An assessment of informal caregivers' knowledge levels on daily and emergency care practices for the elderly: A descriptive cross-sectional study.

This study was aimed to determine knowledge level of informal caregivers daily care, emergency situations and the effect of the socio-demographic characteristics of informal caregivers on their knowledge levels. This descriptive and cross-sectional study was conducted between November 1, 2021, and June 30, 2022, with 83 (79.8 %) informal caregivers living in rural areas in northeast Türkiye. The data were collected using the Barthel Index for Activities of Daily Living, the Socio-Demographic Questionnaire, and the Questionnaire for Information on Elderly Care and Situations Requiring Emergency Care. 54 (65.1 %) of caregivers were women, 74 (89.2 %) did not receive training on the daily care of the elderly. A statistically significant difference was determined between the level of knowledge of caregivers about elderly care, caring experience for the elderly and emergency situations, their education level, and their perceptions of needing further information about elderly care (p < 0.05). Informal care givers should be trained by nurses.

Perceived HRM and turnover intentions of elderly care workers: perspective from person-job fit and institutional ownership.

BACKGROUND: Although the phenomenon of high turnover rate in the elderly care industry has existed for a long time, there are few studies that have constructed frameworks to comprehensively analyze the strength of the effects of various factors on the turnover intention of elderly care workers.. This study analyzed the impact of different types of perceived human resource management practices on elderly care workers' turnover intentions and whether this relationship is moderated by person-job fit and ownership of elderly care institutions. METHODS: This is a cross-sectional and regional survey study. The study included questionnaire survey data from a total of 305 elderly care workers from 42 elderly care institutions in 21 provinces in China during June to September 2021. Descriptive statistics, Pearson correlation coefficient, multiple regression, and heterogeneity analyses were performed. RESULTS: Perceived work environment ( ß =-0.5164, p< 0.01), perceived occupational protection ( ß =-0.3390, p< 0.01), perceived welfare benefits ( ß = -0.2620, p< 0.01) and perceived competency training ( ß = -0.1421, p< 0.1) were all significantly and negatively related to turnover intentions, the quality of perceived work environment has the greatest impact on elderly care workers' turnover intentions. Under the moderating effects of person-job fit and ownership of elderly care institutions, there existed heterogeneity between perceived human resource management and turnover intentions among elderly care workers. High level of person-job fit and elderly care institutions' public feature can effectively weaken the negative impact of each type of perceived human resource management on turnover intention among elderly care workers. CONCLUSIONS: The managers of elderly care institutions should optimize the management mechanism, typically pay attention to elderly care workers' working environment, formulate and improve the professional standards and job requirements for elderly care workers, promote the public welfare value of nursing care services, and strengthen the sense of honor and responsibility of elderly care workers to reduce the turnover rate.

Determinants of Nurses' Knowledge Toward the Elderly Care, Southwest, Ethiopia.

Introduction: Elderly individuals are the segment of the population that needs special care. The quality of care provided for elderly individuals is highly determined by the knowledge of nurses in elderly care. Hence, there are limited studies conducted to determine the level of knowledge of nurses regarding elderly care. Therefore, this study aimed to assess determinant factors of nurses' knowledge of elderly care. Methods: A facility-based cross-sectional study design was employed from April 1 to 10, 2021, among 345 nurses. Respondents were selected by a simple random sampling technique. The data were collected through a self-administered structured questionnaire. The collected data were entered and analyzed by using Statistical Package for Social Science software version 25.0. A multivariable binary logistic regression was used to identify factors significantly associated with the knowledge of nurses about elderly care. Result: The response rate of this study was 98.3%. More than half of the respondents were female (51.6%) and 38.3% were single in marital status. Being knowledgeable among nurses about elderly care was 51.9%. Ever living with the elderly (adjusted odd ratio [AOR]: 3.62; 95% CI: 1.661, 7.89) and taking geriatric care training (AOR: 5.209, 95% CI: 2.771, 9.79) were positively associated with the knowledge of nurses toward elderly care while work experience <5 years (AOR: 0.305; 95% CI: 0.134, 0,696), and work experience 5-10 years (AOR: 0.359; 95% CI: 0.15, 0.864) were negatively associated with the knowledge of nurses toward elderly care. Conclusion: The knowledge of nurses about elderly care was moderate. Ever lived with the elderly, work experience, and taking geriatric care training contributed to nurses' knowledge about elderly care. Therefore, hospital administrators and the Ministry of Health should facilitate training, design, and implement standard guidelines on nursing practice for elderly care.

