Age suit simulation replicates in healthy young adults the functional challenges to balance experienced by older adults: an observational study

Aging Suit and Motor Performance in Young Adults: Effects Depend on Why the Suit is Worn!

By 2030, one in six people worldwide will be at least 60 years old, with associated sensorimotor changes that complicate daily activities. Aging suits simulate these conditions for younger individuals to enhance their empathy and understanding of older adults' challenges. Research on aging suits has recently increased, with evidence that these suits impair younger adults' motor performance, but a greater understanding of the motor changes induced by aging suits and to identify any factors that may modify them more research is needed. In this research, we explored how the presentation of the suit and the wearer's physical activity level affected motor performance. We divided 95 younger adults into two groups: (a) one informed about the suit's aging properties (aging suit group); and (b) one in which participants were told that it was a posture training suit (posture training group). Each group was further divided into low and high physical activity levels by a median-split method. Participants completed two fine motor tasks (i.e., placing and building bricks) and two gross motor tasks (i.e., heel-to-toe walking and figure-of-eight walking/running) with and without the suit. The aging suit significantly affected motor performance on all tasks, but participants aware that it was an aging suit performed worse on the figure-of-eight walking/running task than participants who thought it was a posture training suit. In addition, for the same motor task, the groups engaged in low physical activity were more affected by wearing the suit than those engaged in high physical activity. Thus, how aging suits are presented and the general activity level of wearers significantly influenced the aging suits' effects on motor performance. The findings from this study can guide future researchers in validating the use of these suits in larger studies.

"It´s like walking in a bubble", nursing students´ perspectives on age suit simulation in a home environment - group interviews from reflection seminars

BACKGROUND

Older persons with age-related and complex health problems will increasingly depend on care provision from nurses in their own homes. However, a barrier to quality care is ageism and nursing students´ disinterest in geriatrics. In addition, nurse education often falls short in preparing students for the complexity of geriatric care. Welfare technology (WT) is progressively implemented in home care to help older persons live at home despite their health problems. However, this process is intricate and requires acceptance and digital literacy among caregivers and older persons. Despite these challenges, nurse education can address and change negative attitudes through innovative teaching methods such as age suit simulation. Therefore, the study aims to describe nursing students´ experiences of age suit simulation in a home-like environment with WT and technical aids, and will reveal their perspective on ageing and providing care to older adults.

METHODS

A qualitative explorative design using semi-structured group interviews (n=39) among nursing students. Data was analysed through reflexive thematic analysis.

RESULTS

The analysis generated three main themes; "It's like walking in a bubble", "An eye opener" and "Concerns about ageing and the current structure of geriatric care". The main themes included eight subthemes. Adapting to the sensory and physical limitations of the age suit was an immersive experience and caused feelings of frustration, loneliness and disconnection. A prominent result was a raised awareness of cognitive loss, especially impaired vision, and students felt the simulations had made them aware of the everyday challenges older persons faced. Students highlighted the importance of patience and giving enough time in care situations by being present and having a critical perspective of WT. The students were mostly negative towards their own ageing and could better relate to older persons´ vulnerability.

CONCLUSIONS

Age suit simulation was described as an embodied and eye-opening experience, raising nursing students´ awareness of older persons´ functional limitations and the consequences for dignity and independence. Coping with cognitive loss was especially difficult. Students were motivated to apply their new knowledge to clinical practice. Age suit simulation can complement geriatric education, preparing students for the complex care needs of older persons.

Combining 3D skeleton data and deep convolutional neural network for balance assessment during walking

Introduction: Balance impairment is an important indicator to a variety of diseases. Early detection of balance impairment enables doctors to provide timely treatments to patients, thus reduce their fall risk and prevent related disease progression. Currently, balance abilities are usually assessed by balance scales, which depend heavily on the subjective judgement of assessors. Methods: To address this issue, we specifically designed a method combining 3D skeleton data and deep convolutional neural network (DCNN) for automated balance abilities assessment during walking. A 3D skeleton dataset with three standardized balance ability levels were collected and used to establish the proposed method. To obtain better performance, different skeleton-node selections and different DCNN hyperparameters setting were compared. Leave-one-subject-out-cross-validation was used in training and validation of the networks. Results and Discussion: Results showed that the proposed deep learning method was able to achieve 93.33% accuracy, 94.44% precision and 94.46% F1 score, which outperformed four other commonly used machine learning methods and CNN-based methods. We also found that data from body trunk and lower limbs are the most important while data from upper limbs may reduce model accuracy. To further validate the performance of the proposed method, we migrated and applied a state-of-the-art posture classification method to the walking balance ability assessment task. Results showed that the proposed DCNN model improved the accuracy of walking balance ability assessment. Layer-wise Relevance Propagation (LRP) was used to interpret the output of the proposed DCNN model. Our results suggest that DCNN classifier is a fast and accurate method for balance assessment during walking.

Effects of age simulation suits on psychological and physical outcomes: a systematic review

Age simulation suits (ASS) are widely used to simulate sensory and physical restrictions that typically occur as people age. This review has two objectives: first, we synthesize the current research on ASS in terms of the observed psychological and physical effects associated with ASS. Second, we analyze indicators able to estimate the validity of ASS in simulating "true" ageing processes. Following the PRISMA guidelines, eight electronic databases were searched (BASE, Cinhal, Cochrane, Google Scholar, ProQuest, PsychINFO, Pubmed, and Web of Science). Qualitative and quantitative studies addressing effects of ASS interventions regarding psychological outcomes (i.e., empathy, attitudes) or physical parameters (i.e., gait, balance) were included. The Mixed Methods Appraisal Tool was applied for quality assessment. Of 1890 identified citations, we included 94 for full-text screening and finally 26 studies were examined. Publication years ranged from 2001 to 2021. Study populations were predominantly based on students in health-related disciplines. Results suggest that ASS can initiate positive effects on attitudes toward (d_weighted = 0.33) and empathy for older adults (d_weighted = 0.54). Physical performance was significantly reduced; however, there is only little evidence of a realistic simulation of typical ageing processes. Although positive effects of ASS are supported to some extent, more diverse study populations and high-quality controlled designs are needed. Further, validation studies examining whether the simulation indeed reflects "real" ageing are needed and should build on reference data generated by standardized geriatric assessments or adequate comparison groups of older adults.Prospero registration: 232686.