Colors of Aging: Cross-cultural Perception of Lifelogging Technologies
in Older Age
Julia Offermann-van Heek
, Wiktoria Wilkowska
and Martina Ziefle
Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074 Aachen, Germany
Lifelogging Technologies, Acceptance, Perception, Aging, Cross-cultural Analysis.
Within an aging society, characterized by increasing numbers of older people in need of assistance and care
with a simultaneous shortage of professional caregivers, new ways and innovations have to be developed to
facilitate life in older age. Assisting lifelogging technologies have the potential to support older and frail peo-
ple, but also caregivers in their everyday lives. These assisting lifelogging technologies require the acceptance
of future users to reach a sustainable adoption. As research has focused mostly on country-specific analy-
ses so far, a cross-cultural and -national investigation of users’ lifelogging technology acceptance in older
age is necessary. Therefore, an online survey study (N = 1123) examined perceptions regarding aging, care,
and lifelogging technology usage, focusing on the perspective of potential users originated from five different
countries: Germany, Sweden, Canada, Italy, and Spain. The results revealed significant differences between
the countries regarding attitudes towards aging and care as well as perceptions and acceptance of lifelogging
technologies. The insights identify the cultural background of potential users as a relevant impacting parameter
and should be considered when technologies are developed and tailored to the needs of specific user groups.
The care sectors of today’s society are tremendously
challenged by increasing proportions of people in
need of assistance and care caused by their age,
(chronic) illnesses, or disabilities and a simultane-
ous shortage of (professional) care personnel (Greve,
2016; Fekete, 2019; B
orsch-Supan et al., 2015). As a
consequence of a significantly higher life expectancy
including more and more people aged 75 years and
older having specific needs regarding assistance and
(intensive) care, higher numbers of professional and
family caregivers are needed. In fact, the proportions
of professional caregivers have decreased in the last
years. At least in Germany, it is tried to compensate
this described lack by outpatient nursing services or
by care provided by family members (Roth and Re-
ichert, 2019). In line with most older people’s wish –
to stay as independent and as long as possible within
their own home it is thereby tried to enable that
older and frail people can stay within their familiar
home environment (Blackman et al., 2016). Never-
theless, these efforts do not suffice in the course of
demographic change. Much more, it is required to
think about new ways, concepts, and technologies in
order to assist and support older people and people
in need of care. Using assisting lifelogging technolo-
gies in older age represents one possible approach to
support older people in their everyday life to enable
a longer staying within their own home or to relieve
the burdens of (professional) caregivers and family
members. Thereby, assisting lifelogging technolo-
gies refer to diverse technological ways of recording
the everyday life Selke (2014) reaching from wear-
able devices motivating their users to a healthier
lifestyle – to holistic ambient systems installed within
the home environment, that are able to detect emer-
gencies or remind their users for intake of medicine
or appointments. In the last years, a broad variety
of applications has been developed belonging to the
field of ambient assisted living (AAL) and assisting
lifelogging technologies (for an overview see Rashidi
and Mihailidis (2012)). Besides their technical poten-
tial, the future user’s acceptance of innovative techni-
cal solutions presents a prerequisite for a sustainable
adoption and usage within the everyday life. There-
fore, research has increasingly focused on diverse fu-
ture users’ perception and evaluation of assisting tech-
nologies in recent years (e.g., (Larizza et al., 2013;
Heek, J., Wilkowska, W. and Ziefle, M.
Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age.
DOI: 10.5220/0009371000380049
In Proceedings of the 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2020), pages 38-49
ISBN: 978-989-758-420-6
2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
onig et al., 2017; Peek et al., 2014). Most of the
studies in this field have in common that they fo-
cus on the perspectives of participants from one sin-
gle country. Hence, there is hardly any knowledge
about cross-cultural perspectives on using assisting
lifelogging technologies in older age so far, and it is
not known if and to what extent the participants’ ori-
gins or cultural background is an impacting parame-
ter. This is exactly why the present study (N = 1123)
aimed at a cross-cultural and -national comparison
of the perceptions of aging, care, technology-related
benefits and barriers as well as acceptance of using as-
sisting lifelogging in older age differing between par-
ticipants from ve countries: Sweden, Italy, Spain,
Canada, and Germany. Hence, this paper investigated
the influence of culture understood and defined as the
participants’ cultural origins.
The following section presents the theoretical back-
ground of the study, starting with the current state of
acceptance of assisting lifelogging technologies. Af-
terwards, the individuality of users and its impact on
the acceptance of assisting technologies are focused
including demographic and health-related character-
istics as well as culture (i.e. the cultural origins of the
participants) as potential impacting parameter.
