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A healthy building environment, when looking from a gerontechnology perspective, should facilitate ageing adults' functioning, self-esteem, and prosperity. Creating healthy environments is becoming more and more relevant in society. Older adults tend to stay more indoors when compared to younger populations; ageing adults need to work longer than before since the retirement age is increasing. In order to create healthy building environments both outdoor and indoor, environmental aspects need to be considered. Steps towards creating healthy building environments demand further research on the association between indoor environmental factors and ageing adults, how the indoor environment affects older people's health due to pathological ageing, and how the indoor environment affects older people's well-being.

Not much is known about the favourable indoor air quality in long term care facilities (LTCFs), where older adults suffering from dementia live. Older adults, especially those who suffer from dementia, are more sensible to the indoor environment. However, no special requirements for the indoor air in long term care facilities exist. Due to the decrease in cognition function, it is hard to evaluate comfort and health in this group. Nevertheless, infectious diseases are a persistent problem. Based on literature an assessment methodology has been developed to analyse LTCFs to determine if differences in building characteristics and Heating, Ventilation and Air Conditioning (HVAC) systems influence the spread of airborne infectious diseases. The developed methodology is applied in seven long term care facilities in the Netherlands. After that,the methodology has been evaluated and its feasibility and applicability are discussed.From this study, it can be concluded that this method has potential to evaluate, compareLTCFs, and develop design guidelines for these buildings. However, some adjustments tothe methodology are necessary to achieve this objective. Therefore, the relation betweenthe indoor environment and infection risk is not yet analysed, but a consistent procedureto analyse this link is provided.

The common ocular pathologies relating to the aging eye, such as cataract, diabetic retinopathy, glaucoma, or macular degeneration, are all known to reduce visual functioning. Less wellknown is the effect of common, age-related dry eye disease (DED). The impact of DED on daily activities can be intense, especially with reduced visual functioning, for example, an inability to watch television, or read from a tablet or smartphone screen. As a result of reduced visual functioning, DED is particularly problematic for ageing office-workers. Moreover, office work involving computer-use is known to adversely affect the tear film. Consequently, with the extension in retirement age in the working population, an increase in the incidence and extent of (dry) eye-related problems can be expected. This literature paper addresses the impact of age-related DED on visual functioning, the complexity of assessing visual functioning in daily activities at home or at work, the development of dry eye symptoms with increasing age, and the relationship of these issues with environmental factors. Special attention is made to the influence of light and light conditions that can positively and negatively influence visual functioning.

The purpose of the project was to increase the daily activities and exercises of single-living older people with one or more limitations in functioning after a period of rehabilitation.

Networked and ubiquitous information and communication technologies (ICTs) and ambient intelligence are increasingly used in the home environment to facilitate independent living for older adults. These systems collect and disperse a high volume of personal data, which is used for assistance and monitoring by professional carers in order to provide more responsive care for high-risk individuals. These personal data are often also sent to commercial service providers. The computerisation of the home environments, while providing many positive potential uses, goes together with concerns about privacy, sensitivity of data, ethics, and the inclusion of all groups of older adults, also those with dementia. It is arguable that present privacy regulation lags behind technological developments, especially with society moving into the era of ambient intelligence, which promises to intensify data collection in kind, frequency and volume. Also, personal control by older users is becoming ever more laborious to exercise in ambient intelligence environments. A combined agenda of technological and legislative developments is needed to support, as well as inform, the wider public and especially the older population about the legitimacy and the appropriateness of the data collection for the service provided. While principles hold just as much for the internet domain as for ambient intelligence, the complexity and diversity of the latter call for extra care to ensure transparency for the older population.

Clean indoor air enhances health. In a pilot study, we examined whether a good indoor air quality increases the activity potential of older persons with chronic lung disease. Five older persons were studied while performing kitchen activities. Body movement and heart rate were monitored. Additionally, air parameters (indoor CO 2 and ultra fine dust particle ratio indoor versus outdoor) were logged. When performing tasks in clean air, the ratio of body movement versus actual energy expenditure is larger than in polluted air. We demonstrated a positive correlation between quality of indoor air and physical performance parameters, which may have implications for the individual’s level of physical independence. Building technology and building services technology are in a position to guarantee clean air to the benefit of older persons.

At the end of ISG*ISARC2012 World Conference, Eindhoven, June 27-29, 2012, a discussion took place by video conference, between participants of the AAL summit (chaired by Olga Rivera, Basque Country’s Deputy Minister of Health Research and Innovation) and the gerontechnology conference (chaired by Alain Franco, ISG president). The Basque country declaration has been well received by the Gerontechnology community as convened in Eindhoven at the ISG*ISARC2012 conference. It was understood that the AAL Summit in Bilbao concerned R&D funding and business issues of Ambient Assisted Living (AAL). The Basque country declaration is a sturdy and welcome initiative to turn the aging society in a successful society for all. It looks for new and sustainable models for health and takes into account stakeholders from academia, industry, technological research institutes, care organisations and even users. Some remarks are presented about education, prevention and sustainability, end users, usability and building environments. The Basque country declaration is an important and needed document, which hopefully will have considerable impact. We strongly support the pronounced user orientation regarding technology development and use as clearly highlighted in the declaration. The gerontechnology community may further strengthen our move to a successful aging society by providing insights and results on the interface of gerontology and technology, including needed paradigm changes.