Study on the measurement of coupling and coordinated development level between China's internet and elderly care services and its influencing factors.

BACKGROUND: With the intensification of China's aging population, the demand for elderly care services has become increasingly prominent. At the same time, rapid development of internet technology provides more convenience and possibilities for the elderly. However, the coordinated development between the internet and elderly care services still faces challenges. This study aims to measure the level of coupling and coordinated development between the internet and elderly care services in China, and analyze the influencing factors, in order to provide reference for promoting elderly care services. METHODS: In this paper, the entropy method and coupling coordination degree model were used to measure the coupling coordination development index of the internet and elderly care services in China from 2012 to 2021. In addition, considering that the coordinated development between the two is affected by many factors, the Tobit model was used to analyze the main factors affecting the integration of the internet and elderly care services. RESULTS: (1) The coupling and coordination of the Internet and senior care services is in its infancy, but the coupling and coordination of the two is on the rise, and there is still a lot of room for development in the future. (2) In terms of time scale, the coupling coordination development level between the internet and elderly care services in China has gone through three stages of "disorder recession-transition coordination-coordinated development". (3) In terms of influencing factors, government management ability has a more positive impact on the development of the integration of the Internet and senior care services, financial support, scientific and technological investment and the level of innovation play a mild pulling role, while the level of informatization to a certain extent restricts the level of integration of the Internet and senior care services. CONCLUSION: In order to promote the coordinated development of China's Internet and senior care services, it is necessary to comprehensively understand the current situation and development space of China's Internet and senior care services coupling coordination degree, accurately grasp the dynamic trend of China's Internet and senior care services coupling and coordinated development, promote the stage of leapfrogging, and fully consider the influencing factors, so as to realize the optimal allocation of policies and resources. These measures will help to promote a more coordinated and sustainable development of the internet and elderly care services in China.

Association Between Community Elderly Care Services and the Physical and Emotional Burden of Family Caregivers of Older Adults: Evidence from Beijing, China.

The rate of usage of community elderly care services in China is low, and past studies about the effects of these services on caregiver burden domestically are few. This study used a large sample of Beijing census data (n = 55,634) to examine the impact of these services on caregiver burden. Logistic regression and propensity score matching were used to estimate the effects. The results showed that meal assistance, respite care, and spiritual comfort are all significantly associated with a lower likelihood of perceived emotional burden among caregivers, while only respite care is very significantly associated with a lower likelihood of feeling physically burdened. However, the effects of these services on caregiver burden also depend on the activities of daily living performance and location of residence of the care recipients. The practical implications for policy makers are discussed.

Analysis of Hot Topics Regarding Global Smart Elderly Care Research - 1997-2021.

What is already known about this topic?: With the assistance of the internet, big data, cloud computing, and other technologies, the concept of smart elderly care has emerged. What is added by this report?: This study presents information on the countries or regions that have conducted research on smart elderly care, as well as identifies global hotspots and development trends in this field. What are the implications for public health practice?: The results of this study suggest that future research should focus on fall detection, health monitoring, and guidance systems that are user-friendly and contribute to the creation of smarter safer communities for the well-being of the elderly.

Service Allocators' Experiences of Ethical Dilemmas and Strategies in Long-Term Care: A Qualitative Study.

