Improving Communication for People with Hearing Loss

On March 14 and 15, 2017, we convened a group of distinguished experts representing the fields of medicine, engineering, psychology, sociology, law, government, health economics, health policy, industry, technology, and advocacy, to elaborate key issues, compile existing evidence, and identify questions to which answers are needed in order to guide research, inform public policy, and improve products and services.

The Hearing Project at the Stanford Center on Longevity will include developing research and policy programs to address the following issues:

• Access, prevention, and education
• Technology
• Policies
• Acoustic and built environments

The results of this project will provide actionable insights into the usage, technology, and policies related to greater adoption of hearing aids and other hearing devices, as well as related methods for acoustically improving built environments. Further, the results of this project will provide insights into the effects of hearing devices and improved acoustics on communication among individuals with varying degrees of hearing loss. Data and resources collected by the Hearing Project may serve as a starting point for future research. Ultimately, the Hearing Project seeks to improve overall the psychological, physical, and cognitive well-being of the hearing-impaired and those who interact with them.

The project will seed pilot research on identified topics and convene practitioners, patients, and other stakeholders to develop a strategic plan to improve communication for those with hearing loss in America.

Read the conference proceedings

Study of the Cognitive Benefits of Volunteering–Santa Clara County Project

The Santa Clara County (SCC) Volunteerism Project is key to our mission and one of our premier studies. There is building excitement and optimism about the ability of this project to tap the human capital of SCC workers and retirees, and deploy it to help County residents, primarily youth. The impact of this project will be directed toward:

• Enhancing volunteer participation
• Understanding the benefits of volunteering (improve the physical, mental and cognitive health of volunteers)
• Enhancing community targets (benefits to the recipients of volunteerism)
• Creating a new social norm of volunteering
• Reducing health care costs and utilization (and save the County health care expenditures)
• Becoming the first county in the U.S. to launch such an effort and serve as a model template to other cities, counties and throughout the nation.

We have secured some funding from Santa Clara County to help fund this pilot study where we will test the recruitment and retention of 250 volunteers over 2 years. Since our last meeting, the MoU and contract between Santa Clara County and Stanford has been completed and signed.  We also were informed that the County has reorganized their hospital system such that they now have funding for paid universal screeners. Therefore, we will be offering our research participants a wide variety of volunteer roles within the County Health and Hospital System, and working closely with their Volunteer Coordinator. We tested our recruitment messages successfully, have developed the research protocol and surveys, and have are submitting this project to the Institutional Review Board for approval as a clinical trial. Once we receive Institutional Review Board approval, we expect to begin recruiting in early 2017.

The Cognition and Retirement Study: “Is Working Longer Good for You?”–Understanding potential pathways between working and cognitive performance

Funded by the Alfred P. Sloan Foundation, this research study was designed to identify potential mediators to age-related cognitive decline. Based on longitudinal analysis of the Health and Retirement Study data, this study examined the effects of retirement pathways on cognitive outcomes for individuals moving from full-time work into retirement from jobs with varying levels of cognitive complexity. Preliminary results were presented and discussed at our “Working Longer” conference in April, in additionto other conference presentations. The final manuscript has been submitted for review in a major academic journal, andwill be made available once it has been accepted for publication.

“Hidden in Plain Sight: How Intergenerational Relationships Can Transform Our Future” – Monograph released July 2016

In collaboration with Marc Freedman from Encore.org, we have produced a monograph with four chapters designed to represent the collective thinking of attendees of the “Pass It On” conference (held in June 2014) on matching the skills and talents of older Americans with the pressing needs of young people. You can read the report here: http://longevity3.stanford.edu/hidden-in-plain-sight-how-intergenerational-relationships-can-transform-our-future/The monograph was released nationally together with Encore.org, the Packard Foundation and AARP,  in conjunction with events (such as AARP’s national meeting on intergenerational programs) and program launches (such as Encore.org’s launch of their new initiative, Generation to Generation.). It was picked up in the popular press and social media, and our own DCI Fellow, Kate Jerome (who contributed to the monograph) was asked to give a TED talk on the importance of connections between older and younger generations based on her experience and work with this project.

