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Castro Martínez E, Hernández Encuentra E, Pousada Fernández M. Voice assistants' influence on loneliness in older adults: a systematic review. Disabil Rehabil Assist Technol 2024:1-15. [PMID: 39222000 DOI: 10.1080/17483107.2024.2397030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 07/15/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
Purpose: This review aims to examine how the use of voice assistants influences loneliness in older adults. Materials and methods: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as CINAHL, APA PsycINFO, MEDLINE, PubMed, Web of Science, ScienceDirect, Scopus, SciELO, Google Scholar, and IEEE Xplore were used. We implemented search strategies in English to locate studies published between January 2010 and January 2023, including those examining the impact of voice assistant usage on loneliness in older adults. Descriptive information was examined, assessing its quality with the Mixed Methods Appraisal Tool. Results: A total of 499 studies were yielded from the initial search, with 13 included in the final analysis. Positive outcomes in reducing loneliness were reported in 84.6% of these studies. There was a prevalence of quasi-experimental studies, alongside heterogeneous measurement instruments, scarce use of standardized tests, and small samples predominantly consisting of women. Commercial voice assistants were the most commonly utilized. Conclusions: Voice assistants show potential in mitigating feelings of loneliness in older adults. Adequate training and adaptation to specific needs seem essential to maximize their effectiveness. In particular, voice assistants available in the consumer market hold significant potential in this area. Further research is necessary to comprehend their impact, encompassing potential risks and ethical considerations.
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Affiliation(s)
- Elena Castro Martínez
- Researcher in Health Psychology and Technology, Universitat Oberta de Catalunya, Barcelona, Spain
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2
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Wong N, Jeong S, Reddy M, Stamatis C, Lattie E, Jacobs M. Voice Assistants for Mental Health Services: Designing Dialogues with Homebound Older Adults. DIS. DESIGNING INTERACTIVE SYSTEMS (CONFERENCE) 2024; 2024:844-858. [PMID: 39045493 PMCID: PMC11262314 DOI: 10.1145/3643834.3661536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
The number of older adults who are homebound with depressive symptoms is increasing. Due to their homebound status, they have limited access to trained mental healthcare support, which leaves this support often to untrained family caregivers. To increase access, a growing interest is placed on using technology-mediated solutions, such as voice-assisted intelligent personal assistants (VIPAs), to deliver mental health services to older adults. To better understand how older adults and family caregivers intend to interact with a VIPA for mental health interventions, we conducted a participatory design study during which 6 older adults and 7 caregivers designed VIPA-human dialogues for various scenarios. Using conversation style preferences as a starting point, we present aspects of human-likeness older adults and family caregivers perceived as helpful or uncanny, specifically in the context of the delivery of mental health interventions, which helps inform potential roles VIPAs can play in mental healthcare for older adults.
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Affiliation(s)
- Novia Wong
- University of California, Irvine, Irvine, California, USA
| | | | - Madhu Reddy
- University of California, Irvine, Irvine, California, USA
| | | | - Emily Lattie
- Northwestern University, Evanston, Illinois, USA
| | - Maia Jacobs
- Northwestern University, Evanston, Illinois, USA
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3
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Sun L, Yang B, Kindt E, Chu J. Privacy Barriers in Health Monitoring: Scoping Review. JMIR Nurs 2024; 7:e53592. [PMID: 38723253 PMCID: PMC11117136 DOI: 10.2196/53592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/20/2023] [Accepted: 03/13/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Health monitoring technologies help patients and older adults live better and stay longer in their own homes. However, there are many factors influencing their adoption of these technologies. Privacy is one of them. OBJECTIVE The aim of this study was to provide an overview of the privacy barriers in health monitoring from current research, analyze the factors that influence patients to adopt assisted living technologies, provide a social psychological explanation, and propose suggestions for mitigating these barriers in future research. METHODS A scoping review was conducted, and web-based literature databases were searched for published studies to explore the available research on privacy barriers in a health monitoring environment. RESULTS In total, 65 articles met the inclusion criteria and were selected and analyzed. Contradictory findings and results were found in some of the included articles. We analyzed the contradictory findings and provided possible explanations for current barriers, such as demographic differences, information asymmetry, researchers' conceptual confusion, inducible experiment design and its psychological impacts on participants, researchers' confirmation bias, and a lack of distinction among different user roles. We found that few exploratory studies have been conducted so far to collect privacy-related legal norms in a health monitoring environment. Four research questions related to privacy barriers were raised, and an attempt was made to provide answers. CONCLUSIONS This review highlights the problems of some research, summarizes patients' privacy concerns and legal concerns from the studies conducted, and lists the factors that should be considered when gathering and analyzing people's privacy attitudes.
