Use of Assistive and Interactive Technology and Relation to Quality of Life in Aging Adults

Maintaining quality of life while remaining independent are important goals for aging adults. Recent advancements in technology have provided a variety of physical, cognitive, and social supports to facilitate achieving these goals. This study aimed to improve understanding of older adults’ technology needs, preferences, and use to inform development of innovations for this population. Results of this needs assessment revealed that basic technologies are becoming universal, while newer devices are beginning to be adopted; older, well-educated adults may represent early adopters of technology, Further, traditional barriers, including technology complexity and familiarity, may remain obstacles to adoption. This study suggests older adults use technology in ways that support goals and enhance control, autonomy, pleasure, and self-awareness. This research highlights how forthcoming investigations should continue to diversify understanding of technology needs, preferences, and use across sub-populations, and future technology development should utilize this information to tailor services and products to aging consumers

Path Analysis of Education and Disease Burden in Dementia Vulnerability

When considering the various extrinsic variables that affect disease vulnerability, it is valuable to study temporal ordering of factors to identify areas for disease intervention. This study sought to inform improvement of networks for the purposes of education and health by attempting to better define the causal ordering of ethnicity, age, gender, education, disease burden, and dementia diagnosis with the Aging, Demographics, and Memory Study, a sub-study of the Health and Retirement Study. Participants and/or proxies self-reported total number of chronic conditions, subsequently regarded as disease burden. Assessments occurred over four waves; participants were not reassessed after dementia diagnosis. The current study categorized participants as demented (n=414), identified in any wave, or normal (n=117), identified in the final wave. Cognitively-impaired-not-demented and deceased participants were not considered due to lack of diagnosis. Cross-sectional weighting was used. A path model was developed; ethnicity, age, and gender were antecedent to education, and education was casually ordered before disease burden, which was antecedent to dementia diagnosis. A series of logistic and linear regression analyses were conducted. Results revealed that being Black (Σβ=0.348, all p’s\u3c.001), Hispanic (Σβ=0.253, all p’s\u3c.001), of older age (Σβ=0.264, all p’s\u3c.001), female (Σβ=0.422, all p’s\u3c.001), and having increased disease burden (Σβ=0.113, p\u3c.001) all demonstrated a positive total effect on dementia diagnosis. Conversely, increased education (Σβ=-0.268, p\u3c.001) had a negative total effect on diagnosis. All direct and indirect pathways were statistically significant. Ultimately, these results may indicate a need for dementia interventions that target those with low education or high disease burden

Virtual Reality For Therapeutic Recreation In Dementia Hospice Care: A Feasibility Study

Purpose Feasibility study to explore virtual reality (VR) via wireless goggles as a therapeutic recreation for people with dementia on hospice (hPWD) To explore the acceptability of VR to hPWD To identify any problems and/or benefits associated with using VR as a form of therapeutic recreation in hPWD on hospicehttps://digitalcommons.unmc.edu/emet_posters/1002/thumbnail.jp

Optic flow improves step width and length in older adults while performing dual task

Background Dual-task paradigms are used to investigate gait and cognitive declines in older adults (OA). Optic-flow is a virtual reality environment where the scene flows past the subject while walking on a treadmill, mimicking real-life locomotion. Aims To investigate cost of environment (no optic-flow v. optic-flow) while completing single- and dual-task walking and dual-task costs (DTC; single- v. dual-task) in optic-flow and no optic-flow environments. Methods Twenty OA and seven younger adults (YA) walked on a self-paced treadmill in 3-min segments per task and both environments. Five task conditions included: no task, semantic fluency (category), phonemic fluency (letters), word reading, and serial-subtraction. Results OAs had a benefit of optic-flow compared to no optic-flow for step width (p = 0.015) and step length (p = 0.045) during letters compared to the YA. During letters, OA experienced improvement in step width DTC; whereas YA had a decrement in step width DTC from no optic-flow to optic-flow (p = 0.038). During serial-subtraction, OA had less step width DTC when compared to YA in both environments (p = 0.02). Discussion During letters, step width and step length improved in OA while walking in optic-flow. Also, step width DTC differed between the two groups. Sensory information from optic-flow appears to benefit OA. Letters relies more on verbal ability and word knowledge, which are preserved in aging. However, YA use a complex speech style during dual tasking, searching for complex words and an increased speed of speech. Conclusions OA can benefit from optic-flow by improving spatial gait parameters, specifically, step width, during dual-task walking

