Key determinants and usage patterns of mobile device proficiency in older adults.

Mobile device (e.g., smartphone) proficiency is becoming increasingly necessary to perform important everyday tasks, and inadequate proficiency can prevent groups of individuals such as older adults from obtaining the benefits of mobile computing and smartphone utilization. To facilitate mobile device training and research on barriers to mobile device use and adoption by older adults, Roque and Boot [1] developed the Mobile Device Proficiency Questionnaire (MDPQ). The current study is the first to assess the validity of the MDPQ based on confirmatory factor analysis and objective measures of their smartphone skills. In addition, it represents the first attempt to validate the MDPQ on a sample of older smartphone users. Results suggest that modifications may be necessary for the MDPQ to serve as a valid and reliable measure of proficiency among older adult smartphone users. In this sense, four important implications and recommendations for application of the MDPQ are discussed that could promote the general goal of ensuring that individuals of all ages can benefit from the use of smartphone devices and services such as mobile apps.

Purpose This study aimed to examine a mobile device navigation application’s (apps) usefulness as a guide based on the required time and accuracy of moving to a destination for community-dwelling older adults. Methods Twelve older adults, aged ≥65 years (mean age 77.0 ± 8.0, 62% female) who used the day-care centre for older adults, based on the long-term care insurance system in Kagoshima Prefecture, participated in this study. Study participants performed a Route Navigation Task (RNT), which is a simple real-world navigation test based on the actual living environment, after a brief assessment of physical function, cognitive function, and daily living routine. RNT required that participants arrive at a destination for the shortest time, under three tasks: map-, app-, and photo-language. The order of implementation of each task, determined by one of the tasks, was randomized, with a span of a minimum 1 month between tasks. Results The app-task resulted in a significantly shorter amount of travel time than did the other tasks (p < 0.05). The factors considerably correlating with travel time in the app-task were walking speed, mobile device proficiency, years of mobile device use, and higher-order activities of daily living. Conclusion Our findings suggested the possibility that the navigation app was useful as efficient outdoor mobility support, and healthcare providers should encourage the use of mobile devices for improving the active lifestyle of the community-dwelling older adults. IMPLICATIONS FOR REHABILITATION The navigation apps in mobile devices are expected to be useful for community-dwelling older adults. We examined the effect of navigation app use on path execution using three tasks in RNT and what factors are associated with the ability of route navigation. A significant reduction in travel time when RNT was performed using a navigation app compared to the other two tasks (map, photo-language). Regardless of cognitive function, mobile device proficiency, and mobile device usage were associated with navigation app use. This study suggests the usefulness of a navigation application in providing route assistance to community-dwelling older adults.

Technology adoption rates of older adults typically lag behind those of their younger counterparts; a digital divide. This is unfortunate because technology has many potential benefits for older people. Among older adults, attitudes and cognitive abilities predict computer and Internet adoption, use, and proficiency. However, an important trend over the past two decades has been the rise of mobile computing (specifically with respect to smartphones and tablet computers). High quality interactions with mobile technology critically depend upon individuals’ technology proficiency, making it important to understand how mobile device proficiency might be anticipated. This paper explored predictors of mobile device proficiency among older adults (65+) using a dataset from a cognitive intervention study that included 60 participants. Measures of computer and mobile device proficiency were obtained. Demographic variables and assessments of reasoning ability, processing speed, and executive control were collected and explored as predictors of mobile device proficiency. Even within this older adult sample, mobile device proficiency was related to age, but contrary to predictions, cognition was not significantly related to mobile device proficiency; the strongest predictor of mobile device proficiency was computer proficiency. This implies some transfer of proficiency from one technology platform to another. These results have implications for predicting quality technology interactions given the link between interaction quality and technology proficiency.

Mobile device proficiency is increasingly required to participate in society. Unfortunately, there still exists a digital divide between younger and older adults, especially with respect to mobile devices (i.e., tablet computers and smartphones). Training is an important goal to ensure that older adults can reap the benefits of these devices. However, efficient/effective training depends on the ability to gauge current proficiency levels. We developed a new scale to accurately assess the mobile device proficiency of older adults: the Mobile Device Proficiency Questionnaire (MDPQ). We present and validate the MDPQ and a short 16-question version of the MDPQ (MDPQ-16). The MDPQ, its subscales, and the MDPQ-16 were found to be highly reliable and valid measures of mobile device proficiency in a large sample. We conclude that the MDPQ and MDPQ-16 may serve as useful tools for facilitating mobile device training of older adults and measuring mobile device proficiency for research purposes.

