By 2040, the U.S. Census Bureau estimates that 80 million U.S. citizens—almost a quarter of the population—will be age 65 or older. As new technologies continue to enter our lives at a breakneck pace—many designed by those at the younger end of the age spectrum—what does that mean for this large cadre of people?
The answer, in part, depends on how much tech companies understand these users and collaborate with them on designs and applications to best support their lives. That’s challenging because sometimes older users have different needs than younger users, and also because the range of technical abilities of 65- to 95-year-olds is vast and varied.
Fortunately, thanks to extensive training and knowledge in areas like aging, cognitive psychology, human factors, neuropsychology, and more, psychologists are helping to ensure that technology will be useful for all of us in our later years.
“Augmenting support and enabling individual autonomy are uppermost in my mind when I think about designing technology for older adults,” said Wendy A. Rogers, PhD, head of an interdisciplinary program at the University of Illinois at Urbana-Champaign called CHART (Collaborations in Health, Aging, Research, and Technology). “I can’t emphasize enough that technology’s purpose is not to do away with human support,” she said, “but rather to enhance what is possible.”
The COVID-19 pandemic has made it additionally clear that a comfortable relationship with technology is an important need for older adults, as evidenced by the difficulty many have had in registering for vaccines online and by the way technology has helped mitigate loneliness during a difficult time, said Sara J. Czaja, PhD, director of the Center on Aging and Behavioral Research at Weill Cornell Medicine in New York and a prominent researcher in the area.
“People who saw no value in having access to a computer or mobile device before the pandemic now see that value because having access allows them to connect with family and loved ones,” she said.
Designing homes to serve
One major focus for psychologists in the area is developing home-based technologies to make life easier, safer, and more interesting for older adults. CHART is at the cutting edge of this work, bringing together faculty and students in community health, psychology, engineering, architecture, public health, and other disciplines to design and study technologies for successful aging.
The program’s signature research space is called the McKechnie Family LIFE (Living in Interactive Future Environments) Home, and it opened its doors in January. The space looks like a roomy, ultramodern house outfitted with the latest smart technology and gadgets, including smart refrigerators, ovens, digital assistants, home sensors—even coffee makers. The facility also includes an independent control room where researchers can simulate remote activities like telehealth, as well as an innovation lab and classroom space.
Because the pandemic has made it unsafe for older adults to come to labs, a lot of current work involves tech development for the home, said Rogers. In one set of projects, researchers are testing robots to perform tasks of daily living. StretchTM, a research robot developed by the company Hello Robot, can reach up or down to pick up objects, helping older adults avoid a major cause of falls. Another technology is a type of “soft robot” developed by Girish Krishnan, PhD, an assistant professor in the Grainger College of Engineering at the University of Illinois at Urbana-Champaign. It’s made of soft, elastic materials that can flexibly reach areas that a hard robot can’t. Krishnan’s team is testing a version with a camera on one end for potential telehealth purposes: If a person has a wound in a place that’s hard to see or reach, for example, the robot could take images and forward them to a health care provider—an effective and potentially low-cost alternative to relying on home health aides.
Psychologists’ role in this work is to study how people react to such devices and provide input to engineers on features that could facilitate people’s ability to accept, trust, rely on, and control—to “grok,” in tech terms—their mechanical friends, said Rogers. That means fine-tuning how such robots communicate with people and how they look—a vital area of research that is still evolving.
“The idea of sociability, including appearance, could be very important for building a trust relationship,” she said.
Her team and others are also working to help older adults who aren’t as comfortable with technology make better use of digital assistants like Amazon’s Alexa and Echo. In a pilot study with 12 older-adult Echo owners, for example, a team headed by Lyndsie M. Koon, PhD, now at the University of Kansas, found that disgruntled users cited problems such as difficulty using the voice-activation feature and low levels of perceived support for learning the technology (Ergonomics in Design, Vol. 28, No. 1, 2020).
To improve that situation, the team has created instructional videos that take these factors into account and is now testing them with groups of older adults. Meanwhile, researchers at the TechSAge research center at the Georgia Institute of Technology (Georgia Tech) are studying Alexa’s potential to help people with limited mobility tackle home chores, connect with others, exercise, and perform health care activities, thanks to funding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
Supporting technology uptake
For those with the means and education to use it, modern technology can be a big plus. But there remains a large swath of older adults who can’t afford pricey tech and lack access to and education on the basics. A February report by the nonprofit Older Adults Technology Services, for example, found that 22 million older Americans lack internet access and that older adults with less than a high school degree or an income of less than $25,000 are 10 times more likely than the general population to be offline. Meanwhile, the report found, Black and Latinx older adults are, respectively, more than 2.5 and 3.6 times more likely than the general population to lack computer access.
Helping these individuals access, use, and enjoy computers is the central aim of psychologists involved in an ongoing study called the PRISM (Personal Reminder Information & Social Management) trial, conducted by researchers who are part of a five-university collaborative known as CREATE (Center for Research and Education on Aging and Technology Enhancement). CREATE is directed by Czaja, who founded it in 1999 to ensure that technology benefits and can be successfully used by older adults. Since its inception, CREATE has been continuously funded by the National Institute on Aging.
