Designing For Older Adults

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C M Y CM MY CY CMY K
ERGONOMICS AND HUMAN FACTORS Fisk

Rogers
Charness Human Factors
Czaja
Sharit
& Aging Series
Designing for Older Adults

Nolan Basher exuding healthy aging near 19,000 feet on his way to the “Roof of Africa.”
He summitted Kibo on Kilimanjaro, 19,340 feet, May 29, 2007 at the age of 70. Designing for
Designing for Older Adults
Second Edition
Older Adults
The first edition of Designing for Older Adults: Principles and Creative Human Factors Approaches Principles and
broke ground as an easily accessible source of information, a primer on designing for older adults.
In this second edition, the authors, as any good human factors practitioner would, have considered Creative Human Factors
comments from readers. They have revised and updated each of the original chapters, rearranged
some of them for a more natural flow, added a new section of tutorials, and provided updated
Approaches
recommended readings.
New in the Second Edition: Second Edition

• Two new applications chapters: Transportation and Home Environments
• New Tutorials section provides more hands-on guidance for critical issues
• Re-organization of Design Guidelines section allows for better flow of topics
Arthur D. Fisk
The new Tutorials section begins by focusing on general issues that need to be considered when
involving older adults generally in research and usability studies and specifically in focus group
Wendy A. Rogers
studies. It elucidates statistical considerations relevant to user testing with older adults and modeling
approaches such as task analysis, error prediction, and GOMS analysis. Given the prevalence of
Neil Charness
multimedia in today’s world, the authors include a tutorial on design considerations for multimedia Second Edition Sara J. Czaja
products in general but especially for older adults.
Reflecting the multidisciplinary nature of the field, this multidisciplinary author team translates a
Joseph Sharit
vast array of academic literature into guidelines without losing its strong grounding in science. They
discuss the role the field of human factors plays in creating technology that is effective and safe to
use. This book provides information specific enough to be immediately applicable yet general
enough to be relevant to technologies of the future.
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Designing for
Older Adults
Principles and
Creative Human Factors
Approaches
Second Edition
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Human Factors & Aging Series
Series Editors
Wendy A. Rogers and Arthur D. Fisk
School of Psychology
Georgia Institute of Technology – Atlanta, Georgia
Published Titles
Designing for Older Adults: Principles and Creative Human Factors Approaches,
Second Edition
Arthur D. Fisk, Wendy A. Rogers, Neil Charness, Sara J. Czaja, and Joseph Sharit
Forthcoming Titles
Designing Displays for Older Adults
Richard Pak and Anne Collins McLaughlin
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Designing for
Older Adults
Principles and
Creative Human Factors
Approaches
Second Edition
Arthur D. Fisk
Wendy A. Rogers
Neil Charness
Sara J. Czaja
Joseph Sharit
Boca Raton London New York
CRC Press is an imprint of the

Taylor & Francis Group, an informa business
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CRC Press
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Version Date: 20141117
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Dedication
We dedicate this book to:
The older adults who have inspired us — our parents

and grandparents
The participants in our research studies whose invaluable

efforts have helped us to develop these guidelines
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Contents
Preface to the Second Edition..........................................................................xv
Preface to the First Edition............................................................................ xvii
About the Authors...........................................................................................xix
Author Contact Information...........................................................................xxi
Section 1 Fundamentals
Chapter 1 Toward Better Design for Older Adults.................................. 3

1.1 Demographics............................................................................................. 3
1.2 What Products Do Older Adults Use?.................................................... 5
1.3 Is Good Design Worth the Effort?............................................................ 7
1.4 How Do We Define “Older Adult”?........................................................ 8
1.5 Toward Better Design................................................................................ 9
1.6 General Guidelines, Specific Questions.................................................. 9
1.7 Overview of the Book.............................................................................. 10
Recommended Reading................................................................................... 12
Chapter 2 Characteristics of Older Adult Users..................................... 13

2.1 What Are the Underpinnings of Human Factors?.............................. 13
2.2 What Human Characteristics Should Be Considered?....................... 14
2.3 Aging and the Sensory Modalities........................................................ 15
2.3.1 Taste and Smell........................................................................... 15
2.3.2 Haptics......................................................................................... 16
2.3.3 Audition....................................................................................... 17
2.3.4 Vision............................................................................................ 17
2.4 Cognition................................................................................................... 18
2.4.1 Memory........................................................................................ 20
2.4.2 Attention...................................................................................... 22
2.4.3 Spatial Cognition........................................................................ 23
2.4.4 Understanding Written and Spoken Language..................... 23
2.5 Control of Movements and Movement Speed..................................... 24
2.6 Summary of Review................................................................................ 24
2.7 Guidance for Design................................................................................ 26
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Chapter 3 Guiding the Design Process.................................................... 29
3.1 Principles of Design................................................................................. 29
3.2 Universal Design...................................................................................... 30
3.3 What Makes a Product Usable?............................................................. 31
3.4 Measuring Usability Components......................................................... 32
3.5 User-Centered Design (UCD)................................................................. 33
3.5.1 Task Analysis............................................................................... 33
3.5.2 Usability Testing......................................................................... 35
3.5.2.1 Two Perspectives to Usability Testing.................... 35
3.5.2.2 Usability Test Plan..................................................... 36
3.5.2.3 Think-Aloud Verbal Protocols................................. 37
3.5.2.4 Equipment.................................................................. 38
3.5.2.5 Participants................................................................. 38
3.5.2.6 Pilot Testing and Training......................................... 39
3.5.3 Field Observations...................................................................... 40
3.5.4 Interviews.................................................................................... 41
3.5.5 Questionnaires............................................................................ 41
3.5.6 Focus Groups............................................................................... 42
3.6 Design Methods That Do Not Involve the User.................................. 42
3.6.1 Checklists and Guidelines......................................................... 43
3.6.2 Heuristic Evaluation................................................................... 43
3.6.3 Layout Analysis.......................................................................... 43
3.7 The Product Design Lifecycle................................................................. 44
3.8 Conclusion................................................................................................ 45
Section 2 Design Guidelines
Chapter 4 Improving Perception of Information................................... 49