Strength of Plantar- and Dorsiflexors Mediates Step Regularity During a High Cognitive Load Situation in a Cross-sectional Cohort of Older and Younger Adults

Background and Purpose: Completing simultaneous tasks while standing or walking (ie, a high cognitive load situation [HCLS]) is inevitable in daily activities and can lead to interference in task performances. Age-related physical and cognitive changes may confound performance variability during HCLS in older and younger adults. Identification of these confounding effects may reveal therapy targets to maintain optimal physical function later in life. The aim of this study was to investigate the effect of increasing the difficulty levels of an additional motor task and restricting visual information, on gait parameters in younger and older adults while considering the effect of cognitive and physical covariates. Methods: Fifteen healthy younger and 14 healthy older adults were asked to complete assessments of cognitive function, balance, and strength. They were then asked to walk on a self-paced treadmill with or without carrying a plastic tray. Opaqueness of the tray (vision) and the presence of water in glasses placed on the tray (increasing task difficulty) were varied. Mean, standard deviation, and regularity (sample entropy) of step width and length were compared across conditions and groups using repeated-measures analyses of variance with and without covariate analysis. Only significantly correlated covariates of cognition, balance, and strength were entered into each model. Results and Discussion: Older adults had greater step width irregularity compared with younger adults across all conditions when controlling for concentric plantar- and dorsiflexion strength. A decline in strength may likely alter neuromuscular control of gait, specifically control of step width, which has been associated with fall risk in older adults. Adjusting for the same covariates revealed increased regularity of step length, as visual feedback from the feet was restricted. Specifically, step length was more regular while carrying an opaque tray compared with not carrying a tray. Visual restriction was a contributing factor, which led to more predictable gait kinematics, indicating the role of sensory information to enhance the adaptability during walking under HCLS. Conclusion: The knowledge of the regularity behavior of human movement can expand physical therapists\u27 treatment approaches to promote further interactivity and coordination across body systems that model behavior of healthy young individuals. Targeting strength during therapy may provide additional benefits for gait performance under HCLS

Understanding older people’s voice interactions with smart voice assistants: a new modified rule-based natural language processing model with human input

The COVID-19 pandemic has expedited the integration of Smart Voice Assistants (SVA) among older people. The qualitative data derived from user commands on SVA is pivotal for elucidating the engagement patterns of older individuals with such systems. However, the sheer volume of user-generated voice interaction data presents a formidable challenge for manual coding. Compounding this issue, age-related cognitive decline and alterations in speech patterns further complicate the interpretation of older users’ SVA voice interactions. Conventional dictionary-based textual analysis tools, which count word frequencies, are inadequate in capturing the evolving and communicative essence of these interactions that unfold over a series of dialogues and modify with time. To address these challenges, our study introduces a novel, modified rule-based Natural Language Processing (MR-NLP) model augmented with human input. This reproducible approach capitalizes on human-derived insights to establish a lexicon of critical keywords and to formulate rules for the iterative refinement of the NLP model. English speakers, aged 50 or older and residing alone, were enlisted to engage with Amazon AlexaTM via predefined daily routines for a minimum of 30 min daily spanning three months (N = 35, mean age = 77). We amassed time-stamped, textual data comprising participants’ user commands and responses from AlexaTM. Initially, a subset constituting 20% of the data (1,020 instances) underwent manual coding by human coder, predicated on keywords and commands. Separately, a rule-based Natural Language Processing (NLP) methodology was employed to code the identical subset. Discrepancies arising between human coder and the NLP model programmer were deliberated upon and reconciled to refine the rule-based NLP coding framework for the entire dataset. The modified rule-based NLP approach demonstrated notable enhancements in efficiency and scalability and reduced susceptibility to inadvertent errors in comparison to manual coding. Furthermore, human input was instrumental in augmenting the NLP model, yielding insights germane to the aging adult demographic, such as recurring speech patterns or ambiguities. By disseminating this innovative software solution to the scientific community, we endeavor to advance research and innovation in NLP model formulation, subsequently contributing to the understanding of older people’s interactions with SVA and other AIpowered systems

