Can Changes in Older Adults' Technology Use Patterns be Used to Detect Cognitive Decline?

BACKGROUND AND OBJECTIVES: The number of older adults diagnosed with dementia is expected to more than double by mid-century. Monitoring older adults' cognitive functioning is essential for the early detection of dementia, which can increase treatment efficacy and slow the disease progression. Current approaches to detect preclinical dementia are expensive, invasive, and are not accessible to everyone. This study aimed to determine whether technology use patterns could be used as an indicator of cognitive change. RESEARCH DESIGN AND METHODS: Using six waves (2015 - 2020) from the National Health and Aging Trends Study (NHATS), we examined within-person and between-person effects of stopping four types of technology use on four cognitive outcomes. RESULTS: Our analyses showed that stopping the use of the Internet, computers, tablets, and sending texts and emails were related to cognitive decline. DISCUSSION AND IMPLICATIONS: These results suggest that monitoring technology use patterns may be an innovative approach that is economical and efficient to identify individuals at risk of cognitive decline.

Social Media Use May Not Be As Bad As Some Suggest: Implication for Older Adults.

Background and Objectives: Social media use (SMU) has increased over the past decade among older adults. Cross-sectional studies report SMU is related to negative mental health outcomes (i.e., depression). Given depression is the most common mental health issue for older adults and increases the risk of morbidity and mortality, determining longitudinally whether SMU is related to increased depression is critical. This study examined the longitudinal relationship between SMU and depression. Research Design and Methods: Data from 6 waves (2015-20) of the National Health and Aging Trends Study (NHATS) were analyzed. Participants included a nationally representative sample of U.S. older adults, aged 65 years and older (N = 7,057). We used a Random Intercept Cross-Lagged Panel Modeling (RI-CLPM) framework to examine the relationship between primary outcomes of SMU and depression symptoms. Results: No pattern was found of SMU predicting depression symptoms, or depression symptoms predicting SMU. The major driver of SMU in each wave was SMU in the previous wave. On average, our model accounted for 3.03% of the variance in SMU. The major predictor of depression in each wave was the pre-existing depression. Our model accounted for an average of 22.81% of the variance in depressive symptoms. Discussion and Implications: The results suggest that SMU and depressive symptoms are driven by the previous patterns of SMU and depression, respectively. We did not find any patterns of SMU and depression influencing each other. NHATS measures SMU with a binary instrument. Future longitudinal research should employ measures that account for SMU duration, type, and purpose. These findings suggest that SMU may not be related to negative health outcomes, in this case, depression, for older adults.

Online health information seeking and the association with anxiety among older adults.

Introduction: The Internet supplies users with endless access to a wealth of information and is generally the first source searched by U.S. adults (18 years and older) when seeking health information. Age and anxiety are associated with online health information seeking (OHIS). Older adults (65 years and older) are increasing their OHIS. Importantly, OHIS can potentially lead to improved health outcomes for older adults. The relationship between OHIS and anxiety is less clear. Studies report those with more symptoms of anxiety are more likely to be OHIS, while other studies find the reverse pattern or no association. Generalized anxiety disorder affects up to 11% of older adults and is oftentimes unrecognized and untreated. Methods: To address the mixed findings in the literature, we analyzed six waves (2015-2020) of data from the National Health and Aging Trends Study to assess the causal relationship between anxiety and OHIS using a Random Intercept Cross-lagged Panel Model framework. Results: We found that while anxiety symptoms lead to OHIS in the next wave, OHIS was not associated with anxiety symptoms in the next wave. Discussion: This suggests that for this sample of older adults, OHIS does not reduce or exacerbate older adults' symptoms of anxiety.

Active and passive social media use are differentially related to depressive symptoms in older adults.

OBJECTIVES: Previous research on social media use (SMU) and mental health has focused on younger individuals. For example, in young adults active SMU (e.g. posting content) has been related to decreased depressive symptoms, whereas passive SMU (e.g. browsing content) has been related to increased depressive symptoms. These relationships have not yet been investigated in older adults, however, even though SMU and poor mental health are common. METHODS: We collected data from adults aged 65 years and older, and categorized SMU into active and passive dimensions with a principal component analysis. Next, we conducted t-tests and logistic regressions to assess whether older adults' SMU was associated with depressive symptoms. RESULTS: Our analysis revealed that active SMU was associated with increased odds for depressive symptoms, whereas passive SMU was associated with decreased odds for depressive symptoms. CONCLUSION: Our results suggest that the relationships between active and passive SMU and depressive symptoms in older adults are different from previous literature focusing on younger individuals. We theorize that these findings may be due to older adults' engaging in fewer social comparisons overall, and hence experiencing fewer negative feelings while passively viewing others' social media posts.

Established Adults, Who Self-Identify as Smartphone and/or Social Media Overusers, Struggle to Balance Smartphone Use for Personal and Work Purposes.

