The potential of aquaponics for the wellbeing of elderly citizens

Aquaponics may provide an optimal environment to reach several therapeutic goals in a variety of clients with cognitive and/or physical disabilities, and special population groups like the elderly, children, or developmentally challenged people. The therapeutic goals of health care professionals such as occupational therapists and physiotherapists are the promotion of and/or treatment for wellbeing.

The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this by working with people and communities to enhance their ability to engage in the occupations they want, need, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement (WFOT 2012). In occupational therapy, occupations refer to the everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do (WFOT 2012).

Physical therapists provide services that develop, maintain, and restore people’s maximum movement and functional ability. They can help people at any stage of life, when movement and function are threatened by ageing, injury, diseases, disorders, conditions, or environmental factors. Physical therapists help people to maximise their quality of life, looking at physical, psychological, emotional and social wellbeing (WCPT 2016).

From a therapeutic point of view, an aquaponic unit is a tool that can promote the development of cognitive-behaviour, sensory-motor integration, and motor skills. Activities that can be used as a therapeutic means involve participation in selection of the plants and fish, and their daily care and observation. The expected therapeutic effect of aquaponics in respect of wellbeing can be found in different areas of a person‘s functioning.

Cognitive-behaviour skills

During the process of management and care for fish and plants in an aquaponic unit, cognitive functions such as decision making, short term memory, long term memory, attentional span, reaction time, switching between the tasks, planning, and problem solving can all be facilitated. Decision-making is the process of identifying and choosing alternatives based on the values, preferences and beliefs of the decision-maker. Like cognitive function, decision-making across the life span shows profound age-related changes (Tymula et al. 2013) Short-term memory, is a system for temporarily storing and managing the information required to carry out complex cognitive tasks such as learning, reasoning, and comprehension. Short-term memory is the capacity for holding a small amount of information in the mind in an active, readily available state for a short period of time. For example, short-term memory can be used to remember a phone number that has just been recited. The duration of short-term memory (when rehearsal or active maintenance is prevented) is believed to be in the order of seconds (typically about 18 to 30 seconds) (APA 2006).

With aging the memory storage capacity is not the issue; the brain is not an overloaded hard drive. Rather, the changes appear to come in how people encode and retrieve information. Interference, such as distraction, and slower processing may impede retrieval, such as being able to remember names and dates. However, even with these subtle changes, the majority of older adults still seem to be able to efficiently acquire new information and park it in long-term memory. And implicit learning – learning without conscious effort – seems to more or less be unaffected into old age.

It is believed that a healthy lifestyle supports brain health. Regular aerobic exercise has been shown to aid cognition, probably because it boosts blood flow and brings more oxygen to the brain. Attention span is the amount of concentrated time a person can spend on a task without becoming distracted. Most educators and psychologists agree that the ability to focus and sustain attention on a task is crucial for the achievement of one’s goals. Attention span can have a major impact on performance at work and the ability to deal with the tasks of everyday life – one lapse in attention can result in missing out on important information, errors being made, or worse (APA 2006).

Reaction time is the elapsed time between the presentation of a sensory stimulus and the subsequent behavioural response. In psychometric psychology it is considered to be an index of processing speed: it indicates how fast the individual can execute the mental operations needed for the task at hand. In turn, speed of processing is considered to be an index of processing efficiency. Simple reaction time shortens from infancy into the late 20s, then increases slowly until the 50s and 60s, and then lengthens faster as the person gets into their 70s and beyond. In other words, contrary to their fervent belief, adolescents will probably have slower reaction times than adults. Reaction time also becomes more variable with age and with Alzheimer’s disease. The reason for slowing reaction time with age are not just simple mechanical factors like the speed of nervous conduction, but may be related to the tendency of older people to be more careful and to monitor their responses more thoroughly. It was found that old people who tend to fall in nursing homes had a significantly longer reaction time than those that did not tend to fall.

Sensory-motor integration

Sensory stimuli are increased during the process of management and care for fish and plants in an aquaponic unit, especially in the olfactory and somato-sensory modalities. Everyday objects are used for sensory stimulation, which in an aquaponics unit would be the plants and fish. The goal of sensory stimulation is to promote sensory-motor integration, evoke positive feelings, influence mood, and enhance self-esteem and well-being. Repetitive contact with intensive stimuli promotes sensory integration and enables people to develop cognitive-behaviour skills. Fragrant herbs provide intensive olfactory stimuli which are known to be involved in the limbic system or so-called emotional brain (Figure 3).

Occupational performance difficulties due to sensory modulation challenges or poor integration of sensation can result from difficulties in how the nervous system receives, organizes, and uses sensory information from the body and the physical environment for self-regulation, motor planning, and skill development. These problems impact self-concept, emotional regulation, attention, problem solving, behaviour control, skill performance, and the capacity to develop and maintain interpersonal relationships. In adults, they may negatively impact the ability to parent, work, or engage in home management, social, and leisure activities. Occupational performance concerns due to poor integration and processing of sensation may occur in isolation, contribute to, or coexist with other conditions such as anxiety and panic disorders, depression, post-traumatic stress disorder, or schizophrenia. Those with learning disabilities, attention deficit disorder, developmental disabilities, or autism spectrum disorders may also experience these difficulties. Poor sensory integration can be seen in various aspects of human life throughout the life span (Table 15.1). Used in Europe since the 1960s, sensory integration was originally designed to help people with learning disabilities. It was a way for them to explore a safe, stimulating environment that provided age-appropriate and enjoyable activities. It has been also found that this technique can be used to reduce as much as 30 years of cognitive ageing (WFOT 2012).

Figure 3: Sensory stimulation of touch and smell during management of herbs and other plants

Table 15.1: The consequences of poor sensory organization in adulthood (WFOT 2012)

Motor skills

Mobility is the basic skill that allows someone to adapt to their environment and to fulfil their physiological and psychological needs. Mobility skills can decrease due to injury, disease, or ageing. Decreased mobility leads to loss of independent life and a decrease in the quality of life. A consequence of poor mobility skills is often a sudden and unintentional fall with various outcomes. Fall-related injuries are more common among older people and are a major cause of pain, disability, loss of independence, and premature death (WHO 2007). The financial costs are substantial and are increasing worldwide. The personal, family, and societal impact of fall-related injuries for older people, their families, and society, and the possibility of effective interventions, make this an important global health issue. Effectively targeting resources for the prevention of falls and related injuries requires knowledge of the scale and nature of the problem as well as evidence of effective interventions. This requires raising awareness about the magnitude of older adult falls, intensifying research efforts, and encouraging action towards prevention worldwide.

Increasing number of elderly adults, their need to sustain an active and healthy lifestyle, and increasing costs for rehabilitation after falls are the principal driving force for policy makers, health authorities, and clinicians in the allocation of financial and human resources to find effective programmes for fall prevention and balance enhancement or maintenance. Balance deficits can arise from impairments of the body sensations, inner ear balance, muscles and bones, and vision, and have a significant negative impact on mobility and functional independence. Regular physical exercise has demonstrated its beneficial effect in increasing functional capacity, general mobility, balance, and gait (Gheysen et al. 2018). These are all key components in fall prevention programmes (WHO 2007).

Stepping from level ground onto an elevated surface, such as stair climbing or aerobic step training during exercise, is a complex balance activity. It requires shifting the weight from one leg to the other and stabilisation of the loaded leg, dynamic stability during weight shifts, height and depth perception, eye-leg coordination for height and depth of stairs negotiation, sufficient concentric muscle power to lift the weight of the body during ascending, and sufficient eccentric muscle power to lower the body during descending. Stepping thus includes eight of the identified nine balance components. Dual tasking has become an increasing demand of everyday life. Dual tasking is defined as the concurrent performance of two tasks that can be performed independently and have distinct and separate goals. When humans attempt to do more than one thing at the same time, performance usually suffers. This is called dual task cost. These costs are assumed to arise in the level of information processing within the central nervous system. The decline in quality and speed in the simultaneous execution of two tasks is explained by tasks competing for a limited set of resources. In particular, the attention function is important, since greater attention is implicitly associated with the increased level of cognitive processing required to perform the desired task. The person must increase the level of attention devoted to one task in order to adapt to its increased complexity. The decline in the quality of performance in dual tasking is explained by two theories (Agmon et al. 2014). The capacity theory assumes that the consequence of the simultaneous use of limited attention resources is reduced and the person switches attention from one to the other task. The bottleneck theory, on the other hand, assumes that parallel processing is more difficult when the same cognitive operations are required, and a person prioritizes one task over another and treats them sequentially.

In everyday life people are engaged in the simultaneous performance of several different activities while maintaining postural control and walking. Common functional tasks coupled with standing and walking include cooking, talking on the phone while walking, and talking while crossing the road. Although balance and walking are basic skills for independent and active life, there is still no consensus on how far postural control and walking are automated, or how much attention is needed for their maintenance. Therefore, several therapeutic approaches have been developed where dual tasking situations are safely practiced. The pairs of tasks can be two motor tasks (carrying of objects while walking) and a motor and a cognitive task (standing or walking while talking or decision making). Current research indicates that there is a decrease of dual task cost after training, although it is limited to trained pairs of tasks (Agmon et al. 2014).

Figure 4: An example of obstacle negotiation path as a part of balance specific training of community dwelling elderly (Photographs by Darja Rugelj)

The aqaponic unit can be designed in a way that provides a reach environment for training mobility skills such as balance training, obstacle negotiation, and avoidance during gait, as well as for dual task training. The most prominent skills that are known to decrease the incidence of falls in elderly people are stepping, stair climbing, obstacle negotiation, and turning around vertical axes (Guirguis- Blake et al. 2018). However, environmental risk factors should be recognised, and the environment of an aquaponic unit should comply with known standards of environmental safety. Micro aquaponic system seem to provide an ideal tool for therapeutic and educational purposes given their low cost and low space requirements (Maucieri et al. 2018). Furthermore, the operation of an aquaponic system requires a variety of different professionals, and therefore it is an ideal environment for building interpersonal communication skills and team work in schools or with physically or mentally challenged groups (Morano et al. 2017).

Copyright © Partners of the Aqu@teach Project. Aqu@teach is an Erasmus+ Strategic Partnership in Higher Education (2017-2020) led by the University of Greenwich, in collaboration with the Zurich University of Applied Sciences (Switzerland), the Technical University of Madrid (Spain), the University of Ljubljana and the Biotechnical Centre Naklo (Slovenia).