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Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Purpose Digital storytelling is a method of short personal film making that originated as a form of community empowerment (Lambert 2013). It has many applications ranging from international development, education, social media and health. At present, stories of this kind are video files hosted on a website and consumed passively. This makes them difficult to find and browse, especially for non-technical users. Imagine instead if they could be printed like patient information leaflets, with associated audio or video that plays on a nearby smartphone. Then they could be distributed physically and consumed interactively through a smartphone app that is triggered by the paper itself. This possibility is supported by the Next Generation Paper platform developed at the University of Surrey (Frohlich et al 2019). Here we report a design exploration showing the feasibility and feel of this idea for a corpus of digital stories from a previous study of dementia care. Research insights are generated through design practice itself, ahead of user feedback, although we realise this is unconventional in gerontechnology (Zimmerman et al 2007). Method We took a corpus of 15 digital stories recorded in a previous study of digital storytelling in a Brazilian care home (Abrahão et al 2018). Participants in that study included a 60 year old lady with dementia and her formal and informal carers, all of whom used our Android digital storytelling app called Com-Phone Story Maker to create digital stories about the current life of the lady in the home. All of these had either Brazilian Portuguese voiceover or music clips associated with them (rather than video). So we created a conventional photo album and set of loose printed photos with an audio layer and its textual translation into English. We now reflect on aspects of the media and interaction design which differentiate this medium from traditional story videos. This is a technical analysis not yet informed by user feedback. Results & Discussion Video demonstrations of the augmented album and prints are shown here: Digital story corpus as a photo album: https://vimeo.com/showcase/5956567/video/392030063 Digital story corpus as talking prints: https://vimeo.com/showcase/5956567/video/392031208 We found the augmented album to have different properties to the loose prints. The album lent itself to structured presentation of composite photos in a digital story in a fixed order, and to giving to others as a gift. In contrast, the loose prints allowed for more flexible and interactive presentation, and also to displaying on a wall with occasional access to the links. The 'talking photo' voice associations provided a natural interpretation of the images in local language, and the English text translations were useful for English-speaking audiences. In general, the printing of personal multimedia stories provided an accessible physical reminder and interface to story content, and could be copied and distributed widely if required. The implications for gerontechnology are that they could be valuable for older people who still enjoy paper, but are willing to bridge to screen information on their mobile phones or televisions. Future work should test these assertions for a range of printed digital stories with older audiences. The approach might also be tried 'paper-first' to augment actual patient information leaflets with video illustrations and voiceover. An example of this can be seen here: https://vimeo.com/showcase/5956567/video/391984137 [ABSTRACT FROM AUTHOR]

Purpose The electronic medical record is the sets of individual patient health information stored in a digital format. This format can be shared across medical networks. This system enables the efficient transfer of medical records between institutions, patients and staff. The EMR contains personal health information; therefore, network access to patient-related data must be monitored and controlled to ensure that unlawful parties do not misuse personal information. Han et al. proposed several biometric-based authentication methods. However, Madhusudan et al. revealed that the biometric-based authentication method proposed by Han et al. had various weaknesses and proposed an authentication scheme with improved security suitable for the EMR system. In this paper, through a security analysis, we analyse the operation process of the scheme by Madhusudhan et al. and reveal problems, including H(B_i ) recognition errors, no perfect forward secrecy, insider attacks (user identification guessing attacks), insider attacks (forgery attacks) and denial-of-service attacks. Method In Madhusudhan et al. scheme, a general hash function is used to use biometric information. If a general hash function is used, there is a problem that an error occurs even if biometric information is input slightly differently. The user enters biometric information in the login phase to log in to the server becomes the value of using for encryption. The login step proceeds only when the value is equal to, is, and is to input as Since is biometric information, it shows a little difference each time you enter a value. Since the combination of comes out differently depending on the input value, even if is input slightly differently, the value of may be output differently from the existing value. The fact that Perfect Forward Secrecy is satisfied means that even if one of the important master keys of the scheme is exposed, the previous session key cannot be found. However, in this scheme, if the value of one of the unchanging long-term keys, is exposed, not only the future session key but also the previously used session key can be found, which does not satisfy Perfect Forward Secrecy. And if the attacker acquires the user's smart card and knows the inside information, he can also find out the user's previous session key. Results and Discussion In this paper, after explaining the operation process of the authentication scheme with improved security for the EMR proposed by Madhusudhan et al., a security analysis was conducted. The scheme proposed by Madhusudhan et al. has security problems, such as H(B_i) recognition errors, no perfect forward secrecy, insider attacks (user identification guessing attacks and forgery attacks), and DoS attacks. [ABSTRACT FROM AUTHOR]

Purpose Towards an aging society, there becomes much more critical to conduct social activities such as conversations for older adults to keep their cognitive function in their lives (Livingstone et al. 2017). Along with this social background, our research group has conducted a group conversation experiment for older adults to verify cognitive training with a randomized controlled trial (Otake-Matsuura et al., 2021). The group conversation method is called Coimagination method, which is designed to have a talk in a well-balanced manner with a specialized system (named Fonopane) and moderator robot Bono-05. Because of the COVID-19 situation, those face-to-face experiments have become challenging to conduct. Therefore, we need to extend system to overcome the above physical limitations by interfacing the system to a teleconferencing system such as Zoom. Active listening function is desirable in such a system, since active listening is an essential factor in addressing smooth conversation for older adults and providing rich human-computer interaction (Inoue et al., 2020). In general, integration of different systems has some technical challenges, such as different communication protocols. In addition, the existing active listening system has developed focusing a one-to-one style with humans and AI; hence, there are technical problems for integrating such a one-to-one style system into a multi-party group conversation system. In this paper, as a first step, we integrate system to encourage new fashion to facilitate group conversation for older adults with remote. Method We cope problems above with a step-by-step approach. As a first step, we designed to integrate the existing active listening systems which are used in an autonomous Android ERICA (Inoue et al., 2016). We have developed a system component (RobotHub) that allows each participant in a group conversation to activate multiple systems and link them to existing systems. The system runs on a cloud server and client devices with four components; FrontEndAudioExtraction, CloudAudioGateway, FonopaneRemoteBridge, and SystemDataMapper, as shown in Figure 1. Specifically, audio data is not obtained from the videoconferencing system directly, but from a client application, FrontEndAudioExtraction. The videoconferencing system interoperates with systems developed in the role of using only conventional functions, such as sharing output with screen and voice. FrontEndAudioExtraction is a system that converts the elderly's voices into power (namely, audio data) and then sends these audio data to the cloud server from their home. The system is designed to deploy on the client devices such as laptops or tablets for individual participants. It is designed easy enough to avoid cumbersome operation for people who are not good at devices, especially older adults. CloudAudioGateway is deployed on the cloud server to properly resupply the audio data sent from the client devices to another component inside the cloud server. FonopaneRemoteBridge converts the communication protocol with an existing system and an external system. SystemDataMapper is designed to assign correct relationships between microphones and participants. We also carefully designed to integrate systems to prevent with the sub-modules so that actions/events would not conflict with existing systems and external systems. In addition, we have designed and developed a system to migrate from one-to-one mapping style to one-to-multiple users. We also deployed our system on the cloud to provide experiments to release the physical restriction. Results and Discussion We have integrated the existing group conversation systems to external systems. We have preliminarily tested on laboratory members on Zoom (See Figure 2). RobotHub and other systems are now running on the cloud, so we can experiment anywhere as long as Zoom and FrontEndAudioExtraction are set up. RobotHub manages the utterance status of all participants. Therefore, even when N participants speak as they wish, the AI can detect and issue a response to the speaker who should be most likely to give a nodding response. We plan to use this mechanism in the future to conduct usability and subjective evaluation of older adults in conversational situations. [ABSTRACT FROM AUTHOR]

Exergaming, a new type of sport, combined with virtual reality, has provided new opportunities for the aging population. This study analyzed the differences in leisure constraints, participation benefits, and continuous participation intention in virtual golf (represented as an exergame) depending on the participants' ages. Data collection was conducted from August 2023 to November 2023. A quantitative research design and a convenience sampling method were employed, targeting 310 regular virtual golf participants aged 20 years or older in the Republic of Korea. For comparative analysis, the survey participants were segmented into three groups: Group 1, young adults (18–35 years); Group 2, middle-aged adults (36–55 years); and Group 3, older adults (56–69 years). To compare and analyze participation behaviors in virtual golf, the dependent variables were identified: (a) leisure constraints (four factors) to limit formation and participation in leisure; (b) participation benefits (four factors) to encourage participation in leisure; and (c) continuous participation intention (single factor) to show likelihood to participate in leisure in the future. The results revealed that the young adult group showed statistically high results for costs under leisure constraints (F = 14.949, p < 0.001, ηp2 = 0.089), and the older adult group reported statistically high results in physical (F = 9.346, p < 0.001, ηp2 = 0.057) and mental (F = 7.249, p < 0.001, ηp2 = 0.045) participation benefits and continuous participation intention (F = 6.486, p < 0.01, ηp2 = 0.041). This study confirmed that virtual golf using advanced technology brings physical and mental benefits to older people based on reasonable cost and enables continuous participation in physical activity. [ABSTRACT FROM AUTHOR]

Background: Due to the increasing proportion of older adults in Korea and growing interest in aging, the concepts of oral aging and oral hypofunction have recently been introduced. Thus, it is necessary to investigate the age-specific oral function levels of Korean older adults and develop expert intervention methods for healthy aging. Methods: Dysphagia, independence of daily living, and oral hypofunction were assessed in 206 older adults living in Wonju, Gangwon State, South Korea. Subjective dysphagia was assessed through self-report questionnaires using the Dysphagia Handicap Index (DHI), the Korean version of Eating Assessment Tool-10, and the Korean version of the Modified Barthel Index. In addition, the oral hypofunction assessment items included decreased chewing ability, occlusal pressure, tongue pressure, oral dryness, and oral cleanliness. Results: DHI increased significantly with age, with those in their 80 s reporting the most difficulty swallowing. Oral function in terms of chewing ability (maximum occlusal pressure and number of remaining teeth), maximum occlusal pressure, and maximum tongue pressure also declined with increasing age. While there was no significant difference in oral dryness by age, those in their 80 s had dry mouth according to the criteria of the oral moisture checking device. Conclusions: In an assessment of oral function in community-dwelling, independent Korean older adults, the number of items that were assessed as oral hypofunction increased with age. The findings can be used to standardize the oral hypofunction assessment item and develop age-based individualized intervention plans for the early management of oral health and individual oral myofunctional rehabilitation in Korean community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Background: In California, preventive dental care is covered by Medi-Cal (California's Medicaid program). However, many beneficiaries do not use their dental benefits. Given that a lack of knowledge about oral health and insurance coverage contributes to this underutilization, promoting the use of dental benefits among eligible individuals via an educational program is imperative. Responding to the particular needs of older immigrants with limited English proficiency, we developed a digital oral health intervention for older Korean-American Medi-Cal enrollees in Los Angeles. This educational intervention is designed to be delivered via computers and the Internet. It consists of a 15-min self-running PowerPoint presentation narrated in Korean with links to additional information on the Internet. The slides contain information about the basic etiology of oral diseases, oral hygiene, common myths about oral health and dental care, Medi-Cal coverage of preventive dental care, and how to find a dental clinic. Methods: We pilot tested the intervention with 12 participants to examine its feasibility and acceptability. We also obtained participants' qualitative feedback about the intervention. Results: A post-intervention quantitative assessment yielded high participant satisfaction and improved oral health and dental care knowledge. Participant responses to the intervention yielded four themes: (1) content and structure, (2) linguistic and cultural aspects, (3) delivery mode, and (4) additional concerns and suggestions. Conclusions: Our findings confirm the intervention's feasibility and acceptability and suggest further refinement. [ABSTRACT FROM AUTHOR]