2.1 Lifelogging & Acceptance
In the last years, numerous technologies and inno-
vative systems have been developed in the field of
lifelogging and ambient assisted living. These tech-
nologies and systems cover an extremely broad range
of functions for diverse groups of users with their
specific needs and requirements (Rashidi and Mihai-
lidis, 2012; Abtoy et al., 2018). The potential user
groups are as diverse as the spectrum of the tech-
nologies and systems: for healthy people, lifelogging
technologies provide the opportunity to analyze and
track own behaviors, such as sports or nutrition, to
improve and support a healthy life style, or to en-
hance well-being (e.g., Schoeppe et al., 2016; Mid-
delweerd et al., 2014). For older and frail people,
assisting lifelogging technologies have the potential
to meet the care gap, by supporting them in retain-
ing as independent as possible, staying active, and in
particular by enhancing safety. The latter is realized
using wearable and non-wearable, video- or sensor-
based monitoring and fall detection systems, that en-
able alarms or emergency calls in case of emergen-
cies and falls (e.g., Mubashir et al., 2013; Stone and
Skubic, 2014; Wu and Xue, 2008). Another rele-
vant application area for older and frail people refers
to prompting systems and memory aids: here, di-
verse concepts and systems aim at facilitating every-
day life for older people in need of assistance and care
and, in particular, for people with dementia and their
caregivers, for example by reminding for intake of
medicine or prompting for daily routines (e.g., Hos-
sain et al., 2011; Mihailidis et al., 2007; Wu and Xue,
2008). Other application examples refer for instance
to a barrier-free and independent communication for
older people with friends, family, or caregivers us-
ing telemedicine, telecare, or videoconferencing ser-
vices and technologies (van den Berg et al., 2012),
or to wandering prevention tools (for people with de-
mentia) (e.g., Vuong et al., 2011). Beyond all these
useful opportunities and functions, the future users’
perspective on, and acceptance of, those technologies
are decisive for a long-term adoption and usage of as-
sisting technologies in their everyday lives. Although
the number of studies focusing on the user’s perspec-
tive on innovative technologies in the area of ambi-
ent assisted living and assisting lifelogging technolo-
gies has increased in the last years, systematic eval-
uations and validations of new as well as already ex-
isting technologies are still needed (Peek et al., 2014;
Calvaresi et al., 2017). So far, research has shown
that assisting lifelogging technologies in older age are
predominantly positively perceived by their potential
users and in particular the potential to relief the every-
day life of persons in need of care and their caregivers
is acknowledged (Lorenzen-Huber et al., 2011; Wild
et al., 2008; Lai et al., 2010): thereby, especially in-
creased safety, independence, and autonomy for peo-
ple in need of care are highlighted as benefits of ap-
plying assisting technologies in older age. These ad-
vantages are in particular acknowledged when safety-
relevant functions, such as emergency alarms and fall
detection, or relieving functions like (medical) re-
minders are enabled (e.g., Offermann-van Heek et al.,
2019; Gall et al., 2016; Offermann-van Heek et al.,
2019). Not surprisingly, some barriers and concerns
stand opposite to the advantages and benefits of using
assisting lifelogging technologies (Peek et al., 2014).
Concerns with regard to privacy invasion when deal-
ing with technology-related data (Mihailidis et al.,
2008; Steggell et al., 2010; Lorenzen-Huber et al.,
2011), feelings of being controlled by the technology
as well as assumed high costs (Horton, 2008; Porter
and Ganong, 2002) belong to the most relevant bar-
riers of using assisting lifelogging technology. Be-
sides benefit- and barrier-related aspects that impact
the user’s acceptance of assisting technology, research
has shown that also the specific type of technology as
Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age
well as the respective context (e.g., necessity in terms
of care needs (Offermann-van Heek et al., 2019)) are
impacting parameters for the perceptions and accep-
tance of future users. With regard to the context of de-
mographic change and usage of assisting technologies
in older age, it is also relevant how the topics of aging
and care themselves are perceived by (older) people in
need of care. Here, research has shown that attitudes
and handling of topics like aging and care have the
potential to shape and influence the acceptance and
adoption of assisting lifelogging technologies as well
(Biermann et al., 2018).
2.2 Individuality of Users
In addition to technology-related characteristics as
well as motives and concerns of using assisting lifel-
ogging technology, individual characteristics of fu-
ture users have the potential to impact the evaluation,
perception, and acceptance of assisting technologies.
Relevant findings related to these potential impacting
user factors are described within the next sections.
2.2.1 Influence of Demographics
The most common user characteristics integrated in
technology acceptance are certainly referred to the
participants’ age and gender. In the context of using
assisting lifelogging technology in older age, research
has shown that older people expressed more posi-
tive attitudes towards innovative technologies com-
pared to younger people (e.g., Beringer et al., 2011;
Offermann-van Heek et al., 2019): In more detail, the
older participants showed higher agreements to po-
tential advantages of using assisting technology, such
as a longer staying at the own home or increased in-
dependence, while they showed lower perceptions of
barriers. As an interesting result, they considered
other concerns to be relevant compared to younger
people, e.g., to be dependent on innovative technolo-
gies or to feel unable to control the technology. Re-
search also revealed that the participants’ gender can
have an impact on the evaluation and acceptance of
assisting technology (e.g., Offermann-van Heek et al.,
2019), revealing men to show a higher acceptance of
assisting lifelogging technologies, while the female
participants expressed higher evaluations of barriers.
