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Describes gerontechnology as the use of technology to prevent, delay, or compensate for aging declines and enhance communication, leisure, learning, and artistic expression for elders. Discusses needs assessment, assistive technology, and aspects of this emerging field, including education, professional organizations, funding, and advocacy. (SK)

The opinions of cognitively intact current wheelchair users and their professional caregivers were solicited to explore acceptability of the concept of a passive electric wheelchair-mounted movement monitor to track driving safety and cognitive impairment. Two focus groups of electric wheelchair users (N = 9), and two focus groups of staff caregivers (N = 8) were conducted at a congregate care facility. Participants also completed a questionnaire examining their perceptions of the concept. The results indicated most wheelchair users and staff caregivers were receptive to the idea of a passive safety monitoring system for wheelchairs to detect cognitive impairment. Three main and interrelated themes emerged regarding how the device could promote safety, how such a system might infringe upon the users' autonomy, and how and to whom the cognitive state information should be communicated. Legal, training, and marketing issues reflected similar concerns over balancing autonomy with safety issues. If successfully addressed, it appears there would be support for the device's use not only for older adults in institutional settings, but perhaps also among community living younger and older adults. A passive safety monitoring system for wheelchairs is acceptable to wheelchair users and can be successfully marketed if developers balance autonomy and safety concerns. [ABSTRACT FROM AUTHOR]

Studies have found both gender- and age-related differences in rates of forced expiratory volume at one second (FEV1). FEV1 decline was found to be slower in women than in men, but not at a statistically significant rate. Variability between subjects is also lower in women than in men, and rises with age.

Cross-sectional and longitudinal age-associated reductions in power and isometric strength are described for the upper extremities. Over a 25-year period, repeated measures were taken approximately every 2 years from men and women in the Baltimore Longitudinal Study of Aging (BLSA). The longitudinal measures covered an average 9.6 years, range 1-25 years for men and an average 4.6 years, range 1-8 years for women. Strength and power declined beginning by age 40 in both women and men. Thereafter, power declined about 10% more than strength in men, while no significant differences were found in women. Age had a statistically independent influence on strength and power measures after adjusting for gender, height, weight, caloric expenditure, and muscle mass. Twenty-five-year longitudinal analyses in men confirmed the declines observed cross-sectionally, while no changes were observed in women over the 4-5 years of longitudinal data available. Further longitudinal studies are needed to understand the relationships between strength and power losses with age in women. The differences between power and strength changes with age in men argue for the importance of factors other than strength affecting power.

Men with prostate-specific antigen (PSA) levels less than 2 nanograms per milliliter (ng/ml) who have no clinical signs of prostate cancer should only be screened with PSA testing every two years. Researchers associated with the Baltimore Longitudinal Study of Aging analyzed PSA levels in 40 men who developed prostate cancer and 272 without the disease. Men with PSA levels below 2 ng/ml were unlikely to experience elevated levels even after four years and 94% of the cancers found in these men were curable. On the other hand, 30% of the cancers found in men with PSA levels greater than 5 ng/ml were incurable. These men may require annual screening., Objective.--To evaluate prostate-specific antigen (PSA) testing intervals that maintain the detection of curable cancer and reduce unnecessary testing. Design and Patients.--Historical prospective study of serial PSA measurements at 2- and 4-year intervals from frozen serum samples of 40 men who eventually developed prostate cancer and 272 men without prostate cancer who were participants in a prospective aging study (Gerontology Research Center of the National Institute on Aging, the Baltimore Longitudinal Study of Aging) and the case series of 389 consecutive men treated surgically for nonpalpable prostate cancer. Main Outcome Measures.--Probability of a PSA conversion to 4.1 to 5.0 ng/mL and to greater than 5.0 ng/mL at 2 and 4 years and probability of detecting curable prostate cancer by age and PSA level. Results.--When the pretreatment PSA level was less than or equal to 4.0 ng/mL, nonpalpable prostate cancers were highly likely (34/36, 94%) to be curable (organ-confined or capsular penetration with Gleason score 5.0 ng/mL) is rare (0%) after 2 or 4 years when the initial PSA is less than 2.0 ng/mL. PSA conversion to a range at which cancers are likely to be curable and less likely to be small (4.1-5.0 ng/mL) is rare after 2 years (0%-4%) when the baseline PSA level is less than 2.0 ng/mL but common when the baseline PSA level is between 2.1 and 3.0 ng/mL (27%) or 3.1 and 4.0 ng/mL (36%). Conclusions.--These data suggest that for men with no cancer suspected on digital rectal examination, a PSA level of 4.0 to 5.0 ng/mL is an acceptable range for maintaining the detection of curable prostate cancer and a 2-year PSA testing interval is not likely to miss a curable prostate cancer when the initial PSA level is less than 2.0 ng/mL. Recognizing that 70% of a screened population between the ages of 50 years and 70 years have PSA levels less than 2.0 ng/mL, elimination of annual PSA testing for these men would result in large health care cost savings. JAMA. 1997;277:1456-1460