Family Decision-Making Surrounding Life-Threatening Illness

We continue (in collaboration with the Life Span Development Lab and possible other contributors such as a health economist) to discuss developing a survey to deploy through ClearCare and Comfort Keepers, asking family caregivers about their own beliefs and experiences with end-of-life planning for their loved ones, and to follow them over time as the loved one’s illness progresses. In addition, we’ve had some conversations with a community engagement initiative in San Mateo County with the aim of disseminating information and highlighting the need for early conversations. We continue to maintain a close relationship with Stanford’s Palliative Medicine Department, with an eye for areas of collaboration and support. They include us in their Strategic Planning sessions and other meetings and events, such as the recent screening of the Oscar nominated documentary “Extremis” (which is available to watch on Netflix). Both Dr. Jessica Zitter (http://jessicazitter.com/), the “star” of the film, and the Executive Prodcuer, Dr. Shoshana Ungerleider from the The Ungerleider Fund (http://www.shoshanaungerleider.com/upcef) have contacted us for follow-up meetings to discuss future collaborations.

Staff, Student and Other Updates

We oversaw two quarters (Winter and Spring) of Psych 189 (our Practicum course for undergraduates), creating the syllabus and designing the content, schedule and deliverables. We met weekly with the students as they work on in-depth assignments with our staff.  In addition, we headed up the Roland Fellowship interview and selection process. Of the many talented applicants, we ultimately awarded 4 undergraduate fellowships, and serve as Academic Mentors to these students during their projects. We coordinated two Emeriti Lectures, selecting and inviting speakers to present to our Emeriti Council members. We continue to contribute to our Toolkit Brief and Webinar Initiative for our Corporate Affiliates.  We have written an additional Toolkit on Intergenerational Relationships, and will be presenting a webinar on “The Importance of Social Connectedness for Long Life” in July. In addition, we have been working closely with Dr. Tamara Sims on The Sightlines Project Social Engagement content, including the recent survey of family caregivers. Our next launch conference will be Social Tech and Social Engagement (dates TBD).

2016-2017 Stanford Center on Longevity Design Challenge: “Innovating Aging in Place”

This year’s challenge – “Innovating Aging in Place” – was launched in early September. The topic was chosen in part to allow students to design around a host of emerging technologies in this space – social engagement solutions, Internet of Things devices, universal home design solutions, and wearables – while learning about the ways in which these designs can support high quality of life across a wide age range.

Student response to the challenge was excellent. The 75 entries received in December exceeded last year’s challenge by 50%. Geographic diversity was also strong, with 20 countries representing 5 continents entering designs. The Finals were held on March 30^thwith approximately 225 people attending. A panel of 10 judges representing industry, academia, and non-profits chose the following designs for award:

1^stPlace: “TAME”, from the National University of Sciences and Technology in Islamabad, Pakistan. TAME is a wearable device for real-time pathological wrist tremor suppression that gives back control to tremor patients for doing daily tasks. The device has a sensor near the wrist which tracks the wearer’s tremor profile and electrodes that stimulate the muscles to counteract the tremor and suppress it. Instead of a conventional glove, TAME is a wearable device, small and light weight enough to be discreetly worn under a shirt. The device’s sensors and electrodes correspond to positions recommended by neurologists and physiotherapists. TAME has 2 variants; a sleeve, and a wearable with retractable wires.

2^ndPlace: “Rendever”, from the Massachusetts Institute of Technology
Rendever is a virtual reality platform designed to improve the quality of life of older adults. Rendever’s VR experience allows older adults to visit their childhood homes, travel the world, and connect with family and friends. The content is intended to inspire more conversations, and brings new stimulating experiences to the daily lives of users. The system uses a tablet that controls the experience either on-site or remotely for caregivers, and includes hundreds of hours of content including therapy and lesson plans.

3^rdPlace: “Uppo”, from Virginia Tech
Uppo is a mobility device that maintains the user’s sense of security without compromising posture. A rollator walker, Uppo has an arm rest at a high and wide position, which reinforces scapular retraction –thus encouraging better posture. The walker is also collapsible and compact enough to be transported easily. This walker will help with mobility issue faced by many older people, allowing them to maneuver independently and safely outside their homes.

Following the Finals, the teams participated in a day-long workshop hosted jointly with the Stanford Center for Entrepreneurial Studies at the Graduate School of Business, where they received instruction on business plan development, legal issues, and approaches for procuring funding.

The results of the challenge will also be presented at the 2017 “Dwell on Design” conference in Los Angeles in late June. The conference is one of the largest yearly gatherings of architects and home designers. The presentation will outline the importance of considering aging populations in home design and will leverage the challenge to highlight the diversity of design concepts possible in the space.

