Mobile Technology For Adaptive Aging

To explore how mobile technology can be employed to enhance the lives of older adults, the Board on Behavioral, Cognitive, and Sensory Sciences of the National Academies of Sciences, Engineering, and Medicine commissioned 6 papers, which were presented at a workshop held on December 11 and 12, 2019. These papers review research on mobile technologies and aging, and highlight promising avenues for further research.

Emerging and currently available technologies offer great promise for helping older adults, even those without serious disabilities, to live healthy, comfortable, and productive lives. What technologies offer the most potential benefit? What challenges must be overcome, what problems must be solved, for this promise to be fulfilled? How can federal agencies like the National Institute on Aging best use their resources to support the translation from laboratory findings to useful, marketable products and services? Technology for Adaptive Aging is the product of a workshop that brought together distinguished experts in aging research and in technology to discuss applications of technology to communication, education and learning, employment, health, living environments, and transportation for older adults. It includes all of the workshop papers and the report of the committee that organized the workshop. The committee report synthesizes and evaluates the points made in the workshop papers and recommends priorities for federal support of translational research in technology for older adults.

This book looks at how AgeTech can support the autonomy and independence of people as they grow older. The authors challenge readers to reflect on the concepts of autonomy and independence not as absolutes but as experiences situated within older adults’ social connections and environments. Eleven personas of people around the world provide the context for readers to consider the influence of culture and values on how we understand autonomy and independence and the potential role of technology-based supports. The global pandemic provides a backdrop for the unprecedentedly rapid adoption of AgeTech, such as information and communication technologies or mobile applications that benefit older adults. Each persona in the book demonstrates the opportunity for AgeTech to facilitate autonomy and independence in supporting one’s identity, decision making, advance care planning, self care, health management, economic and social participation, enjoyment and self fulfillment and mobility in the community. The book features AgeTech from around the world to provide examples of commercially available products as well as research and development within the field. Despite the promise of AgeTech, the book highlights the “digital divide,” where some older people experience inadequate access to technology due to their geographic location, socio-economic status, and age. This book is accessible and relevant to everyday readers. Older adults will recognize themselves or peers in the personas and may glean insight from the solutions. Care partners and service providers will identify with the challenges of the personas. AgeTech entrepreneurs, especially “seniorpreneurs,” will appreciate that their endeavours represent a growing trend. Researchers will be reminded that the most important research questions are those that will enhance the quality of life of older adults and their sense of autonomy and independence, or relational autonomy and interdependence.

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

The Institute of Medicine (IOM) and the National Research Council (NRC) have had prominent roles in discussions of aging, disability, and technology for decades. In 1978, Aging and Medical Education (IOM, 1978) raised national awareness of the challenges to physicians posed by the aging of the U.S. population. Thirty years later, Retooling for an Aging America highlighted concerns for the entire health care workforce in view of the aging of the population, including the role of technology in caring for older populations. The 1988 report The Aging Population in the 21st Century examined social, economic, and demographic changes among older adults, as well as many health-related topics: health promotion and disease prevention; quality of life; health care system financing and use; and the quality of care- especially long-term care. In 1991, the landmark report Disability in America laid out a national agenda to prevent disability and improve the lives of people with disabling conditions. The 1997 report Enabling America: Assessing the Role of Rehabilitation Science and Engineering examined the knowledge base of rehabilitation science and engineering and proposed ways to translate scientific findings into interventions that produce better health. And the 2007 report The Future of Disability in America examined progress made since the earlier reports and looked at continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. All these reports were produced by committees appointed in accordance with guidelines of the National Academies and met multiples times to compile and review evidence, reach consensus on conclusions and recommendations, draft a report of the committee, and then modify that draft report in response to comments from outside reviewers. The IOM and NRC have also held several workshops related to aging, disability, and technology and published summary reports, such as Technology for Adaptive Aging and Grand Challenges of Our Aging Society. The IOM and NRC also convene groups that take a different approach to issues of pressing national and international importance. Often known as forums or roundtables, these groups meet regularly to foster dialogue and confront issues of mutual interest and concern among a broad range of stakeholders. They can convene workshops, initiate cooperative projects among members, commission independently authored articles, and generate ideas for independent consensus studies. In 2012 the IOM and NRC joined together to establish the Forum on Aging, Disability, and Independence to provide a neutral venue for broad-ranging discussions among the many stakeholders involved with aging and disability. The goals of the forum are to highlight areas in which the coordination of the aging and disability networks is strong, examine the challenges involved in aligning the aging and disability networks, explore new approaches for resolving problem areas, elevate the visibility and broaden the perspectives of stakeholders, and set the stage for future policy actions. Forum sponsors and members include federal agencies, health professional associations, private sector businesses, academics, and consumers. Fostering Independence, Participation, and Healthy Aging Through Technology summarizes this workshop.

Health Technology Literacy: A Transdisciplinary Framework for Consumer-Oriented Practice examines the wide range of resources used by health consumers to inform, support decision-making, self-monitor, build supportive social networks online or via cell phone, and engage in treatment using interactive programs online or on CD or related media. Using evidence-based practice and relevant theories, this unique text analyzes the trend for health care systems to be reactive, while consumers are proactive for health technology.