A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> Touch screen mobile devices bear the promise of endless leisure, communication, and productivity opportunities to motor-impaired people. Indeed, users with residual capacities in their upper extremities could benefit immensely from a device with no demands regarding strength. However, the precision required to effectively select a target without physical cues creates problems to people with limited motor abilities. Our goal is to thoroughly study mobile touch screen interfaces, their characteristics and parameterizations, thus providing the tools for informed interface design for motor-impaired users. We present an evaluation performed with 15 tetraplegic people that allowed us to understand the factors limiting user performance within a comprehensive set of interaction techniques (Tapping, Crossing, Exiting and Directional Gesturing) and parameterizations (Position, Size and Direction). Our results show that for each technique, accuracy and precision vary across different areas of the screen and directions, in a way that is directly dependent on target size. Overall, Tapping was both the preferred technique and among the most effective. This proves that it is possible to design inclusive unified interfaces for motor-impaired and able-bodied users once the correct parameterization or adaptability is assured. <s> BIB001 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> Smartphones with touchscreen-based interfaces are increasingly used by non-technical groups including the elderly. However, application developers have little understanding of how senior users interact with their products and of how to design senior-friendly interfaces. As an initial study to assess standard mobile touchscreen interfaces for the elderly, we conducted performance measurements and observational evaluations of 20 elderly participants. The tasks included performing basic gestures such as taps, drags, and pinching motions and using basic interactive components such as software keyboards and photo viewers. We found that mobile touchscreens were generally easy for the elderly to use and a week's experience generally improved their proficiency. However, careful observations identified several typical problems that should be addressed in future interfaces. We discuss the implications of our experiments, seeking to provide informal guidelines for application developers to design better interfaces for elderly people. <s> BIB002 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> This paper describes a study exploring the multi-touch interaction for older adults. The aim of this experiment was to check the relevance of this interaction versus single-touch interaction to realize object manipulation tasks: move, rotate and zoom. For each task, the user had to manipulate a rectangle and superimpose it to a picture frame. Our study shows that adults and principally older adults had more difficulties to realize these tasks for multi-touch interaction than for single-touch interaction. <s> BIB003 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> The introduction of the iPad and similar form-factor devices e.g. Samsung Galaxy Tab, Asus Eee Pad and Motorola Xoom has provided a unique opportunity for older adults to engage with mobile computing devices and platforms. Engagement with 'traditional' computing devices amongst older adults, including arguably mobile devices, such as laptop computers is low due to dexterity issues amongst this population Hertzum & Hornbaek, 2010. Whilst the iPad removes some of the traditional barriers to computer engagement, new barriers including weight and screen reflection are evident to an older user group. This paper provides an exploratory evaluation of how older adults in 11 UK care-home settings and the staff engaged in their care are using iPads to help improve communication, build physical social networks amongst residents, staff and family members, and map the most frequently used applications by an older population during a six-month pilot period. Results suggest that applications involving information searching for personally related and historical information were most valued by older adults. Further, older adults and care staff alike report mainly positive experiences of iPad use in care settings including the increased opportunities for social interaction and the enhancement of intergenerational communication. Additionally, the barriers to use e.g. device weight are often overcome by low-tech adaptations and adjustment when using the device. This paper argues that the portability and adaptive nature of the iPad combined with the increased social interaction afforded by device could increase quality of life in care settings. <s> BIB004 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> Despite the apparent popularity of touchscreens for older adults, little is known about the psychomotor performance of these devices. We compared performance between older adults and younger adults on four desktop and touchscreen tasks: pointing, dragging, crossing and steering. On the touchscreen, we also examined pinch-to-zoom. Our results show that while older adults were significantly slower than younger adults in general, the touchscreen reduced this performance gap relative to the desktop and mouse. Indeed, the touchscreen resulted in a significant movement time reduction of 35% over the mouse for older adults, compared to only 16% for younger adults. Error rates also decreased. <s> BIB005 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> This paper presents new touch-screen collaborative interaction models for people with dementia. The authors argue that dementia technology has yet to focus on group musical interactions. The project aims to contribute to dementia care while addressing a significant gap in current literature. Research includes observations and two system trials exploring contrasting musical scenarios: the performance of abstract electronic music and the distributed performance of J. S. Bach's Goldberg Variations. Findings presented in this paper suggest that dementia people are able to successfully perform and engage in collaborative music performance activities with little or no scaffolded instruction. <s> BIB006 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> As computing devices continue to become more heavily integrated into our lives, proper design of human-computer interfaces becomes a more important topic of discussion. Efficient and useful human-computer interfaces need to take into account the abilities of the humans who will be using such interfaces, and adapt to difficulties that different users may face - such as the difficulties that elderly users must deal with. Interfaces that allow for user-specific customization, while taking into account the multiple difficulties that older users might face, can assist the elderly in properly using these newer computing devices, and in doing so possibly achieving a better quality of life through the advanced technological support that these devices offer. In this paper, we explore common problems the elderly face when using computing devices and solutions developed for these problems. Difficulties ultimately fall into several categories: cognition, auditory, haptic, visual, and motor-based troubles. We also present an idea for a new adaptive operating system with advanced customizations that would simplify computing for older users. <s> BIB007 </s> A Survey of Tablet Applications for Promoting Successful Aging in Older Adults <s> III. TABLET ADOPTION <s> Caregiver anecdotes attest that music and photographs play an important role for family members diagnosed with Alzheimer's disease (AD), even those with severe AD. Tablets and iPads, which are prevalent, can be utilized with dementia patients in portraying favorite music and family photographs via apps developed in close partnership with