An increasing number of older adults are using computers for communication, entertainment, and information. This descriptive study examined the perceived benefits and barriers encountered by 58 older adults. Benefits of computer use listed by these elders included a sense of connectedness, satisfaction, utility, and positive learning experiences. Barriers included frustration, physical and mental limitations, mistrust, and time issues. Professionals who teach and care for older adults need to be aware of the characteristics of older computer users. They also need to know the perceived barriers and benefits of computer, Internet, and e-mail use in order to tailor education and interventions to this population.

Engagement in social and leisure activities is an indicator of quality of life and well-being in nursing homes. There are few studies in which nursing home residents with dementia self-reported their experiences in activity engagement. This qualitative study describes types of current activity involvement and barriers to activities as perceived by nursing home residents with dementia. Thirty-one residents participated in short, open-ended interviews and six in in-depth interviews. Thematic content analysis showed that participants primarily depended on activities organized by their nursing homes. Few participants engaged in self-directed activities such as walking, visiting other residents and family members, and attending church services. Many residents felt they had limited opportunities and motivation for activities. They missed past hobbies greatly but could not continue them due to lack of accommodation and limitation in physical function. Environmental factors, along with a fixed activity schedule, further prevented them from engaging in activities. Residents with dementia should be invited to participate in activity planning and have necessary assistance and accommodation in order to engage in activities that matter to them. Based on the findings, a checklist for individualizing and evaluating activities for persons with dementia is detailed.

Mild cognitive impairment (MCI) is recognized as a transitional phase in the progression toward more severe forms of dementia and is an early precursor to Alzheimer's disease. Previous neuroimaging studies reveal that MCI is associated with aberrant sensory–perceptual processing in cortical brain regions subserving auditory and language function. However, whether the pathophysiology of MCI extends to speech processing before conscious awareness (brainstem) is unknown. Using a novel electrophysiological approach, we recorded both brainstem and cortical speech-evoked brain event-related potentials (ERPs) in older, hearing-matched human listeners who did and did not present with subtle cognitive impairment revealed through behavioral neuropsychological testing. We found that MCI was associated with changes in neural speech processing characterized as hypersensitivity (larger) brainstem and cortical speech encoding in MCI compared with controls in the absence of any perceptual speech deficits. Group differences also interacted with age differentially across the auditory pathway; brainstem responses became larger and cortical ERPs smaller with advancing age. Multivariate classification revealed that dual brainstem–cortical speech activity correctly identified MCI listeners with 80% accuracy, suggesting its application as a biomarker of early cognitive decline. Brainstem responses were also a more robust predictor of individuals' MCI severity than cortical activity. Our findings suggest that MCI is associated with poorer encoding and transfer of speech signals between functional levels of the auditory system and advance the pathophysiological understanding of cognitive aging by identifying subcortical deficits in auditory sensory processing mere milliseconds (<10 ms) after sound onset and before the emergence of perceptual speech deficits.SIGNIFICANCE STATEMENTMild cognitive impairment (MCI) is a precursor to dementia marked by declines in communication skills. Whether MCI pathophysiology extends below cerebral cortex to affect speech processing before conscious awareness (brainstem) is unknown. By recording neuroelectric brain activity to speech from brainstem and cortex, we show that MCI hypersensitizes the normal encoding of speech information across the hearing brain. Deficient neural responses to speech (particularly those generated from the brainstem) predicted the presence of MCI with high accuracy and before behavioral deficits. Our findings advance the neurological understanding of MCI by identifying a subcortical biomarker in auditory–sensory processing before conscious awareness, which may be a precursor to declines in speech understanding.

Background: Digital technology has dramatically changed the world in which we live, and the ability to access and understand information through these new technologies is becoming increasingly important. eHealth literacy is closely related to digital literacy, and some concepts may overlap to a certain extent. Identifying personal and digital-related factors related to eHealth literacy levels in middle-aged adults would be useful for planning tailored interventions and health promotion strategies. Objective: We aimed to identify the differences in digital literacy and eHealth literacy levels according to demographic features, and to elucidate the factors associated with eHealth literacy in the middle-aged population. Methods: We conducted a cross-sectional, observational study from 4th to 8th February 2021. A total of 320 South Korean participants aged 40–64 years were recruited and completed an online questionnaire, where demographic features, chronic disease status, frequency of Internet use, digital skills, digital competence, and eHealth literacy were measured. eHealth literacy was measured with the eHEALS. We used multiple regression analysis to elucidate the factors associated with eHealth literacy. Results: Multiple regression analysis revealed that digital competence was the highest contributor to an individual's eHealth literacy ( β = 0.330, P < 0.001), while digital skills was not significantly associated with eHealth literacy ( β = 0.086, P = 0.267). In addition, eHealth literacy was positively associated with increasing age ( β = 0.258, P < 0.001), female gender ( β = −0.118, P = 0.022), and higher education levels ( β = 0.114, P = 0.041), while marital state, chronic disease, and frequency of internet use were not significantly associated with eHealth literacy. Conclusions: Our study provides valuable information on digital literacy and eHealth literacy in middle-aged adults and may be used to guide tailored interventions for improving eHealth literacy. Future studies should consider the differences in digital literacy levels across generations when assessing eHealth literacy or planning digital health interventions.

Background: Fear of falling is a persistent concern about falls that commonly occur in older adults. Recently, it has been argued that fear of falling doesn’t simply mean a state of low falls efficacy, but is a concept distinct from falls efficacy. However, the two concepts are still indistinguishable. Therefore, it is necessary to understand the unique characteristics of the fear of falling. This study aims to analyze the concept of ‘fear of falling’ faced by older adults. Methods: This study is designed as a concept analysis. A concept analysis was conducted by Walker & Avant’s eight-step concept analysis method. A total of 16 pieces of literature were selected by inclusion and exclusion criteria from those published in Pubmed and Scopus between 1993 and 2022 on 8 November 2022. Results: Two antecedents, four attributes, and five consequences were identified. Apprehension caused by the unpredictable nature of falls, unease related to one’s vulnerability, high vigilance-related to the environment, and concern about potential harm after fall events were presented as attributes of fear of falling in older adults. There were two antecedents of fear of falling which were awareness of falls and near falls, and direct/indirect experience about falls and near falls. As consequences of fear of falling, protective effect, activities curtailment, reduction in radius of living, restricted freedom, and limited social activities were reported. Conclusion: It was confirmed that falls and the fear-inducing process were fused to constitute the unique characteristics of the fear of falling. This can be presented as an important basis for future research on the fear of falling or dealing with various aspects of the fear of falling in the clinical field.

Severe staff shortages in long-term care (LTC) make it difficult to meet the demands of the growing aging population. Further, technology-savvy Baby Boomers are expected to reshape the current institutional environments toward gaining more freedom and control in their care and lives. Voices from business, academia, research, advocacy organizations, and government bodies suggest that innovative technological approaches are the linchpin that may prepare society to cope with these projected demands. In this article, we review the current state of aging-related technology, identify potential areas for efficacy testing on improving the quality of life of LTC residents in future research, and discuss barriers to implementation of LTC technology. Finally, we present a vision of future technology use that could transform current care practices.