Background: The coronavirus disease 2019 (COVID‐19) pandemic has highlighted the importance of using information and communication technology (ICT) to address daily and healthcare needs. The barriers for older adults in the United States to learn a new technology to go online during the pandemic remain to be studied. Methods: Using data from the 2019–2020 National Health and Aging Trends Study (NHATS), a nationally representative survey of older Medicare beneficiaries aged 65 years and older in the United States, we used multivariable logistic regression models to identify sociodemographic and clinical factors associated with learning a new technology to go online during the COVID‐19 pandemic. Results: Our sample represented 23,547,688 older adults nationally, of which the majority (60.2%) increased ICT use during the COVID‐19 pandemic. However, most older adults (71.8%) did not report learning a new technology to go online. Those who did not learn a new technology to go online had less of an increase in ICT use than those who learned either with help or by themselves (50.7% vs. 78.4% or 89.2% respectively, p < 0.01). The odds of learning a new technology decreased with increasing age (aOR [95%CI] = 0.96 [0.94–0.98]), being male (aOR [95%CI] = 0.56 [0.45–0.72]), having lower than high school educational attainment (aOR [95%CI] = 0.38 [0.29–0.50]), decreasing income levels (aORs ranged from 0.28 to 0.54), and self‐reported fair or poor general health (aOR [95%CI] = 0.65 [0.47–0.90]). Conclusion: The identified sociodemographic and clinical factors could inform targeted intervention strategies to improve ICT use among older adults during the evolving COVID‐19 pandemic and in the future.

INTRODUCTION: Although recent guidelines recommend endoscopic resection of rectal neuroendocrine tumors (NET) ≤10 mm, there is no consensus on which endoscopic modality should be performed. We aimed to compare the safety and efficacy of modified cap-assisted endoscopic mucosal resection (mEMR-C) and endoscopic submucosal dissection (ESD) methods for the treatment of rectal NET ≤10 mm. METHODS: A randomized noninferiority trial comparing mEMR-C and ESD was conducted. The primary outcome was the histological complete resection rate; the secondary outcomes included en bloc resection rate, operation time, complications, and so on. Subgroup analyses and follow-up were also performed. RESULTS: Ninety patients were enrolled, and 79 patients with pathologically confirmed rectal NET were finally analyzed, including 38 cases of mEMR-C and 41 cases of ESD. Histological complete resection rate was 97.4% in the mEMR-C group and 92.7% in the ESD group. The noninferiority of mEMR-C compared with that of ESD was confirmed because the absolute difference was 4.7% (2-sided 90% confidence interval, −3.3% to 12.2%; P = 0.616). En bloc resection and successful removal of rectal NET were achieved in all patients. Advantages of mEMR-C over ESD included shorter operation time (8.89 ± 4.58 vs 24.8 ± 9.14 minutes, P < 0.05) and lower hospitalization cost ($2,233.76 ± $717.70 vs $2,987.27 ± $871.81, P < 0.05). Postoperative complications were recorded in 4 patients who received mEMR-C and 2 patients in the ESD group (11.5% vs 4.9%, P = 0.509), which were all well managed using endoscopy. Similar findings were observed when subgroup analysis was performed. DISCUSSION: mEMR-C is noninferior to ESD with a similar complete resection rate. In addition, mEMR-C had shorter procedure duration time and lower hospitalization costs. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03982264.

We assessed the association between physical activity (PA) patterns and cognitive health. Using the 2011–2014 National Health and Nutrition Examination Survey data among older adults (≥60 years), we defined scoring below the 25th percentile in the average z-scores from 3 cognitive tests as having low cognitive performance. We used latent class analysis to categorize PA patterns and examined their association with cognitive performance using logistic regressions while adjusting for relevant covariates. We identified three PA groups: inactive (50.2%), moderate intensity leisure (34.5%), and high intensity multiple activities (15.3%). Compared to the inactive group, the moderate intensity leisure and high intensity multiple activities groups were less likely to have low cognitive performance (adjusted proportion ratio .85; 95% CI: .75, .94; and .76; 95% CI: .57, .96). The results highlight the need for improving cognitive health of a large proportion of physically inactive older adults by promoting multiple types of PA.