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  <p align="center"><a href="#contents">Contents</a></p>
  <p> <a href="http://www.w3.org/"><img height="48" width="72" alt="W3C" src="http://www.w3.org/Icons/w3c_home"/></a></p>
  <h1 style="clear:both" id="title">Web Accessibility for Older Users: A Literature Review</h1>

  <h2  id="W3C-doctype">W3C Working Draft 14 May 2008</h2>
  <dl>
    <dt>This version:</dt>
    <dd><a href="http://www.w3.org/TR/2008/WD-wai-age-literature-20080514/">http://www.w3.org/TR/2008/WD-wai-age-literature-20080514/</a></dd>
    <dt>Latest version:</dt>
    <dd><a href="http://www.w3.org/TR/wai-age-literature/">http://www.w3.org/TR/wai-age-literature/</a></dd>
    <dt>Previous version:</dt>
    <dd>None </dd>

    <dt>Author:</dt>
    <dd>Andrew Arch (W3C)</dd>
  </dl>
  <p class="copyright"><a href="http://www.w3.org/Consortium/Legal/ipr-notice#Copyright">Copyright</a> © 2008 <a href="http://www.w3.org/"><acronym title="World Wide Web Consortium">W3C</acronym></a><sup>®</sup> (<a href="http://www.csail.mit.edu/"><acronym title="Massachusetts Institute of Technology">MIT</acronym></a>, <a href="http://www.ercim.org/"><acronym title="European Research Consortium for Informatics and Mathematics"> ERCIM</acronym></a>, <a href="http://www.keio.ac.jp/">Keio</a>),
    All Rights Reserved. W3C <a href="http://www.w3.org/Consortium/Legal/ipr-notice#Legal_Disclaimer"> liability</a>, <a href="http://www.w3.org/Consortium/Legal/ipr-notice#W3C_Trademarks"> trademark</a> and <a href="http://www.w3.org/Consortium/Legal/copyright-documents">document
    use</a> rules apply.</p>
  <hr/>
</div>
<h2 id="abstract">Abstract</h2>
<p>This document  provides a review and analysis of guidelines and articles relating to the needs of older people with Web accessibility needs due to ageing, and compares these with the needs of people with disabilities as already addressed in WAI guidelines. The focus is particularly on Europe but applies internationally as well. This review is being undertaken in order to inform the development of educational materials which can better promote the needs of people who have accessibility needs due to ageing, and potential development of profiles and/or extensions on WAI guidelines.</p>
<h2 id="status">Status of This Document</h2>
<p><em>This section describes the status of this document at the
  time of its publication. Other documents may supersede this
  document.
  A list of current W3C publications and the latest
  revision of this technical report can be found in the <a href="http://www.w3.org/TR/">W3C technical reports index</a> at
  http://www.w3.org/TR/.</em></p>
<p>This First Public Working Draft of the Literature Review of Web Accessibility and Older Adults is an output from the "Web Accessibility Initiative: Ageing Education and Harmonisation (WAI-AGE)" project supported by the European Union's 6th Research Framework Programme (FP6); background on this project is available on the <a href="http://www.w3.org/WAI/WAI-AGE/">WAI-AGE home page</a>. </p>
<p>This document is intended to provide an overview of currently available literature about the needs of older adults with functional impairments accessing the web. It will compare how well these requirements are addressed and communicated by the WAI guidelines. This early version is intended to elicit comment and feedback on the literature collected and discussed so far. In particular we are interested in whether there are gaps in our coverage, or key resources overlooked. It should be noted that this is a work-in-progress and that not all sections are yet complete.</p>
<p>This document was developed through the <a href="http://www.w3.org/WAI/EO/">Education and Outreach Working Group</a>. The Working Group expects to publish this document as a Working Group Note.</p>
<p>Please send comments about  this document to <a href="mailto:public-comments-wai-age@w3.org">public-comments-wai-age@w3.org</a> (with <a href="http://lists.w3.org/Archives/Public/public-comments-wai-age/">public archive</a>) by Wednesday 4 June 2008.</p>
<p>Publication as a Working Draft does not imply endorsement by the W3C Membership. This is a draft document and may be updated, replaced or obsoleted by other documents at any time. It is inappropriate to cite this document as other than work in progress.</p>
This document was produced by a group operating under the <a href="http://www.w3.org/Consortium/Patent-Policy-20040205/">5
  February 2004 W3C Patent Policy</a>. The group does not expect this document to become a W3C Recommendation.

    W3C maintains a <a rel="disclosure" href="http://www.w3.org/2004/01/pp-impl/35532/status">public list of any
    patent disclosures</a> made in connection with the
    deliverables of the group; that page also includes
    instructions for disclosing a patent.

  An individual who has actual knowledge of a patent which the
  individual believes contains <a href="http://www.w3.org/Consortium/Patent-Policy-20040205/#def-essential">Essential Claim(s)</a> must disclose the
  information in accordance with <a href="http://www.w3.org/Consortium/Patent-Policy-20040205/#sec-Disclosure">section 6 of the W3C Patent Policy</a>.
<h2 id="contents">Table of Contents</h2>
<ul style="list-style-type:none;">
  <li  style=" padding-bottom:0.3em"> <a href="#intro">1. Introduction</a> </li>
  <li style=" padding-bottom:0.3em"><a href="#arfl">2. Older adults and age-related  functional limitations</a>
    <ul style="list-style-type:none">
      <li style=" padding-bottom:0.3em"><a href="#who">2.1 Who is an older adult?</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#how">2.2 How older adults use the Web</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#what">2.3 What are age-related functional  limitations?</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#attitude">2.4 Attitude and Aptitude</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#userreqs">2.5 User requirements for an elderly Web  user</a> </li>
    </ul>
  </li>
  <li style=" padding-bottom:0.3em"><a href="#revlit">3. A Review of the Literature</a>
    <ul style="list-style-type:none;">
      <li style=" padding-bottom:0.3em"><a href="#exist">3.1 Existing literature reviews</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#existguide">3.2 Previous approaches to ‘senior  friendly’ Web guidelines</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#waiguide">3.3 WAI guidelines</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#training">3.4 Training  older adults to Use ICT and  the Web</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#elderlyusers">3.5 Studies of older Web users’  specific disabilities</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#design">3.6 Aspects of Web Design affecting the  elderly</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#involve">3.7 Involving the elderly in Web design  and development</a> </li>
      <li style=" padding-bottom:0.3em"><a href="#genusability">3.8 General usability studies involving  elderly people</a> </li>
    </ul>
  </li>
  <li style=" padding-bottom:0.3em"><a href="#influence">4. Studies that influence WAI work</a> </li>
  <li style=" padding-bottom:0.3em"><a href="#furtherresearch">5. Questions for further research</a> </li>
  <li style=" padding-bottom:0.3em"><a href="#conclusion">6. Conclusions/Recommendations</a> </li>
  <li style=" padding-bottom:0.3em"><a href="#refs">References</a> </li>
  <li><a href="#appendix">Appendix – statistics</a>
    <ul  style="list-style-type:none;">
      <li><a href="#demog">A.1 Demographics</a></li>
      <li><a href="#online">A.2 Older people online</a></li>
    </ul>
  </li>
</ul>
<h2  id="intro">1. Introduction</h2>
<p>The World Wide Web (<acronym>Web</acronym>) was invented in 1989 and the World Wide Web Consortium (<acronym>W3C</acronym>) was established in 1994 to lead the World Wide Web to its full potential. By the turn of the century the Web had entered most aspects of our lives from communication to e-Government, e-Commerce and e-Learning, making it much more than just an information repository. By 2006, in addition to online services (banking, taxation, shopping, etc), we also saw the advent of web-based applications such as calendars, office-type applications, forums, chat, blogs, etc. This evolving online world presents ongoing access challenges to people with functional impairments and disabilities.</p>
<p>Tim Berners-Lee, inventor of the Web and Director of the World Wide Web Consortium (W3C), is regularly cited for saying “The power of the Web is in its universality. Access by everyone regardless of disability is an essential aspect”  [<cite><a href="#tbl1997">TBL 1997</a></cite>] and more recently “One Web for anyone, everywhere on anything” [<cite><a href="#tbl2004">TBL 2004</a></cite>] – this is all part of the Web’s ‘full potential’. In 1999 the W3C Web Accessibility Initiative (WAI) published the first set of international guidelines for <cite><a href="http://www.w3.org/TR/WCAG10/">Web accessibility, the Web Content Accessibility Guidelines 1.0 (WCAG)</a></cite>, documenting the essential requirements for Web content to be accessible to people with disabilities. Accessibility requirements for <cite><a href="http://www.w3.org/WAI/intro/atag.php">authoring tools (ATAG)</a></cite> and <cite><a href="http://www.w3.org/WAI/intro/uaag.php">user agents (UAAG)</a></cite>, including browsers followed. At the time of writing (early 2008), the W3C had advanced drafts available of <cite><a href="http://www.w3.org/WAI/intro/wcag20">WCAG 2.0</a></cite> and <cite><a href="http://www.w3.org/TR/ATAG20/">ATAG 2.0</a></cite> along with a specification for <cite><a href="http://www.w3.org/WAI/intro/aria/">Accessible Rich Internet Applications (WAI-ARIA)</a></cite> that will assist scripted Internet applications to become accessible.</p>
<p>Many countries in Europe and elsewhere have legislation in place to reduce discrimination against people with disabilities, both young and old, along with related policies or guidelines applying to online services [<cite><a href="#policies">Policies</a></cite>]. Furthermore, the European Union (<acronym>EU</acronym>) and the European Commission (EC) have programmes in place to ensure that e-Inclusion for people with disabilities is enhanced among the Member States, and it is also addressing the needs of the elderly and other disadvantaged groups. In particular, they have agreed to “address the needs of older workers and elderly people by … exploiting the full potential of the internal market of information and communications technology (<acronym>ICT</acronym>) services and products for the elderly, amongst others by addressing demand fragmentation by promoting interoperability through standards and common specifications where appropriate” [<cite><a href="#ec2006">EC 2006</a></cite>]. The <acronym>EC</acronym> has been addressing the technology needs of the elderly for some time; however under the 6th Framework Programme (<acronym>FP6</acronym>) of research under the Information Society and Technology (IST) programme, several calls have focused on the needs of the elderly in the information society [<cite><a href="#pp2007">Placencia-Porrero 2007</a></cite>].</p>
<p>This issue is compounding because the world’s population is living longer with a disproportionate number of people soon to be elderly as compared with any other period in human history. The United Nations (<acronym>UN</acronym>) estimates that by 2050 one out of every five people will be over 60 years, and by 2150, one third of the people in the world are expected to be 60 years of age or older [<a href="#un2007"><cite>UN 2007</cite></a>; <a href="#un1998"><cite>UN 1998</cite></a>]. In Europe in the near future, it is estimated that  the <acronym>EU-25</acronym> countries will experience a demographic shift  from 2000 when 15.7% of the population was over 64, to an estimated older population of 17.6% in 2010 and 20.7% in 2020 [<cite><a href="#ec2007a">EC 2007a</a></cite>].</p>
<p>This demographic shift is also impacting the workforce and the <acronym>EC</acronym> expects employment rates for older workers to “increase massively from 40% in 2004 for the EU-25 to 47% by 2010 and 59% in 2025” that will “need to be supported by ensuring lifelong access to suitable training” [<cite><a href="#ec2007b">EC 2007b</a></cite>].</p>
<p>There has been extensive development <acronym>and adoption </acronym>of the WAI guidelines for Web accessibility for people with disabilities. However, while these guidelines address many of the requirements needed by the ageing population, the relevance of the WAI guidelines to the needs of older people with functional disabilities caused by ageing does not seem to be well understood.</p>
<p>This review examines the literature relating to the use of the Web by older people to primarily look for intersections and differences between the <acronym>WAI</acronym> guidelines and recommendations for web design and development issues that will improve the accessibility and usability for older people. It is intended that the review will: </p>
<ul>
  <li> better inform the ongoing work of <acronym>W3C</acronym>/<acronym>WAI</acronym> with regard to the needs of older computer users and their web accessibility related needs </li>
  <li> inform the development of potential extensions on <acronym>WAI</acronym> guidelines and techniques and/or provide direct input into future versions of <acronym>WAI</acronym> guidelines </li>
  <li>lead to the development of
    educational resources focussed towards   industry implementers, and  organisations representing and serving ageing communities </li>
  <li>help foster dialog between ageing communities, disability   communities, industry, and other interested parties around issues of web accessibility </li>
  <li> inform the contributions that <acronym>W3C</acronym> makes into the standards development processes in Europe and internationally.</li>
</ul>
<h2 id="arfl">2. Older adults and age-related functional limitations</h2>
<h3 id="who">2.1 Who is an older adult?</h3>
<p>Are they 50+ or 65+?</p>
<p>Goldman Sachs [<cite><a href="#gs2005">Goldman Sachs 2005</a></cite>], along with many others, have defined 60 as the new 55 in terms of retirement from full-time work as life expectancy, health, and economic expectations increase. </p>
<p>In the <acronym>WHO</acronym> document ‘Definition of an older or elderly person ’ [<cite><a href="#who-a">WHO a</a></cite>] it is suggested that “Most developed world countries have accepted the chronological age of 65 years as a definition of 'elderly' or older person”, but goes on to say “The <acronym>UN</acronym> has not adopted a standard criterion, but generally use 60+ years to refer to the older population” (e.g. [<cite><a href="#who-b">WHO b</a></cite>]). </p>
<p>The American Association of Retired Persons' (<acronym>AARP</acronym>) 2004 study found that previous studies (undertaken during 2000 - 2004) of the elderly and their use of the <acronym>ICT</acronym> and the Web used a variety of definitions, from 50+ years through to 65+ years [<cite><a href="#redish2004">Redish &amp; Chisnell 2004</a></cite>]. Bailey [<cite><a href="#bailey2002">Bailey 2002</a></cite>] [<cite><a href="#bailey2004">Bailey 2004</a></cite>] reviewed a number of studies and journals and proposed the following classification: </p>
<ul>
  <li>Young: 18-39 years </li>
  <li>Middle-aged: 40-59 years </li>
  <li>Older: 60-74 years </li>
  <li>Old-old: 75+ years</li>
</ul>
<p>The <acronym>AARP</acronym> itself considers ‘older adults’ to be those over 50 years, while many western countries (including the <acronym>USA</acronym>) consider the retirement age to be 65 years.</p>
<p>However, in addition to chronological age defining ‘elderly’, we need to account for the diversity in ability resulting from the development of functional limitations associated with ageing, and also the diversity of attitude and aptitude, when we are discussing the use of technology, especially <acronym>ICT</acronym> and the Web. </p>
<h3 id="how">2.2 How older adults use the Web</h3>
<p>All the evidence from the studies that report about the online activities of the elderly suggest that they do  much the same online as most other age groups – that is, communication and information searches as well as using online services. Kantner &amp; Rosenbaum (2003) [<a href="#kantner2003"><cite>Kantner 2003</cite></a>] observe, that “email and children were primary reasons” why many seniors started to learn using computers; Morris, Goodman and Brading (2007)  [<a href="#mgb2007a"><cite>MGB 2007</cite></a>] also found that email and communication was an important factor in the elderly being online.</p>
<p>Fox (2004) [<a href="#fox2004a"><cite>Fox 2004</cite></a>] found that  older <acronym>US</acronym> Web users do product research (66%), purchase goods (47%), make travel reservations (41%), visit government Web sites (100%), look up religious and spiritual information (26%) and do online banking (20%). Morris, Goodman and Brading (2007), in their <acronym>UK</acronym> (Derbyshire) study, found that the information searches were often related to hobbies and interests (68%), travel and holidays (50%) and health or medical (28%). Dinet et al. (2007) [<a href="#dinet2007"><cite>Dinet 2007</cite></a>] found from a study of older French users (age 68 – 73 years) that health was the most looked for topic online, the second was recreation and travel and the third most popular was services. </p>
<p>Wired seniors are often as enthusiastic as younger users in the major activities that define online life such as email and the use of search engines to answer specific questions (Fox, 2004). In other words, we should not stereotype all older adults as technophobes. Weinschenk (2006) [<a href="#wein2006"><cite>Weinschenk 2006</cite></a>], citing Human Factors International’s experience along with other research ([<a href="#ohara2004"><cite>O’Hara 2004</cite></a>]), warns designers against stereotyping the elderly as non-computer, non-internet, users. </p>
<p>Several studies even report that the elderly use the Web for romantic interests (e.g. [<a href="#malta2007"><cite>Malta 2007</cite></a>]) and the Wall Street Journal in 2004  [<a href="#wsj2004"><cite>WSJ 2004</cite></a>] was warning Web site designers that overlooking older adults was “an oversight that can be costly to businesses online as the population ages and as more seniors discover the Internet”. </p>
<p>Morris, Goodman and Brading (2007) concluded that the Internet “does enhance the lives of older people” even if the older elderly use the Internet less than younger elderly groups. </p>
<div class="comment">
  <p>Author's note:-</p>
  <p><em>Other areas of importance?</em></p>
  <ul>
    <li><em>Leisure – including libraries (Mates, 2003)</em></li>
    <li><em>Why the elderly may not be online? </em></li>
  </ul>
  <p><em>Also discuss the potential  difference between current groups who often have no prior ICT experience and  future groups (e.g. baby-boomers) who will often have prior ICT experience … </em></p>
  <p class="os">end of note</p>
</div>
<h4 id="many">2.2.1 How many older users are online?</h4>
<p>The Eurostat 2005 community survey on <acronym>ICT</acronym> usage in households and by individuals found declining access to the Internet with age, and only 10% of people over 65 years having Internet access (Figure 1; Table 1) [<a href="#eurostat2005a"><cite>Eurostat 2005</cite></a>]. However, this is low by many countries' measurements,  and more detailed country-based statistics are provided in the <a href="#appendix">Appendix</a>.</p>
<p><strong>Figure  1: EU Internet Use by age in 2005</strong><br />
  (Eurostat, Community survey on ICT usage in households and by individuals, 2005)<br />
  <img src="eunetstats.png" alt="Figure 1 - EU Internet Use by age in 2005 as per Table 1" width="584" height="316" longdesc="#tab-eunetuse" /></p>
<table  border="1" cellpadding="1" id="tab-eunetuse">
  <caption>
  <strong>Table 1: EU Internet Use at least one per week by age in 2005</strong><br />
  (Eurostat, Community survey on ICT usage in households and by individuals, 2005)
  </caption>
  <tr>
    <th scope="row">Age Group</th>
    <td>16-24 years</td>
    <td>25-34 years</td>
    <td>35-44 years</td>
    <td>45-54 years</td>
    <td>45-54 years</td>
    <td>55-64 years</td>
  </tr>
  <tr>
    <th scope="row">Weekly Internet access</th>
    <td><div align="right">86%</div></td>