2.2.2 Influence of Health and Care
As other individual characteristics of users, the partic-
ipants health status, potential care needs, and previous
experiences with care have been identified in previous
research. Previous research has shown that the partic-
ipants’ health status, such as existing chronic diseases
or disabilities of older people, have an influence on as-
sessments as well as acceptance of assisting technolo-
gies (e.g., Chappell and Zimmer, 1999; Gentry, 2009;
Wilkowska, 2015; Offermann-van Heek et al., 2019).
In addition, further studies revealed that previous ex-
periences with care (e.g., professional care experi-
ence Larizza et al. (2013); Offermann-van Heek et al.
(2019) as well as private care experience (Lorenzen-
Huber et al., 2011; Offermann-van Heek and Ziefle,
2019)) impact the perception and acceptance of as-
sisting technology: For instance, professional care-
givers showed in parts higher concerns and evalua-
tions of barriers as well as a lower technology accep-
tance compared to lay persons.
2.2.3 Influence of Culture
The most studies regarding technology acceptance of
assisting lifelogging technology have in common that
they investigated the perceptions and acceptance of
participants from one single country and cultural ori-
gin, although the cultural background is considered as
an individual factor of users that could play a role as
impacting parameter on technology acceptance (Sun
and Zhang, 2006). Occasionally, some studies in-
vestigated the acceptance and perception of (assist-
ing) technology depending on the cultural origin of
the participants. For example, the research of Alag
et al. (2011) and Wilkowska et al. (2012) revealed sig-
nificant influences of the participants’ cultural back-
grounds on their acceptance of assisting eHealth tech-
nology – in addition to other user factors such as age
and gender. In more detail, it was found that Turk-
ish, Polish, and German participants differ in their
evaluations of motives and barriers of using assist-
ing technology, revealing that in particular barriers
and concerns with regard to technology usage were
assessed higher by the Turkish compared to the Ger-
man and Polish participants. Although these results
constitute the presumption that culture operational-
ized as cultural origin could be an impacting param-
eter for the acceptance of assisting lifelogging tech-
nology in older age, it is not known yet to what
extent the contextual perception of care and aging,
but also the perception of technology-related bene-
fits and barriers, and acceptance are shaped by origin-
and culture-dependent characteristics. Hence, an ap-
proach is needed that investigates lifelogging technol-
ogy perception and acceptance in dependence of the
participants’ origins taking different countries into ac-
count. In order to enable cross-national and -cultural
comparisons in Europe, it is necessary to systemati-
cally compare countries from different regions (e.g.,
Northern vs. Central vs. Southern Europe). In addi-
tion, it would be useful to integrate a non-EU country
ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health
in order to draw some first conclusions about Europe
and continent spreading relationships between culture
and lifelogging technology acceptance.
The background for the current study presents the Eu-
ropean research project PAAL (“Privacy Aware and
Acceptable Lifelogging services for older and frail
people”). Within PAAL, an interdisciplinary team of
lawyers, diverse engineers, and communication sci-
entists develop different assisting lifelogging services
that are specifically tailored to the needs and require-
ments of older users. In order to reach a broad accep-
tance and to understand acceptance patterns from as
diverse people as possible (younger vs. older people,
“healthy” people vs. people in need of assistance and
care, people from diverse countries), cross-national
studies, surveys, and experiments are conducted. The
specific research aim of the present study was to ex-
amine the potential influence of the participants’ cul-
tural origins on their perceptions of aging and care as
well as their evaluation, perception, and acceptance
of using lifelogging technology in older age. In order
to reach this aim, an online survey was conceptualized
and people from five different countries were asked to
participate in the survey. To reach participants from a
broad range in Europe, Italy and Spain were chosen
to represent Southern Europe, Sweden as example for
Northern Europe, and Germany as example for Cen-
tral Europe. As counterpart to the euro states, Canada
was chosen as control group enabling a comparison
beyond the European countries. The specific underly-
ing research questions were the following:
RQ1: Does the handling of care within families
differ depending on the participants’ origins?
RQ2: Do the attitudes towards aging and care dif-
fer depending on the participants’ origins?
RQ3: Do the perceptions of technology-related
benefits and barriers differ depending on the par-
ticipants’ origins?
RQ4: Does the acceptance of lifelogging technol-
ogy in older age differ depending on the partici-
pants’ origins?
3.1 Concept of the Online Survey
Subsequent to the present study different qualita-
tive as well as quantitative studies were conducted.
These studies enabled to derive central guidelines for
Aging & Care
Handling of
(4 items)
towards Aging
(10 items)
towards Care
(12 items)
Evaluation of Lifelogging Technology
Perception of
(9 items)
Perception of
(9 items)
(3 items)
Individual Characteristics
(Origin, Age,
Health and
Figure 1: Structural overview of the survey’s parts and the
investigated constructs.
a human-centered development of lifelogging tech-
nologies and provided a broad overview of impact-
ing user factors Offermann-van Heek et al. (2019).