Background: Loneliness was found to be a commonly experienced feeling among older adults during the COVID-19 pandemic and is considered to be a high-risk factor for depressive symptoms. Maintaining meaning in life has been found to be a protective resource for mental health among older adults. The purpose of this study was to examine the mediating effects of an individual's meaning in life in the relationship between loneliness and depressive symptoms among older Korean adults. Methods: The data were obtained from a sample of 213 community-dwelling older adults aged over 65. The instruments were the UCLA Loneliness Scale, the Center for Epidemiologic Studies Depression Scale, and the Meaning in Life Questionnaire. Results: Loneliness was positively associated with depressive symptoms and negatively associated with the presence of and search for meaning among older adults. The presence of meaning mediated the relationship between loneliness and depressive symptoms but the search for meaning did not. The search for meaning mediated the relationship between loneliness and depressive symptoms through the presence of meaning. Conclusions: Our study findings suggest that efforts to reduce loneliness and improve meaning in life should be undertaken to prevent depressive symptoms among older adults. [ABSTRACT FROM AUTHOR]

Background: Many complex factors contribute to suicide in older adults. The suicidal ideation that precedes suicide is an especially direct predictor of suicide. This study aimed to identify the effects between variables affecting suicidal ideation among older adults using the International Classification of Functioning, Disability and Health (ICF) model and understand the causal relationships to systematize complex factors. Methods: This study used data from 9920 community-dwelling older adults who completed a national survey in 2020 to classify predictors of suicidal ideation (e.g., depression, subjective health status, sociodemographic factors, health factors, social support, instrumental activities of daily living (IADL), and social participation) by using the ICF model. To determine the causal relationship between variables, this study examined significance based on the critical ratio (C.R.) and squared multiple correlation (SMC) by using a path model. Results: Gender, education level, economic level, age, IADL, relationship satisfaction with a child, depression, and the number of chronic diseases significantly affected suicidal ideation, while age, employment status, participation in social groups, formal and informal support, satisfaction with a friend/neighbor relationship, and subjective health status did not significantly influence it. Moreover, depression mediated the relationship between each of these variables and suicidal ideation. Conclusions: It was found that depression was the most direct and mediating factor in suicidal ideation among many factors affecting the suicidal ideation of community-dwelling older adults. Additional studies should be conducted to develop community-level strategies based on these factors and understand causal relationships. [ABSTRACT FROM AUTHOR]

We investigated a screening method for mild cognitive impairment (MCI) that combined bioimpedance features and the Korean Mini-Mental State Examination (K-MMSE) score. Data were collected from 539 subjects aged 60 years or older at the Gwangju Alzheimer's & Related Dementias (GARD) Cohort Research Center, A total of 470 participants were used for the analysis, including 318 normal controls and 152 MCI participants. We measured bioimpedance, K-MMSE, and the Seoul Neuropsychological Screening Battery (SNSB-II). We developed a multiple linear regression model to predict MCI by combining bioimpedance variables and K-MMSE total score and compared the model's accuracy with SNSB-II domain scores by the area under the receiver operating characteristic curve (AUROC). We additionally compared the model performance with several machine learning models such as extreme gradient boosting, random forest, support vector machine, and elastic net. To test the model performances, the dataset was divided into a training set (70%) and a test set (30%). The AUROC values of SNSB-II scores were 0.803 in both sexes, 0.840 for males, and 0.770 for females. In the combined model, the AUROC values were 0.790 (0.773) for males (and females), which were significantly higher than those from the model including MMSE scores alone (0.723 for males and 0.622 for females) or bioimpedance variables alone (0.640 for males and 0.615 for females). Furthermore, the accuracies of the combined model were comparable to those of machine learning models. The bioimpedance-MMSE combined model effectively distinguished the MCI participants and suggests a technique for rapid and improved screening of the elderly population at risk of cognitive impairment. [ABSTRACT FROM AUTHOR]

Previous studies have reported that low levels of physical activity result in sarcopenic obesity (SO). However, the effects of specific intensities of physical activity on SO and the optimal amount of physical activity for lowering the prevalence of SO have not been well studied. This study aimed to identify the effects of physical activity levels and intensity on SO and the optimal amount of physical activity related to a lower prevalence of SO. This cross-sectional study used data from the nationwide Korean Frailty and Aging Cohort Study (KFACS), which included 2071 older adults (1030 men, 1041 women). SO was defined according to the criteria of the European Society for Clinical Nutrition Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO). Multivariate logistic regression analysis was performed to investigate the association between the physical activity level and SO. The high activity group had a significantly lower prevalence of SO than the non-high activity (low and moderate activity) group. On the other hand, moderate-intensity physical activity was associated with a lower prevalence of SO. A total physical activity energy expenditure of > 3032 kcal/week (433 kcal/day) for men and 2730 kcal/week (390 kcal/day) for women was associated with a reduced prevalence of SO. The high physical activity and total physical energy expenditure described above may be beneficial for reducing the prevalence of SO. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aimed to anticipate the short- and long-term PCa incidence projected from the PSA testing rate (PSAr) trend and social aging during the last decade. We found that the incidence of PCa increased fourfold (4533 in 2006 to 16,815 in 2020), with each age subgroup accounting for 7.9% (50s), 31.4% (60s), 43.0% (70s), and 17.1% (over 80s) of cases in 2020. According to the projection of this study, the incidence of PCa will increase twofold by 2034 compared to 2020. If national screening were only carried out in the 60s and 70s age groups, a higher detection of almost threefold would be expected by 2040. The current incidence of prostate-specific antigen (PSA) testing, which plays a crucial role in detecting prostate cancer (PCa) in an aged population, is low in Korea. Reflecting these epidemiologic characteristics, we estimated the short- and long-term incidences of PCa. A regression equation model was extracted based on two critical pieces of information: (1) the distribution of newly detected PCa cases in each age group of the 50s, 60s, 70s, and over 80s from a recent period (2006–2020), and (2) the PSA testing rate (PSAr) from the previous decade (2006–2016) for each age subgroup. The incidence increased fourfold (4533 in 2006 to 16,815 in 2020), with each age subgroup accounting for 7.9% (50s), 31.4% (60s), 43.0% (70s), and 17.1% (over 80s) of cases in 2020. PSAr increased by an average of 1.08% annually. If these trends are maintained, 28,822 new cases will be diagnosed in 2030 (expected PSAr: 14.4%) and 40,478 cases in 2040 (expected PSAr: 26.4%). If a public PSA screening were implemented for men only in their 60s (assuming a PSAr of 60% in the 60s) and 70s (assuming a PSAr of 80% in the 70s) in 2030, 37,503 cases in 2030 (expected PSAr: 23.1%) and 43,719 cases in 2040 (expected PSAr: 29.9%) would be estimated. According to the projection, the incidence of PCa will increase twofold by 2034 compared to 2020. If national screening were only conducted in the 60s and 70s, a higher detection of almost threefold would be expected by 2040. [ABSTRACT FROM AUTHOR]

Older adults engage in online activities for various purposes. An increasing number of studies are establishing connections between the purposes of internet use and their impacts on health outcomes. This study aimed to examine how the purposes of internet use affect self-rated health and depressive symptoms among Korean older adults. A nationally representative survey of community-dwelling older adults in Korea was used in the analysis (n = 5094). Instrumental internet use (using the internet to access various forms of information, services, and other resources) in Korean older adults was as common as interpersonal communication use, and the purposes of internet use were mainly for information seeking for everyday needs and engaging in various activities for enjoyment. Internet use for interpersonal communication and instrumental purposes was significantly associated with depressive symptoms and self-rated health. Internet use for instrumental purposes had a greater impact on self-rated health (β = −0.186) and depressive symptoms (β = −0.160) compared with the impacts of interpersonal communication internet use on self-rated health (β = −0.101) and depressive symptoms (β = −0.047). The findings highlighted the necessity of designing interventions that take into account the different purposes of internet use for older adults in order to maximize its benefits, paying special emphasis for information seeking online. [ABSTRACT FROM AUTHOR]

Since the WHO's 2021 aging redefinition emphasizes "healthy aging" by focusing on the elderly's ability to perform daily activities, sarcopenia, which is defined as the loss of skeletal muscle mass, is now becoming a critical health concern, especially in South Korea with a rapidly aging population. Therefore, we develop a prediction model for sarcopenia by using machine learning (ML) techniques based on the Korea National Health and Nutrition Examination Survey (KNHANES) data 2008–2011, in which we focus on the role of socioeconomic status (SES), social infrastructure, and quality of life (QoL) in the prevalence of sarcopenia. We successfully identify sarcopenia with approximately 80% accuracy by using random forest (RF) and LightGBM (LGB), CatBoost (CAT), and a deep neural network (DNN). For prediction reliability, we achieve area under curve (AUC) values of 0.831, 0.868, and 0.773 for both genders, males, and females, respectively. Especially when using only male data, all the models consistently exhibit better performance overall. Furthermore, using the SHapley Additive exPlanations (SHAP) analysis, we find several common key features, which mainly contribute to model building. These include SES features, such as monthly household income, housing type, marriage status, and social infrastructure accessibility. Furthermore, the causal relationships of household income, per capita neighborhood sports facility area, and life satisfaction are analyzed to establish an effective prediction model for sarcopenia management in an aging population. [ABSTRACT FROM AUTHOR]