    <td><div align="right">55%</div></td>
    <td><div align="right">51%</div></td>
    <td><div align="right">39%</div></td>
    <td><div align="right">27%</div></td>
    <td><div align="right">10%</div></td>
  </tr>
</table>
<p>&nbsp;</p>
<h3 id="what">2.3 What are age-related functional limitations?</h3>
<p>The commonly accepted limitations that often arise during the normal ageing process are:</p>
<ul>
  <li><a href="#whatvision">Vision decline</a> </li>
  <li><a href="#whathearing">Hearing loss</a> </li>
  <li><a href="#whatmotor">Motor skill diminishment</a> </li>
  <li><a href="#whatcog">Cognition effects</a> </li>
</ul>
<p>The ageing process can often result in elderly people experiencing multiple functional limitations. </p>
<h4 id="whatvision">2.3.1 Vision decline with ageing</h4>
<p>Lighthouse International [<cite><a href="#lhtae">Lighthouse TAE</a></cite>], Agelight  [<cite><a href="#al2001">Agelight 2001</a></cite>] and Salvi, Akhtar and Currie (2006) [<a href="#sac2006"><cite>SAC 2006</cite></a>] give excellent descriptions of many of the declining vision conditions that most older adults naturally experience, from the yellowing of the eye’s lens and presbyopia (loss of elasticity of the lens) to pupil shrinkage. These conditions result in a variety of vision changes:</p>
<ul>
  <li>Decreasing ability to focus on near tasks, including a computer screen </li>
  <li>Colour perception and sensitivity; less violet light is registered, making it easier to see red and yellows than blues and greens and often making darker blues and black indistinguishable </li>
  <li>Pupil shrinkage; resulting in the need for more light and a diminished capacity to adjust to changing light levels. For example, 60 year old retinas receive only 40% of the light that 20 year old retinas receive [<a href="#liile"><cite>Lighthouse ILE</cite></a>] while 80 year old retinas only receive around 15% [<a href="#eyedigest"><cite>Eye Digest</cite></a>]</li>
  <li>Contrast sensitivity; from the age of 40, contrast sensitivity at higher spatial frequencies starts to decline until at the age of 80 it has been reduced by up to 83%  (See Figure 2) </li>
  <li>Reduction in visual field </li>
</ul>
<p><strong>Figure 2: Contrast sensitivity decreases dramatically with age for all but low spatial frequencies</strong> <br />
  (reproduced from [<a href="#ee2004"><cite>EveryEye 2004</cite></a>])</p>
<p><img src="contrast.png" alt="Figure 2 shows contrast senstivity significantly decreased for 80 year old vs. 20 year olds" width="416" height="300" longdesc="http://www.everyeye.co.uk/htms/oldAgeVision.htm" /></p>
<p>The Royal National Institute for the Blind (<acronym>RNIB</acronym>)  has estimates of eyesight decline in the older population in the <acronym>UK</acronym> for people whose declining sight significantly affects their daily life [<cite><a href="#rnib2008a">RNIB 2008a</a></cite>]:</p>
<ul>
  <li>15.8% aged 65 to 74 years </li>
  <li>18.7% for ages 75 – 84 years </li>
  <li>45.8% for ages 85+ years </li>
</ul>
<p>In addition to the natural ageing of the eye, two common eye diseases of the elderly can also seriously affect vision: </p>
<ul>
  <li>Cataracts [<cite><a href="#rnib2008b">RNIB 2008b</a></cite>], which is a clouding of the clear lens in the eye resulting in blurred vision and glare sensitivity. This is treatable in it’s early stages.</li>
  <li>Age-related Macular Degeneration  (<acronym>AMD</acronym>) [<cite><a href="#rnib2008c">RNIB 2008c</a></cite>], resulting in central vision deterioration and an inability to see fine detail and distinguish colour possibly combined with a sensitivity to glare. <acronym>AMD</acronym> is not reversible.</li>
</ul>
<table border="1" cellspacing="1" cellpadding="3">
  <caption>
  <strong>Table 2: Causes of sight problems in older people</strong> [<cite><a href="#rnib2008a">RNIB 2008a</a></cite>]
  </caption>
  <tr>
    <th  align="left" valign="top" scope="col">Cause</th>
    <th  valign="top">Percentage of population <br />
      (for binocular Visual Acuity &lt; 6/18)</th>
  </tr>
  <tr>
    <th width="189" align="left" valign="top">Age-related Macular Degeneration (<acronym>AMD</acronym>)</th>
    <td width="217" valign="top"><div align="right">36.2%</div></td>
  </tr>
  <tr>
    <th width="189" align="left" valign="top">Refractive error</th>
    <td width="217" valign="top"><div align="right">31.6%</div></td>
  </tr>
  <tr>
    <th width="189" align="left" valign="top">Cataract</th>
    <td width="217" valign="top"><div align="right">24.5%</div></td>
  </tr>
  <tr>
    <th width="189" align="left" valign="top">Glaucoma</th>
    <td width="217" valign="top"><div align="right">7.9%</div></td>
  </tr>
  <tr>
    <th width="189" align="left" valign="top">Myopic degeneration</th>
    <td width="217" valign="top"><div align="right">2.9%</div></td>
  </tr>
  <tr>
    <th width="189" align="left" valign="top">Diabetic eye disease</th>
    <td width="217" valign="top"><div align="right">2.3%</div></td>
  </tr>
</table>
<p>&nbsp;</p>
<h4 id="whathearing">2.3.2 Hearing loss with age</h4>
<p>The majority of people who have a hearing loss are older people; they usually notice a gradual age-related reduction and the increasing inability to hear high-pitched sounds [<a href="#hearingconcern"><cite>Hearing Concern</cite></a>]. The Royal National Institute for Deaf People (<acronym>RNID</acronym>) estimates for the <acronym>UK</acronym> that at around the age of 50 the proportion of deaf people begins to increase sharply and 55% of people over 60 are deaf or hard of hearing [<cite><a href="#rnid">RNID</a></cite>].</p>
<table border="1" cellspacing="1" cellpadding="3">
  <caption >
  <strong>Table 3: Estimated percentages of the UK population who are deaf or hard of hearing</strong> [<cite><a href="#rnid">RNID</a></cite>]
  </caption>
  <tr>
    <td valign="top"><p><strong>&nbsp;</strong></p></td>
    <th valign="top"><p>&nbsp;16&nbsp;to 60 years </p></th>
    <th valign="top"><p> 61 to 80 years </p></th>
    <th valign="top"><p> Over 81 years </p></th>
  </tr>
  <tr>
    <th align="left" valign="top"><em>All degrees of deafness</em></th>
    <td valign="top"><div align="right"><em>6.6%</em></div></td>
    <td valign="top"><div align="right"><em>46.9%</em></div></td>
    <td valign="top"><div align="right"><em>93.2%</em></div></td>
  </tr>
  <tr>
    <th align="left" valign="top" >&nbsp;&nbsp;Mild deafness</th>
    <td valign="top"><div align="right">4.6%</div></td>
    <td valign="top"><div align="right">28.1%</div></td>
    <td valign="top"><div align="right">18.4%</div></td>
  </tr>
  <tr>
    <th align="left" valign="top">&nbsp;&nbsp;Moderate deafness</th>
    <td valign="top"><div align="right">1.6%</div></td>
    <td valign="top"><div align="right">16.5%</div></td>
    <td valign="top"><div align="right">57.9%</div></td>
  </tr>
  <tr>
    <th align="left" valign="top">&nbsp;&nbsp;Severe deafness</th>
    <td valign="top"><div align="right">0.2%</div></td>
    <td valign="top"><div align="right">1.9%</div></td>
    <td valign="top"><div align="right">13.2%</div></td>
  </tr>
  <tr>
    <th align="left" valign="top">&nbsp;&nbsp;Profound deafness</th>
    <td valign="top"><div align="right">0.1%</div></td>
    <td valign="top"><div align="right">0.4%</div></td>
    <td valign="top"><div align="right">3.6%</div></td>
  </tr>
</table>
<p>&nbsp;</p>
<h4 id="whatmotor">2.3.3 Motor skill diminishment</h4>
<p>Arthritis is a major cause of mobility issues for the elderly and Wikipedia  [<a href="#wikimsd"><cite>Wiki MSD</cite></a>] reports that arthritis is the leading cause of disability in people older than 55 years. The <acronym>US</acronym>-based Arthritis Foundation reports that 50% of Americans over 65 experience arthritis [<a href="#arthritisfndn2008"><cite>Arthritis Foundation 2008</cite></a>] , while Arthritis Care in the <acronym>UK</acronym> report that 20% of all adults in the <acronym>UK</acronym> are affected [<a href="#arthritiscare2007"><cite>Arthritis Care 2007</cite></a>].</p>
<p>Another age-related condition is Parkinson's Disease, a progressive neurological condition affecting movements such as walking, talking, and writing. The National Institute of Neurological Disorders and Stroke in the US reports that the four primary symptoms of Parkinson’s Disease are [<a href="#ninds2008"><cite>NINDS 2008</cite></a>]: </p>
<ul>
  <li>Tremor – trembling in the hands, arms, legs, jaw and face </li>
  <li>Rigidity – stiffness of he limbs and trunk</li>
  <li>Bradykinesia – slowness of movement </li>
  <li>Postural instability – impaired balance and coordination </li>
</ul>
<p>The Parkinson’s Disease Society in the UK states “The risk of developing Parkinson's increases with age, and symptoms often appear after the age of 50. Some people may not be diagnosed until they are in their 70s or 80s” [<a href="#parkinsons"><cite>Parkinson's</cite></a>]. Wikipedia reports that Parkinson’s Disease can also lead to cognitive and visual disturbances [<a href="#wikipd"><cite>Wiki PD</cite></a>]. </p>
<p>Both arthritis and Parkinson’s are likely to cause difficulties with the mouse use, and even other pointing devices, as well as keyboard use for some sufferers. </p>
<h4 id="whatcog">2.3.4 Cognitive decline with age</h4>
<p>Wikipedia’s entry on Memory and Aging    talks about memory decline in the normal ageing process and states [<a href="#wikima"><cite>Wiki MA</cite></a>]:</p>
<blockquote>“The ability to encode new memories of events or facts and working memory shows decline in both cross-sectional and longitudinal studies [<a href="#hg2004"><cite>Hedden &amp; Gabrieli 2004</cite></a>]. Studies comparing the effects of aging on episodic memory, semantic memory, short-term memory and priming find that episodic memory is especially impaired in normal aging [<a href="#nilsson2003"><cite>Nilsson 2003</cite></a>]. These deficits may be related to impairments seen in the ability to refresh recently processed information [<a href="#johnson2002"><cite>Johnson 2002</cite></a>]. In addition, even when equated in memory for a particular item or fact, older adults tend to be worse at remembering the source of their information [<a href="#johnson1993"><cite>Johnson 1993</cite></a>], a deficit that may be related to declines in the ability to bind information together in memory [<a href="#mitchell2000"><cite>Mitchell 2000</cite></a>].”</blockquote>
<p>It has also been suggested [<a href="#ca2007"><cite>Caserta &amp; Abrams 2007</cite></a>] that situation awareness may be relevant to cognitive ageing, affecting older adults’ perception and comprehension of their environment.</p>
<p>Cognitive deficits come in many forms as discussed earlier, but among the elderly, dementia, including Alzheimer’s Disease, appears to be the most prevalent. Alzheimer’s Disease International provides figures showing that the incidence of dementia is nearly 25% among over 85 years olds (<a href="#table4">Table 4</a>) [<a href="#adi1999"><cite>ADI 1999</cite></a>]. Alzheimer Europe (2005) estimate that between 1.14% and 1.27% of citizens over the age of 30 years in the European Union are living with a form of dementia [<a href="#ae2005"><cite>AE 2005</cite></a>].</p>
<table border="1" cellspacing="1" cellpadding="3" id="table4">
  <caption >
  <strong>Table 4: Prevalence rate of dementia with age</strong>[<a href="#adi1999"><cite>ADI 1999</cite></a>]
  </caption>
  <tr>
    <th valign="top">Age    group</th>
    <th valign="top">Rate</th>
  </tr>
  <tr>
    <th valign="top">65-69    years</th>
    <td valign="top"><div align="right">1.4%</div></td>
  </tr>
  <tr>
    <th valign="top">70-74    years</th>
    <td valign="top"><div align="right">2.8%</div></td>
  </tr>
  <tr>
    <th valign="top">75-79    years</th>
    <td valign="top"><div align="right">5.6%</div></td>
  </tr>
  <tr>
    <th valign="top">80-84    years</th>
    <td valign="top"><div align="right">11.1%</div></td>
  </tr>
  <tr>
    <th valign="top">85+    years</th>
    <td valign="top"><div align="right">23.6%</div></td>
  </tr>
</table>
<p>Alzheimer’s organisations suggest that dementia is progressive and that during the course of the disease the chemistry and structure of the brain changes, leading to the death of brain cells (e.g. [<a href="#asuk2003"><cite>ASUK Alzheimer’s Society UK, 2003</cite></a>]) They also suggest that people with multiple sclerosis, motor neurone disease, Parkinson's disease and Huntington's disease may also be more likely to develop dementia. Symptoms are identified as including:</p>
<ul>
  <li> Loss of memory </li>
  <li>Confusion and problems with speech and understanding </li>
  <li>Mood changes </li>
  <li>Communication problems.</li>
</ul>
<p>The Alzheimer’s Forum in the UK publishes tips for coping, including computer tips which include the suggestion of getting a mouse that works properly for the users and adjusting the mouse pointer to suit the user [<a href="#afonline"><cite>AF Online</cite></a>]. </p>
<div class="comment">
  <p >Author's note:-</p>
  <p><em>Distractibility as a cognitive issue … need to discuss following articles:</em></p>
  <ul>
    <li><em>Fabiani  et al, 2006</em></li>
    <li><em>Grady  et al, 2006</em></li>
  </ul>
  <p class="os">end of note</p>
</div>
<p>Many older adults may not suffer from dementia or Alzheimer’s Disease, but do suffer Mild Cognitive Impairment (<acronym>MCI</acronym>) or subjective memory loss ([<a href="#ucsfmac"><cite>UCSF MAC</cite></a>]; [<a href="#aa2006"><cite>AA 2006</cite></a>]). The complaints associated with <acronym>MCI</acronym> include:</p>
<ul>
  <li> trouble remembering the names of people they met recently </li>
  <li>trouble remembering the flow of a conversation </li>
  <li>an increased tendency to misplace things</li>
</ul>
<p>All these complaints are likely to also impact on the use of many Web sites.

  Other forms of cognitive diminishment may also arise with ageing, for example the effects of stroke can result in conditions similar to intellectual impairment.</p>
<h4 id="whatmulitple">2.3.5 Multiple sensory loss and function impairments</h4>
<p>Brennan, Horowitz and Ya-ping (2005) [<a href="#bhy2005"><cite>Brennan 2005</cite></a>] report that twenty percent of America’s older adults (over 70 years) reported dual sensory impairment and the high levels of dual impairment were shown to increase the risk of difficulty with the ‘instrumental activities of daily living’  (including using a telephone, and hence probably a computer and the Web). Brennan, Horowitz and Ya-ping’s findings highlight the importance of sensory resources for everyday competence and the elderly maintaining their functional independence.</p>
<h3 id="attitude">2.4 Attitude and Aptitude</h3>
<p>Many authors observed that not all older adults are the same, and that attitude and aptitude can vary significantly across the elderly age group (e.g. [<a href="#cn2002"><cite>Coyne &amp; Nielsen 2002</cite></a>]; [<a href="#gregor2002a"><cite>Gregor 2002</cite></a>]; [<cite><a href="#redish2004">Redish &amp; Chisnell 2004</a></cite>]; [<a href="#scott1999"><cite>Scott 1999</cite></a>]). Ability is often related to experience, for example mouse control for elderly new computer users can be problematic ([<a href="#dickinson2005a"><cite>Dickinson  2005</cite></a>]; [<a href="#hawthorn2005a"><cite>Hawthorn 2005</cite></a>]).</p>
<p>Morris, Goodman and Brading (2007) [<a href="#mgb2007a"><cite>MGB 2007</cite></a>] found that “the barrier is not age, but the respondents’ idea that older people cannot or do not use computers”. Additionally, many of the survey respondents in their UK study cited a lack of Internet access as a key barrier to use. </p>
<p>However, as Morrell (2005) suggests [<cite><a href="#morrell2005">Morrell 2005</a></cite>], the post-WWII “baby boomers”, who are moving into the category of ‘older adult’, have often been using ICT at work, and will have greater ability than many current retirees who don’t have a history of experience with ICT and may have begun by using the Web for the first time in the 1990’s and early 2000’s. </p>
<h3 id="userreqs">2.5 User requirements for an elderly Web user</h3>
<p class="comment"><em>Note - section 2.5 still to be written ...</em></p>
<h2 id="revlit">3. A  Review of the Literature</h2>
<p>Many studies have been undertaken of the use of the web by older people, some research based, some user observation, some surveys, some expert opinion. Some of these studies have looked at the elderly as a group, others have focussed on specific issues faced by the elderly, including their approach to learning about <acronym>ICT</acronym> and the Web. Some of the studies have referenced the work of the W3C Web Accessibility Initiative (<acronym>WAI</acronym>), but many seem to have been undertaken in oblivion of this work and the <acronym>WAI</acronym> Guidelines which were first released in 1999.</p>
<p>Many of the studies discovered (see <a href="#refs">References</a>) identify the sensory impairments that develop with age such as vision, dexterity, and hearing as important, while others identify the issue of cognitive ability and overload as key to some elders’ ability to use Web technologies. A compounding issue is that people with accessibility needs due to ageing are less likely to identify themselves as “disabled” than people who experience these changes earlier in life (e.g. [<a href="#bjorneby1999"><cite>Bjørneby 1999</cite></a>]). As a result, they are less likely to learn of, and to avail themselves of, resources which can help address their needs.
  The studies listed in the Appendix can be classified in many different ways by the methods used or approaches taken, in their investigations, for example:</p>
<ul>
  <li>Methodology focus – Observation of users, often around case studies; Surveys; Focus groups, but not task oriented; Expert opinion, sometimes based on a review of previous work </li>
  <li>Disability or impairment focus – Physical/mobility; Cognition; Vision; Pan-disability </li>
  <li>Web aspect studied – Searching; Forms completion; Shopping; e-Learning; Web use training; e-Health access </li>
  <li>Web Design aspects – Involving older people in the design process; Site architecture</li>
</ul>
<p>Of course, there are always studies that do not fall into these categories.</p>
<p>There is also the cross-over between Accessibility and Usability to consider; for this review accessibility is taken to include the Guidelines and Success Criteria from <acronym>WCAG</acronym> 2.0 that address the needs of people with disabilities using the Web, along with those parts of <acronym>ATAG</acronym> and <acronym>UAAG</acronym> that affect Web usage and participation. A consideration of the cross-overs may lead to more useful outcomes/recommendations for future <acronym>WAI</acronym> work. </p>
<p>A majority of the articles discovered (see <a href="#refs">References</a>) originated from Europe, but a significant number also originated from North America, with a few from Asia and Australasia. </p>
<h3 id="exist">3.1 Existing literature reviews</h3>
<p>Most of the scientific papers identified in the <a href="#refs">References</a> included literature reviews relevant to their particular topics, but a few papers were primarily reviews of previous literature.</p>
<p>Redish and Chisnell (2004) [<cite><a href="#redish2004">Redish 2004</a></cite>] reviewed a large number of articles, books, presentations, Web sites and papers published between 2000 and 2004 relating to web design for older adults. They were looking for broad usability issues for older Web users, while this review aims to identify opportunities to extend the existing WAI technical, education, and outreach work to accommodate the overlapping needs of people with disabilities and older adults with age-related functional limitations.
  Redish and Chisnell were not surprised to find that much of what they found in the literature about older adults on the Web is good usable design for everyone – consistent navigation, clear writing, skim-able text with lists, etc. Another aspect of the elderly that their study reinforced is that older adults are not a homogenous group – something that many others have also commented on (e.g. [<cite><a href="#gregor2002a">Gregor 2002</a></cite>]; [<cite><a href="#fox2004a">Fox 2004</a></cite>]; <cite>[<a href="#morrell2005">Morrell 2005</a></cite>]). </p>
<p>Redish and Chisnell commented that older adults are actually less homogenous as an age-group than younger adults.