This study examines cross-sectional age differences, longitudinal age changes, and secular changes in obligatory, committed, and discretionary activities, using activity questionnaires completed by men and women participants in the Baltimore Longitudinal Study of Aging between 1958 and 1992. (1) Time spent, on obligatory activities and passive leisure is greatest, and on committed activities and active leisure least, for older adults. (2) Longitudinal patterns usually mirror cross-sectional ones. There are pronounced exceptions for women whose paid work time has been increasing and housework decreasing, while cross-sectional patterns show the reverse. (3) Over recent decades, time in committed activities shifted in opposite ways for men and women. Men decreased paid work and increased housework, repairs and yardwork, shopping, and child-care, while women increased paid work and decreased housework. In sum, the age structure of activities has persisted in the midst of new social opportunities; gender roles have proven more malleable than age roles.

Cross-sectional and longitudinal experimental techniques reveal the extent to which reactive capacity decreases with age, sex and type of reaction time task. Males are faster than females in all age groups. Disjunctive reaction time increases more directly with age than simple reaction time. Aging inhibits decision-making processes and higher cortical functions.

Increased blood levels of prostate-specific antigen (PSA) as men age may indicate greater risk for developing prostate cancer and other prostate diseases than in men with lower blood levels of PSA. Of 54 men whose blood levels of androgen and PSA were measured over seven to 25 years, 16 did not develop prostate disease, 20 developed benign prostatic hyperplasia (enlargement) (BPH), and 18 developed prostate cancer. Men who developed prostate cancer had a more rapid increase in PSA levels with age than men who developed BPH. Men who developed BPH had a more rapid increase in PSA levels with age than men who did not develop prostate disease. Five years before diagnosis, changes in PSA levels among men who developed BPH were approximately the same as those of men who did not develop prostate disease. The PSA levels of men who developed prostate cancer increased at a much more rapid rate compared to the other two groups, however.

Although there are well-recognized declines in visual functioning with age, their contribution to the problems of older persons on tasks in the natural environment, including driving, are largely unknown. Adults ranging in age from 22-92 years were surveyed in regard to their visual difficulties when driving and performing everyday tasks. The visual problems of drivers increased with age along five different visual dimensions; unexpected vehicles, vehicle speed, dim displays, windshield problems, and sign reading. Several of the age-related visual problems that were reported appear to be related to the types of automobile accidents more common among old drivers. The study also replicated the findings from an earlier investigation of non-driving tasks that showed visual declines with age on five dimensions; visual proceeding speed, light sensitivity, dynamic vision, near vision and visual search. These findings indicate promising areas of research regarding the effects of visual aging on tasks in the natural environment.