4.1 Visual Perception..................................................................................... 49
4.1.1 Text Characteristics..................................................................... 51
4.1.2 Icons versus Text......................................................................... 51
4.1.3 Additional Factors to Consider................................................. 52
4.2 Guidelines for Visual Presentation of Information............................. 52
4.2.1 General Lighting Guidelines..................................................... 52
4.2.2 Text................................................................................................ 53
4.2.3 Use of Three-Dimensional Displays........................................ 54
4.3 Issues in Aging and Auditory Perception............................................ 54
4.3.1 Thresholds for Sounds............................................................... 55
4.3.2 Speech Perception....................................................................... 55
4.3.3 Localization................................................................................. 56
4.4 Guidelines for Auditory Presentation of Information........................ 57
4.4.1 Sound............................................................................................ 57
4.4.2 Speech........................................................................................... 57
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4.5 Issues in Haptics....................................................................................... 58
4.5.1 Overview of Haptics.................................................................. 58
4.5.2 Vibration Perception................................................................... 58
4.6 Guidelines for Haptic Presentation of Information............................ 59
4.7 Using These Guidelines for Optimizing
Perception of Information................................................................... 59
Chapter 5 Design of Input and Output Devices..................................... 61

5.1 Issues in Aging and the Design
of Input Devices................................................................................... 62
5.1.1 Minimizing Steps........................................................................ 62
5.1.2 Consistency.................................................................................. 64
5.2 Types of Input Devices............................................................................ 65
5.3 Guidelines for the Design of Input Devices......................................... 68
5.4 Issues in Aging and the Design of Output Devices............................ 70
5.5 Guidelines for the Design of Output Devices...................................... 70
5.6 Using These Guidelines for Effective Design of Input
and Output Devices............................................................................. 71
Chapter 6 Interface Design......................................................................... 73

6.1 Interface Design Issues............................................................................ 73
6.2 Issues in Aging and Interface Design.................................................... 75
6.2.1 Do Older Adults Use Computer Technologies?..................... 75
6.2.2 Multiple Levels of User Abilities.............................................. 77
6.2.3 User Goals and Expectations.................................................... 77
6.2.4 Information Organization......................................................... 78
6.2.5 Getting Lost in the System and Navigation Tools................. 80
6.2.6 Depth versus Breadth................................................................. 80
6.2.7 Compatibility.............................................................................. 82
6.2.8 Documentation and Error Recovery........................................ 83
6.3 Guidelines for Effective Interface Design............................................. 85
6.3.1 Physical Characteristics............................................................. 85
6.3.2 Navigation................................................................................... 86
6.3.3 Information Organization......................................................... 86
6.3.4 Conceptual................................................................................... 86
6.4 Using These Guidelines to Facilitate Proper
Interface Design................................................................................... 87
Chapter 7 Design of Training and Instructional Programs................. 89

7.1 Principles of Instruction.......................................................................... 90
7.2 An Integrated Approach to Instructional
Design for Complex Tasks.................................................................. 92
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7.3 Human Cognitive Limitations and the Design
of Instructional Programs................................................................... 93
7.3.1 Learning Tasks.......................................................................... 94
7.3.2 Supportive Information........................................................... 96
7.3.3 Procedural Information........................................................... 96
7.3.4 Part-Task Practice...................................................................... 97
7.4 Illustration of Design Principles and Strategies..................................98
7.5 Pacing....................................................................................................... 99
7.6 Organization of the Training Material.............................................. 100
7.7 Consistency of Information................................................................ 100
7.8 Temporal Spacing Considerations..................................................... 101
7.9 Adaptive Training................................................................................ 102
7.10 Feedback................................................................................................ 102
7.11 The Use of Simulation in Training..................................................... 103
7.12 E-Learning............................................................................................. 104
7.13 Performance Assessment.................................................................... 105
7.14 Guidelines for the Design of Training
and Instructional Programs............................................................ 106
7.14.1 Train Using Sets of Holistic Practice Tasks......................... 106
7.14.2 Provide Supportive Information.......................................... 107
7.14.3 Training Procedural Information.......................................... 107
7.14.4 Promoting Deeper Learning................................................. 108
7.14.5 Environmental Considerations............................................. 108
7.14.6 Learning Materials.................................................................. 108
7.14.7 Reducing Training Demands................................................ 109
7.15 Conclusion............................................................................................ 109
Recommended Reading................................................................................. 109
Section 3 Exemplar Applications
Chapter 8 Making the Work Environment Age-Friendly.................. 113

8.1 The Workplace of the 21st Century....................................................115
8.1.1 Technology in the Workplace.................................................115
8.1.2 Changes in Work Arrangements...........................................116
8.2 What We Know about Older Workers: Myths and Realities..........117
8.2.1 Adaptation to Changes in Jobs..............................................117
8.2.2 Older Workers and Productivity...........................................118
8.3 The Potential Implications of Aging for Work..................................119
8.3.1 Sensory and Perceptual Changes..........................................119
8.3.2 Psychomotor Skills, Strength, and Endurance................... 120
8.3.3 Cognition and Learning......................................................... 121
8.4 Conclusion............................................................................................ 122
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Chapter 9 Maximizing the Usefulness and Usability of
Healthcare Technologies.................................................... 125
9.1 What Makes Healthcare Technologies Unique?.............................. 127
9.2 Movement Control, Perception, Cognition,
and Interface Design........................................................................ 128
9.3 Training Issues...................................................................................... 132
9.4 Maintenance, Calibration, and Updating of the Technology........ 133
9.4.1 Maintenance............................................................................ 134
9.4.2 Calibration............................................................................... 134
9.4.3 Updating.................................................................................. 135
9.5 Safety Issues.......................................................................................... 135
9.5.1 Hazard Awareness.................................................................. 135
9.5.2 Warnings.................................................................................. 136
9.6 Credibility............................................................................................. 136
9.6.1 The Internet............................................................................. 137
9.6.2 Medical Devices...................................................................... 137
9.7 Conclusion............................................................................................ 138
Chapter 10 Transportation........................................................................ 141