Influencing Nutrition with Taste

As presented in the last Council update, the Center is working with Dr. Christopher Gardner at the Stanford Prevention Research Center to develop a project on nutrition. Dr. Gardner has worked on diet and nutrition for over 20 years and has recently become involved with a group of universities and the Culinary Institute of America looking at ways to influence better nutrition beyond the traditional food pyramid approach.  This is essentially “leading with taste” – working with chefs to create menus making the healthy choices ones that are also most appealing.

Dr. Gardner recently applied for and received a Stanford-internal “Spectrum” pilot grant for translational research in nutrition. He will be applying this grant to fund the initial phase of an interventional study on motivating nutrition with taste that will be conducted at the Continuing Life senior living community in Pleasanton, CA.  This initial phase will consist of a series of interviews of chefs, residents, and culinary management at the community to understand how to best design an interventional study for this environment. This phase should be complete in the next 2-3 months and will be followed by a proposal for the full study.

Stanford Biodesign Innovation Fellowship

The BioDesign Fellowship program has been a flagship innovation program at the Stanford Medical School for the past 15 years. Each year, a cohort of 12 fellows is selected in a very competitive application cycle. The fellows, typically either M.D.’s and graduate level engineers, is led through a 9-month structured innovation program, with the goal of creating new biomedical products. The program has launched 41 new companies to date. Each year is focused on a specific topic area – the 2017-2018 topic was “aging”. This was the program’s first foray into an area that is not purely clinical and the Center on Longevity was asked to help create a “bootcamp” for the incoming fellows to help steep them in the important aspects of aging, followed by a series of immersive visits to a range of senior care settings ranging from homes to memory care facilities. This program is just completing its work and the resulting projects will be presented prior to the Council meeting.

“Working Longer and Retirement: Apply Research to Help Manage an Aging Workforce”

This conference was held in April 2017 and gathered a small group of academic researchers, employers and human resource practitioners to discuss practical ideas that apply emerging academic research to managing an aging workforce.  The topics of the conference included:

• Myths about the older workforce, measuring older worker productivity/labor costs
• Strategies to enhance older worker productivity, including alternative career trajectories
• Strategies, issues, and programs to help older workers transition from the workplace.

A number of areas for future research emerged, including the need for a business case which provides the support for hiring and retaining older workers.  The feedback from attendees was very positive and we are considering making this conference a regular (every 2 years) event.

Optimizing Retirement Income Solutions Integrating In-Plan and Out-of-Plan Strategies

This project analyzes retirement income solutions in IRAs, compares to solutions in employer-sponsored retirement plans, and develops metrics to assess retirement income strategies.  The project is currently under way and we expect completion by mid-2017.

The Milestones Project

This project which is examining how important life milestones, especially those that have a significant influence on financial outcomes (e.g.: education completion, first job, marriage/cohabitation, children, house purchase) are changing generation to generation and across socio-economic groups. The initial analysis confirmed that there have been significant shifts across education and economic groups.  A paper and brief on those findings is being drafted.  A significant finding from that initial analysis has led to a secondary “Milestones” project to further examine how these shifts are affecting women, especially highly educated women and their financial decision-making.  A survey was fielded in December, 2016 and the results are currently being analyzed.

State of Financial Fraud in America Conference

Our inaugural fraud conference was held 5 years ago, and this conference, again co-sponsored with the FINRA Investor Education Foundation, and held in Washington, D.C. on November 30^th, brought together researchers, regulators and practitioners to hear presentations on topics ranging from the prevalence of fraud, to how technology is being used to combat fraud and what is happening on the front line of fraud defense.  Keynote speeches were given by Robert Cook, President/CEO of FINRA and Chair of the FINRA Investor Education Foundation, Bill Baer, Principal Deputy Associate Attorney General, Department of Justice and Charles Schaeffer, Executive Producer of CNBC’s American Greed.  The conference was well attended with close to 175 participants.

Health and Retirement Survey Module on Fraud

Working with Profs. Olivia Mitchell (Wharton) and Annamaria Lusardi (George Mason), we developed a survey module to be included in the HRS study.  Data expected to be available in 2017 and we received a grant from TIAA to complete the analysis.