The home environment is increasingly emphasized as a key factor in home falls among frail older people. In this study, we aimed at exploring and synthesizing empirical studies that considered the environmental factors of home falls among frail older people. We performed a systematic review to draw comprehensive conclusions regarding these environmental factors by searching MEDLINE, CINAHL, Embase, and Cochrane Library, as well as gray literature databases. Intervention and nonintervention studies that specifically reported home environmental factors related to falls in community-dwelling frail older people aged 65 years and over were selected. Of the 8374 studies initially retrieved, seven intervention and seven nonintervention studies were included in the analysis. In seven of the 14 studies, environmental hazards were evaluated using relevant assessment tools. Interventions were provided for the bathroom/toilet, bedroom, living room, and for slipping and tripping, identified as frequent fall locations and situations, respectively, through nonintervention studies. The most common intervention was to provide advice/counseling and disseminate information to enhance knowledge after visiting the home and evaluating the home environmental factors that could affect falls. In the majority of the studies, the intervention was of a multicomponent nature, and in only two intervention studies was there practical modification of the home environment to lower the fall risk. In all the four studies with statistically significant results, the intervention was provided by a multidisciplinary team. Through this review, we identified environmental factors for home falls, helping clinicians and health professionals gain a better understanding of the situation to prevent recurrence in frail older people who have experienced falls. The findings indicate that comprehensive standardized environmental evaluations should be conducted considering older people's functional characteristics and needs and that the intervention process requires the participation of older people with a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Aim: To examine self‐care behaviours among older adults with hypertension and identify related factors, including cognitive function, religious belief and comorbidities. Design: A cross‐sectional study. Methods: Self‐care behaviours included diet and health. Participants completed a survey including items on demographics, disease‐related characteristics and self‐care behaviours and underwent cognitive function tests. Data were analysed using descriptive statistics, and multiple regression analysis was performed to analyse the factors affecting self‐care. Results: Regarding diet behaviour, older religious adults and those with higher scores on the Montreal Cognitive Assessment‐Korean version had higher levels of self‐care scores according to the HBP‐SC. Regarding health behaviour, older adults with no comorbidities had higher levels of self‐care scores according to the HBP‐SC. Conclusion: Factors affecting self‐care diet behaviour include religion and Montreal Cognitive Assessment‐Korean version scores and those affecting health behaviour include comorbidities among older adults with hypertension. Therefore, to improve their self‐care behaviours, their religious practices and comorbidities should be considered, cognitive function should be assessed, and tailored education should be provided. Implications for the Profession and/or Patient Care: This study investigated factors affecting self‐care behaviours of hypertensive older adults in South Korea. The self‐care was divided into diet and health behaviours. The factors influencing diet behaviour were religion and Montreal Cognitive Assessment‐Korean version scores, and the factor influencing health behaviour was comorbidities. We also investigated self‐care behaviour patterns. Older adults with hypertension were good at controlling alcohol consumption and did not forget to fill prescriptions. However, they were poor at reading nutrition labels to check on sodium content and checking blood pressure at home. Therefore, nurses could develop interventions considering these influencing factors and behavioural patterns to improve self‐care behaviours and enhance health for older adults with hypertension. Impact Hypertension in older adults affects their health conditions and performance of self‐care behaviours. Nurses could assess self‐care based on diet and health behaviours. Additionally, further developing tailored programmes is recommended considering factors like religious belief, cognitive function and comorbidities. Reporting Method: This study followed the STROBE guidelines. Patient or Public Contribution: This study used a convenience sample of 105 participants aged ≥ 65 years recruited from a Korean hospital. [ABSTRACT FROM AUTHOR]

Patients with diabetes must have self-efficacy to perform necessary self-care tasks. Self-efficacy has been considered as one of the primary motivators on diabetes self-care; therefore, it is essential for health care professionals to assess the self-efficacy of patients with diabetes to provide optimal care. Despite older Korean immigrants having greater difficulty in diabetes management, research on self-efficacy for them is lacking. This study aims to examine the psychometric property of the General Self-Efficacy scale Korean version for older Korean immigrants with diabetes in the United States. In this cross-sectional, methodological study, data were collected using convenience sampling. Cronbach's alpha, exploratory factor analysis, and confirmatory factor analysis were employed to examine the psychometric properties. Cronbach's alpha for the entire GSE scale Korean version is 0.81. The initial Eigenvalues show two factors, coping and confidence; however, the confirmatory factor analysis showed reasonable goodness of fit to the data (χ2(35) = 86.24, p < 0.01), χ2/df ratio = 2.46, AGFI = 0.87, GFI = 0.91, IFI = 0.90, ECVI = 0.74, CFI = 0.89, and RMSEA = 0.093 in the one-factor model. The General Self-Efficacy scale Korean version demonstrated acceptable reliability and validity. It can be used to investigate self-efficacy and to devise culturally tailored diabetes interventions. [ABSTRACT FROM AUTHOR]

Objectives: Income poverty is one of the most common problems of old age. It varies among older adults living in different societies. This study aims to investigate the predictors of income poverty in older adults based on the data from Organization for Economic Cooperation and Development (OECD) countries. Methods: The secondary data analysis method was used in the present study. The income poverty rate and its associated variables were extracted from 36 members of OECD countries and entered into the SPSS software, version 22. For data analysis, descriptive and inferential statistics, including the Pearson correlation coefficient test and multiple linear regression analysis were employed. Results: The results showed that in the studied countries, the mean of income poverty among older adults was higher in women (11.48±16.2), and the elderly aged 75 years or above (12.57±16.1). The income poverty of older adults was significantly correlated with older adults' share in the gross domestic product (r=-0.376, P=024), targeted pension coverage (r=-0.505, P=0.003), income sources based on public transfers (r=-0.460, P=0.005), income sources from work (r=0.697, P=0.000), mandatory pension contribution rate (r=-0.343, P=0.040), and net pension replacement rate (r=-0.424, P=0.010). The results of regression analysis also revealed that variables of income sources from work and targeted pension coverage explained 66% of the variance in income poverty among older adults. Discussion: It is important to pay attention to the variables of age and gender of older people to overcome economic vulnerability in social policies. It is also necessary to consider the role of the share of public transfers and basic old-age pensions to reduce older adults' poverty. The lessons to be learned from OECD countries in this research are useful for the social rehabilitation of older adults in Iran. [ABSTRACT FROM AUTHOR]

Purpose Older people with disabilities mostly found difficulties in their communication, mobility, self-care (Lim, Song, Kweon, & Ro, 2022). Use of assistive technology could make older people more independent and reduce the physical care burden of caregivers (Mortenson et al., 2012). Korean government started to the first Assistive Technology (AT) R&D from 2020-2023 for older adults and people with disabilities (Kim, An, Ro, Kweon, & Eun, 2022). In this study, we will introduce AT R&D for older people with disabilities in Korea and discuss future plans for the AT R&D. Method The AT R&D in Korea is classified into two categories such as economic and social value projects considering the market need for AT and industry characteristics. There are ten economic value projects mainly performed by companies, universities, and research center to make a commercially available AT product (figure 1). The AT open platform operated by the National Rehabilitation Center (NRC) in pursuit of social value collects ideas of appropriate assistive technology (AAT), develops it with consumers, and shares the results as an open-source format through the open page (www.nrc.go.kr/at_rd) (Kim, Lim, Lee, & Eun, 2021). Among the current AT R&D including economic/social value projects, three researchers in NRC discussed and organized which projects are the AT devices for older people with disabilities according to the ICF major classification (WHO, 2001). Results and Discussion There are seven projects directly related to enhancing quality of life of older people with disabilities out of ten economic value projects overall. The economic value projects can be classified into the activity and participation in ICF such as d3 communication (P8 Augmentative and Alternative Communication System, P9 Hearing AT), d4 mobility (P2 Li-on Battery for AT, P4 Soft Robotics for people with stroke, P6 Stepless AT), d5 selfcare (P3 Changing Place Toilets), and d9 community, social and civic life (P10 leisure). There are also fifteen AAT devices have been developed within the scope of social value project. The AT devices can be classified into the activity and participation in ICF are d3 communication (remote call bell, lip mouse), d4 mobility (walker, grip bar, sling, special seating, universal holder, package tearing aids), d5 selfcare (wearing socks, nail clipper, one-handed hair tie, shoelace aids), d6 domestic life (Electric plug aids), and d9 community, social and civic life (gardening tools). In the next generation of AT R&D starting from 2024, the place where older adults, caregivers, developers, and policy makers meet using the AT open platform will continue to operate. The areas of activities and participation according to ICF will be expanded from the existing areas to all areas such as d1 learning and applying knowledge, d2 general tasks and demands, d7 interpersonal interactions and relationships, and d8 major life areas. Furthermore, future R&D items for older adults including those activity and participation were identified through the 2030 Future Vision Scenario (NRC, 2022). [ABSTRACT FROM AUTHOR]

(1) Background: Continuous participation in a comprehensive dementia prevention program is important for community-dwelling older adults during the coronavirus disease (COVID-19) pandemic, as limitations on their communities and social participation have increased and participation in daily tasks has decreased. These factors can negatively affect their cognitive function and symptoms of depression. This study aimed to introduce an evidence-based online dementia prevention program in the South Korean context and to identify its effect on cognitive function and symptoms of depression in community-dwelling older adults during the COVID-19 pandemic. (2) Methods: One hundred and one community-dwelling older adults without dementia participated in twelve sessions of an online dementia prevention program designed by occupational therapists. Cognitive function and symptoms of depression were assessed before and after the program. Cognitive function was tested using the Cognitive Impairment Screening Test and symptoms of depression were assessed using the Korean version of the Short Geriatric Depression Scale. The participants' opinions were gathered using open-ended questions. (3) Results: After the program, according to the raw score, orientation was maintained and attention, visuospatial function, executive function, memory, and language function increased. The memory and total cognitive score was improved significantly. Symptoms of depression significantly decreased. The program's benefits according to the participants were participation in new activities, boredom reduction, online communication, and reminiscence. (4) Conclusions: An online dementia prevention program is effective in maintaining and increasing cognitive function and preventing depression in community-dwelling older adults. An online dementia prevention program is a useful method in providing opportunities to participate in cognitive training and continuous daily activities during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Sarcopenia is a well-known age-related disease that can lead to musculoskeletal disorders and chronic metabolic syndromes, such as sarcopenic obesity. Numerous studies have researched the relationship between sarcopenia and various risk factors, leading to the development of predictive models based on these factors. In this study, we explored the impact of physical activity (PA) in daily life and obesity on sarcopenia prediction. PA is easier to measure using personal devices, such as smartphones and watches, or lifelogs, than using other factors that require medical equipment and examination. To demonstrate the feasibility of sarcopenia prediction using PA, we trained various machine learning models, including gradient boosting machine (GBM), xgboost (XGB), lightgbm (LGB), catboost (CAT), logistic regression, support vector classifier, k-nearest neighbors, random forest (RF), multi-layer perceptron, and deep neural network (DNN), using data samples from the Korea National Health and Nutrition Examination Survey. Among the models, the DNN achieved the most precise accuracy on average, 81%, with PA features across all data combinations, and the accuracy increased up to 90% with the addition of obesity information, such as total fat mass and fat percentage. Considering the difficulty of measuring the obesity feature, when adding waist circumference to the PA features, the DNN recorded the highest accuracy of 84%. This model accuracy could be improved by using separate training sets according to gender. As a result of measurement with various metrics for accurate evaluation of models, GBM, XGB, LGB, CAT, RF, and DNN demonstrated significant predictive performance using only PA features including waist circumference, with AUC values at least around 0.85 and often approaching or exceeding 0.9. We also found the key features for a highly performing model such as the quantified PA value and metabolic equivalent score in addition to a simple obesity measure such as body mass index (BMI) and waist circumference using SHAP analysis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop a new chewing problem directory (CPD) and validate it with oral health indicators such as total occlusion force, number of natural and rehabilitated teeth (NRT), NRT posterior, natural teeth, natural teeth posterior, and dental status among Korean elders. Background: Chewing problem is the main oral health problem in elders. However, there has been no validated tool using both subjective and objective assessment of chewing problem. Subjects and methods: A total of 537 participants aged 65 years or more were randomly assigned into 2 subsamples: developing sample (n = 260) for developing and internally validating the new CPD as the 1st stage and confirmation sample (n = 277) for confirming validation of CPD as the 2nd stage. CPD was developed using three subjective questionnaires (general eating, chewing nuts, and chewing meat problem) and objective NRT. Periodontitis, age, sex, education, smoking, alcohol drinking, metabolic syndrome, and frailty were considered as confounders. Following the development of CPD, CPD was validated using multiple multivariable logistic regression after controlling for confounders in confirmation sample and total sample. Results: The Cronbach's alpha value for three subjective questionnaires of CPD was 0.87. Among oral health indicators, NRT (0–28) showed the highest impact association with subjective chewing problem score (partial r = − 0.276). The chewing problem from the new CPD was associated with all items of oral health indicators. The prevalence of chewing problems by CPD was 57.7% in developing sample. Elders with NRT ≤ 24, compared with those with NRT ≥ 25, showed the highest impact on chewing problems by new CPD (Odds Ratio = 7.3 in the confirmation sample and 5.04 in the total sample, p < 0.05) among oral health indicators. Conclusion: This new CPD was developed as a valid tool to evaluate the chewing problem for Korean elders in dental clinics and community-based settings. [ABSTRACT FROM AUTHOR]

