Age is not a suitable criterion for recruitment in studies about the benefits of assistive information and communication technologies for healthy ageing: a mapping review of Pubmed literature (Preprint)

Abstract

Two fields of research and development, targeting the needs of the ageing population of the world are flourishing: One focuses on discovering pharmacological or behavioral solutions that promote successful ageing. Another one focuses on developing assistive information and communication technologies (A-ICT) that help ageing populations retain healthy and independent living in later years of life. Critical ageing studies warn about risks of ageist stereotypes emerging from how we communicate both of these discourses. This raises question about whether using specific age criterion in the context of 'ageing deficits' can bias participation in, or compliance with research process by those who fear age-related stigma.

The aim of this study is to examine subject recruitment and study designs (based on 65+ age criteria), as well as discourses in research objectives, and conclusions, in health research about affordances of A-ICTs for older adults.

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: The study should have a) recruited older participants (65+); b) been qualitative or quantitative research; and c) involved introduction of at least one A-ICT for health-related improvements. Exclusion: Reviews, viewpoints, surveys, or studies that used an ICT for data collection instead of lifestyle intervention. Analysis: Content, thematic and discourse analyses were used to maps study characteristics and synthesize results with respect to the research question.

From 180 studies that passed the search logic, 31 satisfied the inclusion criteria (6 randomized controlled trials, 4 purely quantitative studies, 9 focus groups, 2 observational studies and 10 mixed methods.) In all but one, recruitment was pragmatic and non-random. Thematic analysis of rationales revealed high likelihood of emphasis on burdens of ageing such as rising costs of care (12/31) and age-related deficits (14/31). The objectives of research fell under four categories: promotion of physical activity; acceptance and feasibility of robots and remote health monitoring systems; risk detection, and the future of A-ICTs in healthcare for older adults. Qualitative studies were more attentive to non-ageist research guidelines. Heterogeneity in 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 characterising variations in study outcomes. Studies that documented recruitment dynamics revealed that fear of stigma was a factor that biased participant engagement.

This review indicates age is not an informative criterion for recruitment and retention of participants. Adopting eco-social, flexible and personalized frameworks to chart the dynamics of adoption of, and interaction with A-ICTs, is more critical to advance research and technology development.