scholarly journals Strategies to Improve Health Technologies for Older Adults With Cognitive Impairment and Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 862-862
Author(s):  
Stacey Schepens Niemiec ◽  
Elissa Lee ◽  
Jeanine Blanchard ◽  
Adam Strizich
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Older People ◽  
Cognitive Deficits ◽  
Technology Use ◽  
Community Organization ◽  
Digital Health ◽  
Health Technologies ◽  
Partner Involvement ◽  
Improve Health

Abstract Technology may improve health self-management of older people with cognitive deficits, yet these individuals may have unique needs influencing its utility. This study’s purpose was to gather current strategies described in the literature and by expert stakeholders for utilizing digital health technologies in older adults with cognitive impairment (CI) or dementia. We conducted a rapid literature review to identify articles that featured digital health technology use in persons with CI/dementia. Additionally, we conducted interviews (n=12) with expert stakeholders who were identified through online academic, professional, and community organization biographies and snowball referral. Qualitative-based thematic analysis was used to identify emergent themes from selected literature and transcribed interviews. Recommended strategies addressed instructional methods (e.g., reducing distractions), technology adaptations (e.g., simplified interface), care partner involvement, and dosage/exposure. Findings are applicable to development of technology-driven interventions and products, with the aim of improving the effectiveness of such technology for older people with CI/dementia.

scholarly journals Digital Health Interventions for Healthy Aging: A Qualitative User Evaluation and Ethical Assessment

2020 ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto Kressig ◽  
Tenzin Wangmo
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
Ethical Issues ◽  
Digital Health ◽  
Functional Independence ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Health Technologies ◽  
Community Dwelling Older Adults

Abstract BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. AimThe aim of this study is to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. ResultsThree main themes and twelve sub-themes emerged. The three main themes revolved around the following thematic areas: favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact also emerged as key considerations.

scholarly journals Digital Predictors of Morbidity, Hospitalization, and Mortality Among Older Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Sofia Daniolou ◽  
Andreas Rapp ◽  
Celina Haase ◽  
Alfred Ruppert ◽  
Marlene Wittwer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Outcomes ◽  
Digital Health ◽  
Meta Analysis ◽  
Design Development ◽  
Clinical Implementation ◽  
Care Needs ◽  
Health Technologies ◽  
Improve Health

The widespread adoption of digital health technologies such as smartphone-based mobile applications, wearable activity trackers and Internet of Things systems has rapidly enabled new opportunities for predictive health monitoring. Leveraging digital health tools to track parameters relevant to human health is particularly important for the older segments of the population as old age is associated with multimorbidity and higher care needs. In order to assess the potential of these digital health technologies to improve health outcomes, it is paramount to investigate which digitally measurable parameters can effectively improve health outcomes among the elderly population. Currently, there is a lack of systematic evidence on this topic due to the inherent heterogeneity of the digital health domain and the lack of clinical validation of both novel prototypes and marketed devices. For this reason, the aim of the current study is to synthesize and systematically analyse which digitally measurable data may be effectively collected through digital health devices to improve health outcomes for older people. Using a modified PICO process and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, we provide the results of a systematic review and subsequent meta-analysis of digitally measurable predictors of morbidity, hospitalization, and mortality among older adults aged 65 or older. These findings can inform both technology developers and clinicians involved in the design, development and clinical implementation of digital health technologies for elderly citizens.

scholarly journals Older Adults Engage With Personalized Digital Coaching Programs at Rates That Exceed Those of Younger Adults

2021 ◽  
Vol 3 ◽  
Author(s):  
Sarah A. Graham ◽  
Natalie Stein ◽  
Fjori Shemaj ◽  
OraLee H. Branch ◽  
Jason Paruthi ◽  
...  
Keyword(s):  
Older Adults ◽  
Technology Use ◽  
Chronic Conditions ◽  
Digital Health ◽  
Cost Effective ◽  
Health Programs ◽  
Care Providers ◽  
Younger Adults ◽  
Health Technologies ◽  
Healthcare Needs