Although it has undergone several iterations, PRISM is in essence a software system that’s designed to be easy to use from the get-go and to support people’s social connectivity, access to resources, memory, and new learning. Now, researchers in PRISM’s second phase are conducting intervention studies with low-income and ethnically diverse participants in assisted living facilities in Miami, senior housing in Atlanta, and rural areas in Tallahassee, Florida. They’re also testing the system with individuals in New York City who have cognitive impairments.
The first phase of the trial, held at three sites, involved 300 adults ages 65 to 85 who received the PRISM system on their computers or in binders containing the same information. At 6 months, the online group reported significantly less loneliness and greater perceived social support and well-being than the binder recipients. They also showed greater computer self-efficacy, proficiency, and comfort with computers at 6 and 12 months than they did at baseline, the team found (The Gerontologist, Vol. 58, No. 3, 2018).
In a second, ongoing phase, 250 additional older adults in a variety of living contexts are receiving a similar PRISM intervention on a tablet with added social interaction features such as videoconferencing and social media. Researchers are comparing PRISM 2 with a typical tablet computer without the PRISM software. Results will be released later this year.
As with many studies that involve older adults in planning and testing, quantitative results don’t adequately capture the importance that PRISM has for participants, said cognitive psychologist Walter “Wally” Boot, PhD, a CREATE principal investigator at Florida State University (other CREATE sites include Weill Cornell Medicine, the University of Miami, Georgia Tech, and the University of Illinois at Urbana-Champaign). One participant, for instance, was upset that her church had gone completely online and no longer mailed out church bulletins.
“She said she didn’t want to be a burden and request that a copy be printed just for her,” said Boot. So, when she discovered that she could connect with the church online and get her materials electronically, she was thrilled.
“In some ways, the standardized measures of loneliness and social isolation undersell the real impact that technology can have on older adults’ lives,” Boot said.
Many of the same researchers who have been involved with CREATE and PRISM are now collaborating with additional centers that include other aging populations that could reap significant benefits from technology. One example is a new 5-year center called ENHANCE (Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement), also funded by the NIDILRR. Codirected by Czaja and Boot, its mission is to help people who have mild cognitive impairment, traumatic brain injury, or post-stroke cognitive impairment gain social support and connect with community resources through technology.
For example, the team plans to develop user-friendly instructional support for transportation apps like Uber and Google Maps that will include a PRISM-like system designed specifically for people with these types of cognitive impairments.
The success of these programs depends on researchers collaborating closely with end users, said Boot.
“Before you start designing technology solutions,” he said, “you really need to do the homework and talk with people about their issues and challenges.”
Promoting safe driving
Other researchers are using technology to study the best ways to enhance driving safety among older adults, including in automated vehicles.
In one line of work, a team of researchers headed by cognitive and engineering psychology researcher Jing Feng, PhD, of North Carolina State University (NC State), have developed and are studying a task that tests people’s reactions in simulated driving scenarios that require focused attention, for example driving through a busy intersection with pedestrians present.
In a study under review, two groups of drivers received training on the task, while a third group did not. Then, participants either performed the driving task, watched others doing it, or did nothing at all. Those who took the training and performed the task had fewer incidents and were better able to detect and avoid pedestrians and other obstacles than those in both control groups. If the task were tested and validated on a wider scale, it could prove a useful tool for drivers who want to assess and improve their attentional abilities on the road, Feng said.
Meanwhile, Feng and others are also studying how older adults might adapt to automated vehicles as they become more common. In one study, Hallie Clark, PhD, also of NC State, and Feng found that young and old drivers responded equally quickly to an automatic vehicle’s notification to resume manual control but that, in doing so, older drivers tended to brake harder (Accident Analysis & Prevention, Vol. 106, 2017).
Eventually, such findings could inform training for drivers of all ages on the use of these vehicles, Feng said. “These factors need to be taken into account so that people can become more comfortable with the technology while also understanding its limitations.”
Inspiring new thinking
Studying the intersection of psychology, technology, and aging tends to challenge stereotypes that older people can’t cope with technology or that they only want simplistic designs. In fact, research by Georgia Tech senior research scientist Tracy Mitzner, PhD, and the CREATE team indicated that older adults generally hold positive views about technology and are open to using helpful devices in their daily lives (Computers in Human Behavior, Vol. 26, No. 6, 2010). What’s more, they’re sometimes as proficient as younger adults at some tasks. For example, Feng thought older drivers might have more difficulty and be slower in assuming control of automated vehicles than younger drivers. But “they were equally good at taking over, and they didn’t really show inferior capability,” she said.
Designing technology for older adults can also hold surprises, said NC State professor and human factors psychologist Anne McLaughlin, PhD. Many technology companies, for example, forge ahead with designs that they think would benefit older adults without understanding the differences in various age ranges or consulting potential users. But many would-be buyers end up finding those products clunky and unattractive. “They say, ‘That’s not for me—I’m going to be 70, but I’m not old,’” she said.
For these reasons and more, psychologists are important and necessary partners in this work, Rogers and others said. “Engineers and roboticists and computer scientists can do the building, but we bring that needed human perspective,” she said.
Psychologists also understand that technology will never be a substitute for human interaction, Czaja added.
“But if technology is well designed and people are given the appropriate training, it can be used to augment the delivery of programs and services, especially to people who really need it,” she said. “And we’re certainly learning that that is not only feasible, but that people embrace it.”