Digital Proficiency and Teleaudiology: Key Implications in Hearing Care

INTRODUCTION: Self-Management Health Systems (SMHS) are envisioned to support older adults and contribute to ageing in place. To promote the use and acceptance of SMHS, designers may resort to using motivational design techniques (MDT).OBJECTIVES: This paper investigates how and which older adults prefer MDT in SMHS and whether these preferences are mediated by either motivation for health management (MHM) or mobile device proficiency (MDP).METHODS: Based on a user evaluation with 45 older adults (mean age=84, SD=6.75), 32 MDT, MHM, and MDP were polled through questionnaires and informal interviews.RESULTS: Findings showed that most techniques were welcomed, but also that scores vary widely, reflecting heterogeneity in the population and calling for caution in its implementation. These findings are then translated into implications for design.CONCLUSION: Overall, older adults welcome MDT in SMHS. However, MDT are no panacea; tailoring MDT to users’ needs is therefore crucial.

Background and Objectives Technology has potential for providing support for aging adults. This study evaluated the Personal Reminder Information and Social Management 2.0 (PRISM 2.0) software, in terms of enhancing social engagement and quality of life, and decreasing loneliness among older adults. Research Design and Methods The randomized field trial conducted in diverse living contexts (rural locations, senior housing, and assisted living communities [ALC]). Two hundred and forty-five adults, aged 64 to 99 years, were randomly assigned to the PRISM 2.0 (integrated software system designed for aging through an iterative design process) or a Standard Tablet (without PRISM) Control condition, where participants received the same amount of contact and training as those in the PRISM 2.0 condition. Primary outcomes included measures of loneliness, social support, social connectedness, and quality of life. Secondary outcomes included measures of social isolation, mobile device proficiency, and technology readiness. Data were collected at baseline and 6 and 9 months postrandomization. This article focuses on the 6-month outcomes due to coronavirus disease 2019-related data challenges at 9 months. Results Contrary to our hypothesis, participants in rural locations and senior housing in both conditions reported less loneliness and social isolation, and greater social support and quality of life at 6 months, and an increase in mobile device proficiency. Participants in the ALCs in both conditions also evidenced an increase in mobile device proficiency. Improvements in quality of life and health-related quality of life were associated with decreases in loneliness. Discussion and Implications This study provides compelling evidence about the benefits of technology for older adults in terms of enhancing social outcomes and quality of life. However, the findings also underscore that for technology applications to be successful, they need to be adapted to the abilities and needs of the user group and instructional support needs to be provided. Clinical Trials Registration # NCT03116399

A number of real-world digital literacy training programs exist to support engagement with mobile devices, but these have been understudied. The purpose of this study was to examine the effectiveness and program acceptability of a digital skills training program among middle-aged and older adults (aged ≥50 years) and to gather participants' recommendations for lifelong digital skills promotion. The Gluu Essentials digital skills training program includes learning resources to support tablet use. Through pre-post surveys, this study assessed mobile device proficiency, confidence in going online and in avoiding frauds and scams, the frequency of engaging in online activities, program engagement, acceptability, and suggestions for continued support. A total of 270 middle-aged and older adults completed baseline surveys. Of these 270 participants, 145 (53.7%) completed follow-up surveys. Our findings indicate that mobile device proficiency increased (P<.001), whereas confidence was unchanged. Participants also reported going online more frequently to shop (P=.01) and access government services (P=.02) at follow-up. Program engagement varied considerably, but program acceptability was high. Participants' recommendations included the need for providing ongoing programs for support and training because technology constantly changes, reducing costs for technology and internet access, and keeping learning resources simple and easy to access. The Gluu Essentials digital skills training program increased mobile device proficiency and frequency of web-based activities (shopping and accessing government services) among middle-aged and older adults.