Attempts to isolate lexical access latencies by measuring word-naming times in two conditions: (1) words were preidentified and had only to be pronounced on signal; (2) words had to be both identified and pronounced. Results strengthen the conclusion that vocal programing is exempt from the age declines seen in other sensory-motor tracts. (Author/AS)

Age-related differences in continuous recognition memory were assessed in adults. High and low frequency words were presented to the subject one at a time. No age difference was found in recognition latency or errors. Low frequency words were recognized faster and with higher accuracy. (Author)

We examined the effects of age and gender on the relationship between knee strength and walking time during a walk-turn-walk test in 176 male and 168 female generally healthy participants of the Baltimore Longitudinal Study of Aging who were aged 21-89 years. Subjects were timed as they walked 50 ft (15.24 m), turned around, and walked back to the starting point, both at a comfortable pace and as fast as possible. Isokinetic concentric knee extensor strength was measured at 30[degrees]/s by using a Kin-Com dynamometer. Both comfortable and fast gait times increased with increasing age for both women and men, starting in middle age. An interaction was found between gender and age showing that older women are slower than older men at both paces. Gait time decreased linearly with increasing knee extensor strength, plateauing at higher strength levels ([is greater than] 130 N m for comfortable gait, and 190 N m for fast gait). Most women occupied the linear part of the curve below the plateau. Adjustment for body size, age, physical activity, and particularly number of steps to complete the task removed the relationship between strength and gait time for the comfortable gait. Women took longer to complete the walk-turn-walk test than men at older ages, were on the linear part of the strength--gait time relationship, and used more steps to complete the task, all of which may contribute to their greater likelihood of frailty in later years.

Background. Because of the scarcity of data available from direct comparisons of age and gender groups using the same relative training stimulus, it is unknown whether older individuals can increase their muscle mass as much as young individuals and whether women can increase as much as men in response to strength training (ST). In addition, little is known about whether the hypertrophic response to ST is affected by myostatin genotype, a candidate gene for muscle hypertrophy. Methods. Eleven young men (25 [+ or -] 3 years, range 21-29 years), 11 young women (26 [+ or -] 2 years, range 23-28 years), 12 older men (69 [+ or -] 3 years, range 65-75 years), and 11 older women (68 [+ or -] 2 years, range 65-73 years) had bilateral quadriceps muscle volume measurements performed using magnetic resonance imaging (MRI) before and after ST and detraining. Training consisted of knee extension exercises of the dominant leg three times per week for 9 weeks. The contralateral limb was left untrained throughout the ST program. Following the unilateral training period, the subjects underwent 31 weeks of detraining during which no regular exercise was performed. Myostatin genotype was determined in a subgroup of 32 subjects, of which five female subjects were carriers of a myostatin gene variant. Results. A significantly greater absolute increase in muscle volume was observed in men than in women (204 [+ or -] 20 vs 101 [+ or -] 13 [cm.sup.3], p [is less than].01), but there was no significant difference in muscle volume response to ST between young and older individuals. The gender effect remained after adjusting for baseline muscle volume. In addition, there was a significantly greater loss of absolute muscle volume after 31 weeks of detraining in men than in women (151 [+ or -] 13 vs 88 [+ or -] 7 [cm.sup.3], p [is less than] .05), but no significant difference between young and older individuals. Myostatin genotype did not explain the hypertrophic response to ST when all 32 subjects were assessed. However, when only women were analyzed, those with the less common myostatin allele exhibited a 68% larger increase in muscle volume in response to ST (p = .056). Conclusions. Aging does not affect the muscle mass response to either ST or detraining, whereas gender does, as men increased their muscle volume about twice as much in response to ST as did women and experienced larger losses in response to detraining than women. Young men were the only group that maintained muscle volume adaptation after 31 weeks of detraining. Although myostatin genotype may not explain the observed gender difference in the hypertrophic response to ST, a role for myostatin genotype may be indicated in this regard for women, but future studies are needed with larger subject numbers in each genotype group to confirm this observation.