<p>A Comprehensive Scoping Review Protocol of Using Living Labs to Explore Needs and Solutions for Older Adults with Dementia</p>

BackgroundNumerous living labs have established a new approach for studying the health, independent living, and well-being of older adults with dementia. Living labs interact with a broad set of stakeholders, including students, academic institutions, private companies, health care organizations, and patient representative bodies and even with other living labs. Hence, it is crucial to identify the types of cocreations that should be attempted and how they can be facilitated through living labs.ObjectiveThis study aims to scope publications that examine all types of living lab activities, exploring the needs and expectations of older adults with dementia and seeking solutions, whether they live in the community or long-term health care facilities (LTHFs).MethodsThis scoping review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations for the extension of scoping reviews. We searched six bibliographic databases for publications up to March 2020, and a forward-backward citation chasing was performed. Additional searches were conducted using Google Scholar. The quality of the selected papers was assessed.ResultsOf the 5609 articles identified, we read 58 (1.03%) articles and retained 12 (0.21%) articles for inclusion and final analysis. All 12 articles presented an innovative product, developed in 4 main living labs, to assist older adults with cognitive disorders or dementia living in the community or LTHFs. The objectives of these studies were to optimize health, quality of life, independent living, home care, and safety of older adults with cognitive disorders or dementia, as well as to support professional and family caregivers or reduce their burdens. The overall methodological quality of the studies ranged from poor to moderate.ConclusionsThis scoping review identified several living labs playing a pivotal role in research aimed at older adults with dementia living in the community or LTHFs. However, it also revealed that living labs should conduct more better-quality interventional research to prove the effectiveness of their technological products or service solutions.International Registered Report Identifier (IRRID)RR2-10.2147/SHTT.S233130

While debate over the appropriate scope and goals of COVID‐19 lockdowns has raged, all public health agencies have been clear on one matter: older adults have the highest rates of mortality (Comas‐Herrera et al., 2020) and should be isolated (Public Health Agency of Canada, 2020). Older adults and individuals with complex health conditions are most vulnerable to the virus. Yet, social isolation contributes to the onset and intensifies depression, feelings of despair and, in older adults with dementia, further cognitive decline.

The impact of a PARO intervention on depression and well-being in older adults in long-term care in Taiwan

Comparative epidemiology and factors associated with major healthcare-associated methicillin-resistant Staphylococcus aureus clones among interconnected acute-, intermediate- and long-term healthcare facilities in Singapore

There are two core concepts that make living labs distinguishable: involvement of users as co-creators and evaluation in a real-world setting. Living labs increase the potential for product acceptance and adoption due to testing and tailoring with target users. Currently, there is a lack of a universally accepted guideline for best practices. The objective of this review is to identify the best practices of living labs that can be recognized by the scientific community and followed in future labs. A 5-stage scoping review, following Arksey and O’Malley’s (2005) framework, was used to map out the coverage of different aspects of living lab methodology. A systematic search for articles involving living lab framework and older adults published between 2016-2021, was conducted in seven databases. Nine articles were included after review, the majority of which were published in health journals and were from Italy and the United States. An overview of consistent user involvement in the innovation process, real-world testing vs. laboratory testing, and participant scope findings will be shared. Multiple rounds of user feedback, real-world testing, and a small but diverse participant group were the most successful in increasing positive sentiments about the products tested in a living lab environment. The lack of published articles on living lab frameworks studying older adults indicate a gap in the literature. Creating a universally accepted definition for living labs and guidelines for best practices will allow for scientific validity and comparisons of studies and may increase the use and popularity of living labs.

There is a growing body of literature regarding living labs, which are seen as an effective way to develop and evaluate research for novel products and services with the actual end users. With growth in the living labs model, there is an increasing need for guidelines to steer and support the set-up and maintenance of initiatives, and to facilitate relationships and engagement with stakeholders and users in this context. This study seeks to address this need, in part, by exploring the needs, expectations, and motivations that older adults have in relation to research participation in an emerging living lab. This work is part of a wider research project to develop an integrated framework to guide emerging living labs. Eight semi-structured interviews were undertaken with six residents and two family members from two residential settings for older adults that were collaborating to establish a living lab environment. A concept-driven coding frame supported the coding and analysis of the interview transcripts. The results provide insights in relation to participant motivation to take part in research, and they identify some issues of concern for participants, both residents and family members, related to living lab initiatives. As a first step in developing a successful living lab culture of collaborative research, this study has demonstrated that open discussion with residents and their families should continue to guide processes and research design as the emerging living lab initiative continues.