  Redish and Chisnell grouped their findings into four aspects of design – interaction, information architecture, visual design, and information design. Some of the issues they highlighted include:</p>
<ul>
  <li> Interaction design:
    <ul>
      <li>Design convention such as underlined links should be followed </li>
      <li>Scrolling and other mouse activities are a learned behaviour and becomes more difficult with age making pull-down menus, scrolling lists, and scrolling pages difficult for some users </li>
      <li>Understanding, and accessing, what is clickable can be problematic for some elderly users </li>
      <li>Feedback in multiple modes (visual and auditory) may be beneficial </li>
    </ul>
  </li>
  <li>Information architecture:
    <ul>
      <li>Clear labelling (of links, headings and menu items) seems to be more important for older users than younger users </li>
      <li>Breadth vs. depth - shallow information hierarchies seemed to work better for older users </li>
      <li>Redundant links – the studies they reviewed leant both ways </li>
    </ul>
  </li>
  <li>Visual design:
    <ul>
      <li>Experienced older users can scan pages as well as younger users, but newer elderly users can find busy pages and pages with irrelevant material (such as adverts) distracting </li>
      <li>Older users generally prefer larger text – naturally </li>
      <li>Older adults with vision deficits need to be accommodated with suitable contrast along with headings to help them narrow their visual search </li>
    </ul>
  </li>
  <li>Information design:
    <ul>
      <li>Skimming and scanning is common across all age groups and vision abilities </li>
      <li>Content development, plain language and ‘writing for the web’ are critical</li>
    </ul>
  </li>
</ul>
<p>Redish and Chisnell conclude by suggesting that older adults should be included more in usability studies of Web design. </p>
<div class="comment">
  <p><em>Author's note:</em></p>
  <p><em>Other papers to discuss:</em></p>
  <ul>
    <li><em><a href="#ps2005"><cite>Paul &amp; Stegbauer 2005</cite></a></em></li>
  </ul>
  <p class="os">end of note</p>
</div>
<h3 id="existguide">3.2 Previous approaches to ‘senior friendly’ Web guidelines</h3>
<p>Many investigations this decade have developed or compiled usability guidelines for making Web sites “senior friendly”, in addition to the Web Content Accessibility Guidelines from W3C for people with disabilities. As Zaphiris, Kurniawan and Ghiawadwala (2006) suggest, some of these are developed in academia and are theory driven, while others come from the Web industry and are derived from practical experience. A selection of these guidelines published since the release of WCAG 1.0 include:</p>
<ul>
  <li class="comment">[<cite><a href="#spry1999">SPRY 1999</a></cite>] - A Guide for Web Site Creators <br />
    (not discussed as released the same year as WCAG 1.0) </li>
  <li>[<cite><a href="#holt2000">Holt 2000</a></cite>] - Creating senior-friendly web sites </li>
  <li>[<cite><a href="#al2001">AgeLight 2001</a></cite>] – Interface design guidelines for users of all ages </li>
  <li>[<cite><a href="#nihnlm2002">NIH/NLM 2002</a></cite>] – Making your Web site senior friendly – A checklist </li>
  <li>[<cite><a href="#cn2002">Coyne &amp; Nielsen 2002</a></cite>] – Web usability for senior citizens </li>
  <li class="comment">[<a href="#sac2003">de Sales &amp; de Abreu Cybis 2003</a>] - <span lang="es">Desenvolviment de um <em>checklist</em> para a avalia&ccedil;&atilde; de acessibilidade da <em>web</em> para usu&aacute;rios idosos</span> <br />
    (not discussed yet as material only available in Spanish)</li>
  <li>[<cite><a href="#aarp2004">AARP 2004</a></cite>] – Designing Web sites for older adults: heuristics </li>
  <li>[<cite><a href="#kz2005">Kurniawan &amp; Zaphiris 2005</a></cite>] –  Research-Derived Web Design Guidelines for Older People </li>
  <li>[<cite><a href="#fidgeon2006">Fidgeon 2006</a></cite>] – Usability for older Web users</li>
</ul>
<p>Morrell (2005) in writing up the experience of compiling guidelines for a site to be used by older adults (www.nihseniorhealth.gov) found adequate systematic and descriptive research to facilitate this, but expressed dismay over the duplication of research by recent studies. This confirms the general feeling that this author has had, that many studies are either “reinventing the wheel” or not surveying and building on the appropriate range of existing literature. Other studies seem to repeat the mistakes of others in their recommendations, e.g. recommending against double-clicking.</p>
<p class="question">Editor's question - retain or remove the H4 headings identifying the guidelines being discussed?</p>
<h4 id="existguideholt">3.2.1 Holt’s guidelines (2000)</h4>
<p>Holt (2000) created one of the earliest set of guidelines for senior-friendly Web sites where she focussed on addressing some of the functional declines often experienced with ageing. Holt specifically mentions a variety of visual, intellectual,  hearing and motor-skill impairments that are common in older adults. This early checklist contained four groups of recommendations concerning:</p>
<ul>
  <li>Design</li>
  <li>Layout</li>
  <li>Content</li>
  <li>Multimedia</li>
</ul>
<p>While the basis of  Holt’s checklist was not clear, much of Holt’s discussion reflected the Checkpoints from WCAG 1.0, while some of it addressed additional issues many functionally limited older adults will experience such as difficulty with pull-down menus and auto-scrolling text. Many of Holt's recommendations are reflected in the other guidelines discussed below.</p>
<h4 id="existguideagelight">3.2.2 AgeLight’s guidelines (2001)</h4>
<p>In 2001, the AgeLight  organisation, in consideration of the ageing population and the functional limitations often faced by them, published a set of guidelines to help Web designers accommodate the natural changes in ability often associated with ageing [<a href="#al2001"><cite>AgeLight 2001</cite></a>]. These guidelines, described as “interface design guidelines for all ages” were based on focus groups, user feedback, and wide collaboration with practitioners and researchers. The AgeLight guidelines were centred around six aspects of page design:</p>
<ul>
  <li> Layout and style</li>
  <li>Colour</li>
  <li>Text</li>
  <li>General usability and testing</li>
  <li>Accessibility and Disability</li>
  <li>User customisation</li>
</ul>
<p>Under these page design aspects, AgeLight discussed many factors that were captured in <acronym>WCAG</acronym> 1.0 - <acronym>WAI</acronym> is acknowledged in their resource listing - such as flashing and blinking, relative text size, descriptive links, consistent navigation, colour alone, new browser windows, and frame support. They also discussed a number of additional factors addressing the specific needs of some older people facing various functional limitations such as readability, fine motor control, and cognition such as the use of CAPITALS, large text size, colour schemes, and uncluttered pages. AgeLight also considered some of the software and hardware issues that could assist older users such as different mice and browser adjustments.</p>
<p>AgeLight liken the accommodation of people with disabilities and their assistive technologies to curb-cuts for wheel chair users which benefit a much broader group. Like Holt, AgeLight have emphasised the importance of broad usability for older users, especially those new to ICT and Web technologies.</p>
<h4 id="existguidenia">3.2.3 National Institute of Aging’s guidelines (2002)</h4>
<p>NIA/NLM prepared a checklist in 2002 [<cite><a href="#nihnlm2002">NIA/NLM 2002</a></cite>] for making sites ‘senior friendly’ compiled from a variety of previous research findings. This checklist includes five groups of recommendations:</p>
<ul>
  <li>Designing readable text for older adults:</li>
  <li>Presenting information to older adults:</li>
  <li>Incorporating other media:</li>
  <li>Increasing the ease of navigation:</li>
  <li>Final check (usability testing)</li>
</ul>
<p>Some of the NIA/NLM checklist items are targeted at overcoming the functional limitations experienced by many elderly users, for example contrast and the use of colour, pull-down menus, scrolling text, and captioning. Other items address a potential lack of familiarity with the browsers and the Web, such as providing 'previous/next' buttons on a page. Some of the NIA/NLM checkpoints duplicate WCAG 1.0 checkpoints (e.g. provide alternatives for multimedia, and provide a consistent layout), while others could be seen to conflict (e.g. use 12 or 14 point text).</p>
<p>The NIA/NLM checklist reinforces a theme that runs across most of these guidelines - usability is crucial for older Web users including readable text and clear language.</p>
<p>Morrell (2005) provides a description of the development of the NIA/NLM Checklist, and its application to the development of the www.nihseniorhealth.gov Web site providing information on health topics applicable to older adults. The usability testing of the NIHseniorhealth Web site and other sites following the Checklist has confirmed its usefulness in making sites senior-friendly. </p>
<h4 id="existguidecn">3.2.4 Coyne  and Nielsen’s guidelines (2002)</h4>
<p>Coyne and Nielsen [<a href="#cn2002"><cite>Coyne &amp; Nielsen 2002</cite></a>] could be considered to have prepared the first definitive set of senior-friendly Web site design recommendations based on user observation published as “Web Usability for Senior Citizens”. Their study of 40 (experienced) users over 65 years derived 65 guidelines in 6 groupings for Web site designs that would better accommodate older users:</p>
<ul>
  <li>Presenting information and text</li>
  <li>Presenting navigational elements and links</li>
  <li>Search
    forms and results</li>
  <li>Presenting items for sale</li>
  <li>Forms and data entry</li>
  <li>Web address and homepage</li>
</ul>
<p>Although Coyne and Nielsen's users were experienced, additional usability issues relating to the browser and operating system were discussed, including the issues of users confusing the address field with the site’s search field (also observed by Kantner and Rosenbaum [<cite><a href="#kantner2003">Kantner 2003</a></cite>]). They also recommended a text-resizing button or link on Web pages to overcome older users' lack of familiarity with browser controls.</p>
<p>Coyne and Nielsen emphasised issues often associated with  functional impairment related to ageing such as text size, contrast, scrolling, and drop-down menus, as well as general usability. Like the previous guidelines they also raised broader useability issues that will benefit everyone such as their Search recommendations.</p>
<h4 id="existguideaarp">3.2.5 AARP’s guidelines (2004)</h4>
<p>The <acronym>AARP</acronym> [<a href="#aarp2004"><cite>AARP 2004</cite></a>] from the investigation and review by Redish and Chisnell [<a href="#redish2004"><cite>Redish 2004</cite></a>] published a set of heuristics (issues) for the evaluation of web site design for older adults:</p>
<ul>
  <li>Interaction design: designing the way users interact with the site</li>
  <li>Information architecture: organising the content</li>
  <li>Visual design: designing the pages</li>
  <li>Information design: writing and formatting the content</li>
</ul>
<p>The majority of the <acronym>AARP</acronym>’s heuristics might just be considered conventional usability wisdom – most of this list is of benefit to all users, not just elderly users or users with functional limitations. </p>
<p>We are also seeing some patterns develop through all these guidelines about using conventional design and interaction mechanisms, an emphasis on clear presentation and writing, and a requirement for readability with the use of white space and good contrast. It is interesting to note that the <acronym>AARP</acronym> did not empasise the requirement for large text size like the previous guidelines have. </p>
<h4 id="existguidekz">3.2.6 Kurniawan and Zaphiris’ guidelines (2005)</h4>
<p>Kurniawan and Zaphiris (2005) [<a href="#kz2005"><cite>Kurniawan 2005</cite></a>] and their colleagues reviewed much previous literature in the area of HCI and ageing to derive an overwhelming initial set of 52 guidelines. These were then categorised by postgraduate computing students through a card-sorting exercise into nine distinct categories. A focus group of HCI experts reviewed the categories to derive the final set of 38 guidelines in 11 categories. The guidelines were validated through a process of heuristic reviews of two Web sites targeting older people by six participants with HCI experience. A final verification used a panel of sixteen older web users (average age 59.2 years) to look at the same two sites and rank the usefulness of each guideline from ‘one’ (useless) to ‘five’ (very useful) – all the guidelines were ranked ‘three’ or above. The elderly users were also asked for any suggestions for missing guidelines – eight additions were suggested that will be considered in future developments (Zaphiris, Kurniawan and Ghiawdwala, 2006) [<a href="#zaphiris2006"><cite>Zaphris 2006</cite></a>]. </p>
<p>Kurniawan, Zaphiris and colleagues derived eleven categories of guidelines, termed “SilverWeb Guidelines” by Zaphiris, Kurniawan and Ghiawdwala, from their review of previous HCI research:</p>
<ul>
  <li>Target (link) design</li>
  <li>Graphics</li>
  <li>Navigation</li>
  <li>Browser window features</li>
  <li>Content layout design</li>
  <li>Links</li>
  <li>User cognitive design</li>
  <li>Use of colour and background</li>
  <li>Text design</li>
  <li>Search engine</li>
  <li>User feedback and support</li>
</ul>
<p> Clark (2005) [<a href="#clark2005"><cite>Clark 2005</cite></a>] criticised some of the recommendations as being irrelevant or too general, including:</p>
<ul>
  <li>Double clicking – not required anyway on web pages </li>
  <li>Graphics should not be used for decoration – does away with graphic design?</li>
  <li>Avoid scroll bars – vertical scrolling is part of the web, &quot;if they meant avoid horizontal scrolling they should say so&quot; </li>
</ul>
<p>Kurniawan and Zaphiris' guidelines are interesting in that they reflect many of the recommendations of previous guidelines, while based much more on scientific literature rather than user observational studies. Many of these guidelines are similar to the WCAG 1.0 Checklist, while others emphasis the specific needs of older users with functional limitations including clarity and readability of text, clear (large) links, and providing reading time.</p>
<h4 id="existguidewebcred">3.2.7 Webcredible’s guidelines (2006)</h4>
<p>Fidgeon [<a href="#fidgeon2006"><cite>Fidgeon 2006</cite></a>] at Webcredible  analysed eight usability sessions they had undertaken with older users (over 65 years) and compared them with eight similar sessions they had conducted with younger Web users (under 40 years). </p>
<p>Some of their findings were that older users used more emotive terms when describing Web sites and were more likely to assign blame, to themselves, when encountering difficulties. They also found that the elderly users often failed to scroll down, thus missing key information, were less likely to understand technical language, but had a higher propensity to use the search facility than their younger counterparts. The older users also required over twice the time to complete tasks than the younger users, maybe because they read all the text on a page before selecting a link and/or because they were more likely to click on text areas that were not links. Fidgeon  made nine suggestions for improving the usability of Web pages for elderly users:</p>
<ul>
  <li>Investigate ways to indicate that a page is not finished and requires scrolling</li>
  <li>Avoid technical terms if possible</li>
  <li>Identify links in a consistent and obvious way</li>
  <li>The attention grabbing features on a page should be links</li>
  <li>Visited links should change colour</li>
  <li>Provide all content as HTML where possible</li>
  <li>Make the content as clear and concise as possible</li>
  <li>Provide a “make the writing bigger” link and always use high contrast</li>
  <li>Provide explicit instruction by using the imperative forms of verbs (e.g. ‘Go to more details about XXX’)</li>
</ul>
<p>Some of these recommendations reflect the WCAG 1.0 checkpoints; other are designed to accommodate newer users without Web  experience (e.g. scrolling indicators, and text-resizing buttons). Webcredible recommend these design features for all sites and acknowledge a need for further investigation. </p>
<h4 id="existguidecommon">3.2.8 Common themes from existing Guidelines</h4>
<p>Several other authors (e.g. [<a href="#spry1999"><cite>SPRY 1999</cite></a>]; [<cite><a href="#zhao2001">Zhao 2001</a></cite>]; [<a href="#sac2003">de Sales &amp; de Abrew Cybis 2003</a>]; [<cite><a href="#moreno2007">Moreno 2007</a></cite>]) have prepared guidelines and recommendations for senior-friendly Web sites with most of the same recommendations as others.</p>
<p>With so many guidelines in existence, it is interesting to ask who knows of them or uses them. Sloan (2006), acknowledging that WCAG 1.0 was the de facto standard for Web site accessibility, undertook a survey of web designers to see which ‘senior-friendly’ and other usability guidelines Web designers and developers were aware of and used. In addition to Coyne and Nielsen (2002), NIA/NLM (2002) and Kurniawan and Zaphiris (2005), Sloan included:</p>
<ul>
  <li>“Beyond ALT Text: Usability for disabled users” [<a href="#cn2001"><cite>Coyne &amp; Nielsen 2001</cite></a>]</li>
  <li>“Research-based Web design and usability guidelines” from the National Cancer Council [<a href="#dhhs2006"><cite>DHHS 2006</cite></a> - replaced NCC 2004]</li>
  <li>“Guidelines for accessible and usable Web sites: Observing users who work with screen readers” [<a href="#theofanis2005"><cite>Theofanis 2005</cite></a>]</li>
</ul>
<p>Sloan’s 57 respondents consistently responded “I’ve never heard of them” to all but the Coyne and Nielsen publications with only a few acknowledging that they had read or used them.</p>
<p>This lack of awareness, combined with the observed repetitiveness within them, confirms the need for this project and publication.</p>
<div class="comment">
  <p >Author's note:-</p>
  <p><em>Many common themes emerge from these guidelines as noted already …
    Questions to ask include:</em></p>
  <ol>
    <li><em> What specific commonality is there across these guidelines?</em></li>
    <li class="style5"> Which guidelines/recommendations address:
      <ol style="list-style-type:lower-alpha">
        <li>Good usability</li>
        <li>Overcoming a lack of ICT/Web experience</li>
        <li>ageing specific functional limitations</li>
      </ol>
    </li>
    <li><em>What match is there to WCAG 2.0 Success Criteria? </em></li>
    <li><em>Within the cognition section – what is different between cognitive impairments experienced by the elderly, and cognitive impairments experienced by the general population?</em></li>
    <li><em>A similar question probably needs to be asked about vision impairment and mobility impairment.</em></li>
  </ol>
  <p class="os">end of note</p>
</div>
<h3 id="waiguide">3.3 WAI guidelines</h3>
<p>The W3C Web Accessibility Initiative has released several sets of guidelines to help make the Web more accessible to people with disabilities. These include guidelines relating to the presentation of content (<a href="http://www.w3.org/WAI/intro/wcag.php">Web Content Accessibility Guidelines</a>), the accessibility of user agents, including browsers (<a href="http://www.w3.org/WAI/intro/uaag.php">User Agent Accessibility Guidelines</a>) and the requirements of authoring tools, including blogs and online forums, for the creation of accessible content and for use by people with disabilities (<a href="http://www.w3.org/WAI/intro/atag.php">Authoring Tool Accessibility Guidelines</a>). As the Web has become an interactive medium, the interrelationships between the guidelines and the users become increasingly important to allow access to information and to allow the creation of information.</p>
<p>It is essential that the different components of Web development and interaction work together in order for the Web to be accessible to people with disabilities (Figure 3). These components include [<a href="#henry2006"><cite>Henry 2006</cite></a>]:</p>
<ul>
  <li>content - the information in a Web page or Web application, including:
    <ul>
      <li>natural information such as text, images, and sounds</li>
      <li>code or markup that defines structure, presentation, etc.</li>
    </ul>
  </li>
  <li>Web browsers, media players, and other &quot;user agents&quot;</li>
  <li>assistive technology, in some cases - screen readers, alternative keyboards, switches, scanning software, etc</li>
  <li>users' knowledge, experiences, and in some cases, adaptive strategies using the Web</li>
  <li>developers - designers, coders, authors, etc., including developers with disabilities and users who contribute content</li>
  <li>authoring tools - software that creates Web sites, including blogs, content management systems, and learning management systems</li>
  <li>evaluation tools - Web accessibility evaluation tools, HTML validators, CSS validators, etc. </li>
</ul>
<p><strong>Figure 3: How the components of web accessibility relate to each other</strong></p>
<p><img src="http://www.w3.org/WAI/intro/specs.png" alt="illustration showing the guidelines for the different components, detailed description at http://www.w3.org/WAI/intro/components-desc.html#guide" width="484" height="404" border="1" longdesc="http://www.w3.org/WAI/intro/components.php" /></p>
<p>The draft <acronym>WCAG</acronym> 2.0 has twelve guidelines for accessible content:</p>
<ul style="list-style-image:none">
  <li>1.1 Text Alternatives: Provide text alternatives for any non-text content so that it can be changed into other forms people need, such as large print, braille, speech, symbols or simpler language</li>
  <li>1.2 Synchronized Media: Provide synchronized alternatives for synchronized media</li>
  <li>1.3 Adaptable: Create content that can be presented in different ways (for example simpler layout) without losing information or structure</li>
  <li>1.4 Distinguishable: Make it easier for users to see and hear content including separating foreground from background</li>
  <li>2.1 Keyboard Accessible: Make all functionality available from a keyboard</li>
  <li>2.2 Enough Time: Provide users with disabilities enough time to read and use content</li>
  <li>2.3 Seizures: Do not design content in a way that is known to cause seizures</li>
  <li>2.4 Navigable: Provide ways to help users with disabilities navigate, find content and determine where they are</li>
  <li>3.1 Readable: Make text content readable and understandable</li>
  <li>3.2 Predictable: Make Web pages appear and operate in predictable ways</li>
  <li>3.3 Input Assistance: Help users avoid and correct mistakes</li>
  <li>4.1 Compatible: Maximize compatibility with current and future user agents, including assistive technologies</li>
</ul>
<p>The draft <acronym>ATAG</acronym> 2.0 has seven principles:</p>
<ul>
  <li  style="list-style-image:none">PART A: Make the authoring tool user interface accessible
    <ul style="list-style-image:none">
      <li>A.1: Authoring tool must facilitate access by assistive technologies</li>
      <li>A.2: Authoring tool user interface must be perceivable</li>
      <li>A.3: Authoring tool user interface must be operable</li>
      <li>A.4: Authoring tool user interface must be understandable</li>
    </ul>
  </li>
  <li>PART B: Support the production of accessible content
    <ul style="list-style-image:none">
      <li>B.1: Production of accessible content must be enabled</li>
      <li>B.2: Authors must be supported in the production of accessible content</li>
      <li>B.3: Accessibility solutions must be promoted and integrated</li>
    </ul>
  </li>
</ul>
<p>The draft <acronym>UAAG</acronym> 2.0 has 5 principles:</p>
<ol>
  <li>Follow applicable specifications and conventions</li>
  <li>Facilitate access by assistive technologies</li>
  <li>Ensure that the user interface is perceivable</li>
  <li>Ensure that the user interface is operable</li>
  <li>Ensure that the user interface is understandable</li>
</ol>
<p>At the guideline or principle level, it can be seen that most of these will be required in order for an increasing number of elderly to be able to access and interact with the Web in future. The detail within these guidelines tells Web site developers, Web application developers, authoring tool and blog developers, and browser and users agent developers, how to achieve this. </p>
<h3 id="training">3.4 Training  the elderly to Use ICT and the Web</h3>
<p>Dickinson et al. (2005) [<cite><a href="#dickinson2005a">Dickinson 2005</a></cite>] suggest that the provision of training courses to overcome the lack of experience with computers and the Web of many elderly people is a necessary short-term approach to encouraging participation in the digital world. Computer and Web training can take the form of formal class-based training, but also informal training by friends and family who act as “coaches”. While many community groups and local libraries provide computer and Web training for their elderly citizens , such as SeniorNett   in Norway ([<cite><a href="#bjorneby1999">Bjørneby 1999</a></cite>]; [<cite><a href="#reogneflaten2004">Rogneflåten 2004</a></cite>]) there were few studies that reported on this widespread activity. The studies identified around this topic generally related to formal training situations established for research purposes (e.g. UTOPIA [<cite><a href="#dickinson2002a">Dickinson 2002</a></cite>]), and provide insights to the problems experienced by the elderly online. </p>
<p>Kantner and Rosenbaum (2003) [<a href="#kantner2003"><cite>Kantner 2003</cite></a>] undertook a study with a small group of people who had undertaken the role of “coach” to the elderly in Michigan in the USA to identify some of the problems elderly computer users encounter, and some of the solutions. They interviewed seven people who coached elderly people (65 years or older) to use computers and the Web and asked them about the top two problems they had observed, and about their training strategy. Ten common problems were observed by at least 4 of the coaches (<a href="#table5">Table 5</a>) and a variety of solutions identified. Some of these problems can be attributed to functional limitations associated with ageing while others (e.g. files/folders, operating systems, and typing) are more a result of lack of familiarity with ICT.</p>
<table border="1" cellspacing="0" cellpadding="0" id="table5">
  <caption >
  <strong>Table 5: Problems identified by people coaching seniors</strong>
  </caption>
  <tr>
    <th valign="top"><p align="left">Problem</p></th>
    <th valign="top"><p align="left">Solutions</p></th>
  </tr>
  <tr>
    <td valign="top"><p>Dexterity, including: <br />
        Not anchoring    the mouse or holding it straight; Moving the mouse during clicking; Tremor or fine motor control during    fly-out/drop-down menu use</p></td>
    <td valign="top"><p>Demonstrate required action; send to    special “mousing class”; suggest trying various mice; checking desk height;    Teach alternative keystroke options (Alt keys, Enter, arrows); using two    hands for the mouse</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Fear of making a mistake -         Losing data or    ‘breaking something’</p></td>
    <td valign="top"><p>Reassurance</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Working with files/folders</p></td>