Background: The US population is aging and has an expanding set of healthcare needs for the prevention and management of chronic conditions. Older adults contribute disproportionately to US healthcare costs, accounting for 34% of total healthcare expenditures in 2014 but only 15% of the population. Fully automated, digital health programs offer a scalable and cost-effective option to help manage chronic conditions. However, the literature on technology use suggests that older adults face barriers to the use of digital technologies that could limit their engagement with digital health programs. The objective of this study was to characterize the engagement of adults 65 years and older with a fully automated digital health platform called Lark Health and compare their engagement to that of adults aged 35–64 years.Methods: We analyzed data from 2,169 Lark platform users across four different coaching programs (diabetes prevention, diabetes care, hypertension care, and prevention) over a 12-month period. We characterized user engagement as participation in digital coaching conversations, meals logged, and device measurements. We compared engagement metrics between older and younger adults using nonparametric bivariate analyses.Main Results: Aggregate engagement across all users during the 12-month period included 1,623,178 coaching conversations, 588,436 meals logged, and 203,693 device measurements. We found that older adults were significantly more engaged with the digital platform than younger adults, evidenced by older adults participating in a larger median number of coaching conversations (514 vs. 428) and logging more meals (174 vs. 89) and device measurements (39 vs. 28) all p ≤ 0.01.Conclusions: Older adult users of a commercially available, fully digital health platform exhibited greater engagement than younger adults. These findings suggest that despite potential barriers, older adults readily adopted digital health technologies. Fully digital health programs may present a widely scalable and cost-effective alternative to traditional telehealth models that still require costly touchpoints with human care providers.

scholarly journals Digital health interventions for healthy ageing: a qualitative user evaluation and ethical assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto W. Kressig ◽  
Tenzin Wangmo
Keyword(s):  
Older Adults ◽  
Older People ◽  
Ethical Issues ◽  
Digital Health ◽  
Functional Independence ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Economic Effects ◽  
Health Technologies ◽  
Community Dwelling Older Adults

Abstract Background Digital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. Aim The aim of this study was to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. Method Face-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. Results Three main themes and twelve sub-themes addressing our study aim resulted from the data obtained. The main themes revolved around favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. Conclusions Our study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact were also addressed by participants as key considerations.

scholarly journals Appropriateness of pharmacological treatment in older people with dementia

2015 ◽  
Vol 9 (3) ◽  
pp. 212 ◽  
Author(s):  
Eleonora Meloni ◽  
Davide Liborio Vetrano ◽  
Roberto Bernabei ◽  
Graziano Onder
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Older People ◽  
Cognitive Deficits ◽  
The Elderly ◽  
Inappropriate Drug ◽  
Limited Life Expectancy ◽  
Inappropriate Drugs ◽  
People With Dementia ◽  
Limited Life

Dementia is associated with a number of comorbidities often observed in older people, including hypertension, cardiovascular disease, stroke and diabetes. Treating these comorbidities in older adults with dementia results challenging for many reasons. First, older adults with dementia are generally excluded from clinical trials, so application of clinical guidelines for treatment of chronic diseases in this population might lead to polypharmacy and adverse drugs effects. Second, memory, intellectual function, judgment and language are commonly impaired in patients with cognitive deficits, compromising the compliance to complex pharmacological regimens, increasing the risk of adverse drug reactions. Third, cognitive impairment is associated with limited life expectancy and therefore limits the efficacy of pharmacological treatments and questions the appropriateness of treatment. In the present study we examine most relevant concerns related to the treatment of comorbidities in demented patients, referring also to the existing criteria for inappropriate drugs in the elderly. The application of such instruments, along with the comprehensive geriatric assessment of the older adult with cognitive impairment, could result useful to reduce the burden of polypharmacy and inappropriate drug prescriptions.

