Assistive Technologies for Supporting the Wellbeing of Older Adults

As people age, they are more likely to develop multiple chronic diseases and experience a decline in some of their physical and cognitive functions, leading to the decrease in their ability to live independently. Innovative technology-based interventions tailored to older adults’ functional levels and focused on healthy lifestyles are considered imperative. This work proposed a framework of active and healthy ageing through the integration of a broad spectrum of digital solutions into an open Pan-European technological platform in the context of the SHAPES project, an EU-funded innovation action. In conclusion, the SHAPES project can potentially engage older adults in a holistic technological ecosystem and, therefore, facilitate the maintenance of a high-quality standard of life.

Impact of chronic stress exposure on cognitive performance incorporating the active and healthy aging (AHA) concept within the cross-sectional Bern Cohort Study 2014 (BeCS-14)

Purpose This study aims to verify that the mental-cognitive domain of the validated generic bio-functional status (BFS)/bio-functional age (BFA) assessment tool, incorporating the concept of Active and Healthy Ageing (AHA), reflects cognitive performance. In addition, the effects of chronic stress exposure on the mental-cognitive BFS/BFA should be investigated. Methods The study was carried out as a monocenter, cross-sectional, observational, non-interventional trial (Bern Cohort Study 2014, BeCS-14) with the participation of 147 non-pediatric, non-geriatric subjects. All participants followed a standardized battery of biopsychosocial assessments consisting of BFS/BFA, a validated cognitive performance test battery (Inventar zur Gedächtnisdiagnostik; IGD) and a validated questionnaire for the assessment of chronic stress (Trier Inventory for the assessment of Chronic Stress; TICS), respectively. Results Mean cognitive performance was average and higher in younger or better educated individuals. The BFA of the participants was 7.8 ± 7.8 year-equivalents below their chronological age. The mental-cognitive BFS/BFA assessment correlated well with the validated questionnaire for cognition assessment, the IGD. Further, three TICS subdomains (work overload (r = − 0.246, p = 0.003), work discontent (r = − 0.299, p = 0.006) and pressure to succeed (r = − 0.274, p < 0.001)), reflecting mainly work-related stress, showed a significant negative correlation with the mental-cognitive BFS/BFA. Conclusions Our study shows that the BFS/BFA assessment tool follows European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) requirements. Further, we could demonstrate that higher levels of chronic work-related stress may be associated with poorer mental-cognitive performance and a pro-aging state indicating that cognitive impairments can be reduced by stress management interventions.

User Requirements Analysis of an Embodied Conversational Agent for Coaching Older Adults to Choose Active and Healthy Ageing Behaviors during the Transition to Retirement: A Cross-National User Centered Design Study

Background: Retirement is recognized as a factor influencing the ageing process. Today, virtual health coaching systems can play a pivotal role in supporting older adults’ active and healthy ageing. This study wants to answer two research questions: (1) What are the user requirements of a virtual coach (VC) based on an Embodied Conversational Agent (ECA) for motivating older adults in transition to retirement to adopt a healthy lifestyle? (2) How could a VC address the active and healthy ageing dimensions, even during COVID-19 times? Methods: Two-wave focus-groups with 60 end-users aged 55 and over and 27 follow-up telephone interviews were carried out in Austria, Italy and the Netherlands in 2019–2020. Qualitative data were analysed by way of framework analysis. Results: End-users suggest the VC should motivate older workers and retirees to practice physical activity, maintain social contacts and emotional well-being. The ECA should be reactive, customizable, expressive, sympathetic, not directive nor patronizing, with a pleasant and motivating language. The COVID-19 outbreak increased the users’ need for functions boosting community relationships and promoting emotional well-being. Conclusions: the VC can address the active and healthy ageing paradigm by increasing the chances of doing low-cost healthy activities at any time and in any place.

From Mattering to Mattering More: ‘Goods’ and ‘Bads’ in Ageing and Innovation Policy Discourses

This paper provides an empirical ethics analysis of the goods and bads enacted in EU ageing and innovation policy discourses. It revolves around a case study of the persona Maria, developed as part of the EU’s Active and Healthy Ageing Policies. Drawing on Pols’ empirical ethics as a theoretical and methodological approach, we describe the variety of goods (practices/situations to be strived for) and bads (practices/situations to be avoided) that are articulated in Maria’s persona. We analyse how certain ideas about good and bad ageing—those associated with the use of sophisticated technologies—come to matter more in the solutions proposed for Maria and the framing of her unmet needs, while others which were initially seen as relevant and that describe her dreams, fears and interactions, are marginalised. The paper adds to existing studies of ageing and technology by analysing specific practices that render visible how the idea of technology and data sharing as evidently the right path towards futures of (good) ageing, comes to prevail.

