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

Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto Kressig ◽  
Tenzin Wangmo

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.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto W. Kressig ◽  
Tenzin Wangmo

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.


2017 ◽  
Vol 20 (15) ◽  
pp. 2685-2693 ◽  
Author(s):  
Ilse Bloom ◽  
Wendy Lawrence ◽  
Mary Barker ◽  
Janis Baird ◽  
Elaine Dennison ◽  
...  

AbstractObjectiveTo explore influences on diet in a group of community-dwelling older adults in the UK.DesignData were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.SettingHertfordshire, UK.SubjectsParticipants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.ResultsNinety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.ConclusionsInterventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.


2019 ◽  
Vol 48 (6) ◽  
pp. 910-916 ◽  
Author(s):  
Miji Kim ◽  
Chang Won Won

Abstract Background in October 2018, the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) updated their original definition of sarcopenia to reflect the scientific and clinical evidence that has accumulated over the last decade. Objective to determine the prevalence of sarcopenia in a large group of community-dwelling older adults using the EWGSOP2 definition and algorithm. Design a cross-sectional study. Setting the nationwide Korean Frailty and Aging Cohort Study (KFACS). Subjects a total of 2,099 ambulatory community-dwelling older adults, aged 70–84 years (mean age, 75.9 ± 4.0 years; 49.8% women) who were enrolled in the KFACS. Methods physical function was assessed by handgrip strength, usual gait speed, the five-times-sit-to-stand test, the timed up-and-go test, and the Short Physical Performance Battery. Appendicular skeletal muscle mass (ASM) was measured by dual-energy X-ray absorptiometry. Results according to the criteria of the EWGSOP2, the sarcopenia indicators of combined low muscle strength and low muscle quantity were present in 4.6–14.5% of men and 6.7–14.4% of women. The severe sarcopenia indicators of combined low muscle strength, low muscle quantity and low physical performance were present in 0.3–2.2% of men and 0.2–6.2% of women. Using the clinical algorithm with SARC-F as a screening tool, the prevalence of probable sarcopenia (2.2%), confirmed sarcopenia (1.4%) and severe sarcopenia (0.8%) was low. Conclusions the prevalence of sarcopenia among community-dwelling older individuals varied depending on which components of the revised EWGSOP2 definition were used, such as the tools used to measure muscle strength and the ASM indicators for low muscle mass.


Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 253 ◽  
Author(s):  
Vita Lesauskaitė ◽  
Gytė Damulevičienė ◽  
Jurgita Knašienė ◽  
Egidijus Kazanavičius ◽  
Agnius Liutkevičius ◽  
...  

Background and objective: The successful adoption of technology is becoming increasingly important to functional independence and successful ageing in place. A better understanding of technology usage amongst older people may help to direct future interventions aimed at improving their healthcare. We aimed to obtain the first data regarding technology use, including gerontechnologies, represented by fall detectors, from older adults in Lithuania. Material and methods: The research was carried out in the framework of the project Smart Gerontechnology for Healthy Ageing, which involved assessing the use of technologies and the readiness to use gerontechnologies, as represented by fall detectors. A total of 375 individuals that were more than 60 years of age were enrolled in the study. The self-reporting questionnaires were completed by geriatric in-patients, hospitalized in the geriatric department, and also by community-dwelling older adults. Results: Geriatric in-patients’ use of computers and the internet was associated with age (every year of age decreased the probability of computer and internet use by 0.9-times) and a positive attitude towards new technologies—this predictor increased the use of a computer by six-times in comparison with people who did not have such an attitude. Sex and education had no influence on computer use for geriatric in-patients. For community-dwelling older adults, the use of computers and internet was associated with age, education (a university education increased the use of computers and the internet by four times), and a positive attitude towards technologies. Conclusions: Lithuanian older women in the study used computers, the internet, and cell phones equally with men. Increasing age was a strong negative predictor of technology use. A positive attitude to new technologies was a strong positive predictor of technology use. Most geriatric patients and community-dwelling older adults were ready to use technologies that permit ageing in place.


2019 ◽  
Vol 74 (4) ◽  
pp. 573-580 ◽  
Author(s):  
Nathalia Perleberg Bachettini ◽  
Renata Moraes Bielemann ◽  
Thiago Gonzalez Barbosa-Silva ◽  
Ana Maria Baptista Menezes ◽  
Elaine Tomasi ◽  
...  

2017 ◽  
Vol 89 ◽  
pp. 103-111 ◽  
Author(s):  
Bruno de Souza Moreira ◽  
Rosana Ferreira Sampaio ◽  
Juliano Bergamaschine Mata Diz ◽  
Alessandra de Carvalho Bastone ◽  
Eduardo Ferriolli ◽  
...  