Background: Interstitial lung abnormality (ILA) is closely related to lung cancer. This study aimed to assess whether the presence of ILA is associated with the clinicoradiological features of elderly patients (≥70 years) with early‐stage non‐small cell lung cancer (NSCLC). Methods: Elderly patients who underwent surgical resection for stage I or II NSCLC with preserved lung function between 2012 and 2019 were retrospectively identified. ILA was evaluated using a three‐point scale. Univariate analyses were performed for clinicoradiological features based on the presence of ILA. Logistic and linear regression analyses were performed for cancer staging and tumor size, respectively. Results: A total of 254 patients were evaluated. The presence of ILA (score = 2) was significantly associated with male sex, current or former smoker status, higher pack‐years of smoking, low forced expiratory volume in one second/forced vital capacity ratios and diffusing capacity of the lung for carbon monoxide, and presence of emphysema (≥5%). Tumor characteristics, such as lower lobe and outer one‐third location, squamous cell carcinoma, and higher cancer stage (stage II) were significantly associated with ILA. The presence of ILA independently predicted a higher cancer stage (adjusted odds ratio, 1.81; 95% confidence interval, 1.10–2.96; p = 0.02) and a larger tumor size in linear regression analysis (p = 0.04). Conclusions: Patients with ILA showed clinicoradiological features similar to those of idiopathic pulmonary fibrosis in elderly patients with early‐stage NSCLC. Identifying the clinical implications of ILA in early‐stage lung cancer will guide clinicians in providing appropriate management for these patients. [ABSTRACT FROM AUTHOR]

Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N  = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one's community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers. [ABSTRACT FROM AUTHOR]

Objective This study aims to identify distinct patterns of 10-year multimorbidity trajectory among Korean older adults and examine factors associated with the patterns. Methods Data were drawn from the six waves of the Korean Longitudinal Study of Ageing (KLoSA, 2006–2016). We examined trajectories of multimorbidity of 1,705 older adults aged 65 and older using Growth Mixture Modeling. Then, the identified patterns were used as dependent variables to examine the correlates of multimorbidity trajectories. Explanatory variables considered were sociodemographic, psychological, health behavioural and interpersonal factors at baseline. Results Four distinct patterns of multimorbidity trajectories were identified: 'maintaining-low' (59.4%), 'chronically-high' (7.5%), 'moderately-increasing' (26.0%) and 'rapidly- increasing' (7.1%). Gender, depressive symptoms, life satisfaction and frequency of contacts with others were associated with trajectory membership. Specifically, women were more likely to be in the 'chronically-high' group than any other groups. Compared to the 'maintaining-low' group, those with higher levels of depressive symptoms and lower levels of life satisfaction were more likely to belong to the 'chronically-high' group and 'moderately-increasing' group, respectively. Respondents who had less frequent meetings with others in close relationships were more likely to be in the 'rapidly-increasing' group than the 'maintaining-low' group. Discussion These findings are suggestive of distinct trajectories of multimorbidity across older adulthood, indicating that multimorbidity experiences might differ among older adults. Moreover, results suggest that there may be gender inequalities in multimorbidity trajectories, and that levels of psychological well-being and social engagement could be useful in identifying older adults who are at higher risk of worsening multimorbidity. [ABSTRACT FROM AUTHOR]

Background: To encourage older adults with chronic disease to use information and communications technology (ICT) services effectively, it is necessary to identify users' needs and factors affecting acceptance. Objective: To identify the psychological factors affecting the acceptance of ICT services, and the service-related preferences/priorities in home-dwelling South Korean older adults. Method: We conducted focus group interviews with 2 groups of older adults (6 males and 6 females, age = 65-75 years) with chronic diseases in June 2019. To identify which services they prioritized, we made 20 service show cards, scored on a 5-point Likert scale. Additionally, we utilized a self-developed semi-structured interview guide based on the unified theory of acceptance and use of technology 3 model (UTAUT3) to comprehensively identify how the factors affect older adults' acceptance. Results: Most participants prioritized their autonomy and worried about being dependent on ICT services. They were also reluctant to learn about and use new technology; feared the social stigma related to "being old"; and were anxious that the use of ICT services could result in deepened isolation. There was ambivalence regarding the impact of ICT services on connection with family/acquaintances. The prioritized services were emergency assistance (e.g., notifying family in case of emergencies), diet and exercise-related information, and medication reminders. Service needs and psychological factors affecting the acceptance differed by gender. Conclusion: The ICT services offered to the elderly should be developed in a way that guarantees autonomy and supports self-reliance. Services must also ensure the enhancement of social networks and maintenance of connectedness with family. Older people have a fear of learning new services; so, personal guidance and tailored education need to be offered. Further, service development must reflect the diverse needs of each user. [ABSTRACT FROM AUTHOR]

Background/Objectives: The purpose of this study is to evaluate the prevalence and related risk factors of problem drinking in the Korean elderly population. Method/Statistical Analysis: Participants (n=817) aged 65 years or older were selected from the Korea National Health and Nutrition Examination Survey [KNHANES] of 2018. Sociodemographic characteristics and AUDIT-C score were obtained from the KNHANES dataset. AUDIT-C scores were categorized into two groups, including low risk, high-risk alcohol drinking according to WHO guidelines. Data analysis was performed using SPSS WIN 25.0 program. Findings: In this study, the prevalence of high-risk alcohol drinking was 31.9%, respectively. Adjusted mean AUDIT score was higher in men, younger elderly individuals, as well as those with lower education levels and those that smoked. Results revealed that demographic variables, including sex, age, education level, and smoking, were important factors affected high-risk drinking. In particular, since family number and smoking were the most significant risk factor, the odds ratio for high-risk drinking among participants that smoked was 2.49 [(95% confidence interval (CI)=1.31-4.71)]. Improvements/Applications: This study suggests that men, younger age, low educational level, and smoking are the risk factors for a high-risk alcohol drinking [ABSTRACT FROM AUTHOR]

Background: Although severe dementia could protect against suicide death by decreasing a person's capacity to implement a suicide plan, patients with early dementia may have better cognition, giving them more sustained insight into their disease and better enabling them to carry out a suicide plan. This study investigated suicide risk in older adults within 1 year of receiving a diagnosis of dementia. Methods: This study used National Health Insurance Service Senior Cohort data and included 36 541 older adults with newly diagnosed dementia (a Mini-Mental State Examination score ≤ 26 and a Clinical Dementia Rating score ≥ 1 or a Global Deterioration Scale score ≥ 3), including Alzheimer disease, vascular dementia and other/unspecified dementia, from 2004 to 2012. We selected older adults without dementia through 1:1 propensity-score matching using sex, age, comorbidities and index year, with follow-up throughout 2013. We estimated adjusted hazard ratios (AHRs) of suicide deaths within 1 year after diagnosis using a time-dependent Cox proportional hazards model. Results: We verified 46 suicide deaths during the first year after a dementia diagnosis. Older adults with dementia had an increased risk of suicide death compared to those without dementia (AHR 2.57; 95% confidence interval [CI] 1.49-4.44). Older adults with Alzheimer disease (AHR 2.50; 95% CI 1.41-4.44) or other/unspecified dementia (AHR 4.32; 95% CI 2.04-9.15) had an increased risk of suicide death compared to those without dementia. Patients with dementia but without other mental disorders (AHR 1.96; 95% CI 1.02-3.77) and patients with dementia and other mental disorders (AHR 3.22; 95% CI 1.78-5.83) had an increased risk of suicide death compared to patients without dementia. Patients with dementia and schizophrenia (AHR 8.73; 95% CI 2.57-29.71), mood disorders (AHR 2.84; 95% CI 1.23-6.53) or anxiety or somatoform disorders (AHR 3.53; 95% CI 1.73-7.21), respectively, had an increased risk of suicide death compared to patients with those conditions but without dementia. Limitations: This study examined only elderly patients in South Korea, a population with a substantially higher suicide rate than the global population. Caution must be exercised when generalizing the results to populations with dissimilar backgrounds. Conclusion: Patients with dementia had an increased risk of suicide death within 1 year after diagnosis compared to those without dementia. [ABSTRACT FROM AUTHOR]

Objectives. This study is aimed at developing multidimensional leisure participation assessment tool for the elderly to achieve quantitative and qualitative assessment of leisure participation and leisure exploration. Methods. This study collected preliminary items through literature review, statistical office data, and survey of the elderly's leisure activities and considered the list of leisure activities as assessment items by conducting a Delphi survey. Reliability was verified through internal consistency and test-retest reliability. The assessment tool was finally confirmed using content validity and discriminant validity. Results. A total of 81 leisure items classified into 8 categories and 22 subcategories were obtained through data collection and Delphi survey. Cronbach's α value was 0.939, and Intraclass Correlation Coefficient was 0.941. A content validity test was confirmed by validating that I-CVI was 0.78 or more and the S-CVI was 0.95. According to the result of discriminant validity, there was a difference in the number of participating leisure activities and leisure activities with participation intention by age. Conclusion. The leisure participation assessment tool for the elderly developed in this study can obtain information on the overall view of the leisure of the elderly by measuring leisure exploration, leisure participation, and interference factor affecting leisure participation. [ABSTRACT FROM AUTHOR]

