Colors of Aging: Cross-cultural Perception of Lifelogging Technologies

in Older Age

Julia Offermann-van Heek

, Wiktoria Wilkowska

and Martina Zieﬂe

Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074 Aachen, Germany

Keywords:

Lifelogging Technologies, Acceptance, Perception, Aging, Cross-cultural Analysis.

Abstract:

Within an aging society, characterized by increasing numbers of older people in need of assistance and care

with a simultaneous shortage of professional caregivers, new ways and innovations have to be developed to

facilitate life in older age. Assisting lifelogging technologies have the potential to support older and frail peo-

ple, but also caregivers in their everyday lives. These assisting lifelogging technologies require the acceptance

of future users to reach a sustainable adoption. As research has focused mostly on country-speciﬁc analy-

ses so far, a cross-cultural and -national investigation of users’ lifelogging technology acceptance in older

age is necessary. Therefore, an online survey study (N = 1123) examined perceptions regarding aging, care,

and lifelogging technology usage, focusing on the perspective of potential users originated from ﬁve different

countries: Germany, Sweden, Canada, Italy, and Spain. The results revealed signiﬁcant differences between

the countries regarding attitudes towards aging and care as well as perceptions and acceptance of lifelogging

technologies. The insights identify the cultural background of potential users as a relevant impacting parameter

and should be considered when technologies are developed and tailored to the needs of speciﬁc user groups.

1 INTRODUCTION

The care sectors of today’s society are tremendously

challenged by increasing proportions of people in

need of assistance and care caused by their age,

(chronic) illnesses, or disabilities and a simultane-

ous shortage of (professional) care personnel (Greve,

2016; Fekete, 2019; B

orsch-Supan et al., 2015). As a

consequence of a signiﬁcantly higher life expectancy

including more and more people aged 75 years and

older having speciﬁc needs regarding assistance and

(intensive) care, higher numbers of professional and

family caregivers are needed. In fact, the proportions

of professional caregivers have decreased in the last

years. At least in Germany, it is tried to compensate

this described lack by outpatient nursing services or

by care provided by family members (Roth and Re-

ichert, 2019). In line with most older people’s wish –

to stay as independent and as long as possible within

their own home – it is thereby tried to enable that

older and frail people can stay within their familiar

home environment (Blackman et al., 2016). Never-

theless, these efforts do not sufﬁce in the course of

https://orcid.org/0000-0003-1870-2775

https://orcid.org/0000-0002-7163-3492

https://orcid.org/0000-0002-6105-4729

demographic change. Much more, it is required to

think about new ways, concepts, and technologies in

order to assist and support older people and people

in need of care. Using assisting lifelogging technolo-

gies in older age represents one possible approach to

support older people in their everyday life to enable

a longer staying within their own home or to relieve

the burdens of (professional) caregivers and family

members. Thereby, assisting lifelogging technolo-

gies refer to diverse technological ways of recording

the everyday life Selke (2014) reaching from wear-

able devices – motivating their users to a healthier

lifestyle – to holistic ambient systems installed within

the home environment, that are able to detect emer-

gencies or remind their users for intake of medicine

or appointments. In the last years, a broad variety

of applications has been developed belonging to the

ﬁeld of ambient assisted living (AAL) and assisting

lifelogging technologies (for an overview see Rashidi

and Mihailidis (2012)). Besides their technical poten-

tial, the future user’s acceptance of innovative techni-

cal solutions presents a prerequisite for a sustainable

adoption and usage within the everyday life. There-

fore, research has increasingly focused on diverse fu-

ture users’ perception and evaluation of assisting tech-

nologies in recent years (e.g., (Larizza et al., 2013;

Heek, J., Wilkowska, W. and Zieﬂe, M.

Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age.

DOI: 10.5220/0009371000380049

In Proceedings of the 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2020), pages 38-49

ISBN: 978-989-758-420-6

onig et al., 2017; Peek et al., 2014). Most of the

studies in this ﬁeld have in common that they fo-

cus on the perspectives of participants from one sin-

gle country. Hence, there is hardly any knowledge

about cross-cultural perspectives on using assisting

lifelogging technologies in older age so far, and it is

not known if and to what extent the participants’ ori-

gins or cultural background is an impacting parame-

ter. This is exactly why the present study (N = 1123)

aimed at a cross-cultural and -national comparison

of the perceptions of aging, care, technology-related

beneﬁts and barriers as well as acceptance of using as-

sisting lifelogging in older age differing between par-

ticipants from ﬁve countries: Sweden, Italy, Spain,

Canada, and Germany. Hence, this paper investigated

the inﬂuence of culture understood and deﬁned as the

participants’ cultural origins.

2 STATE OF THE ART

The following section presents the theoretical back-

ground of the study, starting with the current state of

acceptance of assisting lifelogging technologies. Af-

terwards, the individuality of users and its impact on

the acceptance of assisting technologies are focused

including demographic and health-related character-

istics as well as culture (i.e. the cultural origins of the

participants) as potential impacting parameter.

2.1 Lifelogging & Acceptance

In the last years, numerous technologies and inno-

vative systems have been developed in the ﬁeld of

lifelogging and ambient assisted living. These tech-

nologies and systems cover an extremely broad range

of functions for diverse groups of users with their

speciﬁc needs and requirements (Rashidi and Mihai-

lidis, 2012; Abtoy et al., 2018). The potential user

groups are as diverse as the spectrum of the tech-

nologies and systems: for healthy people, lifelogging

technologies provide the opportunity to analyze and

track own behaviors, such as sports or nutrition, to

improve and support a healthy life style, or to en-

hance well-being (e.g., Schoeppe et al., 2016; Mid-

delweerd et al., 2014). For older and frail people,

assisting lifelogging technologies have the potential

to meet the care gap, by supporting them in retain-

ing as independent as possible, staying active, and in

particular by enhancing safety. The latter is realized

using wearable and non-wearable, video- or sensor-

based monitoring and fall detection systems, that en-

able alarms or emergency calls in case of emergen-

cies and falls (e.g., Mubashir et al., 2013; Stone and

Skubic, 2014; Wu and Xue, 2008). Another rele-

vant application area for older and frail people refers

to prompting systems and memory aids: here, di-

verse concepts and systems aim at facilitating every-

day life for older people in need of assistance and care

and, in particular, for people with dementia and their

caregivers, for example by reminding for intake of

medicine or prompting for daily routines (e.g., Hos-

sain et al., 2011; Mihailidis et al., 2007; Wu and Xue,

2008). Other application examples refer for instance

to a barrier-free and independent communication for

older people with friends, family, or caregivers us-

ing telemedicine, telecare, or videoconferencing ser-

vices and technologies (van den Berg et al., 2012),

or to wandering prevention tools (for people with de-

mentia) (e.g., Vuong et al., 2011). Beyond all these

useful opportunities and functions, the future users’

perspective on, and acceptance of, those technologies

are decisive for a long-term adoption and usage of as-

sisting technologies in their everyday lives. Although

the number of studies focusing on the user’s perspec-

tive on innovative technologies in the area of ambi-

ent assisted living and assisting lifelogging technolo-

gies has increased in the last years, systematic eval-

uations and validations of new as well as already ex-

isting technologies are still needed (Peek et al., 2014;