BackgroundLiving Labs are user-centered, open innovation ecosystems based on a systematic user cocreation approach, which integrates research and innovation processes in real-life communities and settings. The Horizon 2020 Project VITALISE (Virtual Health and Wellbeing Living Lab Infrastructure) unites 19 partners across 11 countries. The project aims to harmonize Living Lab procedures and enable effective and convenient transnational and virtual access to key European health and well-being research infrastructures, which are governed by Living Labs. The VITALISE consortium will conduct joint research activities in the fields included in the care pathway of patients: rehabilitation, transitional care, and everyday living environments for older adults. This protocol focuses on health and well-being research in everyday living environments.ObjectiveThe main aim of this study is to cocreate and test a harmonized research protocol for developing big data–driven hybrid persona, which are hypothetical user archetypes created to represent a user community. In addition, the use and applicability of innovative technologies will be investigated in the context of various everyday living and Living Lab environments.MethodsIn phase 1, surveys and structured interviews will be used to identify the most suitable Living Lab methods, tools, and instruments for health-related research among VITALISE project Living Labs (N=10). A series of web-based cocreation workshops and iterative cowriting processes will be applied to define the initial protocols. In phase 2, five small-scale case studies will be conducted to test the cocreated research protocols in various real-life everyday living settings and Living Lab infrastructures. In phase 3, a cross-case analysis grounded on semistructured interviews will be conducted to identify the challenges and benefits of using the proposed research protocols. Furthermore, a series of cocreation workshops and the consensus seeking Delphi study process will be conducted in parallel to cocreate and validate the acceptance of the defined harmonized research protocols among wider Living Lab communities.ResultsAs of September 30, 2021, project deliverables Ethics and safety manual and Living lab standard version 1 have been submitted to the European Commission review process. The study will be finished by March 2024.ConclusionsThe outcome of this research will lead to harmonized procedures and protocols in the context of big data–driven hybrid persona development among health and well-being Living Labs in Europe and beyond. Harmonized protocols enable Living Labs to exploit similar research protocols, devices, hardware, and software for interventions and complex data collection purposes. Economies of scale and improved use of resources will speed up and improve research quality and offer novel possibilities for open data sharing, multidisciplinary research, and comparative studies beyond current practices. Case studies will also provide novel insights for implementing innovative technologies in the context of everyday Living Lab research.International Registered Report Identifier (IRRID)DERR1-10.2196/34567

More travel, more well-being of older adults? A longitudinal cohort study in China

Facing the <scp>COVID</scp>‐19 Winter: Ethical Lessons for Treating Older Adults

BackgroundLiving labs in the health and well-being domain have become increasingly common over the past decade but vary in available infrastructure, implemented study designs, and outcome measures. The Horizon 2020 Project Virtual Health and Wellbeing Living Lab Infrastructure aims to harmonize living lab procedures and open living lab infrastructures to facilitate and promote research activities in the health and well-being domain in Europe and beyond. This protocol will describe the design of a joint research activity, focusing on the use of innovative technology for both rehabilitation interventions and data collection in a rehabilitation context.ObjectiveWith this joint research activity, this study primarily aims to gain insight into each living lab’s infrastructure and procedures to harmonize health and well-being living lab procedures and infrastructures in Europe and beyond, particularly in the context of rehabilitation. Secondarily, this study aims to investigate the potential of innovative technologies for rehabilitation through living lab methodologies.MethodsThis study has a mixed methods design comprising multiple phases. There are two main phases of data collection: cocreation (phase 1) and small-scale pilot studies (phase 2), which are preceded by a preliminary harmonization of procedures among the different international living labs. An intermediate phase further allows the implementation of minor adjustments to the intervention or protocol depending on the input that was obtained in the cocreation phase. A total of 6 small-scale pilot studies using innovative technologies for intervention or data collection will be performed across 4 countries. The target study sample comprises patients with stroke and older adults with mild cognitive impairment. The third and final phases involve Delphi procedures to reach a consensus on harmonized procedures and protocols.ResultsPhase 1 data collection will begin in March 2022, and phase 2 data collection will begin in June 2022. Results will include the output of the cocreation sessions, small-scale pilot studies, and advice on harmonizing procedures and protocols for health and well-being living labs focusing on rehabilitation.ConclusionsThe knowledge gained by the execution of this research will lead to harmonized procedures and protocols in a rehabilitation context for health and well-being living labs in Europe and beyond. In addition to the harmonized procedures and protocols in rehabilitation, we will also be able to provide new insights for improving the implementation of innovative technologies in rehabilitation.International Registered Report Identifier (IRRID)PRR1-10.2196/34537

Do COVID-19 Control Guidelines for Long-Term Care Facilities Include Oral Healthcare Orientations?