There are several reasons to use of e-Health. First, an increasing number of older adults prefer to age-in-place, even when their health deteriorates. Moreover, the need for more demand-oriented care also increases. Older adults can age in place when signs of a deteriorating condition are recognised early and adequately dealt with. Older adults, who live in accessible homes, experience a greater sense of well-being than those living in homes that are not so accessible. Second, older adults tend to move to assisted living facilities when they do no longer feel safe and secure in their own home, or when their health declines to such an extent that professional care is needed. own home, or when their health declines to such an extent that professional care is needed2.

Purpose eHealth projects in the Netherlands have various backgrounds. First, the number of persons aged 65 and over will have increased by 400,000 between 2008 and 20131. Over the same period, the potential workforce will have decreased from 4.2 persons at present to 3.6 persons for each 65 plus. Second, there is a shift from institutional care to care provided at home. The Dutch government promotes healthy behaviour and emphasises the importance of disease prevention2. People prefer to continue living in the community, even when their health is declining. Finally, Dutch policies stimulate the use of e-health in order to (i) support ageing-in-place (AiP), (ii) to enhance the quality of life of older adults, and (iii) to reduce the workload of professional carers. Method Vilans’ Centre of Excellence for Long-Term Care3 database of 85 projects was analyzed. The projects included in the database date from 2004 and after. Some of these projects have been completed and terminated; other projects are still ongoing. Although the database includes the majority of the projects, a complete coverage of all projects in The Netherlands is not guaranteed. To analyse the barriers, all projects were sorted according to one type of e-Health project (videoconferencing, activity monitoring, other types). In this study, basic, functional and economic values from the Model of Integrated Building Design4 were considered as relevant stakeholder values deemed necessary for a successful implementation. Results & Discussion Most projects in the database use e-Health for the support of older adults with (48 projects) or without (35 projects) care needs. In addition, dementia (19 projects), COPD and diabetes (both 11 projects) are the three health conditions that e-Health applications are most often used for. A major barrier for implementation is that only 11 out the 85 projects have a social business case. Another barrier is that requirements to building construction, building systems, e-Health applications or (building) services are hardly ever considered in the projects that also aim to support ageing-in-place. There are many stakeholders involved in the e-Health projects, and not all of the needs of these stakeholders are met in the design and implementation of the accompanying technologies. The execution of these projects seems to consist merely of an analysis of the technological applications with emphasis on the needs of the care recipient and other primary users. To date, e-Health projects in The Netherlands have not been fully implemented5. As well as a failure to include stakeholder needs and accounting for potential barriers, another reason may be that use of e-Health in care will imply innovating care protocols. Care provision shifting from a medical disease oriented model towards a care and wellbeing model. A structural exchange of knowledge and experience in functionalities and user needs will be necessary to take away barriers to a large-scale and successful implementation of e-Health in The Netherlands.

Purpose In the Netherlands 43% of nursing home residents have visual impairments1. Visual impairments can be a result of the normal ageing process or specific diseases. Vision impairment can result in the loss of basic visual abilities: acuity, contrast sensitivity, or visual field 2. In 56% of the cases of low vision, treatment, or slow down, of further decline is possible1. Still, 44% of people affected by low vision remain untreated. The impact of vision loss affects daily care and the design of the environment for older adults in the nursing home. Basic strategies for a healthy living environment for older adults with low vision include: (i) increasing illuminance levels, (ii) controlling brightness (glare) and luminance ratio, (iii) using clear and contrasting colours, (iv) arranging a convenient layout of spaces, and (v) clear acoustics2-4,6. In this pilot study, an assessment was made of the light situation in nursing homes in the Netherlands. Method Light conditions were assessed in common spaces and corridors in three nursing homes using a Konica Minolta chromameter CL-200 to measure vertical (at the eye, gazing direction) and horizontal (for instance, table level) illuminance levels as well as colour temperature (Tc [K]). The results were compared to the minimum illumination levels as given in a guideline by the Dutch Society for Illumination (NSVV). Results & Discussion Results show that the illumination level in the nursing homes fell far below standard5 in over 90% of measurements (min-max 6-2,500 lx), with Tc levels of min-max 2,300-6,250 K. Light conditions in private rooms were better. Assuming that specific tasks are performed in common rooms, additional illumination is needed to perform (I)ADL tasks and for leisure. Light conditions in corridors vary according to the position in the corridor. Right below the luminaires conditions met the lower criteria, although levels decline sharply when stepping out of the direct flux. Such variation may go together with an increased risk for falls.

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