Calvaresi et al., 2017). So far, research has shown

that assisting lifelogging technologies in older age are

predominantly positively perceived by their potential

users and in particular the potential to relief the every-

day life of persons in need of care and their caregivers

is acknowledged (Lorenzen-Huber et al., 2011; Wild

et al., 2008; Lai et al., 2010): thereby, especially in-

creased safety, independence, and autonomy for peo-

ple in need of care are highlighted as beneﬁts of ap-

plying assisting technologies in older age. These ad-

vantages are in particular acknowledged when safety-

relevant functions, such as emergency alarms and fall

detection, or relieving functions like (medical) re-

minders are enabled (e.g., Offermann-van Heek et al.,

2019; Gall et al., 2016; Offermann-van Heek et al.,

2019). Not surprisingly, some barriers and concerns

stand opposite to the advantages and beneﬁts of using

assisting lifelogging technologies (Peek et al., 2014).

Concerns with regard to privacy invasion when deal-

ing with technology-related data (Mihailidis et al.,

2008; Steggell et al., 2010; Lorenzen-Huber et al.,

2011), feelings of being controlled by the technology

as well as assumed high costs (Horton, 2008; Porter

and Ganong, 2002) belong to the most relevant bar-

riers of using assisting lifelogging technology. Be-

sides beneﬁt- and barrier-related aspects that impact

the user’s acceptance of assisting technology, research

has shown that also the speciﬁc type of technology as

Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age

well as the respective context (e.g., necessity in terms

of care needs (Offermann-van Heek et al., 2019)) are

impacting parameters for the perceptions and accep-

tance of future users. With regard to the context of de-

mographic change and usage of assisting technologies

in older age, it is also relevant how the topics of aging

and care themselves are perceived by (older) people in

need of care. Here, research has shown that attitudes

and handling of topics like aging and care have the

potential to shape and inﬂuence the acceptance and

adoption of assisting lifelogging technologies as well

(Biermann et al., 2018).

2.2 Individuality of Users

In addition to technology-related characteristics as

well as motives and concerns of using assisting lifel-

ogging technology, individual characteristics of fu-

ture users have the potential to impact the evaluation,

perception, and acceptance of assisting technologies.

Relevant ﬁndings related to these potential impacting

user factors are described within the next sections.

2.2.1 Inﬂuence of Demographics

The most common user characteristics integrated in

technology acceptance are certainly referred to the

participants’ age and gender. In the context of using

assisting lifelogging technology in older age, research

has shown that older people expressed more posi-

tive attitudes towards innovative technologies com-

pared to younger people (e.g., Beringer et al., 2011;

Offermann-van Heek et al., 2019): In more detail, the

older participants showed higher agreements to po-

tential advantages of using assisting technology, such

as a longer staying at the own home or increased in-

dependence, while they showed lower perceptions of

barriers. As an interesting result, they considered

other concerns to be relevant compared to younger

people, e.g., to be dependent on innovative technolo-

gies or to feel unable to control the technology. Re-

search also revealed that the participants’ gender can

have an impact on the evaluation and acceptance of

assisting technology (e.g., Offermann-van Heek et al.,

2019), revealing men to show a higher acceptance of

assisting lifelogging technologies, while the female

participants expressed higher evaluations of barriers.

2.2.2 Inﬂuence of Health and Care

As other individual characteristics of users, the partic-

ipants health status, potential care needs, and previous

experiences with care have been identiﬁed in previous

research. Previous research has shown that the partic-

ipants’ health status, such as existing chronic diseases

or disabilities of older people, have an inﬂuence on as-

sessments as well as acceptance of assisting technolo-

gies (e.g., Chappell and Zimmer, 1999; Gentry, 2009;

Wilkowska, 2015; Offermann-van Heek et al., 2019).

In addition, further studies revealed that previous ex-

periences with care (e.g., professional care experi-

ence Larizza et al. (2013); Offermann-van Heek et al.

(2019) as well as private care experience (Lorenzen-

Huber et al., 2011; Offermann-van Heek and Zieﬂe,

2019)) impact the perception and acceptance of as-

sisting technology: For instance, professional care-

givers showed in parts higher concerns and evalua-

tions of barriers as well as a lower technology accep-

tance compared to lay persons.

2.2.3 Inﬂuence of Culture

The most studies regarding technology acceptance of

assisting lifelogging technology have in common that

they investigated the perceptions and acceptance of

participants from one single country and cultural ori-

gin, although the cultural background is considered as

an individual factor of users that could play a role as

impacting parameter on technology acceptance (Sun

and Zhang, 2006). Occasionally, some studies in-

vestigated the acceptance and perception of (assist-

ing) technology depending on the cultural origin of

the participants. For example, the research of Alag

et al. (2011) and Wilkowska et al. (2012) revealed sig-

niﬁcant inﬂuences of the participants’ cultural back-

grounds on their acceptance of assisting eHealth tech-

nology – in addition to other user factors such as age

and gender. In more detail, it was found that Turk-

ish, Polish, and German participants differ in their

evaluations of motives and barriers of using assist-

ing technology, revealing that in particular barriers

and concerns with regard to technology usage were

assessed higher by the Turkish compared to the Ger-

man and Polish participants. Although these results

constitute the presumption that culture operational-

ized as cultural origin could be an impacting param-

eter for the acceptance of assisting lifelogging tech-

nology in older age, it is not known yet to what

extent the contextual perception of care and aging,

but also the perception of technology-related bene-

ﬁts and barriers, and acceptance are shaped by origin-

and culture-dependent characteristics. Hence, an ap-

proach is needed that investigates lifelogging technol-

ogy perception and acceptance in dependence of the

participants’ origins taking different countries into ac-

count. In order to enable cross-national and -cultural

comparisons in Europe, it is necessary to systemati-

cally compare countries from different regions (e.g.,

Northern vs. Central vs. Southern Europe). In addi-

tion, it would be useful to integrate a non-EU country

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

in order to draw some ﬁrst conclusions about Europe

and continent spreading relationships between culture

and lifelogging technology acceptance.