Living labs integrated into smart city development offer promising strategies for citizen engagement and participatory urban planning. This study introduces a comprehensive framework for quantitatively analyzing living labs' impact on citizens' capabilities and smart city perceptions. Through a case study of Min-Lab in Tsukuba, Japan, we examined how participation influences knowledge acquisition, civic engagement, and attitudes toward smart city initiatives. Survey data from 143 participants were analyzed using statistical methods to evaluate living labs' effectiveness in fostering citizen empowerment. Results showed significant improvements in participants' technological knowledge and civic pride across all participation levels. The study revealed positive correlations between living lab-induced capabilities and perception shifts regarding smart cities. Notably, older adults demonstrated substantial knowledge gains, suggesting living labs' potential to address digital divides. Our findings indicate that living labs can serve as effective platforms for enhancing citizen capabilities and aligning smart-city deployment with community expectations. These evidence-based insights support integrating living labs into smart city strategies for more inclusive urban development.

Introduction: As Earth’s population is rapidly aging, the question of how best to care for its older adults suffering from psychiatric disorders is becoming a constant and growing preoccupation. Depression is one of the most common psychiatric disorders among older adults, and depressed nursing home residents are at a particularly high risk of a decreased quality of life. The complex requirements of supporting and caring for depressed older adults in nursing homes demand the development and implementation of innovative clinical and organizational models that can ensure early identification of the disorder and high-quality multidisciplinary services for dealing with it. This perspective article aims to provide an overview of the literature and the state of the art of and the urgent need for research on the epidemiology and clinical treatment of depression among older adults. Method: In collaboration with a medical librarian, we conducted literature and bibliometric reviews of published articles in Medline Ovid SP from inception until September 30, 2020, to identify studies related to depression, depressive symptoms, mood disorders, dementia, cognitive disorders, and health complications in long-term care facilities and nursing homes. Results: We had 38,777 and 40,277 hits for depression and dementia, respectively, in long-term care facilities or nursing homes. The search equation found 536 and 1,447 studies exploring depression and dementia, respectively, and their related health complications in long-term care facilities or nursing homes. Conclusion: Depression’s relationships with other health complications have been poorly studied in long-term care facilities and nursing homes. More research is needed to understand them better.

The well-being of older adults is significantly influenced by their adult children, especially in countries with less developed welfare systems. We aim to examine the relationship between children’s intergenerational support, children’s socioeconomic status and the well-being of older adults, as well as compare the differences among various elderly groups. The data in our research are from the 2014 China Longitudinal Aging Social Survey. The survey covered 29 provinces, autonomous regions and municipalities in China with 9146 valid samples. We adopted descriptive statistical analysis and structural equation modeling to analyze the data, and the bootstrap method to test the mediating effects. Our results indicate that the children’s education level and intergenerational support do not significantly affect the well-being of all groups of older adults in China. However, the financial conditions of adult children have a significant and direct impact on the well-being of all groups of older adults. From one child to multiple children, the impact of children’s financial condition on the well-being of older adults is 0.360, 0.452, 0.412 in three urban groups and 0.496, 0.468, 0.443 in three rural groups, specifically. The influence of adult children’s financial conditions on the well-being of all groups of older adults in China is significant, surpassing that of children’s education level and intergenerational support. Moreover, the impact of children’s socioeconomic status on the well-being of older adults is primarily through direct effects, with minimal intervention from intergenerational support. For older adults in China, "whether my children are living well" is more important than "what they could give me".

To investigate the relationships between demographic characteristics of the elderly, type of long-term care (LTC) facilities, and the reasons for moving into LTC facilities. Research participants included people aged over 65 years, living in LTC facilities. A total of 1280 questionnaires were distributed to 111 LTC facilities in Taiwan; 480 questionnaires were retrieved, and 232 were included in the valid sample. The study used a non-linear canonical correlation analysis, which assesses the relationships among similar sets of categorical variables. The results showed that the older adults in quadrant I were characterized by being involved in the decision-making regarding the choice of LTC facilities and received economic support from their children. The older adults in quadrant II mainly lived in LTC facilities to receive medical care, whereas those in quadrant III typically included individuals with low income, who did not choose to live in LTC facilities. Furthermore, those in quadrant IV had positive cognitions associated with LTC facilities. We believe that the results of the present study will facilitate policy-making in the field of LTC, provide reference to the practitioners and the older adults, and identify the types of decisions older adults make when moving into LTC facilities, thus assisting older adults to improve their strategies regarding staying in LTC facilities. Geriatr Gerontol Int 2017; 17: 1319-1327.