Smartphone ownership and use continues to proliferate, allowing people to easily access online communication, entertainment, and information. Importantly, individuals can perceive that they overuse their smartphone and/or the social media applications (apps) they access on their devices. Much of the research on smartphone overuse has focused on youth and emerging adults, with little research focusing on individuals in the established adulthood stage of life. This study examines smartphone use among established adults who perceive that they overuse their smartphone and/or social media. As part of a larger study, we conducted in-depth interviews with 21 individuals (30-45 years old) who self-identified as smartphone and/or social media overusers. Data were collected through a pre-survey, 1-hour interview, and smartphone use screenshots. Audio-recorded interviews were transcribed and then coded using NVivo software. Participants' average age was 35.9 years (SD = 4.1). The majority of the sample were female (67%), White (76%), and had a master's degree or higher (76%). Participants spent an average of 215 min on their smartphone daily, primarily using social media, video conferencing, and texting apps. Issues with smartphone use occurred when there was an unclear separation between work and personal use. Participants felt pressure to always respond quickly to work emails. An effort was made to limit smartphone use for work and during family time to be present for their family. Established adults strive to balance smartphone use for personal and work purposes. Creating boundaries for how and when established adults use their smartphone may help them find this balance.

Social media use and well-being among older adults.

While older adults (aged 65 years and older) are increasingly using social media, their usage rates still lag those of younger age groups. Social media use has been observed to have some positive effects on older adults' well-being; however, divergent findings exist depending upon the sample, measures, and methodological approach. This review highlights what is currently known about social media use and well-being among older adults, identifies strengths and weaknesses of current research on this topic, and argues that methodological and content-related research gaps must be closed before researchers can confirm a positive overall effect of social media use in everyday situations for older adults.

COVID-19's Influence on Information and Communication Technologies in Long-Term Care: Results From a Web-Based Survey With Long-Term Care Administrators.

BACKGROUND: The prevalence of COVID-19 in the United States led to mandated lockdowns for long-term care (LTC) facilities, resulting in loss of in-person contact with social ties for LTC residents. Though information and communication technologies (ICTs) can be used by LTC residents to support their socioemotional needs, residents must have access to ICTs to use them. OBJECTIVE: This study explored ICT access and use in LTC facilities and how LTC facilities adapted to try to enhance social connections for their residents during the COVID-19 pandemic. METHODS: LTC administrators in South Carolina (United States) were invited to complete a web-based survey exploring ICT access and use in LTC facilities and whether access and use changed as a result of the COVID-19 pandemic. RESULTS: LTC administrators (N=70, 12 nursing homes [NHs], and 58 assisted living facilities [ALFs]) completed the web-based survey. Since March 2020, a total of 53% (37/70) of the LTC facilities have purchased ICTs for residents' use. ICTs have mainly been used for videoconferencing with family members (31/36, 86%), friends (25/36, 69%), and health care providers (26/36, 72%). NHs were 10.23 times more likely to purchase ICTs for residents' use during the COVID-19 pandemic than ALFs (odds ratio 11.23, 95% CI 1.12-113.02; P=.04). Benefits of ICT use included residents feeling connected to their family members, friends, and other residents. Barriers to ICT use included staff not having time to assist residents with using the technology, nonfunctional technology, and residents who do not want to share technology. CONCLUSIONS: Our results suggest that over half of the LTC facilities in this study were able to acquire ICTs for their residents to use during the COVID-19 pandemic. Additional research is needed to explore how residents adapted to using the ICTs and whether LTC facilities developed and adopted technology integration plans, which could help them be prepared for future situations that may affect LTC residents' engagement and communication opportunities, such as another pandemic.

Solutions to the Challenge of Meeting Rural Transportation Needs: Middle-Aged and Older Adults' Perspectives.

This study aimed to explore how the aging population in Appalachia manages its transportation and plans for the transition to non-driving and to seek possible solutions to the challenge of meeting rural transportation needs. Four focus groups (N = 38) were conducted, supplemented by a questionnaire, in Appalachian Kentucky. The results showed that few alternative transportation existed except a local paratransit service and informal transportation support. Compared to older adults, middle-aged adults reported a greater willingness to use mobile phones and the Internet to arrange transportation if they were available. Participants also recommended expanding the use of existing transportation in the community - such as church vans - to better meet the aging population's needs. The findings suggest that partnership between government, non-profit, and private sectors is needed, not solely focusing on a tax-dependent solution. Additionally, information and communication technology-based transportation management system would help maximize the use of scare but existing resources in rural areas.

Video Communication With Cognitively Intact Nursing Home Residents: A Scoping Review.

Limited research exists examining video communication among cognitively intact nursing home residents to connect with family. This scoping review evaluated existing literature for video communication usage with nursing home residents, family, and nursing homes. A comprehensive search was completed using PubMed and EBSCOhost (including AgeLine, CINAHL, and PsycINFO) between 1972 and 2016 to locate English-language articles. The analysis identified five eligible studies (four involved an intervention, one assessed family views) meeting inclusion criteria. Findings included, seeing family members separated by distance, seeing other parts of their life, and visually monitoring resident's health. Participants described frustration with technology limitations, such as video or audio lag. Current literature does not show a comprehensive assessment of video communication usage for residents, family, and nursing homes. Future studies should address the complexity of the intersection of the person, nursing home, and families in terms of potential benefits and capability of video communication use with residents.