As these studies did not integrate cross-cultural anal-
yses, an online survey was developed based on the
existing knowledge specifically aiming for an cross-
cultural investigation of perceptions of aging and care
as well as acceptance and perception of using lifel-
ogging technologies in older age. In order to reach
participants from different countries, the survey was
made available in English, German, Italian, and Span-
ish. At the beginning, participants were able to choose
the language, in which they desired to fill out the sur-
vey. Afterwards, they were welcomed and shortly in-
troduced into the topic of an aging society and the
development of lifelogging technology in order to fa-
cilitate life in older age. The main part of the survey
consisted of three parts (see Figure 1). In the first
part, the participants were asked for individual char-
acteristics, starting with indicating demographic in-
formation, such as their origin, age, gender, highest
educational level, or living situation. Subsequently,
the participants indicated if they suffer from a chronic
illness and/or if they are in need of assistance and care
in their everyday life (answer options: yes/no). Fur-
ther, the participants were asked, if they have previ-
ous experiences in care (answer options: yes/no) dif-
fering between professional experience, (private) pas-
sive, and private active experience. Here, passive ex-
perience meant that the participant has a person in her
or his family circle, who is in need of assistance and
care; whereby active care experience meant that the
participant has already been the caregiver for a family
member in need of care. Following these details, the
participants were introduced into the topic of aging
and care within the second part of the survey. Here,
the participants initially assessed four items dealing
with the handling of care of older family members
Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age
within their families. The items are presented in Fig-
ure 2 and the participants’ evaluations based on a
four-point scale reaching from “1 = I disagree” to ”4
= I agree”. Further, the participants evaluated their at-
titudes towards aging and care. For this purpose, they
first assessed 10 items (α = .86) referring to poten-
tial positive (e.g., /sayAging means to me... that I can
still have a lot of fun in my life.) and negative as-
pects of aging (e.g., /sayAging means to me... to be
less independent.). The evaluation of this and the next
scales based on six-point Likert scales (reaching from
/say1 = I totally disagree” to ”6 = I totally agree). The
attitude towards care was evaluated using 12 items
(α = .74) covering aspects like the desired living sit-
uation in older age (e.g., “I do not wish to be placed
in a nursing home under any circumstances.”), needs
for autonomy and independence (e.g., “In my every-
day life I would improvise to be able to do things my-
self.”), and who should be the caregiver in case of care
needs (e.g., “I’d be glad to have someone in my fam-
ily to help me.”). After these aging- and care-related
aspects, the participants were introduced to the devel-
opment of lifelogging technologies and their potential
benefits and barriers within the third part of the sur-
vey. The participants should empathize with the situ-
ation that they are in need of care themselves and that
assisting lifelogging technology has the potential to
facilitate their everyday life by detecting emergencies
such as falls or by reminding for daily routines (such
as intake of medicine or adherence to schedules). In
the following, the participants were asked to assess
each nine potential benefits (α = .94, e.g., “Increase
in independence (autonomy)” or “Fast reactions in
emergencies”) and potential barriers (α = .89, e.g.,
“Insights into personal health data for unauthorized
persons” or “Replacing human care by technology””
of using lifelogging technology in older age. Finally,
the participants evaluated their acceptance and inten-
tion to use lifelogging technology using three items
(α = .76; e.g., “I do not want to use an assisting lifel-
ogging system.” or “I think an assisting lifelogging
system is generally useful.”). For all these evalua-
tions, also six-point Likert scales were used. At the
end of the survey, the participants had the opportunity
to give feedback on the topic and the survey.
3.2 Data Acquisition, Preparation, and
In order to reach representative samples (in particular
with regard to age) and participants from five differ-
ent countries, the service of an independent market
research institute was used. The respondents were
invited to participate in the survey via email by the
market research institute. Further the market research
institute was engaged to acquire respondents from the
mentioned five countries, fulfilling previously defined
age and gender quotas (i.e. equal distributions with
regard to gender and age groups: 18-40 years, 41-65
years, 65+ years).
As only complete data sets could be used for de-
tailed statistical analyses, incomplete data sets were
excluded from the data base. In addition, partici-
pants with very short processing times (less than the
median of the processing time 30%) were also ex-
cluded from the subsequent data analysis. As a fur-
ther preparation for the data analysis, negative items
were re-coded, all scales were tested for reliability,
and overall scores were calculated.
For the statistical analysis of the influence of the
participants’ cultural origins on the perceptions of ag-
ing, care, benefits, barriers, and acceptance of lifelog-
ging technologies, one-way between groups analyses
of variance (ANOVA) were applied in order to an-
alyze potential differences between Spanish, Italian,
Canadian, Swedish, and German participants (partial
eta squared (η
) was calculated for effect sizes). If
the homogeneity of variance was violated, Brown-
Forsythe (BF) tests were applied in order to verify the
equality of group variances. In order to identify spe-
cific differences between the countries, Tukey’s post-
hoc tests were applied. Significant group differences
are presented using square brackets within the dia-
grams in addition to the respective significance level.
