Information and Communication Technology Use Is Related to Higher Well-Being Among the Oldest-Old

Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study

BACKGROUND

Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain.

OBJECTIVE

This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education.

METHODS

The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered "No" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019.

RESULTS

After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively.

CONCLUSIONS

These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.

Characterizing different patterns of digital competence and their associations with loneliness and social isolation among older adults: findings from South Korea

OBJECTIVES

With the advent of worldwide internet networks in the digital age, digital competence can play an important role in decreasing loneliness and social isolation in older adults. This study characterized different patterns of digital competence among older adults and examined their associations with loneliness and social isolation.

METHOD

The sample included 315 older Korean adults (M = 68.79, range = 65-84) who completed an online survey.

RESULTS

Latent profile analysis identified four different profiles of digital competence, including 1) low activity (28%) who did not choose digital participation despite advanced technical skills, 2) unskilled (13%) who had limited technical skills, 3) passive participation (25%) who was motivated for digital interactions even with insufficient technical skills, and 4) active participation (34%) who were involved in digital activities with the necessary skills. Additionally, the unskilled profile had relatively higher levels of loneliness than did the active participation profile. The passive participation and low activity profiles showed the highest level of social isolation, followed by the unskilled, and active participation profiles.

CONCLUSION

The present findings suggest that understanding different profiles of digital competence and facilitating active digital participation related to specific profiles can be an effective strategy to reduce older adults' social isolation and loneliness.

The impact of internet use on health among older adults in China: a nationally representative study

BACKGROUND AND OBJECTIVES

Aging poses a significant challenge worldwide, with China's aging status becoming particularly severe. What is the impact of Internet use on the health of the elderly? Existing studies have drawn conflicting conclusions that Internet use improves or harms health. The purpose of this study was to explore how Internet use affects the health of older adults, and the mechanisms and heterogeneity of these effects.

RESEARCH DESIGN AND METHODS

Based on Grossman's theory, this paper constructs a health production function model. Using the data of China Family Panel Studies (CFPS) from 2014 to 2020, we investigated the impact of Internet use on the health of older adults using fixed effect model and instrumental variable method. We also examined the mediating role of health information acquisition, lifestyle, and social interaction in these associations.

RESULTS

Internet use is positively associated with self-rated health and negatively associated with psychological sub-health level. Internet use promotes the health of older adults by facilitating access to health information, healthy lifestyles, and enhancing social interaction. And the impacts are heterogeneous at the individual and regional levels.

DISCUSSION AND IMPLICATIONS

We should progressively enhance the level of internet accessibility for older adults, while concurrently addressing and narrowing the 'digital divide'. By generating an abundance of superior health-related information, we can significantly improve health education tailored for the elderly. Additionally, it is crucial to offer extensive training opportunities designed to equip older adults with the necessary skills to proficiently navigate the internet.

The Effect of Social Media Forwarding on Subjective Well-Being in Chinese Older Adults: A Moderated Mediation Model

Purpose

In the intersection of the aging and information era, the development of digital aging significantly influences the well-being of older individuals. Given the divergent findings in various studies exploring the effects of social media use on mental health, this study specifically examined the impact of forwarding, a prevalent social media behavior among older individuals, focusing on the effects of use intensity on their subjective well-being (SWB) and the specific mechanisms involved.

Materials and Methods

A total of 323 Chinese older adults completed the questionnaire. SPSS along with Hayes Process Models 4 and 7 was employed to test the hypotheses.

Results

The results indicated that social media forwarding intensity significantly and positively predicted SWB of older adults. This association was partially mediated by perceived social support (PSS) and self-esteem. Gender served as a moderator, highlighting that the positive predictive effects of forwarding intensity on PSS and self-esteem were more pronounced for older men than for older women. Further, the findings confirmed the existence of the moderated mediating effect such that the impact of forwarding on SWB was mediated through both PSS and self-esteem for older men, while, for older women, it was solely mediated by PSS.

