Gerontechnology

A computer-based 'Useful Field of View' (UFOV) training program has been shown to be effective in improving visual processing in older adults. Studies of young adults have shown that playing video games can have similar benefits; however, these studies involved realistic and violent 'first-person shooter' (FPS) games. The willingness of older adults to play such games has not been established. OBJECTIVES: To determine the degree to which older adults would accept playing a realistic, violent FPS-game, compared to video games not involving realistic depiction of violence. METHODS: Sixteen older adults (ages 64-77) viewed and rated video-clip demonstrations of the UFOV program and three video-game genres (realistic-FPS, cartoon-FPS, fixed-shooter), and were then given an opportunity to try them out (30 minutes per game) and rate various features. RESULTS: The results supported a hypothesis that the participants would be less willing to play the realistic-FPS game in comparison to the less violent alternatives (p's<0.02). After viewing the video-clip demonstrations, 10 of 16 participants indicated they would be unwilling to try out the realistic-FPS game. Of the six who were willing, three did not enjoy the experience and were not interested in playing again. In contrast, all 12 subjects who were willing to try the cartoon-FPS game reported that they enjoyed it and would be willing to play again. A high proportion also tried and enjoyed the UFOV training (15/16) and the fixed-shooter game (12/15). DISCUSSION: A realistic, violent FPS video game is unlikely to be an appropriate choice for older adults. Cartoon-FPS and fixed-shooter games are more viable options. Although most subjects also enjoyed UFOV training, a video-game approach has a number of potential advantages (for instance, 'addictive' properties, low cost, self-administration at home). We therefore conclude that non-violent cartoon-FPS and fixed-shooter video games warrant further investigation as an alternative to the UFOV program for training improved visual processing in seniors.

Older adult participants in the Intelligent Systems for Assessment of Aging Changes study (ISAAC) carried out by the Oregon Center for Aging and Technology (ORCATECH) were surveyed regarding their attitudes about unobtrusive home monitoring and computer use at baseline and after one year (n=119). The survey was part of a longitudinal study using in-home sensor technology to detect cognitive changes and other health problems. Our primary objective was to measure willingness to share health or activity data with one's doctor or family members and concerns about privacy or security of monitoring over one year of study participation. Differences in attitudes of participants with Mild Cognitive Impairment (MCI) compared to those with normal cognition were also examined. A high proportion (over 72%) of participants reported acceptance of in-home and computer monitoring and willingness to have data shared with their doctor or family members. However, a majority (60%) reported concerns related to privacy or security; these concerns increased after one year of participation. Few differences between participants with MCI and those with normal cognition were identified. Findings suggest that involvement in this unobtrusive in-home monitoring study may have raised awareness about the potential privacy risks of technology. Still, results show high acceptance, stable over time, of sharing information from monitoring systems with family members and doctors. Our findings have important implications for the deployment of technologies among older adults in research studies as well as in the general community.

PURPOSE: The biomechanics community have to date had limited success in communicating complex biomechanical data and analyses outside of their field. The authors have created an innovative prototype software tool to visualise objective dynamic movement data captured from older adults undertaking activities of daily living (ADLs). Evaluation of this tool has shown it to be a successful way of communicating the complexity of older adult mobility data in an accessible manner for non-biomechanical specialists and lay audiences(1,2). METHODS: A software tool was developed, which generates a 3D animated human 'stick figure', on which the biomechanical demands of ADLs are represented visually at the joints as a percentage of each individual's maximum capability using a continuous colour gradient from green at 0%, amber at 50%, through to red at 100% (Figure 1). The tool was evaluated using a qualitative methodology of interviews and focus groups, where older adults and professionals viewed a series of visualisations of dynamic movement data(3). RESULTS AND DISCUSSION: Analysis of focus group discussions facilitated by the visualizations revealed new kinds of dialogues about biomechanical issues. The method of visualising and presenting the data clearly enabled people without training in biomechanics, both professionals and lay older people, to access and interpret the biomechanical information, based on their background, knowledge of a field or their personal experience. Further, the common visual medium enabled the sharing of different insights without recourse to specialist terminology or knowledge. New kinds of dialogues occurred in focus groups between older people and professionals about their experiences, based on real understanding of where the mobility problems were occurring. New dialogues also emerged between professionals from a range of different disciplines, crucial for different aspects of the care, wellbeing or design of the built environment for older people. Neither of these would have been possible using current conventions of presenting biomechanical data. The visualisations also appear to allow a deeper understanding of the issues within professions, both in healthcare and in design. These findings have led to new research with five discrete yet complementary studies covering a range of clinical applications of this method for: i) mobility and exercise advice for the healthy older adult; ii) falls prevention; iii) rehabilitation of total knee replacement; iv) to enhance early mobilisation of acute stroke patients and v) to enhance biomechanical diagnosis and fitting of ankle foot orthoses (AFO) in late stage stroke.