geriatric facilities. Anecdotal research has shown that non-verbal late-stage dementia patients have become stimulated when iPods played their beloved tunes. There is an unmet need in geriatric facilities for stimulating dementia patients, as well providing hard-core data for proving increased cognitive abilities with technology. Technology can help bridge the gap between patients and staff to improve the quality of life for the cognitively impaired. This study addresses cognitive functioning and quality of life for people diagnosed with dementia via technology. In recent times, the influx of older adults suffering from Alzheimer's or dementia related illness has impacted the U.S. Healthcare system. Cognition significantly declines in older adults with AD or dementia over the course of the disease, causing most to be dependent on caregivers, thus routinely institutionalized. Caregivers are often required to focus their attention on addressing the agitation or discomfort of the AD or dementia patient. Research has shown that technology instruments such as iPods, help stimulate those with dementia. This study focuses on innovative devices such as iPads and tablets, which are mainstream and easy to use, cannot only help determine stage of dementia, but also provide stimulation to improve cognitive functioning. It is hoped that this research will analyze that specially created apps and existing assistive software can be used to decrease the symptoms and improve cognition of older adults suffering from AD or other dementia related diseases. Via service-learning courses, students developed an easy-to-use application for tablets to help older adults with disabilities more readily use the technology. Student programmers produced apps and performed usability tests with the dementia patients, as well as met with geriatric facility personnel to produce application software that meets the patients, family, and caregiver needs and expectations. For example, a student term project produced an application entitled Candoo that utilizes Google's voice recognition and synthesis engine to navigate the web, provide the weather, and supply pill reminder alerts. Another application example included one that allows families to electronically send photographs, video clips, and favorite music from anywhere to loved ones for enjoyment. Furthermore, older adults were assessed by nursing students for cognitive functioning before, and after the semester's intervention. Such mobile apps could allow dementia persons to become less agitated and stay in their homes longer, while also providing awareness and positive change of attitude by those of another generation towards the elderly. This research will discuss student developed mobile applications in the scope of helping improve the quality of life of patients with AD or dementia. <s> BIB008
With the inception of the iPad (tablet) in 2010 and increasing popularity of tablets among older adults  , it is gradually becoming important to identify the advantages and challenges faced by older adults in tablet adoption. Few studies have been conducted to evaluate the usability of tablets for older adults. One of the initial studies was conducted by Werner et al. in 2012 for evaluating the general usability and acceptance of a tablet among older novice users  ,  . Eleven novice computer users (60 years and above) were recruited to perform a set of predefined tasks that included turning on the tablet, searching with Google, reading and composing an email, and finally searching a video on YouTube. In general, the study participants found the tablet easy to use, and were satisfied with complexity of the study tasks. Due to inexperience, everyone needed some time to get familiar with the nuances of the device, but the learning experience was easier and faster than their expectations. The magnifying feature was important attribute for readability of the device. In another study, 77 participants (aged between 73-87 years) provided qualitative feedback on tablet (iPad) usability BIB004 . The participants used the tablet for at least five minutes and rated using a 10-point rating scale, 22 recommended tablet-based applications. This study found similar findings as  ,  . In addition, the tablet promoted social engagement, and increased interpersonal and intergenerational communications. The study also found that the absence of keys and mouse made the technology (tablet) easy to use. The participants appreciated the mobility using the tablet but found the tablet to be heavy and faced difficulties with the screen resolution. In another study, researchers found that older adults preferred to use applications related to lifestyle, technology, digital content, independence and for gathering information for younger family members  . These categories were derived from data based on observations and interviews conducted in 2012-2013 with nine participants having less than 2 years of tablet experience. The participants in this study found the downloading applications to be easy, and the operating system to be interactive and customizable. In addition to these usability evaluation studies, studies have been conducted to compare older adults' touchscreen performance against desktop/mouse performance. For example, Findlater et al. compared the performance of 20 older adults and 20 younger adults on four desktop and touchscreen tasks: pointing, dragging, crossing and steering BIB005 . They found that even though the performance of older adults was slower than that of the younger adults on both the devices, the performance gap was smaller for the touchscreen than that for the desktop. The older adults found steering task with desktop and dragging with touchscreen as the most difficult task. A decrease in error rate for older adults was reported using the touchscreen over that with a desktop. Further, there was no significant difference in error rates using the touchscreen among younger and older adults. There was also no significant difference in subjective difficulty (measured using a rating given by the participant for each task) among tasks using touchscreen in older adults, and also between older and younger adults. Kobayashi et al. compared the touchscreen performance between a tablet (large touchscreen device) and a smartphone (small touchscreen device) among nineteen participants in a week-long study BIB002 . They found that, on both devices, dragging and pinching (zoom in and out) was easier than tapping (click on a target for a small period of time), even though the former action required greater hand movement. This is in contrast with the findings for older adults with motor disabilities BIB001 . The performance on all the tasks improved after a week of practice for both the devices. For all tasks, the completion time was significantly lower on a tablet versus on a smartphone, primarily because of the larger screen size. Despite these positive findings, tablets may pose several challenges to the older adults. Israel  have highlighted some barriers associated with using tablets, including complexity of the technology, software complications and fear of harming the screen/tablet. Favilla et al. reported some difficulties faced by older adults in using tablet touchscreens BIB006 . Firstly, the capacitive screens do not provide any haptic response BIB007 . Secondly, finger swiping, one of the most common movements for capacitive screens, is normally difficult for older adults BIB008 . Further, older adults, especially those with dementia and reduced motoring abilities, may find it difficult to exert and maintain sustained pressure on a touchscreen BIB003 . They may also find the tablet heavy and screen resolution unoptimal (glare) BIB004 . To manage the weight, older adults either use some form of support (table/pillow) or avoid hand-holding the tablet BIB004 , BIB008 . Finally, older adults find difficult to type using the onscreen keyboard  .