Transcript Slide 1

FIRST INTERNATIONAL SOCIETY FOR
GERONTECHNOLOGY
MASTERCLASS IN GERONTECHNOLOGY
TUE, EINDHOVEN, NL MAY 22-23 2006
Methodologies in Compensation Studies
James L. Fozard, Ph.D.
School of Aging Studies
University of South Florida
Tampa, FL 33260
For electronic copy of slides, send
me an e-mail request at
[email protected]
Tools for planning compensatory
interventions
• Four steps are involved
– Identify the domain(s) of human activity that is
the target of the intervention—health,
housing, communication, transportation, work
and leisure
– Identify the typical age of the target population
and the relation of age to stage of secular
development of technology to be used
– Identify the target and site of the intervention
Gerontechnology Matrix: 4 types of technological
interventions in 5 domains of human activity
Domain of Human Activity
Technology
Intervention
Enhancement &
Satisfaction
Prevention &
Engagement
Compensation &
Assistance
Care & Organization
Health & Selfesteem
Housing &
Daily Activities
Communication
& Governance
Mobility &
Transport
Work &
Leisure
Person
Receptors Internal
Structures
Effectors
Human
aging
System
Output
Measure
Interface
Secular
change
Social Built Natural
Time
Environment
LESSON: BOTH age-related
and secular changes affect
system output dynamics
Past
Future
Putting the 4 gerontechnology
interventions to work
Fozard, JL Impacts of technology interventions on health and selfesteem. Gerontechnology, 2005, 4, 63-76.
• The diagrams relating the interactions
between people and their environments are
just the first step in planning environmental
interventions
• The next steps include identifying the
–
–
–
–
Desired impact, e.g. prevention vs. compensation
Target of intervention
Site and placement of technology
Timing of intervention
Planning Practical Application of
Gerontechnology Concepts
IMPACT?
IMPACT?
INTERVENE:
Prevention
Enhance
TYPE, SITE?
Prevent
Compensation
Person:
Compensate
Care/organization
Care/organization Train, motivate
Select
Enhance
Personality
Demographics
FUNCTION? Environment:
TARGET?
Physical
Physical
Mental
Cognitive
Emotional/social
Emotional/Social
Built, social, natural
Device on person
Device: located
Fig.2
near or Fozard,
remotely
Person
System
Output
Environment
Time
Technology for Compensation in
Perceptual-Motor Functioning
• There is some evidence for using
technology to reduce or delay the impact
of presbycusis on age related hearing loss
• The evidence for using technology for
vision and complex perceptual motor
function is less clear
• Presentation will focus on vision
Hearing: Compensation 1
• Improve Auditory Image Quality
– Amplification by hearing aids and direct signal
transmission, aural rehabilitation
• Reduce temporal distortion from
reverberation and time compression of
signals
Hearing: Compensation 2
• Reverberation
– Clearly age-related—interventions available
•
Schieber F, Fozard JL, Gordon-Salant S, Weiffenbach J Optimizing the
sensory-perceptual environment of older adults Int J Indust Ergon
1991;7:133-162
• Speech too fast, e.g, speech compressed
– Clearly age-related—one intervention is processor
to slow broadcast speech without frequency
distortion
Mutsuhashi T Human-friendly broadcasting technology NHK R&D 1998;50:53-59
Hearing: Compensation 3
• Reverberation and time compression often
occur together in public places
• Useful to have guidelines to set goals for
both factors
• Gordon-Salant and Fitzgibbons describe
effort to create equal audibility index
Equivalent S/N Ratio: Age and
Hearing Impairement Effects
• Gordon-Salant, S., Fitzgibbons, P.J. J Speech
Hearing Research 1995,38, 706-13.
• % correct word recognition in SPIN test
measured in Young (18-40) and Old (65-76)
with Normal (N)—HL no more than 15dB at
250-4000Hz or Hearing Impaired (HI)—mild
to moderate sensorineural hearing loss.
Equivalent S/N Ratio: Age and
Hearing Impairement Effects
Equivalent S/N Ratio Defined:
% Correct Data of Young-N Group in Noise at
different S/N ratios used in Equation relating
S/N to % Correct.
Predicted S/N ratios used to compare effects of
Age and Hearing Impairment under 4 levels
of speech compression and 4 levels of
reverberation—higher Equivalent S/N
ratio=better performance.