The provision of long-term care services for older adults is characterised by increasing needs and scarce resources, leading to ethical dilemmas. This qualitative study explored the ethical dilemmas experienced by healthcare professionals when allocating long-term care services to older adults and the strategies used to handle ethical dilemmas. Data from semi-structured individual interviews, focus group interviews, and observations of service allocators assessing needs and assigning long-term care services to older adults were analysed using content analysis. The overarching theme was the struggle for safe and equitable service allocation. The identified dilemmas were: (i) Struggles with A Just Allocation of Services due to Limited Time and Trust, (ii) Pressure on Professional Values Concerning Safety and Dignity, and (iii) Difficulties in Prioritising One Group Over Another. The strategies to deal with ethical dilemmas were: (i) Assessing Needs Across the Entire Municipality, (ii) Ensuring Distance to Service Recipients, (iii) Working as a Team, and (iv) Interprofessional Decision-Making. Scarce resources, organisational limitations, and political expectations drive the ethical dilemmas in long-term care service allocation. An open public discussion regarding the acceptable minimum standard of long-term care is needed to reduce the ethical pressure on service allocators.

A survey of non-consultant hospital doctors' perspectives, knowledge, and practices toward delirium in a large Irish hospital.

BACKGROUND: Delirium is a common condition in hospitals, particularly among older people. This refers to a dramatic decline in mental capabilities, which is marked by diminished concentration and consciousness. AIM: The purpose of this study was to assess the views, knowledge, and behavior of non-consultant hospital doctors in managing delirium in a large Irish hospital. METHODS: Questionnaires were administered to 28 healthcare professionals from various departments according to Davis and MacLullich (Age Ageing 38(5):559-563, 2009). It was conducted between July and September 2023, with an emphasis on determining the prevalence rate, diagnostic criteria, and management strategies for delirium. RESULTS: The study established that the majority of respondents recognized the importance of delirium, but there appears to be a gap in the practical management of this clinical syndrome. Although many doctors agreed that delirium was significant, most lacked confidence in its diagnosis and management. The use of standardized assessment tools, such as the 4AT, was limited. CONCLUSIONS: This study highlights the disparity between what is known and practiced by hospital doctors regarding delirium care. This implies increased training for delirium management with frequent use of assessment tools and ongoing education aimed at enhancing patient outcomes in cases of delirium.

Perspective analysis of assistive robots for elderly in India.

PURPOSE: Assistive technology for elderly are advancing, and this study aimed to analyse the Indian perspective on utilising assistive robot technology for aiding elderly individuals. MATERIALS AND METHODS: A population-based survey was undertaken to collect data from three perspectives: Relatives of the elderly, Healthcare professionals and Elderly individuals. The survey gathered 389 responses. The responses are statistically analysed, and data is visualised with different plots for better understanding. RESULTS: It is observed that the older people rate with less conviction on the use of technology when compared to the relatives and healthcare professionals. Out of the three target groups, the elderly individuals had the most correlating attributes to purchasing the robot. Also, healthcare personnel, relatives, and older people gave 82%, 63% and 55% affirmatives to the question on purchasing the robot, respectively. And the cost of the robot is preferred to be under 6 lakh rupees. CONCLUSIONS: Though the younger generation has more orientation towards technology, older people are skeptical about handling computer gadgets or robots. However, there are significant expectations and concerns expressed by three target groups such as conversational, navigational, reminder features, security and malfunction concerns.

The Impact of Scholarly Concentration Programs on Graduates' Career Choices and Interest in the Care of Older Patients.