Conclusion

This study revealed the positive impact of forwarding, a user-friendly social media function, on the well-being of older adults and elucidated the specific mechanisms through a moderated mediation model. In light of these findings, we propose customizing the development of age-friendly social media functions to address the diverse psychological needs of older adults, taking into account gender differences. These findings may offer valuable insights for constructing digital age-friendly platforms and fostering active aging development.

Technology Use, Barriers, and Future Needs Among Community-Dwelling Older Adults

PURPOSE

Social isolation and loneliness are social determinants of health (SDOH) that can negatively affect the well-being of older adults. Using technology has the potential to reduce social isolation; thus, increasing safe use of technology among older adults can positively impact their health and promote aging in place.

METHOD

Older adults (N = 730) were surveyed regarding their use of, access and barriers to, satisfaction with, and anticipated future needs related to technology.

RESULTS

Survey respondents found technology was a significant resource for staying connected; however, low levels of satisfaction with devices and fear of scams indicate the need for additional training on the best and safest use of technology.

CONCLUSION/IMPLICATIONS

By screening older adults for SDOH, identifying their current and anticipated needs, and advocating for changes in health care and communities to meet these needs, nurses can help facilitate safe and healthy aging in place for their patients. [Journal of Gerontological Nursing, 50(2), 26-31.].

Urban digital economy, environmental pollution, and resident's health-empirical evidence from China

In light of China's rapid advancement in the digital economy and the implementation of the "Healthy China" initiative, it is crucial to assess the impact of the digital economy on residents' health. This study analyzes data from the 2012, 2014, and 2016 China Labor Force Dynamics Survey (CLDS) to evaluate the health of residents using both subjective and objective criteria. Furthermore, it calculates the digital economy development index for Chinese cities and investigates its influence on the subjective and objective health of residents, along with the underlying mechanisms. The empirical results reveal a U-shaped pattern in the effect of the digital economy on health levels, initially detrimental but subsequently beneficial. The analysis of mechanisms shows that the digital economy's development initially increases and then decreases environmental pollution, impacting health through environmental changes. Additionally, the study finds variations in this impact based on age and urban-rural differences, with more pronounced effects on rural and older adult populations, who also experience the U-shaped curve's turning point more rapidly. These findings highlight the necessity of advancing digital economy infrastructure to positively influence environmental quality and improve public health. The study emphasizes the urgent need for policymakers to invest in digital infrastructure to foster a sustainable and healthy future. This requires a holistic approach to development, focusing on both urban and rural areas, to promote inclusive growth and reduce the digital divide.

Understanding the influencing factors and mechanism of social compensation for Chinese older adults using social media in the context of smart home: a qualitative analysis

As a new generation of necessary terminals for future homes, smart homes have become one of the essential mediums for smart aging at home. This paper aims to explore how older adults who age at home can overcome the digital divide of the new medium and achieve social participation in the home context to realize active aging. Based on the theory of social compensation, we select the smart-home smart screen, a representative new medium product in China, and carry out open coding, spindle coding, selective coding, and theoretical construction of the original interview data through the grounded theory research method. The results show that the main factors affecting the social compensation of older adults to smart home social media include user interface quality, interaction quality, content quality, and service quality, and these four factors are used as external variables to compensate older adults socially, thereby stimulating the emotional experience and perception changes at the cognitive level of older adults and then affecting the adoption and acceptance of smart home social media by older adults. This study refines the factors influencing the older adults' use of smart home social media from the perspective of social compensation. It explains the mechanism of acceptable behavior of older adults, bridging the gap in previous literature on the influencing factors and behavioral mechanisms of older adults of smart home social media. This paper provides a theoretical basis and guidance for the subsequent academic research and software development practice of social media under new technological devices to further help older adults in China achieve active and healthy aging.

Impact of technology on social isolation: Longitudinal analysis from the National Health Aging Trends Study

BACKGROUND

Social isolation is a key public health concern and has been associated with numerous negative health consequences. Technology is increasingly thought of as a solution to address social isolation. This study examines the longitudinal association between the access and use of technology and social isolation in older adults 65 and older, living in the United States.