Equivalent S/N Ratios for 0-60%
Time Compression(N-HI)
25
20
Young N
Old N
Young HI
Old HI
15
S/N
10
5
0
0
30
40
50
Time Compression (%)
60
Equivalent S/N Ratios for 0-0.6
Reverberation (N-HI)
25
S/N
20
Young N
Old N
Young HI
Old HI
15
10
5
0
0
0.2
0.3
0.4
0.6
Reverberation Time (sec)
Clusters of Equivalent S/N
Ratios for N and HI Listeners
N
COMPRESSION (T30-T-60 ) AND
REVERB (R.2-R.6) WITH EQUIVALENT
S/N RATIOS
0
T3 T4 R.2 T5 R.3 R.4 T6 R.6
S/N 19
19
HI
0
S/N 15
19
13
13
13
R.2 T3
R.3 T4
T5
R.4 R.6 T6
12
8
8
8
12
19
8
8
3
8
3
From:Gordon-Salant S and Fitzgibbons PJ J Speech Hear Res 1995;38:711
Compensation: Vision 1
• Improve visual image quality
– Increase illumination, contrast, letter size
improve target quality, reduce glare, and
requirements for light/dark adaptation
• Decrease requirements for fast adaptation
and speed in complex visual tasks.
– Target magnification, longer presentation
times, cueing
Compensation: Vision 2
• The loss of sensitivity with age extends
across visible spectrum:
– Discrimination between white light and
mixture of white light and monochromatic light
(420-680 nm) showed that older adults were
less able to discriminate color at 2 levels of
illumination after controlling for pupil size,
retinal luminance etc.
•
Kraft JM, Werner JS Aging and the satuation of colors. 1.. Colorimetric
purity discrimination J Opt Soc Am 1999;16:223-230.
Color Discrimination for 2 Age
and Luminance Levels
3
2.5
2
30-10
74-10
30-250
74-250
Log(1/Pc) 1.5
1
0.5
0
420
500
570
640
420
500
Wavelength (nm)
Data from Kraft JM and Werner JS, 1999
570
640
Compensation: Visual acuity in
clinical testing conditions
• Longitudinal data on monocular acuity (better
eye) obtained with standard apparatus confirms
earlier published data showing that presenting
acuity changes little until the 70s for both men
and women
• Example of resolution acuity comes from data
from the Baltimore Longitudinal Study of Aging.
Same finding with letter acuity.
Snellen
Fraction
Squares=men;Circles=women
Data from BLSA, unpublished
20
30
40
50
60
Estimated US % w/Acuity<0,5: 4
70
4 9
80 Age
16
Compensation: Visual Acuity
• In everyday situations, poor illumination,
contrast and target characteristics greatly
reduce acuity and contrast sensitivity of
older persons.
• Examples from Japan and the Netherlands
follow. Both illustrate lighting and contrast
needed to reduce/eliminate age
differences.
Visual acuity
measured by letter or
Landolt Ring
increases as much as
80% with luminance
and brings oldest
group almost to level
of youngest at lower
luminance levels.
Data from Research
Institute of Human
Engineering for
Quality Life, Osaka
Japan, 1999.
Illumination and Contrast
Effects on Readability of Type
•
Steenbekkers LPA (1998) Visual contrast sensitivity. In LPA Steenbekkers CEM
van Beijsterveldt (Eds) Design-relevant characteristics of ageing users. Delft,
NL: Delft University of Technology Press, pp.131-136.
• Size of lower case Times Roman type needed to
read standard passages by Dutch adults in four
age groups was measured. Three levels of
illumination (10,100,1000 lx) and 4 levels of
contrast (10, 33, 100 black on white and 100
white on black used.
Type Size Needed to Read
Illumination, Contrast Effects
Illum
Age
Contrast
10
33
100
100
10
25
lux
75
100
25
10.0
5.0
4.0
3.2
12.6
10.0
8.0
8.0
4.0
4.0
3.2
3.2
lux 1000
75
25
8.0
8.0
6.3
5.0
3.2
3.2
3.2
3.2
lux
75
6.3
6.3
5.0
4.0
Need Multiple Approaches to
Improving Image Quality
• Applied research on equivalent visibility
functions across age--using combinations of
illumination, contrast, and targets
• Consumer education: Mockups of kitchen,
home office etc. that allow older people to see
how to improve personal lighting etc. Mockups
could be in lighting stores, Optician stores,
senior centers etc.
Need Multiple Approaches to
Improving Image Quality
• Consumer services: Small portable lighting aids
in restaurants for menus and bills; better design
of price tags, directions and prices of
merchandise.
• Improved use of electronic reading devices:
flexible print size and contrast.
• Device to automatically change focal lengths of
lens for presbyopic viewers.