    <td valign="top"><p>Using the analogy of a filing cabinet;    saving to the desktop</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Specifying searches       (though    understanding the results was only identified as a problem by one    participant)</p></td>
    <td valign="top"><p>‘work-in-pair’ activities</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Too much information, including: <br />
        What is/isn't    an advertisement;           Prevalence of ‘pop-up’ ads;           Clutter of portal pages</p></td>
    <td valign="top"><p>Switching the start page to Google;    training in advertisement recognition; training in clicking the “X” to close    pop-up windows</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Using different computers and operating    systems - this became a    problem with senior-centre classes when the attendees returned home to    practice, and sometimes when telephone coaching as provided to family and    friends.</p></td>
    <td valign="top"><p>No solution was evident for this problem,    however it was observed that it became an impediment to system upgrades, and    also posed a problem when Web sites were upgraded</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Vision</p></td>
    <td valign="top"><p>Coaches were able to change the default    font size in Word, but didn't know what to do for browsers or at the    operating system level. <br />
        One coach changed the resolution to 800x600 as a solution and installed glare    filters.</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Working with attachments and downloading (
        Email    attachments may be important documents)</p></td>
    <td valign="top"><p>Generally the users did not download    programs or files from the Web.</p></td>
  </tr>
  <tr>
    <td valign="top"><p>Typing</p></td>
    <td valign="top"><p>Practice was the only solution, and    preparing ahead of going to the computer for some activities.</p></td>
  </tr>
</table>
<p>When asked about suggestions for making the Internet easier for seniors to use, the suggestions included:</p>
<ul>
  <li>Simpler pages; fewer [browser?] buttons</li>
  <li>Clearer Back/Forward option, including having the Back button in a new window closing it and returning the user to the window and page where it was linked from</li>
  <li>Search to display result in associated grouping (like e-commerce sites)</li>
  <li>Fewer pop-ups </li>
</ul>
<p>With respect to the accessibility settings available, three coaches had not thought of it, one did not have the authority, and three had adjusted the mouse settings.</p>
<p>Kantner and Rosenbaum recommended that success stories from coaches need to be collected and published so that others can learn from their experiences.</p>
<p>The experience of the University of Dundee [<a href="#dickinson2005a"><cite>Dickinson 2005</cite></a>] reflected many of the experiences of the Michigan coaches reported earlier by Kantner and Rosenbaum, including a lack of knowledge and confidence, and confusion about searching. The UTOPIA team at the University of Dundee in Scotland was approached to teach a class of older adults to use computers and the Web. Of the twelve initial participants (five were 55-65 years; five were 65-74 years; two were over 75 years), one had hearing loss, one had impaired fine motor control as a result of stroke, one was dyslexic and ten of them required reading glasses. As experienced computer users themselves, the researchers conducting the classes had to recognise that their own knowledge was a potential problem.</p>
<p>To reduce the software complexity, the interfaces to Word, Outlook Express and Internet Explorer (IE) were simplified (e.g. Figure 4). Even with the reduced IE interface, users became confused when trying to search and often used the address bar instead of the search engine input box. The learners were also surprised when search results loaded a PDF document, and often missed the PDF icon often associated with these files. Drop-down lists allowing for search refinement often confused the participant too.</p>
<p><strong>Figure 4: The simplified IE interface used at the University of Dundee</strong></p>
<p><img src="dickinson05.png" alt="Figure 4 shows the simplified Internet Explorere browser interface used at the University of Dundee" width="474" height="104" /></p>
<p>Dickinson et al. endorsed WAI’s guidelines in contributing to the accessibility of Web sites to elderly users, but suggested that that browser changes could also make significant differences to older learners' experience. Compared with the simplified IE interface they worked with, (Figure 4) they emphasised the value of the Home button, and questioned the value of the ‘forward arrow’ and the address bar. The experience at the University of Dundee also emphasised the importance of written combined with hand-on support for older learners.</p>
<p>Hawthorn (2005) [<cite><a href="#hawthorn2005a">Hawthorn 2005</a></cite>] also stresses the importance of simplifying the interface for older users new to computers and the Web. Hawthorn worked with a group of 25 older users (average age 70 years) to teach them file management skills using a modification of the UTOPIA methodology [<a href="#eisma2004"><cite>Eisma  2004</cite></a>]. Part of simplifying the interface to the learning environment included large fonts, high contrast, and simple sentence structure. Hawthorn found that building a conceptual framework was possible, but that many of the participants required time and active hands-on exercises.</p>
<p>In another UK study of an Internet training project called Care Online, Osman et al (2005) [<a href="#osman2005"><cite>Osman 2005</cite></a>] report that, while most of the volunteers had no intention of connecting to the Internet before the project, the majority intended to stay connected afterwards. The project included a portal  with large buttons, associated graphics and exceeding the accessibility requirements of <acronym>WCAG</acronym> 1.0 &quot;single-a' accessibility. Like Hawthorn, Osman et al. found that appropriate training and support was a key to elderly adults Web usage.</p>
<div class="comment">
  <p >Author's note:-</p>
  <p><em>Papers still to discuss:</em></p>
  <ul>
    <li><em>Campbell and Wabby (2003) <a href="#cw2003">[<cite>Campbell 2003</cite>]</a> – the Elderly and the Internet: a case study (in training to access health information)</em></li>
    <li><em>Elliot, P. (1992). [<a href="#elliot1992"><cite>Elliot 1992</cite></a>] Assistive Technology for the Frail Elderly: An Introduction and Overview, U.S. Department of Health and Human Services.
      available at http://aspe.hhs.gov/daltcp/reports/asttech.pdf
      “…assistive technology has not been fully successful in the geriatric marketplace… Experts attribute this to four factors: (a) inadequate training and orientation for the elderly consumer; (b) inappropriate match of assistive device to the person's need; (c) unwieldy designs; and (d) failure to realize that assistive technology involves more than just giving a person a device.” </em></li>
  </ul>
  <p class="os">end of note</p>
</div>
<h3 id="elderlyusers">3.5 Studies of elderly Web users’ specific disabilities</h3>
<p class="question"><em>General ageing studies … to be discussed here or later in Section 3.8?</em></p>
<h4 id="elderlyusersmobility">3.5.1 Mobility</h4>
<p>In addition to the studies on the general issues of ageing, some studies focussed on the particular issues of mobility and dexterity with input devices, specifically mouse use. No studies were identified which investigated issues of keyboard use, although casual observation of the authors own elderly family members indicates that this can be an impediment to ICT usage.</p>
<p>Three studies have been considered here dealing with Parkinson’s Disease, general ageing and pointing devices, and a possible solution provided via expanding targets. </p>
<p>Keates and Trewin (2005) [<a href="#keates2005"><cite>Keates 2005</cite></a>] investigated  one of the common motor skill diminishments associated with ageing – Parkinson’s Disease. In a previous study Trewin and Pain (1999) [<a href="#trewin1999"><cite>Trewin 1999</cite></a>] found that people with motor disabilities had error rates of greater than 10% when trying to point and click with a mouse on small targets. The 2005 investigation included young adults, adults, older adults (average age 79 years) and adults with Parkinson’s Disease (average age 57 years); most of the participants were experienced mouse users.</p>
<p>Keates and Trewin found that seniors take longer to complete tasks, and pause frequently, while initiating movement can be difficult for people with Parkinson’s disease. Parkinson’s Disease users were also observed to make slight mouse movements while trying to press the button. Both of these groups behaved differently from the behaviours predicted by the theoretical models developed for able-bodied users. Pointing issues reported from this study and another study (Paradise, Trewin and Keates, 2005) [<a href="#paradise2005"><cite>Paradise 2005</cite></a>] included:</p>
<ul>
  <li>Keeping the hand steady when navigating</li>
  <li>Slipping off [multi-level] menus</li>
  <li>Losing the cursor</li>
  <li>Moving in the desired direction</li>
  <li>Running out of room on the mouse mat</li>
  <li>The mouse ball getting stuck</li>
</ul>
<p>Some of these issues are related specifically to using the Web (e.g. menu use) while others are more broadly disability-related (e.g. hand steadiness and losing the cursor) or very broad ICT usability issues.</p>
<p>Jastrzembski et al (2005) [<a href="#jastrzembski2005"><cite>Jastrzembski 2005</cite></a>] undertook a study on input devices  and age/hand effects. Their participants were experienced mouse users and they were investigating whether age had any impact on mouse use and whether a light pen may be a better input device for older users. Of their 72 participants, they had 24 young adults (median age 21.7 years), 25 middle aged adults (median age 49.9 years) and 24 older adults (median age 70.9 years). The study involved both clicking, and data entry, to simulate practical Web use.</p>
<p>While previous studies apparently showed preferences for direct pointing devices such as a light pen, supporting the observation that older adults experience declines in spatial abilities and in motor control and coordination, Jastrzembski et al showed that tasks requiring a combination of keyboard entry and pointer were best completed with a mouse unless the user was required to change from their preferred hand.
  Jastrzembski et al did suggest that adjusting the mouse acceleration could be a tactic for improving ‘target acquisition’ among older novice users. Jastrzembski et al did not comment on target size.</p>
<p>The third study reviewed, by Bohan and Scarlett (2003) [<a href="#bohan2003"><cite>Bohan 2003</cite></a>],  considered the accommodation of older adults difficulties with mouse use via expanding targets as the cursor approaches. Participants in this study were young adults (median age 20 years) or elderly (median age 81 years), and all reported to be daily computer users. Bohan's and Scarlet’s older adults took significantly longer to acquire the ‘target’ than the younger adults, regardless of target expansion, although early target expansion was found to significantly help the older users almost as much as a stationary larger target.</p>
<p>The first two studies highlighted mouse use issues faced by older ICT users, while the final study suggested a possible Web site technique for overcoming some of these. </p>
<h4 id="elderlyusersvision">3.5.2 Vision</h4>
<p>Parker and Scharff (1998) [<a href="#parker1998"><cite>Parker 1998</cite></a>] in a study of contrast sensitivity and age on readability, found that older adults (over 45 years) performed better with high contrast and positive polarity. In particular, they found that “white text presented on a black background (high-contrast, positive polarity) slows reaction times compared with black text on a white background (high-contrast, negative polarity). At the other [lower] contrast levels, polarity makes no significant difference.” They also reported that the effect of polarity was significant for the older age group but not for the younger (18 – 25 years) group.</p>
<p class="question"><em>Editor's Question: Are there some other studies to precede or support this next one of Bernard, Liao and Mills? </em></p>
<p>Bernard, Liao and Mills (2001) [<a href="#bernard2001"><cite>Bernard 2001</cite></a>] looked at what might be the best font for older adults online bearing in mind the many age-related factors affecting reading. They looked at legibility, reading time and general preference of two types of serif and sans serif fonts at 12 and 14 point sizes. Two-thirds of the 27 participants (mean age 70 years) regularly read material on computer screens, and all had at least 20/40 vision  unaided or corrected. Bernard, Liao and Mills found that size was the major factor in legibility as measured by reading efficiency, while a marginal type/size interaction was found for reading speed slightly favouring the sans serif fonts. When just asked about their perception of legibility, the participants indicated that size was the major factor, and overall they had a preference for the san serif fonts. </p>
<p>Bernard, Liao and Mills concluded, not surprisingly, that larger san serif fonts gave the best online reading results for older adults. </p>
<p>Tiresias has some general recommendations with regard to the use of font styles [<cite><a href="#tiresias">Tiresias</a></cite>], reflecting many of the guidelines discussed earlier:</p>
<ul>
  <li>Text in upper and lower case is easier to read than all capital letters</li>
  <li>Underlining makes the text harder to read by interfering with descenders</li>
  <li>Italics are more difficult and slower to read so minimise their usage</li>
  <li>Left justified (<span class="comment">English etc</span>) text is easier to read. </li>
</ul>
<h4 id="elderlyuserscog">3.5.3 Cognition</h4>
<p>There have been many practical and theoretical studies of cognition and Web user interfaces, e.g. Bernard, Hamblin and Scofield (2002) [<a href="#bernard2002"><cite>Bernard 2002</cite></a>], Czerwinski and Larson (2002) [<a href="#czerwinski2002"><cite>Czerwinski 2002</cite></a>] and Sevilla et al (2007) [<a href="#sevilla2007"><cite>Sevilla 2007</cite></a>]. Some researchers have looked specifically at cognition issues as they relate to the elderly, e.g. Savitch and Zaphiris (2006) [<a href="#savitch2006"><cite>Savitch 2006</cite></a>], Caserta and Abrams (2007) [<cite><a href="#ca2007">Caserta &amp; Abrams 2007</a></cite>], <em class="comment">XXXX</em>. Some of these studies deal with general cognition issues for the elderly, while others look at specific situations such as dementia.</p>
<p>Czerwinski and Larson (2002) [<a href="#czerwinski2002"><cite>Czerwinski 2002</cite></a>] discuss some basic principles from cognitive science that should be applied to Web site design, in particular how grouping and symmetry can be applied to leverage visual perception and attention, and the use of spatial layout to leverage human spatial memory. This later principle supports Jacob Nielsen’s suggestions that “users prefer your site to work the same way as all the other sites they already know” [<a href="#nielsen2000"><cite>Nielsen 2000</cite></a>].</p>
<p>Czerwinski and Larson also raise an interesting phenomenon of cognition and the Web that applies to many users, but may apply particularly to elderly users, and is particularly relevant with the move to scripted partial page updates. The phenomenon is “change blindness”, where small changes on a page are not noticed by the user. This ‘blindness’ may be due to distraction, or may be related to concentration and perception. For some users it may actually not even be within the current view, depending on the size of the current browser window and how much of the page is actually displayed. Hudson (2001) [<a href="#savitch2006"><cite>Hudson 2001</cite></a>] suggests that form validation is a particular problem area.</p>
<p>In more elderly-targeted studies, Savitch and Zaphiris (2006) [<a href="#savitch2006"><cite>Savitch 2006</cite></a>] were looking at information architecture issues for people suffering from dementia. They found, in a study involving 10 participants with dementia, that some of them found it difficult to group topics, leading to questions about flat vs. deep navigation systems and the usability of hierarchical navigation systems by this group. While Savitch and Zaphiris suggest that it might be tempting to dismiss the sub-group that couldn't’t undertake the grouping exercise, they had no evidence that these people could not use a computer or would not be interested in the information on the Alzheimer’s Society Web site as they were very happy to discuss the topics being presented. Savitch and Zaphiris suggest more research is needed around site architecture and navigation system requirements for dementia sufferers.</p>
<p>Berkov (2007) [<a href="#berkov2007"><cite>Berkov 2007</cite></a>] in a small study of Web users with Mild Cognitive Impairment (average age 82 years) who were regular computer users, found that having too many choices on the home page (i.e. a broad navigation system) was confusing for this group.</p>
<p>A study in Spain by Sevilla et al. (2007) [<a href="#sevilla2007"><cite>Sevilla 2007</cite></a>] of twenty participants with varying degrees of “intellectual difficulties” ranging in age from 24 to 36 years found that simplified content was a good model. This approach may also assist elderly users suffering from some of the possible effects of stroke such as short-term memory problems and “difficulty in learning new information and problems in conceptualising and generalising” [<cite><a href="#brain2003">Brain Foundation 2003</a></cite>]. They present automatic content transformation as a challenge to be solved by the Semantic Web community along with language transformation research.</p>
<p>Gregor and Dickinson (2007) [<cite><a href="#gregor2007">Gregor 2007</a></cite>] looked at simplified interfaces as a solution to some forms of cognitive impairment, criticising some Web designs for providing ‘idiosyncratic means of navigation’ and duplicating the functionality of the browser as sources of confusion for some users. They also acknowledged the conflict between on-screen complexity, which can reduce comprehension, and deep interface structure, which places a burden on memory. In a study with novice older Web users, the authors were involved in the development of the “non-browser” in which the browser itself was stripped away to allow the content to fully occupy the screen, and a very reduced set of controls was presented on the bottom of the screen as five buttons (Figure 5) - ideally on a touch screen – such as “go back to start, “go back a page”, “look down”, “make black and white”, and “magnify”.</p>
<p><strong>Figure 5: showing the simplified interface from the &quot;non-browser&quot;</strong></p>
<p><img src="nonbrowser.png" alt="Figure 5 shows the 'navigation' panel of the non-browser" width="332" height="63" /></p>
<p>Initial studies of eye-movement with older users working with the “non-browser” facilitated users’ ability to access the content. This approach is similar to the approach taken by IBM in the development of “Easy Web Browsing” (Figure 6) [<a href="#takizawa2008"><cite>Takizawa 2008</cite></a>], but simpler and more drastic visually.</p>
<p><strong>Figure 6: IBM's Easy Web Browsing</strong> (CSUN, 2008)</p>
<p><img src="ewb.png" alt="Figure 6 showing the navigation bar from IBM's easy web browsing with a very much simplified interface to the Internet Exlorer browser" width="327" height="73" longdesc="http://www-06.ibm.com/jp/accessibility/raku2web/jp/start_en.html" /></p>
<h4 id="elderlyusersother">3.5.4 Other aspects</h4>
<h5>Tolerance</h5>
<p> Selvidge (2003) [<a href="#selvidge2003"><cite>Selvidge 2003</cite></a>] in a study on tolerance for delays found that older adults (mean age 70.65 years) were more tolerant of delays than younger adults (mean age 20.13 years) in that they waited longer before leaving a site and switched sites less often. Selvidge also observed that the level of Internet experience did not affect tolerance. </p>
<p>Coyne and Nielsen (2002) [<cite><a href="#cn2002">Coyne &amp; Nielsen 2002</a></cite>] also found that older users were more forgiving of negative experiences than their younger counterparts. </p>
<h3 id="design">3.6 Aspects of Web Design affecting the elderly</h3>
<p>A study by Johnson and Kent [<a href="#johnson2007"><cite>Johnson 2007</cite></a>] with both younger users (18 – 59 years) and older users (over 60 years) found that designs specifically for the elderly group improved task performance for that group while not detracting from task performance for the younger group. Some of the design aspects targeting the older group were large text size, clearer link text, plain neutral background, input by selection rather than free text, and detailed instructions.</p>
<p>Hawthorn (2003) [<a href="#hawthorn2003"><cite>Hawthorn 2003</cite></a>], examining the issues that arose during the design of an email system for older users, found that most new older ICT users wanted to “keep it simple so we can learn it”. This is in conflict with the techniques used by most designers to support a modern feature rich application, and may also limit the power of an application to serve the requirements of more able and more demanding users. Hawthorn also observes that with the declines in memory, cognition, eyesight and dexterity faced by many ageing people, the ability to adapt to new, more demanding applications is reduced. This observation is probably applicable to the ability of some elderly users to adapt to upgraded browsers and newer Web 2.0 style dynamic online applications. </p>
<h4 id="designforms">3.6.1 Forms</h4>
<p>Forms are part of our world, and now the Web, and a necessary requirement for e-Commerce, e-Government e-Publishing and most online applications. Even in the paper world, forms are confusing for many users – witness voting, taxes, banking, etc.   A form that works on paper may not necessarily work online [<cite><a href="#ugforms">Usability.gov forms</a></cite>], however when implemented well, online forms should benefit users. Many people have written about form usability and accessibility (e.g. [<a href="#crescimanno2005"><cite>Crescimanno 2005</cite></a>]; [<a href="#hudson2004"><cite>Hudson 2004</cite></a>]; [<a href="#meadhra2004"><cite>Meadhra 2004</cite></a>]).</p>
<p>Lines and her colleagues from Brunel University ([<a href="#lines2004"><cite>Lines, Patel and Hones, 2004</cite></a>]; [<a href="#lines2006"><cite>Lines et al., 2006</cite></a>]; [<a href="#lines2007"><cite>Lines, Ikechi and Hones, 2007</cite></a>]) looked at a variety of welfare and services forms from the UK local government. Based on a series of interviews with older adults (over 60 years), combined with evaluation of some prototypes, they derived an initial set of seven guidelines, and with a follow-up study, they extended this with six additional requirements. Lines initial requirements were:</p>
<ul>
  <li>Form layout – extra space between questions and answer boxes (not confirmed in the second study)</li>
  <li>Simplified question structure – to avoid creating ‘excessive’ cognitive loads</li>
  <li>Question completion assistance – pop-up messages and/or hyperlinked context sensitive help with each appropriate questions</li>
  <li>Additional information – including a list at the top of what information will be required to complete the form</li>
  <li>Data entry – automatic checking and validation during completion</li>
  <li>Form personalisation – presenting only those questions appropriate to the users, e.g. a widow should not be asked for information about her spouse</li>
  <li>Form submission – online submission will be easy for many mobility impaired elderly people, and may lead to quicker processing time</li>
</ul>
<p>Lines second study, with additional forms, led to the following additional requirements: </p>
<ul>
  <li>Bullet point instructions – easier to read than paragraph text</li>
  <li>Logical information groupings – to ensure that the user does not need to go back-and-forth within a form</li>
  <li>Justification for personal/sensitive questions – the participants resented providing some information for no apparent good reason</li>
  <li>Security information – how could the users be sure their data would remain confidential?</li>
  <li>Help and assistance feature – this second study suggested a ‘formal’ help page in addition to the pop-up and/or hyperlinks suggested previously</li>
  <li>Save and return – an advantage of paper-based forms is that you can put them down and finish completing them later; this was requested by users for online forms</li>
</ul>
<p>As can be seen, these requirements mirror many of the requirements for usable online forms identified by many others, but confirm them as necessary for the older person online. </p>
<p>Sayago and Blat (2007) [<cite><a href="http://usability.com.au/resources/forms.cfm">Sayago 2007</a></cite>] considered two aspects of form design and their impact on elderly users (65-74 years), namely distinguishing between optional and compulsory fields, and the usability of checkboxes, radio-buttons and list-boxes.</p>
<p>While designing a site for a pensioners association in Spain, they found that members had difficulty distinguishing between optional and compulsory fields when the conventional asterisk was used as this was largely invisible to them. In a trial with the conventional asterisk and a form that clearly separated required fields from optional fields, all the participants expressed strong preferences for the “divided online form”.</p>
<p>Sayago's and Blat's second evaluation was between checkboxes and radio-buttons vs. list-boxes; they hypothesised that list-boxes might be harder to use due to the number of clicks required. Independently of any previous computer experience, all the participants had difficulty with the list-boxes. The checkbox/radio-button form allowed for a direct selection from the choices, and had larger targets (it used accessible form mark-up) than the list-boxes form with its small down arrow that needs to be clicked to see the available options. </p>
<h4 id="designsearch">3.6.2 Search</h4>
<p>Search has been reported as a key usability feature for many elderly users, but what are the issues for elderly users? Aula (2005) [<a href="#aula2005a"><cite>Aula 2005a</cite></a>] reported on a study of elderly users (mean age 67.3 years) in Finland with varied computer experience using search engines. Some of the problems observed were:</p>
<ul>
  <li>Links to non-HTML pages trying to open other applications</li>
  <li>Ensuring the focus is in the input box before typing the query – many participants moved the mouse over the input field, but did not click to apply the focus</li>
  <li>Returning to the search results page, even though in theory they knew about the browser’s ‘back’ button</li>
  <li>Difficultly with scrolling and mouse usage – especially when clicking the mouse wheel</li>
</ul>
<p>In a follow up study Aula and K&auml;ki (2005) [<a href="#aula2005b"><cite>Aula 2005b</cite></a>] had participants use a simplified version of a Finnish search engine, <a href="http://ktmatu.com/etsin/">Etsin</a>, in addition to <a href="http://www.google.com">Google</a>. Etsin searches were more successful than Google searches. Aula and K&auml;ki concluded that new elderly Web users benefit from simplified interfaces, especially while learning.
