Assistive Technology and Healthy Ageing: A Global Review

Assistive technology (AT), like hearing aids, wheelchairs, and glasses, is critical to healthy ageing as it supports functioning and independence. As most countries are rapidly and dynamically ageing (or already aged), access to AT cannot be underestimated. Yet evidence on what AT is needed, where, and by whom is sparsely available in global health literature.

Monitoring trends in AT access to prepare for the needs of ageing populations requires longitudinal data on AT outcomes, which is inconsistently available globally, or for all types of AT. Furthermore, only some studies have been published utilising what longitudinal AT data do exist. Further, without follow-up data, it’s difficult to understand why provided AT may go unused or how to improve service provision overall. These sector-wide challenges indicate problems with current data collection and use that ultimately restrict our capacity to enhance AT access.

We sought to create a global minimum dataset of longitudinal AT data by identifying, reviewing, and collating what data currently exist. Unfortunately, these datasets have yet to generate publications with AT-related findings in nearly every case. Our global review ultimately included 47 population-based cohort studies and 62 national surveys that are already or intended to be, multi-wave. 

Globally, the WHO Africa region (AFR) was the most represented region for national surveys, including AT, at 40% of all included surveys, with only three surveys (5%) based in the Eastern Mediterranean Region (EMR). Established, routine national surveys like population and housing censuses increasingly include questions on AT. However, these are often limited to a binary question about AT use (using/not using) and only consider two types of AT: glasses and hearing aids. This limits our understanding concerning other functional domains, like mobility, self-care, and communication, and other indicators of AT access, such as unmet needs. 

Alternatively, most population cohorts were based in high-income countries already aged considerably, which limits their international relevance, particularly against low/middle-income and young countries. For example, only two cohorts included populations in AFR, and none included countries in the Middle East. Additionally, many cohorts studying ageing do not enrol participants who live in care homes, have support needs, or have chronic/severely limiting diagnoses. These criteria disproportionately exclude people with disabilities and restrict researchers’ capacity to study people ageing with disabilities in comparison with people acquiring disabilities as a result of ageing. 

This collation of data is helpful in planning for some of the needs accompanying disability, which are increasingly urgent as countries age and many functioning limitations become more prevalent. However, the representativeness of global AT data is limited in many respects. Our review, therefore, highlights ways to improve data collection. It identifies methods to maximise currently available data, ultimately improve evidence-based decision-making, expand AT access, and make healthy longevity more inclusive.

As the Middle East is on the cusp of an ageing transition with large cohorts of its population entering old age, AT is one promising intervention to help people maintain their independence for as long as possible. Embracing innovations, including technology-based interventions, such as telemedicine and improving access to and understanding of healthy ageing behaviour in a cultural and gender-sensitive manner. This is particularly important for older people living in rural or remote areas with limited access to essential services.

Link to full paper: AT access in longitudinal datasets | AT2030 Programme

Full Reference: Danemayer, J., Mitra, S., Holloway, C. & Hussein, S. (2023). Assistive Technology Access in Longitudinal Datasets: A Global Review. International Journal of Population Data Science. 8(1).