Adaptations in the Age of Technology in Seniors
Citation: Adaptations in the Age of Technology in Seniors. American Research Journal of Geriatrics and Aging; V1, I1; pp:1-13.
Copyright This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The deployment of technology in today’s environment has led to significant advancements in communication, socialization, and information sharing. We hypothesized that the benefits of these technologies might be underutilized in the geriatric population. Previous methods of assessing an individual’s capacity for independent living relied on tools such as the Activities of Daily Living (ADL) and the Instrumental Activities of Daily Living (IADL). In recent years, with a proliferation of devices requiring technology, there exists a need for new instruments to evaluate the functional capacity of older individuals in the understanding and use of technology. We developed a structured survey to investigate the frequency of utilization of technology (cell phones, computers, blood pressure monitors, etc.) and the application and understanding of these technologies by older patients (50–90+yrs., n=127) at a geriatric out-patient university clinic. Our results indicated that while >97% of individuals surveyed possessed a cell phone, only 83% made calls daily, with less than 55% utilizing text messaging. 83% of individuals owned a computer and only9% lacked internet connectivity. There were several differences in the understanding and use of technological devices between the octogenarian-nonagenarian compared with younger age groups. Nevertheless, 75% of seniors were either interested in learning more about their cell phones and how to use the different features, or already knew how to use their cellphones. In summary, our results showed that older individuals were utilizing technology and were interested in advancing their technological skills. It is important to test the ability of older adults in their understanding and use of technology because its appropriate use can be helpful for monitoring health, security, communication and maintaining an independent lifestyle. Keywords: technology, elderly, function, communication
Keywords: technology, elderly, function, communication
Currently, more than 13% of the US population is greater than 65 years of age . Since more than 70% of those in the geriatric age group live independently, technological adaptation is essential to facilitate everyday tasks. Such knowledge may support the ability to age in place, allowing the elderly to maintain their physical independence as well as maintaining a strong social life, even for those who are physically or geographically isolated [3-6].Furthermore, information and communication devices (ICDs) such as cell phones, tablets, and computers, can provide methods for communication, entertainment, and lifesaving functions in emergencies. Studies have demonstrated a desire for older individuals to adopt new technologies to facilitate a safer home environment and increased physical health, as well as assist with the development of knowledge acquisition [6-8].
In 2006, the Center for Research and Education on Aging and Technology Enhancement (CREATE) reported thatolder individuals were less likely to adopt ICDs than their younger peers . This hesitation of the older adultsin using ICDswas due in part to difficultyoperating the devices and understanding the complexities of eachdevice, including ATMs, cell phones, computers, and other devices[9-16]. However, adoption of technology byolder individuals has been shown in some studies to decrease depression and improve self-esteem, particularlyin individuals living alone, or for whom a physical limitation (other than old age) decreases their ability tosocialize [6, 17,18].
Understanding the utilization of ICDs in the aging population is critical for maintaining independence inmodern society. Furthermore, adoption of ICDs could provide additional benefits to older individuals includinghealth monitoring, communication, intellectual stimulation and education. Herein, we explore the use of ICDsby community dwelling elderly individuals and how they interact with technology.
Materials and Methods
This study was conducted at the Thomas and Lyon Longevity Clinic, one of the largest geriatric outpatientclinics in the United States, located at the University of Arkansas for Medical Sciences (UAMS). Participation waslimited to individuals over the age of 50.The study was approved by the Institutional Review Board at UAMS(IRB protocol # 202655).
This was a cross-sectional study using a convenience sample methodology. Ananonymous 51-questionstructuredsurvey was designed to evaluate the personal ownership and utilization of ICDs (cell phones, tablet, computers),as well as other electronic technology (alarm systems and health monitoring devices). Geriatric patients inthe waiting room of the clinic were asked if they wanted to participate in a brief anonymous survey on use oftechnology(n=127). If the patients agreed, they were offered either electronic or paper versions of the surveyto complete.Participants either completed the survey themselves or a trained research technician read thequestions and possible answers to them, and the participants indicated the answer(s) they favored.
The survey results were analyzed with SAS software (version 9.3, SAS Institute Inc.). Categorical variables werepresented as counts and percentages. Responses to questions in different age groups were compared using thestandard t-test or Mann-Whitney U test and the Chi-square or Fisher’s exact test, where applicable, with a cut-offp-value< 0.05 for significance.
The majority of the subjects were between 70-79 years (46%), followed by age groups60-69 (29%) and 80-89years (14%). Those between 50-59 years of age and > 90 years represented 6% and 5% of the study subjects,respectively. This was a relatively well educated cohort with a significant number of the participants havingan advanced degree (44%) or at least a bachelor’s degree (37%). Individuals who only finished high school orgrade school represented 14% and 4%, respectively (Table 1).
Table 1: Demographic information from survey participants. Most were in the 70-79 year old group, had attaineda professional education level, and used technology every day during their career.
