Margarida Cerqueira

The International Classification of Functioning, Disability and Health as a conceptual model for the evaluation of environmental factors

Abstract The concept of Design for All emphasizes the impact of the surrounding environment in the individuals functionality. The International Classification of Functioning, Disability and Health brought the concepts of functionality and disability into a comprehensive whole of multiple dimensions of human functioning, such as biological, psychological, social and environmental. In order to contribute to a greater overall functionality of the individual, the use of software and complex systems can be decisive to assist the people with special needs in all areas of life. The paradigm introduced with ICF is inclusive and universal, so it favors not only the old people, but all others, whether they have a limitation or not. The characteristics of Ambient Assisted Living (AAL) are appropriate to fulfill elderly needs. However, the current state of development is still mostly oriented to a technological perspective, where the individuals functionality has not been fully addressed. Under the Living Usability Lab project we have defined a methodology and created some evaluation tools for assessment of AAL services according to a Living Lab perspective, based on the ICF. In this paper we intend to describe the base fundamentals of this proposal, as well as present some results concerning a practical implementation of this methodology.

ICF Inspired Personas to Improve Development for Usability and Accessibility in Ambient Assisted Living

Abstract Ambient Assisted Living (AAL) is an important research and development area. The acceptance of the AAL paradigm is closely related to the quality of the available systems and services, namely in terms of the user interaction. This means that usability and accessibility are crucial issues. The paper presents how the concepts of the International Classification of Functioning, Disability and Health (ICF) can be used to optimize the role of personas and scenarios in the development and evaluation of AAL systems and services, especially in aspects related with human functioning and health conditions.

How images of old age vary with age: an exploratory study among the Portuguese population

Agism was the term chosen by Butler to name the process of discrimination based on chronological age, which usually results in an image of the elderly as unproductive, sick, depressed and with cognitive impairment. This form of bias, like others that devaluate and stereotype groups of people, has a marked effect on social interaction, influencing social attitudes and perceptions in a covert manner. The use of negative images relating to old age and the aging process promotes negative attitudes relating to elderly people, affects the way they live and the way people of other ages prepare to face their old age.

Living Too Long? Exploring Attitudes Toward Reaching 100 Years Old

Objective This study analyses the relationship between pro- and anti-longevity attitudes, attitudes toward centenarians, and the wish to reach 100 years of age in a sample of community dwelling older adults. Methods Participants (N = 137) completed a questionnaire on attitudes toward life-extension and an aging semantic differential using centenarians as an attitudinal target. Sociodemographic information, perceived health status, and information on knowing a centenarian were also obtained. A cluster analysis was used to identify subgroups (leaning anti-longevity group vs. leaning prolongevity group), and their associations with personal attributes were tested using logistic regression models. Results Most respondents said they would wish to reach 100 years old (54.7%) and presented a leaning positive attitude toward centenarians (52.6%). Holding a negative attitude toward centenarians rather than any other attribute increases the odds of having more negative attitudes toward life extension. Conclusion Results stress the importance of social views on extreme longevity in shaping life extension attitudes.

Technologies for ageing in place to support community-dewlling older adults

Objectives: This study aimed to systematize current evidence of technologies for ageing in place designed to support the daily living of community-dwelling older adults. Methods: A systematic review of reviews and meta-analysis was performed based on a search of the literature. Results: A total of 24 reviews and meta-analysis were retrieved and interventions related to physical activity, nutrition and weight management, health education, loneliness and social isolation, and emergency situations were identified; These studies analyse the impact of different technologies in community-dwelling older adults, considering several health-related outcomes. Conclusion: Technologies for ageing in place have positive effects on various health related outcomes, but further research is required.

Inter-rater reliability, standard error of measurement and minimal detectable change of the 12-item WHODAS 2.0 and four performance tests in institutionalized ambulatory older adults

Abstract Purpose: Self-reported and performance-based instruments are both necessary for a comprehensive view of the functioning of institutionalized older adults. Our aim was to assess the reliability and measurement error of the 12-item World Health Organization Disability assessment Schedule and compare these indexes against performance-based tests. Materials and methods: One hundred participants from Nursing Homes and Day Care Centers were assessed twice (two days to one week apart) by two independent assessors. Reliability and measurement error indexes were calculated. Results: Reliability of the World Health Organization Disability assessment Schedule total score, and of three performance tests was appropriate for individual comparisons (ICC ≥ 0.92). Reliability for the five times seat to stand test was appropriate for group comparisons only (ICC = 0.84). The high measurement error of the timed up and go test (SEM = 4.25; MDC = 11.78) and of the five times seat to stand test (SEM = 3.47; MDC = 9.62) and the number of participants unable to perform them (TUG: n = 11; FTSST: n = 41) suggest that these tests are less suitable to monitor individual changes. Conclusions: The 12-item World Health Organization Disability Assessment Schedule total score, the gait speed and hand grip tests could be used to monitor changes at both the individual and group level in a population with decreased functioning. Implications for Rehabilitation The 12-item World Health Organization Disability assessment Schedule, could be used to monitor changes in perceived functioning both at the individual and group level in institutionalized ambulatory older adults. The gait speed and hand grip tests could be used to monitor changes in performance both at the individual and group level in institutionalized ambulatory older adults’ functioning. The utility of the time up and go and of the five times seat to stand test might be of limited value when aiming to monitor changes in institutionalized older adults’ functioning.

Pervasive Health and Regulatory Frameworks

Pervasive health deals with the application of pervasive computing for health and wellness management and its developments should be subject of regulatory oversight. The paper presents a general overview of pervasive health concepts and applications, and aims to verify the level of conformity of current developments with existing regulatory frameworks.

AAL systems and services for end users: Are the AT models and frameworks suitable for prescription and selection?

The complexity inherent to Ambient Assisted Living raises some of issues not yet quiet solved within similar fields like Assistive Technology, namely those related with prescription and selection. This paper aims to identify models of frameworks for the prescription of AT that may serve as a foundation to develop comprehensive models for the selection, prescription and counselling process of ALL solutions. A systematic literature search was conducted in Pubmed, Eric and CiteSeerX databases using a predefined strategy. The relevant literature extracted was screened and a list of models and frameworks was elaborated. Seven models or frameworks were included for analyses. It was possible to find ICF components in all of the models or frameworks. The results showed a shift between the models from the end of last century, based in an instrumental description of components involved to a predictive end users behaviour concern. Future work should deepen the conceptual issues about the selection, prescription and counselling process of AAL systems and services.

Age variations in the perceptions of how to age successfully: an exploratory study in the Portuguese population

Successful aging seeks to counteract and replace the old ‘decline and loss’ paradigm that views aging as a series of individual decrements or losses to which both older people and society needed to adapt or adjust. This new gerontology, based on the concept of successful aging, adopts a preventive model: modify individual behaviours throughout life in order to avoid the decrements and losses. Research has led to the development of a variety of models for successful aging, which share the fundamental assumption that successful aging is a result of a lifelong developmental process that involves the combination or interaction of traits or predispositions present at birth or in early life and cumulative life experiences. Successful aging builds on a life history of successful adaptation, which in turn, is a result of interactions among inherited and learned personality attributes and levels of adversity or advantage and resources. Research driven by the successful aging theorist is turning attention to the development of indicators that might explain and predict successful old age. A number of factors are already well known to promote well-being, for instance regular exercise, cognitive stimulation, friendship and the presence of a confiding relationship. However, little is known on how persons from different age groups perceive the preparation of a good old age . In this exploratory study we attempt to expand this topic, since it will allow the understanding of how these perceptions can influence, in a positive or negative way, the achieving of a good old age .