• Greater use of digital hearing aids that selectively
amplify frequencies and suppress very high
intensity signals
Vision: Compensation in
Complex Tasks
• When improving visual information helps
performance in complex task depends on
specifics of task requirements for
– attention and search
– visual guidance of control movements
– maintenance of balance and gait.
• Behavioral slowing with age results in a
reduction of reserve capacity needed for
complex behavior
Vision: Compensation in
Complex Tasks
• Visually controlled movements
• Elderly adults require relatively more time to
complete a repetitive movement task as
difficulty increases. For small and long
movements, smaller targets mean longer
times.
•
Welford AT, Norris AH, Shock NW Speed and accuracy of movement and their
changes with age Acta Psychol 1969;30:3-15.
Brogmus GE (1997) Effects of age and sex on speed and accuracy of hand
movements and the refinements they suggest for Fitts’Law. In WA Rogers (Ed)
Designing for an aging population. Santa Monica CA: Human Factors and
Ergonomics Society, pp.25-29.
Data from Brogmus,
1991. Women
performed better than
men. 15 year
longitudinal followup of
men showed an initial
practice effect followed
by poorer performance
because of greater
variability in location of
spots in the target
space.
Visually Controlled Movements
• The slowing of making single and repetitive
movements occurs mostly in the last segment
of the movement. Practice does not help
reduce age difference in speed.
• Target magnification, control damping,
improved contrast provide best ways of
improving performance in tasks like moving
the computer screen cursor with a mouse
control.
•
Seidler-Dobrin RD, Stelmach GE. (1996) Practice and visual feedback in
the elderly. In G Huber (Ed) Healthy aging, activity and sports. Heidelberg
GE:Health Promotion Publications, Pp.109-117.
Vision: Compensation Driving
• Self reports by current and former drivers
identify same visual problems found in
laboratory studies; in one study complaints
correlate with age declines in carefully
measured contrast sensitivity.
•
•
Kline DW, Kline TJB, Fozard JL, Kosnick W, Schieber F, Sekuler R Aging and
driving: the problems of older drivers. J Gerontol 1992;47:27-34
Schieber F, Kline DW, Kline TJB, Fozard JL The relationship between contrast
sensitivity and the visual problems of older drivers. Warrendale PA: Society of
Automotive Engineers Technical Paper 920613 1992 pp 1-7
Ratings 1-3: none to
moderate difficulty. Age
trends in all 7 complaints
predicted by contrast
sensitivity data
From Schieber et al 1992
Vision: Compensation: Driving
• As in static visual environments, illumination
levels and glare profoundly affect visibility for
signs and objects while driving
• Compensations include better sign lighting and
increased size of sign symbols
•
•
Schieber F, Kline DW Age differences in the legibility of symbol highway signs
as a function of luminance and glare level. Proceedings of the Human Factors
and Ergonomics Society 38th Annual Meeting 1994 133-135
Dewar RE, Kline DW Mark I, Schieber F Symbol signing design for older
drivers. Final Report, DTFH-61-C-0018 McLean VA: Federal Highway
Administration, 1994
Vision: Compensation: Driving
• Steering task study and illumination
• Old adults are involved in relatively fewer night
time automobile accidents than younger drivers.
• Older adults make more steering errors in
driving simulator under poor illumination than
young adults
•
Owens DA, Tyrell RA Effects of luminance, blur and age on nighttime visual
guidance: A test of the selective degradation hypothesis. J Exp Psychol:Appl
1999;5:1-14
Steering
errors in
driving
simulator
under four
luminance
levels. Data
from Owens
and Tyrrell
(1999)
30
20
10
Luminance (log cd/m2)
Compensation: Falls and Gait
• Poor illumination, confusing information
resulting from bad stair design implicated in
many studies of falls and accidents.
•
Architect John Templar documents these in a multivolume book.
• Population based studies show consistent
relation between visual acuity and contrast
sensitivity and measures of gait and history of
falls and hip fractures.
•
Klein BEK, Klein F, Lee KE, Cruickshanks KJ Performance-based and selfasssessed measures of visual function as related to history of falls, hip
fractures and measured gait time:Beaver Dam Study Ophthalmology
1998;105:160-164.
Conclusions
• Focus has been on perceptual motor
applications because these are relatively
resistant to prevention based technology
interventions
• Person oriented interventions such as
training in how to fall without injury need
more research and development attention
Conclusions
• Major choices for compensation
– Choice of human or machine as provider of
intervention
– Acceptability of machine intervention to user,
especially important if intervention is in home
environment
– Complexity of intervention—is design within
scope of ‘universal design’ or is it very
idiosyncratic to this particular application??