To examine baseline factors (i.e., age, gender, mobile device proficiency, sensory impairment) associated with app engagement in a 12-week mental health app intervention and to explore whether app engagement predicts changes in depression and anxiety symptoms among middle-aged and older adults. Mobile device proficiency, sensory impairment, depression, and anxiety symptoms were measured using questionnaires. App engagement was defined by metrics characterizing the core intervention features (i.e., messages sent to therapist, mindfulness meditation minutes, action tasks completed). Multiple regressions and multilevel models were conducted. Forty-nineparticipants (M age = 57.40, SD = 11.09 years) enrolled. Women (β = .35, p < .05) and participants with less sensory impairment completed more action tasks (β = -.40, p < .05). Depressive and anxiety symptoms measured within the app declined significantly across treatment. Clinical significant improvements were observed for depression in 48.9% and for anxiety in 40% of participants. App engagement metrics were not predictive of depression or anxiety symptoms, either incrementally in time-lagged models or cumulatively in hierarchical linear regression analyses. App engagement is multifaceted; participants engaged differently by gender and ability. Participation in this digital mental health intervention reduced depression and anxiety symptoms, but these findings should be interpreted with caution as the study did not include a control condition. Our findings underscore the importance of considering individual factors that may influence use of a digital mental health intervention.

IDENTIFYING PROBLEMS DURING TRANSITIONS OF CARE AND REASONS FOR EMERGENCY DEPARTMENT UTILIZATION IN COMMUNITY-DWELLING OLDER ADULTS By Antoinette Bartolotta Coe, Pharm.D., Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2015 Major Advisor: Director: Leticia R. Moczygemba, Pharm.D., Ph.D. Associate Professor, Department of Pharmacotherapy and Outcomes Science A mixed methods approach was used for this study. The setting was a low-income, subsidized housing apartment building for community-dwelling older and younger disabled adults identified as a health care hot spot due to high rates of ambulance use. The study purpose was to identify reasons for ED use and problems during transition from ED to home, predictors of zip code 23220 (health care hot spot) in emergent and non-emergent ED visits, and predictors of total ED costs in community-dwelling older adults living in a health care hot spot. Semi-structured interviews with residents who used the ED, an existing database from an interprofessional care coordination and wellness program for residents, and community-dwelling older adults’ electronic medical record and billing data from 2010-2013 ED visits from an academic medical center were used. The Gelberg-Andersen Behavioral Model for Vulnerable Populations was

BACKGROUND: A recent study by Walton et al. (2004) showed that differential control demands within the same task were associated with differential activation of regions within the brain. We have demonstrated that cognitive function is associated with some types of physical function. In a clinical setting of nursing prevention in older adults, some physical performance tests related to cognitive function could be useful in identifying mild cognitive impairment in older adults. Objective: The purpose of this study was to develop a physical performance battery assessing cognitive function in community-dwelling older adults. METHODS: One hundred and seventy-nine community-dwelling older Japanese adults with a mean age of 74.1 ± 5.4 years were recruited. The participants were classified as having aging-associated cognitive decline (AACD) or a normal level of cognition, based on the Five-cognitive Function Test. The physical performance battery included a hand-operated peg board (X1), 4-way choice reaction time (X2), timed up and go (X3), and 5-repetition sit-to-stand (X4). An equation of the physical performance score (PPS) was developed using principal component analysis. Participants were divided into tertile levels (T1, T2, T3) according to the PPS. Multiple logistic regression was performed to evaluate whether the PPS was independently associated with AACD. The cut-off point to distinguish AACD from normal was identified by a receiver-operating characteristic curve. RESULTS: The following equation was developed: PPS = -0.037X1 - 0.002X2 - 0.211X3 - 0.119X4 + 5.846. In the logistic regression model, the odds ratios (95% confidence interval) of AACD compared with T1 were 0.61 (0.23-1.61), 0.27 (0.08-0.87) in T2 and T3, after adjusting age, sex, and education level. A PPS of 0.27 (AUC 0.75, 95%CI 0.66 - 0.84) was defined as an optimal cut-off point that maximized the sum of sensitivity and specificity (sensitivity 85%, specificity 59%). CONCLUSION: This physical performance battery should be a useful tool for assessing cognitive function in community-dwelling older adults.

