Clinical Applications of Technology in Aging

Fellow clinical gerontologists, various technology platforms are promoted for self-managed health for medication self-management, exercise promotion, activity engagement, cognition, and other areas. But is such use effective and well-received by older adults? Four articles in this issue address clinical applications of technology in aging. The advertisement of computerized cognitive training (CCT) or “brain games” to “prevent dementia” continues in popular media and in direct-toconsumer advertisement. How can the clinician give an informed response when an older adult asks about the utility of CCT for this purpose? O’Shea and colleagues report 9 of 12 studies find CCT improves episodic memory performance; however there is no evidence that such interventions would prevent dementia (O’Shea, De Wit, & Smith, 2017). Their article provides helpful definitions of cognitive training, cognitive stimulation, and cognitive rehabilitation to assist in responding to questions potentially posed by older clients. Tablets are used increasingly in healthcare settings, but are they effective? In their systematic review of 12 studies, Ramprasad and colleagues find good evidence for user satisfaction with tablets but not for improving clinical outcomes (Ramprasad, Tamariz, Garcia-Barcena, Nemeth, & Palacio, 2017). Virtual reality (VR) may be a mechanism to bring personally meaningful activities to adults with mobility limitations, but is VR acceptable to older adults? Seven focus groups examine reactions to VR in 41 older adults living in a continuing care retirement community (Roberts, Schutter, Franks, & Radina, 2018). Qualitative analyses detail a range of positive and negative perceptions, providing direction for improving success in future applications of VR. Automatedmedication dispensers (AMD) increase medication adherence in the short term what about the long term? In our Clinical Comments section an increase in medication adherence and decrease in caregiver burden is described in four individuals diagnosed with Alzheimer’s dementia who used AMD for at least three years (Kamimura, 2017). In other articles we continue with our longstanding interest in caregiving research. New articles articulate the role of relationship strain, attentional flexibility, and self-compassion in coping with caregiving stress (Lloyd, Muers, Patterson, & Marczak, 2018; Morimoto, Furuta, Kono, & Kabeya, 2017; Pine & Steffen, 2017). Readers interested in more about compassion focused interventions may refer to Collins and colleagues (Collins, Gilligan, & Poz, 2018). Two larger scale studies in this issue investigate social aspects of aging. In the first study, nearly half of 2,449 older adults admitted to an urban medical hospital in the United States were found to be at risk of social isolation with the oldest and persons of color at greatest risk (Ha, Hougham, & Meltzer, 2018). In the second study, low social capital (friend and family networks) mediated the relationship between stress in depression in 2,362 older adults drawing from the United States National Social Life, Health, and Aging Project study sample (An, Jung, & Lee, 2018). Next up are two studies that use innovative methods to extend our understanding of quality of life. Jiange and Lu (Jiang & Lu, 2018) model mental health and mental illness using a two-axis model in 12,389 adults age 50+ living in China. This approach allows for distinct considerations of predictors of wellness and illness. Robleda & Pachana (Robleda & Pachana, 2017) use “leximancer” analysis of qualitative data to describe age differences in domains most relevant for quality of life in 153 adults age 50+ living in Australia. Finally, we return to consider social aspects of aging in a thoughtful study by Diaz and colleagues (Garcia Diaz, Savundranayagam, Kloseck, & Fitzsimmons,