BACKGROUND: More geriatricians are needed to care for the aging population. Geriatric scholarly concentration programs (GSCPs) may promote medical students' interest in this underserved field or careers working with older adults. Additionally, graduates of GSCPs may be more comfortable and competent in providing care for older adults. Surveys were administered to graduates of GSCPs to determine the role of these programs in shaping medical students' careers and views about caring for older adults.  Methods: The purpose of this study is to understand the impact of GSCPs on medical graduates' career choices and self-perceived skill and comfort in caring for older adults. A Qualtrics survey (Qualtrics International Inc., Seattle, Washington, United States) was developed and distributed to 83 graduates of four GSCPs in the United States. Data were analyzed using a significance level of p>0.05 for all tests. Descriptive statistics were calculated to summarize the data. Wilcoxon signed-rank tests were used to test for significant differences in interest in pursuing a career in geriatrics or working with older adults. Qualitative responses were coded and analyzed for themes.  Results: A total of 34 out of 83 surveyed graduates of GSCPs indicated a higher interest in geriatrics as a career as well as increased comfort and self-perceived skill in caring for older adults after completing the GSCP. The components of the GSCP that most strongly improved the participants' ability to care for older adults included the curriculum (n=31, 91%) and mentoring (n=28, 82%). An overwhelming majority of survey participants felt GSCPs should be offered as part of medical school programming (n=33, 97%).  Conclusion: This study suggests that GSCPs increase interest and competence in caring for older adults and increase interest in a career in geriatrics. GSCPs should be implemented across medical schools.

ADAM: a robotic companion for enhanced quality of life in aging populations.

One of the major problems of today's society is the rapid aging of its population. Life expectancy is increasing, but the quality of life is not. Faced with the growing number of people who require cognitive or physical assistance, new technological tools are emerging to help them. In this article, we present the ADAM robot, a new robot designed for domestic physical assistance. It mainly consists of a mobile base, two arms with grippers and vision systems. All this allows the performance of physical tasks that require navigation and manipulation of the environment. Among ADAM's features are its modularity, its adaptability to indoor environments and its versatility to function as an experimental platform and for service applications. In addition, it is designed to work respecting the user's personal space and is collaborative, so it can learn from experiences taught by them. We present the design of the robot as well as examples of use in domestic environments both alone and in collaboration with other domestic platforms, demonstrating its potential.

Middle-aged and older people's preference for medical-elderly care integrated institutions in China: a discrete choice experiment study.

BACKGROUND: With the continuing impact of the aging population, medical-elderly care integrated institutions, as a way to bear the pressure of medical and elderly care, effectively ensure the quality of life of the elderly in their later years. OBJECTIVES: To explore the preferences of medical-elderly care integrated institutions among Chinese middle-aged and older people and to provide a reference for establishing elderly-oriented development of medical-elderly care integrated institutions. METHODS: In this study, a discrete choice experiment (DCE) was used to investigate the preferences of people aged 45 years and older in medical-elderly care integrated institutions in China from October 20, 2022, to November 10, 2022. A mixed logit regression model was used to analyze the DCE data. Participants' willingness to pay for each attribute was also calculated. RESULTS: Data from 420 participants who provided valid responses were included in the analysis. In terms of the choice preference, moderate service quality (vs. poor service quality: ß = 1.707, p < 0.001, 95% CI 1.343 ~ 2.071) and high medical technology level (vs. low medical technology level: ß = 1.535, p < 0.001, 95% CI 1.240 ~ 1.830) were the most important attributes to middle-aged and older people, followed by monthly cost, environmental facilities, the convenience of transportation, and entertainment activities. Regarding the willingness to pay, participants were more willing to pay for service quality and medical technology level than for other attributes. They were willing to pay $3156 and $2838 more for "poor service quality" and "low medical technology level," respectively, to receive "moderate service quality " (p = 0.007, 95% CI 963 ~ 5349) and "high medical technology level" (p = 0.005, 95% CI 852 ~ 4824). CONCLUSIONS: The state should attach great importance to the development of medical-elderly care integrated services industry, actively optimize the model of the medical-elderly care integrated service, improve the facilities, and create a healthy environment. At the same time, give full play to the role of medical insurance, long-term care insurance, and commercial insurance, so as to improve the comprehensive quality of life of the elderly. PUBLIC CONTRIBUTION: The design of the experimental selection was guided by 10 experts in the field, 5 Chinese government officials, and interviews and focus group discussions, without whose participation this study would not have been possible.

Choice Preference of Middle-Aged and Elderly People on Integrated Medical Services and Elderly Care Model: A Cross-Sectional Study.