3 METHODOLOGICAL

FRAMEWORK

The background for the current study presents the Eu-

ropean research project PAAL (“Privacy Aware and

Acceptable Lifelogging services for older and frail

people”). Within PAAL, an interdisciplinary team of

lawyers, diverse engineers, and communication sci-

entists develop different assisting lifelogging services

that are speciﬁcally tailored to the needs and require-

ments of older users. In order to reach a broad accep-

tance and to understand acceptance patterns from as

diverse people as possible (younger vs. older people,

“healthy” people vs. people in need of assistance and

care, people from diverse countries), cross-national

studies, surveys, and experiments are conducted. The

speciﬁc research aim of the present study was to ex-

amine the potential inﬂuence of the participants’ cul-

tural origins on their perceptions of aging and care as

well as their evaluation, perception, and acceptance

of using lifelogging technology in older age. In order

to reach this aim, an online survey was conceptualized

and people from ﬁve different countries were asked to

participate in the survey. To reach participants from a

broad range in Europe, Italy and Spain were chosen

to represent Southern Europe, Sweden as example for

Northern Europe, and Germany as example for Cen-

tral Europe. As counterpart to the euro states, Canada

was chosen as control group enabling a comparison

beyond the European countries. The speciﬁc underly-

ing research questions were the following:

• RQ1: Does the handling of care within families

differ depending on the participants’ origins?

• RQ2: Do the attitudes towards aging and care dif-

fer depending on the participants’ origins?

• RQ3: Do the perceptions of technology-related

beneﬁts and barriers differ depending on the par-

ticipants’ origins?

• RQ4: Does the acceptance of lifelogging technol-

ogy in older age differ depending on the partici-

pants’ origins?

3.1 Concept of the Online Survey

Subsequent to the present study different qualita-

tive as well as quantitative studies were conducted.

These studies enabled to derive central guidelines for

Aging & Care

Handling of

Care

(4 items)

Attitude

towards Aging

(10 items)

Attitude

towards Care

(12 items)

Evaluation of Lifelogging Technology

Perception of

Benefits

(9 items)

Perception of

Barriers

(9 items)

Technology

Acceptance

(3 items)

Individual Characteristics

Demographics

(Origin, Age,

...)

Health and

Care

Conditions

Care

Experience

Figure 1: Structural overview of the survey’s parts and the

investigated constructs.

a human-centered development of lifelogging tech-

nologies and provided a broad overview of impact-

ing user factors Offermann-van Heek et al. (2019).

As these studies did not integrate cross-cultural anal-

yses, an online survey was developed based on the

existing knowledge speciﬁcally aiming for an cross-

cultural investigation of perceptions of aging and care

as well as acceptance and perception of using lifel-

ogging technologies in older age. In order to reach

participants from different countries, the survey was

made available in English, German, Italian, and Span-

ish. At the beginning, participants were able to choose

the language, in which they desired to ﬁll out the sur-

vey. Afterwards, they were welcomed and shortly in-

troduced into the topic of an aging society and the

development of lifelogging technology in order to fa-

cilitate life in older age. The main part of the survey

consisted of three parts (see Figure 1). In the ﬁrst

part, the participants were asked for individual char-

acteristics, starting with indicating demographic in-

formation, such as their origin, age, gender, highest

educational level, or living situation. Subsequently,

the participants indicated if they suffer from a chronic

illness and/or if they are in need of assistance and care

in their everyday life (answer options: yes/no). Fur-

ther, the participants were asked, if they have previ-

ous experiences in care (answer options: yes/no) dif-

fering between professional experience, (private) pas-

sive, and private active experience. Here, passive ex-

perience meant that the participant has a person in her

or his family circle, who is in need of assistance and

care; whereby active care experience meant that the

participant has already been the caregiver for a family

member in need of care. Following these details, the

participants were introduced into the topic of aging

and care within the second part of the survey. Here,

the participants initially assessed four items dealing

with the handling of care of older family members

Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age

within their families. The items are presented in Fig-

ure 2 and the participants’ evaluations based on a

four-point scale reaching from “1 = I disagree” to ”4

= I agree”. Further, the participants evaluated their at-

titudes towards aging and care. For this purpose, they

ﬁrst assessed 10 items (α = .86) referring to poten-

tial positive (e.g., /sayAging means to me... that I can

still have a lot of fun in my life.) and negative as-

pects of aging (e.g., /sayAging means to me... to be

less independent.). The evaluation of this and the next

scales based on six-point Likert scales (reaching from

/say1 = I totally disagree” to ”6 = I totally agree). The

attitude towards care was evaluated using 12 items

(α = .74) covering aspects like the desired living sit-

uation in older age (e.g., “I do not wish to be placed

in a nursing home under any circumstances.”), needs

for autonomy and independence (e.g., “In my every-

day life I would improvise to be able to do things my-

self.”), and who should be the caregiver in case of care

needs (e.g., “I’d be glad to have someone in my fam-

ily to help me.”). After these aging- and care-related

aspects, the participants were introduced to the devel-

opment of lifelogging technologies and their potential

beneﬁts and barriers within the third part of the sur-

vey. The participants should empathize with the situ-

ation that they are in need of care themselves and that

assisting lifelogging technology has the potential to

facilitate their everyday life by detecting emergencies

such as falls or by reminding for daily routines (such

as intake of medicine or adherence to schedules). In

the following, the participants were asked to assess

each nine potential beneﬁts (α = .94, e.g., “Increase

in independence (autonomy)” or “Fast reactions in

emergencies”) and potential barriers (α = .89, e.g.,

“Insights into personal health data for unauthorized

persons” or “Replacing human care by technology””

of using lifelogging technology in older age. Finally,

the participants evaluated their acceptance and inten-

tion to use lifelogging technology using three items

(α = .76; e.g., “I do not want to use an assisting lifel-

ogging system.” or “I think an assisting lifelogging

system is generally useful.”). For all these evalua-

tions, also six-point Likert scales were used. At the

end of the survey, the participants had the opportunity

to give feedback on the topic and the survey.

3.2 Data Acquisition, Preparation, and

Analysis

In order to reach representative samples (in particular

with regard to age) and participants from ﬁve differ-

ent countries, the service of an independent market

research institute was used. The respondents were

invited to participate in the survey via email by the

market research institute. Further the market research

institute was engaged to acquire respondents from the

mentioned ﬁve countries, fulﬁlling previously deﬁned

age and gender quotas (i.e. equal distributions with

regard to gender and age groups: 18-40 years, 41-65

years, 65+ years).

