Digital Health Technology Use Among Older Adults: Exploring the Impact of Frailty on Utilization, Purpose, and Satisfaction in Korea.

BACKGROUND: The importance of digital technology is increasing among older adults. In this study, the digital health technology utilization status, purpose, and satisfaction of older adults were investigated according to frailty. METHODS: A face-to-face survey was conducted among adults aged 65 years or older. Frailty was defined using the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight scale. RESULTS: A total of 505 participants completed the survey, with 153 (30.3%) identified as pre-frail or frail and 352 (69.7%) as healthy. All respondents used smartphones; 440 (87.1%) were application users, and 290 (57.4%) were healthcare application users. Wearable devices were used by only 36 patients (7.1%). Pre-frail or frail respondents used social media more frequently than healthy respondents (19.4% vs. 7.4%, P < 0.001). Among the respondents, 319 (63.2%) were not able to install or delete the application themselves, and 277 (54.9%) stated that the application was recommended by their children (or partner). Pre-frail and frail respondents used more healthcare applications to obtain health information (P = 0.002) and were less satisfied with wearable devices (P = 0.02). CONCLUSION: The usage rate of digital devices, including mobile phones among older adults in Korea is high, whereas that of wearable devices is low. There was a notable difference in the services used by pre-frail and frail respondents compared to healthy respondents. Therefore, when developing digital devices for pre-frail and frail older adults, it is crucial to incorporate customized services that meet their unique needs, particularly those services that they frequently use.

Accuracy and Diversity of Wearable Device-Based Gait Speed Measurement Among Older Men: Observational Study.

BACKGROUND: Gait speed measurements are widely used in clinical practice, as slow gait is a major predictor of frailty and a diagnostic criterion for sarcopenia. With the development of wearable devices, it is possible to estimate the gait speed in daily life by simply wearing the device. OBJECTIVE: This study aims to accurately determine the characteristics of daily life gait speed and analyze their association with sarcopenia. METHODS: We invited community-dwelling men aged >50 years who had visited the outpatient clinic at a tertiary university hospital to participate in the study. Daily life gait speed was assessed using a wearable smart belt (WELT) for a period of 4 weeks. Data from participants who wore the smart belt for at least 10 days during this period were included. After 4 weeks, data from a survey about medical and social history, usual gait speed measurements, handgrip strength measurements, and dual-energy x-ray absorptiometry were analyzed. RESULTS: A total of 217,578 daily life gait speed measurements from 106 participants (mean age 71.1, SD 7.6 years) were analyzed. The mean daily life gait speed was 1.23 (SD 0.26) m/s. The daily life gait speed of the participants varied according to the time of the day and day of the week. Daily life gait speed significantly slowed down with age (P<.001). Participants with sarcopenia had significantly lower mean daily life gait speed (mean 1.12, SD 0.11 m/s) than participants without sarcopenia (mean 1.23, SD 0.08 m/s; P<.001). Analysis of factors related to mean daily life gait speed showed that age and skeletal muscle mass of the lower limbs were significantly associated characteristics. CONCLUSIONS: More diverse and accurate information about gait speed can be obtained by measuring daily life gait speed using a wearable device over an appropriate period, compared with one-time measurements performed in a laboratory setting. Importantly, in addition to age, daily life gait speed is significantly associated with skeletal muscle mass of the lower limbs.

The difference in diffusion-weighted imaging with apparent diffusion coefficient between spontaneous and postoperative intracranial infection.

BACKGROUND: Although the roles of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) have been accepted as the initial or confirmatory diagnostic tool for spontaneous intracranial infections, the usefulness of these has rarely been investigated in intracranial infections after a craniotomy procedure. Through an analysis of the clinico-radiological characteristics of spontaneous and postoperative intracranial infections, the authors revealed the specific factors that affect the accuracy of DWI and ADC in diagnosing intracranial infections. METHODS: The authors retrospectively analyzed 67 intracranial infections confirmed using preoperative MR imaging, including the DWI, ADC and gadolium-enhanced (Gd) images, and by peroperative pus drainage. RESULTS: In 67 enrolled patients, no or uncertain diffusion restriction on DWI and ADC was found in 9 cases (13%). All the cases showed typical peripheral enhancement on Gd images. Among nine cases without diffusion restriction, postoperative infection was seen in five cases (62.5% [5/8 postoperative infection group] vs. 6.8% [4/59 spontaneous infection group], p = 0.001). On multivariate analysis, postoperative infection was the predictive factor for false-negative restriction on DWI and ADC (hazard ratio: 41.2, 95% confidential index: 2.39-710.25, p = 0.01). CONCLUSION: Despite the excellent availability of DWI and ADC for diagnosing spontaneous intracranial infections, negative restriction results of those images are not sufficient to exclude postoperative intracranial infection.