Facing the increasingly severe aging situation, China has started to implement the "integrated medical services and elderly care (IMSEC)" policy, which covers a variety of IMSEC models. However, there is currently little research on middle-aged and elderly people's choice preference for these IMSEC models and their associated factors. Through the face-to-face questionnaire method, the choice preference of middle-aged and elderly people aged 45 years and over in Zhejiang Province, China, to the IMSEC model is explored. Through the multinomial logistic regression model, the influencing factors of choice preference are analyzed. A total of 1034 people are included in 2022. Their choice preference for the 4 major types of IMSEC models are Home IMSEC model (48.07%), Community IMSEC model (23.79%), Institutional IMSEC model (21.76%), and Internet Plus IMSEC model (6.38%). "C1. Home elderly care and contracted with a family doctor" is the most chosen subtype, accounting for 34.53%. The rural elderly are more likely to choose "Home IMSEC model" (OR(95%CI) = 2.977(1.343-6.601)). Elderly people with relatively large life care needs are more likely to choose "Institutional IMSEC model" (OR(95%CI) = 1.114(1.042-1.190)). Moreover, age, education, and self-reported health status are also influencing factors of choice preference. The government should focus on promoting the development of the "Home IMSEC model" and increase the promotion of "Internet Plus IMSEC model." In addition, the life care service capacity and spiritual comfort capacity of IMSEC institutions, as well as the medical service capacity of the community, need to be enhanced.

The care needs of the elderly in China's elderly care institutions: a narrative synthesis.

China's population is ageing, affecting trends in social development and basic national conditions. More attention must be paid to the lack of care needs assessments for the elderly in China's pension institutions. This paper discusses a systematic evaluation of the care needs of the elderly in China's elderly care institutions. Literature was collected and synthesized after a search of the Web of Science, PubMed, and other databases for works published up to August 2021. Relevant content is proposed, including the name of the first author, publication date, study area, and sample size. Exactly 18 articles were included in the literature, documents that reported on a total of 7277 elderly people. The results showed a combined demand rate of primary care needs ≥50%. The top five needs included mental/psychological (76%), tranquillity/care (73%), living/environmental (71%), medical treatment (64%), and preventive healthcare (64%). The combined demand rate of secondary care needs was ≥50%. The top five needs included 79% for room/laundry/cleaning, 77% for psychological comfort and nursing, 73% for end-of-life care, 70% for disease diagnosis and treatment, and 69% for physical examination. The health needs of older people are diverse and focus mainly on mental/psychological, tranquility/care, living/environmental (71%), pharmacotherapy, and preventive healthcare.

Digital Microlearning for Training and Competency Development of Older Adult Care Personnel: Mixed Methods Intervention Study to Assess Needs, Effectiveness, and Areas of Application.

BACKGROUND: Older adult care organizations face challenges today due to high personnel turnover and pandemic-related obstacles in conducting training and competence development programs in a time-sensitive and fit-for-purpose manner. Digital microlearning is a method that attempts to meet these challenges by more quickly adapting to the educational needs of organizations and individual employees in terms of time, place, urgency, and retention capacity more than the traditional competency development methods. OBJECTIVE: This study aimed to determine if and how an app-based digital microlearning intervention can meet older adult care organizations' personnel competency development needs in terms of knowledge retention and work performance. METHODS: This study assessed the use of a digital microlearning app, which was at the testing stage in the design thinking model among managerial (n=4) and operational (n=22) employees within 3 older adult care organizations. The app was used to conduct predetermined competency development courses for the staff. Baseline measurements included participants' previous training and competency development methods and participation, as well as perceived needs in terms of time, design, and channel. They then were introduced to and used a digital microlearning app to conduct 2 courses on one or more digital devices, schedules, and locations of their own choice during a period of ~1 month. The digital app and course content, perceived knowledge retention, and work performance and satisfaction were individually assessed via survey upon completion. The survey was complemented with 4 semistructured focus group interviews, which allowed participants (in total 16 individuals: 6 managerial-administrative employees and 10 operational employees) to describe their experiences with the app and its potential usefulness within their organizations. RESULTS: The proposed advantages of the digital microlearning app were largely confirmed by the participants' perceptions, particularly regarding the ease of use and accessibility, and efficiency and timeliness of knowledge delivery. Assessments were more positive among younger or less experienced employees with more diverse backgrounds. Participants expressed a positive inclination toward using the app, and suggestions provided regarding its potential development and broader use suggested a positive view of digitalization in general. CONCLUSIONS: Our results show that app-based digital microlearning appears to be an appropriate new method for providing personnel competency development within the older adult care setting. Its implementation in a larger sample can potentially provide more detailed insights regarding its intended effects.