Significant technological device ownership exists in elderly populations
We examined ICD ownership by survey participants of cell phones, tablets, and personal laptop/computers.We found 98% of participants owned a cell phone, including 83% of individuals over the age of 90. High levelsof ownership were also observed for personal computers and/or laptops, with 83% of participants possessingthese devices. All individuals 80-89yearsofage had a computer in their house, in contrast to only about 50%of individuals aged 90 or above. Conversely, tablet ownership was comparatively smaller, with only 43% of allindividuals surveyed owning a tablet. There was a significant difference between ownership of a tablet betweenoctogenarians and nonagenarians versus the other age groups (p < 0.05). Only22% of 80-89yearolds ownedtablets versus 60% of participants between ages 50-59 (Figure 1). None of the participants over age 90 owneda tablet.
Fig 1: Ownership of information and communication devices (ICDs) in the different age groups surveyed. Nearly98% of all individuals surveyed owned a cell phone, and over 82% owned a computer, while only 43% owned atablet. *p< 0.05 for tablet; <80 years old vs 80+ years old.
In addition to asking participants about ICDs, we also enquired about ownership of other technological devices.100% of the 50-59 year old group owned both a GPS device and a DVD player. There was a significant difference between the age groups in the use of GPS devices, which ranged from 0-53% in the ≥70 year old groupvs 76-100% between ages 50-69 (p < 0.05). None of those over 90 years owned a GPS device. DVD playerswere commonly owned by all age groups except the 90+ year old group. Electronic medical devices, such asblood pressure machines and glucometers,were reported by 64% of the participants. The highest percentage ofownership of electronic health devices was claimed by the 50-59 year olds at 75%, while the lowest percentagewas found among the 80-89 year olds at 56% (Table 2).
Table 2: DVD players and electronic medical devices were very common among nearly all of this surveyed cohort.However, for GPS devices, there was a linear inverse relationship between age and ownership.‡Blood pressuremachine and/or glucometer.*p<0.05 for GPS device; <70 years old vs >79 years old.
Elderly individuals are actively using cell phones.
As almost all study participants acknowledged ownership of a cell phone, we wanted to explore how often theparticipants used them. Participants were asked to rate their cell phones usage as “daily”, weekly”, or “only incase of emergency”. Our results suggested a relationship between increased age and decreased cell phone usage.Allindividuals between 50-59 years old used their cell phones daily, whereas more than 80% of those <80 yearsold considered themselves daily users. This trend was reversed in the octogenarians and nonagenarians for“weekly” and “emergency only”, which accounted for 20-22% of their calls, respectively (p < 0.05, Figure 2).
Fig 2: Cell phone usage. Those who indicated that they owned a cell phone were then asked how often it was used.More than 80% of all individuals surveyed used their cell phone daily. Less than 9% indicated that they only used the cell phone if there was an emergency. *p< 0.05 for daily use; <60 years old vs. 80+ years old.
Are elderly individuals sending/receiving text messages?
In order to understand how individuals were using cell phones to communicate, we investigated how oftentext-based communications were being sent or received. The results indicated an inverse relationship betweenage and sending/receiving texts. Approximately 88% of individuals 50-59 years of age reported receiving textmessages daily, and only 63% sent text messages. This trend continued downward with a significant differencein receiving or sending texts in the octogenarians and nonagenarians vs other age groups (p <0.05, Figure 3).
Fig. 3: Frequency of received and sent text messages for individuals who owned a cell phone. Over 40% of allindividuals in this demographic reported either sending or receiving text messages on a daily basis. The highestprevalence of daily text messages was in the 50-59 year old group, while those 90 and over did not report havingused text messaging at all. *p< 0.05 for sending and receiving texts; <80 years old vs 80+ years old.
What type of cell phone operating systems are being utilized by the elderly?
We wanted to understand whether elderly individuals knew the type of operating system (OS) that wasinstalled on their cell phones. In addition to the three most common OSs (Android, iOS, and Windows), choicesfor “unsure”, “other”, and “No OS” were also provided. We discovered a preference for iOS in this population,with 32% of all participants listing this OS, including 88% of those aged 50-59. Additionally, 15% and 9% ofall participants listed Android and Windows OSs, respectively. However, increasing age was associated with asignificant gap in knowledge of operating systems with 50% of octogenarians and 80% of nonagenarians beingunsure about the OS in their cellphone vs other age groups (p <0.05). Interestingly, 10% of all individuals listedtheir phone as not possessing an operating system. (Figure 4).
Fig. 4: Cell phone operating systems (OS). Participants were asked to identify what, if any, operating system their cellphone used. Only 20% stated that they were not sure, while 69% were not only aware that their cell phone used an OS, they were able to indicate what OS the cell phone used. *p< 0.05 for “unsure” response; <80 years old vs 80+ years old.
Are the elderly using their cell phone for non-traditional uses?
While cellphone use was listed as daily for most of the survey respondents, we wanted to find out what percentof participants used it just for phone calls or if they used applications and accessories as well. We askedrespondents if they had installed applications(apps) on their cellphone, how often they used apps, and if theyhad ever used a Bluetooth device or a health tracker app. As with the results to most other questions, there wasan inverse relationship between age and technologyutilization. There was a significant difference in the agegroups 70 and above in the installation and use of apps vs the under 70 age groups (p < 0.05, Figure 5).