METHODS

This observational cohort study included community-dwelling older adults (N = 6704) who participated in the National Health and Aging Trends Study. Regression analyses were conducted using data from 2015 to 2019. Information about technology access and use was ascertained using self-reported questionnaires. The primary outcome was the risk of social isolation.

RESULTS

At baseline, the majority of older adults that were not socially isolated had a working cell phone (88%) or computer (71%) and used email or text messaging (56%). Older adults that had access to (cell phone- incidence rate ratio [IRR] 0.62 [95% CI 0.48-0.81]; computer- IRR 0.63 [95% CI 0.51-0.78]), and used technology (email or text messaging- IRR 0.64 [95% CI 0.51-0.80]) in the year prior had a lower risk of social isolation than older adults who reported they did not access or use technology. Additionally, over four years, older adults who reported that they had access to a computer had a lower risk (0.69 [0.57, 0.84]) for social isolation than their counterparts.

CONCLUSION

In this cohort study, technology access was associated with a lower risk for social isolation among community-dwelling older adults. These findings suggest that technology has an important role in approaches that seek to prevent social isolation among older adults.

Effects of a 'social activity program that encourages interaction' on rural older people's psychosocial health: Mixed-methods research

BACKGROUND

We developed a program that encourages interaction among older people living at home by combining face-to-face and online activities and examined its effects on older adults' psychosocial health.

METHODS

In this mixed-methods study, we recruited 11 women and 6 men (Mage = 79.5 ± 6.4 years), who lived in a rural community and participated in a senior citizen club. The intervention was conducted for 13 months, comprising monthly face-to-face group and social media activities. For the program process evaluation, we collected focus-group interview data on participants' perceptions of their personal lives, club membership, and community post-intervention. For the outcome evaluation, we collected six outcome measures pre- and post-intervention: loneliness, subjective health, subjective well-being, self-esteem, social support and social activity satisfaction. Finally, through the integration of the process-outcome evaluation, we inferred what effects the program had on participants' psychosocial health.

RESULTS

In the process evaluation, we identified four themes: 'Stimulation brought about by relationships with peers,' 'Realization as to where they feel they belong,' 'Rethinking of oneself in the community,' and 'Awareness of attachment to and coexistence with the community.' In the outcome evaluation, the outcome measures were maintained without significant decline post-intervention.

CONCLUSION

Through the integration of the process-outcome evaluation, we deduced three effects of the program on psychosocial health: (1) fulfilment of subjective health, (2) maintenance and assurance of moderate distance connectedness and (3) orientation toward aging in place.

IMPLICATIONS FOR PRACTICE

This study offers a promising opportunity for further development and research into community-based preventive nursing care intervention strategies to maintain the psychosocial health of homebound older people in communities with social activity groups.

Internet use and depressive symptoms among Chinese older adults: Two sides of internet use

Objective

To explore the relationship between internet use which includes time spent on the internet, internet skills, types of online activities, and depressive symptoms in older adults.

Methods

We used 2020 China Family Panel Studies (CFPS) data with 3,171 older adults aged 60 years. Depression symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D), and internet use was measured by time spent on the internet, internet skills, and types of online activities. Multiple linear regression models were used to explore the relationship between internet use and depressive symptoms in older adults.

Results

Longer time spent on the internet was associated with higher scores of depressive symptoms (β = 0.14). Higher internet skills were associated with lower scores of depressive symptoms (β = −0.42). Watching short-form videos (β = 1.34) was associated with higher depressive symptom scores, and the use of the WeChat function (β = −0.96) was associated with lower depressive symptom scores, while online games and online shopping were not significant.

Conclusion

The effect of internet use on depressive symptoms in older adults is a double-edged sword. Controlling the time spent on the internet, improving internet skills, and guiding specific a type of online activities in older adults can improve depressive symptoms through rational use.