scholarly journals Educating Minority, Older Adults in Plant-Based Diet During the Pandemic: Opportunities Using Digital Health and Telehealth Technologies (Preprint)

2020 ◽  
Author(s):  
Heidi Benavides ◽  
Christiane Meireles ◽  
Viola Benavente ◽  
Jing Wang
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Health Disparities ◽  
Body Mass ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Community Outreach ◽  
Health Technologies ◽  
Populations At Risk ◽  
Improve Health

BACKGROUND United States (U.S.) ambulatory visits drastically fell during the COVID-19 pandemic, threatening an individual’s health promotion and chronic illness management. Considering the disproportionate number of COVID-19 cases affecting older minority populations, plant-based diet may be an intervention improve health. Plant-based diets reduce Body Mass Index (BMI) and inflammation and boost the immune system with antioxidants. Promoting plant-based diet eating patterns with the use of telehealth and digital technology can be powerful instruments which may contribute to weight loss and help keep older, minority adults stay connected to during times of physical isolation. OBJECTIVE Due to the COVID-19 pandemic, more people are staying home; therefore, encouraging healthy diet is critical to promote wellness. Dietary modification is an accessible, measurable, and translatable health behavior. Identifying achievable self-management behaviors that promote and maintain plant-based diet has been shown to decrease adiposity, body mass index (BMI), and hemoglobin A1C values in certain minority groups and older adults.1,2 This promising diet needs to be further explored utilizing telehealth and digital technologies, which may reduce COVID-19 related health disparities and promote community connections. METHODS None RESULTS None CONCLUSIONS The pandemic has rapidly shifted the healthcare delivery system to utilize more telehealth and digital health technologies. Interdisciplinary teams must consider using technology to implement a solid plant-based diet program to combat the obesity epidemic and associated conditions plaguing ethnically diverse individuals, families, and communities. The family and community network are critically important to help improve health outcomes for populations at risk for the COVID-19 virus. As plant-based diets are integrated into the plan of care, telehealth education and community outreach programs could significantly benefit future generations and improve health disparities.

scholarly journals Designing Technology for Aging and Disability

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 861-861
Author(s):  
Shelia Cotten
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Digital Health ◽  
Cognitive Impairments ◽  
Diverse Population ◽  
Future Directions ◽  
Health Technologies ◽  
Design Considerations ◽  
Important Design

Abstract Technology has massive potential to improve the lives of older adults in terms of their health, wellbeing, quality of life, and independence. However, benefits will not be realized unless these technologies are designed considering the needs, abilities, and attitudes of the diverse population of older adults. This is especially true when we consider older adults experiencing physical, sensory, or cognitive impairments that influence their ability to adopt and use technology-based solutions. This symposium highlights a variety of approaches to using technology to support older adults living with disability, and important design considerations. The first talk will highlight the important role technology can play in helping persons with cognitive and /or physical impairment in the workplace. The next talk outlines a framework and methodology designed to provide older adults with hearing or visual impairments the capability to use and adapt digital health tools. This is followed by a discussion of a research agenda to use technology to help older adults experiencing disability as a result of cognitive impairment participate in their community. Then, there will be a discussion of how digital health technologies, when considering their unique needs and abilities, can support older adults with cognitive impairment and dementia. The final talk focuses on the intersection of technology, cognitive impairment, and leisure, and explores engagement with digital games by older adults with and without dementia. Common themes that emerge and future directions will be highlighted.

scholarly journals Body mass index and mild cognitive impairment among rural older adults in China: the moderating roles of gender and age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemin Yuan ◽  
Jie Li ◽  
Nan Zhang ◽  
Peipei Fu ◽  
Zhengyue Jing ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Older People ◽  
Older Women ◽  
Older Men ◽  
Gender And Age ◽  
Low Bmi ◽  
Rural Older Adults

