Gerontechnology: Timely R&D Applications for Aging People in a Rapidly Changing Society

James L. Fozard, Ph.D.College of Arts and Sciences - School

of Aging Studies University of South Florida

Tampa, FL

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We Live in a Era of Two Big-Time Historical Trends Current and projected relative increases in

older end of society’s age distribution are occurring for the first time in history

Changes in the man-made technological environment are progressing more rapidly than ever before in history

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USA Census 1975

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Projected USA Census 2050

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Older people’s goals—continued functional independence Maintain health as long as possible Maintain functional independence in housing,

transportation, recreation, learning and work Maintain financial resources to live independently Maintain and enhance communication with family and

friends Create new social contacts to substitute for those lost

through death and separation from family

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Rapid changes in the man-made technological environment Historians of technology indicate that some 90% of

the advances in technology occurred during the 20th century

Some examples of widespread technology applications since about 1990 Internet and e-mail; search machines Mobile phone; sms Digital camera Navigation tools (GSM) Games Robots Smart products and systems (adaptive)

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Rapid changes in the man-made technological environment One result is that an old person today has

experienced: First time exposure to new technology at a

relatively advanced age, e.g., navigation systems, robots, Internet

Changes in the user interfaces of established technological products, e.g.,

camera (film to digital), telephone (party line to wireless cell phone), washing machines and other devices

(electro-mechanical to menu-driven controls)

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Framework needed to analyze person-environment interactions Starting in 1990 engineers and gerontologists at the

Technische Universiteit Eindhoven developed the interdisciplinary discipline called gerontechnology. Gerontechnology addresses the following issues: Analyze how best to link technology to needs of aged

and aging people How to involve people in planning for development,

distribution and dispersion of technology Systematically evaluate technology’s age-specific goals

for health, housing, transportation, communication and work and leisure

Study how to utilize the motivating properties of technology

Address policy issues related to technology applications

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Definition: Gerontechnology is

An integrative discipline concerned with

Development, dispersal and distribution of technologically-based products, environments and services that improve the

Functioning and quality of life of Aging and aged persons.

Word is composite of gerontology, the study of aging and technology the creation of technological products, environments and services

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Overview of basic concepts of gerontechnology

Gerontechnology theory connects human aging to environmental change over time

5 Domains of gerontechnology Health and self esteem Housing and everyday activities

Communication and governance Transportation and mobility

Work and leisureRef: Fozard J. Impact of technology interventions on health

and self esteem. Gerontechnology. 2005,4,463-76

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Gerontechnology’s four types of intervention (goals) Prevention and engagement—technology that delays or prevents

age-associated physiological and behavioral changes that restrict human functioning, e.g., accidents lifestyle and environmental factors contributing to allergies, depression and other modifiable conditions

Compensation and assistance—technology that compensates for age-associated losses in strength and perceptual-motor functioning—the most frequent use

Care support and organization—technology used by caregivers of elderly persons with disabilities, e.g., devices that

lift and move physically disabled persons, machines that administer and monitor the use of medications and equipment that provides information about physiological functioning to

remote location Enhancement and Satisfaction

Improve quality of life at all three levels The four interventions are applicable to all 5 domains—health, housing,

etc. Ref: Bronswijk JEMH, Bouma H, Fozard JL. Technology for quality of life: An enriched

taxonomy. Gerontechnology, 2003;2,169-172.

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Gerontechnology Impact matrixSlide courtesy of Prof. Dr. Herman Bouma 5/22/06

Life DomainHealth &

Self-esteem

Housing &

Daily Living

Mobility &

Transport

Communica-

tion & Governance

Work &

Leisure

Goal of Intervention

Enhancement

& Satisfaction

Telemedicine

Internet

Wireless / remote phone

GPS navigation Mobile phone

Internet

Digital camera

Internet

Prevention &

Engagement

Healthy diet

Home trainer

Smart ventilation

“Intelligent” car Video links Focused

lighting

Compensation

& Assistance

Passive

alarms

Smart IADL Rollator/walker

Battery powered wheelchair

Hearing aids Power tools

Robot pet

Care Support & Organization

Smart intake

Control-PDA

Electronic keys Powered lifting Care networks

Video links

Robots

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How does human aging relate to changes in the environment? Gerontechnology systematically links aging to

changes in the environment The dynamics of person/environment interactions

change over time. Continuous changes occur in the environment—called

secular changes Overlapping generations of aging people—called age

cohorts-- who create and use environment are affected differently by environmental change

A person aging from 10 to 20 years starting in 2007 will never experience the changes in the environment experienced by a 60 year old

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Environment

Person

Social Built Natural

Receptors Internal Effectors Structures

Interface

System Output Measure

At any point in time, the Person-Environment Interaction may be analyzed using the well-known human factors approach. System output can be altered by changing the environment, the person, or both.

