Purpose Anchored in the World Health Organization's perspective on aging-which advocates for the preservation of functional abilities essential for well-being in later life-this review scrutinizes the role of intrinsic capacity (IC), spanning cognitive, psychological, locomotor, sensory, and vitality dimensions.Moreover, it considers the environmental dynamics that shape older adults' operational capabilities.Amidst global challenges, such as demographic shifts and healthcare crises, the mobility of older adults emerges as a pivotal concern.This review seeks to fill the research void on the comprehensive effects of LLE on IC and functional abilities, evaluating how LLE technology can support active aging, mitigate injury risks, and foster a more autonomous community of older adults in the face of sustainability and crisis challenges.It aims to unfold the capacities of LLE interventions to revitalize IC, enhance functional abilities, and navigate the complexities of aging, thereby offering insights into the expansive utility of LLE beyond conventional rehabilitative and assistive scopes.Method This systematic review, registered in PROSPERO (CRD42023434655) and adhering to PRISMA 2020 and the Cochrane Handbook, employed a comprehensive search across PubMed, EMBASE, Web of Science, and other databases in June 2023, targeting studies on the use of lower-limb exoskeletons (LLE) in older adults to enhance functional ability and intrinsic capacity (IC).The search included a wide range of study designs, settings, and populations, focusing on individuals aged 50 years, with a mean age of 65 years, without limiting health conditions, exoskeleton types, or intervention specifics.Studies were screened and data extracted using EndNote X9 and Rayyan QCRI, with inclusion determined by two independent researchers and disputes resolved by a third.Data on study design, outcomes, and participant demographics were systematically collected.The extracted information was categorized based on the WHO's vision on healthy aging into IC and functional ability, with a further subdivision for performance indicators within the IC domain.The methodological quality of included studies was evaluated using the Downs and Black Scale, classifying studies from excellent to poor.Results and Discussion The systematic review analyzed 36 articles, highlighting the diverse application of lower-limb exoskeletons (LLE) in enhancing functional abilities, intrinsic capacities (IC), and performance indicators in older adults across various health conditions.Methodological quality varied, with 22.2% rated as poor, 55.5% as fair, and the remaining 22.2% as good.Studies spanned multiple conditions, including stroke, Parkinson's Disease, osteoarthritis, and more, with significant positive outcomes in mobility, functional abilities, and various performance measures.Specifically, improvements were noted in mobility measures across different conditions, with varied efficacy depending on the health issue and the type of LLE used.Additionally, the review revealed enhancements in IC through LLE interventions, demonstrating improvements in locomotor capacity and vitality, among others.The analysis also underscored significant gains in performance indicators, such as walking speed and endurance, underlining the potential of LLE to support healthy aging and rehabilitative efforts across a broad spectrum of older adults.While longer intervention durations can aid in the rehabilitation of intrinsic capacities, even instantaneous augmentation of functional abilities can be observed in a single session.

Purpose The use of voice assistants (e.g., Amazon Alexa, Google Home) is being widely advocated as part of supporting people living with dementia at home.The development of this technology is largely driven by industry, and there is little research to determine how people living with dementia, family carers and professionals can use voice assistants, and understand the challenges that this technology presents.In the UK there is an impending digital switch away from analogue systems that is poised to take place by 2025, hence it is essential that alternative technologies are adopted by mainstream health and care services and that acceptance and utilization is high.This paper presents the findings from two studies: 1 -a qualitative enquiry aiming to identify the views and barriers of using voice assistants by people living with dementia, family carers and professionals; 2 -a pilot case study evaluating a prototype that addresses barriers identified during study 1, entitled IntraVox.Based on processing of smart home sensor data, IntraVox uses a personalised human voice to send prompts and reminders to end-users to conduct daily life activities and to activate smart home processes using voice assistants.Method Study 1a Community of Practice (CoP) comprised of 24 members-two people with dementia (1 = F, 85 years; 1 = M, 94 years), 3 family carers (live-in daughter of the woman; live-in daughter and son-in-law of the man), 4 individuals from carer organisations, 5 Local Authority adult social care professionals, 2 commissioners, 6 National Health Service older people's service managers, 2 NHS technology managers of digital health care solutions were recruited.Seven group interviews were conducted.We firstly conducted 3 group interviews with a mix of health, social care, technologist professionals, and carer organisation CoP members, followed by 2 group interviews comprised of the people with dementia and their family carers.Participants were asked about their personal experience and views of smart technology (e.g., purposes, barriers), with a focus on voice assistants.Following analysis of this data, a technological solution, IntraVox (Cook et al, 2020), was developed to address barriers to use of voice assistants.In keeping with co-production methods a further 2 on-line interviews, were conducted with 9 CoP members to explore their views of the IntraVox prototype.Design changes were subsequently made, such as type of voice used to activate the voice assistant.Study 2was a pilot study of IntraVox with one person with severe dementia and their family carer.These individuals were identified through discussion with a Local Authority provider that was aware that, although the client was using telecare and smart products, problems persisted.The client was a woman with advanced dementia, who lived alone at home.Her son provided care and stayed with her during evenings and mornings.Several carers (city council employees) visited the mother twice daily to prepare meals and provide medication prompts.As this was the first deployment of this technology the service provider supported the use of the technology, with restriction to one client.The pilot study had two phases of data collection.In Phase 1, the pre-deployment of IntraVox, a semi-structured interview was carried out with the son to determine his familiarity with smart home devices, key issues in his caring role and how IntraVox could provide an intervention.Through this interview, it was identified that IntraVox should provide a prompt to alter the mothers behaviour when entering a food storage area.Following this initial interview, IntraVox was installed in the mother's home for use over 7 days.In Phase 2, a post-study semi-structured interview was conducted to explore the son's views and experiences of IntraVox, and his views of the impact that IntraVox had on his mother's situation.Results and Discussion The results of these studies indicate that family carers and professionals use voice assistants in their caring role for home automation, skills maintenance and development, prompts and reminders, behaviour and environment monitoring, and for leisure and social interaction support.The findings also show that family carers and professionals have specific challenges that need to be overcome for optimum use.The case study provided a useful demonstration that interoperability can be achieved to enable exchanges between IntraVox and voice assistants, providing customised and personalised technological solutions that address some of the barriers that people with dementia and their carers face in the use of voice assistant technology.