Background/Objectives: The purpose is to find out utilization and necessity of public support related to the physical and mental health experienced by the middle-aged and elderly people. Method/Statistical Analysis: In distribution of 28 cities and 3 Guns of Gyeonggi-Do, 8,653 subjects are middle-aged people between 50 to 64 years old, and 6,547 subjects are the group under 49 years old and 11,953 subjects are the group over 65 years old. This study examined the differences in physical and mental health characteristics of the middle-aged and comparative groups through χ² validation and one-way ANOVA analysis by SPSS 21.0 program. Findings: The middle-aged showed relatively low level of difficulty than the group over 65 years old in all areas of physical health problems, physical health care difficulty, mental health problems, and mental health care difficulty. However, it showed a significantly higher level of difficulty than the group under 49 years old. The 6,731 people (77.8%) had no intention of using the social services provided to alleviate physical health problems, and 266 people (3.1%) are currently using related services. Among those who are willing to use the service, 1,135 people (13.1%) did not know the related service, the next highest rate, and 377 (4.4%) who knew the service but did not apply, 114 people (1.3%) applied for the application but could not use it. In the analysis of social service use to alleviate the difficulties of mental health, 7,165 (82.8%) of the middle-aged group had no intention of using it. Improvements/Applications: The results showed that the physical and mental difficulties experienced by the elderly and the level of difficulty were lower than normal, but higher than those under the age of 49. [ABSTRACT FROM AUTHOR]

Background/Objectives: 6-minute walking distance is a method for evaluating cardiopulmonary function and assessing physical performance. However, the data used in clinics are calculated from Americans. So we measure distance for Asians. Method/Statistical Analysis: In this study, measurement of 6-minute walking distance was performed according to the 2003 American Thoracic Society guidelines. We measured the 6-minute walking distance, body mass index, oxygen saturation, heart rate, and blood pressure. Findings: The mean 6-minute walking distance of elderly Koreans was found to be 458.5 m. The mean 6-minute walking distances for elderly Korean men and women were determined to be 470.01 m and 452.18 m, respectively, with a statistically significant difference (p<0.05). Improvements/Applications: Although Koreans do not represent all Asians, it is necessary that calculations of the 6-minute walking distance are tailored for the Asian population or using the body muscle mass weight. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to determine the cutoff value and efficacy of the EuroQol Visual Analogue Scale (EQ-VAS) for predicting frailty.Design: The EQ-VAS medians (Interquartile Range) were compared and analyzed against the FFI.Participants: The subjects were 1471 older adults aged 70 to 84 years who had completed both EQ-VAS and Fried Frailty index (FFI) in the first baseline year (2016) of the Korean Frailty and Aging Cohort Study.Results: Of the 1471 subjects,600 were classified as robust, 716 as pre-frail, and 155 as frail. The median EQ-VAS scores were 80.00 (20.00) for robust, 75.00 (25.00) for pre-frail, and 60.00 (25.00) for frail subjects.The medians of all five components of the FFI, weight loss (70.00 vs. 80.00), grip strength (70.00 vs. 80.00), exhaustion (70.00 vs. 80.00), walking velocity (70.00 vs. 80.00), and physical activity (70.00 vs. 80.00), were lower in the abnormal groups. We tested the efficacy of EQ-VAS as a diagnostic tool to predict frailty, and the area under the curve of EQ-VAS was 0.71 withthe optimal cut-off value of 72.Conclusion: EQ-VAS presented negative correlation with FFI, and the optimal cut off value for frailty was 72. These results suggest that EQ-VAS is a valuable tool for assessing frailty andmay be a good predictor of frailty in Korean elderly population. [ABSTRACT FROM AUTHOR]

Purpose Korean society is rapidly aging, and it is expected that more than 10 million elderly people will enter the super-aged society by 2025. It is very important for the elderly to have a physically and mentally healthy old age. However, according to the 2020 Survey on the Elderly, 84% of the elderly answered that they had one or more chronic diseases, 27.1% of the two chronic diseases, and 27.8% of the elderly with three or more chronic diseases. Serious problems in chronic diseases are related to heart failure, diabetes, and infection such as Covid19. Recently Civid19 pandemic swept across global aging societies and put elderly people with chronic disease more vulnerable to mobility (Kim& Oak, 2022).Therefore, remote monitoring an elderly with chronic disease is an important issue than ever. Smart health care systems as remote monitoring is so called telemetry system which enable doctors or health care providers to manage remotely to consult, diagnose and treat patient with chronic disease and infectious disease as well. The goal of telemetry system is to meet timely medical need in elderly people in distant place through communication technologies. Through technological breakthrough, particularly in real-time health care industry, telemetry system with real-time monitoring of heart rhythm and blood glucose level can play an important role in managing healthcare services in elderly(Kim & Oak, 2022). The purpose of this study was to examine effectiveness of smart health care as remote monitoring on health-related quality of life of the elderly with chronic diseases. Method The survey was conducted from July to November 2021 on 32 elderly people with diabetes and heart disease among outpatients in endocrinology, cardiology, and respiratory medicine. On the first day, a pre-test investigated gender, age, living family, disease, subjective health awareness, and health-related quality of life(mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and post-test was conducted after realtime ECG monitoring and blood glucose monitoring for 2 weeks. We used the EQ-5D scale of EuroQol to measure health-related quality of life. There were 14 women(44%) and 18 men(56%) and their average age was 66. 27(84%) had diabetes and heart disease, and 4(14%) had diabetes. Subjective health awareness was responded by 7(22%) for good, 18(56%) of normal, 6(19%) for bad. After real-time ECG monitoring and blood glucose monitoring for 2 weeks, paired t-test was conducted to analyze changes in health- related quality of life. Results and Discussion As a result, there was significant positive result on the health-related quality of life of the elderly with chronic disease after real-time ECG monitoring and blood glucose monitoring for 2 weeks(Table1). This study was conducted as an exploratory study in the first year, targeting only experimental group, but it is very meaningful that positive changes in health-related quality of life were observed. Therefore, in the second year study, we plan to more precisely verify the effectiveness by dividing a larger number of study subjects into experimental and control groups. [ABSTRACT FROM AUTHOR]

Purpose Hypertension is the most common disease in the general population, highly prevalent after the age of 65, and it affects more than 60% of individuals in developed countries (Burnier et al, 2020; Uchmanowicz et al., 2018). There have been significant pharmaceutical and medical advancements designed to address this disease; however, medication nonadherence remains a significant barrier to hypertension management (Burnier et al. 2020; Dzau & Balatbat, 2019; Egan et al., 2019, Lo et al., 2016). Technology interventions can improve medication adherence and an increasing number of older adults are using smartphones (Kakulla, 2020). An important challenge for technology interventions that include educational materials is the incorporation of images that are both clinically appropriate and meaningful for older adults (Morrow et al., 2012). Hence, the focus of this presentation is on the process followed for developing and selecting images for educational materials used in a technology intervention to facilitate comprehension and motivate a wide range of older adults. Method An interdisciplinary team of clinical, cognitive aging, gerontechnology, community health, human factors, and health technology experts across multiple institutions collaborated to develop the Medication Education, Decision Support, Reminding, and Monitoring (MEDSReM©) system to improve hypertension medication adherence by older adults. MEDSReM is a theory-based and integrated digital system comprised of a mobile app and a companion website (Al-Saleh et al., 2022). The mission of the MEDSReM education team is to provide evidence-based education tailored to older adults, to educate them on hypertension, medications, and health self-management strategies. The educational materials were developed in three formats: (1) thirty-two brief educational tips, (2) fifteen mobile app articles, and (3) twenty-three detailed educational articles for the companion website. Images were developed or selected in an iterative process. First, initial images or concepts reviewed collectively by the MEDSReM education team as well by older adults and healthcare providers in pilot studies. Then, images were then revised and implemented on the mobile app and website. Lastly, older adults reviewed all educational materials and images to provide feedback and final validation prior to the use of these materials in an upcoming randomized controlled trial. Results and Discussion The finalized images include a wide range of older adults and health-care providers to ensure our audience see people who look like them. Challenges included identifying appropriate images and excluding cases that misrepresented medical and hypertension management recommendations. Our approach combined multiple strategies, including selection and use of free-stock images, development of drawings, and screenshots and photographs taken by team members. This approach can benefit future research projects that seek to design educational materials. Additionally, the usability testing with older adults is pivotal to ensure that these images appropriately convey the educational content and support its comprehension. [ABSTRACT FROM AUTHOR]

Purpose During the last years, many researches have studied how solitude impact on health (Steptoe, A. et al., 2004), identifying loneliness among elders as a high priority problem. This issue is especially apparent in rural areas where a large proportion of the population are older adults who live alone. However, this reality is hard to be objectively measured. Resources as scales and questionnaires (Ventura-León, J. et al, 2020) are usually applied to detect unwanted loneliness. Nevertheless, these approaches are not always able to reflect the reality and the whole context of solitude (Nzabona, A. et al., 2016). Therefore, the loneliness problems require a qualitative perspective, finding on technology a substantial resource to measure it. In the present work, a distributed sustainable architecture for studying loneliness is introduced, defining the components and evaluating its technical viability. Method The proposed architecture aims to detect, store and process the physical encounters of older adults to define a social graph which identifies potential candidates of suffering loneliness. Considering the possible lack of Internet connection in rural areas, the solution applies Bluetooth to operate. For this, the proposed solution counts with three main entities: 1) bracelets for ageing people, 2) smartphones from neighbors and 3) fixed beacons to receive data. Thus, ageing people are equipped with smart bracelets which keep track of the physical encounters they have with other older adults. Besides, considering elders may encounter with people from other ages, neighbors are identified by their smartphone, being discoverable by the bracelets. Finally, all this data is transmitted to a beacon which receives the registered encounters data from bracelets and builds a social graph, defining elders as nodes and links as the relations they have with other people. As a result, it is possible to identify potential candidates of suffering unwanted loneliness. Results and Discussion The proposed architecture requires the autonomous collaboration of bracelets and smartphones to scan devices and to transfer data. Then, considering the energetical constraints of these devices, battery consumption becomes a critical aspect to the technical viability. To analyze this, a study of the power consumption has been made, identifying the most recurrent tasks (scanning, sending and receiving) and its associated power requirement. Thus, Figure 1 reflects the obtained results, showing three different scenarios (c1, c2 and c3) where node density is increased from low to high. This way, the left-y axe represents the average battery life in hours (B(h)) and right-y axe reflects the average energy consumption (Eg (jA)). As a result, the estimations shows that the architecture is operable for low density spaces (c1 and c2), however, bracelets present some limitations at battery life, especially when device density is high (c3). Nevertheless, considering a future increase in battery capacity, the solution may find operability for every scenario. [ABSTRACT FROM AUTHOR]

