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BackgroundWearable activity trackers offer potential to optimize behavior and support self-management. To assist older adults in benefiting from mobile technologies, theory-driven deployment strategies are needed to overcome personal, technological, and sociocontextual barriers in technology adoption. ObjectiveTo test the effectiveness of a social group–based strategy to improve the acceptability and adoption of activity trackers by middle-aged and older adults. MethodsA cluster randomized controlled trial was conducted among 13 groups of middle-aged and older adults (≥45 years) performing group dancing (ie, square dancing) as a form of exercise in Guangzhou from November 2017 to October 2018. These dancing groups were randomized 1:1 into two arms, and both received wrist-worn activity trackers and instructions at the baseline face-to-face assessment. Based on the Information-Motivation-Behavior Skill framework, the intervention arm was also given a tutorial on the purpose of exercise monitoring (Information), encouraged to participate in exercise and share their exercise records with their dancing peers (Motivation), and were further assisted with the use of the activity tracker (Behavior Skill). We examined two process outcomes: acceptability evaluated by a 14-item questionnaire, and adoption assessed by the uploaded step count data. Intention-to-treat analysis was applied, with the treatment effects estimated by multilevel models. ResultsAll dancing groups were followed up for the postintervention reassessment, with 61/69 (88%) participants of the intervention arm (7 groups) and 56/80 (70%) participants of the control arm (6 groups). Participants’ sociodemographic characteristics (mean age 62 years, retired) and health status were comparable between the two arms, except the intervention arm had fewer female participants and lower cognitive test scores. Our intervention significantly increased the participants’ overall acceptability by 6.8 points (95% CI 2.2-11.4), mainly driven by promoted motivation (adjusted group difference 2.0, 95% CI 0.5-3.6), increased usefulness (adjusted group difference 2.5, 95% CI 0.9-4.1), and better perceived ease of use (adjusted group difference 1.2, 95% CI 0.1-2.4), whereas enjoyment and comfort were not increased (adjusted group difference 0.9, 95% CI –0.4-2.3). Higher adoption was also observed among participants in the intervention arm, who were twice as likely to have valid daily step account data than their controlled counterparts (adjusted incidence relative risk [IRR]=2.0, 95% CI 1.2-3.3). The average daily step counts (7803 vs 5653 steps/day for the intervention and control, respectively) were similar between the two arms (adjusted IRR=1.4, 95% CI 0.7-2.5). ConclusionsOur social group–based deployment strategy incorporating information, motivation, and behavior skill components effectively promoted acceptability and adoption of activity trackers among community-dwelling middle-aged and older adults. Future studies are needed to examine the long-term effectiveness and apply this social engagement strategy in other group settings or meeting places. Trial RegistrationChinese Clinical Trial Registry ChiCTR-IOC-17013185; https://tinyurl.com/vedwc7h.

Background: Evidence suggests the importance of physical activity and social engagement in cognitive preservation. Group-based dancing combining exercise and prosocial features may generate physical and cognitive benefits. Objectives: To investigate the association between multiyear habitual square dancing and domain-specific cognitive function, and assess the relative importance and joint impact of physical activity and social activity on cognition. Methods: Using the cross-sectional propensity score matching method, the study compared the mental status, episodic memory, and overall cognitive performances of 145 amateur female square-dancing participants (aged ≥45 y) to their sociodemographic- and health-status–matched 222 nondancing counterparts, selected from the China Health and Retirement Longitudinal Study. Results: The authors found a positive association between multiyear square dancing (average 8 y) and overall cognitive performances (mean difference = 2.84; 95% confidence interval [CI], 1.65 to 4.02), which was apparent in processing capacity (2.29; 95% CI, 1.51 to 3.07) but not in memory (0.55; 95% CI, −0.13 to 1.23). The hypothesized synergic effect of physical activity and social activity on cognition was only observed in group-based exercises embodying these 2 components simultaneously. Conclusions: Long-term square dancing as one type of physically and socially engaging activities may preserve cognition. Future longitudinal and interventional studies are needed to further clarify the causal relationship. [ABSTRACT FROM AUTHOR]

