We searched the US Apple App and Google Play stores with the criteria that included apps needed to be available in the US Google Play or Apple App stores, accessible to users out of the box, and primarily intended for use by an informal (family or friend) care partner of a person living with ADRD. We classified and tabulated app functionalities. The included apps were then evaluated using the Mobile App Rating Scale (MARS) using 23 items across 5 dimensions: engagement, functionality, aesthetics, information, and subjective quality. We computed descriptive statistics for each rating. To identify recommendations for future research and app development, we categorized rater comments on score-driving factors for each MARS rating item and what the app could have done to improve the item score.

Results

We evaluated 17 apps. We found that, on average, apps are of minimally acceptable quality. Functionalities supported by apps included education (12/17, 71%), interactive training (3/17, 18%), documentation (3/17, 18%), tracking symptoms (2/17, 12%), care partner community (3/17, 18%), interaction with clinical experts (1/17, 6%), care coordination (2/17, 12%), and activities for the person living with ADRD (2/17, 12%). Of the 17 apps, 8 (47%) had only 1 feature, 6 (35%) had 2 features, and 3 (18%) had 3 features. The MARS quality mean score across apps was 3.08 (SD 0.83) on the 5-point rating scale (1=inadequate to 5=excellent), with apps scoring highest on average on functionality (mean 3.37, SD 0.99) and aesthetics (mean 3.24, SD 0.92) and lowest on average on information (mean 2.95, SD 0.95) and engagement (mean 2.76, SD 0.89). The MARS subjective quality mean score across apps was 2.26 (SD 1.02).

Conclusions

We identified apps whose mean scores were more than 1 point below minimally acceptable quality, whereas some were more than 1 point above. Many apps had broken features and were rated as below acceptable for engagement and information. Minimally acceptable quality is likely to be insufficient to meet care partner needs. Future research should establish minimum quality standards across dimensions for care partner mobile apps. Design features of high-quality apps identified in this study can provide the foundation for benchmarking these standards.