Use of assistive devices in caring for individuals with dementia has not been systematically examined, particularly as it concerns managing behavioral symptoms. We tested a nonpharmacologic intervention to manage behaviors that involved instructing families in effective communication techniques, simplifying tasks and the home environment and using assistive devices. This paper describes the assistive devices provided to families assigned to intervention, extent of use of issued devices, their perceived helpfulness, and cost. Following each treatment session, occupational therapists (OT) documented time spent training in the use of strategies to manage problem behaviors. For families receiving assistive devices, OTs asked caregivers after 4 months whether they continued to use the device (yes/no), and extent to which it helped manage the targeted problems (not at all, somewhat, very helpful). We also tracked the costs associated with ordering, delivering and installing devices. Of 272 caregiver-patient dyads enrolled in the original trial, 136 were randomized to the intervention group, of whom 63 received one or more assistive devices. Of 13 intervention sessions, an average of 4 (31%) involved discussing or training caregivers in using assistive devices. A total of 197 devices (3 per dyad) were issued of which 87.6% were reported in use at 4 months. Caregivers reported that overall, devices were somewhat to very helpful. Devices ranged in cost from US$4.80 to US$282.93 with an average cost per dyad of US$152.52(SD=US$102.70) which included the device, its ordering, delivery and installation.

Performing daily activities without assistance is important to maintaining an independent functional lifestyle. As a result, automated activity prompting systems can potentially extend the period of time that adults can age in place. In this paper we introduce AP, an algorithm to automate activity prompting based on smart home technology. AP learns prompt rules based on the time when activities are typically performed as well as the relationship between activities that normally occur in a sequence. We evaluate the AP algorithm based on smart home datasets and demonstrate its ability to operate within a physical smart environment.

This study investigates whether motion density maps based on passive infrared (PIR) motion sensors and the average time out and average density per hour measures of the density map are sensitive enough to detect changes in mental health over time. Within the sensor network, data are logged from PIR motion sensors which capture motion events as people move around the home. If there is continuous motion, the sensor will generate events at 7 second intervals. If the resident is less active, events will be generated less frequently. A web application displays the data as activity density maps showing events per hour with hours on the vertical axis and progressive days on the horizontal axis. Color and intensity provide textural indications of time spent away from home and activity level. Texture features from the co-occurrence matrix are used to capture the periodicity pattern of the activity (including homogeneity, local variation, and entropy) and are combined with the average motion density per hour and the average time away from home. The similarity of two different density maps is represented by a number that is computed in feature space as the distance from one map to the other, or a measure of dis-similarity. Employing a retrospective approach, density maps were compared with health assessment information (Geriatric Depression Scale, Mini Mental State Exam, and Short Form Health Survey -12) to determine congruence between activity pattern changes and the health information(20). A case by case study method, analyzed the density maps of 5 individuals with identified mental health issues. These density maps were reviewed along with the averages of time out of apartment per day per hour and average density per hour for hours at home and mental health assessment scores to determine if there were activity changes and if activity patterns reflected changes in mental health conditions. The motion density maps show visual changes in the client's activity, including circadian rhythm, time away from home, and general activity level (sedentary vs. puttering). The measures are sensitive enough, yielding averages of time out of apartment and average density per hour for hours at home that indicate significant change. There is evidence of congruence with health assessment scores. This pilot study demonstrates that density maps can be used as a tool for early illness detection. The results indicate that sensor technology has the potential to augment traditional health care assessments and care coordination.

Episodic and working memory processes show pronounced age-related decline, with other memory processes such as semantic, procedural, and metamemory less affected. Older adults tend to complain the most about prospective and retrospective memory failures. We introduce a framework for deciding how to mitigate memory decline using augmentation and substitution and discuss techniques that change the user, through mnemonics training, and change the tool or environment, by providing environmental support. We provide examples of low-tech and high-tech memory supports and discuss constraints on the utility of high-tech systems including effectiveness of devices, attitudes toward memory aids, and reliability of systems.

