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BackgroundCognitive frailty, defined as having both physical frailty and cognitive impairment that does not satisfy the criteria for Major Neurocognitive Disorder, represents an elevated risk for morbidity. Hence, it is crucial to mitigate such risks. Physical activity interventions have been found effective in protecting against physical frailty and cognitive deterioration. This pilot RCT examines if smartwatches and mobile phone applications can help to increase physical activity, thereby improving physical and cognitive outcomes.MethodsOlder individuals (n = 60) aged 60 to 85 years old will have their physical activity tracked using a smartwatch. The subjects will be randomized into two arms: one group will receive daily notification prompts if they did not reach the recommended levels of PA; the control group will not receive prompts. Outcome variables of physical activity level, neurocognitive scores, and physical frailty scores will be measured at baseline, T1 (3 months), and T2 (6 months). Sleep quality, levels of motivation, anxiety, and depression will be controlled for in our analyses. We hypothesize that the intervention group will have higher levels of physical activity resulting in improved cognitive and physical outcomes at follow-up. This study was approved by the National University of Singapore's Institutional Review Board on 17 August 2020 (NUS-IRB Ref. No.: H-20-038).DiscussionWearable sensors technology could prove useful by facilitating self-management in physical activity interventions. The findings of this study can justify the use of technology in physical activity as a preventive measure against cognitive frailty in older adults. This intervention also complements the rapidly rising use of technology, such as smartphones and wearable health devices, in our lives today.Registration detailsThis study has been retrospectively registered on clinicaltrials.gov on 5th January 2021 (NCT Identifier: NCT04692974), after the first participant was recruited.

BackgroundDistrust, and more broadly, public perception of government's handling of a crisis, has been a widely studied topic within health crisis research and suggests that these perceptions are significantly associated with the behavior of its citizens.PurposeTo understand which aspects of the public's perception of government handling of the COVID-19 pandemic predicted engagement of protective behaviors among older adults, who are the most vulnerable to COVID-19.MethodsParticipants were recruited from an ongoing biopsychosocial study on aging amongst community-dwelling older adults. There were two rounds of data collection, during the national lockdown and post-lockdown. The average length of follow-up was 5.88 months. N = 421 completed the first round of data collection and N = 318 subsequently completed the second round of questionnaires.ResultsDuring the lockdown, perceptions that pandemic-related measures in place were sufficient, effective, timely, provided a sense of safety, important information was easily accessible, and government handling of the pandemic could be trusted, were found to significantly predict engagement in protective behaviors. During post-lockdown, only perceptions that measures in place were sufficient, provided a sense of safety, and important information was easily accessible, remained significant predictors. The perception that COVID-19 measures were clear and easy to understand now became a significant predictor.ConclusionsPublic perceptions of government handling of the pandemic predicted engagement in protective behaviors but were less important during post-lockdown. To effectively engage older adults in protective behavior, our findings suggest for pandemic-related information to be accessible, introducing timely safety measures, and having easy-to-understand instructions for nuanced measures.

Study objective To investigate the association between family cancer caregivers’ unmet daily needs and emotional states of depression, anxiety and stress across their care recipient’s treatment phases. Method A cross-sectional study design and self-report questionnaires were used. Family caregivers (N = 237) of cancer patients in ambulatory cancer clinics were recruited from May to December 2017, and completed a sociodemographic and medical questionnaire, the Depression Anxiety Stress Scale and Needs Assessment of Family Caregivers-Cancer Scale. Hierarchical linear regression was conducted to examine the influence of each predictor (sociodemographic variables, unmet personal care and role management needs, cancer treatment phase) on the Depression Anxiety Stress Scale total score, depression subscale, anxiety subscale, and the stress subscale. Results Family caregivers’ unmet daily activity needs, in particular higher unmet personal care needs, during the intermediate phase (6–9 months), were significantly associated (ps9 months), the significant association of unmet personal care needs was with overall distress (b = 5.91), anxiety (b = 1.97) and stress (b = 2.53). After completing treatment, unmet role management needs were only significantly associated with stress (b = -1.59). Caregivers’ higher depression was also associated with greater unmet role management needs, regardless of treatment phases. Conclusions Intermediate and chronic cancer treatment phases were identified as having greatest effect on caregivers’ unmet daily activity needs and emotions. Unmet personal care needs played the major effect on overall negative emotional states in the intermediate treatment phase and stress in the chronic treatment phase. Close attention to caregivers needs in intermediate and chronic treatment phases, would be highly beneficial in alleviating negative emotional disturbances.