As only complete data sets could be used for de-

tailed statistical analyses, incomplete data sets were

excluded from the data base. In addition, partici-

pants with very short processing times (less than the

median of the processing time −30%) were also ex-

cluded from the subsequent data analysis. As a fur-

ther preparation for the data analysis, negative items

were re-coded, all scales were tested for reliability,

and overall scores were calculated.

For the statistical analysis of the inﬂuence of the

participants’ cultural origins on the perceptions of ag-

ing, care, beneﬁts, barriers, and acceptance of lifelog-

ging technologies, one-way between groups analyses

of variance (ANOVA) were applied in order to an-

alyze potential differences between Spanish, Italian,

Canadian, Swedish, and German participants (partial

eta squared (η

) was calculated for effect sizes). If

the homogeneity of variance was violated, Brown-

Forsythe (BF) tests were applied in order to verify the

equality of group variances. In order to identify spe-

ciﬁc differences between the countries, Tukey’s post-

hoc tests were applied. Signiﬁcant group differences

are presented using square brackets within the dia-

grams in addition to the respective signiﬁcance level.

To analyze potential relationships between the per-

ceptions and acceptance, Pearson’s product-moment

correlation coefﬁcients (r) were calculated for contin-

uous variables. In the following, means (M) and stan-

dard deviations (SD) are reported for descriptive anal-

yses and the level of statistical signiﬁcance (p) was set

at the conventional level of 5% (*p < .05; **p < .01).

3.3 Description of Participants

After the data cleansing (deleting incomplete data

sets, speeders etc. (n=568; 33.6%)) a ﬁnal sample

of N = 1123 participants remained for further sta-

tistical analyses. As mentioned above, the partic-

ipants were recruited by an online-panel of a mar-

ket research institute and were paid for participating.

The participants were on average 49.7 (SD = 16.1)

years old (min = 18; max = 99) and the proportion

of male (48%; n = 539) and female (52%; n = 584)

participants was almost balanced. The educational

level of the sample was rather high, as 49% (n =

550) of the sample reported to hold a university en-

trance qualiﬁcation (or completed apprenticeship) and

44.9% (n = 504) a university degree. In contrast, only

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

6.1% (n = 69) of the participants reported a lower

educational level (i.e., completed secondary school).

Regarding their living situation, the majority of the

sample indicated to live together with their families

(45.4% n = 510), while 28.7% (n = 322) reported to

live together with another person and 25.9% (n = 291)

live alone. According to the topic of the study (using

assisting lifelogging technologies in older age), the

participants were also asked for the indication of their

health status, potential care needs, and previous expe-

riences in care. Thereby, 37.8% (n = 424) of the par-

ticipants reported to suffer from at least one chronic

disease, while 12.6% (n = 141) indicated to depend

on care and assistance in their everyday life. Further,

23% (n = 258) of the participants reported profes-

sional experience in care. Regarding private experi-

ence with care, 32% (n = 359) reported to have pas-

sive experience, which means that they currently have

a person in need of care within their family circle.

Even more participants (41.8%; n = 469) indicated to

have an active experience in care (i.e., they have been

the caregiver for a family member in need of care).

As the study aimed for a cross-national and cross-

cultural comparison, the participants came from ﬁve

different countries: Canada (26.3%; n = 295), Swe-

den (26.7%; n = 300), Spain (13.3%; n = 149), Italy

(13.4%; n = 150), and Germany (20.4%; n = 229).

The participants’ characteristics depending on the dif-

ferent countries are described within the next section.

3.4 Description of Cultures

All characteristics of the participants depending on

their (cultural) origins are illustrated in Table 1, which

shows that the ﬁve countries did not differ signiﬁ-

cantly with regard to the participants’ age. The distri-

butions of male and female respondents were slightly

different, but not at a signiﬁcant level. Looking at

the countries’ average educational levels, post-hoc

tests revealed that the participants from Italy and Ger-

many differed both considerably from the participants

from Sweden, Canada, and Spain by holding larger

proportions of low (Germany) and middle education

(Italy). With regard to their living situation, post-hoc

tests showed that Spain as well as Italy differed each

signiﬁcantly from Germany and Sweden. Thereby,

higher proportions of the Spanish and Italian partic-

ipants lived together with their families and only very

small proportions lived alone, compared to Germany

and Sweden. Moving to health-related characteristics,

the proportions of people suffering from a chronic dis-

ease was considerably higher in the German group

compared to all other countries (post-hoc tests). In

contrast, the proportion of people who indicated to

depend on assistance and care in their everyday life

was signiﬁcantly higher in the Swedish participants

compared to all other countries (post-hoc tests). In the

area of previous experience in care, the German and

the Canadian participants were characterized in post-

hoc tests by signiﬁcantly lower percentages of people

having professional care experience each compared to

Spain, Italy, and Sweden. Concerning passive private

care experience, the Canadian group hold the consid-

erably lowest experience compared to all other coun-

tries, while the proportion of people being passively

experienced was signiﬁcantly highest in the Italian

group (compared to all other countries). Finally, the

proportions of people having active care experience

were also signiﬁcantly different, revealing the high-

est proportions of experience for the Italian and Span-

ish participants, followed by Sweden and Canada. In

contrast, the active care experience was lowest in the

German group of participants.

Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age

2.33

1.97

1.91

2.60

2.65

1.91

1.83

2.79

2.66

2.05

3.21

3.14

2.01

1.70

2.31

3.39

2.52

2.09

2.56

1 2 3 4

... are cared by their family at home.

... are cared by a care service at home.

... are cared in an inpatient nursing home.

... are only then cared in an inpatient nursing home,

when there is no other way.

evaluation (min = 1; max = 4)

rejection agreement

Handling of Care within Families

Spain

Italy

Germany

Canada

Sweden

Figure 2: Evaluation of handling of care within families depending on the participants’ origins.

4 RESULTS

The following section represents the results of the

study, starting with handling of care, and attitudes to-

wards aging and care. Further, the results regarding

the perception of beneﬁts and barriers as well as the

participants’ acceptance of lifelogging technology in

older age are presented. In addition to the answer-

ing of the research questions related to the inﬂuence

of the participants’ origins on the evaluations, overall

relationships between the attitudes, perceptions, and

acceptance are shown.