10.1 Driving....................................................................................................141
10.1.1 Driver Training and Screening.............................................. 142
10.1.2 Advanced Technology Systems............................................ 145
10.1.3 Redesign of Roadway and Signage Systems...................... 145
10.2 Pedestrian Behavior............................................................................. 146
10.3 Wayfinding in Built Environments.................................................... 147
10.3.1 Spatial Organization............................................................... 148
10.3.2 Landmarks, Signage, and Directories.................................. 149
10.3.3 Maps......................................................................................... 150
10.4 Negotiating Public Transportation Environments.......................... 151
10.4.1 Wayfinding.............................................................................. 151
10.4.2 Arrival at the Airport............................................................. 152
10.4.3 Boarding Pass Dispensing Devices...................................... 152
10.4.4 Traveling to the Gate.............................................................. 153
10.4.5 Security Area and Embarking/Disembarking Planes....... 153
10.5 Conclusion............................................................................................ 154
Chapter 11 Designing Accommodations for Aging-in-Place............ 157

11.1 Where and How Older Adults Live.................................................. 157
11.2 Evaluating the Home........................................................................... 159
11.2.1 Falls........................................................................................... 159
11.2.2 Structural Modifications........................................................ 160
11.2.3 Lighting.....................................................................................161
11.2.4 Products for Independent Living..........................................162
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11.3 Advanced Technology Development................................................ 163
11.3.1 Memory Supports................................................................... 163
11.3.2 Home Monitoring Systems.................................................... 163
11.3.3 Social Support.......................................................................... 164
11.3.4 Technology Acceptance and Privacy Issues........................ 164
11.3.5 Acceptance Decision Tree...................................................... 165
11.4 Conclusion............................................................................................. 166
Recommended Reading..................................................................................167
Section 4 Tutorials
Chapter 12 Involving Older Adults in Research and

Usability Studies................................................................ 171
12.1 Inclusion of Representative Samples................................................ 171
12.2 Selection Criteria.................................................................................. 172
12.3 Participant Recruitment...................................................................... 173
12.4 Study Protocols......................................................................................174
12.5 Measurement Instruments...................................................................176
12.6 Guidelines for Including Older Adults in
Research and Usability Studies...................................................... 177
Chapter 13 Conducting Focus Groups with Older Adults................. 179

13.1 Developing the Script.......................................................................... 179
13.1.1 Introduction and Icebreaker Question................................. 180
13.1.2 Developing the Questions..................................................... 181
13.2 Preparing for the Interviews.............................................................. 183
13.2.1 Training the Moderator(s)..................................................... 184
13.2.2 Developing Ancillary Materials........................................... 184
13.2.3 Selecting the Interview Environment.................................. 185
13.3 Collecting the Data.............................................................................. 185
13.3.1 Choosing the Participants..................................................... 185
13.3.2 Conducting the Interview..................................................... 186
13.4 Data Analysis........................................................................................ 187
13.4.1 Segmenting and Coding the Data........................................ 187
13.4.2 Interpreting the Data.............................................................. 190
13.5 Guidelines for Effective Focus Group Research.............................. 190
13.5.1 Developing the Script............................................................. 190
13.5.2 Conducting the Focus Group Session.................................. 191
13.5.3 Analyzing and Interpreting the Data................................... 191
Focus Group Research in General...................................................... 191
Focus Group Studies with Older Adults........................................... 191
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Chapter 14 Statistical Considerations in Usability Testing............... 193
14.1 Precise Measurement Studies............................................................. 193
14.2 Problem Discovery Studies................................................................. 196
14.3 Summary............................................................................................... 199
14.4 Guidelines for Determining Sample Sizes for
Usability Test Studies...................................................................... 200
Chapter 15 Task Analysis and Error Prediction................................... 203

15.1 Task Analysis........................................................................................ 203
15.2 Human Failure Modes and Effects Analysis (HFMEA)................. 205
15.3 Example: Self-Checkout Systems....................................................... 206
15.4 Generating the HFMEA for the Example......................................... 209
15.5 Summary................................................................................................214
15.6 Guidelines for Task Analysis and Error Prediction......................... 215
Chapter 16 GOMS Modeling for Older Adults.................................... 217

16.1 Reducing Data Entry Burden for a Software
Authentication Process.................................................................... 219
16.1.1 Assumptions about Task Processes...................................... 221
16.1.2 Modeling Task Performance at the Operator Level........... 221
16.1.3 Error Analysis.......................................................................... 223
16.1.4 Error Correction Cost............................................................. 224
16.2 Trade-Offs in Design............................................................................ 227
16.3 Conclusion............................................................................................ 228
16.4 Guidelines for GOMS Modeling for Older Adults.......................... 228
Chapter 17 Multimedia Design................................................................ 229

17.1 Does Media Matter?............................................................................. 229
17.2 The Role of Cognition in Multimedia Learning Systems............... 231
17.3 Ten Guidelines for Designing Multimedia
Instructional Programs.................................................................... 232
17.4 A Software Application Example....................................................... 237
17.5 Conclusion............................................................................................ 238
Section 5 Conclusion
Chapter 18 Synthesis and Comments..................................................... 241

