March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 1 From reducing mortality to compressing morbidity 2007 International Conference on Gerontic Technology and Service Management Nan Kai Institute of Technology, Taiwan Keynote speech 4 Mach 27, 2007; H

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 2 Aging Source:

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 3 Life course Development = Growth = Aging Heredity (50%) + Environment (50%) Natural environments Technology changes environments

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 4 (Pre)History by Technology Medicine, Agriculture, Industry Stone age: from the wake of humankind to villages Bronze age: walled towns come into being Iron age: living pace starts to increase Industrial age: mechanisation, electrification, ICT Source: J.E. McClellan III, H. Dorn Science and technology in world history. 2nd edition. Baltimore: John Hopkins University Press

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 5 Technology generations in the Industrial age Mechanical: increased urbanisation Electro-mechanical: decreased mortality decrease of morbidity wanted Software: decrease of morbidity wanted = Gerontechnology

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 6

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 7

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 8 Chronic conditions accelerated aging of certain organs / tissues Examples: Lungs: air pollution; indoor, outdoor Brains: lack of challenges nor social interaction Locomotory system: repetitive forces; work, leisure Circulatory system: lack of exercise

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity x cases of acute Pontiac Fever 9-30x surviving Veteran-Disease patients, but with persisting chronic symptoms 1-20x fatal cases Source: JEMH van Bronswijk e.a Gezond en Duurzaam Bouwen (GeDuBo). Research Report for the Netherlands Ministry of Housing Fate of 1000 Legionella infections after inhaling infested water droplets

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 10 Allergy: of Mites and Man

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 11 From the Netherlands

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 12 Improving health Sustainable society, social cohesion Strengthening productivity, vitality Prolonging full citizenship Diminishing societal costs of care Compressing Morbidity through Compressing Morbidity by daily (geron)technology

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 13 Environmental factors in some chronic inflictions Outdoor and indoor air Potable water Liquid and solid waste Noise, sound, lighting Mobility, transport Social contacts and interaction

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 14 Environmental engineering = to control environmental stress, by: Building construction Building services Civil / sanitary engineering Design of work processes

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 15 Preventive part of Gerontechnology Delaying chronic conditions Robust and feasible approach Smart, unobtrusive use of technology Acceptable daily technology Aimed also at younger age groups

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 16 Ambient assisted living Supports – healthy growth, development, aging Compensates –Weakening of functions

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 17 TQM of daily technology TQMTotal Quality Management (TQM) HACCPHazard Analysis Critical Control Point (HACCP) Guarantees quality during the whole working life of a product or service Originates from the food industry Applicable to building services

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 18 HACCP steps for control Base: Process description, end-product defined 1: Process analysis CCP2: Critical Control Points (CCPs) 3: Critical limit / CCP 4: Monitoring procedure / CCP 5: Intervention at exceeded critical limit / CCP 6: Verification procedure / CCP 7: Registration & documentation procedures (for in-company and out-company certification)

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 19 To reduce morbidity AND mortality = Gerontechnology Suitable environments –from cradle to grave, HACCP control Smart coaching services Indoor environmental control –Home automation –Robotics Research –Impact, target, intervention site and type –for each single technology and technology system

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 20 Expectations for smart housing n = Yrs old 56% female 44% male 30% home owners 70% home renters Source: S. Meyer, E. Schultz Vom Otto Normalverbraucher zur Smart Family. Berlin: Berliner Institut für Sozialforschung

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 21 Expected advantages of smart housing Germany 2001 Daily living support Safety & security Comfort Management of energy use Other health issues not yet perceived Source: S. Meyer, E. Schultz Vom Otto Normalverbraucher zur Smart Family. Berlin: Berliner Institut für Sozialforschung;

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 22 Benefits of telemedicine Benefits of telemedicine A meta-analysis of 66 studies from Source: D. Hailey, R. Roine, A. Ohinmaa Systematic review of evidence for the benefits of telemedicine Journal of Telemedicine and Telecare 8(Suppl 1):1-30

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 23 For Sale: Cottage March 27, 2027 Pleasant neighbourhood Modern kitchen Luxury bathroom A spacious living room 3 Bedrooms 103 Built-in butlers for leisure, support and education Free after: S. Marzano Ambient culture. Pp 35-52, in: E.H.L. Aarts, J.L. Encarnaçã0, editors, True visions; the emergence of ambient intelligence. Berlin: Springer

March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 24 Thank you for your attention