Governments in low- and middle-income countries give some thought to access for devices that assist disabled elderly, a recent study suggests, but more attention is needed.
Poorer countries are expected to see the fastest growth rates in their elderly populations, researchers write in BMJ Innovations, so they have to address needs for assistive devices that help those with disabilities and also technologies designed to prevent people from becoming disabled.
Assistive technologies can range from wheelchairs, canes, prosthetic and orthotic devices, to spectacles, low vision aids, hearing aids, communication boards, household robots and assistive mobile and computer technology.
Such items are only available to about one in 10 people in the countries included in the study, said lead author Keshini Marasinghe.
"That's quite a very low baseline considering the state-of-the-art in technological innovations in the 21st century," said Marasinghe, a researcher at the University of Waterloo in Ontario, Canada.
Marasinghe and her coauthors at the WHO Kobe Center in Japan reviewed existing research to learn about the availability of assistive technology in six low- and middle-income countries, as well as potential and current legislation addressing this need.
For the study, published in BMJ Innovations, the researchers examined data from 17 previously published studies that focused on Brazil, Cambodia, Egypt, India, Turkey and Zimbabwe and described use or testing of various assistive devices.
They found that assistive technologies for older adults are somewhat available in all the included countries. For instance, in Turkey, one study found the most used and most desired assistive devices were screen readers for computers and mobile phones. Others found that wheelchairs and walking sticks had beneficial effects on mobility and independence.
In Brazil, canes were the most commonly used assistive device, and only 4 percent of elderly participants in one study had all the assistive devices they needed. Another study documented cognitive benefits from locally developed "geriatric software" and from equipment such as calendars and routine organizers.
Only a few projects focused on assistive devices designed for preventing impairment and disability among older adults, such as grab-bars to prevent falls or smart home technologies.
"Certainly more attention has to be paid to bridge the huge gap in what we know about the situation of poor access to assistive technology and what can be done in terms of serving aging populations with assistive technology, inclusive of supportive legal framework and legislation surrounding it," Marasinghe said.
These devices are often expensive, but initiatives to increase production of low-cost technology have begun in Brazil, Cambodia, Egypt and India, Marasinghe noted.
"The article is a very welcome and timely contribution when more and more countries realize the importance of implementing the assistive technology measures of the UN Convention of the Rights of Persons with Disabilities - it is therefore relevant not only to the six included countries," Johan Borg told Reuters Health in an email.
There is very little published about cost-effective provision of assistive technologies in low- and middle-income countries, said Borg, a researcher with Lund University in Malmo, Sweden, who wasn't involved in the study.
"The authors of the article indicate that community-based programs may be a way forward," Borg said. "This is in line with previous suggestions."
When thinking of developing systems for the provision of assistive technology, it may be possible to utilize already existing infrastructure and personnel to minimize costs, rather than developing new, parallel systems, Borg added.
"Developing a single system that utilizes infrastructure and personnel to cater to broader needs would probably generate 'more bang for the buck'," he said