Information and communicative technology use enhances psychological well-being of older adults: the roles of age, social connectedness, and frailty status

Does digital technology reduce health disparity? Investigating difference of depression stemming from socioeconomic status among Chinese older adults

Background

Prior studies on health disparity have shown that socioeconomic status is critical to inequality of health outcomes such as depression. However, two questions await further investigation: whether disparity in depression correlated with socioeconomic status will become larger when depression becomes severer, and whether digital technology will reduce the disparity in depression correlated with socioeconomic status. Our study aims to answer the above two questions.

Methods

By using the dataset from China Health and Retirement Longitudinal Study 2015, we use quantile regression models to examine the association between socioeconomic status and depression across different quantiles, and test the moderating effect of digital technology.

Results

Our study obtains four key findings. First, the negative effects of socioeconomic status on depression present an increasing trend at high quantiles. Second, Internet usage exacerbates the disparity in depression associated with education level on average, but reduces this disparity associated with education level at high quantiles. Third, Internet usage reduces the disparity in depression associated with income on average and at high quantiles. Fourth, mobile phone ownership has almost no moderating effect on the relationship between socioeconomic status and depression.

Conclusions

Our findings suggest the potential use of digital technology in reducing disparity in depression correlated with socioeconomic status among middle-aged and aged individuals in developing countries.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02175-0.

Impact of the Mass Media on Adherence to the Mediterranean Diet, Psychological Well-Being and Physical Activity. Structural Equation Analysis

BACKGROUND

The influence of mass media on emotions, subjective well-being and behaviours in society should be clearly understood. Physical-health education has an important role to play as a preventive tool. The aim of this study was to develop an explanatory model regarding the relationships between mass media, psychological well-being, physical activity, Mediterranean diet and age and to compare the model with multi-group analysis according to gender.

METHODS

A descriptive, non-experimental, cross-sectional design was used, with 634 participants between 18 and 66 years old (M = 35.18 ± 9.68).

RESULTS

Structural equation modeling was found to be satisfactory for all parameters. Results show that mass media have a significant direct influence on well-being, with negative effects on physical activity and adherence to a Mediterranean diet. The model fitted better for males in terms of gender differences, showing a better fit of psychological well-being being associated with higher levels of physical activity and better adherence to the Mediterranean diet. Among women, no relationships were found between mass media pressure and psychological well-being and healthy physical habits, but higher personal satisfaction was associated with better physical activity and better dietary patterns.

CONCLUSIONS

Thus, the study approaches society to a perspective influenced by mass media and physical-health education, reporting and emphasizing the importance of healthy lifestyles.

A Double Burden of Exclusion? Digital and Social Exclusion of Older Adults in Times of COVID-19

The COVID-19 pandemic has excluded older adults from a society based on physical social contact. Vulnerable populations like older adults also tend to be excluded from digital services because they opt not to use the internet, lack necessary devices and network connectivity, or inexperience using the technology. Older adults who are frail and are not online, many of whom are in long-term care facilities, struggle with the double burden of social and digital exclusion. This paper discusses the potential outcomes of this exclusion and provides recommendations for rectifying the situation, with a particular focus on older adults in long-term care facilities.

More Active Participation in Voluntary Exercise of Older Users of Information and Communicative Technology even during the COVID-19 Pandemic, Independent of Frailty Status

OBJECTIVES

The aim of this study was to examine whether older users of information and communicative technology (ICT) participate in active behaviors, such as voluntary exercise, to maintain health, even under community containment to suppress the coronavirus disease 2019 (COVID-19) pandemic.

DESIGN

Cross-sectional study.

SETTING

Community setting.

PARTICIPANTS

Independent community-dwelling older residents aged ≥75 years.

MEASUREMENTS

The municipality sent the Kihon Checklist (KCL) and Simplified Nutritional Appetite Questionnaire (SNAQ) with several questions on lifestyle and health conditions under social restriction.

