*The following interview with Dr. Steve Goldband, past Director of Private Sector Outreach, was conducted in 2007

In a world with increasing health needs and ever fewer available caregivers, so-called “assistive technologies” play an increasing role in allowing people to maintain mobility, privacy, and dignity as they age. Steve Goldband, PhD is Senior Research Scientist and Director of Private Sector Initiatives of the Stanford Center on Longevity, where he works on creating new and innovative collaborations between Stanford researchers and industry to benefit the population at all ages.

Q: Dr. Goldband, what does the term Assistive Technologies mean?

Maintaining physical and mental capabilities is crucial to your ability to thrive throughout your life span. When a challenge occurs that threatens to limit your sensory, cognitive, or mobility functions, you must take action to restore the function, or, at the very least, do what you can to obtain the highest possible functioning within that limitation. Assistive technologies are those devices, environments, or re-training products that allow you to do so. Some are age old and decidedly low tech; consider the cane or simple eyeglasses. But scientists and engineers have been applying contemporary devices, modern materials, and, especially, know-how about what matters, to make assistive devices that give people new hope.

Q: Why is this a priority for the Center on Longevity?

The reality is that the alternative to an effective assistive technology is dependence. For example, if an individual loses core or leg strength and cannot rise from a chair unassisted, the person suddenly cannot execute the most basic functions of living, such as bathing, dressing, or cooking. Now, it may be that the person, once standing, has the necessary strength and dexterity to do those and many other things, but without the critical ability to rise from a bed or chair, the consequences are profound. All too often, it can become a triggering event that leads to dependence on caregivers.

Q: And that is expensive.

Yes, it puts an enormous financial strain on personal, family and even societal resources. But that’s not the only tragic aspect of this kind of dependence. Once it occurs, the individual may lose hope, become depressed, and begin a downward spiral that draws in other functions. It can lead to declines in coping with chronic disease, eventually resulting in death. This situation is predicted to become even more severe as the number of affected individuals grows sharply with the aging of baby boomers.

Q: Have there been advances in this area?

Absolutely. Consider mobility; devices are now commonplace that allow people with reduced motor skills to navigate their living environment. There are special lifting chairs, for example, that help people get to their feet. There are powered wheeled devices that help people with impaired function get around their homes, visit friends, shop for groceries, and travel. Assistive technologies, coupled with advances in access brought forth by the Americans with Disabilities Act, are allowing people with impaired functioning to be more independent and self-directed. In addition, new devices are allowing caregivers to stay in touch with seniors and maintain confidence that they are functioning well. The best assistive devices are usable by everyone, don’t stigmatize the person they help, and really just make the environment more livable for everyone.

Q: What are the promising technologies SCL is looking at?

There is an exciting array of work going on at Stanford and elsewhere. Some projects are quite dramatic in appearance. For example, scientists at the Massachusetts Institute of Technology are experimenting with exoskeletons and voice-controlled robot arms that will allow people with limited function to remain active. Other projects do not appear high-tech on the outside, but they are the result of a sophisticated understanding of crucial problems. For example, a special shoe developed by Dr. Thomas Andriacchi of the Stanford bio-mechanical engineering program at Stanford aims to modify the gait, so that someone affected with arthritis of the knee can continue to function well much longer without surgical intervention.

In India, many young and older amputees need prosthetic devices to walk. A remarkable advanced student team working under Dr. Andriacchi and Dr. Paul Yock of the Stanford bio-design program is developing a prototype knee that has most of the benefits of expensive western models, but can be manufactured in India for radically lower cost.

Other assistive technologies will come to fruition after successive generations of science and engineering professionals apply their creativity to issues of mobility, cognitive decline, and other physical and mental limitations. Assistive robots that can operate autonomously and help people with reduced function maintain effective lives hold huge promise, for example. A personal robot system originally developed in the lab of Stanford researcher Kenneth Salisbury and now being developed at a startup called Willow Garage is moving in this direction.

Q. What is a “re-training” product?

A re-training product helps someone gain functionality (or get it back when it is compromised). One example is a device currently being investigated by a student team in our course on Medical Devices. This will provide feedback to someone with an unstable gait to encourage them to walk in a way that will strengthen them and make them more resistant to debilitating falls. The device doesn’t intervene directly, but it helps them make better use of the capabilities they already have.