The main aim of this paper is to illustrate the potentials that the use of robotic and mechatronic technologies (in combination with advanced biomechanical models) can offer to help elderly people identifying and slowing down the effects of the age-related modifications of the neuro-musculo-skeletal systems and therefore increasing their possibility of staying at home reducing the hospitalization time. In particular, a three phases approach is proposed in this paper: (i) the use of robotic and mechatronic systems to analyse the age-related modifications of the motor control strategies (in particular for falling risk) in clinics or research laboratories; (ii) the use of wearable systems to assess motor performance in a unstructured environment (e.g., the house of the people); (iii) the use of technological aids to help elderly people to live autonomously in their domestic environment. The results illustrated in this manuscript seems to confirm that this approach can provide interesting and useful tools to increase the quality of life of elderly people.

This study investigates the relationships among computer attitudes, cognitive abilities, and the usage of various technologies among older Japanese adults. Methods: Fifty Japanese adults, 32 males and 18 females, aged 60 to 80, participated. Participants' experience of usage and possession of 18 products and services that utilize various technologies were investigated by questionnaire. The Attitudes Toward Computers Questionnaire (ATCQ) was employed to assess the computer attitudes of the participants. Spatial visualization, spatial orientation, associative memory, perceptual speed, and field independence were measured using the Kit for Factor-Referenced Cognitive Tests. Results: showed a variation in the percentages of participants who had used the assessed products and services (usage ratio) from 8% to 94%. Gender difference could be seen only in the Control subscale of the ATCQ scores, while a significant gender difference could be seen in all cognitive ability factors examined except for associative memory. More positive computer attitudes, especially regarding Comfort and Interest, were related not only to greater usage of computers but also to the greater usage of a number of computerized products and services. Some of the computer attitude subscales were also found to be related to the usage of products and services whose usage ratios were relatively low. On the other hand, higher cognitive abilities, especially spatial abilities and field independence, were related to the use of products and services whose usage ratio were relatively high. Discussion: The implications of the results include the possibilities of mutual relationships among computer attitudes, cognitive abilities, and technology usage among older adults, utilization of one of these factors as a predictor for others, as well as for the design of interventions and training strategies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Technology has become part of today's life. It constitutes a fundamental aspect of the environment also for older people who are not familiar with most of the new technologies. Is their use of technology based on Certain abilities and is this related with such factors as income, lack of alternatives, past performance, or availability of equipment? Methods: The MOBILATE 2000 database of a survey conducted in 5 European countries was aimed at the enhancement of out-of-home mobility of older people. The project offers data describing the use and acceptance of new technologies. Insight can be gained into the characteristics of users and non-users of more or less common technologies like ATM, ticket dispensers, and PIN payments. Results: Findings show that in the present generation of people aged 55 years and older, the share of users for most technologies (PC, internet, electronic banking) is low, but these users are rather satisfied with these. Commonly available technologies like ATM or PIN-payment are used by many older persons. Their experiences are mostly positive. Ticket dispensers are most used by public transport users, but these machines are rather complicated even for the users. Apparently, elderly people feel barriers to start using new technologies. A high educational level, a high income, and a good health offer good conditions for overcoming these barriers. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Universal access has been a central issue in enhancing digital welfare for the elderly. The present study approached this goal by examining the role of multimedia as a training tool for older adults in learning to use a digital camera. Thirty older subjects aged over 65 participated in an experiment that employed multimedia training and task complexity as a within- and between-subject factor, respectively. Displaying operation procedures with animation, narration and static visuals defined the three treatments of multimedia, while task complexity varied by simple and difficult levels of operations. Training performance was evaluated by the time required to successfully complete the operations and the number of requests for help, both assessed by hands-on tests. Results indicated that animation and narration enabled the older subject to complete the tasks significantly faster than the static visuals but only when complex tasks were trained. Animation also resulted in the lowest need for the subjects to resort to hints during successful completion of the hands-on operations. It was suggested that computer-aided training for the elderly should be towards the use of multimedia presentation particularly when complex tasks are to be learned. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Do older people experience the postponement of a desired or planned activity as more troublesome than do younger people, or, on the contrary, do they exhibit more patience? In the present study 24 independently living adults, 12 aged 40-45 years and 12 aged 70-75 years, judged delayed rewards, in this case freely obtainable holidays, by means of pair-wise comparison. The participants' preferences showed a stronger 'temporal discounting' in older and in less healthy individuals than in younger and in healthy individuals, respectively. Delay-time was perceived as a risk factor for enjoying future holidays. This risk perception was related to participants' own and their partners' subjective physical health. However, subjective health could not fully explain the high temporal discount rates in the older participants, suggesting that also age by itself contributed to the perceived risk of postponement. The implications of this study may also address other activities and plans, such as older adults' preparedness to learn using new technology. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Perceptions and experiences of both usability and usefulness can motivate or discourage older adults to use the internet. The present study explores older adults' perceptions of internet usefulness, or benefit. Thirty older internet users and non-users aged 60-74 years evaluated traditional media and internet applications for different communication purposes in their everyday lives. The participants were divided into three groups with different levels of experience. Both the amount of internet experience and the goal of the communication seemed to have affected their judgments. Experienced users valued internet applications more highly than less- and non-experienced users, in general. However, both users and non-users of the internet mentioned merits of the internet depending on the goal of the communication and the establishment of the medium in one's social environment. The goal-dependent differentiation of media evaluations within each of the three groups suggested a benefit-driven approach of media by older adults. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

