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BACKGROUND Older adults are at increased risk of developing health disorders and functional decline. A comprehen-sive geriatric assessment (CGA) to identify early signs of negative trajectories has enormous potential for patients, society and health care system. However, due to time constraints and considerable effort physicians rarely conduct the CGA. If designed properly, digital technologies could identify health risks already at a pre-clinical stage and thereby facilitate preventive efforts and a targeted intervention. For this purpose, a LiSA (Life-integrated Self-Assessment) tablet system will be developed in a structured co-creation process. OBJECTIVE The aim of the present study was to investigate older adults’ perceptions of (1) different self-assessment domains, (2) components affecting user experience, (3) risks and benefits associated with LiSA, (4) characteristics of potential LiSA users, and (5) the LiSA concept in general. METHODS Ten community-dwelling older adults aged ≥70 years were recruited. Six co-creation workshops were held and started with an expert input followed by semi-structured discussion rounds. Participants per-formed “hands-on” activities with a tablet, including testing of pre-installed self-assessment apps. All workshops were audio-recorded and additionally documented by the researchers using flipcharts, notes, and photos. Qualitative content analysis was used to analyze data following a deductive-inductive approach, guided by the Optimized Honeycomb model for user experience (UX). RESULTS The group (mean age 77.8 ± 5.1 years) was heterogeneous in terms of prior technology experience and health status. The mean workshop duration was two hours and an average of eight participants attend-ed each workshop. Eleven thematic categories were identified, covering results on all research ques-tions. Participants emphasized a strong interest in conducting a digital self-assessment of physical activ-ity and function, sensory and cognitive functions, and requested additional features such as recom-mendations for actions or reminders. LiSA was perceived as an empowerment and a motivator to en-gage in active health care planning as well as to enable shared and informed decision making. Concerns and barriers were lack of technical competence, feelings of frustration and fear of being left alone with negative assessment results. In essence, participants expressed a positive attitude towards using LiSA repeatedly and identified it as an option to increase the chances for maintaining independence when growing old. CONCLUSIONS The co-creation participants supported the LiSA approach and were interested in performing regular self-assessments on a long-term basis. In their opinion LiSA should include relevant assessments captur-ing physical activity and function, sensory and cognitive functions as well as recommendations for ac-tions. It should be customizable to individual needs. These results will form the basis for a prototype. Iterative development and validation will aim to make LiSA accessible in the public domain as a reliable tablet-based system for self-assessment.

Digital health apps have a large potential for autonomous screening and monitoring of older people with respect to maintaining their independence. Due to demographic change and the shortage of specialized personnel in medicine, these premedical self-assessment apps could be of great value in the future.This narrative review enables the assessment of whether a digital geriatric self-assessment for older people ≥ 70 years is feasible using currently available apps.A search was carried out for apps that enable a self-assessment in the following domains: physical capacity, cognition, emotion, nutrition, sensory perception and context factors. Based on predefined criteria apps were selected and presented.Self-assessment apps could be identified in four of the six domains: physical capacity, cognition, emotion and sensory perception. In total five apps are presented as examples. No apps were identified regarding nutrition and context factors. Numerous self-assessment apps were identified for the field of physical activity.The presented results indicate that digital self-assessment can currently be realized for certain domains of the comprehensive geriatric assessment. New promising apps are currently under development. More research is needed to verify test quality criteria and usability of available apps. Furthermore, there is a need for a platform that integrates individual assessment apps to provide users with an overview of the results and recommendations.HINTERGRUND: Digitale Gesundheits-Apps haben ein großes Potenzial für das selbstständige Screening sowie das Monitoring älterer Menschen hinsichtlich der Aufrechterhaltung ihrer Selbstständigkeit. Aufgrund des demografischen Wandels und des Fachkräftemangels in der Medizin könnten diese prämedizinischen Self-Assessment-Apps in Zukunft einen großen Stellenwert einnehmen.Dieses narrative Review soll die Einschätzung ermöglichen, ob ein digitales geriatrisches Self-Assessment für ältere Menschen ≥ 70 Jahren mithilfe aktuell verfügbarer Apps durchführbar ist.Es erfolgte die Recherche nach Apps, die ein Self-Assessment in den folgenden Domänen ermöglichen: physische Kapazität, Kognition, Emotion, Ernährung, Sensorik und Kontextfaktoren. Anhand definierter Kriterien werden Apps ausgewählt und vorgestellt.In 4 der 6 Domänen konnten Self-Assessment-Apps identifiziert werden: physische Kapazität, Kognition, Emotion, Sensorik. Insgesamt 5 Apps werden exemplarisch vorgestellt. Für Ernährung und Kontextfaktoren wurden keine Apps identifiziert. Zahlreiche Self-Assessment-Apps wurden für den Bereich physische Aktivität identifiziert.Zum aktuellen Zeitpunkt ist ein Self-Assessment für einige Domänen des umfassenden geriatrischen Assessments möglich. Weitere vielversprechende Apps befinden sich in der Entwicklungsphase. Insgesamt bedarf es der wissenschaftlichen Überprüfungen der App-Testgütekriterien und App Usability. Darüber hinaus wird eine Plattform benötigt, die die einzelnen Assessment-Apps integriert, um Nutzer*innen einen Überblick über die Ergebnisse zu geben und Empfehlungen abzuleiten.

