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

1. 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

2. 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

3. USA Census 1975

4. Projected USA Census 2050

5. 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

6. 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)

7. 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)

8. 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

9. 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

10. 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 leisure Ref: Fozard J. Impact of technology interventions on health and self esteem. Gerontechnology. 2005,4,463-76

11. 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.

13. 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

14. Person Receptors Internal Effectors Structures System Output Measure Interface Social Built Natural Environment 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.

15. 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

16. Person System Output Measure Receptors Internal Effectors Structures Human aging Interface Secular change Future Social Built Natural Time Environment LESSON: BOTHage-related and secular changes affect system output dynamics Past

17. 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

18. 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.

19. Planning Practical Application of Gerontechnology Concepts IMPACT? Enhance Prevent Compensate Care/organization IMPACT? Prevention Compensation Care/organization Enhance INTERVENE: TYPE, SITE? Person: Train, motivate Select Personality Demographics Environment: Built, social, natural Device on person Device: located near or remotely Person System Output TARGET? Physical Mental Emotional/social FUNCTION? Physical Cognitive Emotional/Social Environ- ment Time

20. 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

21. Networking improves coaching in strength training • Preventionis 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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 example Ref: www.seniornet.org;www.gerontechnology.org • Demographics described earlier highlight importance of continued work and learning by older persons

29. 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

30. 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