2005 ◽  
Vol 85 (7) ◽  
pp. 648-655 ◽  
Author(s):  
Anne Shumway-Cook ◽  
Marcia A Ciol ◽  
William Gruber ◽  
Cynthia Robinson

Abstract Background and Purpose. Hip fracture is a major medical problem among older adults, leading to impaired balance and gait and loss of functional independence. The purpose of this study was to determine the incidence of and risk factors for falls 6 months following hospital discharge for a fall-related hip fracture in older adults. Subjects. Ninety of 100 community-dwelling older adults (≥65 years of age) hospitalized for a fall-related hip fracture provided data for this study. Methods. An observational cohort study used interviews and medical records to obtain information on demographics, prefracture health, falls, and functional status. Self-report of falls and performance-based measures of balance and mobility were completed 6 months after discharge. Results. A total of 53.3% of patients (48/90) reported 1 or more falls in the 6 months after hospitalization. Older adults who fell following discharge had greater declines in independence in activities of daily living and lower performance on balance and mobility measures. Prefracture fall history and use of a gait device predicted postdischarge falls. Discussion and Conclusion. Falls following hip fracture can be predicted by premorbid functional status.


2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
S E R Lim ◽  
N J Cox ◽  
H C Roberts

Abstract Introduction Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Yan-Jiao Wang ◽  
Yi Wang ◽  
Jun-Kun Zhan ◽  
Zhi-Yong Tang ◽  
Jie-Yu He ◽  
...  

The aim was to apply AWGS criteria to estimate the prevalence of sarco-osteoporosis and investigate its relationship with frailty, in a sample of 316 community-dwelling Chinese older people. Regression analysis was performed using frailty as the dependent variable. The results showed that the prevalence rate of sarco-osteoporosis was 10.4% in older men and 15.1% in older women. ≧80 years old (OR 4.8; 95% CI, 3.05–10.76;P=0.027), women (OR 2.6; 95% CI, 1.18–2.76;P=0.036), and higher level of comorbidity (OR 3.71; 95% CI, 1.61–10.43;P=0.021) were independently associated with the likelihood of being sarco-osteoporosis. In the frail group, sarco-osteoporosis occurred in 26.3% of men, in 38.5% of women, and in lower proportion in the prefrail (13.6% of men; 16.2% of women) and nonfrail group (1.6% of men; 1.9% of women) (P<0.05, resp.). Furthermore, the likelihood of being frail/prefrail was substantially higher in the presence of sarco-osteoporosis (OR 4.16; 95% CI, 2.17–17.65;P=0.019in men; and OR 4.67; 95% CI, 2.42–18.86;P=0.007in women). The results indicate that patients with sarco-osteoporosis are more likely to be ≧80 yrs with higher burden of comorbidities and to have frailty/prefrailty, especially for women.


2015 ◽  
Vol 18 (3) ◽  
pp. 607-617 ◽  
Author(s):  
Camila Astolphi Lima ◽  
Wuber Jefferson de Souza Soares ◽  
Tereza Loffredo Bilton ◽  
Rosângela Corrêa Dias ◽  
Eduardo Ferrioll ◽  
...  

Excessive daytime sleepiness (EDS) imposes a wide range of adverse health-related outcomes in older people, such as disability, which impair everyday activities and may increase the risk of fall. Few studies have explored EDS in Brazilian older people living in the community who are typically cared in primary health services. This study aims to investigate the prevalence of EDS and its sociodemographic, physical and mental health correlates among community-dwelling older adults. This is an exploratory, population-based study derived from Frailty in Brazilian Older Adults (FIBRA) study including adults aged 65 years and older. Participants with a score ≥ 11 points on the Epworth Sleepiness Scale were considered as having excessive daytime sleepiness. A structured, multidimensional questionnaire was used to investigate sociodemographic, physical and mental health, and self-rated health variables. The sample was composed of 776 older adults, of whom 21% (n = 162) presented excessive daytime sleepiness. Multivariate regression analysis revealed that EDS is associated with obesity (OR = 1.50; 95%CI 1.02 - 2.20), urinary incontinence (OR = 1.53; 95%CI 1.01 - 2.31), poor self-rated health (OR = 1.54; 95%CI 1.06 - 2.24), and depression symptoms (OR = 1.49; 95%CI 1.00 - 2.20). Our results suggest that healthcare professionals should identify older adults with EDS and implement intervention strategies to minimize the negative impact of the co-occurrence of this condition with obesity, depression and urinary incontinence over health and quality of life.


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