Objectives This program evaluation examined the feasibility, acceptability, and preliminary effects of an individualized coaching program to help older Veterans use VA mental health mobile apps to address mental health and well-being goals. Methods The program delivers individual technical and clinical support to facilitate the use of mobile devices and VA apps. Participants completed assessments of mobile device proficiency, app use frequency, app comfort, quality of life, and mental health symptoms (completed by a subset, n = 11) pre- and post-participation. Results Of 24 enrollees, 17 completed the program and received an average of 7.58 (SD = 2.87) sessions including the initial assessment. Mobile device proficiency (t (16) = −3.80, p = .002) and number of days/week apps were used (t (16) = −2.34, p = .032) increased significantly from pre- to post-participation. Depressive and anxiety scores decreased significantly (t (10) = 3.16, p = .010; t (10) = 3.29, p = .008) among the subset completing those measures. Overall satisfaction was high; 100% reported they would recommend the program. Conclusions Findings suggest the program is feasible, highly acceptable, and increases mobile device proficiency and use of apps. Clinical Implications Coaching programs can equip older adults with the skills to use mental health apps.

In the lives of those who are the target of community health nursing, it is important to collaborate with individuals and communities to improve their quality of life. Herein, we aimed to determine the association between Internet use among older individuals and locomotive syndrome (LS), frailty, and sarcopenia. In this cross-sectional study conducted between July 2022 and March 2023, we recruited 105 community-dwelling older Japanese adults who participated in a care prevention project called "Kayoi-no-ba". All participants were divided into Internet and non-Internet user groups according to the classification of a previous study. We assessed LS (standing test, two-step test, and five-question Geriatric Locomotive Function Scale), frailty (through the Questionnaire for Medical Checkup of Old-Old), and sarcopenia (grip strength, normal walking speed, and skeletal muscle mass index) and made group comparisons between Internet users and non-users. Binomial logistic regression analyses were performed with Internet use as the independent variable and sarcopenia or LS as the dependent variables. The Internet and non-Internet user groups had 69 and 36 participants, respectively. The Internet user group comprised 65.7% of all participants, which was similar to that reported in a previous study of the same age group. Between-group comparisons showed significant differences in sarcopenia and LS items, whereas adjusted binomial logistic analysis showed a significant association between sarcopenia and Internet use. In summary, among LS, frailty, and sarcopenia, sarcopenia showed the highest association with Internet use. Older adults without sarcopenia having good physical functions, such as grip strength, walking speed, and skeletal muscle index, more likely used the Internet; while older adults with sarcopenia were less likely to use the Internet. This implied that Internet use may be associated with physical function.

Self-Assessed Kyphosis and Chewing Disorders Predict Disability and Mortality in Community-Dwelling Older Adults

BackgroundAnxiety disorders in older adults have become a prominent public health problem due to their concomitant chronic conditions, reduced quality of life and even death. However, fewer studies have been conducted on differences in anxiety among older individuals in different aged-care models, and the interactive relationship between the influencing factors on anxiety remains unclear. The study aimed to examine the disparities in the prevalence of anxiety between community-dwelling and institutionalized older adults and related influencing factors.MethodsData were collected from the Anhui Healthy Longevity Survey (AHLS) and the Anhui Elderly Caring Social Organizations Survey (AECSOS). Data on demographic variables, lifestyle factors and health-related variables in 6968 older adults were used for analysis. Anxiety symptoms were evaluated using the Generalized Anxiety Disorder Assessment Scale (GAD-7). Binary logistic regression models and a Classification and Regression Tree model (CART) were utilized to examine the relationship between variables.ResultsThe prevalence of anxiety were 24.3% and 16.7% among community-dwelling older adults and institutionalized older adults, respectively. Several factors including age, gender, residence, education, income level, live alone, and number of chronic diseases showed a linkage with anxiety among community-dwelling older adults. For the institutionalized older adults, gender, residence, source of income, and number of chronic diseases exhibited a significant association with anxiety. We noted the interactive effect, suggesting that community-dwelling female older adults with an income level of less than 6500 RMB per year and reported chronic disease comorbidities had the highest likelihood of anxiety, and institutionalized female older adults with income sources such as pension, subsidy, family providing, and resident in rural areas have the greatest risk of experiencing anxiety.ConclusionsThis study has brought to light the higher risk of anxiety among community-dwelling older adults compared to institutionalized older adults. Targeted interventions are, therefore emphasized to address the negative impact of anxiety for populations at higher risk.