  Dinet et al. (2007) [<cite><a href="#dinet2007">Dinnet 2007</a></cite>] found that locating relevant information among the search results from search engines was a major problem for elderly users. </p>
<h4 id="designnav">3.6.3 Navigation</h4>
<p>Meyer et al. (1997) [<cite><a href="#meyer1997">Meyer 1997</a></cite>] in a Web navigation study of both older and younger adults relatively new to the Web, found that the older users used the site map more than younger users and that the older users preferred to start from the home page when looking for information.</p>
<p>More recently Chevalier et al. (2007) [<cite><a href="#chevalier2007">Chevalier 2007</a></cite>] investigated the navigation speed, success and satisfaction compared between 20 older (mean age 64 years) and 20 younger (mean age 31 years) experienced Web users on two versions (ergonomic &amp; non-ergonomic) of an e-shop selling music products. The older users took more time than the younger users to perform tasks on the ergonomic site, but a similar length of time on the non-ergonomic site; both groups performed more quickly on the ergonomic site and were more satisfied with it. Chevalier et al. conclude that more research is needed on the specific needs of older users navigating and searching the Web.</p>
<p> Hudson et al. (2008) [<cite><a href="#hudson2008">Hudson 2008</a></cite>] conducted two studies of young (mean age 20 &amp; 23 years) and older (mean age 61 &amp; 63 years) users use of Web site navigation tools. They found that “Contrary to the assertion that older adults are more prone to disorientation in the WWW, there was no age effect on total pages or repeat pages visited. As well, older adults’ navigation benefited from the inclusion of the dynamic side-tree [expanding <acronym title="left hand side">LHS</acronym> menu] as much as younger adults and they used it in search at least as much as the young.” Hudson et al. did find that the older users took more time to find the information they were seeking. They conclude that cognitive factors, including working memory and processing speed, affect Web navigation performance and that more research is needed as to the optimum ways in which to reduce this. As there is a potential trade-off between increased navigation assistance and page clutter, Hudson et al. also recommend investigating users satisfaction levels and perceived disorientation.</p>
<h4 id="designeservices">3.6.4 e-Services   – Learning, Health, Government, Banking</h4>
<p>The Australian Government published a report in late 2007 [<a href="#bowman2007"><cite>Bowman 2007</cite></a>] that investigated e-Learning for the mature age worker (over 45 years). Interestingly, this report drew heavily on research in the United Kingdom and references activities in Finland, Germany, Greece, Ireland the Netherlands and Sweden. Bowman and Kearns did not consider the difficulties that might be faced as a result of functional limitation experienced by older adults. However, one of the biggest barriers they identified during their study was a lack of ICT skills. This lack of skills this was also found by Taylor and Rose (2005) [<a href="#taylor2005"><cite>Taylor 2005</cite></a>], although they found that older learners were very self motivated and e-Learning can be a powerful tool to provide flexible strategies to address the needs and preferences of older people.</p>
<div class="comment">
  <p><em>Author' note:</em></p>
  <p><em>Need to follow up on the “e-Learning in Later Life” project (<a href="http://www.elill.net">www.elill.net</a>)  and the University of Ulm's 2007 “web4seniors” conference.</em></p>
  <p class="os">end of note</p>
</div>
<p>Australia in 2000 conducted an enquiry into the accessibility of electronic commerce for older people and people with a disability [<a href="#hreoc2000"><cite>HREOC 2000</cite></a>]. Scott, Burmeister and Roberts (2002) [<a href="#scott2002"><cite>Scott 2002</cite></a>] reported on the ensuing initiatives to make Internet banking more accessible for older people in Australia and found an ongoing need for social responsiveness and responsibility toward senior citizens. In reporting on some of the values expressed by seniors they identify independence, security and freedom of choice as some of the reasons for engaging in e-banking activities but that a lack of skills and training combined with Web site inaccessibility were still key barriers. They recommended that the education programs run by senior’s computer clubs, University of the Third Age (<acronym>U3A</acronym>), and others could be extended to include e-finance.</p>
<div class="comment">
  <p><em>Author's note:</em></p>
  <p><em>Other papers to discuss:</em></p>
  <ul>
    <li><em><a href="#ridout2005">Rideout et al (2005)</a> – e-Health and the Elderly</em></li>
    <li><em><a href="#elatar2005">El-Attar, Gray, Nair, Ownby, Czaja (2005)</a> - Older Adults and Internet Health Information Seeking</em></li>
    <li><em><a href="#bush2004">Bush et al (2004)</a> – What do we mean by Internet access? A framework for health researchers </em></li>
  </ul>
  <p class="os">end of note</p>
</div>
<h3 id="involve">3.7 Involving the elderly in Web design and development</h3>
<p>Many authors looked at the involvement of the elderly in Web site design and development. These studies all provide some insights into the various ways of drawing upon older people during design and development.</p>
<h4 id="involveusability">3.7.1 Usability sessions with elderly participants</h4>
<p>Redish and Chisnell (2004) [<a href="#redish2004"><cite>Redish 2004</cite></a>] and Chisnell, Lee and Redish  [<a href="#chisnelllr"><cite>Chisnell LR</cite></a>] from their studies for the AARP give some advice for recruiting and working with older adults. In terms of scheduling user sessions with this group they observed that they typically arrive early, often bring their spouses, are better able to give attention earlier in the day, and like to avoid rush hour. During the usability study sessions they advise:</p>
<ul>
  <li>Making the participants comfortable – making it extra clear up-front what to expect, being extra patient, teaching them something at the end are a few recommendations</li>
  <li>Keeping them on track – many older participants had a lot of stories to tell; keeping focussed requires patience and tact</li>
  <li>Listen for their beliefs about computers and the Web – this is part of their reality and needs to be accounted for in Web site design</li>
  <li>Avoid computer jargon – and take note of the areas, and terms used, on sites that confuse</li>
  <li>Give them time – plan for this as older adults can take up to 25% longer to complete tasks than younger people</li>
  <li>Thinking aloud – when the task becomes complicated, participants may stop talking; sometimes you need to allow for this and go back later to reflect rather than interrupt the silence</li>
  <li>Don’t lead – no matter how tempting it is to help!</li>
  <li>Teach something at the end – for example changing the text size or some keyboard shortcuts</li>
</ul>
<p>Newell et al. (2007) [<cite><a href="#newell2007">Newell 2007</a></cite>] recommend doing away with the traditional usability laboratory and interacting more with the participants, even if it is necessary to record this (e.g. completed x tasks “with no / minimal / significant assistance”). Newell et al. also investigate the use of theatre professionals in which they encouraged interaction between the participants and the actors to elicit discussion about the issues addressed by the presentation. </p>
<h4 id="involvedesign">3.7.2 Design with the elderly</h4>
<p>Gregor, Newell and Zajicek (2002) [<cite><a href="#gregor2002a">Gregor 2002</a></cite>] have suggested that the typical User Centred Design (UCD) process needs to be modified when working with older people due to the greater diversity within the elderly as compared with younger age groups. Gregor, Newell and Zajicek recommend the need for an enhanced UCD methodology, which they refer to as “User Sensitive Inclusive Design”, to address the issues of:</p>
<ul>
  <li>Much greater variety of user characteristics and functionality</li>
  <li>Finding and recruiting &quot;representative users&quot;</li>
  <li>Conflicts of interest between user groups (including &quot;temporarily able-bodied&quot;) </li>
  <li>The need to specify exactly the characteristics and functionality of the user group</li>
  <li>Tailored, personalisable and adaptive interfaces</li>
  <li>Provision for accessibility using additional components (hardware and software)</li>
</ul>
<div class="comment">
  <p >Author's note:-</p>
  <p><em>Other relevant studies still to be discussed:</em></p>
  <ul>
    <li><em><a href="#cn2002">Coyne and Nielsen (2002)</a> …</em></li>
    <li><em><a href="#newell2002">Newell and Gregor (2002)</a> </em></li>
    <li><em><a href="#eisma2004">Eisma et al (2004)</a></em></li>
    <li><em><a href="#goodman2006">Goodman, Clarkson and Langdon (2006)</a></em></li>
    <li><em><a href="#dewsbury2006">Dewsbury et al (2006</a>)</em></li>
    <li><em><a href="#keates2007">Keates, Adams etc (2007)</a> … </em></li>
  </ul>
  <p class="os">end of note</p>
</div>
<h3 id="genusability">3.8 General usability studies involving elderly people</h3>
<p class="comment"><em>Note - Section 3.8 is still to be completed ...</em></p>
<h2 id="influence">4. Studies that influence WAI work</h2>
<p class="comment"><em>Note - Section 4 is still to be completed ...</em></p>
<h2 id="furtherresearch">5. Questions/Topics for further research</h2>
<div class="question">
  <p>Possible ideas:</p>
  <ol>
    <li>Collecting the experience and solutions used by seniors’       training centres and coaches</li>
    <li>Research on the effect of ageing/impairment/disability on cognitive load</li>
    <li>Older users use of navigation mechanisms</li>
  </ol>
</div>
<h2 id="conclusion">6. Conclusions/Recommendations</h2>
<div class="comment">
  <p >Author's note:-</p>
  <p ><em>Discuss what has been drawn from reviewing literature. Where might this discussion proceed?</em></p>
  <p class="os">end of note</p>
</div>
<h2>&nbsp;</h2>
<h2 id="refs"> References</h2>
<dl>
  <dt id="aarp2004">AARP 2004</dt>
  <dd>AARP (2005). <strong>Designing Web Sites for Older Adults: Heuristics</strong>. <br />
    Available at <a href="http://www.aarp.org/olderwiserwired/oww-resources/designing_web_sites_for_older_adults_heuristics.html">www.aarp.org/olderwiserwired/oww-resources/designing_web_sites_for_older_adults_heuristics.html</a> </dd>
  <dt id="abs2007">ABS 2007</dt>
  <dd>Australian Bureau of Statistics (2007). <strong><em>Patterns of Internet access in Australia, 2006</em></strong>, Cat No, 8146.0.55.001 <br />
    (Available via <a href="http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/8146.0.55.0012006?OpenDocument">http://tinyurl.com/yw23wp</a> ; PDF of report is at <a href="http://www.abs.gov.au/AUSSTATS/free.nsf/log?openagent&amp;8146055001_2006.pdf&amp;8146.0.55.001&amp;Publication&amp;1B7DD59C9E8F52ECCA2573A1007EE8DA&amp;0&amp;2006&amp;29.11.2007&amp;Latest">http://tinyurl.com/2gtjaj</a> )</dd>
  <dt id="adi1999">ADI 1999</dt>
  <dd>Alzheimer’s Disease International (1999). <strong>The prevalence of dementia</strong>, ADI Fact Sheet (April 1999)<br />
    Available at <a href="http://www.alz.co.uk/adi/pdf/3preval.pdf">http://www.alz.co.uk/adi/pdf/3preval.pdf</a></dd>
  <dt id="aa2006">AA 2006</dt>
  <dd>Alzheimer’s Australia (2006). <strong>Mild Cognitive Impairment (MCI)</strong>, Update Sheet No. 7. (October 2006)<br />
    Available at <a href="http://www.alzheimers.org.au/upload/US7.pdf">http://www.alzheimers.org.au/upload/US7.pdf</a></dd>
  <dt id="ae2005">AE 2005</dt>
  <dd>Alzheimer Europe (2005) <strong>The Population of People with Dementia in Europe</strong>. <br />
    Available at <a href="http://www.dementia-in-europe.eu/?lm2=OWQAUJKRXAEZ">http://www.dementia-in-europe.eu/?lm2=OWQAUJKRXAEZ</a></dd>
  <dt id="afonline">AF Online</dt>
  <dd>Alzheimer's Forum (undated). <strong>Friendly computer tips</strong>.<br />
    Available at <a href="http://www.alzheimersforum.org/site/scripts/documents_info.php?categoryID=6&amp;documentID=35">http://www.alzheimersforum.org/site/scripts/documents_info.php?categoryID=6&amp;documentID=35</a></dd>
  <dt id="asuk2003">ASUK 2003</dt>
  <dd>Alzheimer’s Society UK (2003). <strong>What is dementia?</strong> (June 2003)<br />
    Available at <a href="http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200131&amp;documentID=106">http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200131&amp;documentID=106</a></dd>
  <dt id="al2001">Agelight 2001</dt>
  <dd>AgeLight (2001). <strong>Interface Design Guidelines for Users of all Ages</strong>. Agelight LLC, September 2001<br />
    PDF available at <a href="http://www.agelight.com/webdocs/designguide.pdf">www.agelight.com/webdocs/designguide.pdf</a> </dd>
  <dt id="arthritiscare2007">Arthritis Care 2007</dt>
  <dd>Arthritis Care (2007). <strong>General information about arthritis</strong>. (13 August 2007)<br />
    Available at <a href="http://www.arthritiscare.org.uk/AboutArthritis/FAQs">http://www.arthritiscare.org.uk/AboutArthritis/FAQs</a></dd>
  <dt id="arthritisfndn2008">Arthritis Foundation 2008</dt>
  <dd>Arthritis Foundation (2008). <strong>Arthritris Prevalence: A Nation in Pain</strong>.<br />
    Pdf aailable at <a href="http://www.arthritis.org/media/newsroom/media-kits/Arthritis_Prevalence.pdf">http://www.arthritis.org/media/newsroom/media-kits/Arthritis_Prevalence.pdf</a></dd>
  <dt id="aula2005a">Aula 2005a</dt>
  <dd>Aula, A. (2005). <strong>User Study on Older Adult’s Use of the Web and Search Engines</strong>. Universal Access in the Information Society, 4(1) pp. 67-81.</dd>
  <dt id="aula2005b">Aula 2005b</dt>
  <dd>Aula, A. and Kaki, M. (2005). <strong>Less is More in Web Search Interfaces for Older Adults</strong>. FirstMonday 10(7) July 2005.<br />
    Available at <a href="http://www.uic.edu/htbin/cgiwrap/bin/ojs/index.php/fm/article/view/1254/1174">http://www.uic.edu/htbin/cgiwrap/bin/ojs/index.php/fm/article/view/1254/1174</a></dd>
  <dt id="bailey2002">Bailey 2002</dt>
  <dd>Bailey B. (2002). <strong>Age Classifications: When Considering the Age of Users, How Old is “Old”? </strong>August 2002.<br />
    Available at <a href="http://www.webusability.com/article_age_classifications_8_2002.htm">http://www.webusability.com/article_age_classifications_8_2002.htm</a></dd>
  <dt id="bailey2004">Bailey 2004</dt>
  <dd>Bailey, B. (2004). <strong>Segmenting Adult Web Users into Meaningful Age Categories</strong> . July 2004.<br />
    Powerpoint presentation available at <a href="http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/Bailey_AgeCategories4.ppt">http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/Bailey_AgeCategories4.ppt</a></dd>
  <dt id="bohan2003">Bohan 2003</dt>
  <dd>Bohen, M. and Scarlett, D. (2003). <strong>Can Expanding Targets Make Object Selection Easier for Older Adults?</strong> Usability News 5(1)<br />
    Was available at http://psychology.wichita.edu/surl/usabilitynews/51/Expanding-target.htm</dd>
  <dt id="bjorneby1999">Bjørneby 1999</dt>
  <dd>Bjørneby, S. (1999). <strong>The Seniornett Project.</strong> ERCIM News No. 27, April 1999<br />
    Available at <a href="http://www.ercim.org/publication/Ercim_News/enw37/bjorneby.html">http://www.ercim.org/publication/Ercim_News/enw37/bjorneby.html</a> </dd>
  <dt id="berkov2007">Berkov 2007</dt>
  <dd>Berkov, J.D. (2007). <strong>An Exploratory Study of the Effects of Mild Cognitive Impairment on Elderly Internet Users</strong>. A Master’s Paper for M.S. in L.S. degree at Uni North Carolina, Chapel Hill, North Carolina (July 2007). <br />
    PDF available at <a href="http://hdl.handle.net/1901/428">http://hdl.handle.net/1901/428</a> </dd>
  <dt id="bernard2001">Bernard 2001</dt>
  <dd>Bernard, M., Liao, C. and Mills, M. (2001). <strong>Determining the Best Online Font for Older Adults</strong>. Usability News, 3(1) Winter 2001.<br />
    Was available at http://psychology.wichita.edu/surl/usabilitynews/3W/fontSR.htm</dd>
  <dt id="bernard2002">Bernard 2002</dt>
  <dd>Bernard, M., Hamblin, C. and Scofield, B. (2002). <strong>Determining Cognitive Predictors of User Performance within Complex User Interfaces</strong>. Usability News 4(2).<br />
    Was available at http://psychology.wichita.edu/surl/usabilitynews/42/cognitive_factors.htm</dd>
  <dt id="bowman2007">Bowman 2007</dt>
  <dd>Bowman, K. and Kearns, P. (2007). <strong>E-Learning for the mature age worker</strong>. Australian Flexible Learning Framework, pp. 51.<br />
    PDF available at <a href="http://www.flexiblelearning.net.au/flx/webdav/site/flxsite/shared/Research%20and%20Policy%20Advice/Report_Mature_Aged_Workers.pdf">http://www.flexiblelearning.net.au/flx/webdav/site/flxsite/shared/Research%20and%20Policy%20Advice/Report_Mature_Aged_Workers.pdf</a></dd>
  <dt id="brain2003">Brain Foundation 2003</dt>
  <dd>Brain Australia (2003). <strong>What are the Effects of Stroke?</strong> Brain Foundation, 26 September 2003.<br />
    Available at <a href="http://www.brainaustralia.org.au/stroke/effects_of_stroke">http://www.brainaustralia.org.au/stroke/effects_of_stroke</a></dd>
  <dt id="bhy2005">Brennan 2005</dt>
  <dd>Brennan, Horowitz and Ya-ping (2005). <strong>Dual Sensory Loss and Its Impact on Everyday Competence</strong>. <em>Gerontologist.</em> 45:  337-346 </dd>
  <dt id="bush2004">Bush 2004</dt>
  <dd>Bush, N.E., Bowen, D.J., Wooldbridge, J., Ludwig, A., Meischke, H. and Robbins, R. (2004). <strong>What Do We Mean by Internet Access? A Framework for Health Researchers</strong>. Preventing Chronic Disease, 1(4).<br />
    Available at <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1277955">www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1277955</a> </dd>
  <dt id="cw2003">Campbell 2003</dt>
  <dd>Campbell, R.J. and Wabby, J. (2003). <strong>The Elderly and the Internet: A Case Study</strong>. The Internet Journal of Health, 3(1)<br />
    Available at <a href="http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijh/vol3n1/elderly.xml">http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijh/vol3n1/elderly.xml</a> </dd>
  <dt id="ca2007">Caserta &amp; Abrams 2007</dt>
  <dd>Caserta, R.J. and Abrams, L (2007). <strong>The relevance of situation awareness in older adults’ cognitive functioning: a review</strong>. European Review of Aging and Physical Activity, 4: 3-13</dd>