RESULTS

Among 3199 responders (72.1%), we analyzed the data of 2304 residents who provided complete answers to the KCL and SNAQ and on ICT use, voluntary exercise, polypharmacy, and families. The mean age was 79.7 years (51.3% male). The percentages of frailty assessed by the KCL, voluntary exercise, and low SNAQ scores (≤14) were 16.0%, 61.4%, and 43.8% in 808 ICT users and 30.3%, 47.2%, and 54.1% in 1496 ICT non-users, respectively (p<0.001). ICT use was significantly associated with voluntary exercise even during social restriction, independent of age, sex, polypharmacy, low SNAQ scores, and frailty status (odds ratio, 1.503; 95% confidential interval, 1.246-1.813).

CONCLUSION

Older ICT users are more active to maintain health even during social restriction, independent of frailty status.

Using virtual care interventions to provide person-centred care to hospitalised older people with dementia

BACKGROUND

Being in an unfamiliar environment away from family can exacerbate emotional stress in hospitalised older people with dementia. Technology solutions can be used to address their mental and emotional health needs.

AIM

To generate greater understanding of technology adoption and to test strategies supporting virtual care interventions in hospitalised older people with dementia, such as the use of an iPad to connect them with their family members.

METHOD

Older people with dementia in two Canadian hospitals were observed and interviewed to explore their experiences of using an iPad. Focus groups were conducted with staff and interviews were undertaken with two frontline nurses and three research partners with lived experience of dementia in hospitalised older people. Data were thematically analysed in collaboration with 12 stakeholders. Strategies to overcome the barriers identified were tested as part of the study.

FINDINGS

There were three main barriers to implementing virtual care interventions: lack of familiarity with the technology; difficulties with operating the device; and privacy and connectivity issues. Strategies to overcome these barriers included providing personalised support, working with users to support adaptation, and ensuring privacy and optimal connectivity.

CONCLUSION

Using an iPad has the potential to enable hospitalised older people with dementia to connect with their family members and take part in activities that support person-centred care. This is particularly important in times, such as the COVID-19 pandemic, when restrictions to hospital visits lead to social isolation.

Chinese Middle-Aged and Older Adults' Internet Use and Happiness: The Mediating Roles of Loneliness and Social Engagement

Little research has examined the effects of internet use in promoting well-being among middle-aged and older people using large-scale samples in developing countries. Using a subsample of a national survey with 4,083 adults aged 50 years and above, we explored this topic in China. Internet users were found to be significantly younger, more educated, with a higher SES, and more likely to live in urban areas. Structural equation modeling showed that internet use was indirectly associated with higher levels of happiness, and this association was mediated by less loneliness and more volunteering. In the multi-group analysis, age, gender, and household registration (urban vs. rural) moderated path coefficients but did not impact the general pattern. This study suggests promising benefits of internet use for Chinese middle-aged and older adults. In addition, the digital divide between our urban and rural subsamples calls for interventions to promote internet use in rural areas.

Older adults' technology use and its association with health and depressive symptoms: Findings from the 2011 National Health and Aging Trends Study

Background

Information and communication technology (ICT) provides older adults with access to information and resources that benefit their health.

Purpose

To explore ICT use among older adults and examine the influence of information technology (IT), communication technology (CT), or ICT use on older adults' self-rated health status and depressive symptoms.

Method

A sample of community-dwelling Medicare beneficiaries aged 65 and older in the United States (N = 4,976) from the 2011 National Health and Aging Trends Study.

Findings

Older adults who embraced ICT and used this technology for a variety of purposes were more likely to report better health status, and were less likely to experience major depressive symptoms than nonusers.

Discussion

In accordance with the Health Information Technology for Economic and Clinical Health Act, nursing professional can play an important role by responding to older adults' diverse technology preferences and effectively incorporating them into nursing practice.