18.1 Themes................................................................................................... 241
18.1.1 Older Adults Do Use New Technologies............................ 241
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18.1.2 Past Experience (or Lack Thereof)
Influences Performance..................................................... 241
18.1.3 If It Cannot Be Seen, Heard, or Manipulated,
It Cannot Be Used............................................................. 242
18.1.4 Age-Related Declines in Cognition Influence
Performance....................................................................... 242
18.1.5 Environmental Support/Knowledge
in the World/Affordances............................................... 243
18.1.6 Preferences Do Not Necessarily
Map to Performance......................................................... 243
18.1.7 Training, Documentation, and User Help Are
Necessary (and Should Be Well Designed)................... 243
18.1.8 User Testing Is Crucial for Successful Design.................. 244
18.1.9 Good Design for Older Adults
Is Generally Good Design for Everyone....................... 244
18.1.10 Attitudes Matter.................................................................... 244
18.2 Development of Future Technology................................................ 245
18.2.1 New Is Always New............................................................. 245
18.2.2 New and Improved Is Not Necessarily Better................. 245
18.3 Conclusion.......................................................................................... 246
References ..................................................................................................... 249
Author Index................................................................................................... 257
Subject Index.................................................................................................. 261
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Preface to the Second Edition
When we set out to write the first edition of this book, the goal was to
develop a brief primer on the topic of designing for older adults. We
wanted the book to be easily accessible to designers. We believe that we
were successful, judging by the feedback we received. However, we also
received comments from our readers that they would like more detailed
information on certain topics. Thus we decided to take this input (like any
good human factors practitioner would) and extend the topics included in
the second edition.
We have revised and updated each of the original chapters, re-
arranged them a bit for a more natural flow, and provided updated recom-
mended readings. We also added two more exemplar application chapters:
“Transportation” (Chapter 10) and “Designing Accommodations for
Aging-in-Place” (Chapter 11). To provide more hands-on guidance for
critical issues in designing for older adults, we have added a “Tutorials”
section to the book. The tutorials begin with a focus on general issues
that should be considered when involving older adults in research and
usability studies (Chapter 12) and specifically in focus group studies
(Chapter 13). We then provide information about statistical considerations
relevant to user testing with older adults (Chapter 14), as well as model-
ing approaches such as task analysis and error prediction (Chapter 15)
and GOMS analysis (Chapter 16). Given the prevalence of multimedia in
today’s world, we include a tutorial about design considerations for multi-
media products in general but especially for older adults (Chapter 17).
Many thanks must be extended to CRC Press, especially Cindy
Carelli, for shepherding us through this process. Thanks to the Scientific
Advisory Board of CREATE for their input: Gregory Abowd, Jim Baker,
Barry Beith, Jim Lewis, Susan Meadows, Michelle Robertson, Richard
Schulz, and Pamela Whitten. We appreciate the readers of the first edition
who provided constructive feedback for the second edition. We are for-
tunate to have the support of extremely hard-working students and staff.
We sincerely hope that this book is useful to people who design for older
adults. We look forward to receiving feedback on this edition to guide us
in developing the next one.
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Preface to the First Edition
Our goal for this book was to provide a primer on the issues that must
be considered when designing systems, products, or environments for
older adults. Our target audience was the design community. Therefore,
we wanted to provide guidelines for design that were accessible to a wide
variety of readers and immediately applicable to the design process.
There is quite a large academic literature on age-related changes in
abilities, learning, and performance and how such changes relate to inter-
actions with technology. The challenge was to translate this information
into guidelines and to present the key information in a readable format.
Our approach to writing this book was to step outside our traditional
style of writing academic books and research articles. The book does not
contain a lot of specific references to support each point or guideline that
we provide. Instead, we present our collective views based on many years
of research in the field of aging.
It is somewhat unusual to have a book that is co-authored by five peo-
ple. Rather than develop an edited volume where we each write chapters
on different topics, we worked together on the content of the book as a
whole. Together as a team we developed the structure of the book, the
main ideas, and the guidelines for each topic. The information we present
is intended to be specific enough to be immediately applicable, yet general
enough to be relevant to technologies of the future that cannot even be
imagined. Although future cohorts of older adults may have more experi-
ence with technologies, general age-related changes in capabilities will
still occur and, given the dynamic nature of technology, there will always
be the need for older adults to learn to use new technologies.
We firmly believe that successful design for older adults will result
from an understanding of the typical changes that accompany aging, how
awareness of such changes should influence the design process, and a
human factors approach to development and testing of products, systems,
and environments. For ease of exposition, we use the term human factors
and assume it to be synonymous with ergonomics. Other related terms that
denote similar perspectives are engineering psychology, applied experimental
psychology, and industrial engineering. The discipline of human factors is a
multidisciplinary approach to design that puts the user at the center of
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xviii Preface to the First Edition
the design process with the goal of developing safe, effective, and efficient
user-system interactions. Our team is also multidisciplinary, comprised of
two industrial engineers and three psychologists.
This book represents the combined efforts of the principal investi-
gators of CREATE — the Center for Research and Education on Aging
and Technology Enhancement. CREATE is sponsored by the National
Institutes of Health (National Institute on Aging) through Grant P01
AG17211. CREATE is directed by Sara Czaja at the University of Miami.
The other investigators on the grant are Joe Sharit, also at the University of
Miami; Neil Charness at Florida State University; and Wendy Rogers and
Arthur (Dan) Fisk at Georgia Institute of Technology.
CREATE is a multidisciplinary, collaborative Center dedicated to
solving the problems of aging and technology use. The development of
the Center was motivated by the increased number of older people in the
population and the increased reliance on technology in most societal con-
texts. It is estimated that people over the age of 65 will represent 22% of
the population by 2030. The overarching goal of CREATE is to help ensure
that current and future generations of older adults will be able to success-
fully use technology and that the potential benefits of technology can be
realized for older populations. To that end, the current volume represents
the development of comprehensive design guidelines for the design of
existing and emerging technologies that may be used by older adults.
The Scientific Advisory Board of CREATE consists of Jim Baker, Colin
Drury, Jim Fozard, Melissa Hardy, Bill Howell, Beth Meyer, John Thomas,
and Rich Schulz. We appreciate their guidance, advice, and support dur-
ing the development of this book.
In addition to support from NIH (NIA), we acknowledge support from
the National Institute for Occupational Safety and Health (NIOSH), and
in particular the guidance of Jim Grosch. We also appreciate the support
we receive from our academic homes: the Georgia Institute of Technology,
Florida State University, and the University of Miami.
We extend our deepest appreciation to all the researchers, graduate
students, and post-doctoral fellows who have been involved in CREATE.
Although there are too many people to list by name, we want them all to
know how much we value our collaborations with them and how much
they have contributed to the development of this book.
—Arthur D. Fisk
—Wendy A. Rogers
—Neil Charness
—Sara J. Czaja
—Joseph Sharit
The CREATE Team
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About the Authors
Arthur (Dan) Fisk received a Ph.D. in experimental psychology from the
University of Illinois in 1982. He is currently professor and coordinator
of the Engineering Psychology Program in the School of Psychology at
Georgia Institute of Technology. Prior to his academic faculty career, he
was manager, Human Factors Engineering at AT&T. He has written over
250 scientific publications and is a member of several scientific societies
including Fellow in the American Psychological Association (APA) and
Human Factors and Ergonomics Society (HFES). Dan is a past president of
the HFES and of APA’s Division of Applied Experimental and Engineering
Psychologists.
Wendy A. Rogers is professor of psychology at Georgia Institute of