  <dt id="chevalier2007">Chevalier 2007</dt>
  <dd>Chevalier, A. Dommes, A, Martins, D and Valérian, C. (2007). <strong>Searching for Information on the Web&nbsp;: Role of Aging and Ergonomic Quality of Website</strong>. In Jacko, J. (Ed.) Human Computer Interaction Pt 1 pp. 691-700, (Springer-Verlag).</dd>
  <dt id="chisnelllr">Chisnell LR</dt>
  <dd>Chisnell, A., Lee, A. and Redish, J. (2004) <strong>Recruiting and Working With Older Participants</strong>. AARP article.<br />
    Available at <a href="http://www.aarp.org/olderwiserwired/oww-features/Articles/a2004-03-03-recruiting-participants.html">http://www.aarp.org/olderwiserwired/oww-features/Articles/a2004-03-03-recruiting-participants.html</a></dd>
  <dt id="clark2005">Clark 2005</dt>
  <dd>Clark, J. (2005). <strong>Web usability for Older People</strong>. Blog entry critiquing [<cite><a href="#kz2005">Kuniawan 2005</a></cite>].<br />
    Available at <a href="http://blog.fawny.org/2005/11/12/elder/">http://blog.fawny.org/2005/11/12/elder/</a> </dd>
  <dt id="cn2001">Coyne &amp; Nielsen 2001</dt>
  <dd>Coyne, K.P. and Nielsen, J. (2001). <strong>Beyond ALT Text: Making the Web Easy to Use for Users with Disabilities</strong>. Nielsen Norman Group, October 2001, pp. 148<br />
    Available at <a href="http://www.nngroup.com/reports/accessibility/beyond_ALT_text.pdf">http://www.nngroup.com/reports/accessibility/beyond_ALT_text.pdf</a></dd>
  <dt id="cn2002">Coyne &amp; Nielsen 2002</dt>
  <dd>Coyne, K.P. and Nielsen, J. (2002). <strong>Web Usability for Senior Citizens - design guidelines based on usability studies with people age 65 and older</strong>. Nielsen Norman Group, April 2002, pp.126.<br />
    An overview is available at http://www.useit.com/alertbox/seniors.html</dd>
  <dt id="crescimanno2005">Crescimanno 2005</dt>
  <dd>Crescimanno, B. (2005). <strong>Sensible Forms: A Form Usability Checklist</strong>. A List Apart, 19 December 2005.<br />
    Available at <a href="http://www.alistapart.com/articles/sensibleforms">http://www.alistapart.com/articles/sensibleforms</a></dd>
  <dt id="czerwinski2002">Czerwinski 2002</dt>
  <dd>Czerwinski, M. and Larson, K. (2002) <strong>Cognition and the Web: Moving from theory to design.</strong><em> Human Factors and Web Development</em>, Erlbaum: NJ, 2002; <br />
    Authors PDF draft available at <a href="http://research.microsoft.com/~marycz/hfandthewebchapter.pdf">http://research.microsoft.com/~marycz/hfandthewebchapter.pdf</a></dd>
  <dt id="dewsbury2006">Dewsbury 2006</dt>
  <dd>Dewsbury, G., Sommerville, I., Bagnall, P., Rouncefield, M. and Onditi, V. (2006). <strong>Software co-design with older people</strong>. In Clarksonm, J., Langdon, P. and Robinson, P. <em>Designing Accessible Technology</em>&nbsp; - proceedings of CWUAAT’06 [incorporating the 6th Cambridge Workshop on rehabilitation Robotics] (Springer Verlag), pp 199-208.</dd>
  <dt id="dhhs2006">DHHS 2006</dt>
  <dd>US Dept Health and Human Services (2006). <strong>Research-Based Web Design and Usability Guidelines</strong>. 2006 Edition, 292p.<br />
    Available at <a href="http://www.usability.gov/pdfs/guidelines.html">http://www.usability.gov/pdfs/guidelines.html</a><br />
    Replaced Koyani, S., Bailey, R., Nall, J., Allison, S., Mulligan,
    C., Bailey, K., and Tolson, M. (2004). Research-based Web
    design and usability guidelines, published by the National Cancer Council</dd>
  <dt id="dickinson2002a">Dickinson 2002</dt>
  <dd>Dickinson, A.,&nbsp; Eisma, R., Syme, A., and Gregor, P. (2002). <strong>UTOPIA Usable Technology for Older People: Inclusive and Appropriate</strong>. A New Research Agenda for Older Adults BCS HCI 2002, pp. 38-39<br />
    PDF available from <a href="http://www.computing.dundee.ac.uk/projects/utopia/abstract_UTOPIA.asp">www.computing.dundee.ac.uk/projects/utopia/abstract_UTOPIA.asp</a> </dd>
  <dt id="dickinson2005a">Dickinson 2005</dt>
  <dd>Dickinson, A.,&nbsp; Eisma, R., Gregor, P., Syme, A. and Milne, S. (2005). <strong>Strategies for teaching older people to use the World Wide Web</strong>. Universal Access in the Information Society, 4(1) pp. 3-15.</dd>
  <dt id="dinet2007">Dinet 2007</dt>
  <dd>Dinet, J., Brangier, E., Michel, G., Vivien, R., Battisti, S. and Doller, R. (2007). <strong>Older People as Information Seekers: Exploratory Studies about their Needs and Actions</strong>. In Stephanidis, C. (Ed.) Human Computer Interaction Pt 1 pp. 877-886, (Springer-Verlag).</dd>
  <dt id="ec2004">EC 2004</dt>
  <dd>European Commission (2004). <strong>2005-2006 Work Programme, 2.5.11 eInclusion</strong><br />
    Available at <a href="http://cordis.europa.eu/ist/workprogramme/wp0506_en/2_5_11.htm">http://cordis.europa.eu/ist/workprogramme/wp0506_en/2_5_11.htm</a></dd>
  <dt id="ec2006">EC 2006</dt>
  <dd>Ministerial Declaration, 11 June 2006, Riga, Latvia  <br />
    PDF available at <a href="http://www.eu2006.bmsg.gv.at/cms/eu2006EN/attachments/3/7/5/CH0631/CMS1142844810665/declaration_riga_en.pdf">http://www.eu2006.bmsg.gv.at/cms/eu2006EN/attachments/3/7/5/CH0631/CMS1142844810665/declaration_riga_en.pdf</a></dd>
  <dt id="ec2007a">EC 2007a</dt>
  <dd>European Commission (2007). <strong>The social situation in the European Union 2005-2006</strong>, 60p.<br />
    PDF available at
    <a href="http://ec.europa.eu/employment_social/social_situation/docs/ssr2005_2006_en.pdf">http://ec.europa.eu/employment_social/social_situation/docs/ssr2005_2006_en.pdf</a> </dd>

  <dt id="ec2007b">EC 2007b</dt>
  <dd>European Commission (2007). <strong>Europe’s demographic future: Facts and figures on challenges and opportunities</strong>, 184p. <br />
    PDF available at <a href="http://ec.europa.eu/employment_social/spsi/docs/social_situation/demo_report_2007_en.pdf">http://ec.europa.eu/employment_social/spsi/docs/social_situation/demo_report_2007_en.pdf</a></dd>
  <dt id="eisma2004">Eisma 2004</dt>
  <dd>Eisma, R., Dickinson, A., Goodman, J., Syme, A., Tiwari, L. and Newell, A. F. (2004). <strong>Early User Involvement in the Development of Information Technology-Related Products for Older People</strong>. Universal Access in the Information Society, 3(2) pp. 131-140<br />
    Draft available at <a href="http://www.dcs.gla.ac.uk/utopia/papers/uais04.html">www.dcs.gla.ac.uk/utopia/papers/uais04.html</a> </dd>
  <dt id="elatar2005">El Atar 2005</dt>
  <dd><span class="comment">El-Attar, Gray, Nair, Ownby, Czaja (2005) - Older Adults and Internet Health Information Seeking</span>.</dd>
  <dt id="elliot1992">Elliot 1992</dt>
  <dd>Elliot, P. (1992). <strong>Assistive Technology for the Frail Elderly: An Introduction and Overview</strong>, U.S. Department of Health and Human Services. <br />
    PDF available at <a href="http://aspe.hhs.gov/daltcp/reports/asttech.pdf">http://aspe.hhs.gov/daltcp/reports/asttech.pdf</a></dd>
  <dt id="etsin">Etsin</dt>
  <dd>Tukiainen, M. (undated). Etsin search.<br />
    Available at <a href="http://ktmatu.com/etsin/">http://ktmatu.com/etsin/</a></dd>
  <dt id="eurostat2005a">Eurostat 2005</dt>
  <dd>Eurostat (2005). <strong>Community survey on ICT usage in households and by individuals</strong>, 2005</dd>
  <dt id="ee2004">EveryEye 2004</dt>
  <dd>EveryEye (2004). <strong>Old age vision: age related vision impairment explained</strong>. <br />
    Available at <a href="http://www.everyeye.co.uk/htms/oldAgeVision.htm">http://www.everyeye.co.uk/htms/oldAgeVision.htm</a><br />
    (N.B. Figure 2 sourced from EveryEye is based on <br />
    Owlsley,C.J., Sekuler,R. &amp;  Siemensne,D. (1983). Contrast sensitivity through adulthood. Vision Research  23, 689-699)</dd>
  <dt id="eyedigest">Eye Digest</dt>
  <dd>University of Illinois Eye and Ear Infirmary (2007). <strong>Eye changes with aging</strong>. In The Eye Digest (17 June 2007).<br />
    Available at <a href="http://www.agingeye.net/visionbasics/theagingeye.php">http://www.agingeye.net/visionbasics/theagingeye.php</a></dd>
  <dt id="fidgeon2006">Fidgeon 2006</dt>
  <dd>Fidgeon, T. (2006). <strong>Usability for Older Web Users</strong>. WebCredible, February 2006.<br />
    Available at <a href="http://www.webcredible.co.uk/user-friendly-resources/web-usability/older-users.shtml">www.webcredible.co.uk/user-friendly-resources/web-usability/older-users.shtml</a> </dd>
  <dt id="fox2004a">Fox 2004</dt>
  <dd>Fox,  S. (2004). <strong>Older Americans and the  Internet</strong>. Pew Internet Project: March 24, 2004, presented at presentation  at “Older  Adults and the Web” event for usability.gov, July 19&amp;20, 2004</dd>
  <dt id="gregor2002a">Gregor 2002</dt>
  <dd>Gregor, P., Newall, A.F. and Zajicek, M. (2002). <strong>Designing for Dynamic Diversity – interfaces for older people</strong>. ASSETS’02 pp. 151-156</dd>
  <dt id="gregor2007">Gregor 2007</dt>
  <dd>Gregor, P. and Dickinson, A. (2007). <strong>Cognitive difficulties and access to information systems: an interaction design perspective</strong>. Universal Access in the Information Society, 5 pp. 393-400.</dd>
  <dt id="goodman2006">Goodman 2006</dt>
  <dd>Goodman, J., Clarkson, P.J. and Langdon, P. (2006) <strong>Providing Information about Older and Disabled users to Designers</strong>. Presented at “HCI, the Web and the Older Population” A full-day workshop at British HCI 2006 Queen Mary, University of London, London, UK.<br />
    PDF available at <a href="http://www-edc.eng.cam.ac.uk/~jag76/hci_workshop06/goodman_et_al.pdf">http://www-edc.eng.cam.ac.uk/~jag76/hci_workshop06/goodman_et_al.pdf</a>&nbsp;&nbsp;</dd>
  <dt id="gs2005">Goodman Sachs 2005</dt>
  <dd>O’Neill, J., Lawson, S. and Purushothaman, R. (2005). <strong><a href="http://www2.goldmansachs.com/ideas/demographic-change/60-is-the-new-55-pdf.pdf">60 Is      the New 55: How the G6 Can Mitigate the Burden of Aging</a></strong><a href="http://www2.goldmansachs.com/ideas/demographic-change/60-is-the-new-55-pdf.pdf"> (PDF, 192kb)</a>. CEO      Confidential Issue 2005-09, September 2005 <br />
    PDF available at
    http://www2.goldmansachs.com/ideas/demographic-change/60-is-the-new-55-pdf.pdf</dd>
  <dt id="hawthorn2003">Hawthorn 2003</dt>
  <dd>Hawthorn, D. (2003). <strong>How Universal is Good Design for Older Users?</strong> Proceedings of the 2003ACM Conference on Universal Usability (Canada), pp. 38-45.</dd>
  <dt id="hawthorn2005a">Hawthorn 2005</dt>
  <dd>Hawthorn, D. (2005). <strong>Training wheels for older users</strong>. ACM International Conference Proceeding Series; Vol. 122 [OZCHI '05: Proceedings of the 19th conference of the computer-human interaction special interest group (CHISIG) of Australia on Computer-human interaction] pp. 1-10</dd>
  <dt id="hearingconcern">Hearing Concern</dt>
  <dd>Hearing Concern (undated). <strong>Advice - hearing loss</strong>. <br />
    Available at <a href="http://www.hearingconcern.org.uk/advice/adv_hloss.html">http://www.hearingconcern.org.uk/advice/adv_hloss.html</a></dd>
  <dt id="hg2004">Hedden 2004</dt>
  <dd>Hedden, T., and Gabrieli, J.D.E. (2004). <strong>Insights into the ageing mind: A view from cognitive neuroscience</strong>. Nature Reviews Neuroscience, 5, 87-97.</dd>
  <dt id="henry2006">Henry 2006</dt>
  <dd>Henry, S.L., Editor (2006). <strong>Essential Components of Web Accessibility</strong>, World Wide Web Consortium.<br />
    Available at <a href="http://www.w3.org/WAI/intro/components.php">http://www.w3.org/WAI/intro/components.php</a></dd>
  <dt id="holt2000">Holt 2000</dt>
  <dd>Holt, B. (2000). <strong>Creating Senior Friendly Websites</strong>. Issue Brief 1(4) Centre for Mediacare Education.<br />
    PDF available at: <a href="http://www.medicareed.org/PublicationFiles/V1N4.pdf">www.medicareed.org/PublicationFiles/V1N4.pdf</a> </dd>
  <dt id="hreoc2000">HREOC 2000</dt>
  <dd>Human Rights and Equal Opportunity Commission (2000). <strong>Access to electronic commerce and new service and information technologies for older Australians and people with a disability</strong>. Reports assoicted with the enquiry.<br />
    Available from <a href="http://www.hreoc.gov.au/disability_rights/inquiries/ecom/ecom.html">http://www.hreoc.gov.au/disability_rights/inquiries/ecom/ecom.html</a></dd>
  <dt id="hudson2001">Hudson 2001</dt>
  <dd>Hudson, W. (2001). <strong>Designing for the Grand Illusion. </strong>SIGCHI Bulletin, Nov/Dec 2001.</dd>
  <dt id="hudson2004">Hudson 2004</dt>
  <dd>Hudson, R. (2004). <strong>Accessible forms</strong>. July 2004<br />
    Available at <a href="http://usability.com.au/resources/forms.cfm">http://usability.com.au/resources/forms.cfm</a></dd>
  <dt id="hudson2008">Hudson 2008</dt>
  <dd>Hudson, C.E., Scialfa, C.T., Diaz-Marino, R., Laberge, J. and MacKillop, S.D. (2008). <strong>Effects of Navigation Aids on Web Performance in Younger and Older Adults.</strong> <em>Gerontechnology</em> 2008: 7(1):3-21. </dd>
  <dt id="jastrzembski2005">Jastrzembski 2005</dt>
  <dd>Jastrzembski, T., Charness, N., Holley, P. and Feddon, J. (2005). <strong>Input devices for web browsing: age and hand effects</strong>. <em>Universal Access in the Information Society Journal</em>, 4(1), pp 39-45.</dd>
  <dt id="johnson1993">Johnson 1993</dt>
  <dd>Johnson, M.K., Hashtroudi, S., &amp; Lindsay, D.S. (1993). <strong>Source monitoring</strong>. Psychological Bulletin, 114, 3-28.</dd>
  <dt id="johnson2002">Johnson 2002</dt>
  <dd>Johnson, M.K., Reeder, J.A., Raye, C.L., &amp; Mitchell, K.J. (2002). <strong>Second thoughts versus second looks: An age-related deficit in selectively refreshing just-active information</strong>. Psychological Science, 13, 64-67.</dd>
  <dt id="johnson2007">Johnson 2007</dt>
  <dd>Johnson, R. and Kent, S. (2007). <strong>Designing universal access: web-applications for the elderly and disabled</strong>. Cognition, Technology and Work, 9(4) pp. 209-218.</dd>
  <dt id="kantner2003">Kantner 2003</dt>
  <dd>Kantner, L. and Rosenbaum, S. (2003). <strong>Usable Computers for the Elderly: Applying Coaching Experience</strong>. IPCC 2003 Proceedings (Annual Conf IEEE Professional Communication Society).<br />
    PDF available at: <a href="http://www.teced.com/PDFs/ipcc_2003.pdf">http://www.teced.com/PDFs/ipcc_2003.pdf</a>&nbsp;</dd>
  <dt id="keates2005">Keates 2005</dt>
  <dd>Keates, S., and Trewin, S. (2005). <strong>Effects of Age and Parkinson’s Disease on Cursor Positioning Using a Mouse</strong>. Proceedings of the 7th International ACM SIGACCESS Conference on Computers and Accessibility, pp 68-75</dd>
  <dt id="keates2007">Keates 2007</dt>
  <dd>Keates, S,. Adams, R., Bodine, C., Czaja, S., Gordon, W., Gregor, P., Hacker, E., Hanson, V., Kemp, J., Laff, M., Lewis, C., Pieper, M., Richards, J., Rose, D., Savidis, A., Schultz, G., Snayd, P., Trewin, S., and Varker, P. (2007). <strong>Cognitive and learning difficulties and how they affect access to IT systems</strong>. <em>Universal Access in the Information Society Journal</em>, 5(4), pp 329-339<br />
    PDF available at <a href="http://www.springerlink.com/content/y4h866486t6x8667/fulltext.pdf">www.springerlink.com/content/y4h866486t6x8667/fulltext.pdf</a> <br />
  </dd>

  <dt id="kz2005">Kurniawan 2005</dt>
  <dd>Kurniawan, S. and Zaphiris, P. (2005). <strong>Research-Derived Web Design Guidelines for Older People</strong>. Proceedings of 7th international ACMSIGACCESS Conference on Computers and Accessibility 20-05 (ASSETS’05), pp 129-135<br />
    PDF available at: <a href="http://personalpages.manchester.ac.uk/staff/S.Kurniawan/files/2005_assets.pdf">http://personalpages.manchester.ac.uk/staff/S.Kurniawan/files/2005_assets.pdf</a></dd>
  <dt id="lhtae">Lighthouse TAE</dt>
  <dd>Lighthouse International (undated). <strong>The Aging Eye</strong>. <br />
    Avalaible at <a href="http://www.lighthouse.org/medical/the-aging-eye/">http://www.lighthouse.org/medical/the-aging-eye/</a></dd>
  <dt id="liile">Lighthouse ILE</dt>
  <dd>Lighthouse International (undated). <strong>The Importance of Lighting for the Elderly</strong>. <br />
    Available at <a href="http://www.lighthouse.org/medical/the-importance-of-lighting-for-the-elderly/">http://www.lighthouse.org/medical/the-importance-of-lighting-for-the-elderly/</a></dd>
  <dt id="lines2004">Lines 2004</dt>
  <dd>Lines, L., Patel, Y. &amp; Hone, K.S (2004). <strong>Online Form Design: Older Adults' Access to Housing and Welfare Services</strong>. In Proceedings of HCI and the Older Population Workshop, Workshop Proceedings, 21-22. HCI 2004, 7- 11 September, Leeds UK.<br />
    PDF available at <a href="http://www.dcs.gla.ac.uk/utopia/workshop/lines.pdf">http://www.dcs.gla.ac.uk/utopia/workshop/lines.pdf</a></dd>
  <dt id="lines2006">Lines 2006</dt>
  <dd>Lines, L., Ikechi, O., Hone, K.S. and Elliman, T. (2006). <strong>Online form design for older adults: Introducing web-automated personalization</strong>. Presented at “HCI, the Web and the Older Population” A full-day workshop at British HCI 2006 Queen Mary, University of London, London, UK.<br />
    PDF available at <a href="http://www-edc.eng.cam.ac.uk/~jag76/hci_workshop06/lines_et_al.pdf">http://www-edc.eng.cam.ac.uk/~jag76/hci_workshop06/lines_et_al.pdf</a>&nbsp;</dd>
  <dt id="lines2007">Lines 2007</dt>
  <dd>Lines, L., Ikechi, O., and Hone, K.S. (2007). <strong>Accessing e-Government Services: Design Requirements for the Older User</strong>, in Stephanides, C. (Ed.) Universal Access in Human-Computer Interaction. Applications and Services, pp 932-940<br />
    <em>4th International Conference on Universal Access in Human-Computer Interaction, UAHCI 2007 Held as Part of HCI International 2007 Beijing, China, July 22-27, 2007 Proceedings, Part III</em>.</dd>
  <dt id="malta2007">Malta 2007</dt>
  <dd>Malta, S. (2007). <strong>Love Actually! Older Adults and their Romantic Internet Relationships</strong>. Australia J. of Emerging Technologies and Society, 5(2) 2007, pp. 84-102.</dd>
  <dt id="meadhra2004">Meadhra 2004</dt>
  <dd>Meadhra, M. (2004). <strong>Enhancing form usability with instructions and validation</strong>. TechRepublic, 28 April 2004.<br />
    Available at <a href="http://articles.techrepublic.com.com/5100-10878_11-5200060.html">http://articles.techrepublic.com.com/5100-10878_11-5200060.html</a><br />
    <span class="comment">Consider http://www.wdvl.com/Authoring/Design/Basics/form1.html or http://www.informit.com/articles/article.aspx?p=29892 instead.</span></dd>
  <dt id="meyer1997">Meyer 1997</dt>