Study protocol for Prospective RELOC-AGE: A longitudinal mixed-methods study exploring associations of housing, relocation and active and healthy ageing in Sweden (Preprint)

BACKGROUND Background: While housing and neighbourhood features have the potential to impact opportunities for active ageing, there is a lack of knowledge related to how older people reason regarding their housing situation and how housing and fulfilment of relocation are associated with active and healthy ageing. OBJECTIVE Objective: The objectives of Prospective RELOC-AGE are to study housing choices and relocation and explore effects on active and healthy ageing among men and women 55 years or older in Sweden considering relocation. METHODS Methods: The estimated sample (n=2800) will include people aged 55+ being listed for relocation at either of two housing companies: a local public housing company in Southern Sweden and a national condominium provider (NCP). Prospective RELOC-AGE has a two-level longitudinal mixed-methods design and include quantitative surveys (implemented by a professional survey company) and a telephone interview for a baseline data collection in 2021, with follow-ups with the same procedures in 2022 and 2023. The survey and interviews include questions related to present housing and neighbourhood, relocation plans and expectations, a range of perspectives on active and healthy ageing, and demographics. Linking to national registers will provide additional data on e.g., home help and health care use, objective housing and neighbourhood characteristics. The study is registered at ClinicalTrials.gov NCT04765696 [1]. To explore what housing attributes older adults considering relocation find important, and to what extent, when making their decisions on housing, we will develop a Discrete Choice Experiment to be implemented with a subsample of participants. Further, a Grounded Theory (GT) approach will be applied to collect in-depth interview data from participants who have moved to another dwelling, within 6 months after the move. A follow-up interview 12 months later will focus on participants´ deepened experience over time in terms of fulfilled expectations relocation experiences. RESULTS Results: As of submission of this protocol (June 2021) recruitment has commenced with approximately n=960 respondents to the survey and with ongoing telephone interviews. We anticipate recruitment and data collection based on surveys and interviews to continue during 2021. CONCLUSIONS Conclusions: Prospective RELOC-AGE has the capacity to generate new policy-relevant knowledge on associations of housing, relocation and active and healthy ageing. Such knowledge is relevant for the development of proactive approaches to housing in old age on the individual, group as well as societal levels. CLINICALTRIAL ClinicalTrials.gov NCT04765696

User requirements analysis of an Embodied Conversational Agent for coaching older adults to choose active and healthy ageing behaviors during the transition to retirement: a cross-national User Centered Design study (Preprint)

BACKGROUND The ageing worldwide population involves an increase of multiple chronic diseases and the consequent demand for healthcare services by older people, thus challenging the healthcare systems’ sustainability and older people’s quality of life. In order to postpone older adults’ need for care, the promotion of healthy ageing is a key action that can be favored today by embodied conversational agents. Nevertheless, the role and benefit of this technology is still relatively ignored by the literature, especially when being applied to older workers and new retirees, and from a preventive perspective. OBJECTIVE This study wants to answer two research questions: 1) What are the user requirements of a virtual coaching based on an Embodied Conversational Agent for motivating older adults in transition to retirement to adopt a healthy lifestyle? 2) How could a virtual coaching system address the active and healthy ageing dimensions, especially during COVID-19 times? METHODS To answer the questions above, according to the User Centered Design approach, two-wave cross-national focus-groups with 60 end-users aged 55 and over and follow-up telephone interviews to 27 end-users were carried out in Austria, Italy and the Netherland between Spring 2019 and January 2021. Qualitative data were analysed through the Framework Analysis in order to highlight cross-country commonalities and national peculiarities. RESULTS End-users suggest the virtual coach motivates older workers and retirees to practice physical activity, maintain social contacts and provide them with practical activities to improve their mental and emotional well-being. It can be used every day based on users’ time, mood, family relationships and social condition. The embodied conversational agent should be reactive, customizable, expected to be expressive, sympathetic, not directive nor patronizing and its language should be appropriate, pleasant and motivating. The COVID-19 outbreak accelerated the acceptance of the system by increasing the users’ need for functions that boost community, physical and emotional well-being activities. CONCLUSIONS The study shows that the virtual coaching system can be one of the solutions that can best address the active and healthy ageing dimensions by suggesting activities that can improve individuals’ physical activity, mental well-being and socialisation. especially in the current worldwide epidemiological situation. Nevertheless, to be fully effective, it has to have a pleasant appearance and voice to motivate users without being patronising nor directive. Moreover, it should be customisable, yet non stigmatising, and should be able to adapt to the ageing process and to the evolution of the retirement transition.

Influence of Active and Healthy Ageing on Quality of Life Changes: Insights from the Comparison of Three European Countries

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement in Europe (SHARE) project, aged 50 and over and living in Portugal, Spain and Sweden, was included. The CASP-12 scale was used to measure QoL. A principal component analysis was performed to group preselected variables related to active and healthy ageing into the dimensions of health, social participation, and lifelong learning. A linear regression model was built using the change in CASP-12 scores over the 4-year follow-up as the dependent variable, including the interactions between country and each independent variable in the model. After four years, the average QoL increased in Portugal (difference = 0.8, p < 0.001), decreased in Spain (−0.8, p < 0.001), and remained constant in Sweden (0.1, p = 0.408). A significant country-participation component interaction (p = 0.039) was found. In Spain, a higher participation (β = 0.031, p = 0.002) was related to a higher QoL improvement at 4 years, but not in Sweden or Portugal. Physical health and emotional components (β = 0.099, p < 0.001), functional ability (β = 0.044, p = 0.023), and cognitive and sensory ability (β = 0.021, p = 0.026) were associated with QoL changes over time in all countries. The country-specific associations between health, social participation and QoL should be taken into account when developing public health policies to promote QoL among European older people.