Technology. She received her B.A. from the University of Massachusetts –
Dartmouth, and her M.S. and Ph.D. from the Georgia Institute of
Technology. Prior to returning to Georgia Tech for her current position,
she was on the faculty at the University of Memphis and the University of
Georgia. She is co-director of the Human Factors and Aging Laboratory.
Her research interests include skill acquisition, human factors, training,
and cognitive aging. She is a fellow of the Human Factors and Ergonomics
Society (HFES) and the American Psychological Association (APA). She is
a recipient of the Franklin V. Taylor Award for Outstanding Contribution
to the Field of Applied Experimental and Engineering Psychology and
the Mentor Award from APA’s Division 20 and the Retirement Research
Foundation. She is past president of Division 21 of APA and of HFES. She
is currently the editor of the Journal of Experimental Psychology: Applied.
Neil Charness is William G. Chase Professor of Psychology and an asso-

ciate of the Pepper Institute on Aging and Public Policy at Florida State
University. He received his B.A. from McGill University, and M.S. and
Ph.D. from Carnegie Mellon University. Prior to coming to Florida, he
was on the faculty at Wilfrid Laurier University and the University of
Waterloo in Canada. Neil’s research focuses on human factors approaches
to aging and technology use, and also on age and expert performance.
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xx About the Authors
Neil is a fellow of Association of Psychological Science, American

Psychological Association (APA), Canadian Psychological Association
(CPA), the Gerontological Society of America, and an honorary member
of the International Society for Gerontechnology. He is a past editor of the
psychology section of the Canadian Journal on Aging/Revue Canadienne du
Vieillissement, and a past president of Division 20 of APA and Section 17
of CPA (Adult Development and Aging).
Sara J. Czaja has a B.S. in psychology and M.S. and Ph.D. in industrial
engineering from the State University of New York at Buffalo. She is
professor of psychiatry and behavioral sciences and industrial engineer-
ing at the University of Miami. Dr. Czaja is the Director of the Center
for Research and Education on Aging and Technology Enhancement
(CREATE) and the co-director of the Center on Aging at the University of
Miami. She has extensive experience in aging research and a long com-
mitment to developing strategies to improve the quality of life for older
adults. Her research interests include aging and cognition, e-health, care-
giving, human-computer interaction, and functional assessment. Dr. Czaja
is very well published in the field of aging and has written numerous
book chapters and scientific articles. She is a fellow of the American
Psychological Association, the Gerontological Society of America and the
Human Factors and Ergonomics Society.
Joseph Sharit received his M.S. and Ph.D. degrees from the School of
Industrial Engineering at Purdue University, specializing in human fac-
tors engineering. He is currently a research professor in the Department
of Industrial Engineering at the University of Miami, and holds second-
ary appointments in the Department of Psychiatry and Behavioral Science
and the Department of Anesthesiology at the University of Miami Miller
School of Medicine. He is one of the principal investigators in the Center
for Research and Education on Aging and Technology Enhancement
(CREATE). Prior to joining the University of Miami, Dr. Sharit was Director
of Graduate Studies in the Department of Industrial Engineering at the
State University of New York at Buffalo. His research interests include
human-machine interaction, assessing the performance of older persons
interacting with technological systems, human reliability analysis and
system safety, and risk analysis. Dr. Sharit’s research has been applied to
medical, manufacturing, marine, nuclear, and aviation domains.
80555_C000.indd 20 2/25/09 12:38:31 PM

Author Contact Information
Neil Charness
Department of Psychology
Florida State University
Tallahassee, Florida 32306-1270
<charness@darwin.psy.fsu.edu>
Sara J. Czaja
Department of Psychiatry and Behavioral Sciences
University of Miami Miller School of Medicine
1695 N.W. 9th Avenue, Suite 3204B
Miami, Florida 33136
<sczaja@med.miami.edu>
Arthur D. Fisk
Georgia Institute of Technology
Atlanta, Georgia 30332-0170
<fisk@gatech.edu>
Wendy A. Rogers
Georgia Institute of Technology
Atlanta, Georgia 30332-0170
<wendy@gatech.edu>
Joseph Sharit
Department of Industrial Engineering
University of Miami School of Medicine
1695 N.W. 9th Avenue, Suite 3204A
Miami, Florida 33136
<jsharit@miami.edu>
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section 1
Fundamentals
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80555_S001.indd 2 2/19/09 4:51:15 PM
chapter 1
Toward Better Design

for Older Adults
Why design for older adults? There are many reasons. Clearly, more and
more consumers and users of technology are joining the ranks of “older
adult.” Such a change in demographics brings with it important changes in
the demands for products and services. Addressing those demands is not
just the role of technology; but more important we would argue, the role of
those who determine how the technology should function. That is, design-
ers hold the key, in many instances, to not only increasing the market share
for a given product, but also increasing the quality of older adults’ lives.
This book provides a practical introduction to human factors and older
adults. The book is aimed at professionals working to develop systems and
environments to accommodate the needs of older adults. It should also
be useful to people interested in the design process as it relates to older
adults. To that end, we emphasize the application of the scientific knowl-
edge base concerning age-related issues of perception, cognition, and
movement control. The book is meant as a reference source with practical
guidelines and advice for design issues ranging from lighting, computer
input device selection, web site design, to training program development,
work task design, and healthcare technology development.
There are many research-oriented publications available. What we
found missing was a reference document, grounded in the current state of
scientific knowledge, accessible to the broad audience of product design-
ers, healthcare practitioners, managers, and others who need answers
derived from the scientific knowledge base but translated for more imme-
diate applicability. Our motivation for developing this reference guide
was to ensure that optimal recommendations for design are provided in
an accessible format. An important caveat is that the recommendations
are based on the current state of knowledge.
1.1 Demographics
As mentioned above, society is getting older. As evident in Figure 1.1, this
aging of society is occurring worldwide. Within Asia, North America, and
Europe, the current percentage of the population over age 65 ranges from 6%
to 16%. By 2030, those percentages are estimated to range from 17% to 29%.
80555_C001.indd 3 2/20/09 12:40:24 PM