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Affiliation(s)
- Luyi Sun
- Department of Information Security and Communication Technology, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Bian Yang
- Department of Information Security and Communication Technology, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Els Kindt
- Centre for IT & IP Law, Faculty of Law and Criminology, KU Leuven, Leuven, Belgium
| | - Jingyi Chu
- Administrative Law, Faculty of Law, China University of Political Science and Law, Beijing, China
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Percy Campbell J, Buchan J, Chu CH, Bianchi A, Hoey J, Khan SS. User Perception of Smart Home Surveillance Among Adults Aged 50 Years and Older: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e48526. [PMID: 38335026 PMCID: PMC10891486 DOI: 10.2196/48526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/02/2023] [Accepted: 12/15/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Smart home technology (SHT) can be useful for aging in place or health-related purposes. However, surveillance studies have highlighted ethical issues with SHTs, including user privacy, security, and autonomy. OBJECTIVE As digital technology is most often designed for younger adults, this review summarizes perceptions of SHTs among users aged 50 years and older to explore their understanding of privacy, the purpose of data collection, risks and benefits, and safety. METHODS Through an integrative review, we explored community-dwelling adults' (aged 50 years and older) perceptions of SHTs based on research questions under 4 nonmutually exclusive themes: privacy, the purpose of data collection, risk and benefits, and safety. We searched 1860 titles and abstracts from Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, and IEEE Xplore or IET Electronic Library, resulting in 15 included studies. RESULTS The 15 studies explored user perception of smart speakers, motion sensors, or home monitoring systems. A total of 13 (87%) studies discussed user privacy concerns regarding data collection and access. A total of 4 (27%) studies explored user knowledge of data collection purposes, 7 (47%) studies featured risk-related concerns such as data breaches and third-party misuse alongside benefits such as convenience, and 9 (60%) studies reported user enthusiasm about the potential for home safety. CONCLUSIONS Due to the growing size of aging populations and advances in technological capabilities, regulators and designers should focus on user concerns by supporting higher levels of agency regarding data collection, use, and disclosure and by bolstering organizational accountability. This way, relevant privacy regulation and SHT design can better support user safety while diminishing potential risks to privacy, security, autonomy, or discriminatory outcomes.
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Affiliation(s)
- Jessica Percy Campbell
- Political Science, University of Victoria, Victoria, BC, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jacob Buchan
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Charlene H Chu
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Andria Bianchi
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Centre for Clinical Ethics, Unity Health Toronto, Toronto, ON, Canada
| | - Jesse Hoey
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- David R Cheriton School of Computer Science, University of Waterloo, Waterloo, ON, Canada
| | - Shehroz S Khan
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Diallo AF, Mackiewicz M, Sargent L, Roman YM, Slattum PW, Waters L, Bennett J, Battle K, Zanjani F, Gendron T, Winship J, Ford G, Falls K, Price ET, Parsons P, Chung J. Cultivating Relationships as a Community-Based Recruitment Strategy in Transdisciplinary Aging Research: Lessons From an Academic-Community Partnership. FAMILY & COMMUNITY HEALTH 2024; 47:32-40. [PMID: 37831622 PMCID: PMC10841158 DOI: 10.1097/fch.0000000000000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Participation of Black American older adults in community-engaged research remains challenging in health sciences. The objectives of this study were to describe the specific efforts, successes, and challenges in recruiting Black American older adults in research led by the Health and Wellness in Aging Across the Lifespan core, part of the Virginia Commonwealth University Institute for Inclusion, Inquiry, and Innovation (iCubed). We conducted a cross-case analysis of 6 community-engaged research projects using the community-engaged research continuum model. Successful recruitment strategies comprised a multifaceted approach to community-based collaboration, including a wellness program with a long standing relationship with the community, engaging key stakeholders and a community advisory board, and building a community-based coalition of stakeholders. Posting flyers and modest monetary compensation remain standard recruitment strategies. The cross-case analysis offered critical lessons on the community's nature and level of engagement in research. Relationship building based on trust and respect is essential to solving complex aging issues in the community.