Relationship between Internet Use and Negative Affect

While positive emotions like happiness and life satisfaction have received great attention, how to eliminate negative affect is largely neglected. This study contributes to the literature by examining the relationship between Internet use and people's negative affect. Unlike previous studies that consider only one indicator, we capture negative affect from different dimensions by considering loneliness, sadness, and life hardship. We employ an endogenous ordered probit model to address the selection bias of Internet use and analyze the 20,107 individual-level samples sourced from the 2020 China Family Panel Studies survey. The results show that Internet use significantly reduces people's loneliness, sadness, and life hardship. We also find that studying online and watching short videos would increase people's loneliness feeling and shopping online deepens people's life hardship. In contrast, using WeChat significantly reduces sadness and life hardship. Our findings confirm that guiding people to use the Internet appropriately is necessary to reduce negative affect and improve the quality of their life.

Internet usage among the oldest-old: does functional health moderate the relationship between internet usage and autonomy?

In recent years, research on internet usage in old age and its associations with well-being outcomes has increased. However, the oldest-old age group (80 years and older) is frequently underrepresented, and autonomy and functional health are rarely considered in these studies. By applying moderation analyses with a representative dataset of the oldest-old in Germany (N = 1863), our study has analyzed the hypothesis that the autonomy of older individuals, in particular of those with limited functional health, can be enhanced by internet usage. The moderation analyses indicate that the positive association between internet usage and autonomy is greater for older individuals with lower functional health. This association remained significant after controlling for social support, housing situation, education, gender, and age. Explanations for these results are discussed, and imply that further research is needed to understand the relationships between internet usage, functional health, and autonomy.

Internet use and life satisfaction among Chinese older adults: the mediating effects of social interaction

Internet use has been suggested to have a crucial effect on older adults' quality of life; however, few studies have investigated the underlying mechanisms in the relationship between internet use and life satisfaction among older adults. Employing multiple linear regression models and mediation analysis with 2019 Chinese Social Survey (CSS) data, this study analyzed the associations between the internet use and life satisfaction of Chinese older adults. Additionally, it explored the mediating role of social interaction, including online and offline social interactions. The results showed that internet use was positively associated with older adults' life satisfaction, and offline social interaction significantly mediated internet use. Our findings indicate that internet use could improve older adults' quality of life by promoting offline social interaction. Therefore, the government, communities, and families should create conditions for older adults to integrate into online society and participate in offline social interaction.

Verification of the Effectiveness of a Communication Application in Improving Social Connectedness and Physical Health among Unacquainted Older Men: A Mixed-Methods Pilot Study

This study aimed to verify the effectiveness of an application (app) in establishing social connectedness among unacquainted older men, as well as improving their physical health. The nine participants were men aged 65 and older in the subarctic zone of Hokkaido, Japan. A mix of quantitative and qualitative methods were adopted as the study design. A questionnaire survey was completed before and after the intervention, and a semi-structured interview was conducted after the intervention. An app-installed smartphone was loaned to the participants, which allowed them to share pictures, voice recordings, and their step count. Quantitative data were analyzed using descriptive statistics and the Wilcoxon signed-rank test, and qualitative data were analyzed using qualitative descriptive analysis to generate categories. The average age of the participants was 77.7 years. The relationship between participants who were interacting for the first time through the app advanced as their understanding of each other's personalities deepened. The average step count during the third and fourth months was significantly higher than in the first two months. By using the app, older men were able to build relationships with one another. In addition, visualizing the number of steps on the app was effective in improving the number of steps.

The association between information and communication technologies, loneliness and social connectedness: A scoping review

Older adults are at a higher risk of loneliness, compared to other demographics. The use of Internet Communication and Technologies (ICTs) among older adults is steadily increasing and given ICTs provide a means of enhancing social connectedness suggests they may have positive effects on reducing loneliness. Therefore, the aim of this scoping review was to examine the research that explores how ICTs may be implicated in mitigating loneliness and increasing social connectedness among older adults. After the examination of 54 articles, we identified three major themes within the literature: (1) ICTs were associated with a reduction in loneliness and increase in wellbeing. (2) ICTs promoted social connectedness by facilitating conversations. (3) Factors such as training, self-efficacy, self-esteem, autonomy, and the design/features, or affordances, of ICTs contribute toward the associations between ICT use and wellbeing. The heterogeneity of methodologies, statistical reporting, the small sample sizes of interventional and observational studies, and the diversity of the experimental contexts underline the challenges of quantitative research in this field and highlights the necessity of tailoring ICT interventions to the needs and contexts of the older users.

