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“Technology Interventions to Promote Longevity” pr “Technology Interventions to Promote Longevity” presents a clear and influential framework explaining how technology can support people in maintaining independence, wellbeing, and functional ability as they age. The central premise is that successful longevity is achieved when individuals can continue to set, pursue, and accomplish their goals across the lifespan, even in the face of typical age-related declines.
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To address these declines, the paper introduces the PRAS hierarchy—a structured system for selecting technology-based interventions:
Prevent functional decline
Rehabilitate lost function
Augment remaining ability
Substitute lost function through technological replacement
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The framework emphasizes that technologies designed for older adults should prioritize prevention and rehabilitation first, resorting to augmentation and substitution only when necessary. It argues that behavioral and technology-driven interventions will be most effective when they align with older adults’ capabilities, preferences, and time constraints.
Key Themes and Insights
1. The Aging Population Meets Rapid Technological Change
The paper highlights two major global trends:
Rapid population aging
Rapid growth and spread of digital technologies (ICTs)
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While technology has helped extend lifespan—through better healthcare, communication, and resource distribution—older adults often adopt these technologies more slowly due to generational, educational, economic, and usability barriers.
2. The Digital Divide in Older Adults
Older adults show significant lag in technology adoption.
For example:
Only 46% of adults 65+ in the U.S. owned smartphones in 2018, compared to 94% of ages 18–29.
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Reasons include:
Limited experience with ICT
Learning costs that increase with age
Poorly designed interfaces that ignore age-related sensory and cognitive changes
Financial barriers
Despite these hurdles, adoption is improving across all regions.
3. Technology’s Benefits and Drawbacks
Technology can expand productivity, social connectivity, and access to care. However, it can also:
Exacerbate inequalities
Have unclear or mixed effects on wellbeing
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Some studies show reduced depression and higher wellbeing among older ICT users, but randomized trials offer inconsistent findings.
4. Technology-Based Interventions Are Increasing
Behavioral clinical trials using technology—particularly for adults 65+—are rapidly growing.
Over 31% of all registered technology-behavioral trials are currently active, with 76% targeting older adults.
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This reflects a shift toward personalized, adaptive digital interventions (e.g., cognitive training software, telehealth).
5. Aging as Functional Decline—But Also Plasticity
The paper acknowledges that aging involves:
Physical decline
Cognitive slowing
Higher rates of chronic diseases
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Yet, it emphasizes that plasticity remains. Older adults can improve performance through training—though with limits—and technologies can amplify or compensate for abilities.
6. The PRAS Framework — A Hierarchy for Choosing Interventions
1. Prevention
The least intrusive and most valuable strategy.
Examples:
Hearing protection
Education that builds cognitive reserve
Healthy lifestyle technologies
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2. Rehabilitation
Training to restore lost or declining function (motor, cognitive, perceptual).
Examples:
Stroke rehabilitation tools
Cognitive training programs
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3. Augmentation
Enhancing existing abilities with supportive technology.
Examples:
Glasses
Smartphone reminder apps
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4. Substitution
Replacing lost human function with external devices—most intrusive, last resort.
Examples:
Cochlear implants
Artificial lenses in cataract surgery
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The hierarchy reflects human preferences: most older adults prefer to maintain their “sense of self,” choosing rehabilitation over augmentation, and augmentation over replacement.
7. Designing Technology for Longevity
For technology to meaningfully improve aging outcomes, it must:
Adapt to an individual’s abilities
Offer graded, personalized challenges
Account for sensory, motor, and cognitive changes
Avoid stigmatizing users
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The paper stresses that simply proving a technology works does not ensure adoption—usability and dignity matter.
Overall Interpretation
This paper reframes longevity not just as living longer but as sustaining capability, and it provides a practical roadmap for how technology can support that goal. Its PRAS framework is widely applicable across healthcare, gerontology, AI, robotics, and assistive technology.
Its central message:
To support successful longevity, technology must be thoughtfully designed and matched to the real needs, abilities, and preferences of aging adults—prioritizing prevention, then rehabilitation, then augmentation, and finally substitution... |