As Information and Communication Technology (ICT) penetrates dwellings worldwide, also the increasing number of older persons will become more dependent on information technology infrastructures. While ICT continues to advance quickly, the ergonomic refinement for use by older adults has lagged behind. In addition, technical problems exist, partly resulting from designers' frequent use of proprietary products having little or no interoperability with products of other vendors. Fortunately, standards are emerging to address this problem; the cellular phone appears to be evolving into the general user interface for all, including older adults, and the addition of networking to ICT will significantly enhance environments to support aging-in-place. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Digital documents, such as those on the world wide web, can present information using rich multimedia forms including video and audio, and can let people choose how information is presented. Older adults are diverse, so individuals will differ in their preferences for reading text on screen, or listening to it, or combining reading and listening. Recent studies suggest that giving people simple onscreen options for selecting whether they want to listen, can accommodate this diversity more effectively than categorising users by age and presenting only the 'older adults' version. The take-home message is to support diversity among older adults by facilitating individuals' choices about how multimedia information is presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

There is a growing recognition that gerontechnology must be about more than usability and technical reliability, it is also about addressing and fulfilling wishes and desires; fitting in to people's lives and according, as far as possible, to their expectations. To create appropriate technologies that will be acceptable and appropriate demands a shift of emphasis from the technology to the people, from analyses of functional decline to more holistic views of ageing as personal and life experience. Most importantly, it demands innovative approaches to gerontechnology: a person-centred approach in which researchers form partnerships with older adults. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Motivation -- The purpose of this study was to explore the relationship between cognitive abilities, well-being and use of new technologies in order to support the development of systems to sustain digital engagement of older people. Research approach -- A literature review analysed scientific articles regarding the relationship between cognitive abilities, well-being and use of new technologies for older people. Findings/Design -- The results showed that cognition has a significant effect on use of new technologies, but only one study looked at the reverse relationship and did not find a clear result. The relationship between well-being and technology use needs to be clarified in further research; however, there is strong evidence that well-being affects cognitive abilities. Research limitations/Implications -- The relationship might have an interactive, reciprocal dynamic, but needs further investigation, as not all factors in this relationship have been equally well explored. Take away message -- The results highlight the need to include well-being and health into the investigation of the relationship between cognitive abilities and use of new technologies.

The elderly population is expected to grow dramatically over the next 20 years. As people grow older, they need more healthcare assistance. Without receiving sufficient care, elderly are at risk of loosing their autonomy. Thus a system permitting elderly to live safely at home is more than needed. Medical professionals believe that one of the best ways to detect emerging physical and mental health problems (before it becomes critical – particularly for the elderly) is to look for changes in their activities of daily living (ADLs). For this purpose, we propose a monitoring system which aims at detecting activities of daily living (ADLs) at home.

Determining the individual transition from the 3rd to the 4th of frailty phase of life is important for both the safety of the older person and to support the care provider. We developed an automatic monitoring system consisting of cameras and different sensors that analyze human behaviors and looks for changes in their activities by detecting the presence of people, their movements, and automatically recognizing events and Activities of Daily Living (ADLs). Assessment took place in a laboratory environment (GERHOME) comprised of four rooms (kitchen, living-room, bedroom, and bathroom). Data from 2 volunteers (64 and 85 years old) were analyzed. Precision in recognizing postures and events ranged from 62-94%, while sensitivity fell in the range of 62-87%. The system could differentiate ADL levels for the 64 and 85 year old subjects. These results are promising and merit replication and extension. Considerable work remains before the complete transition from 3rd to 4th life phase can be reliably detected. The GERHOME system is promising in this respect.