Digital Health Literacy in Patients With Heart Failure in Times of Pandemic

This study sought to determine the effect of a digital health literacy program regarding knowledge and skills in the use of digital resources related to self-care and health empowerment for patients with heart failure. A cross-sectional pilot study was conducted before and after the program in patients (n = 28) with heart failure at a tertiary care center. Both a knowledge test and the Health Empowerment Scale were used with a Cronbach's α of 0.89. The information was processed using the statistical software Restudio, which allowed us to make a descriptive and inferential analysis. Seventy-five percent of the participants were men with an average age of 68 years, 60.7% had elementary schooling, 71.4% had preserved ejection fraction, and 57.6% had a family member as a caregiver. A statistically significant change ( P < .005) was found in the level of empowerment and the knowledge and skills in the use of digital resources applied in health. The results showed that the digital health literacy program is a cost-effective intervention that nursing professionals must integrate into continuity of care, not only in pandemic times but also in a permanent and standardized manner. An empowered patient with knowledge and skills in the use of digital resources is a patient with the ability to decide, satisfy needs, and solve problems, with critical thinking and control over their health.

The Impact of IT-Based Healthcare Communication on Mammography Screening Utilization among Women in the United States: National Health Interview Survey (2011-2018)

Effective patient-provider communication improves mammography utilization. Using information technology (IT) promotes health outcomes. However, there are disparities in access to IT that could contribute to disparities in mammography utilization. This study aims to assess the association between IT-based health care communication and mammography utilization and to evaluate if this effect is modified by race/ethnicity and age. To this end, this study was conducted using the National Health Interview Survey from 2011 to 2018. A total of 94,290 women aged 40 years and older were included. Multiple logistic regression models were used, and odds ratios were reported. The study found that all IT-based healthcare communication strategies were significantly associated with mammography utilization in all years from 2011 to 2018. In 2018, women who looked up health information on the internet, scheduled a medical appointment on the internet, and communicated with providers by email had a significantly higher chance to use mammography (p ≤ 0.005 for all strategies across all years). White women and women aged 50 years and older benefited the most from IT-based healthcare communication. In conclusion, facilitating access to IT may help increase mammography utilization, which may contribute to eliminating disparities in breast cancer mortality.

A study on the impact of Internet use on depression among Chinese older people under the perspective of social participation

PURPOSE

This study aimed to evaluate the role of social participation in the relationship between internet use and depressive symptoms among Chinese older adults and investigate how the internet use interact with social participation to reduce the risk of depressive symptoms.

METHODS

Based on the survey from the China Health and Retirement Longitudinal Study (CHARLS) in 2018, we identified 4645 subjects and used the Ordinary Least Square method (OLS) and Propensity Score Matching method (PSM) to identify the association between Internet use and depression of older people, and further test how social participation played a role in the relationship.

RESULTS

The level of depression of older people was significantly reduced in those who using internet in China, and the effect was still robust under different identification methods. The mental health was improved when using internet because of the increase of social participation and social capital. Further, The positive effect was stronger especially in those who were female, living in rural areas, has low education attainments and were 70-79 years old.

CONCLUSIONS

The popularity of internet use has a positive effect on the depressive symptoms of Chinese older adults. Effective measures were encouraged to improve the friendliness of internet for older people and promote the popularization of the Internet and older group, achieving the spiritual well-being of them in the Internet society.