Assistive and Interactive Technology Use for Social Communication in Non-White Adults

Recent literature suggests that COVID-19 has increased social isolation and loneliness. Across populations, this has been associated with reduced quality of life and poorer health outcomes. Notably, aging adults are at greater risk for both isolation and its negative effects. Assistive and interactive technologies (AITs) may be useful for reducing isolation risk by bolstering communication. However, rapid advancement of AITs may create new barriers, especially for marginalized/underserved communities. Therefore, the purpose of this study was to explore isolation and AIT utilization in a majority-non-white sample. Participants (N=82) completed a Qualtrics survey via Amazon Mechanical Turk. Respondents were categorized as younger adults (YA; N=34, ages 19-34, M=27.7±4.6); middle adults (MA; N=27, ages 35-49, M=41.9±4.1); and older adults (OA; N=20, ages 50-70, M=57.6±6.5). Data were part of a larger survey’s minority subset (92.5% non-white); participants dominantly identified as Black (36.5%) and Hispanic (34.2%). Results suggested most adults used basic AITs regularly. Standard AIT functions, including telephone calls and texting/messaging (YA=58.8%, MA=48.1%, OA=65%) were frequently reported. However, the data from the study suggested that people are having more in-person interaction now, compared to one year ago at this time (46.4%). Additionally, distanced communication was negatively correlated with overall socialization (-.231, p\u3c.05). Social distancing may contribute to feelings of isolation; as such, these results may suggest that those relying on AITs for primary contact are at increased risk for loneliness. This research suggests that current AITs may not be sufficient in mitigating this risk, especially for aging adults needing in-person contact and improved technologies

Child Safety in Grocery Stores: The Impact of Verbal Prompts and Reinforcement on Safety Strap Use in Shopping Carts

Head and face injuries requiring a hospital visit are a consistent problem for young children shopping with their caregivers. Falls from shopping carts are the most common cause of such injuries. Using a reversal design with a 2-month follow-up, research assistants verbally prompted caregivers with small children seated in a shopping cart to put a safety strap on their child when entering a grocery store. Compliance resulted in the child receiving a gold star sticker. The sticker was used to identify participants for subsequent data collection when exiting the store. Verbal prompts and stickers increased safety belt use, and most children (95%) remained strapped in during their entire visit. A 2-month follow-up showed the effects to be short lived

Health Behaviors and Their Impact on Self-Reported Cognitive Impairment, Domains of Daily Function, and Resultant Quality of Life

This abstract has been removed to protect the intellectual property of the project

Communication During COVID-19: ​ A Comparison Between Institutionalized and Community Dwelling Older Adults​

COVID-19 has created communication and socialization challenges for many older adults (OAs) living in community or institutional settings (CECs, IECs respectively) and their essential contacts (ECs). An essential contact is someone who provides emotional, physical, and social support for an older adult. While social distancing measures have decreased the spread and infection rate, these measures have placed strain upon communication and socialization needed for wellbeing which may increase the risk of loneliness and subsequently depression, cognitive functioning, and mortality among OAs. This study compared how general, in-person, and distanced communication between CECs and IECs has changed due to COVID-19. Self-identified ECs to OAs (N=546) completed a Qualtrics questionnaire via Amazon Mechanical Turk. Respondents (Age Range: 19-77; Mean=44.3; SD=14.2) were generally female (54.8%), white (81.0%), and CECs (57.3%). Pearson chi-square was used to evaluate the association between EC and communication type. Phi and Cramer’s V were used to measure effect size. IECs were significantly more likely than CECs to report much less general (41.6% vs. 10.7; medium effect) and in-person (60.0% vs. 22.4%; medium effect) social interaction due to COVID-19. IECs were significantly more likely to report much more distanced communication than CECs (42.8% vs 5.2%; small effect). Overall, this suggests community dwelling OAs’ communication and socialization were less impacted by COVID-19 distancing than institutionalized OAs. Thus, institutionalized OAs may be at greater risk for negative effects of social distancing. Future efforts need to focus on prioritizing ways for institutionalized adults to communicate with their ECs if social distancing is neede