4.1 Handling of Care

In a ﬁrst step (RQ1), handling of care within families

was analyzed depending on the ﬁve countries in order

to understand if life in older age and, in particular,

aging and care are handled differently. The results are

presented in Figure 2.

All four items related to the beginning “In my

family it is usual that older family members in need

of care...” were evaluated signiﬁcantly differently by

the participants. Thereby, the item “... are cared by

their family at home” (F(4, 1036.65) = 36.40; p <

.01; η

= .11) was clearly conﬁrmed by the Span-

ish participants (M = 3.39; SD = 0.82), followed by

the Italians (M = 3.14; SD = 0.99), whereas signif-

icantly lower agreements were found for the Ger-

man (M = 2.79; SD = 0.95) and the Canadian (M =

2.65;SD = 1.04) participants. In contrast, caring

older family members at home was slightly rejected

by the Swedish participants (M = 2.33; SD = 1.11).

The opportunity that older family members “...

are cared by a care service at home” (F(4, 845.25) =

26.75; p < .01; η

= .09) was only marginally pos-

itively evaluated by the German (M = 2.66;SD =

0.82) and the Spanish participants (M = 2.52; SD =

1.13). However, it was rejected and signiﬁcantly

lower evaluated by the Italian (M = 2.01;SD = 1.08),

Canadian (M = 1.91; SD = 0.95), and Swedish partic-

ipants (M = 1.97; SD = 1.04).

All participants rejected that it is usual that older

family members “... are cared in an inpatient nurs-

ing home”, but to a signiﬁcantly different extent

(F(4, 822.02) = 4.89; p < .01; η

= .02). Thereby,

the Spanish (M = 2.09; SD = 1.15) and German par-

ticipants (M = 2.05;SD = 0.81) showed a lower rejec-

tion than the Swedish (M = 1.91; SD = 0.94), Cana-

dian (M = 1.83; SD = 0.88), and in particular the Ital-

ian participants (M = 1.70; SD = 0.90).

Finally, also the evaluation pattern of the last op-

tion “... are only then cared in an impatient nursing

home, when there is no other way” was characterized

by signiﬁcant differences (F(4, 840.06) = 19.13; p <

.01; η

= .07). Here, the German participants showed

the clearly highest agreement (M = 3.21; SD = 0.87),

followed by the Canadians (M = 2.79; SD = 1.04). In

contrast, the Swedish (M = 2.60;SD = 1.11) and the

Spanish participants (M = 2.56;SD = 1.18) showed

almost neutral evaluations, while a slight rejection

was found for the Italian participants (M = 2.31; SD =

1.22).

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

4.2 Attitudes towards Aging & Care

In a next step (RQ2), the participants’ attitudes to-

wards aging and care were investigated. The over-

all results regarding the attitude towards aging are

presented in Figure 3 and a signiﬁcant difference

was found (F(4, 889.41) = 2.40; p < .01; η

= .01).

Thereby, the positive overall attitudes of the Swedish

(M = 4.13;SD = 0.84), Spanish (M = 4.12;SD =

0.95), German (M = 4.04; SD = 0.75), and Canadian

participants (M = 4.01; SD = 0.84) were rather simi-

lar. In contrast, the Italian participants’ attitude (M =

3.89;SD = 0.83) towards aging was signiﬁcantly less

positive (compared to the Swedes).

3.89

4.01

4.04

4.12

4.13

1 2 3 4 5 6

evaluation (min = 1; max = 6)

rejection agreement

Positive Attitude towards Aging

Sweden

Spain

Germany

Canada

Italy

Figure 3: Perception of aging depending on the partici-

pants’ origins.

Further, the results referring to the participants’

attitude towards care are shown in Figure 4 and re-

vealed also a signiﬁcant difference (F(4, 1122) =

4.75; p < .01; η

= .02). Thereby, a positive atti-

tude towards care included high needs for indepen-

dence and autonomy as well as wishes for staying

longer within the own home. The evaluations of all

participants were positive, revealing signiﬁcant dif-

ferences between the Swedish holding a compara-

bly lower (M = 4.19; SD = 0.66) and the Spanish

(M = 4.40;SD = 0.73) as well as the German partici-

pants (M = 4.37;SD = 0.61) with a comparably more

positive attitude towards care.

4.19

4.25

4.35

4.37

4.40

1 2 3 4 5 6

evaluation (min = 1; max = 6)

rejection agreement

Attitude towards Care

Spain

Germany

Italy

Canada

Sweden

Figure 4: Perception of care depending on the participants’

origins.

4.3 Perception of Beneﬁts & Barriers

To identify potential differences regarding the evalua-

tion and perception of lifelogging technology, also the

perception of technology-related beneﬁts and barriers

was examined (RQ3). For this purpose, the partici-

pants evaluated each several beneﬁts and barriers with

regard to their agreement or rejection of the respective

properties.

Starting with the perception of beneﬁts, the overall

results depending on the different countries are pre-

sented in Figure 5 and revealed signiﬁcant differences

between the countries (F(4, 1122) = 13.58; p < .01;

= .05). The Spanish participants (M = 4.96; SD =

0.80) showed deﬁnitely the highest evaluation of ben-

eﬁts of using lifelogging technology, followed by the

Italian participants (M = 4.80; SD = 0.91). The Cana-

dian (M = 4.59;SD = 0.76) and the German partici-

pants (M = 4.55;SD = 0.82) showed also a positive

evaluation, while the Swedish participants evaluated

the beneﬁts of using lifelogging technology least pos-

itive (M = 4.40; SD = 0.88). It can be taken from

Figure 5 that signiﬁcant differences (p < .01) were

located between Spain on the one hand, and each

Canada, Germany, and Sweden on the other Hand. In

addition, there were also signiﬁcant differences be-

tween Italy on the one hand, and Germany (p < .05)

and Sweden (p < .01) on the other hand. Finally, also

the difference between the Canadian and the Swedish

participants was on a signiﬁcant level (p < .05).

Moving to the perception of barriers, the results

are shown in Figure 6 and revealed also signiﬁcant

differences with regard to the participants’ origins

(F(4, 847.4) = 11.15; p < .01; η

= .04). Here, it

was striking that the German (M = 3.78; SD = 0.95),

Canadian (M = 3.74; SD = 0.85), and Swedish par-

ticipants (M = 3.68; SD = 0.91) showed slight con-

ﬁrmations of the potential barriers of using lifelog-

ging technology in older age, while the barriers were

evaluated almost neutrally by the Spanish participants

(M = 3.49; SD = 1.01). In contrast, the Italian partic-

ipants (M = 3.18; SD = 1.09) showed the lowest eval-

4.40

4.55

4.59

4.80

4.96

1 2 3 4 5 6

evaluation (min = 1; max = 6)

rejection agreement

Perception of Benefits

Spain

Italy

Canada

Germany

Sweden

Figure 5: Perception of technology-related beneﬁts depend-

ing on the participants’ origins.

Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age

3.18

3.49

3.68

3.74

3.78

1 2 3 4 5 6

evaluation (min = 1; max = 6)

rejection agreement

Perception of Barriers

Germany

Canada

Sweden

Spain

Italy

Figure 6: Perception of technology-related barriers depend-

ing on the participants’ origins.

4.16

4.23

4.28

4.61

4.64

1 2 3 4 5 6

evaluation (min = 1; max = 6)

rejection agreement

Te c h n o l o g y A c c e p t a n c e

Spain

Italy

Germany

Canada

Sweden

Figure 7: Acceptance of assistive lifelogging depending on

the participants’ origins.

uations, indicating a slight rejection of the potential

barriers. With regard to the evaluation of barriers, all

countries differed signiﬁcantly from the Italian eval-

uations. Further, the difference between the German

and the Spanish evaluations was on a signiﬁcant level.

4.4 Acceptance of Assistive Lifelogging

The participants also evaluated their acceptance of us-

ing assisting lifelogging technology (RQ4, see Fig-

ure 7). The results revealed that participants of the

ﬁve countries also signiﬁcantly differed with regard

to their acceptance and intention to use lifelogging

technology in older age (F(4, 921.16) = 10.91; p <

.01; η

= .04) and a diverse evaluation pattern was

observed: the Spanish (M = 4.64;SD = 0.96) and

Italian participants (M = 4.61; SD = 0.99) showed a

clearly higher level of acceptance compared to the

other three countries – Germany (M = 4.28;SD =

0.95), Canada (M = 4.23;SD = 0.81), and Sweden

(M = 4.16; SD = 1.01), which revealed rather simi-

lar acceptance scores. The differences between the

Spanish and the participants from Germany, Canada,

and Sweden as well as the difference between the Ital-

ians and the participants from Germany, Canada, and

Sweden were all on a signiﬁcant level (p < .01).

Technology

Acceptance

Perceived Benefits

Perceived Barriers

Attitude towards

Aging

Attitude towards

Care

.174 **

-.144 **

.101 **

.508 **

.163 **

.343 **

.630 **

-.405 **

-.152 **

Figure 8: Relationships between the perceptions of aging,

care, beneﬁts and barriers as well as technology acceptance.

4.5 Related Perceptions & Acceptance

In a ﬁnal step of the analysis, it was investigated if the

participants’ perceptions of aging and care, of ben-

eﬁts and barriers, and their acceptance of assisting

lifelogging technology were related with each other.

The results of a correlation analysis are shown in

Figure 8. As expected, the perception of beneﬁts

was strongly positively related with the acceptance of

assisting lifelogging technology (r = .630; p < .01),

while a moderate negative correlation was found for

perceived barriers and the participants’ acceptance

(r = −.405; p < .01). Thereby, the perception of

beneﬁts and barriers was only weakly related (r =

−.152; p < .01).

As comparably new insights, the analysis revealed

that a positive perception of aging was weakly pos-

itively related with the perception of technology-

related beneﬁts (r = .174; p < .01) and with the ac-

ceptance of lifelogging technology (r = .101; p <

.01), while it was slightly negatively related with

perceived barriers (r = −.144; p < .01). Consider-

ing the participants’ attitudes towards care, the re-

sults showed a strong relationship with the perception

of beneﬁts (r = .508; p < .01), a moderate relation-

ship with the acceptance of lifelogging technologies

(r = .343; p < .01), and a weak correlation with the

perception of barriers (r = .163; p < .01). The iden-

tiﬁed results suggest the necessity to analyze those

connections and interrelations in more detail and in

dependence of different cultural origins in future re-

search.

5 DISCUSSION

The current study revealed that the perception of ag-

ing and care, but in particular also the evaluation

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

and acceptance of assisting lifelogging technologies

in older age are inﬂuenced by the participants’ (cul-

tural) origins. This section discusses the results with

regard to the underlying research questions, critically

reﬂects the applied approach, and highlights the ne-

cessity of future work within the research ﬁeld of as-

sisting lifelogging technology acceptance.

5.1 Inﬂuence of Culture

Starting with RQ1, the study revealed new insights

that the evaluation of handling of care differed sig-

niﬁcantly with regard to the investigated countries.

In line with the previous research, which identiﬁed

country- and culture-speciﬁc differences with regard

to the respective health care systems as well as per-

ceived access to care (Blendon et al., 2002; Osborn

et al., 2016), the perception of care handling in this

study also depends on the country and its respec-

tive political and socio-economic circumstances. In

more detail, it was observed that caring for older fam-

ily members within the family is more usual for the

Southern Europe countries than for the more “North-

ern countries” Germany, Sweden, and Canada. Si-

multaneously, using the service of professional care

providers at home seems to be more usual for Ger-

many and Spain than for people in Italy, Sweden, and

Canada. In addition, none of the countries conﬁrmed

that caring of older family members in inpatient nurs-

ing homes is usual, while this was most strongly eval-

uated to be only the last resort by the German partic-

ipants. Further, the results generally revealed positive

perceptions and also signiﬁcant differences with re-

gard to a culture-speciﬁc perception of aging and care

(RQ2), however to a lesser extent (compared to RQ1,

RQ3, and RQ4). In tendency, the results showed that

the Swedish participants expressed a slightly higher

positive perception of aging (compared to Italian re-

spondents), while they simultaneously showed a less

“positive” attitude towards care (compared to Span-

ish and German participants). Thereby, a positive at-

titude towards care referred to high needs for auton-

omy and independence. In comparison, the evaluation

of technology-related beneﬁts and barriers (RQ3) re-

vealed novel and more distinct country-speciﬁc eval-

uation patterns. Summarizing the results, the South-

ern Europe countries showed clearly higher evalua-

tions of beneﬁts with a simultaneously lower evalu-

ations of potential barriers of using assisting lifelog-

ging technology compared to the rather “Northern”

countries, i.e. Germany, Sweden, and Canada. The

same pattern applied for the acceptance of using as-

sisting lifelogging technologies in older age (RQ4):

Here, Spain and Italy representing the southern part

of Europe indicated signiﬁcantly higher acceptance

scores than the other – rather northern – countries

(Germany, Canada, Sweden). These culture-speciﬁc

insights are deﬁnitely novel and show the relevance of

adapting the technology development as well as com-

munication and information about innovative tech-

nologies to the needs of the respective user groups.