Weaving Social Connectivity into the Community Fabric: Exploring Older Adult’s Relationships to Technology and Place

The wellbeing of older adults is positively impacted by ease of access to social networks and opportunities. In urban fringe communities, longer geographical distances, combined with mobility and health issues, can lead to decreased access to community life. Technology can facilitate socialisation opportunities for older adults living in more geographically isolated locations, but we need to work with communities to better understand how technology can fit into their existing social tapestry and community infrastructure. We conducted an explorative, qualitative study consisting of in-depth semi-structured interviews with members of an urban fringe community (n = 2), and a community mapping focus group (n = 14). Transcripts and mapping materials were analysed thematically, and also the method’s suitability explored. The community mapping proved suitable to uncover the complexity of technology use to support social connectivity. We found that while technology was perceived as valuable by our participants, there were also significant fears and concerns surrounding its use related to the abstract concept of online friendship and the steep learning curve required to master some platforms. Inclusive communities connected by technology require tailored and customised community-led technology initiatives in order to accommodate for the unique social and geographical contexts in which they live. We outline the next steps for future research on technology-supported social connectivity within urban fringe communities.

Social and satisfied? Social uses of mobile phone and subjective wellbeing in later life

The current study examined the associations between socio-demographic background and engagement in social uses of mobile phone, and between the engagement in these uses and life satisfaction and health satisfaction in later life through the lens of digital divide and uses and gratifications theories. The data, collected from the retired Internet users (62 and older) residing in seven countries (N = 5713), were analyzed using logistic and linear regression models. The results show that education and age predicted the engagement in social uses in the most consistent way. A number of social uses positively related to both life and health satisfaction. Of the particular uses, e-mailing and instant messaging were positively associated with life and health satisfaction. The results imply that socio-demographic background predicts the engagement in social uses of mobile phone in later life, that the engagement in such uses plays an overall significant role in wellbeing in later life, and that some particular uses play a greater role than others in this regard.

Have changes in Internet use during the COVID-19 pandemic affected older adults' self-rated health? A cross-sectional study of young-old and old-old populations in Korea

Disparities in Internet access are barriers to older populations' well-being. This study examined the association between changes in older adults' Internet usage during the coronavirus disease 2019 (COVID-19) pandemic and their self-rated health. Participants were adults aged 65 years and above, selected from the 2020 Digital Divide Survey conducted in Korea (n = 1150). Changes in Internet use among younger (aged 65-74 years) and older (aged 75 years and above) groups and the association between these changes and participants' self-rated health were examined. Internet usage remained similar or increased during the COVID-19 pandemic, particularly among the younger group. Increased Internet use was associated with better self-rated health of the participants. Other characteristics, including age, income, and education level, were also positively associated with their health. This study highlights the need for increasing older adults' access to online activities to enhance health equity in the digital era.

Impact of Internet Use on Mental Health among Elderly Individuals: A Difference-in-Differences Study Based on 2016-2018 CFPS Data

The number of elderly Internet users has increased significantly in the past few years. However, the impact of Internet use on mental health remains unclear. In this study, we performed a difference-in-differences analysis using data from the 2016 and 2018 waves of the China Family Panel Studies (CFPS) to evaluate the impact of Internet usage on mental health among elderly individuals. A total of 5031 validated respondents were included to explore the relationship between Internet use and reduced levels of depression as well as improved life satisfaction among elderly individuals. The results showed that Internet use significantly reduced depression levels. Unexpectedly, Internet use was not found to improve life satisfaction. Moreover, discontinuing Internet use was not significantly associated with improvements in depression or life satisfaction. More research is needed to fully elucidate the relationship between Internet use and depression levels, as well as life satisfaction among elderly individuals.

Close Social Networks Among Older Adults: The Online and Offline Perspectives

Qualitative studies have found that the use of Information and Communication Technologies is related to an enhanced quality of life for older adults, as these technologies might act as a medium to access social capital regardless of geographical distance. In order to quantitatively study the association between older people’s characteristics and the likelihood of having a network of close friends offline and online, we use data from the Survey of Health, Ageing and Retirement in Europe and data from Facebook. Using a novel approach to analyze aggregated and anonymous Facebook data within a regression framework, we show that the associations between having close friends and age, sex, and being a parent are the same offline and online. Migrants who use internet are less likely to have close friends offline, but migrants who are Facebook users are more likely to have close friends online, suggesting that digital relationships may compensate for the potential lack of offline close friendships among older migrants.