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What happens when changes over time are added to the model? Adding time to the model, e.g., 10 years, allows us to

consider three additional factors: changes within a person as (s)he ages differences between successive age cohorts

Variability among members within any cohort increases because of individual differences in experience of the environment

secular changes in the environment over time and how they interact with aging

Gerontechnology studies how changes in the environment affect age changes and differences

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Environment

Person

Social Built Natural

Receptors Internal Effectors Structures

Interface Future

Past

Time

Humanaging

Secularchange

System Output Measure

LESSON: BOTH age-related and secular

changes affect system output dynamics

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Summary: environmental change and aging Secular changes in technology are creating dramatic changes in

user interfaces Wireless phones used for watching downloaded TV shows

as well as communication Adaptive robotic technology blurs distinctions between

person to person and person to machine communication and interaction

Experience with one user-technology interface can have negative or positive effects on the ability or willingness of a person to use a new one Within an age cohort, aging results in an increased

interdependence between person and various components of the environment

Adaptation process to secular change varies across age cohorts partly because of variety and amount of earlier experiences

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Putting the 4 gerontechnology interventions to work

The diagram just shown is just the first step in planning gerontechnology interventions

The next steps include identifying: Desired impact, e.g. prevention vs. compensation Target of intervention Site and placement of technology Timing of intervention

Ref: Fozard, JL Impacts of technology interventions on health and self-esteem. Gerontechnology, 2005, 4, 63-76.

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IMPACT?Prevention

Compensation

Care/organization

Enhance

FUNCTION?Physical

Cognitive

Emotional/Social

SystemOutput

Environ- ment

Person

IMPACT?EnhancePreventCompensateCare/organization

TARGET?PhysicalMentalEmotional/social

INTERVENE:TYPE, SITE?Person:Train, motivateSelectPersonalityDemographics

Environment:Built, social, naturalDevice on personDevice: located near or remotely

Time

Planning Practical Application of Gerontechnology Concepts

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How high speed networking can expand scope of gerontechnology Prevention: Coaching in cardiovascular and strength training,

available as never before; simulation of aging Compensation: Smart homes/environments, robots Care/support: High quality home based medical and rehab

services available Enhancement: Promote virtual social and artistic activities;

Facilitate shopping, learning and work at home Common feature of examples is enhanced communication

between people and people, people and machines among machines that themselves are networked

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Networking improves coaching in strength training Prevention is appropriate health-related intervention

to improve functioning, gait quality, lower risk of falls Motivation is major issue for utilizing strength training

—machines can have motivational properties Networking can improve motivation and quality of

feedback from strength training Reinforcement from sharing information by peers doing

similar workouts Wearable transducers provide information on quality

and required number of maneuvers

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Virtual simulations of aging and healthy lifestyles

Since the 1970s, many simulations of age related sensory and mobility limitations have been devised to educate the young Clouded lenses, ear plugs, gloves, weighted shoes

etc. Limitation is lack of linkage of these devices and

preventive and compensatory interventions Virtual reality simulations can improve education

by linking simulations of limitations to effects of compensatory and preventive measures

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Technology for compensation and care interventions Established technologies include

Hearing and vision aids Text to speech converters Electronic memory aids

Emerging technologies include Smart homes and environments Robots Telemedicine Location aware cueing

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High speed networking expands range of gerontechnology Telemedicine and communication

applications using video over Internet Ultra-wideband radio allows for precise

location of persons within a home and communication among appliances

Allows for shopping and business without being tied to desktop PC

Faster interactions in games, virtual simulations and machine guided rehabilitation

New opportunities for personal service robots

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High speed networking and embedded technologies improve enhancement

Aging brings new opportunities for: Adventurous and challenging activities New social opportunities and friendships Artistic expression Learning Work

Technical support for all these activities is currently possible in home settings

High speed networking increases the range of possibilities for these activities

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Challenging activities, social opportunities and friendships

Development of virtual environments and games for older persons is a wide open field for development

Aging brings losses in spouses, family, friends Chat rooms, and virtual communities such as

those sponsored through Seniornet exist now but are not widely used

High speed networking increases the range of possibilities for these activities

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People in this group can envision many advantages of high speed networking!

Aging brings new opportunities for: Artistic expression

Individual Visual: making, copying and altering digital images;

drawing, animation and cartoons etc. using existing software

Auditory: create, arrange, add music to visual scenes using contemporary software

Bouma H, Harrington TL Information and communication. In TL Harrrington, MK Harrington Gerontechnology: Why and How Maastricht NL: Shaker Publishing 2000 pp.156-159

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High speed networking potential for learning, work Aging brings new opportunities for Learning,

Work There are many existing examples of how

technology makes it possible to learn “on line” and work at home or in a remote setting. Japanese program of “Kaizen” is recent exampleRef: www.seniornet.org;www.gerontechnology.org

Demographics described earlier highlight importance of continued work and learning by older persons

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High speed networking and basic gerontological research A major goal of fundamental gerontological research

is to describe changes in physiological, biochemical and behavioral systems over time as organism ages

About 35-40 longitudinal studies of human aging are being conducted worldwide. They are expensive and difficult to carry out

High speed networking can increase the verisimilitude, scope and complexity of monitoring of human functioning in natural environmental settings thereby facilitating study of aging cross cultural and specific environmental settings

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Summary and Conclusions

Combination of aging and society and ever more rapid evolution of technology brings new challenges and opportunities for linking people to the man-made environment

Gerontechnology studies changing person-environment interactions for human benefit

4 classes of gerontechnology interventions are applied to 5 areas of human activity

High speed networking and embedded technologies increase scope of gerontechnology