Impact of using aging-in-place technologies on quality of life: Results from a randomized controlled trial in four European countries

Abstract

Background: It is widely recognized that technologies have the potential to contribute to high-quality long-term care for older people at home. Evidence from past RCTs partly confirms the positive effects of technology use, although results are mixed and various questions remain unanswered.Objective: This study aimed to demonstrate the beneficial mid-and long-term effects of using aging-in-place technologies on quality of life (QoL) indicators like perceived safety, control, and participation (ATQoL scale) and other specific psychosocial outcomes (PI-ADS) as well as general health-related QoL (EQ-5D-5L Index value and Health today). Method: We conducted an RCT with 281 older people in Austria, Italy, the Netherlands, and Slovenia. Persons in the intervention group (n=143) obtained a bundle of smart home and assistive technologies which they used for 6 or 13 months in their private homes. Persons in the control group (n=138) received no intervention. Three hypotheses were tested with Generalized Linear Mixed Models. Results: We found slightly positive impacts of technology use on some of the specific QoL indicators for persons who used the technologies for 13 months and were relatively motivated and healthy. No, or even detrimental, effects emerged after 6 months. However, persons who used the emergency watch frequently perceived more favorable outcomes than those who used it rarely. Effects had small to medium standardized effect sizes. No effects emerged for the general health-related QoL measure. Conclusion: Despite study limitations (and the COVID-19 pandemic) we conclude that aging-in-place technologies can mitigate adverse age-related developments, and have stabilizing effects on the QoL of older persons. Our trial showed that outcome indicators that are closely related to technology use should be preferred to general indicators. Findings now have to be consolidated in meta-analyses to paint a clearer picture of the beneficial effects of technology use.