Purpose Elderly people often face the risk of falls, which increases the need for walking aids to ensure mobility and safety.The occurrence of further injuries requires the use of additional orthopedic aids (e.g., foot orthoses).Wearing such an orthopedic aid also impairs the natural gait pattern, which leads to increased instability in older patients.This highlights the need for innovative solutions for assistive smart walking aids.Doan et al., for example, presented a smart walking aid for fall detection that can detect falls based on machine learning with an accuracy of 99.62% (Doan et al., 2024).This development can lead to improvements in home care and remote health monitoring technologies.However, a solution that allows the combined use of an intelligent walking aid with a smart foot orthosis to provide patients with active feedback does not exist.Based on the identified research gap, we propose the technical development of an augmented walking aid with haptic feedback that enables direct communication of sensor data with a smart foot orthosis.Providing additional feedback in case of problems with the foot orthosis is particularly important for patients with neuropathy in the feet (such as diabetic foot syndrome), for which neural feedback is not possible.Our approach enables direct haptic feedback through vibrations on the handle of the walking aid when acute problems are detected by the smart foot orthosis.The system achieves this by continuously monitoring relevant gait parameters and pressure distributions in the foot orthosis.This should support the proactive adaptation of gait problems and increase safety when using assistive technologies for older people.Method The concept development is based on a comprehensive literature analysis of existing walking aids, as well as the identification of patient needs for the use of augmented feedback and wearable technologies.Based on these findings, we have developed an initial concept for a feedback-enabled walking aid designed for combined use with a smart foot orthosis, which provides real-time feedback on the patient's gait behavior.Figure 1 shows the proposed conceptual design of the intelligent walking aid with an integrated vibration motor on the handle and an inertial measurement unit to determine the spatial parameters.Wireless communication of recorded data occurs via Bluetooth.Results and Discussion We propose to investigate the system in an experimental within-subject study to evaluate the effectiveness of gait improvement, as well as usability and social acceptance, with a sample size of 20 participants.In this context, we intend to use the think-aloud protocol to gain deeper insights into the participants' thought processes during interaction with the system.By combining the proposed concept with a smart foot wearable device that provides specific data on foot positioning and movement, we expect a more reliable gait analysis and better tailored corrective suggestions.Additionally, the application of machine learning allows the identification of gait patterns and the initiation of preventive measures against potential fall risks.In future applications, the system can be modularly expanded to include additional walking aids, such as walking sticks, crutches, or walkers.

