Connecting: the use of information and communication technologies by older adults in a retirement community

This is a long-term study of the use of information and communication technologies by 30 older adults (ages 70–97) living in a large retirement community. The study spanned the years of 1996 to 2008, during which time the research participants grappled with the challenges of computer use while aging 12 years. The researcher, herself a ‘mature learner,’ used a qualitative research design which included observations and open-ended interviews. Using a strategy of “intermittent immersion,” she spent an average of two weeks per visit on site and participated in the lives of the research population in numerous ways, including service as their computer tutor. With e-mail and telephone contact, she was able to continue her interactions with participants throughout the 12-year period. A long-term perspective afforded the view of the evolution, devolution or cessation of the technology use by these older adults, and this process is chronicled in detail through five individual “profiles.” Three research questions dominated the inquiry: What function do computers serve in the lives of older adults? Does computer use foster or interfere with social ties? Is social support necessary for success in the face of challenging learning tasks? In answer to the first question, it became clear that computers were valued as a symbol of competence and intelligence. Some individuals brought their computers with them when transferred to the single-room residences of assisted living or nursing care facilities. Even when use had ceased, their computers were displayed to signal that their owners were or had once been keeping up to date. In answer to the second question, computer owners socialized around computing use (with in-person family members or friends) more than, or as much as, they socialized through their computers in the digital realm of the Internet. And in answer to the third question, while the existence of social support did facilitate computer exploration, more important was the social support network generated and developed among fellow computer users.

Quantification of the human postural control system to perturbations

Human standing posture is inherently unstable. The postural control system (PCS), which maintains standing posture, is composed of the sensory, musculoskeletal, and central nervous systems. Together these systems integrate sensory afferents and generate appropriate motor efferents to adjust posture. The PCS maintains the body center of mass (COM) with respect to the base of support while constantly resisting destabilizing forces from internal and external perturbations. To assess the human PCS, postural sway during quiet standing or in response to external perturbation have frequently been examined descriptively. Minimal work has been done to understand and quantify the robustness of the PCS to perturbations. Further, there have been some previous attempts to assess the dynamical systems aspects of the PCS or time evolutionary properties of postural sway. However those techniques can only provide summary information about the PCS characteristics; they cannot provide specific information about or recreate the actual sway behavior. This dissertation consists of two parts: part I, the development of two novel methods to assess the human PCS and, part II, the application of these methods. In study 1, a systematic method for analyzing the human PCS during perturbed stance was developed. A mild impulsive perturbation that subjects can easily experience in their daily lives was used. A measure of robustness of the PCS, 1/MaxSens that was based on the inverse of the sensitivity of the system, was introduced. 1/MaxSens successfully quantified the reduced robustness to external perturbations due to age-related degradation of the PCS. In study 2, a stochastic model was used to better understand the human PCS in terms of dynamical systems aspect. This methodology also has the advantage over previous methods in that the sway behavior is captured in a model that can be used to recreate the random oscillatory properties of the PCS. The invariant density which describes the long-term stationary behavior of the center of pressure (COP) was computed from a Markov chain model that was applied to postural sway data during quiet stance. In order to validate the Invariant Density Analysis (IDA), we applied the technique to COP data from different age groups. We found that older adults swayed farther from the centroid and in more stochastic and random manner than young adults. In part II, the tools developed in part I were applied to both occupational and clinical situations. In study 3, 1/MaxSens and IDA were applied to a population of firefighters to investigate the effects of air bottle configuration (weight and size) and vision on the postural stability of firefighters. We found that both air bottle weight and loss of vision, but not size of air bottle, significantly decreased balance performance and increased fall risk. In study 4, IDA was applied to data collected on 444 community-dwelling elderly adults from the MOBILIZE Boston Study. Four out of five IDA parameters were able to successfully differentiate recurrent fallers from non-fallers, while only five out of 30 more common descriptive and stochastic COP measures could distinguish the two groups. Fall history and the IDA parameter of entropy were found to be significant risk factors for falls. This research proposed a new measure for the PCS robustness (1/MaxSens) and a new technique for quantifying the dynamical systems aspect of the PCS (IDA). These new PCS analysis techniques provide easy and effective ways to assess the PCS in occupational and clinical environments.