  <dd>Meyer, B., Sit, R.A., Spaulding, V.A., Mead, S.E and Walker, N. (1997). <strong>Age Group Differences in World Wide Web Navigation</strong>. CHI 97 Electronic Publications: Late-Breaking/Short Talks<br />
    Available at <a href="http://sigchi.org/chi97/proceedings/short-talk/bm.htm">http://sigchi.org/chi97/proceedings/short-talk/bm.htm</a> </dd>
  <dt id="mgb2007a">MGB 2007</dt>
  <dd>Morris, A., Goodman, J. and Brading, H. (2007). <strong>Internet use and non-use: views of older adults</strong>. Universal Access in the Information Society, 6(1) pp. 43-57.</dd>
  <dt id="mitchell2000">Mitchell 2000</dt>
  <dd>Mitchell, K.J., Johnson, M.K., Raye, C.L., Mather, M., &amp; D'Esposito, M. (2000). <strong>Aging and reflective processes of working memory: Binding and test load deficits</strong>. Psychology and Aging, 15, 527-541.</dd>
  <dt id="morrell2005">Morrell 2005</dt>
  <dd>Morrell. R.W. (2005). <strong>http://www.nihseniorhealth.gov: The process of construction and revision in the development of a model site for use by older adults</strong>. Universal Access in the Information Society, 4(1) pp. 24-38.</dd>
  <dt id="moreno2007">Moreno 2007</dt>
  <dd>Moreno, T. (2007). <strong>Respect Your Elders - Web Accessibility for Seniors</strong>. Usability Sciences article, Feb, 13th 2007.<br />
    Available at <a href="http://www.usabilitysciences.com/respect-your-elders-web-accessibility-for-seniors/">www.usabilitysciences.com/respect-your-elders-web-accessibility-for-seniors/</a> </dd>
  <dt id="newell2002">Newell 2002</dt>
  <dd>Newell, A.F. and Gregor, P. (2002). <strong>Design for older and disabled people – where do we go from here?</strong> Universal Access in the Information Society, 2(1) pp. 3-7.</dd>
  <dt id="newell2007">Newell 2007</dt>
  <dd>Newell, A.F., Arnott, J., Carmichael, A. and Morgan, M. (2007) <strong>Methodologies for Involving Older Adults in the Design Process</strong>. In Stephanides, S. (Ed.) Universal Access in Human Computer Interaction. Coping with Diversity [4th International Conference on Universal Access in Human-Computer Interaction, UAHCI 2007, Held as Part of HCI International 2007, Beijing, China, July 22-27, 2007, Proceedings, Part I] pp. 982-989.</dd>
  <dt id="nihnlm2002">NIH/NLM 2002</dt>
  <dd>National Institute on Aging and National Library of Medicine (2002). <strong>Making Your Web Site Senior Friendly: A Checklist</strong>. , NIH &amp; NLM, September 2002.<br />
    PDF available at <a href="http://www.nlm.nih.gov/pubs/checklist.pdf">www.nlm.nih.gov/pubs/checklist.pdf</a> </dd>
  <dt id="nielsen2000">Nielsen 2000</dt>
  <dd>Nielsen, J. (2000). <strong>End of Web Design</strong>. Jakob Nielsen's Alertbox, 23 July 2000.<br />
    Available at <a href="http://www.useit.com/alertbox/20000723.html">http://www.useit.com/alertbox/20000723.html</a></dd>
  <dt id="nilsson2003">Nilsson 2003</dt>
  <dd>Nilsson, L-G. (2003). <strong>Memory function in normal aging</strong>. Acta Neurol Scand 2003: 107 (Suppl. 179), pp.7-13.</dd>
  <dt id="ninds2008">NINDS 2008</dt>
  <dd>National Institute of Neurological Disorders and Stroke (2008). <strong>NINDS Parkinson's Disease Information Page</strong>. (10 April 2008)<br />
    Available at <a href="http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm">http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm</a></dd>
  <dt id="ohara2004">O'Hara 2004</dt>
  <dd>O’Hara, K. (2004). <strong>“Curb Cuts” on the Information Highway: Older Adults and the Internet</strong><em>.</em> <em>Technical Communication Quarterly</em>, <em>13</em>(4), 423-45.</dd>
  <dt id="osman2005">Osman 2005</dt>
  <dd>Osman, A., Poulson, D. and Nicolle, C. (2005). <strong>Introducing computers and the Internet to older&nbsp; users: findings from the Care OnLine project</strong>. <em>Universal Access in the Information Society Journal</em>, 4(1), pp. 16-23.</dd>
  <dt id="paradise2005">Paradise 2005</dt>
  <dd ><span class="comment">detail to be provided</span></dd>
  <dt id="parker1998">Parker 1998</dt>
  <dd>Parker, B. and Scharff, L.F.V. (1998). <strong>Influences of Contrast Sensitivity on Text Readability in the Context of a Graphical User Interface. <br />
    </strong><a href="http://hubel.sfasu.edu/research/agecontrast.html">http://hubel.sfasu.edu/research/agecontrast.html</a></dd>
  <dt id="parkinsons">Parkinson's</dt>
  <dd>Parkinson's Disease Society (undated). <strong>At what age do people get Parkinson's?</strong><br />
    Available at <a href="http://www.parkinsons.org.uk/about-parkinsons/what-is-parkinsons/at-what-age-do-people-get-park.aspx">http://www.parkinsons.org.uk/about-parkinsons/what-is-parkinsons/at-what-age-do-people-get-park.aspx</a></dd>
  <dt id="ps2005">Paul 2005</dt>
  <dd>Paul, G. and Stegbauer, C. (2005). <strong>Is the digital divide between young and elderly people increasing?</strong> First Monday, volume 10, number 10 (October 2005)</dd>
  <dt id="pp2007">Placencia-Porrero 2007</dt>
  <dd>Placencia-Porrero, I. (2007). <strong>The Information Society in Demographically Changing Europe</strong>. Gerontechnology 2007; 6(3):125-128</dd>
  <dt id="policies">Policies</dt>
  <dd><a href="http://www.w3.org/WAI/Policy/">Policies Relating to Web Accessibility</a> (http://www.w3.org/WAI/Policy/)</dd>
  <dt id="redish2004">Redish 2004</dt>
  <dd>Redish, J. and Chisnell, D. (2004). <strong>Designing Web Sites for Older Adults: A Review of Recent Literature</strong>. Prepared for AARP December 2004.<br />
    PDF available at <a href="http://assets.aarp.org/www.aarp.org_/articles/research/oww/AARP-LitReview2004.pdf">http://assets.aarp.org/www.aarp.org_/articles/research/oww/AARP-LitReview2004.pdf</a> </dd>
  <dt id="ridout2005">Rideout 2005</dt>
  <dd>Rideout, V., Neuman, T., Kitchman, M. and Brodie, M. (2005). <strong>e-Health and the Elderly: How seniors use the internet for healthy information</strong>. Kaiser Family Foundation Report, Jan 2005 44 pp.<br />
    PDF available at <a href="http://tinyurl.com/ykcvtr">http://tinyurl.com/ykcvtr</a> <br />
    Presentation slides &amp; webcast available from <a href="http://www.kff.org/entmedia/entmedia011205pkg.cfm">http://www.kff.org/entmedia/entmedia011205pkg.cfm</a></dd>
  <dt id="rnib2008a">RNIB 2008a</dt>
  <dd>Royal National Institute of Blind People (2008). <strong>Statistics - numbers of people with sight problems by age group in the UK</strong>.<br />
    Available at <a href="http://www.rnib.org.uk/xpedio/groups/public/documents/publicwebsite/public_researchstats.hcsp#P216_14802">http://www.rnib.org.uk/xpedio/groups/public/documents/publicwebsite/public_researchstats.hcsp#P216_14802</a></dd>
  <dt id="rnib2008b">RNIB 2008b</dt>
  <dd>Royal National Institute of Blind People (2008). <strong>Eye Info - Understanding cataracts</strong>.<br />
    Available at <a href="http://www.rnib.org.uk/xpedio/groups/public/documents/PublicWebsite/public_rnib003640.hcsp">http://www.rnib.org.uk/xpedio/groups/public/documents/PublicWebsite/public_rnib003640.hcsp</a></dd>
  <dt id="rnib2008c">RNIB 2008c</dt>
  <dd>Royal National Institute of Blind People (2008). <strong>Eye Info - Understanding age-related macular degeneration (AMD)</strong>.<br />
    Available at <a href="http://www.rnib.org.uk/xpedio/groups/public/documents/PublicWebsite/public_rnib003635.hcsp">http://www.rnib.org.uk/xpedio/groups/public/documents/PublicWebsite/public_rnib003635.hcsp</a>  </dd>
  <dt id="rnid">RNID</dt>
  <dd>The Royal National Institute for Deaf People (undated). <strong>Facts and figures on deafness and tinnitus (factsheet)</strong>.<br />
    Available at <a href="http://www.rnid.org.uk/information_resources/factsheets/deaf_awareness/factsheets_leaflets/facts_and_figures_on_deafness_and_tinnitus.htm">http://tinyurl.com/83yfz</a></dd>
  <dt id="reogneflaten2004">Rogneflåten 2004</dt>
  <dd>Rogneflåten, E.H. (2004).&nbsp; <strong>SeniorSurf in Norway</strong>. Scandinavian Public Library Quarterly Vol. 37-4. <br />
    Available at <a href="http://www.splq.info/issues/vol37_4/10.htm">http://www.splq.info/issues/vol37_4/10.htm</a> </dd>
  <dt id="sac2006">SAC 2006</dt>
  <dd><span class="comment">Salvi, Akhtar and Currie (2006)</span>.</dd>
  <dt id="sac2003">de Sales 2003</dt>
  <dd>de Sales, M.B. and de Abrew Cybis, W. (2003). <strong>Development of a checklist for the evaluation of the web accessibility for the aged users</strong>. ACM International Conference Proceeding Series; Vol. 46 - Proceedings of the Latin American conference on Human-computer interaction (Brazil), pp 125-133. (paper in Spanish)</dd>
  <dt id="savitch2006">Savitch 2006</dt>
  <dd>Savitch, N. and Zaphiris, P. (2006). <strong>Accessible Websites for People with Dementia: A preliminary investigation into information architecture</strong>. In Miesenberger, K. et al. (Eds), Computers Helping People with Special Needs [10th International Conference, ICCHP 2006, Linz, Austria, July 11-13, 2006. Proceedings] pp. 144-151.</dd>
  <dt id="sayago2007">Sayago 2007</dt>
  <dd>Sayago, S. and Blat, J. (2007). <strong>Some Aspects of Designing Accessible Online Forms for the Young Elderly.</strong> in Third International Conference on Web Information Systems and Technologies. Barcelona, Spain. 3-6 March 2007.&nbsp; INSTICC Press. ISBN: 978-972-8865-78-8, pp: 13-18.<br />
    PDF available at <a href="http://www.tecn.upf.es/~ssayag/PhD/webist2007_sayago_blat.pdf">http://www.tecn.upf.es/~ssayag/PhD/webist2007_sayago_blat.pdf</a>)</dd>
  <dt id="scott1999">Scott 1999</dt>
  <dd ><span class="comment">Scott, H. (1999)</span>. </dd>
  <dt id="scott2002">Scott 2002</dt>
  <dd>Scott, H., Burmeister, O.K. and Roberts, S. (2002). <strong>Accessible e-Commerce: Crossing the Digital Generation Gap</strong>. 3rd Australian Institute of Computer Ethics Conference (AiCE 2002), 30 September 2002, Sydney, New South Wales, Australia, pp. 106-117.</dd>
  <dt id="selvidge2003">Selvidge 2003</dt>
  <dd>Selvidge, P. (2003). <strong>Examining Tolerance for Online Delays</strong>. Usability News 5(1)<br />
    Was available at http://psychology.wichita.edu/surl/usabilitynews/51/delaytime.htm</dd>
  <dt id="sevilla2007">Sevilla 2007</dt>
  <dd>Sevilla, J., Herrera, G., Martínez, B. and Alcantud, F. (2007). <strong>Web Accessibility for Individuals with Cognitive Deficits: A comparative study between an existing commercial Web and its cognitively accessible equivalent</strong>. ACM Transactions of Computer Human Interaction, 14(3), article No. 12.</dd>
  <dt  id="sloan2006">Sloan 2006</dt>
  <dd>Sloan  D. (2006) <strong>Two cultures? The disconnect  between the Web standards movement and research based Web design guidelines for  older people</strong>. <em>Gerontechnology Journal</em> 5(2) (July 2006) pp. 106-112.<br />
    PDF available at <a href="http://www.gerontechnology.info/Journal/Content/Volume_5/nr_2/pdf/106-112.pdf">www.gerontechnology.info/Journal/Content/Volume_5/nr_2/pdf/106-112.pdf (PDF, 368kb)</a></dd>
  <dt id="spry1999">SPRY 1999</dt>
  <dd>Holt, B.J. and Komlos-Weimer. M (1999). <strong>Older Adults and the World Wide Web: a Guide for Web Site Creators</strong>. SPRY Foundation, pp.36.<br />
    PDF available at <a href="http://www.spry.org/pdf/website_creators_guide.pdf">http://www.spry.org/pdf/website_creators_guide.pdf</a></dd>
  <dt id="taylor2005">Taylor 2005</dt>
  <dd>Taylor, T. and Rose, J. (2005).&nbsp; <strong>Bridging the divide: older learners and new technologies.</strong> Brisbane, Australia: 2005.<br />
    PDF available at <a href="http://www.avetra.org.au/publications/documents/PA028Taylor.pdf">http://www.avetra.org.au/publications/documents/PA028Taylor.pdf</a>.</dd>
  <dt id="tbl1997">TBL 1997</dt>
  <dd>Tim Berners-Lee (1997) on the launch of the International Program Office for Web Accessibility Initiative - <a href="http://www.w3.org/Press/IPO-announce">http://www.w3.org/Press/IPO-announce</a></dd>
  <dt id="tbl2004">TBL 2004</dt>
  <dd>Tim  Berners-Lee (2004) in an interview &quot;<strong>Connecting the Dots</strong>&quot; in The Age newspaper, October 2004<br />
    <a href="http://www.theage.com.au/articles/2004/10/18/1097951617438.html">http://www.theage.com.au/articles/2004/10/18/1097951617438.html</a></dd>
  <dt id="theofanis2005">Theofanis 2005</dt>
  <dd>Theofanis and Redish (2005). <strong>Guidelines for Accessible and Usable Web Sites: Observing Users Who Work With Screen Readers</strong>. Author's of paper published in Interactions,  Volume X, Issue 6, November-December 2003, pages 38-51.<br />
    Available at <a href="http://redish.net/content/papers/interactions.html">http://redish.net/content/papers/interactions.html</a></dd>
  <dt id="tiresias">Tiresias</dt>
  <dd>Tiresias (2008). <strong>Guidelines - Fonts</strong>. 19 February 2008.<br />
    Available at <a href="http://www.tiresias.org/guidelines/fonts.htm">http://www.tiresias.org/guidelines/fonts.htm</a></dd>
  <dt id="trewin1999">Trewin 1999</dt>
  <dd><span class="comment">detail to be provided</span></dd>
  <dt id="takizawa2008">Takizawa 2008</dt>
  <dd>Takizawa, M. (2008). <strong>Developing a Really Comfortable Web Browser for IT Minorities</strong>. Presentation at CSUN 2008.<br />
    See also <a href="http://www-06.ibm.com/jp/accessibility/raku2web/jp/start_en.html">http://www-06.ibm.com/jp/accessibility/raku2web/jp/start_en.html</a></dd>
  <dt id="ucsfmac">UCSF MAC</dt>
  <dd>University of California, Memory &amp; Ageing Center (undated). <strong>Mild Cognitrive Inpairment (<acronym>MCI</acronym>)</strong>.<br />
    Available at <a href="http://memory.ucsf.edu/Education/Disease/mci.html">http://memory.ucsf.edu/Education/Disease/mci.html</a></dd>
   <dt id="un1998">UN 1998</dt>
  <dd>United Nations (1998). <strong>Long-range World Population Projections: Based on the 1998 Revision</strong>. Population Division, Department of Economic and Social Affairs, United Nations. <br />
  Available at <a href="http://www.un.org/esa/population/publications/longrange/longrange.htm">http://www.un.org/esa/population/publications/longrange/longrange.htm</a></dd>
 <dt id="un2007">UN 2007</dt>
  <dd>United Nations (2007). <strong>World Population Ageing 2007</strong>. Population Division, Department of Economic and Social Affairs, United Nations. (Updated 21 August 2007).<br />
  Available at <a href="http://www.un.org/esa/population/publications/WPA2007/wpp2007.htm">http://www.un.org/esa/population/publications/WPA2007/wpp2007.htm</a></dd>
  <dt id="ugforms">Usability.gov forms</dt>
  <dd>Dept Health and Human Serices (undated). <strong>Developing an Online Form</strong>. In Usability.gov. <br />
    Available at <a href="http://www.usability.gov/lessons/form.html"> http://www.usability.gov/lessons/form.html</a></dd>
  <dt id="wsj2004">WSJ 2004</dt>
  <dd><span class="comment">Wall Street Journal (2004)</span>.</dd>
  <dt id="wein2006">Wein 2006</dt>
  <dd>Weinschenk, S. (2006). <strong>Selling Older User Short</strong>, UI Design Newsletter, Human Factors International January 2006.<br />
    <a href="http://www.humanfactors.com/downloads/jan06.asp">www.humanfactors.com/downloads/jan06.asp</a></dd>
  <dt id="who-a">WHO a</dt>
  <dd>WHO (undated a). <a href="http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html"><strong>Definition of an older or elderly person</strong></a> in &quot;Health statistics and health information systems&quot;<br />
    http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html</dd>
  <dt id="who-b">WHO b</dt>
  <dd>WHO (undated b). <a href="http://www.who.int/topics/ageing/en/"><strong>Ageing</strong></a> <br />
    http://www.who.int/topics/ageing/en/</dd>
  <dt id="wikima">Wiki MA</dt>
  <dd>Wikipedia (2008). <strong>Memory and aging (Memory decline in normal aging) entry</strong> (7 April 2008).<br />
    Available at <a href="http://en.wikipedia.org/wiki/Aging_and_memory">http://en.wikipedia.org/wiki/Aging_and_memory</a></dd>
  <dt id="wikimsd">Wiki MSD</dt>
  <dd>Wikipedia (2008). <strong>Arthritis entry</strong>. (6 May 2008)<br />
    Available at <a href="http://en.wikipedia.org/wiki/Arthritis">http://en.wikipedia.org/wiki/Arthritis</a></dd>
  <dt id="wikipd">Wiki PD</dt>
  <dd>Wikipedia (2008). <strong>Parkinson's disease entry</strong>. (6 May 2008)<br />
    Available at <a href="http://en.wikipedia.org/wiki/Parkinson's_disease">http://en.wikipedia.org/wiki/Parkinson's_disease</a></dd>
  <dt id="zaphiris2006">Zaphiris 2006</dt>
  <dd>Zaphiris, P., Kurniawan, S., and Ghiawadwala, M. (2007)., <strong>A Systematic Approach to the Development of Research-Based Web Design Guidelines for Older People</strong>. <em>Universal Access in the Information Society Journal</em>, 6(1), Pages 59-76</dd>
  <dt id="zhao2001">Zhao 2001</dt>
  <dd>Zhao, H. (2001). <strong>Universal Usability Web Design Guidelines for the Elderly (Age 65 and Older)</strong> Universal Usability in Practice<br />
    Available at <a href="http://www.otal.umd.edu/UUPractice/elderly/">http://www.otal.umd.edu/UUPractice/elderly/</a></dd>
</dl>
<p class="comment">Note - The following is a  listing of  additional ageing and the Web/ICT references collected and consulted during the search phase of this study.</p>
<p class="comment">Note - all the following references will all be moved to the formatted listing above before final publication.</p>
<ul class="spacedlist">
  <li>Bailey, B. (2005). <strong>Age-Related Research-Based Usability Guidelines. </strong>Nov. 2005; Usability Updates Newsletters<br />
    Available at <a href="http://www.usability.gov/pubs/112005news.html">http://www.usability.gov/pubs/112005news.html</a></li>
  <li>Becker, S.A. (undated). <strong>Web Accessibility for Older Adults Project Highlights</strong>. Northern Arizona University<br />
  PDF available at http://dgrc.org/dgo2004/disc/presentations/itadoption/becker.pdf</li>
  <li>Becker, S.A. (2006). <strong>A study of Web usability for older adults seeking online health resources</strong>. Presentation related to Becker, S.A. (2004) TOCHI paper<br />
    PDF of PPT available at <a href="http://bioivlab.ils.unc.edu/JoomlaBioinfo/images/stories/docs/20060208-Kulla-Mader-slides.pdf">http://bioivlab.ils.unc.edu/JoomlaBioinfo/images/stories/docs/20060208-Kulla-Mader-slides.pdf</a> </li>
  <li>Becker, S.A. (2007?). <strong>Designing for Older Adult Users: Web Mobile and Handheld Technologies</strong>. Presentation at Michigan State University for World Usability Day.<br />