Research status of elderly-care robots and safe human-robot interaction methods.

Faced with the increasingly severe global aging population with fewer children, the research, development, and application of elderly-care robots are expected to provide some technical means to solve the problems of elderly care, disability and semi-disability nursing, and rehabilitation. Elderly-care robots involve biomechanics, computer science, automatic control, ethics, and other fields of knowledge, which is one of the most challenging and most concerned research fields of robotics. Unlike other robots, elderly-care robots work for the frail elderly. There is information exchange and energy exchange between people and robots, and the safe human-robot interaction methods are the research core and key technology. The states of the art of elderly-care robots and their various nursing modes and safe interaction methods are introduced and discussed in this paper. To conclude, considering the disparity between current elderly care robots and their anticipated objectives, we offer a comprehensive overview of the critical technologies and research trends that impact and enhance the feasibility and acceptance of elderly care robots. These areas encompass the collaborative assistance of diverse assistive robots, the establishment of a novel smart home care model for elderly individuals using sensor networks, the optimization of robot design for improved flexibility, and the enhancement of robot acceptability.

How to Manage the Suffering of the Patient and the Family in the Final Stage of Life: A Qualitative Study.

BACKGROUND: The end of life and death have changed from being issues managed within the family, assumed as part of life, to occur within health institutions for the majority of patients. The amount of patients dying at home has decreased, and the roles of families and communities in death and dying have become involuted, threatening related traditions and knowledge. As a result, a need to promote the end of life at home in this new self-serving society has arisen. In that context, the main objective of this study was to find out what patients and their families need during the end-of-life process in order to feel effectively accompanied at this time. METHODS: With that objective, a descriptive qualitative study was conducted via the content analysis of data from semi-structured interviews and focus groups. This research adhered to the COREQ guidelines. The sample consisted of 36 informants selected via intentional sampling of family members and patients integrated into the Comprehensive Palliative Care Process (PAI Paliativos). RESULTS: The results suggest the existence of several common needs such as communication and presence, including the conspiracy of silence as an important factor generating suffering for both. However, there are specific needs such as autonomy, dignity, and respect for patients, which must be taken into account. CONCLUSIONS: The results of this study will allow us to establish intervention strategies for effective accompaniment of patients' family members at the end of life and the avoidance of ethnocentrism in this process. This study was retrospectively registered with the (nursrep-1194226) on the (21 April 2023).

[Implementation of fall sensors in long-term care : An interview study to identify promoting and inhibiting factors from the perspective of professional caregivers]. / Implementation einer Sturzsensorik in der Langzeitpflege : Eine Interviewstudie zur Betrachtung fördernder und hemmender Faktoren aus Sicht professionell Pflegender.

BACKGROUND AND OBJECTIVE: Digital support systems are becoming increasingly more important in long-term inpatient care facilities. Welfare technologies have the potential to make a valuable contribution to maintaining independence in advanced age. At the same time the technologies can support professional caregivers. The aim of the study was to describe the expectations and experiences with a new technology, using the example of a fall sensor system, from the perspective of professional caregivers. METHOD: We used a qualitative design with semistructured interviews in two long-term inpatient care facilities. In one facility, three individual interviews took place, while in the other long-term care facility, a group interview with three nursing professionals was conducted. Additionally, one individual interview was conducted with a person in a leadership role in each facility. The time from implementation of the fall sensors to the interviews was between 1 and 3 months. Data were analyzed using qualitative content analysis in MAXQDA. RESULTS AND DISCUSSION: The study demonstrated that there was a correspondence between expectations of and retrospective experiences with the new technology among professional nurses. The main facilitating factors of the implementation that were identified were timely information about the risk of falling or a fall that has occurred, maintenance of residents' autonomy and freedom of movement as well as the enhancement of the sense of security among nursing professionals and the associated psychological relief effect. The inhibiting factors of the implementation were compulsory presetting, false alarms and faulty handling of the technology due to missing knowledge.