To analyze potential relationships between the per-
ceptions and acceptance, Pearson’s product-moment
correlation coefficients (r) were calculated for contin-
uous variables. In the following, means (M) and stan-
dard deviations (SD) are reported for descriptive anal-
yses and the level of statistical significance (p) was set
at the conventional level of 5% (*p < .05; **p < .01).
3.3 Description of Participants
After the data cleansing (deleting incomplete data
sets, speeders etc. (n=568; 33.6%)) a final sample
of N = 1123 participants remained for further sta-
tistical analyses. As mentioned above, the partic-
ipants were recruited by an online-panel of a mar-
ket research institute and were paid for participating.
The participants were on average 49.7 (SD = 16.1)
years old (min = 18; max = 99) and the proportion
of male (48%; n = 539) and female (52%; n = 584)
participants was almost balanced. The educational
level of the sample was rather high, as 49% (n =
550) of the sample reported to hold a university en-
trance qualification (or completed apprenticeship) and
44.9% (n = 504) a university degree. In contrast, only
ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health
6.1% (n = 69) of the participants reported a lower
educational level (i.e., completed secondary school).
Regarding their living situation, the majority of the
sample indicated to live together with their families
(45.4% n = 510), while 28.7% (n = 322) reported to
live together with another person and 25.9% (n = 291)
live alone. According to the topic of the study (using
assisting lifelogging technologies in older age), the
participants were also asked for the indication of their
health status, potential care needs, and previous expe-
riences in care. Thereby, 37.8% (n = 424) of the par-
ticipants reported to suffer from at least one chronic
disease, while 12.6% (n = 141) indicated to depend
on care and assistance in their everyday life. Further,
23% (n = 258) of the participants reported profes-
sional experience in care. Regarding private experi-
ence with care, 32% (n = 359) reported to have pas-
sive experience, which means that they currently have
a person in need of care within their family circle.
Even more participants (41.8%; n = 469) indicated to
have an active experience in care (i.e., they have been
the caregiver for a family member in need of care).
As the study aimed for a cross-national and cross-
cultural comparison, the participants came from five
different countries: Canada (26.3%; n = 295), Swe-
den (26.7%; n = 300), Spain (13.3%; n = 149), Italy
(13.4%; n = 150), and Germany (20.4%; n = 229).
The participants’ characteristics depending on the dif-
ferent countries are described within the next section.
3.4 Description of Cultures
All characteristics of the participants depending on
their (cultural) origins are illustrated in Table 1, which
shows that the five countries did not differ signifi-
cantly with regard to the participants’ age. The distri-
butions of male and female respondents were slightly
different, but not at a significant level. Looking at
the countries’ average educational levels, post-hoc
tests revealed that the participants from Italy and Ger-
many differed both considerably from the participants
from Sweden, Canada, and Spain by holding larger
proportions of low (Germany) and middle education
(Italy). With regard to their living situation, post-hoc
tests showed that Spain as well as Italy differed each
significantly from Germany and Sweden. Thereby,
higher proportions of the Spanish and Italian partic-
ipants lived together with their families and only very
small proportions lived alone, compared to Germany
and Sweden. Moving to health-related characteristics,
the proportions of people suffering from a chronic dis-
ease was considerably higher in the German group
compared to all other countries (post-hoc tests). In
contrast, the proportion of people who indicated to
depend on assistance and care in their everyday life
was significantly higher in the Swedish participants
compared to all other countries (post-hoc tests). In the
area of previous experience in care, the German and
the Canadian participants were characterized in post-
hoc tests by significantly lower percentages of people
having professional care experience each compared to
Spain, Italy, and Sweden. Concerning passive private
care experience, the Canadian group hold the consid-
erably lowest experience compared to all other coun-
tries, while the proportion of people being passively
experienced was significantly highest in the Italian
group (compared to all other countries). Finally, the
proportions of people having active care experience
were also significantly different, revealing the high-
est proportions of experience for the Italian and Span-
ish participants, followed by Sweden and Canada. In
contrast, the active care experience was lowest in the
German group of participants.
Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age
1 2 3 4
... are cared by their family at home.
... are cared by a care service at home.
... are cared in an inpatient nursing home.
... are only then cared in an inpatient nursing home,
when there is no other way.
evaluation (min = 1; max = 4)
rejection agreement
Handling of Care within Families
Figure 2: Evaluation of handling of care within families depending on the participants’ origins.
The following section represents the results of the
study, starting with handling of care, and attitudes to-
wards aging and care. Further, the results regarding
the perception of benefits and barriers as well as the
participants’ acceptance of lifelogging technology in
older age are presented. In addition to the answer-
ing of the research questions related to the influence
of the participants’ origins on the evaluations, overall
relationships between the attitudes, perceptions, and
acceptance are shown.
4.1 Handling of Care
In a first step (RQ1), handling of care within families
was analyzed depending on the five countries in order
to understand if life in older age and, in particular,
aging and care are handled differently. The results are
presented in Figure 2.
