2012 Spring Editorial

Journal of CyberTherapy & Rehabilitation

Spring 2012, Volume 5, Issue 1



As defined by the European Commission, ambient assisted living (AAL) “refers to intelligent systems of assistance for a better, healthier, and safer life in the preferred living environment and covers concepts, products, and services that interlink and improve new technologies and the social environment. It aims at enhancing the quality of life (the physical, mental, and social well-being) for everyone (with a focus on elder persons) in all stages of their life. AAL can help elder individuals to improve their quality of life, to stay healthier and to live longer, thus extending one’s active and creative participation in the community.” AAL relies on Ambient Intelligence (AmI) to ensure that devices are noninvasive or in- visible, personalized to the user’s needs, adaptive to the user and the environment, and anticipatory of the user’s wishes. Its roots are in assistive technologies for people with disabilities, and in accessibility requirements for interactive technologies (e.g., Section 508 Web site requirements in the U.S.).

The impetus for accelerated AAL research and implementation is our elders, who live longer and can remain in their homes longer with the assistance of technology, thereby preventing costly hospitalizations and nursing home admissions. The number of older people worldwide has tripled in the last 50 years, and will more than triple again in the next 50 years.

A recent literature review categorizes AAL into services that handle adverse conditions, assess health state, consult and educate, motivate and provide feedback, facilitate ordering of service, and promote social inclusion. AAL devices use sensors and actuators in the home environment to, for example, detect falls in elders or spikes in blood sugar of people with diabetes, and fuse data to trigger caregiver alerts. Other systems of interest to our readers include those designed to help people who have mild cognitive impairments with activities of daily living. Most challenging to develop are pattern recognition applications that can, for example, sense an elder’s behavior change and prevent depression by motivating the elder to socialize.

Both Virtual Reality and mixed reality (augmented reality and aug- mented virtuality) environments for AAL have been proposed. For example, in an extension of the current boundaries of telemedicine, the physician could view the whole body of the at-home patient, and the patient could more easily understand(s) he was undergoing a physical examination. At least one paper reports elders’ positive reactions to AAL, so this scenario may not be far in the future.

However, a recent issue of ERCIM News highlighted the fundamental research challenges that remain in AAL and AmI:

  • “Knowledge of user requirements. Age-related factors are crucial, and the current understanding of the interaction requirements of older users in complex technological environments is limited.
  • Ready-to-use accessibility solutions supporting alternative interaction techniques. Most available assistive technologies are limited to specific devices, and cannot be easily made compatible with complex environments including a variety of devices.
  • Architectural frameworks supporting the integration and management accessibility solutions.
  • Tools supporting the development lifecycle of accessible AAL environments (e.g., requirements analysis, design and prototyping, evaluation).”
  • We applaud the clinicians and researchers who are working to solve AAL and AmI research problems, and look forward to the day when smart homes for our elders are the norm.



Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute