Use of Connected Technologies to Assess Barriers and Stressors for Age and Disability-Friendly Communities.

Background: The benefits of engaging in outdoor physical activity are numerous for older adults. However, previous work on outdoor monitoring of physical activities did not sufficiently identify how older adults characterize and respond to diverse elements of urban built environments, including structural characteristics, safety attributes, and aesthetics. Objective: To synthesize emerging multidisciplinary trends on the use of connected technologies to assess environmental barriers and stressors among older adults and for persons with disability. Methods: A multidisciplinary overview and literature synthesis. Results: First, we review measurement and monitoring of outdoor physical activity in community environments and during transport using wearable sensing technologies, their contextualization and using smartphone-based applications. We describe physiological responses (e.g., gait patterns, electrodermal activity, brain activity, and heart rate), stressors and physical barriers during outdoor physical activity. Second, we review the use of visual data (e.g., Google street images, Street score) and machine learning algorithms to assess physical (e.g., walkability) and emotional stressors (e.g., stress) in community environments and their impact on human perception. Third, we synthesize the challenges and limitations of using real-time smartphone-based data on driving behavior, incompatibility with software data platforms, and the potential for such data to be confounded by environmental signals in older adults. Lastly, we summarize alternative modes of transport for older adults and for persons with disability. Conclusion: Environmental design for connected technologies, interventions to promote independence and mobility, and to reduce barriers and stressors, likely requires smart connected age and disability-friendly communities and cities.