All four items related to the beginning “In my
family it is usual that older family members in need
of care...” were evaluated significantly differently by
the participants. Thereby, the item “... are cared by
their family at home” (F(4, 1036.65) = 36.40; p <
.01; η
= .11) was clearly confirmed by the Span-
ish participants (M = 3.39; SD = 0.82), followed by
the Italians (M = 3.14; SD = 0.99), whereas signif-
icantly lower agreements were found for the Ger-
man (M = 2.79; SD = 0.95) and the Canadian (M =
2.65;SD = 1.04) participants. In contrast, caring
older family members at home was slightly rejected
by the Swedish participants (M = 2.33; SD = 1.11).
The opportunity that older family members “...
are cared by a care service at home” (F(4, 845.25) =
26.75; p < .01; η
= .09) was only marginally pos-
itively evaluated by the German (M = 2.66;SD =
0.82) and the Spanish participants (M = 2.52; SD =
1.13). However, it was rejected and significantly
lower evaluated by the Italian (M = 2.01;SD = 1.08),
Canadian (M = 1.91; SD = 0.95), and Swedish partic-
ipants (M = 1.97; SD = 1.04).
All participants rejected that it is usual that older
family members “... are cared in an inpatient nurs-
ing home”, but to a significantly different extent
(F(4, 822.02) = 4.89; p < .01; η
= .02). Thereby,
the Spanish (M = 2.09; SD = 1.15) and German par-
ticipants (M = 2.05;SD = 0.81) showed a lower rejec-
tion than the Swedish (M = 1.91; SD = 0.94), Cana-
dian (M = 1.83; SD = 0.88), and in particular the Ital-
ian participants (M = 1.70; SD = 0.90).
Finally, also the evaluation pattern of the last op-
tion “... are only then cared in an impatient nursing
home, when there is no other way” was characterized
by significant differences (F(4, 840.06) = 19.13; p <
.01; η
= .07). Here, the German participants showed
the clearly highest agreement (M = 3.21; SD = 0.87),
followed by the Canadians (M = 2.79; SD = 1.04). In
contrast, the Swedish (M = 2.60;SD = 1.11) and the
Spanish participants (M = 2.56;SD = 1.18) showed
almost neutral evaluations, while a slight rejection
was found for the Italian participants (M = 2.31; SD =
ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health
4.2 Attitudes towards Aging & Care
In a next step (RQ2), the participants’ attitudes to-
wards aging and care were investigated. The over-
all results regarding the attitude towards aging are
presented in Figure 3 and a significant difference
was found (F(4, 889.41) = 2.40; p < .01; η
= .01).
Thereby, the positive overall attitudes of the Swedish
(M = 4.13;SD = 0.84), Spanish (M = 4.12;SD =
0.95), German (M = 4.04; SD = 0.75), and Canadian
participants (M = 4.01; SD = 0.84) were rather simi-
lar. In contrast, the Italian participants’ attitude (M =
3.89;SD = 0.83) towards aging was significantly less
positive (compared to the Swedes).
1 2 3 4 5 6
evaluation (min = 1; max = 6)
rejection agreement
Positive Attitude towards Aging
Figure 3: Perception of aging depending on the partici-
pants’ origins.
Further, the results referring to the participants’
attitude towards care are shown in Figure 4 and re-
vealed also a significant difference (F(4, 1122) =
4.75; p < .01; η
= .02). Thereby, a positive atti-
tude towards care included high needs for indepen-
dence and autonomy as well as wishes for staying
longer within the own home. The evaluations of all
participants were positive, revealing significant dif-
ferences between the Swedish holding a compara-
bly lower (M = 4.19; SD = 0.66) and the Spanish
(M = 4.40;SD = 0.73) as well as the German partici-
pants (M = 4.37;SD = 0.61) with a comparably more
positive attitude towards care.
1 2 3 4 5 6
evaluation (min = 1; max = 6)
rejection agreement
Attitude towards Care
Figure 4: Perception of care depending on the participants’
4.3 Perception of Benefits & Barriers
To identify potential differences regarding the evalua-
tion and perception of lifelogging technology, also the
perception of technology-related benefits and barriers
was examined (RQ3). For this purpose, the partici-
pants evaluated each several benefits and barriers with
regard to their agreement or rejection of the respective
Starting with the perception of benefits, the overall
results depending on the different countries are pre-
sented in Figure 5 and revealed significant differences
between the countries (F(4, 1122) = 13.58; p < .01;
= .05). The Spanish participants (M = 4.96; SD =
0.80) showed definitely the highest evaluation of ben-
efits of using lifelogging technology, followed by the
Italian participants (M = 4.80; SD = 0.91). The Cana-
dian (M = 4.59;SD = 0.76) and the German partici-
pants (M = 4.55;SD = 0.82) showed also a positive
evaluation, while the Swedish participants evaluated
the benefits of using lifelogging technology least pos-
itive (M = 4.40; SD = 0.88). It can be taken from
Figure 5 that significant differences (p < .01) were
located between Spain on the one hand, and each
Canada, Germany, and Sweden on the other Hand. In
addition, there were also significant differences be-
tween Italy on the one hand, and Germany (p < .05)
and Sweden (p < .01) on the other hand. Finally, also
the difference between the Canadian and the Swedish
participants was on a significant level (p < .05).
Moving to the perception of barriers, the results
are shown in Figure 6 and revealed also significant
differences with regard to the participants’ origins
(F(4, 847.4) = 11.15; p < .01; η
= .04). Here, it
was striking that the German (M = 3.78; SD = 0.95),
Canadian (M = 3.74; SD = 0.85), and Swedish par-
ticipants (M = 3.68; SD = 0.91) showed slight con-
firmations of the potential barriers of using lifelog-
ging technology in older age, while the barriers were
evaluated almost neutrally by the Spanish participants
(M = 3.49; SD = 1.01). In contrast, the Italian partic-
ipants (M = 3.18; SD = 1.09) showed the lowest eval-
1 2 3 4 5 6
evaluation (min = 1; max = 6)
rejection agreement
Perception of Benefits
Figure 5: Perception of technology-related benefits depend-
ing on the participants’ origins.
Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age
1 2 3 4 5 6
evaluation (min = 1; max = 6)
rejection agreement
Perception of Barriers
Figure 6: Perception of technology-related barriers depend-
ing on the participants’ origins.
1 2 3 4 5 6
evaluation (min = 1; max = 6)
rejection agreement
Te c h n o l o g y A c c e p t a n c e
Figure 7: Acceptance of assistive lifelogging depending on
the participants’ origins.
uations, indicating a slight rejection of the potential
barriers. With regard to the evaluation of barriers, all
countries differed significantly from the Italian eval-
uations. Further, the difference between the German
and the Spanish evaluations was on a significant level.
4.4 Acceptance of Assistive Lifelogging
The participants also evaluated their acceptance of us-
ing assisting lifelogging technology (RQ4, see Fig-
ure 7). The results revealed that participants of the
five countries also significantly differed with regard
to their acceptance and intention to use lifelogging
technology in older age (F(4, 921.16) = 10.91; p <
.01; η
= .04) and a diverse evaluation pattern was
observed: the Spanish (M = 4.64;SD = 0.96) and
Italian participants (M = 4.61; SD = 0.99) showed a
clearly higher level of acceptance compared to the
other three countries Germany (M = 4.28;SD =
0.95), Canada (M = 4.23;SD = 0.81), and Sweden
(M = 4.16; SD = 1.01), which revealed rather simi-
lar acceptance scores. The differences between the
Spanish and the participants from Germany, Canada,
and Sweden as well as the difference between the Ital-
ians and the participants from Germany, Canada, and
Sweden were all on a significant level (p < .01).
Perceived Benefits
Perceived Barriers
Attitude towards
Attitude towards
.174 **
-.144 **
.101 **
.508 **
.163 **
.343 **
.630 **
-.405 **
-.152 **
Figure 8: Relationships between the perceptions of aging,
care, benefits and barriers as well as technology acceptance.
4.5 Related Perceptions & Acceptance
In a final step of the analysis, it was investigated if the
participants’ perceptions of aging and care, of ben-
efits and barriers, and their acceptance of assisting
lifelogging technology were related with each other.
The results of a correlation analysis are shown in
Figure 8. As expected, the perception of benefits
was strongly positively related with the acceptance of
assisting lifelogging technology (r = .630; p < .01),
while a moderate negative correlation was found for
perceived barriers and the participants’ acceptance
(r = .405; p < .01). Thereby, the perception of
benefits and barriers was only weakly related (r =
.152; p < .01).
As comparably new insights, the analysis revealed
that a positive perception of aging was weakly pos-
itively related with the perception of technology-
related benefits (r = .174; p < .01) and with the ac-
ceptance of lifelogging technology (r = .101; p <
.01), while it was slightly negatively related with
perceived barriers (r = .144; p < .01). Consider-
ing the participants’ attitudes towards care, the re-
sults showed a strong relationship with the perception
of benefits (r = .508; p < .01), a moderate relation-
ship with the acceptance of lifelogging technologies
(r = .343; p < .01), and a weak correlation with the
perception of barriers (r = .163; p < .01). The iden-
tified results suggest the necessity to analyze those
connections and interrelations in more detail and in
dependence of different cultural origins in future re-
The current study revealed that the perception of ag-
ing and care, but in particular also the evaluation
ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health
and acceptance of assisting lifelogging technologies
in older age are influenced by the participants’ (cul-
tural) origins. This section discusses the results with
regard to the underlying research questions, critically
reflects the applied approach, and highlights the ne-
cessity of future work within the research field of as-
sisting lifelogging technology acceptance.
5.1 Influence of Culture
Starting with RQ1, the study revealed new insights
that the evaluation of handling of care differed sig-
nificantly with regard to the investigated countries.
In line with the previous research, which identified
country- and culture-specific differences with regard
to the respective health care systems as well as per-
ceived access to care (Blendon et al., 2002; Osborn
et al., 2016), the perception of care handling in this
study also depends on the country and its respec-
tive political and socio-economic circumstances. In
more detail, it was observed that caring for older fam-
ily members within the family is more usual for the
Southern Europe countries than for the more “North-
ern countries” Germany, Sweden, and Canada. Si-
multaneously, using the service of professional care
providers at home seems to be more usual for Ger-
many and Spain than for people in Italy, Sweden, and
Canada. In addition, none of the countries confirmed
that caring of older family members in inpatient nurs-
ing homes is usual, while this was most strongly eval-
uated to be only the last resort by the German partic-
ipants. Further, the results generally revealed positive
perceptions and also significant differences with re-
gard to a culture-specific perception of aging and care
(RQ2), however to a lesser extent (compared to RQ1,
RQ3, and RQ4). In tendency, the results showed that
the Swedish participants expressed a slightly higher
positive perception of aging (compared to Italian re-
spondents), while they simultaneously showed a less
“positive” attitude towards care (compared to Span-
ish and German participants). Thereby, a positive at-
titude towards care referred to high needs for auton-
omy and independence. In comparison, the evaluation
of technology-related benefits and barriers (RQ3) re-
vealed novel and more distinct country-specific eval-
uation patterns. Summarizing the results, the South-
ern Europe countries showed clearly higher evalua-
tions of benefits with a simultaneously lower evalu-
ations of potential barriers of using assisting lifelog-
ging technology compared to the rather “Northern”
countries, i.e. Germany, Sweden, and Canada. The
same pattern applied for the acceptance of using as-
sisting lifelogging technologies in older age (RQ4):
Here, Spain and Italy representing the southern part
of Europe indicated significantly higher acceptance
scores than the other rather northern countries
(Germany, Canada, Sweden). These culture-specific
insights are definitely novel and show the relevance of
adapting the technology development as well as com-
munication and information about innovative tech-
nologies to the needs of the respective user groups.
In line with this, the results confirmed that the ac-
ceptance of lifelogging technologies is related with
the perception of aging and care, but in particular
with the perceptions of benefits and barriers. Exactly
at this point, communication and information strate-
gies should consider the country- and culture-specific
findings from this study. For example, the higher
evaluations of barriers by the Swedish, German, and
Canadian participants let assume that the communi-
cation and information about the handling of poten-
tial barriers of using assisting lifelogging technolo-
gies are of high relevance for these potential users.
When perceived concerns are adequately addressed
and their handling comprehensively explained (e.g.,
transparent regulations of data storage and data access
Offermann-van Heek et al. (2019)), concerns could be
diminished and the probability of a sustainable accep-
tance and adoption of assisting lifelogging technolo-
gies could thereby be increased.
5.2 Limitations and Future Work
Although the study revealed novel insights into cross-
cultural perceptions of aging, care, and lifelogging
technologies in older age, there are still some limi-
tations with regard to the applied approach and nec-
essary future work that should be considered for fu-
ture research in the field. As a first limitation, it
should be kept in mind that the country-specific sam-
ples differed with regard to individual characteristics
of the participants (e.g., health status, care experi-
ence, etc.). For this study, it can therefore not be
excluded that the differences between the countries
were shaped by other user factors as well. Here, the
results should be analyzed for interaction effects be-
tween culture and other user factors (e.g., care experi-
ence, care needs etc.) in a next step. As one example,
the level of previous experience in using ICT applica-
tions could also be an interesting user factor, which
probably influences the perception and acceptance
of lifelogging technology. Other limitations of the
present study refer to the applied online survey and
the email-based invitation to participate in the sur-
vey. This procedure could have led to the fact that in
tendency especially technologically advanced (older)
people were reached. In order to include less tech-
nologically advanced (older) people likewise, future
Colors of Aging: Cross-cultural Perception of Lifelogging Technologies in Older Age
studies should apply both, online and paper-based sur-
veys. In addition, future investigations with regard
to this study should focus on an analysis of the sin-
gle benefits and barriers as well as decisions between
these technology-related aspects to gain more detailed
insights and possible explanations with regard to the
divergent evaluation patterns. A further limitation re-
gards the restricted number of countries which were
integrated into the present study. Nevertheless, ask-
ing participants from four different European coun-
tries and an additional non-EU country enabled a first
cross-national and cross-cultural investigation of dif-
ferences and similarities within the perceptions of ag-
ing, care, and lifelogging technology usage in older
age. The results showed that there were considerable
differences between the investigated countries. Fur-
thermore, future research should aim at integrating
even more countries from diverse continents in the
world, as it is assumed that in particular perceptions
of aging and care differ enormously when also partic-
ipants from developing countries are asked for their
opinions and perspectives.
The authors would like to thank all participants for
sharing their opinions on assisting lifelogging tech-
nologies. This work resulted from the project PAAL -
“Privacy Aware and Acceptable Lifelogging services
for older and frail people” and was funded by the
German Federal Ministry of Education and Research
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