    PDF of PPT slides available at <a href="http://usability.msu.edu/WUD07_beckerPresentation.pdf">http://usability.msu.edu/WUD07_beckerPresentation.pdf</a> </li>
  <li>Becker, S.A. (2005). <strong>E-government usability for older adults.</strong> <em>Commun. ACM</em>,&nbsp; vol. 48, 2005, pp. 102-104.</li>
  <li>Borges, I.M. (2006). <strong>Can ICT help the European Union meet the needs of its ageing population?</strong> Presented at the International Conference: Live Forever! (Portugal)<br />
    PDF available at <a href="http://www.age-platform.org/EN/IMG/pdf_COM_Portugal_ICT_and_Ageing.pdf">http://www.age-platform.org/EN/IMG/pdf_COM_Portugal_ICT_and_Ageing.pdf</a> </li>
  <li>Browne, H. (2000). <strong>Accessibility and Usability of Information Technology by the Elderly</strong>. University of Maryland, College Park, MD 20742 USA, April 2000.<br />
    Accessed 2007.12.27 at <a href="http://www.otal.umd.edu/UUGuide/hbrowne/">www.otal.umd.edu/UUGuide/hbrowne/</a> </li>
  <li>de Bruïne, F. (2007). <strong>Turning the Silver Challenge into a Golden Opportunity</strong>. Interview in SAPInfo, 1 August 2007.<br />
    Accessed 2007.12.28 at <a href="http://www.sap.info/public/INT/int/index/Category-12603c61b2d8e182c-int/0/articlesVersions-197646a9bac38295d">http://tinyurl.com/2g8mhs</a> </li>
  <li>Carpenter, M. (2004). <strong>Older Wiser Wired: Why This Matters</strong>, presentation at “Older Adults and the Web” event for usability.gov, July 19&amp;20, 2004<br />
    PDF available at <a href="http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/CarpenterPresentation.pdf">http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/CarpenterPresentation.pdf</a> </li>
  <li>Chaparro, B. and Stumpfhauser, L. (2001). <strong>Designing a Touch Screen Kiosk for Older Adults: A Case Study</strong>. Usability News 3(1).<br />
  Accessed 2008.02.12 at http://psychology.wichita.edu/surl/usabilitynews/3W/kiosk.htm</li>
  <li>Chaparro, B.S. (2004). <strong>Evaluation of Websites for Older Adults: How &quot;Senior-Friendly&quot;</strong> <strong>Are They?</strong> Jul. 2004.<br />
    Word document available at <a href="http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/Chaparro_handout.doc">http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/Chaparro_handout.doc</a>.</li>
  <li>Chisnell, D. and Redish, J. (2005). <strong>Designing Web Sites for Older Adults: Expert Review of Usability for Older Adults at 50 Web Sites</strong>. Prepared for AARP February 2005.<br />
    PDF available at <a href="http://assets.aarp.org/www.aarp.org_/articles/research/oww/AARP-50Sites.pdf">http://assets.aarp.org/www.aarp.org_/articles/research/oww/AARP-50Sites.pdf</a> &nbsp;</li>
  <li> Connelly, K. (2006). <strong>Older adults more vulnerable to distraction from irrelevant information.</strong> <em>Eureka Alert</em>, Feb. 2006.<br />
    Available at <a href="http://www.eurekalert.org/pub_releases/2006-02/b-oam013006.php">http://www.eurekalert.org/pub_releases/2006-02/b-oam013006.php</a>.</li>
  <li>Crews,J.E. and Campbell, V.A. (2004). <strong>Vision Impairment and Hearing Loss Among Community-Dwelling Older Americans: Implications for Health and Functioning.</strong> <em>Am J Public Health.</em> 2004 May; 94(5): 823–829.<br />
    Available at <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1448344">http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1448344</a></li>
  <li>Crews, D.E. (2005). <strong>Artificial Environments and an Aging Population: Designing for Age-Related Functional Losses</strong>. Journal of Physiological Anthropology and Applied Human Science, 24(1), pp. 103-109.<br />
    PDF available at <a href="http://www.jstage.jst.go.jp/article/jpa/24/1/103/_pdf">http://www.jstage.jst.go.jp/article/jpa/24/1/103/_pdf</a> </li>
  <li>Czaja, S.J. (2006). <strong>Technology and Older Adults: Designing for Accessibility and Usability</strong>. Keynote talk at ASSETS’06 (Proceedings of 8th International ACMSIGACCESS Conference on Computers and Accessibility 20-05 {ASSETS’06}, p. 1)</li>
  <li>Czaja, S.J. and Lee, C.C. (2007). <strong>The impact of aging on Access to Technology</strong>. <em>Universal Access in the Information Society Journal</em>, 5(4), Pages 341-349</li>
  <li>Dailey, S. (2004). <strong>Changes Resulting From Aging - Physical, Sensory and Cognitive</strong>. Jul. 2004;<br />
    PPT available at <a href="http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/DaileySlides.ppt">http://assets.aarp.org/www.aarp.org_/articles/research/oww/university/DaileySlides.ppt</a></li>
  <li>Davis, L.M. and Lafrado, L.J. (2003). <strong>Addressing Senior Needs in the Accessibility of Internet Health-Related Information</strong>.<em> Journal of Hospital Librarianship </em>,&nbsp; vol. 3, Jan. 2003, pp. 7 - 14 .</li>
  <li>Dewsbury, G., Sommerville, I., Bagnall, P., Rouncefield, M. and Onditi, V. (2006). <strong>Software co-design with older people</strong>. In Clarksonm, J., Langdon, P. and Robinson, P. <em>Designing Accessible Technology</em>&nbsp; - proceedings of CWUAAT’06 [incorporating the 6th Cambridge Workshop on rehabilitation Robotics] (Springer Verlag), pp 199-208.</li>
  <li>Dickinson, A. and Dewsbury, G. (2006). <strong>Designing Computer Technologies with Older People.</strong> <em>Gerontechnology</em> 2006; 5(1);1-3. </li>
  <li>DiDuca, D. (2004). <strong>Ageing and Technology</strong>. Presentation at Chimera, University of Essex (July 2004)<br />
    PPT available at <a href="http://www.essex.ac.uk/chimera/content/seminars/Ageing%20and%20technology.ppt">http://www.essex.ac.uk/chimera/content/seminars/Ageing%20and%20technology.ppt</a> </li>
  <li>Fabiani, M., Low, K.A., Wee, E., Sable, J.J. &amp; Gratton, G. 2006. <strong>Reduced Suppression or Labile Memory? Mechanisms of Inefficient Filtering of Irrelevant Information in Older Adults</strong>. <em>Journal of Cognitive Neuroscience,</em> 18, 637-650.</li>
  <li>Fox, S. (2005). <strong>Future of the Internet</strong>. Nov. 2005.<br />
    PPT presentation available at <a href="http://assets.aarp.org/www.aarp.org_/articles/research/oww/internetfuture2005/fox-slides-1105.ppt">http://assets.aarp.org/www.aarp.org_/articles/research/oww/internetfuture2005/fox-slides-1105.ppt</a>.</li>
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</ul>
<h2 id="appendix"> Appendix - Statistics</h2>
<h3 id="demog">A.1 Demographics</h3>
<p class="comment">Additional demographic data from <a href="http://www.w3.org/WAI/EO/Drafts/ageing/literature.html">Internal  Draft</a> will be relocated here and/or supplemenatary data provided.</p>
<p>The world’s population is living
longer with a disproportionate number of people soon to be elderly as
compared with any other period in human history. The United Nations estimates
that by 2050 one out of every five people will be over 60 years, and by 2150,
one third of the people in the world are expected to be 60 years of age or
older [<a href="#un1998"><cite>UN 1998</cite></a>]. </p>
<p>In Europe, as elsewhere, the population is also aging. European countries
  in 1950 had a population of age 65+ of some 45 million; in 1995 the
  population of age 65+ had already more than doubled to 101 million (approx.
  15%); by 2050 Europe will have 173 million people age 65+ (20% of the
  population). </p>
<p>In the EU-25 countries, this means a change from 2000 when 15.7% of the
  population was over 64, to an estimated 17.6% in 2010 and 20.7% in 2020
  (Figure A.1.1; Table A.1.1). The trends by country are also interesting, and vary
  considerably (Figure A.1.2). The EU-25 countries had a dependency ratio of
  approximately 18 percent in 1970, but expected to rise to approximately 27%
  by 2010 and 54 percent by 2050; across the EU the 2010 prediction ranges from
  approx 17 percent in Slovakia to 32 percent in Italy (Figure A.1.2). </p>
<p>This trend will put tremendous pressure on society in terms of supporting
  the elderly population, and any means to assist them to continue contributing
  to and participating in society, and to “age in place”, needs to be
  adopted.</p>
<p><strong>Figure A.1.1: Population structure by major age group for EU-25
  countries (1960 to 2050 estimates)</strong><br />
  see also Table A.1.1 below (<a href="#ec2007a">EC 2007a</a>) </p>
<p><img src="eudemog.png"
alt="Figure 1.2.1 - Population structure by age (1960 to 2050) - see Table A.1.1 for details" width="668"
height="343" longdesc="#table1" /></p>
<table border="1" cellspacing="1" cellpadding="3" width="94%" id="table1">
  <caption>
  <strong>Table A.1.1: Population structure by major age groups: EU-25
    for 1960 through 2050 by decade</strong> (<a href="#ec2007a">EC 2007a</a>)
  </caption>
  <tbody>
    <tr>
      <th scope="col">Age</th>
      <th>1960</th>
      <th>1970</th>
      <th>1980</th>
      <th>1990</th>
      <th>2000</th>
      <th>2010</th>
      <th>2020</th>
      <th>2030</th>
      <th>2040</th>
      <th>2050</th>
    </tr>
    <tr>
      <th>80+ years </th>
      <td><div align="right">1.5%</div></td>
      <td><div align="right">1.8%</div></td>
      <td><div align="right">2.3%</div></td>
      <td><div align="right">3.2%</div></td>
      <td><div align="right">3.4%</div></td>
      <td><div align="right">4.7%</div></td>
      <td><div align="right">5.8%</div></td>
      <td><div align="right">7.2%</div></td>
      <td><div align="right">9.2% </div></td>
      <td><div align="right">11.4%</div></td>
    </tr>
    <tr>
      <th>65-79 years</th>
      <td><div align="right">8.5%</div></td>
      <td><div align="right">9.9%</div></td>
      <td><div align="right">11.2%</div></td>
      <td><div align="right">10.7%</div></td>
      <td><div align="right">12.3%</div></td>
      <td><div align="right">12.9%</div></td>
      <td><div align="right">14.9%</div></td>
      <td><div align="right">17.5%</div></td>
      <td><div align="right">19.0%</div></td>
      <td><div align="right">18.5%</div></td>
    </tr>
    <tr>
      <th>15-64 years</th>
      <td><div align="right">64.7%</div></td>
      <td><div align="right">63.5%</div></td>
      <td><div align="right">64.4%</div></td>
      <td><div align="right">66.9%</div></td>
      <td><div align="right">67.1%</div></td>
      <td><div align="right">66.9%</div></td>
      <td><div align="right">64.5%</div></td>
      <td><div align="right">61.3%</div></td>
      <td><div align="right">58.3%</div></td>
      <td><div align="right">56.7%</div></td>
    </tr>
    <tr>
      <th>0-14 years</th>
      <td><div align="right">25.3%</div></td>
      <td><div align="right">24.8%</div></td>
      <td><div align="right">22.1%</div></td>
      <td><div align="right">19.2%</div></td>
      <td><div align="right">17.2%</div></td>
      <td><div align="right">15.5%</div></td>
      <td><div align="right">14.8%</div></td>
      <td><div align="right">14.0%</div></td>
      <td><div align="right">13.5%</div></td>
      <td><div align="right">13.4%</div></td>
    </tr>
  </tbody>
</table>
<p><strong>Figure A.1.2: Old age dependency ratio for EU-25 countries (1970 and
  2010, 2050 estimates)</strong><br />
  (population aged 65 and over as a percentage of the working age population
[15-64 years]) (<a href="#ec2007a">EC 2007a</a>)</p>
<p><img src="oldagedependency.png"
alt="Figure A.1.2 - Old age dependency ratio for EU-25 countries (1970 and 2010, 2050 estimates)"
width="668" height="323" /></p>
<p class="comment">(Data from Figure A.1.2 to be provided in a tabular format.)</p>
<h3 id="online">A.2 Older people online</h3>
<p class="comment">Introductory paragraph needs to be formulated ... Statistics from other countries may be added when identified.</p>
<h4>Australia</h4>
<p>Internet access in 2006 in Australia by people living in occupied private dwellings was analysed by age group. The Australia Bureau of Statistics found that people with ages between 5 and 14 have the highest proportion of access, followed by people in the 15-24 age range. They found the proportion tapers off sharply for people over 55 years, with only a quarter of people 75 years or above having access to the Internet in 2006 as shown in Figures&nbsp;A.2.1a and A.2.1b [<a href="#abs2007">ABS 2007</a>].</p>
<p><strong>Figure A.2.1a - Internet access by age group in 2006 for Australian males</strong><br />
  <img src="ausnetaccessmales.png" alt="Figure A.2.1a - Internet access by age group in 2006 for Australian males" width="558" height="368" /></p>
<p><strong>Figure A.2.1b - Internet access by age group in 2006 for Australian  females</strong> (<a href="#abs2007">ABS, 2007</a>)<br />
  <img src="ausnetaccessfemales.png" alt="Figure 4b - Internet access by age group in 2006 for Australian females" width="558" height="408" /></p>
<p class="comment">Tables to be prepared for the Australian data if available.</p>
<h4>United Kingdom</h4>
<p>In the UK a 2004 survey (Morris, Goodman  and Brading, 2007) showed that approximately one-third of older people in Scotland and in Derbyshire in the UK (over 55  years) had used the internet at some point in their lives with use dropping  with age (Figure A.2.2). The Office of National Statistics in the UK showed that by 2006 that figured was increasing (Table A.2.1).</p>
<p><strong>Figure A.2.2 - Internet use at any point in their lives</strong> (survey from Scotland and  Derbyshire UK,  2004)<br />
  <img src="sdstats.png" alt="Figure A.2.2 - Internet usage by age in Scotland and Derbyshire, 2004" width="422" height="208" /></p>
<p>&nbsp;</p>
<table width="85%" border="1" cellpadding="1">
  <caption>
  <strong>Table A.2.1: UK Adult internet usage</strong> (Office National Statistics UK, 2006)
  </caption>
  <tr>
    <th scope="col"><div align="left">Age Group</div></th>
    <th scope="col"><div align="right">Within the last 3 month</div></th>
    <th scope="col"><div align="right">Between 3 months<br />
        and
        1 year ago</div></th>
    <th scope="col"><div align="right">More than 1 year ago</div></th>
    <th scope="col"><div align="right">Never used it</div></th>
  </tr>
  <tr>
    <th scope="row"><div align="left">16-24 years</div></th>
    <td><div align="right">83%</div></td>
    <td><div align="right">4%</div></td>
    <td><div align="right">3%</div></td>
    <td><div align="right">10%</div></td>
  </tr>
  <tr>
    <th scope="row"><div align="left">25-44 years</div></th>
    <td><div align="right">79%</div></td>
    <td><div align="right">3%</div></td>
    <td><div align="right">2%</div></td>
    <td><div align="right">17%</div></td>
  </tr>
  <tr>
    <th scope="row"><div align="left">45-54 years</div></th>
    <td><div align="right">68%</div></td>
    <td><div align="right">4%</div></td>
    <td><div align="right">2%</div></td>
    <td><div align="right">26%</div></td>
  </tr>
  <tr>
    <th scope="row"><div align="left">55-64 years</div></th>
    <td><div align="right">52%</div></td>
    <td><div align="right">3%</div></td>
    <td><div align="right">2%</div></td>
    <td><div align="right">43%</div></td>
  </tr>
  <tr>
    <th scope="row"><div align="left">75+ years</div></th>
    <td><div align="right">15%</div></td>
    <td><div align="right">1%</div></td>
    <td><div align="right">2%</div></td>
    <td><div align="right">82%</div></td>
  </tr>
</table>
<h4>Spain</h4>
<p>In Spain,  a 2007 survey by the National Statistics Institute reported that percentage of  older people using computers and the internet dropped very sharply for 65-74  years old people compared with 55-64 year olds (Table 2.2.2).</p>
<table border="1" cellspacing="1" cellpadding="3" width="80%">
  <caption>
  <strong>Table A.2.2: Spanish Survey on  Use of  Information and Communication Technologies in Households</strong> <br />
  (Instituto Nacional de  Estadística, 2007)
  </caption>
  <tr>
    <th  nowrap="nowrap" valign="top" scope="col">Age groups</th>
    <th  valign="top">used a computer in the last 3 month</th>
    <th  valign="top">used the  Internet in the last 3 months</th>
    <th  valign="top">used the Internet at least once a week in the last 3 months</th>
    <th  valign="top">made a purchase over the Internet in the last 3 months</th>
  </tr>
  <tr>
    <th nowrap="nowrap" valign="top">16 to 24 years</th>
    <td  nowrap="nowrap" valign="top"><div align="right">89.3%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">86.3%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">76.9%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">16.5%</div></td>
  </tr>
  <tr>
    <th nowrap="nowrap" valign="top">25 to 34 years</th>
    <td  nowrap="nowrap" valign="top"><div align="right">78.0%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">72.6%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">61.3%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">21.0%</div></td>
  </tr>
  <tr>
    <th nowrap="nowrap" valign="top">35    to 44 years</th>
    <td  nowrap="nowrap" valign="top"><div align="right">64.9%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">57.1%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">47.8%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">15.1%</div></td>
  </tr>
  <tr>
    <th nowrap="nowrap" valign="top">45 to 54 years</th>
    <td  nowrap="nowrap" valign="top"><div align="right">52.1%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">45.9%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">38.4%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">11.6%</div></td>
  </tr>
  <tr>
    <th nowrap="nowrap" valign="top">55 to 64 years</th>
    <td nowrap="nowrap" valign="top"><div align="right">25.7%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">21.1%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">18.3%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">4.4%</div></td>
  </tr>
  <tr>
    <th nowrap="nowrap" valign="top">65 to 74 years</th>
    <td  nowrap="nowrap" valign="top"><div align="right">7.5%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">6.4%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">5.2%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">1.3%</div></td>
  </tr>
  <tr>
    <th nowrap="nowrap" valign="top">Total Personas</th>
    <td  nowrap="nowrap" valign="top"><div align="right">57.2%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">52.0%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">44.4%</div></td>
    <td  nowrap="nowrap" valign="top"><div align="right">13%</div></td>
  </tr>
</table>
</body>
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