Background Technology offers opportunities to support older adults with mild cognitive impairments to remain independent and socially connected, but is often not used. Although determinants of technology use among older adults in general are well studied, much less is known about how these factors impact technology use behaviour in cognitively impaired older adults. This study aimed to bridge this gap in research by examining the factors underlying technology use in community-dwelling older adults with mild cognitive impairments. Methods We applied a generic qualitative design and used 16 semi-structured interviews to collect data from Belgian (Flemish) community-dwelling older adults diagnosed with Mild Cognitive Impairment or dementia and informal caregivers. To get data from different perspectives, a focus group with professional caregivers was added. We used thematic analysis with an inductive approach to identify and select themes from the data. Results We identified two themes: introduction of technology and determinants of technology adoption and continued use. Successful technology adoption in cognitively impaired older adults is need-driven and subject to individual, technological and contextual characteristics. Specific for older adults with cognitive impairments are the importance of disease awareness and cognitive ability for adoption and continued use, respectively. Although social support can be a valuable alternative to technology, it is an important facilitator of continued technology use in these older adults. Similarly, integration of technologies in daily routines can buffer discontinuation of technologies. Conclusions Future research is encouraged to validate our findings in a postpandemic era and to further develop a novel theoretical framework for technology acceptance among older adults with cognitive impairments. Moreover, identification of crucial determinants as well as strategies to remove use barriers are also important future research tasks. Clinical practice should focus on improving disease awareness to facilitate technology adoption and policies should invest in training and support of professional caregivers and in reimbursement strategies to facilitate implementation of technology in practice.

Background The impact of rheumatic and musculoskeletal diseases is significant worldwide. Progress in disease management has put current care models under pressure. Mobile Health solutions may constitute a solution for these changes. However, vulnerable populations groups including people with a migration or ethnic background different from the host country, people with low socio-economic status and people with low (digital) literacy skills seem to be underrepresented in mHealth research and practice. Main body In this editorial, we propose tailored interventions with mobile health applications on three levels including patient-related strategies, healthcare provider-related strategies and healthcare system-related strategies to solve this unmet need for patients from vulnerable populations groups with rheumatic and musculoskeletal diseases. Patient-related mobile health strategies should focus on increasing self-efficacy and enabling peer-education. Gamification could be a solution to motivate patients to use mobile health. On the level of the healthcare provider, we propose strategies including technology-enhanced learning and adaptative communication strategies, to tailor mobile health towards vulnerable populations groups with rheumatic and musculoskeletal diseases. Regarding healthcare system-related strategies, the aim is to increase minority participation in research in a cost-effective manner by remote longitudinal data tracking, using teleconsultation or remote symptom monitoring devices to ensure quality care for all patients with rheumatic and musculoskeletal diseases, even in vulnerable populations groups that are normally hard to reach. Conclusion Vulnerable population groups in rheumatic and musculoskeletal diseases are underrepresented in mobile health research and practice. Evidence is sparce on the scale of the digital divide between patients using or not using mobile health. Interventions that directly attempt to reduce health disparities among vulnerable populations groups are needed to guarantee all patients with rheumatic and musculoskeletal diseases might be engaged in the rheumatology care of the future.

Although research on sociodemographic correlates of internet use in older adults without and with pronounced cognitive impairment is already quite extensive, much less is known about the relationship between cognitive frailty (CF) and this behaviour. As CF is associated to multidimensional frailty aspects, this study explored the relationship between internet use and CF, operationalised as Subjective Cognitive Impairment, in older adults by means of a comprehensive explanatory model including sociodemographic factors and multiple frailty measures. The dataset included a sample of community-dwelling 60 + older adults that were included in the Belgian Ageing Studies (BAS) and that completed survey questions on (i) internet use frequency and (ii) internet activities. Multidimensional frailty was measured with the CFAI-Plus. The analysis comprised a structural equation modelling (SEM) procedure. Internet use was frequent; however, it became less frequent with higher CF. Moreover, the latter used less tablets as compared to the no-low CF group. Navigating the web, sharing email and online banking were the most frequently reported activities. Tele-communicating with Skype, online shopping and using e-government services were the least frequent. Age, female gender, lower income and living with a partner were also negatively associated with internet use. To conclude, CF, along with other frailty and sociodemographic factors, was negatively related to internet use in older adults. Future research should focus, amongst others, on the dynamic processes underlying internet use in the population of older adults affected by CF.

Objective As worldwide population aging is accelerating, innovative technologies are being developed to support independent living among community-dwelling older adults with mild cognitive decline. However, the successful implementation of these interventions is often challenging. Until now, literature on implementation issues related to the specific context of older adults with mild cognitive decline is lacking and the few studies available do not focus specifically on the perspective of professional caregivers. Yet the perspective of these caregivers is important as they can be considered a key facilitator for technology implementation among this population. Therefore, this study was the first to examine technology implementation among community-dwelling older adults with mild cognitive decline from the broader perspective of professional caregivers. Methods In this qualitative study, two focus groups consisting of a heterogeneous pool of professional caregivers were conducted: one in Quebec (Canada, n = 6) and one in Brussels (Belgium, n = 8). Braun and Clarke’ method for thematic analysis, guided by a qualitative descriptive approach was applied to inductively identify themes from the data. Results We identified factors influencing technology implementation in older adults with mild cognitive decline on three levels: an individual level (e.g., characteristics of older adults with mild cognitive decline and professional caregivers’ attitude), an organizational level (e.g., lack of training among professional caregivers) and a level referring to the broader context (e.g., ethical considerations). Conclusions This study contributes to the research gap in knowledge on the needs of professional caregivers to facilitate technology implementation among the population of older adults with cognitive decline. Future directions for research, practice, and policy are given, more specifically to improve knowledge among caregivers and on the development of decision support to retrieve safe and effective technologies that suit patient-centered care.

The 2020 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic introduced unprecedented disruptions in both working conditions and social life. This lead to a variety of additional stressors for academics. The objective of this study was to determine the effect of the SARS-CoV-2 measures on academics, introduced during the first SARS-CoV-2 wave in Belgium, and to verify possible intervening variables in coping with these measures (stress management). The position, family and home situation of the respondents was checked. A cross-sectional study design was used. The study included 1837 respondents from the different Belgian universities. The overall mental and physical well-being amongst academics was lower during the SARS-CoV-2 measures. The results of a hierarchical regression suggest that decline in physical health is associated with an increase in tasks at home, sickness, less options to plan work and breaks, the self-perceived lower quality of teaching and research and the fear that the measures create a backlog at work. Furthermore, having kids had a negative effect on the work/private life balance, which in turn had an effect on physical well-being. A decline in mental well-being was associated with a fading boundary between work and private life, the necessity to take on more house-keeping tasks, sickness, the fear that the disruptions would create a backlog at work, less control over the work planning and less periods of pause during work.