Effects of a Gamified Agent-Based System for Personalized Elderly Care: Pilot Usability Study.

BACKGROUND: The global percentage of older people has increased significantly over the last decades. Information and communication technologies have become essential to develop and motivate them to pursue healthier ways of living. This paper examines a personalized coaching health care service designed to maintain living conditions and active aging among older people. Among the technologies the service includes, we highlight the use of both gamification and cognitive assistant technologies designed to support older people and an application combining a cognitive virtual assistant to directly interact with the older person and provide feedback on their current health condition and several gamification techniques to motivate the older person to stay engaged with the application and pursuit of healthier daily habits. OBJECTIVE: This pilot study aimed to investigate the feasibility and usability of a gamified agent-based system for older people and obtain preliminary results on the effectiveness of the intervention regarding physical activity health outcomes. METHODS: The study was designed as an intervention study comparing pre- and posttest results. The proposed gamified agent-based system was used by 12 participants over 7 days (1 week), and step count data were collected with access to the Google Fit application programming interface. Step count data after the intervention were compared with average step count data before the intervention (average daily values over a period of 4 weeks before the intervention). A　1-tailed Student t test was used to determine the relationship between the dependent and independent variables. Usability was measured using the System Usability Scale questionnaire, which was answered by 8 of the 12 participants in the study. RESULTS: The posttest results showed significant pre- to posttest changes (P=.30; 1-tailed Student t test) with a moderate effect size (Cohen d=0.65). The application obtained an average usability score of 78. CONCLUSIONS: The presented pilot was validated, showing the positive health effects of using gamification techniques and a virtual cognitive assistant. Additionally, usability metrics considered for this study confirmed high adherence and interest from most participants in the pilot.

Poor Sleep Quality as a Risk Factor for Constipation Among Community-Dwelling Older Adults in Japan.

Background Older adults commonly experience both sleep disturbances and constipation. Pathophysiological mechanisms such as inhibition of colonic peristalsis due to sympathetic activation associated with sleep disturbances have been postulated. Here, we aimed to assess the temporal association between the degree of sleep quality and the incidence of constipation. Methods We conducted a prospective cohort study of independent community-dwelling older adults aged ≥75 years (the Sukagawa Study). Using a self-administered questionnaire inquiring about awareness of own constipation or the use of laxatives in 2019 and 2020, we determined the onset of constipation. The Japanese version of the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality in 2019. The global PSQI score was divided into quartiles. We analyzed the association between the degree of sleep quality and the incidence of constipation using logistic regression models. Results Overall, 1,696 participants without constipation at baseline were analyzed after 1 year, of whom 823 (48.5%) were male. The mean age of participants was 79.9 years. In total, 191 participants (11.3%) developed constipation. The median (interquartile range; IQR) global PSQI score was 4 (2, 6). According to the quartiles of the global PSQI scores (0-2, 3-4, 5-6, and ≥7), 35 (7.8%), 55 (11.3%), 48 (12.8%), and 53 (13.8%), respectively, developed constipation. Compared to those with global PSQI scores of 0-2, the odds ratios, adjusted by age, sex, smoking status, alcohol status, educational level, working status, exercise, and medical history were 1.57, 1.78, and 2.02 for participants with global PSQI scores of 3-4, 5-6, and ≥7, respectively (p = 0.003 for trend). Conclusions We identified poor sleep quality as a new risk factor for developing constipation in independent, community-dwelling, older adults aged ≥75 years.