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 ◽  
...  

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.

2021 ◽  
Author(s):  
Ghada Alhussein ◽  
Leontios Hadjileontiadis

BACKGROUND Osteoporosis is the fourth most common chronic disease in the world. Adopting preventative measures and effective self-management interventions help in improving bone health. Mobile health (mHealth) technologies can play a key role in osteoporosis patient care and self- management. OBJECTIVE This study presents a systematic review and meta-analysis of the currently available mHealth applications targeting osteoporosis self-management, aiming to determine the current status, gaps and challenges the future research could address, proposing appropriate recommendations. METHODS In this systematic review and meta-analysis, we searched PubMed, Scopus, EBSCO, Web of Science, and IEEExplore databases between Jan 1, 2010 and May 31, 2021, for all English publications that describe apps dedicated to or being useful for osteoporosis, targeting self-management, nutrition, physical activity, risk assessment, delivered on smartphone devices for young and older adults. In addition, a survey of all osteoporosis-related apps available in iOS and Android app stores as of May 31, 2021 was also conducted. Primary outcomes of interest were the prevention or reduction of unhealthy behaviours or improvement in healthy behaviours of the six behaviours. Outcomes were summarised in a narrative synthesis and combined using random-effects meta-analysis. RESULTS In total, 3906 unique articles were identified. Of these, 32 articles met the inclusion criteria and were reviewed in depth. The 32 studies were comprising 14 235 participants, of whom on average 69.5% were female, with a mean age of 49.8 years (SD 17.8). The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth supported interventions resulted in a significant reduction in pain (Hedge’s g -1.09, 95%CI -1.68 to -0.45) and disability (Hedge’s g -0.77, 95%CI -1.59 to 0.05). The post-treatment effect of the digital intervention was significant for physical function (Hedge’s g 2.54, 95%CI -4.08 to 4.08); yet nonsignificant for wellbeing (Hedge’s g 0.17, 95% CI -1.84 to 2.17), physical activity (Hedges’ g 0.09, 95%CI -0.59 to 0.50), anxiety (Hedge’s g -0.29, 95%CI -6.11 to 5.53), fatigue (Hedge’s g -0.34, 95%CI -5.84 to 5.16), calcium (Hedge’s g -0.05, 95%CI -0.59 to 0.50) and vitamin D (Hedge’s g 0.10, 95% CI -4.05 to 4.26) intake, and trabecular score (Hedge’s g 0.06, 95%CI -1.00 to 1.12). CONCLUSIONS Osteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be a valuable tool for patients and health professionals. However, the majority of the apps that are currently available lack clinically validated evidence of their efficacy and they most focus on a limited number of symptoms. A more holistic and personalized approach, within a co-creation design ecosystem, is needed.


Psychosis ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 362-373
Author(s):  
Stephen Clarke ◽  
Donncha Hanna ◽  
Ciaran Mulholland ◽  
Ciaran Shannon ◽  
Callum Urquhart

2021 ◽  
pp. 1-19
Author(s):  
Xiaolong Zhang ◽  
Shôn Lewis ◽  
Joseph Firth ◽  
Xu Chen ◽  
Sandra Bucci

Abstract Mental health problems are highly prevalent in China; however, China's mental health services lack resources to deliver high-quality care to people in need. Digital mental health is a promising solution to this short-fall in view of the population's digital literacy. In this review, we aim to: (i) investigate the effectiveness, acceptability, usability, and safety of digital health technologies (DHTs) for people with mental health problems in China; (ii) critically appraise the literature; and (iii) make recommendations for future research directions. The databases MEDLINE, PsycINFO, EMBASE, Web of Science, CNKI, WANFANG, and VIP were systemically searched for English and Chinese language articles evaluating DHTs for people with mental health problems in mainland China. Eligible studies were systematically reviewed. The heterogeneity of studies included precluded a meta-analysis. In total, 39 articles were retrieved, reporting on 32 DHTs for various mental health problems. Compared with the digital mental health field in the West, the Chinese studies targeted schizophrenia and substance use disorder more often and investigated social anxiety mediated by shame and culturally specific variants, DHTs were rarely developed in a co-production approach, and methodology quality was less rigorous. To our knowledge, this is the first systematic review focused on digital mental health in the Chinese context including studies published in both English and the Chinese language. DHTs were acceptable and usable among Chinese people with mental health problems in general, similar to findings from the West. Due to heterogeneity across studies and a paucity of robust control trial research, conclusions about the efficacy of DHTs are lacking.


2020 ◽  
Vol 10 (5) ◽  
pp. 1078-1085
Author(s):  
Jo-Ana D Chase ◽  
Jennifer Otmanowski ◽  
Sheri Rowland ◽  
Pamela S Cooper

Abstract Sedentary behavior (SB) is associated with numerous negative health outcomes, independent of physical activity behavior. Older adults are the most sedentary population in the United States. Understanding the effects and characteristics of existing interventions to reduce SB can inform practice, future research, and public health initiatives to improve older adults’ health. We conducted a systematic review and meta-analysis to examine existing SB intervention research among older adults and quantitatively synthesize intervention effects. Comprehensive searches were conducted to identify studies testing interventions to reduce SB time among adults at least 60 years old. Data on study design, intervention content and delivery, and participant characteristics were extracted from eligible studies. Standardized mean difference effect sizes (Cohen’s d) were synthesized using a random-effects model for two-group pretest–posttest design studies. Twenty-two reports describing 17 distinct studies were included in the narrative synthesis, with eight studies included in the meta-analysis (k = 8; n = 1,024). Most interventions were theory-driven and employed multiple strategies, including education, self-monitoring, and goal setting. Although SB interventions significantly reduced total sedentary time, the overall effect was small (d = −0.25, 95% confidence interval [−0.50, 0.00], p = .05). Studies were significantly heterogeneous (Q = 22.34, p < .01); however, the small number of comparisons prevented moderator analyses. Practitioners should employ diverse SB-specific strategies to encourage older adults to reduce time spent sedentary. To develop public health programs targeting SB in older adults, future research should include measures of time spent in specific SB and duration/number of breaks in sedentary time and investigate SB intervention effects on health outcomes.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 862-862
Author(s):  
Stacey Schepens Niemiec ◽  
Elissa Lee ◽  
Jeanine Blanchard ◽  
Adam Strizich

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.


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