Background: Many technology-assisted innovations have been used to manage disease. However, most of these innovations are not broadly used by older adults due to their cost. Additionally, disease management through technology-assisted innovations has not been compared with other interventions. Objective: In this study, we tested the employment of a free and widely used social and communication app to help older adults with diabetes manage their distress and glycemic control. We also compared the effectiveness of the app with 2 other methods, namely telephone and conventional health education, and determined which subgroup experiences the most effects within each intervention. Methods: Adults aged ≥50 years with type 2 diabetes were recruited from Southern Taiwan (N=231) and were allocated to different 3-month interventions. Informed consent was obtained at the Ministry of Science and Technology and approved by the National Cheng Kung University Hospital Institutional Review Board (No. A-ER-102-425). Results: Participants in the mobile-based group had significant reductions in hemoglobin A1c compared with the telephone-based and usual care groups (mean changes of –0.4%, 0.1%, and 0.03%, respectively; P=.02). Diabetes-specific distress decreased to a greater extent in the mobile-based group compared to the other 2 groups (mean changes of –5.16, –3.49, and –2.44, respectively, P=.02). Subgroup analyses further revealed that the effects on reducing blood glucose levels in the social and communication app groups were especially evident in patients with lower distress scores, and diabetes-related distress was especially evident in participants who were younger than 60 years or had higher educational levels. Conclusions: The findings of this study inform more flexible use of social and communication apps with in-person diabetes education and counselling.

Objective: Chronic kidney disease (CKD) is irreversible and linked with various adverse health outcomes and diminished quality of life. Although obesity is recognized as a risk factor for the progression of kidney damage, reliance solely on body mass index (BMI) to measure obesity has been increasingly questioned. The use of other indicators that reflect more on abdominal adiposity like waist circumference (WC) have been proposed. This study aims to determine whether WC can serve as an alternative predictor of kidney damage progression. Methods: This prospective study enrolled individuals with normal kidney function during their annual health checkups from April 2016 to March 2019. Data on BMI, WC, WC-related devices, health-related lifestyle, and comorbidities were collected at baseline. WC was categorized using various definitions and analyzed for its association with the risk of kidney damage progression, taking into account BMI categories. The participants were monitored until March 2023 to observe kidney damage progression. Results: Out of the 4,129 participants, WC showed a higher risk of kidney damage progression in males (HR=1.01–1.39, p-value<0.05). These associations were not observed in females. After adjusting for BMI categories, the associations disappeared. Males in the overweight BMI category, defined as a BMI ≥ 25 kg/m², showed a significantly increased risk of kidney damage progression (HR = 1.69, p-value < 0.0001). Conclusions: The findings indicate that waist circumference significantly affects the progression of kidney damage in males. However, the study also reaffirms BMI as a dependable predictor of kidney damage. It underscores the importance of maintaining normal ranges for both BMI and waist circumference to reduce the risk of progressing kidney damage.

Diabetic overweight patients are more likely to show the progression of kidney damage than the general population. The majority of people in the early stages of kidney damage do not recognize the importance of risk modification, mainly due to the asymptomatic nature of the disease. This study aimed to examine specific risk combinations of lifestyle and BMI regarding the deterioration of kidney function and to explore whether there are gender-based differences among the prediabetic population. Prediabetic participants with normal kidney function were identified via annual health examination from April 2016 to March 2019. The information on health status and lifestyle was collected at enrollment. The study subjects were followed until March 2021 to observe the progression of kidney damage. There were 2241 participants enrolled in this study. Smoking (HR = 3.5, p < 0.001), eating snacks (HR = 3.2, p < 0.001), not engaging in regular exercise (HR = 2.9, p < 0.001), and not having adequate sleep (HR = 3.0, p < 0.001) showed accelerated risks for kidney damage progression among the prediabetic population in males. These lifestyle effects were not observed in females. In conclusion, risk-based modification of lifestyle behavior is important to prevent kidney function damage among the overweight prediabetic population in males.

Aim: Early detection of dementia is crucial for effective intervention. The computer-based cognitive assessment tool (CompBased-CAT) was designed to assess cognitive function using a tablet computer. While its predictive validity for mild cognitive impairment (MCI) is established, its test–retest reliability remains unclear. This study aimed to evaluate the test–retest reliability of CompBased-CAT among older Japanese adults in a community setting. Methods: This is a methodological study that examined the test–retest reliability of CompBased-CAT. Community-dwelling older adults aged 65 years or older who participated in both the pre-test and post-test were included. Pre-test assessments were conducted during the 2023 Otassha study from 28 September to 8 October 2023, with the post-test administered 62 days (±14 days) later. Subtest scores were normalized to z-scores, and the total CompBased-CAT score was computed by summing these z-scores. Test–retest reliability was assessed using paired t-tests and intraclass correlation coefficient (ICC) two-way random-effects models, with analyses stratified by age, sex, and MCI status. Results: A total of 80 participants (mean age: 76.8 years; 27.5% male) were analyzed. Paired t-tests showed no significant difference in total scores between the pre-test (mean = −0.75; standard deviation [SD] = 3.73) and the post-test (mean = −0.42; SD = 4.45). The total score exhibited an ICC of 0.64 (95% confidence interval [CI] = 0.49–0.75) for all participants, increasing to 0.74 (95% CI = 0.48–0.88) among those with MCI. Conclusion: CompBased-CAT demonstrated good test–retest reliability, with an ICC of 0.64 among all participants, which increased to 0.74 among participants with MCI over a 2-month period, indicating its potential for monitoring cognitive function through repeated assessments.

BACKGROUND Many technology-assisted innovations have been used to manage disease. However, most of these innovations are not broadly used by older adults due to their cost. Additionally, disease management through technology-assisted innovations has not been compared with other interventions. OBJECTIVE In this study, we tested the employment of a free and widely used social and communication app to help older adults with diabetes manage their distress and glycemic control. We also compared the effectiveness of the app with 2 other methods, namely telephone and conventional health education, and determined which subgroup experiences the most effects within each intervention. METHODS Adults aged ≥50 years with type 2 diabetes were recruited from Southern Taiwan (N=231) and were allocated to different 3-month interventions. Informed consent was obtained at the Ministry of Science and Technology and approved by the National Cheng Kung University Hospital Institutional Review Board (No. A-ER-102-425). RESULTS Participants in the mobile-based group had significant reductions in hemoglobin A1c compared with the telephone-based and usual care groups (mean changes of –0.4%, 0.1%, and 0.03%, respectively; P=.02). Diabetes-specific distress decreased to a greater extent in the mobile-based group compared to the other 2 groups (mean changes of –5.16, –3.49, and –2.44, respectively, P=.02). Subgroup analyses further revealed that the effects on reducing blood glucose levels in the social and communication app groups were especially evident in patients with lower distress scores, and diabetes-related distress was especially evident in participants who were younger than 60 years or had higher educational levels. CONCLUSIONS The findings of this study inform more flexible use of social and communication apps with in-person diabetes education and counselling.