In line with this, the results conﬁrmed that the ac-

ceptance of lifelogging technologies is related with

the perception of aging and care, but in particular

with the perceptions of beneﬁts and barriers. Exactly

at this point, communication and information strate-

gies should consider the country- and culture-speciﬁc

ﬁndings from this study. For example, the higher

evaluations of barriers by the Swedish, German, and

Canadian participants let assume that the communi-

cation and information about the handling of poten-

tial barriers of using assisting lifelogging technolo-

gies are of high relevance for these potential users.

When perceived concerns are adequately addressed

and their handling comprehensively explained (e.g.,

transparent regulations of data storage and data access

Offermann-van Heek et al. (2019)), concerns could be

diminished and the probability of a sustainable accep-

tance and adoption of assisting lifelogging technolo-

gies could thereby be increased.

5.2 Limitations and Future Work

Although the study revealed novel insights into cross-

cultural perceptions of aging, care, and lifelogging

technologies in older age, there are still some limi-

tations with regard to the applied approach and nec-

essary future work that should be considered for fu-

ture research in the ﬁeld. As a ﬁrst limitation, it

should be kept in mind that the country-speciﬁc sam-

ples differed with regard to individual characteristics

of the participants (e.g., health status, care experi-

ence, etc.). For this study, it can therefore not be

excluded that the differences between the countries

were shaped by other user factors as well. Here, the

results should be analyzed for interaction effects be-

tween culture and other user factors (e.g., care experi-

ence, care needs etc.) in a next step. As one example,

the level of previous experience in using ICT applica-

tions could also be an interesting user factor, which

probably inﬂuences the perception and acceptance

of lifelogging technology. Other limitations of the

present study refer to the applied online survey and

the email-based invitation to participate in the sur-

vey. This procedure could have led to the fact that in

tendency especially technologically advanced (older)

people were reached. In order to include less tech-

nologically advanced (older) people likewise, future

Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age

studies should apply both, online and paper-based sur-

veys. In addition, future investigations with regard

to this study should focus on an analysis of the sin-

gle beneﬁts and barriers as well as decisions between

these technology-related aspects to gain more detailed

insights and possible explanations with regard to the

divergent evaluation patterns. A further limitation re-

gards the restricted number of countries which were

integrated into the present study. Nevertheless, ask-

ing participants from four different European coun-

tries and an additional non-EU country enabled a ﬁrst

cross-national and cross-cultural investigation of dif-

ferences and similarities within the perceptions of ag-

ing, care, and lifelogging technology usage in older

age. The results showed that there were considerable

differences between the investigated countries. Fur-

thermore, future research should aim at integrating

even more countries from diverse continents in the

world, as it is assumed that in particular perceptions

of aging and care differ enormously when also partic-

ipants from developing countries are asked for their

opinions and perspectives.

ACKNOWLEDGEMENTS

The authors would like to thank all participants for

sharing their opinions on assisting lifelogging tech-

nologies. This work resulted from the project PAAL -

“Privacy Aware and Acceptable Lifelogging services

for older and frail people” and was funded by the

German Federal Ministry of Education and Research

(16SV7955).

REFERENCES

Abtoy, A., Touhaﬁ, A., Tahiri, A., et al. (2018). Ambient

assisted living system’s models and architectures: A

survey of the state of the art. Journal of King Saud

University-Computer and Information Sciences.

Alag

oz, F., Zieﬂe, M., Wilkowska, W., and Valdez, A. C.

(2011). Openness to accept medical technology-a cul-

tural view. In Symposium of the Austrian HCI and Us-

ability Engineering Group, pages 151–170. Springer.

Beringer, R., Sixsmith, A., Campo, M., Brown, J., and Mc-

Closkey, R. (2011). The “acceptance” of ambient as-

sisted living: Developing an alternate methodology to

this limited research lens. In International Confer-

ence on Smart Homes and Health Telematics, pages

161–167. Springer.

Biermann, H., Himmel, S., Offermann-van Heek, J., and

Zieﬂe, M. (2018). User-speciﬁc concepts of aging–a

qualitative approach on aal-acceptance regarding ul-

trasonic whistles. In International Conference on Hu-

man Aspects of IT for the Aged Population, pages

231–249. Springer.

Blackman, S., Matlo, C., Bobrovitskiy, C., Waldoch, A.,

Fang, M. L., Jackson, P., Mihailidis, A., Nyg

ard, L.,

Astell, A., and Sixsmith, A. (2016). Ambient assisted

living technologies for aging well: a scoping review.

Journal of Intelligent Systems, 25(1):55–69.

Blendon, R. J., Schoen, C., DesRoches, C. M., Osborn,

R., Scoles, K. L., and Zapert, K. (2002). Inequities

in health care: a ﬁve-country survey. Health Affairs,

21(3):182–191.

orsch-Supan, A., Bucher-Koenen, T., Coppola, M., and

Lamla, B. (2015). Savings in times of demographic

change: Lessons from the german experience. Journal

of Economic Surveys, 29(4):807–829.

Calvaresi, D., Cesarini, D., Sernani, P., Marinoni, M., Drag-

oni, A. F., and Sturm, A. (2017). Exploring the ambi-

ent assisted living domain: a systematic review. Jour-

nal of Ambient Intelligence and Humanized Comput-

ing, 8(2):239–257.

Chappell, N. L. and Zimmer, Z. (1999). Receptivity to new

technology among older adults. Disability and reha-

bilitation, 21(5-6):222–230.

Fekete, A. (2019). Social vulnerability change assess-

ment: monitoring longitudinal demographic indica-

tors of disaster risk in germany from 2005 to 2015.

Natural Hazards, 95(3):585–614.

Gall, D., Lugrin, J.-L., Wiebusch, D., and Latoschik, M. E.

(2016). Remind me: An adaptive recommendation-

based simulation of biographic associations. In Pro-

ceedings of the 21st International Conference on In-

telligent User Interfaces, pages 191–195. ACM.

Gentry, T. (2009). Smart homes for people with neurolog-

ical disability: State of the art. NeuroRehabilitation,

25(3):209–217.

Greve, B. (2016). Long-term care for the elderly in Europe:

Development and prospects. Taylor & Francis.

Horton, K. (2008). Falls in older people: the place of tele-

monitoring in rehabilitation. Journal of rehabilitation

research and development, 45(8):1183–1194.