Objective: To examine sensitivity to change and responsiveness of the Community Balance and Mobility Scale (CBM) and shortened CBM (s-CBM). Design: Secondary analysis using data of a randomized controlled trial. Setting: General community. Participants: Young community-dwelling seniors aged 61-70 years (N=134; mean age, 66.2±2.5y). Interventions: Participants underwent 12 months of exercise intervention. Main Outcome Measures: CBM and s-CBM. Sensitivity to change was assessed using standardized response mean (SRM) and paired t tests as appropriate. Responsiveness was assessed using 2 minimal important difference (MID) estimates. Analyses were conducted for the full sample and for the subgroups “high-balance” and “low-balance,” divided by median split. Results: Inferential statistics revealed a significant CBM (P

Context Long-term adherence to physical activity (PA) interventions is challenging. The Lifestyle-integrated Functional Exercise programmes were adapted Lifestyle-integrated Functional Exercise (aLiFE) to include more challenging activities and a behavioural change framework, and then enhanced Lifestyle-integrated Functional Exercise (eLiFE) to be delivered using smartphones and smartwatches., Objectives To (1) compare adherence measures, (2) identify determinants of adherence and (3) assess the impact on outcome measures of a lifestyle-integrated programme., Design, setting and participants A multicentre, feasibility randomised controlled trial including participants aged 61-70 years conducted in three European cities., Interventions Six-month trainer-supported aLiFE or eLiFE compared with a control group, which received written PA advice., Outcome measures Self-reporting adherence per month using a single question and after 6-month intervention using the Exercise Adherence Rating Scale (EARS, score range 6-24). Treatment outcomes included function and disability scores (measured using the Late-Life Function and Disability Index) and sensor-derived physical behaviour complexity measure. Determinants of adherence (EARS score) were identified using linear multivariate analysis. Linear regression estimated the association of adherence on treatment outcome., Results We included 120 participants randomised to the intervention groups (aLiFE/eLiFE) (66.3 +/- 2.3 years, 53% women). The 106 participants reassessed after 6 months had a mean EARS score of 16.0 +/- 5.1. Better adherence was associated with lower number of medications taken, lower depression and lower risk of functional decline. We estimated adherence to significantly increase basic lower extremity function by 1.3 points (p, Conclusion PA adherence was associated with better lower extremity function and physical behavioural complexity. Barriers to adherence should be addressed preintervention to enhance intervention efficacy. Further research is needed to unravel the impact of behaviour change techniques embedded into technology-delivered activity interventions on adherence.