4 Designing for Older Adults
35%
30%
25%
Percent over age 65
20% 2005
2025
15% 2050
10%
5%
0%
Africa Latin Asia Oceania North Europe
America America
Figure 1.1. Percentage of the population over age 65, currently and estimated for
the future. (Source: 2005 data from United Nations Demographic Yearbook [2005]; 2025
and 2050 estimates from United Nations [2002].)
The fastest growing subgroup represents those over 80 years of age. In addi-
tion, the ethnic diversity of the older population is increasing, as illustrated
in Figure 1.2 for the United States.
People are living longer, remaining more active into older age, and
staying in their homes longer before finding the need for “assisted living”
arrangements. Aging brings with it changes in perception, cognition, and
control of movements. We address these changes as they relate to design
in the following chapters of the book.
Ethnic Group Distributions

(for adults over age 65)
100
80
Percent of U.S.
Hispanic (any race)

Population
60 Other Races
Asian alone
40
Black alone
20 White alone
0
2003 2030 2050
Year
Figure 1.2. Current and projected distribution of ethnic groups for adults over
age 65 in the U.S. population. (Source: U.S. Census Bureau [2004].)
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Chapter 1: Toward Better Design for Older Adults 5
In addition to changes in demographics, there has been an enormous

change in technological capabilities. There have been changes in the way
products work, look, act, and react to people who use them. These changes
in technology coupled with changing capabilities of the people using the
technology can lead to less than desirable interactions with products. We
have conducted numerous focus group and survey research studies and
have found that the range of technologies encountered in the daily lives of
older adults is very broad. Unfortunately, the extent of frustration encoun-
tered when dealing with technologies is also quite evident. Proper atten-
tion to design will eliminate much of this frustration.
Our research has also made it clear that, although older adults do have
unique usability constraints compared to younger adults, these usability
problems are often shared among age groups. When usability is improved
for older adults, it is also improved for younger adults. What is also clear
from human factors research is that improved usability will enhance mar-
ket penetration of a given product. Improved usability will improve qual-
ity of life and, with some classes of products, save lives.
1.2 What Products Do Older Adults Use?

Age does not necessarily limit the number of products used. In our
research, we have found the myth that older adults wish to avoid new
technology to be largely a fallacy. However, it is true that older adults are
less likely to use technology compared to younger adults as illustrated
in Figure 1.3. Even for commonly available technologies, the older adults
used fewer of them compared to younger and middle-aged adults; more-
over, older women used fewer than older men did. Similar patterns were
observed for breadth of computer use and Internet use.
Age-related technology usage differences may be mediated by age-
related income disparities, perception of actual need to use the technol-
ogy, products being too difficult to learn to use, and other factors. Our
research has shown that when there is a need to use a particular type of
technology, older adults want to use it. The “need to use” — or rather the
benefits of use — must be made clear before older adults will voluntarily
adopt technology.
In a recent study using focus groups to explore older adults’ use of and
attitudes toward technology, we found that older adults are using a wide
variety of technologies and they have many opinions about them. The focus
group participants were asked about their technology use in the domains
of home, work, and health. Technology was defined as electronic or digital
products and services. Each group was asked, “What technologies do you
use [in the context of each domain]?” and “For those of you who have used [each
technology item], what do you like and dislike about using this technology [in the
context of each domain]?” The participants reported using many technology
80555_C001.indd 5 2/20/09 12:40:26 PM

18
16
14
Number of Technologies Used
12
10
Male
Female
8
0
Younger Middle‒Aged Older
Age Group
Figure 1.3. Mean number (and standard deviation) of technologies used as

selected from a list of 17 common items: answering machine, automatic teller
machine, cellular phone, clock radio, compact disc player, copy machine, cruise
control, fax machine, microwave oven, online card catalog, pay at the pump sys-
tem, security system, telephone banking, videocassette recorder, video camera,
video game, and voice mail. The sample consisted of 470 younger adults (age
18–39), 273 middle-aged adults (aged 40–59), and 461 older adults (aged 60–91).
(Source: Czaja et al. [2006].)
items, particularly in their homes, and they expressed both positive and
negative attitudes about those technology items. However, contrary to ste-
reotypes of older adults holding negatively biased attitudes about tech-
nology, participants’ attitudes were mostly positive in nature across all
domains. Of all the attitudes expressed, 62% were likes whereas 38% were
dislikes. These findings confirm that older adults are using technology and
they perceive the benefits of that use as outweighing the costs.
Many new technologies are not optional — that is, older adults have
no choice but to use them. For example, telephone voice menu systems,
online card catalogs, and airport check-in kiosks are so prevalent they are
difficult to avoid. These technologies are presumably designed with the
expectation that anyone — and that means people of all ages — should be
able to walk up and successfully interact with the system. However, older
adults report frustrations in their interactions with these technologies;
this suggests the systems may not have been designed to accommodate
older adults’ limitations and capabilities.
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New technology notwithstanding, what can we say about the usage

of products in general? How does age affect usage of common everyday
products? A prevalent belief is that everyday household products are
“user friendly.” Product instructions and usage information on common
everyday products seem easy to comprehend and remember, at least to
the designers of the product. Because many household products are famil-
iar to many people, product designers may assume that the products are
simple to use. Consequently, testing the actual usability may be minimal
or nonexistent.
This kind of thinking often leads to an under-appreciation for the dif-
ficulties that people will encounter using even common household prod-
ucts. We conducted a study with a large sample of individuals of different
ages and backgrounds to answer that question. We asked people of all
ages about the frequency with which they used products across a variety
of everyday activities. We found that individuals of all age groups used
a large percentage of products across various categories (such as tools,
cleaners, over-the-counter medications, toiletries, and healthcare prod-
ucts). However, almost 75% of them reported experiencing usage difficul-
ties such as difficulty seeing or comprehending text and symbols on the
product; problems remembering instructions or warnings; or movement
control difficulties related to holding or opening the product. Older adults
were especially likely to report perceptual (e.g., “labels difficult to see”)
and movement control difficulties (e.g., “trouble getting open”).
1.3 Is Good Design Worth the Effort?