Internet and Health Information Technology Use and Psychological Distress Among Older Adults With Self-Reported Vision Impairment: Case-Control Study

BACKGROUND

The number of older adults with vision impairment (VI) is growing. As health care services increasingly call for patients to use technology, it is important to examine internet/health information technology (HIT) use among older adults with VI.

OBJECTIVE

This study aimed to examine (1) the rates of internet/HIT use among older adults with VI compared with a matched sample of their peers without VI, (2) associations of VI with internet/HIT use, and (3) association of HIT use with psychological distress, assessed with the Kessler-6 screen.

METHODS

Data were obtained from the 2013 to 2018 US National Health Interview Survey. Older adults (aged ≥65 years) with self-reported VI were matched with older adults without VI, in a 1:1 ratio, based on age, sex, number of chronic medical conditions, and functional limitations (N=2866). Descriptive statistics and multivariable logistic regression models, with sociodemographic factors, health conditions, health insurance type, and health care service use as covariates, were used to examine the research questions.

RESULTS

In total, 3.28% of older adults (compared with 0.84% of those aged 18-64 years) reported VI, and 25.7% of them were aged ≥85 years. Those with VI were significantly more socioeconomically disadvantaged than those without VI and less likely to use the internet (adjusted odds ratio [aOR] 0.64, 95% CI0.49-0.83) and HIT (aOR 0.74, 95% CI 0.56-0.97). However, among internet users, VI was not associated with HIT use. HIT use was associated with lower odds of mild/moderate or serious psychological distress (aOR 0.62, 95% CI 0.43-0.90), whereas VI was associated with greater odds of mild/moderate or serious distress (aOR 1.84, 95% CI 1.36-2.49). Health care provider contacts were also associated with higher odds of internet or HIT use.

CONCLUSIONS

Compared with their matched age peers without VI, older adults with VI are less likely to use HIT because they are less likely to use the internet. Socioeconomically disadvantaged older adults experiencing a digital divide need help to access information and communication technologies through a fee waiver or subsidy to cover internet equipment and subscription and ensure continuous connectivity. Older adults with VI who do not know how to use the internet/HIT but want to learn should be provided instruction, with special attention to accessibility features and adaptive devices. Older adults with a low income also need better access to preventive eye care and treatment of VI as well as other health care services.

Depression, everyday technology use and life satisfaction in older adults with cognitive impairments: a cross-sectional exploratory study

RATIONAL

Life satisfaction is strongly associated with participation in everyday life activities. Yet, older adults with cognitive impairments have been found to experience difficulties in accessing and engaging in more complex everyday activities, especially, if these involve everyday technology. Considering the rapidly advancing technological landscape, this may substantially affect individuals' life satisfaction and their participation in meaningful community-based and home-based activities.

OBJECTIVES

This study aimed to explore the associations between life satisfaction, ability to use everyday technology and number of relevant everyday technologies used in older adults (n = 117) with and without mild cognitive impairment (MCI) and Alzheimer's disease (AD). It also aimed to understand the role of depression, activity involvement and diagnosis regarding life satisfaction in this sample.

METHOD

Descriptive statistics, Mann-Whitney U tests and t-tests were applied to compare those satisfied and those dissatisfied with life regarding ability to use everyday technology and number of relevant everyday technologies used.

FINDINGS

The number of relevant community-based everyday technologies currently not used was significantly associated with being dissatisfied with life (p < 0.05). Further, depression and withdrawal from activities and interests significantly differed across life satisfaction groups, while no group differences were found regarding overall number of everyday technologies in use and ability to use everyday technology.

CONCLUSION

Attention from healthcare professionals and researchers to early withdrawal from activities that rely on community-based everyday technologies is called for, especially in older adults with depression. Preventing everyday technology-related barriers in community life may increase life satisfaction.

Association between sleep-wake habits and use of health care services of middle-aged and elderly adults in China

OBJECTIVE

To examine the relationship between sleep-wake habits and the use of health care services.

