Understanding community-dwelling older adults' preferences for home- and community-based services: A conjoint analysis.

BACKGROUND: Older adults' preference for home- and community-based service programs has been highlighted as an essential but usually ignored ingredient in current care models. Disentangling how preferences contribute to older adults' decision-making could facilitate finding optimal ways to deliver home- and community-based services in times of increasing scarcity. OBJECTIVE: To identify Chinese community-dwelling older adults' preference structure for home- and community-based services and thus to optimize service provision. METHODS: Conjoint analysis, a preference-based technique, was employed to study older adults' preferences. A stepwise qualitative approach was first adopted to identify the attributes and attribute levels of home- and community-based services. Scenarios were defined through an orthogonal fractional factorial design, and a cross-sectional survey was conducted through a face-to-face, anonymous questionnaire. Conjoint analysis was performed to determine preference weights representing the relative importance of the identified attributes, and cluster analysis was performed to identify clusters of participants with similar preference structures. All data analyses were performed using SAS v9.4 and SPSS 22.0. RESULTS: A total of 321 of 350 invited participants completed the questionnaire. Four attributes were identified and used to create the conjoint scenarios: care-giving attitude, price, technical care-giving skills, and the type of service provider. Care-giving attitude was the most valued attribute for older adults when making decisions (relative importance score = 48.28), followed by price (relative importance score = 21.618), technical care-giving skills (relative importance score = 19.518), and finally, the type of service provider (relative importance score = 10.585). Three preference phenotypes were identified by applying cluster analysis: "price-oriented", "comprehensively balanced", and "attitude-oriented". CONCLUSION: The present study underscored the importance of considering attributes valued by Chinese older adults in the design and delivery of home- and community-based services. The preference structure, including the utility score of the attribute levels, differs among older adults. The findings could inform future research and practice and suggest incorporating flexibility during the service delivery stage.

Artificial intelligence in elderly healthcare: A scoping review.

The ageing population has led to a surge in the adoption of artificial intelligence (AI) technologies in elderly healthcare worldwide. However, in the advancement of AI technologies, there is currently a lack of clarity about the types and roles of AI technologies in elderly healthcare. This scoping review aimed to provide a comprehensive overview of AI technologies in elderly healthcare by exploring the types of AI technologies employed, and identifying their roles in elderly healthcare based on existing studies. A total of 10 databases were searched for this review, from January 1 2000 to July 31 2022. Based on the inclusion criteria, 105 studies were included. The AI devices utilized in elderly healthcare were summarised as robots, exoskeleton devices, intelligent homes, AI-enabled health smart applications and wearables, voice-activated devices, and virtual reality. Five roles of AI technologies were identified: rehabilitation therapists, emotional supporters, social facilitators, supervisors, and cognitive promoters. Results showed that the impact of AI technologies on elderly healthcare is promising and that AI technologies are capable of satisfying the unmet care needs of older adults and demonstrating great potential in its further development in this area. More well-designed randomised controlled trials are needed in the future to validate the roles of AI technologies in elderly healthcare.

The Variability of Mental Timeline in Vertical Dimension.

People often use concrete spatial terms to represent abstract time. Previous studies have shown that mental timeline (MTL) is represented along a horizontal axis. Studies of the mental timeline have demonstrated that compared with English speakers, Mandarin speakers are more likely to think about time vertically (up-down) than horizontally (left-right/front-back). Prior studies have suggested that MTL in the up and down dimensions originated from temporal-spatial metaphors in language. However, there are still a large number of perceptual experiences in the up and down dimensions, such as visual and sensorimotor experience. Then does the visual experience in daily life affect the MTL in the vertical dimension? This study is aimed to investigate whether visual experience can promote or activate the opposite direction of MTL from implicit and explicit levels. The results showed that when the time information in the task was not prominent, the direction of vertical MTL cannot be affected by ascending or descending perceptual experience. While when the time information was prominent, whether the task was implicit or explicit, compared with the control group, watching the top-down scene significantly increased the top-down direction selection, while in the implicit task, watching the bottom-up scene made the top-down MTL disappear. To the best of our knowledge, our study provides the first evidence that the flexibility of space-time associations in vertical dimension extends beyond explicit and embraces even implicit levels. This study shows that the vertical MTL is activated in certain conditions and could be affected by the visual experience.