Fig 5: Cell phone applications (apps), accessories, and frequency of use. A) Individuals who owned a cell phonewere asked if they had ever installed an app on their cell phone, whether they had ever used Bluetooth technology,and if they had ever used an app to track their health. B) Additionally, we asked each group how often they usedapps on their cell phone. Over half of those 69 years and younger had both installed an app and used it daily, whilethose over 90 stated that they never used apps. *p< 0.05 for installation and use of apps; <70 years old vs 70+ years old.
Over 87% of individuals in the 50-59 year old group had installed applications and used them daily. In contrast,approximately 30% of those in the 80-89 year old group had installed applications and used themdaily (33% and 28%, respectively). Additionally, 88% of those in the 50-59 year old range indicated that theyuse a health tracker app, and 62% reported using a Bluetooth device, whereas only 20% and 30% of 60-69 yearolds report having used a health tracker app or Bluetooth device, respectively.
Are elderly individuals interested in learning how to use ICDs?
For individuals who possessed a cellphone or other ICD, we wanted to understand whether they were interestedin learning more about how to use the device. Our results indicated a moderately strong interest, with 35%of individuals surveyed stating that they would liketo learn more. However, increasing age was associatedwith a decreasing interest in learning about this subject with a significant difference observed between theoctogenarian and nonagenarian age groups versus the younger age groups (p < 0.05). Youngerrespondents,between 50-69 years (50%),felt they already knew how to use their ICDs and were comfortable withtheircurrent knowledge.(Figure 6A).
Fig 6: Knowledge of ICD use and communication preference. A) Due to the common assumption that with increasingage, ICD knowledge decreases, we asked survey participants about taking classes on using modern electronics. 37%of participants indicated that they would be interested in the classes, while 42% stated that they already knew howto use ICDs. *p< 0.05 for no interest in learning; <80 years old vs 80+ years old. B) We also asked participants whatsort of communication methods they enjoyed using. The younger groups preferred emails to phone calls while theolder groups preferred phone calls over emails. *p< 0.05 for email vs phone calls; within 50-59 year old group and50-59 years old vs 80+ years old.
How do elderly individuals like to communicate?
We were also interested in what communication methods survey participants enjoyed using. Email was verypopular in the younger age ranges, with 100% of the 50-59 year olds, as well as 73% and 57% of those 60-69and 70-79 years old, respectively, choosing this response. Email was not as favored by the octogenarians, asno more than 39% selectedthis correspondence. Phone calls were a highly-favored communication methodwith every group over age 60, including 100% of theoctogenariansand more than 60% of the nonagenariansindicating that they enjoyed phone calls. However, the 50-59 year old group preferred e-mail as the mode ofcommunication vs phone calls (p < 0.05 Figure 6B). There were significant differences between the preferredmodes of communication selected by the younger 50-59 group vs the octogenarians and nonagenarians(p < 0.05, Figure 6B).Interestingly, neither the youngest age group (under 60) nor the oldest (over 90) chosewritten correspondence (letters) as a mode of communication. Just under 20% of the participants still enjoyedreceiving letters; this type of correspondence was only chosen by those 60-89 years of age.
Frequency of tablet or computer use
Study participants who possessed tablets or computers were asked how frequently they utilized those devices.We found that these devices were used almost daily across all age-groups. Moreover, computers were utilizedmore frequently in those >60 years ofage (83-100%), as compared to those 50-59 years old (43%).None of theparticipants over 90 used tablets. However, there was a significant preference for tablet use among the 50-59age group vs the computer/laptop. (p <0.05, Figure 7).
Fig 7: Tablet and computer use. Over 80% of those who owned a tablet or computer used them daily. Daily computeruse was least common for those under 60 and most common for those over 90 years of age. However, tablet ownershipwas highest for those under 60 and lowest for those over 90. *p< 0.05 for tablet use; within 50-59year old group.
Internet connectivity and location of use
Only 9% of individuals reported having no internet access at all. Among those with internet access, wirelessaccess was the most common form used by 50% of all participants, followed closely by wired access at 38%.83% of all respondents accessed the internet at home, however the 80-89 year old group was the only one forwhich 100% reported accessing the internet at home. Use of internet at work showed an age-relateddecline (p <0.05, Figure 8A).Finally, approximately 11% of respondents in age groups between 50-89 years ofage listed that they had internet access via hotspot (data not shown).
Reasons for using the computers or the internet
Interestingly, the octo-nonagenarians used the internet for games approximately 60% of the time but also equallyselected surfing, looking up medical records and using the computer for writing. (Figure 8B).Looking up medicalrecords was a fairly consistent activity across all age groups(range across groups, 47-71%). In addition, all agegroups also used the computer for writing (range across groups, 43-74%).However, individuals < 80 tended touse the computer less for games and more for surfing the web (32 vs 92%, p < 0.05, Figure 8B).Interestingly,46% of all age groups also utilized their computer’s electronic calendar for maintaining appointments andother reminders (data not shown).