The chapter aims to examine the definitional challenges associated with the term quality of life, measurement challenges, the challenges associated with enhancing quality of life, and the role of information and communication technologies (ICT) in quality of life in old age, and finally comments on the challenges of a modern information society for older people. The term quality of life started as a social scientific index of the relative well-being of whole populations, i.e. the state of states. Nowadays quality of life is more likely to be viewed as an individualized aspect of the modern psyche. This shift in conceptualization is problematic in that, if quality of life is individualized, it cannot be meaningful to assess it in the same way for everyone. Nevertheless, over the years a vast range of methods of measuring quality of life has emerged, leading to several measurement challenges. Wealth, health and social relations have all been found to be prime determinants of subjective quality of life; for ICT to enhance quality of life for older people they need to mediate the relationships between these three important factors and quality of life. To date there is relatively little evidence that ICT has improved the quality of life of older people. Suggestions are made as to why ICT is unlikely to influence life quality for older citizens. The chapter is drawn to a close by asking if quality of life is a meaningless term and if the future is bleak for old people in a modern information society. The answer to both questions is no.

Gerontechnology Vol.7 Nr.2, 188 - 6th Conference of the International Society for Gerontechnology. Tuscany, Italy, 4 - 6 June 2008

People with neurodegenerative disorders (NDD) who live in and want to remain in the community often have to modify their home or move to a different home to accommodate their changing needs. This paper examines one aspect of the home environment as experienced by people with NDD, in terms of Lawton's [1] model of environmental gerontology, using data from a 2007 postal survey in Western Australia. The paper concludes that, for people with declining mobility, house design is clearly an important factor involved in enabling people with NDD, and indeed frail people in general, to manage their physical difficulties and remain in their homes.

If older users of multimedia displays could select among presentation options, would they choose display combinations that supported their performance? After three short touch-screen tasks which measured the perceptual and cognitive abilities of 50 older adults, they answered questions about a route on an online map that could be accompanied by written and/or spoken text. Half the participants saw animated routes; and they were less accurate answering questions than those who saw static routes but this did not affect people’s multimedia choices which, although diverse, were systematic. Spoken text was more often selected by people who had lower scores on the spatial working memory task, than by the older adults with higher scores. This suggests that older people with cognitive limitations recognise ways in which multimedia information can be supportive.

Gerontechnology Vol.9 Nr.2, 228 Technology should be harnessed to support and enhance the quality of people's everyday life. This is why the analysis of life should form the very beginning of ICT-design. Current trends in the design of ICT products and services seldom truly manage to support the goals that people have in their lives. This is especially evident tendency in technology driven design. Consequently, design processes lack the ability to holistically consider life and thus often fail in producing successful artefacts that would support people's lives. The re-evaluation of design thinking is important now as technology development is focusing more and more on services. Design of service concepts, if any, has to be carried out with a much broader design approach than what the traditional approaches to human-technology design can offer. A workable solution is to adopt 'Life-Based Design', with the premise in 'forms of life' as a analytical ground concept for ICT design. In order to gain understanding on where to go and which aspects to stress in the design from the user's point of view, it is crucial to understand how the users perceive their everyday life, what kinds of biological, psychological and socio-cultural restrictions and incentives they have in their daily activities, and how these would collide with the demands of the information society.

This article was published in the journal, Gerontechnology [© International Society for Gerontechnology]. The definitive version is available at: http://www.gerontechjournal.net/ This article reports a study that explored user requirements for web-based interactive TV (iTV) services from the perspective of older users. Members of a University of the Third Age (U3A) group were recruited for the study in order to explore the potential for web-based iTV to be used as a tool for mediating social communities. Focus groups and user trials were used to explore participants’ reactions to the concept of web-based iTV and to identify barriers to use. The study found that the web-based iTV service offered in some contexts several advantages to personal computer use that were valued by study participants. However, significant physical and cognitive barriers to use were identified, such as cost of services, lack of privacy, information overload and learning interface equipment. Recommendations for designing web-based iTV services for older users, generated in response to these concerns, include keeping the user interface simple, avoiding multi-modal keys on the keypad and providing information portals tailored to the interests of older users.