Purpose Public facilities, including schools and restaurants have been restricted under coercive measures during COVID-19. People were forced to stay at home or residential facilities and the opportunities of face-to-face gathering were minimal. Adults and young people have switched to the online medium for their work and study. However, many older adults could not take advantage of the Internet or online resources because they lacked the skill and resources, leading to loneliness and social isolation. There was an association between depression and stay-home measures, which also impacted the physical functioning of older adults (Kwan et al., 2020). On the other hand, universities hosted service-learning education to help those in need. In addition, students can apply their knowledge learnt from the university onto the society or community, in which the gerontechnology course is one of the good examples. Recently, gerontechnology has been widely embraced by caregivers to promote the well-being of elderly, including the use of smartphone apps, fall detector, anti-wandering sensor and companion robot (Cheung et al, 2010, 2021, 2020). This study aimed to develop a social robot to promote intergenerational interaction that alleviates the loneliness among elderly. Method As shown in Figure 1, a social robot was developed using the Raspberry Pi 4 single board computer (Raspberry Pi Foundation, Cambridge UK), a 7-inch LCD display, a 16-channel 12-bit PWM/Servo Driver - I2C interface PCA9685 module (AdaFruit Industries, NYC, USA), and 6 compact servo motors. The LCD was used as the face of the robot. An in-house design robot housing and internal structure were fabricated using 3D printed acrylonitrile butadiene styrene (ABS). The customized software was coded using Python running on Raspbian OS. Three games were designed, including guessing traditional Chinese food, mathematics multiple operation, and daily news quiz. The setup also includes robot cover, backdrop, pair of Bluetooth speakers, and projector (Figure 1). Question, narrative, and game flow were generated and controlled by the program with native voice support. The question and photo were shown on the protection screen during the game. The "emotion response" of the robot appeared by means of the facial expression on LCD display and arms motion. The robot voice was controlled by the program and an operator to accommodate different service recipients. The students developed and operated the robot to serve the older adults in a community center in the service learning course (gerontechnology) during COVID-19 in compliance with the pandemic control measures. Results and Discussion The community center arranged 2 days for service and robotic team with 6 students interacted with approximate 60 elderlies per visit. The older adults and students demonstrated good interactions modulated by the robot and game. The center staff reported that the older adults had an improved mood and psychosocial change after the event. Future study may consider enhance the voice recognition function, motor feedback system and question bank management system. [ABSTRACT FROM AUTHOR]

Purpose The majority of developments in care robots for older adults have focused on functionality and usability evaluations (Pino et al., 2015). This is perhaps not surprising, considering the prevailing challenges connected with safety, cost, and capabilities of the robot, which are currently still being addressed (Aguiar et al., 2021). However, the eventual acceptance of these robots by older adults will require more than a usability-based approach. The emergence of new technologies and particularly care robots supporting older adults has revealed high expectations of the older adults regarding design of these products (Rogers et al., 2021). Older adults are not likely to be satisfied by just the existence of robots or their usability but seek more in terms of excitement, pleasure, and joy of using the robots. This pleasurable aspect of the design of care robots has not been given sufficient attention in the past decade; yet it might influence widespread acceptability of robots (De Angeli et al., 2020). This spurs the need for a more holistic approach to the interaction design. The goal of this research is to present an interaction design strategy that bridges the ergonomic and hedonic values in care robots to create a more appealing and engaging interaction with older adults that will promote sustained engagement and acceptance of care robots in the long term. Method We adopted a structured approach to developing a framework for robot design that will incorporate this pleasurable experience. The framework incorporates understanding older adults more comprehensively, beyond their anthropometrics and abilities, to their personalities, preferences, fears, hopes and values. Based on the literature we identified the different dimensions of pleasure that should be considered and link the benefits to different aspects of the interaction. These dimensions include: physio pleasure (e.g. ensuring that the robot's communication fits in pleasurably with the physical sense of hearing), socio pleasure (e.g. ensuring that the robot interactions provides enjoyable social engagement with others), pyscho pleasure (e.g. ensuring that the emotional state of the older adult is considered in the interactions), and ideo pleasure (e.g. ensuring that the interactions considers the values and ideals of the older adult). We propose this framework as a guide for incorporating these dimensions of pleasure into the interaction with the care robot. Results and Discussion The outcome of our review and conceptualization is a pleasurable interaction design model for care robots that incorporates a richer understanding of the values and lifestyle of the older adults. This framework provides a testbed for an improved generation of well-designed care robots that older adults can enjoy. In addition, we have developed a properties checklist that can be used as an evaluation tool for researchers, care partners, and designers to assess pleasurable interactions with such care robots. Our framework encourages a holistic approach to designing care robots that extends the design beyond ease of use to the joy of use for the enrichment of the lives of the older adults. [ABSTRACT FROM AUTHOR]

Purpose Given the rapidly ageing nature of our global population, policy makers around the world are now more actively promoting active ageing. Researchers have begun exploring the use of assistive technologies in the form of social robots as companions for older persons to address their psychosocial needs, a key component of active ageing. However, there has been limited evidence on the efficacy of such social robots, especially in the Asian context. This article elucidates the protocol of a study to investigate the acceptance and quality of interaction between a Japanese social robot, LOVOT, and elderly singletons in Singapore and Hong Kong. Method In this mixed-method study design, 15 elderly singletons from Singapore and another 15 from Hong Kong were recruited: participants were 60-75 years of age, living alone, and had no known cognitive or mental issues. The primary outcome measure is the participants' differences in responses to and acceptance of LOVOT prior to and following their interaction with the robot, as outlined in the baseline assessment: the Qualtrics survey measured the participants' technology acceptance (Chen & Lou, 2020), loneliness (Russell, 1996), older people's quality of life (Bowling et al., 2013 & Herdman et al., 2011), subjective happiness (Lyubomirsky & Lepper, 1999), cultural inclinations, willingness to pay, and demographic characteristics, along with the LOVOT's sociability (Heerink et al., 2010) and system usability (Brooke, 1996). During the first session, participants were interviewed about their opinions on gerontechnology, social robots, and pets. Following the interview, participants were given 15 minutes to freely interact with LOVOT. This interaction was succeeded by a Qualtrics survey and interview to measure the elders' acceptance and attitudes toward LOVOT. The interaction, post-interaction survey and interview, was repeated for two subsequent sessions for a total of three interactions with LOVOT. The study was conducted in both Singapore and Hong Kong. Results and Discussion This review outlines the protocol of a pioneer study investigating the efficacy of the social robot, LOVOT, as companions for older persons in Singapore and Hong Kong. Such studies introduce innovative solutions to improving the psychosocial health and engagement of older adults. This protocol can be adapted to explore the efficacy of these assistive technologies in other elder care settings as well. [ABSTRACT FROM AUTHOR]

Purpose Technologies to age in place must be personalized to meet the changing reality of aging and to respond to individual needs. A variety of technology applications can be used to help those with chronic conditions to remain at home, provide support to family caregivers at work or at a distant location, check on the status or activities of their loved ones, and enhance access to information and community resources including formal and informal support services (Czaja, 2016). ADel (Assistante Domestique électronique) is an Electronic Domestic Assistant developed in Quebec (Canada) by SoftBiomed to help older adults build personalized virtual networks of care including their family caregivers and healthcare professionals. ADel is an application provided in an electronic tablet with a locked mode (kiosk mode) to family caregivers and clinicians (Figure 1) and a cellphone application to be downloaded by family caregivers (Figure 2). With ADel, it is possible to customize contacts to make video calls, personalize medication and appointment reminders, and services (e.g., meal delivery and community services). With a panic button and a fall detector integrated into a watch, it provides peace of mind to older adults and their family caregivers. The objective of this pilot study is to explore the feasibility, usability, and user satisfaction of ADel from the perspectives of older adults returning home after a hospitalization, family caregivers, and clinicians being part of a personalized network of care. Methods Participants include 10 older adults without neurocognitive impairment returning home after a hospitalization, 10 family caregivers, and two clinicians. Data on feasibility (semi-structured interview), usability (System Usability Scale), and users' satisfaction (Visual Analog Scale) are collected at one and two months of use of the technology at home. A steering committee with different stakeholders informs the project from the beginning to anticipate any technical, human, cultural, logistical barriers, and facilitators. Results and Discussion The pilot study will allow sharing of expertise between different stakeholders to inform the improvement of this technology across the continuum of care. ADel has the potential to be implemented in individuals with minor and major neurocognitive disorders, older adults living with chronic health conditions, and palliative care. The results will help to improve and adapt this technology according to the older adult's cognitive and physical health status, provide a technological solution to support home care, and prevent social isolation during the current pandemic (Daly et al., 2021). As the degree of usefulness of these technologies impacts positively elderly people's intention to accept their usage (Etemad-Sajadi & Gomes Dos Santos, 2019), this pilot study will certainly provide insights into ADel's positive impact. [ABSTRACT FROM AUTHOR]

Purpose Although the proportion of older adults using Information and Communication Technologies (ICTs) is increasing globally, this rate remains low compared to that of other ages. Lower rates are tied to perceptions of difficulty in using ICTs, little value, and serious security challenges. Furthermore, age, education, and income can affect ICT adoption, challenging digital equity. At the same time, it is known that ICT use can help address social isolation, loneliness, and health care access. One successful approach to overcoming ICT resistance is use of "warm experts," usually young family members (Hanninen et al., 2021). These relatives introduce devices and applications, illustrate their use, and support older adults as they expand use. Unfortunately, many low-income older adults live alone with no family or friends who can assume this role. Recipients of home-delivered meals (HDMs) - over 800,000 in the US alone - face this issue. The Virtual Table model hypothesizes that meal drivers, who often see recipients multiple times a week, can become "warm experts" to introduce ICTs (Papadaki et al., 2021). Methods The Virtual Table pilot recruited 25 participants, ages 61-86. HDM recipients were provided: a TCL tablet with 6 months cellular coverage; a manual using screenshots and large print with instructions on basic functions like email and video apps; weekly peer tutor sessions to cover first ICTs and then telehealth preparedness; weekly contact from a volunteer initially for simple greeting and later scripted content on loneliness. Data collection includes Baseline surveys covering demographics; technology ownership, use, and competency; loneliness, networks, and PHQ-9; Midpoint surveys to assess perceptions of model components and obtain telehealth experience; weekly notes from tutors and volunteers; and Posttest surveys including Baseline items plus feedback on model components and their impact on participants. Results and Discussion Most participants use cell phones but have little other technology use more than occasionally. Results to date show a range of participant experience with ICTs requiring flexibility in tutoring. COVID-19 forced movement to video (Zoom, Duo) for some sessions, and negatively affected recruitment. Participants have initiated video contacts with others in the pilot, and helped organize monthly virtual celebrations to connect as a group. Reaction to telehealth content has been very positive. Of the 25 participants recruited, 20 (80%) completed the entire program including telehealth preparedness. Participants report overall positive assessment of the tutor training. Most have demonstrated competence in using email, videoconferencing, internet searching, and photo tools. [ABSTRACT FROM AUTHOR]

