Double-Bind of Recruitment of Older Adults Into Studies of Successful Aging via Assistive Information and Communication Technologies: Mapping Review

Abstract

Background Two fields of research and development targeting the needs of the aging population of the world are flourishing, successful aging and assistive information and communication technologies (A-ICTs). The risks of ageist stereotypes emerging from how we communicate in both discourses are long known. This raises questions about whether using specific age criteria in the context of “aging deficits” can bias participation in, or compliance with, the research process by older adults who try to avoid age-related stigma. Objective This study aimed to examine subject recruitment, study designs (based on age >65 years criteria), as well as discourses in research objectives and conclusions in health research on affordances of A-ICTs for older adults. Methods A systematic mapping approach was used to characterize rationales, methods, stated objectives, and expected outcomes of studies indexed in PubMed and retrieved through the search logic ([“Older Adults” OR Seniors OR Elderly] AND [ICT OR gerontechnology OR “Assistive Technology”)] AND (“Healthy Aging” OR “Successful Aging” OR “healthy ageing” OR “successful ageing”). Inclusion criteria were as follows: the study should have recruited older participants (aged >65 years), been qualitative or quantitative research, and involved the introduction of at least one A-ICT for health-related improvements. Exclusion criteria were as follows: reviews, viewpoints, surveys, or studies that used information and communication technology for data collection instead of lifestyle interventions. Content, thematic, and discourse analyses were used to map the study characteristics and synthesize results with respect to the research question. Results Of 180 studies that passed the search logic, 31 (17.2%) satisfied the inclusion criteria (6 randomized controlled trials, 4 purely quantitative studies, 9 focus groups, 2 observational studies, and 10 mixed methods studies). In all but one case, recruitment was pragmatic and nonrandom. Thematic analysis of rationales revealed a high likelihood of emphasis on the burdens of aging, such as rising costs of care (12/31, 39%) and age-related deficits (14/31, 45%). The objectives of the research fell under 4 categories: promotion of physical activity, acceptance and feasibility of robots and remote health monitoring systems, risk detection, and the future of A-ICTs in health care for older adults. Qualitative studies were more attentive to the nonageist research guidelines. Heterogeneity in the study results (both qualitative and quantitative) was not related to age but to individual agency, acceptance, and adherence. A combination of research strategies (participatory, longitudinal, playful, flexible, and need-based designs) proved successful in characterizing variations in study outcomes. Studies that documented recruitment dynamics revealed that fear of stigma was a factor that biased participants’ engagement. Conclusions This review indicates that age is not an informative criterion for recruitment and retention of participants. Charting the dynamics of adoption of, and interaction with, A-ICTs is critical for advancing research and technology development.

The Impact of a Multicomponent Platform Intervention on the Daily Lives of Older Adults

“…This is probably due to a minimum time of exposition, 21 days, which did not engage the older adults for a long time to appreciate such benefits. Indeed, the methodological approach such as the design of the study presents challenges [6].…”

“…Therefore, gerontechnology has enormous potential to ensure better care and an improved sense of security and quality of life for older adults [3], but it also clashes with three different types of barriers, such as decreased cognitive functions, accessibility, and a lack of knowledge about technology [4,5]. In fact, although gerontechnology is really supportive of daily living, over the last few decades, several studies have investigated the numerous reasons why older individuals are less inclined to use technology [6].…”

“…Any device that projects negative aging stereotypes is likely to be rejected by older adults, even if the device is helpful [15]. A recent mapping review on studies of successful aging via assistive information and communication technologies [6] mapped a heterogeneous scenario of research gaps where mixed methods research and the cooperation among clinical, technical, societal, and research areas might help in reaching the effectiveness of solutions to improve the quality of life of older adults [6].…”

“…For all of these reasons, this manuscript aims to assess two research questions: (1) to what extent usability and acceptance can impact a multicomponent platform intervention and (2) to what extent a multicomponent platform intervention improves well-being, quality of life, and self-efficacy in a sample of 25 older adults aged over 65 with a Mini-Mental State Evaluation (MMSE) [18] score between 21 and 27 after 21 days of non-supervised usage at home. Therefore, this paper first describes the study design and the participants' interaction with the SAVE platform, then discusses the results obtained in terms of usability, acceptance, well-being, and self-efficacy, and finally offers food for thought for developers that aim to create products that meet the end users' needs [19], and could also be a source of inspiration for larger studies [6].…”

The association between information and communication technologies, loneliness and social connectedness: A scoping review

“…A qualitative study of Technologies in Later Life (TILL) in 37 rural communities indicates that older adults may welcome the introduction of ICTs to their lives by their children, and deem them useful for creating connections, while at the same time acknowledging that the adoption of ICTS do not fully correspond to their actual needs or interests ( Freeman et al, 2020 ). Issues surrounding older adults’ adherence and acceptance of ICTs in randomized controlled trials (RCTs) has been documented by Khalili-Mahani and Sawchuk (2022) . Furthermore, there remains inconsistency as to whether ICTs are efficacious in reducing loneliness and increasing social connectedness as measured with RCTs.…”