Attention to characteristics of design to improve usability can improve
the lives of older adults. In a focus group study of the problems that
older adults encounter in daily activities, we classified their reported
difficulties according to the activity engaged in when the problem was
encountered; the source of the problem (i.e., motor, visual, auditory, cog-
nitive, external, or general health limitations); whether the problems
were related to the inherent difficulty of tasks or potential negative
outcomes; and how participants responded to a certain problem (e.g.,
stopped performing the task in response to their limitations, compen-
sated somehow).
Of the problems reported by the older adults, 47% were due to
financial limitations, health difficulties, or other general concerns. Each
remaining problem was classified according to whether it could poten-
tially be solved through redesign, training, or some combination of the
two. Approximately 25% of the problems could potentially be remedied
by improving the design of the systems. Such redesign efforts could be
applied to solve sensory or motor problems and might involve changes
such as lowering steps on buses, developing tools for grasping or scrub-
bing, improving chair design, or enlarging letter size on a label.
80555_C001.indd 7 2/20/09 12:40:27 PM

The remaining 28% of the reported problems had the potential to be

solved through the provision of training, or through a combination of
training and redesign. For example, an older person learning to drive for
the first time would benefit from driver training (redesign of the auto-
mobile would not be feasible). However, for more complex systems such
as the use of a personal computer or healthcare technologies, training
would be needed for a novice older adult, and there is clearly the poten-
tial for design improvements that would improve the usability of such
systems for users of all ages. These data are quite striking: over 50% of
the problems of daily living reported by that sample of older adults were
potentially addressable through human factors design efforts. We may
find that for the 47% of the problems that do not appear initially to be
directly addressable through human factors interventions, such problems
could be lessened through proper application and design of technology.
Consider, for example, the promise of properly designed technology for
aiding some health-related problems, or to assist people at risk for isola-
tion and other problems related to being far away from family or friends.
1.4 How Do We Define “Older Adult”?

If forced to give a number to the question of when a person is an “older
adult,” we would most likely say that older adults are those individuals
who are 60 years of age and above. However, it is important to keep in
mind that such classification is not always straightforward. There are no
definitive boundaries between what is considered young and what is con-
sidered old; thus, age is not easily represented as a nominal variable. As
a result of reporting differences across databases, some of the graphs we
include in the book represent older adults as over age 50 or as those over
age 65.
Chronological age itself is useful only as a marker for correspond-
ing behavioral changes. Scientific understanding of behavior can best be
achieved through a careful analysis and description of change. Thus, a
major goal of current aging research is to identify specific changes that
occur throughout the aging process. For example, the detection thresh-
old for the normal range of human speech goes through a more rapid
decline after age 60. In vision, accommodation is severely limited by the
age of 65, resulting in difficulty tracking objects at varying distances;
but visual acuity for reading small print declines for many people by
age 40.
Aging occurs on many levels and can be categorized on at least three
dimensions: (1) biological, (2) psychological, and (3) social. Simple obser-
vation should make it clear that older adults, however defined, are not
a homogeneous group. Individual differences are prevalent regardless
of the decade of adult life. Until a much more complete understanding
80555_C001.indd 8 2/20/09 12:40:27 PM

of age-related changes is available, researchers and practitioners gener-

ally rely on chronological age as an index. We believe that it is useful to
think of two groupings of older adults: (1) one grouping is what we refer
to as the younger-old, ranging in age from about 60 to 75; and (2) the
other grouping we refer to as the older-old, comprising those individu-
als over 75 years of age. Of course, adding to the difficulty of defining
older adults is the fact that we must consider the task or situation — what
is “young” for some activities may be “old” for others. For example, an
individual aged 40 could be classified as an older worker but probably
not as an older driver.
Why then do we think about older adults and not just individuals?
Generally, older adults do have much in common in terms of the biologi-
cal, psychological, and social dimensions, although they do demonstrate
individual differences. When considering design, we are focusing on those
similarities that allow us to optimize the design. However, to determine
whom our design can or cannot accommodate, we must also be aware of
those individual differences.
1.5 Toward Better Design

The objectives of this book center on improved design, especially for prod-
ucts, services, and environments used and encountered by older adults.
The primary audience for this book is those individuals involved in mak-
ing design decisions. These decisions might be associated with web pages,
work tasks, training programs, healthcare technologies, etc. We believe
the book will also be helpful to those who make decisions concerning liv-
ing environments, such as lighting or navigational signage.
Our goal is to translate scientific knowledge into information that
can lead to “best practices.” However, the science is better developed in
some areas than in others. Therefore, in some chapters, the guidelines are
more explicit and detailed than in other chapters. Moreover, it is always
important to consider the task and the context in which a given recom-
mendation will be applied. For example, when we provide recommenda-
tions regarding assisting the aging eye, we would recommend 12-point
font size for labels on products. However, if the design task involves web
pages, 12-point font may slow down reading and increase the need for
scrolling, so a trade-off might be 10-point font in such a usage context.
Additionally, if the text will have to be read from a distance, font sizes
larger than 12-point would be recommended.
1.6 General Guidelines, Specific Questions

In most instances, the guidelines we supply provide a starting point for
good design. The information is certainly necessary for good design
80555_C001.indd 9 2/20/09 12:40:27 PM

but should not be thought of as sufficient without final user testing. As

an analogy, anthropometry data might give someone a starting point
for determining proper shelf height, but for each situation one would
still be required to perform “fitting trials” to ensure proper height for
the users of the shelving. In Chapter 3 we discuss and provide details
concerning basic issues in design and usability testing. That chapter
is meant to be a primer concerning the tools and techniques impor-
tant for analyzing the prospective users’ needs, the possible system
capabilities, and testing to determine if the needs and capabilities of
the person actually match the proposed system, environment, or train-
ing. Designers should be familiar with this material before attempting
design for older adults; understanding the target users and their needs
is essential.
The material in this book is a compilation of our knowledge, research,
and experience. Use of this information cannot be guaranteed to fit every
design problem encountered. We focus on application of the scientific
knowledge base in a general sense.
1.7 Overview of the Book