Abstract Background Evidence concerning the association between body mass index (BMI) and cognitive function among older people is inconsistent. This study aimed to investigate gender and age as moderators in association between BMI and mild cognitive impairment (MCI) among rural older adults. Methods Data were derived from the 2019 Health Service for Rural Elderly Families Survey in Shandong, China. In total, 3242 people aged 60 years and above were included in the analysis. Multilevel mixed-effects logistic regression was used to examine the moderating roles of gender and age, then further to explore the relationship between BMI and MCI. Results There were 601 (18.5%) participants with MCI. Compared with normal BMI group, low BMI group had a higher risk of MCI among older people [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.26–3.44], women (aOR = 2.06, 95% CI: 1.35–3.12), or the older elderly aged ≥75 years old (aOR = 3.20, 95% CI: 1.34–7.45). This effect remained statistically significant among older women (aOR = 3.38, 95% CI: 1.69–6.73). Among older men, elevated BMI group had a higher risk of MCI (aOR = 2.32, 95% CI: 1.17–4.61) than normal BMI group. Conclusions Gender and age moderated the association between BMI and MCI among Chinese rural older adults. Older women with low BMI were more likely to have MCI, but older men with elevated BMI were more likely to have MCI. These findings suggest rural community managers strengthen the health management by grouping the weight of older people to prevent the risk of dementia.

Interpersonal psychotherapy

2020 ◽  
pp. 261-264
Author(s):  
Philip Wilkinson ◽  
Ken Laidlaw
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Older People ◽  
Psychological Treatment ◽  
Interpersonal Psychotherapy ◽  
Evidence Base ◽  
Theory And Practice ◽  
Role Transitions ◽  
Treatment Of Depression

This chapter on interpersonal psychotherapy (IPT) describes the theory and practice of this structured psychological treatment. It discusses the implementation of IPT with older people. Next it reviews the applications of IPT with a main focus on the treatment of depression in older adults and distinguishes between the treatment of depression with and without cognitive impairment. It summarizes the structure of IPT and the use of specific techniques, and it then addresses the main therapeutic foci encountered in treatment (grief, interpersonal role disputes, role transitions, and interpersonal deficits). Finally, it briefly reviews the evidence base for IPT with older people.

scholarly journals EXPLORING THE POWER OF COMBINATORIAL HEALTH TECHNOLOGIES TO SUPPORT SELF-MANAGEMENT OF COPD AMONG OLDER PEOPLE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S443-S443
Author(s):  
Sandra Varey ◽  
Mandy Dixon ◽  
Alejandra Hernandez ◽  
Ceu Mateus ◽  
Tom Palmer ◽  
...  
Keyword(s):  
Older People ◽  
Large Scale ◽  
Digital Health ◽  
Self Management ◽  
Chronic Obstructive ◽  
Test Bed ◽  
Long Term Conditions ◽  
Health Technologies ◽  
Healthcare Needs ◽  
The Impact

Abstract Ways to address the increasing healthcare needs of older people are a priority for the National Health Service (NHS) in England. The NHS England Test Bed programme was designed to trial new models of care that are supported by digital health technologies. This paper reports on findings from one Test Bed programme, the Lancashire and Cumbria Innovation Alliance (LCIA) – a partnership between NHS England, industry and Lancaster University, which ran from 2016 to 2018. A key aim of the LCIA Test Bed was to explore the extent to which supported self-care telehealth technology helped older people with long-term conditions to better self-manage their own care, promoting independence and enabling them to remain at home for longer. Each patient received a combination of health technologies over a six-month period. This paper presents results from the qualitative data that formed part of a large-scale mixed-methods evaluation. Specifically it draws on the analysis of 34 observational interviews with 17 participants with chronic obstructive pulmonary disease (COPD) to understand the role of these technologies in the self-management of their care. The data revealed that the majority of participants felt more confident about self-managing COPD as a result of their participation in the programme. These increases in confidence were the result of participants’ increased knowledge and skills in managing their COPD. The paper demonstrates how patients learned to better manage their respiratory condition, the impact of this learning on their daily lives and that of their family carers, and the implications for healthcare practice.

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