Background: Studies have shown the existence of health concordance between patients with type 2 diabetes mellitus (T2DM) and their spouses, and also that spouses could influence the effect of self-management, benefiting patients' health. However, these studies are heterogeneous and the evidence is inconclusive.Objective: To synthesize evidence from published randomized controlled trials: the interventional effects and the quality of study performance, also to identify the research gap and the directions for future studies.Methods: We performed the scoping review by following the PRISMA-ScR guidance. We searched and examined the reports from MEDLINE, EMBASE, PsychInfo, CINAHL Plus by the pre-specified criteria. Key characteristics and information of eligible reports were extracted, analysed and synthesized comprehensively, and the results were presented in the form of words and diagrams.Results: We identified 5 reports from 4 studies out of 3479 records included. Qualified studies indicated a positive effect of couple-based interventions on couples' distress. Insufficient evidence on physiological health or health behaviours was identified owing to the small number of included studies and inconsistent assessment outcomes. The methodological quality across these studies was generally low due to inadequate reporting of study process and substantial biases.Conclusions: Couple-based interventions for patients with T2DM showed small effects on the couple's distress while the effects of other outcomes were inconclusive. Future studies should strengthen methodologies by using standard measures of core diabetic outcomes, including detailed assessments of implementation process, and taking a dyadic approach to systematically examine the effects. [ABSTRACT FROM AUTHOR]

Introduction: It is valuable to identify common latent cognitive constructs for dementia prevalence estimation across Chinese aging cohorts., Methods: Based on cognitive measures of 12015 Chinese Longitudinal Healthy Longevity Survey (CLHLS; 13 items) and 6623 China Health and Retirement Longitudinal Study (CHARLS; 9 items) participants aged 65 to 99 in 2018, confirmatory factor analysis was applied to identify latent cognitive constructs, and to estimate dementia prevalence compared to Mini-Mental State Examination (MMSE) and nationwide estimates of the literature., Results: A common three-factor cognitive construct of orientation, memory, and executive function and language was found for both cohorts with adequate model fits. Crude dementia prevalence estimated by factor scores was similar to MMSE in CLHLS, and was more reliable in CHARLS. Age-standardized dementia estimates of CLHLS were lower than CHARLS among those aged 70+, which were close to the nationwide prevalence reported by the COAST study and Global Burden of Disease., Discussion: We verified common three-factor cognitive constructs for both cohorts, providing an approach to estimate dementia prevalence at the national level., Highlights: Common three-factor cognitive constructs were identified in Chinese Longitudinal Healthy Longevity Survey (CLHLS) and China Health and Retirement Longitudinal Study (CHARLS).Crude dementia estimates using factor scores were reliable in both cohorts.Estimates of CHARLS were close to current evidence, but higher than that of CLHLS., Competing Interests: The authors have no relevant conflicts of interest to disclose. Author disclosures are available in the supporting information., (© 2022 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)

This report introduces the nursing caring experience with a male patient with frontotemporal dementia (FTD) who was hospitalized in an acute psychiatric ward from March 5th to April 30th, 2012 due to the clinical manifestations of verbally expressive impairment, aggression, and subsequent caregiver burden. The patient was assessed according to the guidelines of clinical competencies for mental health nursing assessments developed by the Psychiatric Mental Health Nurses Association. Three clinical diagnoses were identified after this assessment, including (1) impaired verbal communication, (2) chronic confusion, and (3) caregiver role strain. The current report focuses only on the clinical issue of impaired verbal communication. We adopted a props-integrated communicative approach by integrating props and physical motions with communicative strategies. This approach enabled us to formulate a patient-centered communicating model and prompt for active expression and adequate communication, which ultimately resolved the patient's aggression problem. In addition, we provided psychoeducation to the family members in order to teach them the relevant knowledge, skills, and approaches that caregivers may use to enhance their caring capabilities and reduce the burden of caregiving. This successful experience may be used as a reference in caring for FTD patients with communicative impairments. Our proposed approach integrates props with simple language and develops an appropriate communicating model to provide high quality care for patients.