RESULTS

The proportions of the participants who were "early to bed" and "late to bed" were 48.7% and 51.3%, respectively. In the full sample, compared with those who were early to bed and early to rise, participants who went to bed late were more likely to report physician visits (late to bed and early to rise: OR = 1.13, 95% CI: 1.08-1.19, late to bed and late to rise: OR = 1.27, 95% CI: 1.18-1.38, respectively). We found no significant association between sleep-wake habits and the number of hospitalization.

CONCLUSIONS

Those middle-aged and elderly people who stayed up late and got up late are more likely to visit the doctors than those who went to bed early and got up early.

METHODS

We obtained data from a cohort study of retired employees in China, and 36,601 (95.59%) involved in the present study. The participants were allocated into 4 sleep-wake habits groups: Early-bed/Early-rise, Early-bed/Late-rise, Late-bed/Early-rise, and Late-bed/Late-rise. We explored the association between sleep-wake habits with the number of physician visits and hospitalizations.

Technology, Physical Activity, Loneliness, and Cognitive Functioning in Old Age

Abstract. Information and communication technology (ICT) has the potential to benefit aging processes. This study examined portable ICT usage and associated changes in physical activity, loneliness, and cognitive functioning. Ninety-two mostly-novice tablet-users aged 51–85 years participated in technology workshops and then reported on their portable ICT use biweekly for 6+ months. Physical activity, loneliness, and executive functioning were assessed before and after this period. More frequent use of exercise functions was associated with more moderate-intensity physical activity and less sitting, controlling for pretracking levels. More frequent use of social functions was associated with more social loneliness and a tendency toward less emotional loneliness, controlling for pretracking levels of loneliness. The use of exercise and social functions showed no associations with executive functioning. Portable ICT thus may bring both risks and benefits for physical and social functioning in older adulthood.

Loneliness Shapes the Relationship between Information and Communications Technology Use and Psychological Adjustment among Older Adults

BACKGROUND

Given findings that generally support the benefits of information and communication technology (ICT) for older adults' psychosocial adjustment, one might surmise that lonely older adults, who have a stronger need for psychological support, would reap more psychosocial benefits from ICT use. However, scant research has examined this view, much less the likelihood that ICT use might worsen the psychological well-being of lonely older adults, as has been shown to be the case in younger adults.

OBJECTIVE

To examine whether the association between ICT use and psychological adjustment (i.e., psychological distress and sense of community [SOC]) among older adults depends on their loneliness levels.

METHODS

A representative sample of 738 Hong Kong SAR Chinese older adults aged 60 years or older (56% female) was interviewed in 2017 on loneliness, frequency of ICT use (i.e., Internet and smart devices), psychological distress (6-item Kessler scale; K6), and SOC.

RESULTS

Regression analyses showed that loneliness significantly moderated the relationship between ICT use frequency and psychological adjustment (psychological distress and SOC); more frequent ICT use was associated with more psychological distress and less SOC, with higher levels of loneliness.

CONCLUSION

These findings suggest that ICT use may be a mixed blessing for older adults, i.e., using more ICT might predict worse psychological adjustment among lonelier older adults. Efforts that promote ICT use among older adults should take their loneliness levels into account.

Recognizing Physical Activity of Older People from Wearable Sensors and Inconsistent Data

The physiological monitoring of older people using wearable sensors has shown great potential in improving their quality of life and preventing undesired events related to their health status. Nevertheless, creating robust predictive models from data collected unobtrusively in home environments can be challenging, especially for vulnerable ageing population. Under that premise, we propose an activity recognition scheme for older people exploiting feature extraction and machine learning, along with heuristic computational solutions to address the challenges due to inconsistent measurements in non-standardized environments. In addition, we compare the customized pipeline with deep learning architectures, such as convolutional neural networks, applied to raw sensor data without any pre- or post-processing adjustments. The results demonstrate that the generalizable deep architectures can compensate for inconsistencies during data acquisition providing a valuable alternative.