Purpose Japan, with its rapidly progressing low birth rate and aging population, reached an aging rate of 29.1% in 2023, marking the highest level both in its history and globally.By 2065, approximately one in every 2.6 people is expected to be 65 or older.Simultaneously, the shortage of care workers is expected to reach approximately 690,000 by 2040.To address these challenges, the Japanese government is promoting measures such as improving productivity in care settings by leveraging ICT, utilizing diverse human resources, and creating more conducive working environments.Considering these issues, this study aimed to develop a "Digital Transformation (DX) Care Worker Training Program" to train care workers equipped with ICT skills (Ministry of Health, Labor and Welfare).This program also includes job placement mechanisms to facilitate the smooth transition of trainees to the caregiving profession.Methods The program was designed to enable participants to leverage their existing "skills" and "experience" to find employment or transition into the caregiving field, not only by imparting specialized knowledge and skills in caregiving but also by fostering ICT-capable care workers.Initially, surveys were conducted among care workers and educators at care worker training schools.Based on the survey results, a program was developed that integrates three courses, namely: the "Care Worker Induction Course," which is an introductory course in caregiving; the "Smart Care Worker Course," which teaches the use of ICT in caregiving settings; and the "Practical Training Program for Care Workers," which aims to develop leadership, career planning skills, and the ability to utilize ICT and robotics.The impact of the developed "DX Care Worker Training Program" on participants was evaluated through questionnaire surveys and interview surveys.

Background: In the coming decades, the population of individuals aged 65 and above is projected to experience a notable surge.This demographic transition demands novel approaches to improve and transform elder care practices using emerging gerontechnologies.Objective: This article presents a comprehensive analysis of the gerontechnology domain and its applications in elderly care.Furthermore, it aims to improve understanding in the care field and promote the advancement of elder care by utilizing evidence-based strategies and identifying research priorities.Method: This article is based on a systematic review of the literature published between January 2022 and December 2023, which was conducted by employing the PRISMA methodology, and reputable databases such as PsycInfo, PubMed, IEEE Xplore, and CINAHL were used to compile the data.Results: This research aims to categorize existing technologies to reveal a diverse array of products and technologies to address the distinct needs of the elderly.Their implementation within the care sector is given particular attention in order to emphasize innovative approaches to enhance the quality of senior care.Moreover, the research highlights the current scientific challenges, limitations and research gaps in the development and integration of advanced technologies that are observed within the field of gerontechnology.This enables the researchers to improve the existing knowledge of the field and offers a comprehensive foundation for directing future research efforts and technological innovations.Conclusion: This framework is intended to serve as a strategic guide for advancing the integration of emerging technologies into elder care practices.This paper provides valuable insights for researchers, practitioners, and policymakers by presenting a thorough analysis of the current state of gerontechnology.It highlights critical scientific challenges as well as strategic recommendations for addressing these issues.

Purpose To describe the financial demands, feelings and concerns of Brazilian elderly people that can influence their aging-in-place (AIP) to serve as input in the choice of technologies, improving the financial management of vulnerable older adults.Such management can ensure resources that favor personal and environmental factors or even absorb security costs.Methodology Exploratory, cross-sectional, qualitative study (Figure 1).A group of 119 older adults were interviewed using the question "Regarding your finances, what are your current needs that can influence your aging-in-place?"Results and discussion Participants were men (23.1%) and women (76.9%), with an average age of 67.7 years, married (51.1%), widowed (24.5%), with more 10 years of study (59.1%), 45.7% retired and 40.4% continue working; 75 had chronic health conditions.Thirty-three denied financial needs because they were retired and received a pension; be supported by the family, be financially stable and independent.To think about the AIP, the financial demands of the remaining 86 participants were organized into the categories Present and Future Demands (DPF) and Autonomy and Independence.These include the fact that they have to continue working to supplement their income, seek retirement benefits and achieve financial stability for basic expenses in the present (food, water, electricity, housing) and in the future (diapers, medicine, caregivers, etc.), in addition to maintaining health insurance in old age, and concerns about the lack of financial reserves for emergencies and old age expenses.They highlight debt and the need to pay off bank loans and debts owed to children and grandchildren.As for Autonomy and Independence, they want to manage their own money, as well as have the skills to use internet banking and maintain their current lifestyle, enjoying comfort, leisure and good health.The feelings and concerns describe the fear of financial losses associated with functional decline, frustration at not having planned other sources of income and accumulation of assets aiming for financial independence.Feelings related to financial demands are related to AIP in all its dimensions, requiring knowledge of the demands of the present to resize the future.Supported by the WHO (2016) 5P construct for successful AIP (place, person, politics, personal services and products), finance appears as an essential aspect.The production of knowledge in gerontechnology and finance has addressed the potential of digital technologies for financial education (Doll& Hollerweger, 2022); financial resources as the main barrier in the implementation of gerontechnology, pointing out several schemes that can function as one of the financial drivers for AIP, such as savings, for example (Franchimon & Van Der Vlies, 2010) in addition to financial condition as a predictor of satisfaction with life (Lein et al, 2014).Financial challenges are directly linked to the dimensions of gerontechnology, as it generates interdisciplinary knowledge to design technology, services and environments that can support independent living and care, and as an interdisciplinary field, it can offer paths for the development skills to generate income, use digital technologies that enable financial operations and governance of everyday life, promoting autonomy and independence in old age.