Purpose The ever-increasing ageing population has raised awareness globally. The deterioration of health among older persons commonly leads to an increased risk of falling. The desire to live independently has the consequences for them and society as well. Enabling environments for older persons can be created, easing the social challenge of preparing for an ageing society while improving quality of life in their golden years. Technology solutions have been a game-changer supporting the families as the default caretakers for ageing relatives, bringing peace of mind. Fall detection systems represent one of the assistive technologies for older persons, as they can offer immediate assistance in case of emergency. Albeit the usage of the device is statistically low in Malaysia, they have been known to save lives (Bourke et al., 2010). Studies regarding fall detections and balance intervention have resulted in increasing safety, improving gait and physical activities (Lin & Wai, 2021; Hsieh et al., 2018). This study aims to improve the device by incorporating balance monitoring system, delivering better care for older persons. Rather than simply detecting falls, the proposed system will monitor balance instability, alerting the user to predict future falls and therefore serving as a fall prevention device. Method A simulation-based study has been developed to monitor balance instability of older persons. A fall prevention algorithm is proposed to be integrated with fall detection devices, where two notable variables of balance were selected as the inputs for the system: Limit of Stability (LOS) and Degree of Sway (DOS). Findings are validated using real data of older persons' LOS and DOS, adopted from a previous research by Ashari (2007) which used Neurocom™ Balance Master for balance analysis. The balance instability is then analysed using fuzzy logic and categorised as low, medium, or high; signified as the fall risk level (Figure 1). The classification will be displayed in the balance assessment while the system concurrently detecting fall events. Results and Discussion This study demonstrates a fall prevention algorithm to improve the accuracy of fall detection systems while monitoring balance instability. The system will notify the user if there are instabilities detected to avoid falling or prolonged loss of balance. When the simulation is initiated, the system will continuously monitor older person's stability while detecting falls. Results will display balance category with an indicator displaying fall risk level and notifications of actions to be taken for safety purposes. Figure 1 demonstrates the balance assessment of a user with low level of stability, thus the fall risk indicator level becomes high and necessary actions is taken immediately via the system. Analysing balance instability among older persons is an important aspect for their daily monitoring and to be aware of their conditions periodically. This will help health care professionals to provide proper rehabilitation if needed. The enhanced fall detection and balance monitoring can bridge the gap between family members' concerns and one's desire to stay independent. The proposed fall prevention system can increase safety in daily life; encouraging older persons to practise active ageing. [ABSTRACT FROM AUTHOR]

Purpose Europe has called attention to the importance of e-inclusion of older adults (McLean, 2011). Society indicates that the developers, websites and devices are causing age bias in technology. This affects living independently, the values of ethical principles associated with an older person, and digital ageism: which is age-related bias in artificial intelligence systems (AI) (Chu et al., 2022). AI is promising in healthcare. Robots are becoming an emotional friend to the older adult, especially in people with mild dementia (Abdollahi et al., 2022); however, when ageist attitudes are underlying the technology, the effects of the advancement need to be reconsidered. If older adults are not able to follow because of a negative view of the process of aging, it becomes a problem for sustainable and successful aging (Lythreatis et al., 2022). Older adults use internet services and assistive technology devices differently depending on their regions. Compared to Italy, Swedish older adults display a positive attitude toward information communication technology ICT devices (Zambianchi et al., 2019). A Dutch study indicated in 2019 that there was a significant difference in older adults who started using the Internet (11.6%) compared to those who stopped (3.1%) (Berner et al., 2019). This research investigates the association between digital ageism (measured by digital social participation (DSP), age, cognitive function, gender, health), technology anxiety and enthusiasm, and assistive technology devices during 2019- 2021. The assistive technology device we will investigate in this study is the adoption of a service designed for online health consultations. Method The participants are part of the longitudinal Swedish National Study on Aging and Care (SNAC). More details on this study can be found elsewhere (Lagergren et al., 2004). Technology anxiety and technology enthusiasm are two factors that comprise the instrument techPH, which aims at measuring technophilia (vs technophobia) in older adults (Anderberg et al., 2021). This instrument was developed and validated and is currently used in (SNAC) to investigate and evaluate older people's attitudes toward and usage of the technology. The age range is 63 -99 in 2019 T1 and 66 -101 in 2021 T2. Wilcoxon rank test was conducted to investigate technology enthusiasm, anxiety, and how they changed over time. An Edwards Nunnally index was then calculated for both variables to observe a significant change in score from T1 to T2. Mann Whitney U test was used to investigate the variables sex and health status with technology anxiety & technology enthusiasm in T1 & T2. Age, Cognitive function MMSE, digital social participation were investigated through a Kruskall-Wallis test. Logistic regression was conducted with the significant variables. Results and Discussion Between 2019-2021, change in technology enthusiasm was based on less DSP (OR: 0.608; CI 95%: 0.476- 0.792). Technology anxiety was significantly higher due to age (OR: 1.086, CI 95%: 1.035-1.139) and less DSP (OR: 0.684; CI95%: 0.522- 0.895). The want for online healthcare consultations was popular but usage low. [ABSTRACT FROM AUTHOR]

Purpose In Brazil, an increasing number of older people becoming indebted (Paraíso, Fernandes, 2019). There are different reasons for that, such as critical life events, low financial knowledge, aggressive marketing strategies performed by financial institutions, seduction of the consumer market and low income. (Doll et al., 2021). Due to the Brazilian scenario, Federal Law n° 14.181/21, known as the Over-indebtedness Law, was created. It enables reconciliation through debt renegotiation before the Courts guaranteeing an existential minimum (Bertoncello, 2015). Although there are a few financial education initiatives, fewer are suitable for older people (Doll, Hollerweger, 2021). Considering the potential of digital technologies for financial education (Hollerweger, 2018), a partnership between the School of Education of UFRGS, the Public Defender's Office of the State of Rio Grande do Sul and the Court of Law specialized in reconciliation has been developing a project to disseminate more information about financial issues using different digital technologies. The objective is to bring, through digital technologies, information in a clear, objective and accessible way to a mature and older population with low income and low schooling, in order to prevent indebtedness and to offer guidance for seeking support in cases of over-indebtedness. Method The project consists in the elaboration of educational materials in digital format, such as short videos and informative cards to be disseminated on social networks, institutional websites of the organizations involved and through other means of digital communication. The educational materials are developed by an interdisciplinary group of specialists, involving law, education, and gerontology. Before disseminating it, the information material is evaluated by a focus group of older people, as to discuss the quality of information, language, and ease of understanding, using a semi-structured questionnaire. The records of the focus group are analysed by content analysis (Bardin, 1977) to adequate the educational materials to the specific target group. Results and Discussion So far, the ongoing study shows that there is exists a lack of basic financial knowledge, such as understanding the meaning of interest or how to read a credit card bill, among the target population. The analysis of the needs identified by the Public Defender's Office and the peculiarity of the target audience shows the importance of videos being short (1 to 3 min.), concentrating on a very specific issue, as well as working with examples and illustrative material. [ABSTRACT FROM AUTHOR]

Purpose Dialogue systems for older adults become more important because some of the older adults living alone have fewer chances to do that because they are alone; because of the COVID-19 situation, they have decreased the opportunity of conversation in the world. However, for academic studies, dialogue systems have been evaluated at laboratories. This is because the experimental conditions can be standardized. Moreover, on-site support is easier for the experimental staff than home-based experiments because some older adults are not familiar with ICT technologies such as tablets, robots, etc. Some researchers tackle developing a dialogue system specializing for older adults by Inoue et al. (2020); however, there is no information on what kind of robot interaction is effective for the cognitive function to the best of the authors' knowledge of the elderly. Hence home-based dialogue system experiments have become much more important. Method In a total, 11 groups consisted of a maximum of 8 persons per group, and the experiments were conducted with 1 group sequentially. The experiment is conducted along with a randomized controlled experiment with two sub-groups. An intervention group participant listens to the story and asks questions to the robots (Bono-06 reported in Tokunaga et al. (2019)) within 4 minutes. The other is a control group of participants who only listen to stories and speak a short greeting to the robots, which indicates they participate in the session within 1 minute. The experiment was designed to examine the effect of difference for cognitive training by listening to the stories and asking questions or just listening to the stories. In the experiment, participants listened to a total of 12 stories over a period of 2-3 weeks with our specializing system (DBSPS), as shown in Figure 1. Participants participated in 2 sessions per day at their home, except for the first day, where we had an exceptional practice session and the other two sessions. We remotely checked the progress of experiment status of the participants that we monitored with Slack bots (See Center of Figure 1). The essential of our system is reported in Tokunaga et al. (2021). Results and Discussion We have completed our experiments with 81 participants. The participants include those who have not familiar with smartphones or tablets. There were no lost to follow up. We found that the number of utterances is varied for each topic (Figure 2). The average number of questions seems to vary because some topics were easy to ask questions, others were not. We have confirmed through the interviews that many participants have enjoyed our experiment because due to COVID-19, older adults have less schedules than usual. Hence the participation to the experiment becomes pleasurable events in daily lives. We have received remarkable comments that some participants said, "I was glad to join the experiment so much." We have also received negative comments, "I felt thinking about the question was difficult" and "I felt nervous in the experiment." Those comments would be helpful to be designed for a home-based experiment. [ABSTRACT FROM AUTHOR]

Purpose Exercise training has been associated with health benefits such as decreased cardiovascular mortality and sarcopenia among older people. Over the past decade, a lot of private and public gyms were open for the public in Taiwan. Some of them provided a discount on entrance fees or even free for the middle-aged and older people to work out. The aim is to understand the factors affecting the intention to work out in the gym among middle-aged and older people. Method The study used the Theory of Planned Behavior proposed by Ajzen and Fishbein to build up the research architecture. Besides that, the "willing to pay" new construct was added to the research framework to increase the explanatory power. And, the study adopted a questionnaire survey and convenient sampling method, 315 valid questionnaires were collected. Descriptive statistics and regression analysis were used to analyze these data. Results and Discussion Analysis of the data indicated the respondents have a strong intention to work out in the gym. The higher the education background, the stronger the "attitude toward the behavior", "subjective norm", "perceived behavioral control", and "behavioral intention" are. The respondents are also willing to pay for workouts at the gym. Pearson correlation analysis shows that there is a significant positive correlation between each construct. Multiple regression analysis indicated that "attitude toward the behavior", "subjective norms", "perceived behavioral control" and "willing to pay" positively affect the behavioral intention. The "subjective norm" is the highest influencing construct. It showed the workout intention of the respondents was highly affected by the third party such as friends and family members. [ABSTRACT FROM AUTHOR]