Hossain, S., Hallenborg, K., and Demazeau, Y. (2011).

iroute: Cognitive support for independent living using

bdi agent deliberation. In Trends in Practical Applica-

tions of Agents and Multiagent Systems, pages 41–50.

Springer.

onig, A., Francis, L. E., Joshi, J., Robillard, J. M.,

and Hoey, J. (2017). Qualitative study of affec-

tive identities in dementia patients for the design

of cognitive assistive technologies. Journal of re-

habilitation and assistive technologies engineering,

4:2055668316685038.

Lai, C. K., Chung, J. C., Leung, N. K., Wong, J. C., and

Mak, D. P. (2010). A survey of older hong kong peo-

ple’s perceptions of telecommunication technologies

and telecare devices. Journal of telemedicine and tele-

care, 16(8):441–446.

Larizza, M. F., Zukerman, I., Bohnert, F., Busija, L., Bent-

ley, S. A., Russell, R. A., and Rees, G. (2013). In-

home monitoring of older adults with vision impair-

ment: exploring patients’, caregivers’ and profession-

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

als’ views. Journal of the American Medical Infor-

matics Association, 21(1):56–63.

Lorenzen-Huber, L., Boutain, M., Camp, L. J., Shankar, K.,

and Connelly, K. H. (2011). Privacy, technology, and

aging: a proposed framework. Ageing International,

36(2):232–252.

Middelweerd, A., Mollee, J. S., van der Wal, C. N., Brug,

J., and Te Velde, S. J. (2014). Apps to promote physi-

cal activity among adults: a review and content analy-

sis. International journal of behavioral nutrition and

physical activity, 11(1):97.

Mihailidis, A., Boger, J., Canido, M., and Hoey, J. (2007).

The use of an intelligent prompting system for people

with dementia. interactions, 14(4):34–37.

Mihailidis, A., Cockburn, A., Longley, C., and Boger, J.

(2008). The acceptability of home monitoring tech-

nology among community-dwelling older adults and

baby boomers. Assistive technology, 20(1):1–12.

Mubashir, M., Shao, L., and Seed, L. (2013). A survey on

fall detection: Principles and approaches. Neurocom-

puting, 100:144–152.

Offermann-van Heek, J., Schomakers, E.-M., and Zieﬂe, M.

(2019). Bare necessities? how the need for care mod-

ulates the acceptance of ambient assisted living tech-

nologies. International journal of medical informat-

ics, 127:147–156.

Offermann-van Heek, J., Wilkowska, W., Brauner, P., and

Zieﬂe, M. (2019). Guidelines for integrating so-

cial and ethical user requirements in lifelogging tech-

nology development. In 5th International Confer-

ence on Information and Communication Technolo-

gies for Ageing Well and e-Health, pages 67–79.

SCITEPRESS.

Offermann-van Heek, J. and Zieﬂe, M. (2019). Nothing

else matters! trade-offs between perceived beneﬁts

and barriers of aal technology usage. Frontiers in Pub-

lic Health, 7.

Osborn, R., Squires, D., Doty, M. M., Sarnak, D. O., and

Schneider, E. C. (2016). In new survey of eleven coun-

tries, us adults still struggle with access to and afford-

ability of health care. Health Affairs, 35(12):2327–

2336.

Peek, S. T., Wouters, E. J., Van Hoof, J., Luijkx, K. G.,

Boeije, H. R., and Vrijhoef, H. J. (2014). Factors in-

ﬂuencing acceptance of technology for aging in place:

a systematic review. International journal of medical

informatics, 83(4):235–248.

Porter, E. J. and Ganong, L. H. (2002). Considering the use

of a personal emergency response system: an experi-

ence of frail, older women. Care Management Jour-

nals, 3(4):192–198.

Rashidi, P. and Mihailidis, A. (2012). A survey on ambient-

assisted living tools for older adults. IEEE journal of

biomedical and health informatics, 17(3):579–590.

Roth, G. and Reichert, M. (2019). Providing integrated

health and social care for older persons in germany.

Providing Integrated Health and Social Care for

Older Persons: A European Overview of Issues at

Stake.

Schoeppe, S., Alley, S., Van Lippevelde, W., Bray, N. A.,

Williams, S. L., Duncan, M. J., and Vandelanotte, C.

(2016). Efﬁcacy of interventions that use apps to im-

prove diet, physical activity and sedentary behaviour:

a systematic review. International Journal of Behav-

ioral Nutrition and Physical Activity, 13(1):127.

Selke, S. (2014). Lifelogging: Wie die digitale Selb-

stvermessung unsere Gesellschaft ver

andert. Ullstein

eBooks.

Steggell, C. D., Hooker, K., Bowman, S., Choun, S., and

Kim, S. J. (2010). The role of technology for healthy

aging among korean and hispanic women in the united

states: A pilot study. Gerontechnology.

Stone, E. E. and Skubic, M. (2014). Fall detection in homes

of older adults using the microsoft kinect. IEEE jour-

nal of biomedical and health informatics, 19(1):290–

301.

Sun, H. and Zhang, P. (2006). The role of moderating fac-

tors in user technology acceptance. International jour-

nal of human-computer studies, 64(2):53–78.

van den Berg, N., Schumann, M., Kraft, K., and Hoffmann,

W. (2012). Telemedicine and telecare for older pa-

tients—a systematic review. Maturitas, 73(2):94–114.

Vuong, N., Chan, S., Lau, C. T., and Lau, K. (2011). Fea-

sibility study of a real-time wandering detection al-

gorithm for dementia patients. In Proceedings of the

First ACM MobiHoc Workshop on Pervasive Wireless

Healthcare, page 11. ACM.

Wild, K., Boise, L., Lundell, J., and Foucek, A. (2008). Un-

obtrusive in-home monitoring of cognitive and physi-

cal health: Reactions and perceptions of older adults.

Journal of applied gerontology, 27(2):181–200.

Wilkowska, W. (2015). Acceptance of eHealth technology

in home environments: Advanced studies on user di-

versity in ambient assisted living. Aachen, Apprimus

Verlag.

Wilkowska, W., Zieﬂe, M., and Alag

oz, F. (2012). How

user diversity and country of origin impact the readi-

ness to adopt e-health technologies: an intercultural

comparison. Work, 41(Supplement 1):2072–2080.

Wu, G. and Xue, S. (2008). Portable preimpact fall detector

with inertial sensors. IEEE Transactions on neural

systems and Rehabilitation Engineering, 16(2):178–

183.

Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age