Although no book can serve as a sole source representing all the subfields
of human factors and aging, we have attempted to provide a broad cov-
erage of important usability topics. The book is divided into four main
sections — “Fundamentals” (Chapters 1 through 3), “Design Guidelines”
(Chapters 4 through 7), “Exemplar Applications” (Chapters 8 through 11),
“Tutorials” (Chapters 12 through 17), and the “Conclusion” (Chapter 18).
At the end of each chapter, there is a short list of “Recommended Reading”
to supplement the materials discussed in that chapter.
In the “Fundamentals” section, Chapter 1 provides the background
and purpose of the book. Chapter 2 provides more details concerning
characteristics of older adults; we briefly review psychological character-
istics that are important to consider during the design process. Chapter 3
is a primer on human factors tools and techniques.
The “Design Guidelines” chapters each target a specific domain —
providing an overview of key findings related to aging in that domain as
well as specific design guidelines. Chapter 4 provides practical translations
of scientific data concerning perception into design recommendations.
Chapter 5 offers practical translations of scientific data concerning input
and output devices into recommendations for design and for the selection
of input and output devices. Chapter 6 focuses on the design of system
interfaces, including issues relevant to human-computer interaction (e.g.,
personal computers, the Internet) as well as facilitating interaction with
systems such as automated teller machines, library systems, microwave
80555_C001.indd 10 2/20/09 12:40:27 PM

panels, cell phone menus, and hand-held devices. Chapter 7 concerns the
development and implementation of training and instruction. The chapter
provides material relevant to the creation of workplace training as well as
instruction for the use of technology. At the end of each “Design Guidelines”
chapter, we provide a bulleted list of our primary recommendations.
The four chapters in the “Exemplar Applications” section provide
examples of how the design guidelines are applicable in the broad areas of
work, healthcare, transportation, and home design. Chapter 8 addresses
making the work environment age-friendly and concerns issues of struc-
turing work tasks for an aging workforce, information flow, work pacing,
etc. Chapter 9 addresses healthcare technology. Healthcare is a critical
concern for adults of all ages but especially for older adults, given their
propensity to illness and chronic conditions. Technology offers the poten-
tial to help older adults be actively involved in the management of their
own health and healthcare, and to facilitate healthcare delivery to older
adults and their families. However, for such technology to be effective and
safe to use, attention to human factors is crucial. Chapter 10 illustrates the
relevance of design guidelines to driving, pedestrian behavior, and public
transportation. Chapter 11 concerns issues related to aging-in-place and
how accommodating the needs and capabilities of older adults can enable
them to maintain their independence.
The “Tutorials” section of the book provides specific “how-to”
information regarding different aspects of designing for older adults.
We emphasize throughout the book the importance of user-centered
design and the need to involve older adults in usability assessments.
To that end, we provide a general tutorial on involving older adults in
such studies in Chapter 12 and specific guidance for focus group stud-
ies in Chapter 13. Chapter 14 offers guidance for interpretation of find-
ings and assistance for estimating the number of participants needed,
whereas Chapters 15 and 16 focus on methods of task analysis, error
prediction, and modeling. We then provide recommendations regard-
ing multimedia design in Chapter 17; these tips are very useful, given
the increasing prevalence of multimedia for information transmission,
training, and entertainment.
Chapter 18 provides a synthesis of the themes that emerged through-
out all the chapters. These themes illustrate the key issues to consider when
designing for older adults. The guidelines presented in the book will not
solve all design problems for all systems and situations. They do not pro-
vide an algorithm to ensure success. The goal of the book is to help con-
strain the design solution space and provide designers with guidance about
how to accommodate older users. Design is an iterative process, and we
hope that by constraining or reducing the solution space, less iteration —
from initial mock-up to final product — will be required.
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Recommended Reading
Czaja, S.J., Charness, N., Fisk, A.D., Hertzog, C., Nair, S.N., Rogers, W.A., and
Sharit, J. (2006). Factors predicting the use of technology: findings from the
Center for Research and Education on Aging and Technology Enhancement
(CREATE). Psychology and Aging, 21, 333–352.
Charness, N. and Schaie, K.W. (2003). Impact of Technology on Successful Aging. New
York: Springer.
Pew, R.W. and Van Hemel, S.B. (2004). Technology for Adaptive Aging. Washington,
D.C.: National Academy Press.
Rogers, W.A., Stronge, A.J., and Fisk, A.D. (2006). Technology and aging.
In R. Nickerson (Ed.), Reviews of Human Factors and Ergonomics (Vol. 1,
pp. 130–171). HFES: Santa Monica, CA.
Schulz, R., Noelker, L., Rockwood, K., and Sprott, R. (2006). Encyclopedia of Aging
(4th ed.). New York: Springer.
80555_C001.indd 12 2/20/09 12:40:27 PM

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80555_cover 2/25/09 1:30 PM Page 1

ERGONOMICS AND HUMAN FACTORS Fisk

Designing for Older Adults

New in the Second Edition: Second Edition

6000 Broken Sound Parkway, NW

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Boca Raton London New York

CRC Press is an imprint of the

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© 2009 by Taylor & Francis Group, LLC

No claim to original U.S. Government works

International Standard Book Number-13: 978-1-4200-8068-1 (eBook - PDF)

and the CRC Press Web site at

The older adults who have inspired us — our parents

The participants in our research studies whose invaluable

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Chapter 1 Toward Better Design for Older Adults.................................. 3

Chapter 2 Characteristics of Older Adult Users..................................... 13

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Section 2 Design Guidelines

Chapter 4 Improving Perception of Information................................... 49

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Chapter 5 Design of Input and Output Devices..................................... 61

Chapter 6 Interface Design......................................................................... 73

Chapter 7 Design of Training and Instructional Programs................. 89

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Section 3 Exemplar Applications

Chapter 8 Making the Work Environment Age-Friendly.................. 113

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Chapter 10 Transportation........................................................................ 141

Chapter 11 Designing Accommodations for Aging-in-Place............ 157

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Chapter 12 Involving Older Adults in Research and

Chapter 13 Conducting Focus Groups with Older Adults................. 179

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Chapter 15 Task Analysis and Error Prediction................................... 203

Chapter 16 GOMS Modeling for Older Adults.................................... 217

Chapter 17 Multimedia Design................................................................ 229

Chapter 18 Synthesis and Comments..................................................... 241

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References ..................................................................................................... 249

Author Index................................................................................................... 257

Subject Index.................................................................................................. 261

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Wendy A. Rogers is professor of psychology at Georgia Institute of

Neil Charness is William G. Chase Professor of Psychology and an asso-

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Neil is a fellow of Association of Psychological Science, American

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Toward Better Design

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Ethnic Group Distributions