Purpose Pressure injuries caused by prolonged pressure remain a significant health care issue for bed-ridden older adults in various settings. Pressure monitoring was found to be one of the most promising current solutions (Mansfield et al., 2019). A motion-sensing smart mattress (WhizPad®) has been developed for patient fall prevention. It is a comfortable mattress made with viscoelastic, temperature-sensitive, polyurethane memory foam. In a study with 254 participants at risk of developing pressure injuries recruited from the intensive care unit of a medical center, the use of the pressure redistributing foam mattress was associated with an 88% reduced risk of pressure injury development (Bai et al., 2020). This study aims to develop the function of prolonged pressure monitoring for the smart mattress and provide visual feedback to the healthcare staff to reduce further the risk of bed-ridden older adults developing pressure injuries. Method The smart mattress contains 30 sensing areas for on/off pressure sensing. When an event is detected, the control box sends out a Bluetooth Low Energy (BLE) broadcast message, which contains the duration of time a sensing area has been under pressure. As shown in Figure 1, the system displays sensing areas in deep blue (under pressure within 1 hour), orange, between 1 and 2 hours) and red (over 2 hours) for the real-time status. In addition, the control box sends out a beacon message every 10 minutes, which also contains the duration of time a sensing area has been under pressure. The data is accumulated for 24 hours (8 am to 8 am the next day). The system displays the prolonged pressure record on the next day, including the continuous pressure areas in different colors, the maximum time, and the accumulated pressure areas for 24 hours (Figure 2). Results and discussion The real-time status has been implemented in the system. Nursing home caregivers responded that this visual display, together with the audio alert, helps remind them to do back tapping and body turning for bed-ridden older adults every two hours. The prototype of the prolonged pressure record function has been built and tested. We are conducting a field trial to collect feedback. We expect the record of continuous pressure area and maximum time can reflect whether the caregivers have regularly performed back tapping and body turning for the bed-ridden older adults. The accumulated pressure areas and time can also provide helpful information for assessing the risk of pressure injury in bed-ridden older adults, particularly the body areas that have a higher risk of developing pressure injuries. [ABSTRACT FROM AUTHOR]

Purpose AI nurturing or complementing human intelligence is becoming more important than ever. The goal of the Cognitive Behavioral Assistive Technology (CBAT), advocated by the author since 2017, is to develop technology assisting cognition and behavior of human with and without disabilities. For the first step, we focus on technology which promotes cognitive health for preventing cognitive decline and dementia among older adults by social activities, since a systematic review found that social activity intervention may help maintain cognitive function among healthy older adults (Kelly et al., 2017), there are no global recommendations for social activity interventions related to cognitive health because evidence of the impact of such intervention is limited (World Health Organization, 2019). One major reason was the lack of technology for generating quantitatively and qualitatively consistent social activities necessary for cognitive intervention. Method In order to realize cognitive intervention via social activities, we develop novel technologies which promote intensive conversations among older adults, and demonstrate their effects on older adults' cognitive and brain functions. We also develop technologies to predict cognitive functions from different modalities of behavioral and/or physiological data, aiming to monitor cognitive functions in everyday life. Results and Discussion The five main results were obtained as follows: 1) Photo-Integrated Conversation Moderated by Robots (PICMOR), a group conversation intervention program and its supporting systems, was developed to build resilience against cognitive decline and dementia. A randomized controlled trial (RCT) of PICMOR demonstrated for the first time the positive effects of a robotic social activity intervention on cognitive function in healthy older adults (Otake-Matsuura et al. 2021). 2) A voxel-based morphometric analysis was applied to the structural MRI data. In the analysis, the regional brain volume was compared between the intervention group and the control group. Candidate brain regions were identified successfully that reflect the beneficial effect of conversation-based interventions on cognitive function (Sugimoto and Otake-Matsuura 2022). 3) We recorded large-scale data of one million words from group conversations among healthy elderly people through an RCT and analyzed the relationship between spoken language and cognitive functions in terms of scaling laws, namely, Heaps' law (Abe and Otake-Matsuura 2020). The results suggest that we can predict the cognitive function of the speaker through analyzing transcribed conversation data. 4) A Dialogue-Based System with Photo and Storytelling for Older Adults (DBS-PS), a dialogue-based robot system, was developed for cognitive training at home (Tokunaga et al. 2021). The system was successfully utilized by older adults during the pandemic. 5) Behavioral responses were analyzed in a facial emotion implicit-short-term-memory learning and evaluation experiment. Various shallow and deep learning machine learning models were applied, resulting in median accuracies just under a 90% benchmark for automatic discrimination of normal cognition versus a mild cognitive impairment (MCI) (Rutkowski et al. 2020). The results show that the application of machine learning (ML) to data collected through simple behavioral examination is effective for MCI and dementia onset diagnostics. The developed technologies are exemplars of CBAT as AI for super aged society. [ABSTRACT FROM AUTHOR]

Purpose With a growing population of older persons globally, the need for mainstream assistive technology (AT) as well as assistive technology specifically intended for older persons is on the increase. The association between age and functional limitations strongly indicates a growing demand due the current demographic development. There was however until recently limited data that can describe the situation, monitor development and compare between countries and populations. Quality data is essential for developing regional, national and international responses to current and future need for AT globally. The Global Report on Assistive Technology (GReAT) was launched on 16th May 2022 and highlights both substantial gaps in provision of AT and AT related services globally and in particular in low- and middle-income countries. As part of the process leading up to the GReAT, World Health Organization and partners developed the "rapid Assistive Technology Assessment" (rATA) survey to enable data collection that for the first time can provide estimates of AT use and need in a global perspective. The purpose of this presentation is to present key indicators from rATA among older persons in the countries that participated in the global data collection. Method Data from recent, nationally representative rATA surveys of perceived use of and need for AT among older persons (60 years and older) in more than 30 countries across all WHO regions will be analyzed against sex, rural/urban and Human Development Index (HDI). rATA includes indicators on access to and need for AT, specification of products in use and in need, urban/rural location, and on aspects of provision and quality of services and products. Results Prevalence of access to assistive products increases with increasing level of development (HDI index) among persons aged 60 years and above. The need in this age group reduces on the other hand with increasing HDI levels, indicating a higher level of met need in countries with higher HDI. The estimated global need among persons aged 60 years and above is 68.7% including spectacles and 31.2 % excluding spectacles. It is expected that further analyses will reveal similarities across countries/regions in the association between AT use and need and demographic and socio-economic indicators. It is however also expected that we will demonstrate substantial differences in the levels of use and need between countries with different level of development (HDI). These results are important for developing models for estimating needs and building broad-based evidence for developing AT programs in diverse contexts. [ABSTRACT FROM AUTHOR]

Purpose With the rapid aging of the population, the increase in the number and severity of the elderly with dementia has become a major issue for elderly care in Japan. In particular, the progression of dementia among the elderly has strained on the staff, making communication with them difficult. How can we strengthen the relationship between the elderly with dementia and care staff in day care? As one possibility, previous studies have shown that communication robots have a positive effect on enriching emotions and expressions in the elderly with dementia (Matsuyama & Obayashi 2020, Ninomiya 2020). Our research purpose is to clarify human-robot interaction between communication robot and the elderly with dementia. What kinds of character can we find in the interaction? What kind of benefits does the interaction bring to the elderly with dementia? And what kinds of benefits does it bring to care staff? Or does human-robot interaction give any disadvantage? Method [ROBOT] PALRO is a 40 cm long communication robot developed in 2010 by the ICT company FUJISOFT, Inc. and has been improved over the years (figure1). It possesses advanced conversational, voice recognition, facial recognition and memory abilities, and is capable of smooth communication with elderly people with dementia. [Subjects] The subjects were two elderly people with dementia who use a daycare service in Kobe, Japan (2 females, 83 and 69 years old). Their Nursing Care Level is 1 on a 5-point scale, and both have early Alzheimer's disease. [Procedure] We analyzed the communication of the two participants in detail by participant observation on a day when PALRO was placed and on a day not (figure2). The PALRO was then placed in the daycare service on a daily basis for three months, and the interaction with the users was observed. [Assessment] (1) Mini-Mental State Examination score for dementia. (2) participant observation of the participants. (3) focus groups for the staff. This research was approved by the Research Ethics Board of Department of Sociology of Human Sciences at Osaka University. Results and Discussion The study revealed that (1) the two subjects recognized PALRO sometimes as a robot and sometimes as an object of assistance, and conveniently communicate with each other, (2) communication spread to other users and staff through PALRO, and (3) PALRO's presence had a positive impact on staff by providing topics of conversation and temporarily dealing with the elderly, indicating the potential of communication robots in dementia care. [ABSTRACT FROM AUTHOR]

Purpose Recently, increasing care requirements of the aging population has led to an increased demand for daily life support robots. Among them, the need for meal assistance robots for people with severe disabilities, including older adults, is increasing, and various meal assistance robots are being researched and commercialized worldwide [1]. A meal assistance robot is being developed in response to the Korean food culture; however, only few studies have analyzed Korean food scooping and serving using meal assistance robots [2]. Here, the usability test was performed on the success rate of Korean food scooping and serving for self-feeding, and improvement points were analyzed as basic information necessary for a meal assistance robot that can serve Korean food well. Method The study participants were five experts (three nurses, one physical therapist, one occupational therapist) with >15 years of experience who could better understand the physical and mental characteristics of people with severe disabilities. The meal assistance robot was used DESIN's Obi of the United States [3]. In the usability evaluation, 10 types of Korean food (including steamed rice, soup, and side dishes) were prepared, and 8 types were selected and tested. All food was cut into 1- x 1-cm sizes and placed on Obi's plate. Food scooping by the meal assistance robot was attempted three times for each food, and the number of successes was analyzed. Results and Discussion Table 1 shows the results of scooping and serving of Korean food by the robot. The food with the highest success rates of scooping and serving were kongjaban (black bean in soy sauce) (100%), jangjorim (braised beef in soy sauce) (100%), and danmuji (pickled radish) (100%). Curry rice (57.1%), steamed rice (77.8%), fried rice (88.9%), and gosarinamul (bracken salad) (88.9 %) had the lowest success rates. The success rate of obtaining sticky foods including steamed rice was lower than that of other foods because it could not be scooped due to the clumping of rice during scooping with a spoon by the meal assistant robot. Experts' rationale for this was as follows: 1) The spoon size is small, so food is often spilled during scooping and serving. 2) It is likely to be easily colored because the spoon material is plastic. 3) Depending on food shape or viscosity, it is difficult to decrease the amount of attempts to pick up lumps of rice and soup together. 4) As a solution, instead of picking up large amounts at once from the back of the bowl, if the spoon collects food in different positions where the spoon starts step-by-step, it will be possible to control the amount of picking. Conventional scooping-based commercial meal assistance robots have difficulty obtaining it for Korean main food such as rice, soup, and rice in soup. In the future, when developing a meal assistance robot suitable for Korean food, it is necessary to consider differences in spoon size and shape and the varying food sizes and viscosities to increase the success rate of obtaining rice and soup. [ABSTRACT FROM AUTHOR]