Sightlines Project Website

The website is intended to reach engaged audiences with some knowledge of issues surrounding longevity. The content includes in-depth Sightlines data disaggregated by demographic groups, spotlight webpages featuring the latest news and research on aspects of Healthy Living (e.g., diet), Financial Security (e.g., home ownership), and Social Engagement (e.g., volunteering). In addition, these webpages include interviews with faculty affiliates who have expertise on the spotlight topic and related commentaries that range in perspectives from experts in academia, field work, as well as viewpoints from representatives of specific generations (e.g., Millennials). We are continuing to develop a Tools section that includes downloadable content such as a brief 2 page description of Sightlines and a survey that can be used to assess special populations of interest to see how they might compare to the U.S. population. Please visit http://sightlinesproject.stanford.eduto view these features and more.

Sightlines Demographic Report

The inaugural report generated a great deal of interest in how Sightlines’ findings may or may not differ among subgroups of the American population. For instance, is the uptick in physical activity among Millennials similar for men and women?  Or, is social disengagement seen among Baby Boomers more pronounced for unmarried compared to married individuals? Currently, we are developing the second annual Sightlines report focusing in on such demographic trends including variation by gender, educational attainment, income quartile, marital status, and ethnicity. This second report will provide a more in-depth understanding for the purpose of targeted policy development, interventions, and future research. Since the last Advisory Council meeting, we have compiled, analyzed, and reviewed all demographic subgroup data. Using sophisticated software, we have created appealing visualizations of all data to house on our website with select findings to be featured in the written report.

Future Annual Reports

As with the upcoming demographic report in February 2017, we will continue to produce annual reports that describe focused research being conducted within each Sightlines domain. In 2018, we will provide an overview of projects focused on Financial Security, including a more in-depth look at the Milestones project (described below). In 2019 and 2020, we will release reports on focused research in Social Engagement and Healthy Living, respectively. In 2021, we will release our second Sightlines report featuring the next wave of Sightlines data with the intention of illustrating whether any progress has been made since the inaugural report.

The Sightlines Survey

Although we were able to compile data from high quality, nationally representative data sets, there were some limitations of this approach. For instance, many of the outcomes came from different datasets and thus, we were unable to assess how different aspects of one domain relate or how different domains relate to one another. In addition, while we were able to compare groups of Americans at two distinct time points, we were unable to follow the same group of people over time to characterize changes within an individual in living well. Finally, we were restricted to existing measures available to us. (e.g., for social engagement, survey respondents reported how often they interacted with family members outside of the home. There were no measures in the datasets we used that measured interactions with familyinside of the home). Therefore, we plan to administer our own survey of Americans using a nationally representative survey panel. Conducting our own survey will advance the Sightlines project aims in four important ways:

1. We will be able to assess how Healthy Living, Financial Security, and Social Engagement relate to one another.
2. We will analyze the composition of each index to determine what makes up the biggest piece of the pie. For instance, what matters most for Healthy Living: physical activity, sleep, diet, etc.?
3. In addition to comparing different groups of people over historical time as in the inaugural report, we will be able to follow the same people of different age groups annually to assess changes in Healthy Living, Financial Security, and Social Engagement as they enter different stages of life.
4. We will delve deeper into possible explanations for many of the observed patterns identified in the Sightlines project by including additional survey questions refined according to questions raised by the initial analyses.

Focused Research Projects

 Within each area, we will focus in on some of the most compelling findings of the initial Sightlines report. These projects range in approach and include webpages highlighting informative and timely news stories and research studies on select topics, comprehensive reviews of the academic literature, analysis of existing datasets, survey and experimental studies, and randomized interventions. Below are examples of projects currently underway in each domain:

Financial Security: Using data from the national longitudinal survey of youth, we are currently assessing whether shifts in the timing of common life events such as marriage/cohabitation and children is one reason for the lower likelihood of Millennials’ to own a home.

Healthy Living: Measures of a healthy diet are often erroneous and do not capture what   Americans are actually eating. To better capture this, we will be conducting a comprehensive review of the academic literature in both fields of medicine and technology to identify     commonly used assessments of diet and determine the possibility of a gold standard approach.

Social Engagement: Relative to today’s older generation when they were middle-aged, Baby Boomers are less socially engaged.  It is conceivable that this is because they are “sandwiched” between Millennials returning home and aging parents requiring care. We are currently piloting a nationwide survey of family caregivers to begin to explore this idea.