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Affiliation(s)
- Ana F. Diallo
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Marissa Mackiewicz
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, USA
| | - Lana Sargent
- School of Nursing, Virginia Commonwealth University, Richmond, USA
- Geriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
| | - Youssef M. Roman
- Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
| | - Patricia W. Slattum
- Geriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
- Virginia Geriatric Education Center, Virginia Center on Aging, College of Health Professions, Virginia Commonwealth University, Richmond, USA
| | - Leland Waters
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, USA
- Virginia Geriatric Education Center, Virginia Center on Aging, College of Health Professions, Virginia Commonwealth University, Richmond, USA
| | | | - Kimberly Battle
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Faika Zanjani
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, USA
| | - Tracey Gendron
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, USA
| | - Jodi Winship
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, USA
| | - Gregory Ford
- Community member
- Beacon Communities, LLC, Richmond, Virginia, USA
| | - Katherine Falls
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Elvin T. Price
- Geriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
| | - Pamela Parsons
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Jane Chung
- School of Nursing, Virginia Commonwealth University, Richmond, USA
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Wutz M, Hermes M, Winter V, Köberlein-Neu J. Factors Influencing the Acceptability, Acceptance, and Adoption of Conversational Agents in Health Care: Integrative Review. J Med Internet Res 2023; 25:e46548. [PMID: 37751279 PMCID: PMC10565637 DOI: 10.2196/46548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/10/2023] [Accepted: 07/10/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Conversational agents (CAs), also known as chatbots, are digital dialog systems that enable people to have a text-based, speech-based, or nonverbal conversation with a computer or another machine based on natural language via an interface. The use of CAs offers new opportunities and various benefits for health care. However, they are not yet ubiquitous in daily practice. Nevertheless, research regarding the implementation of CAs in health care has grown tremendously in recent years. OBJECTIVE This review aims to present a synthesis of the factors that facilitate or hinder the implementation of CAs from the perspectives of patients and health care professionals. Specifically, it focuses on the early implementation outcomes of acceptability, acceptance, and adoption as cornerstones of later implementation success. METHODS We performed an integrative review. To identify relevant literature, a broad literature search was conducted in June 2021 with no date limits and using all fields in PubMed, Cochrane Library, Web of Science, LIVIVO, and PsycINFO. To keep the review current, another search was conducted in March 2022. To identify as many eligible primary sources as possible, we used a snowballing approach by searching reference lists and conducted a hand search. Factors influencing the acceptability, acceptance, and adoption of CAs in health care were coded through parallel deductive and inductive approaches, which were informed by current technology acceptance and adoption models. Finally, the factors were synthesized in a thematic map. RESULTS Overall, 76 studies were included in this review. We identified influencing factors related to 4 core Unified Theory of Acceptance and Use of Technology (UTAUT) and Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) factors (performance expectancy, effort expectancy, facilitating conditions, and hedonic motivation), with most studies underlining the relevance of performance and effort expectancy. To meet the particularities of the health care context, we redefined the UTAUT2 factors social influence, habit, and price value. We identified 6 other influencing factors: perceived risk, trust, anthropomorphism, health issue, working alliance, and user characteristics. Overall, we identified 10 factors influencing acceptability, acceptance, and adoption among health care professionals (performance expectancy, effort expectancy, facilitating conditions, social influence, price value, perceived risk, trust, anthropomorphism, working alliance, and user characteristics) and 13 factors influencing acceptability, acceptance, and adoption among patients (additionally hedonic motivation, habit, and health issue). CONCLUSIONS This review shows manifold factors influencing the acceptability, acceptance, and adoption of CAs in health care. Knowledge of these factors is fundamental for implementation planning. Therefore, the findings of this review can serve as a basis for future studies to develop appropriate implementation strategies. Furthermore, this review provides an empirical test of current technology acceptance and adoption models and identifies areas where additional research is necessary. TRIAL REGISTRATION PROSPERO CRD42022343690; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343690.
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Affiliation(s)
- Maximilian Wutz
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Marius Hermes
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Vera Winter
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Juliane Köberlein-Neu
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
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Chung J, Winship J, Parsons P, Falls K, Bleich M. Stakeholder Perspectives on Implementation of Smart Speakers for Aging in Place in Low-Income Senior Housing: A Qualitative Study. J Gerontol Nurs 2022; 48:33-39. [PMID: 36169294 DOI: 10.3928/00989134-20220908-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In the current study, a smart speakers-based system (Amazon® Echo Dot device, a safety pendant, and facility tailored functionalities) for supporting aging in place was implemented in one low-income senior housing property. We aimed to explore perceived benefits, concerns, and expectations about this system among three stakeholder groups (older adults, housing staff, and technology developers) to identify facilitators of and barriers to system implementation. A qualitative analysis of individual interviews using inductive coding methods was performed to identify emerging themes. All stakeholder groups perceived smart speakers as valuable for convenience in daily living and safety. Older adults and system developers identified user difficulty with setting up functions they wanted to use, suggesting the need for user-centered technology support. There were differences in priorities for smart speaker use among three stakeholder groups. This work contributes to the identification of factors affecting smart speaker adoption and use among low-income older adults who often have limited technology experience and support. [Journal of Gerontological Nursing, 48(10), 33-39.].
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8
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Zhong R, Ma M. Effects of communication style, anthropomorphic setting and individual differences on older adults using voice assistants in a health context. BMC Geriatr 2022; 22:751. [PMID: 36104775 PMCID: PMC9473738 DOI: 10.1186/s12877-022-03428-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Voice assistants enable older adults to communicate regarding their health as well as facilitate ageing in place. This study investigated the effects of communication style, anthropomorphic setting, and individual differences on the trust, acceptance, and mental workload of older adults using a voice assistant when communicating health issues.
Methods
This is a mixed-methods study utilising both quantitative and qualitative methods. One hundred and six older adults (M = 71.8 years, SD = 4.6 years) participated in a 2 (communication style: social- vs. task-oriented; between-subject)$$\times$$
×
2 (anthropomorphic setting: ordinary profession vs. medical background; within-subject) mixed design experiment. The study used multivariate analysis of variance (MANOVA) to examine the effects of communication style, anthropomorphic setting of the voice assistant, and participants’ use frequency of digital devices on the trust, technology acceptance, and mental workload of older adults using a voice assistant in a health context. End-of-study interviews regarding voice assistant use were conducted with participants. Qualitative content analyses were used to assess the interview findings about the communication content, the more trustworthy anthropomorphic setting, and suggestions for the voice assistant.
Results
Communication style, anthropomorphic setting, and individual differences all had statistically significant effects on older adults’ evaluations of the voice assistant. Compared with a task-oriented voice assistant, older adults preferred a social-oriented voice assistant in terms of trust in ability, integrity, and technology acceptance. Older adults also had better evaluations for a voice assistant with a medical background in terms of trust in ability, integrity, technology acceptance, and mental workload. In addition, older adults with more experience using digital products provided more positive evaluations in terms of trust in ability, integrity, and technology acceptance.
Conclusions
This study suggests that when designing a voice assistant for older adults in the health context, using a social-oriented communication style and providing an anthropomorphic setting in which the voice assistant has a medical background are effective ways to improve the trust and acceptance of older adults of voice assistants in an internet-of-things environment.
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DeSouza DD, Robin J, Gumus M, Yeung A. Natural Language Processing as an Emerging Tool to Detect Late-Life Depression. Front Psychiatry 2021; 12:719125. [PMID: 34552519 PMCID: PMC8450440 DOI: 10.3389/fpsyt.2021.719125] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022] Open
Abstract
Late-life depression (LLD) is a major public health concern. Despite the availability of effective treatments for depression, barriers to screening and diagnosis still exist. The use of current standardized depression assessments can lead to underdiagnosis or misdiagnosis due to subjective symptom reporting and the distinct cognitive, psychomotor, and somatic features of LLD. To overcome these limitations, there has been a growing interest in the development of objective measures of depression using artificial intelligence (AI) technologies such as natural language processing (NLP). NLP approaches focus on the analysis of acoustic and linguistic aspects of human language derived from text and speech and can be integrated with machine learning approaches to classify depression and its severity. In this review, we will provide rationale for the use of NLP methods to study depression using speech, summarize previous research using NLP in LLD, compare findings to younger adults with depression and older adults with other clinical conditions, and discuss future directions including the use of complementary AI strategies to fully capture the spectrum of LLD.
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Affiliation(s)
| | | | | | - Anthony Yeung
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Marston HR, Musselwhite CBA. Improving Older People's Lives Through Digital Technology and Practices. Gerontol Geriatr Med 2021; 7:23337214211036255. [PMID: 34527764 PMCID: PMC8436304 DOI: 10.1177/23337214211036255] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/09/2021] [Indexed: 12/14/2022] Open
Abstract
The Aging and Technology special issue showcases twelve papers spanning a range and diversity of international scholarly research within the field of ageing and technology. The collection of papers demonstrates the positive impact technology can have on the lives of older people including improving cognitive performance, physical and mental health and people's daily activities and practices. There are still barriers to use, including psychological issues of motivation, attitudes, privacy and trust and social issues involving learning to use the technology. In conclusion, to help overcome these barriers, it is recommended that research and development of technology involves older people as co-developers working with stakeholders from different disciplines and backgrounds.
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