Self-management of social well-being in a cross-sectional study among community-dwelling older adults: The added value of digital participation

Background

This study aimed to examine associations between self-management abilities and digital participation among community-dwelling older adults with chronic conditions in the Netherlands.

Methods

The study utilized a cross-sectional design. Community-dwelling older adults were sampled from a Dutch nationwide panel study performed in October and November of 2019. We selected all adults of 65 years and above who had one or more chronic diseases (n = 1,656). Self-management was measured by six abilities (e.g., investing in resources for long-term benefits and taking care of a variety of resources), whereas digital participation was estimated with the frequency of four social internet uses (e.g., using social network websites and calling digitally).

Results

When predicting self-management abilities from digital participation, hierarchical multiple regression analysis determined statistically significant and positive relationships, in particular for e-mailing (β = 0.21; p < .001) and meeting new people online (β = 0.07; p < .05). Correlation analyses showed that highest associations were found between internet usage and the self-management abilities ‘taking initiative’ (r = .23; p < .001) and ‘being self-efficacious’ (r = .21; p < .001). Moreover, the study confirmed that higher age (β = -0.13; p < .001) and increased severity of disability (β = -0.12; p < .01) negatively impact abilities for self-management.

Conclusions

These findings suggest that internet usage and self-management abilities are positively related in the older adult population. Further research should be undertaken to examine the links between self-management abilities and digital participation more closely.

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.

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.

Impact of Internet Use on Elderly Health: Empirical Study Based on Chinese General Social Survey (CGSS) Data

In the current era, the rapid spread of Internet technology has combined with various traditional industries; this provides new research perspectives and solutions for current problems, such as those in the elderly care industry. Elderly health is an important social problem in various countries, and governments have turned to the internet for new methods and better solutions. However, internet-use behavior has a certain influence on the elderly’s health status. This study investigates the effects of internet use on the elderly’s physical health, mental health, and self-rated health, along with the moderating role of individual cognitive ability in the above relationship. This study uses data from the Chinese General Social Survey (CGSS) in 2012 and 2015 as samples for analysis via the hierarchical regression method. The sample is from China and had 2821 and 3185 valid respondents in 2012 and 2015, respectively. Results show that internet use significantly affects the physical and mental health of the elderly and does not significantly affect self-rated health. In addition, individual cognitive ability plays a negative moderating role between internet use and physical and mental health. Finally, on the basis of results analysis and discussion, this study provides new recommendations to achieve targeted health improvements.

Using Technology Adoption Theory and a Lifespan Approach to Develop a Theoretical Framework for eHealth Literacy: Extending UTAUT

Advancements in health information technology (HealthIT) and the electronic exchanges of health information have "revolutionized" health systems in the US. However, adopting technological developments into the healthcare system has the potential to benefit populations with more resources, further exacerbating health status disparities. Efficacious utilization of HealthIT requires eHealth literacy. Although eHealth literacy is comprised of six factors, new research indicates that the components related to technology literacy may be more impactful in eHealth literacy among certain populations (e.g., older populations who shoulder a greater illness-management burden). Recognizing the importance of technology literacy in eHealth literacy across the lifespan, we investigate generational differences in New Communication Technology (NCT) use and eHealth literacy, especially considering how NCT adoption theory might systematically inform scholars' understanding of eHealth literacy. Participants included 525 adults primarily in the Midwestern United States. We found significant differences between generational groups across all variables. We found that UTAUT determinants such as performance expectancy and effort expectancy explained 38% of the variance in eHealth literacy, controlling for age, sex, level of education, and prior online health information seeking. Finally, we engaged with early critiques of UTAUT, finding that when applying UTAUT in voluntary (vs. mandatory) contexts, scholars should reconsider variables previously dismissed, such as attitude. In doing this, we extend UTAUT in three ways: new contexts (voluntary NCT adoption), endogenous theoretical mechanisms (eHealth literacy), and exogenous variables (attitude; lifespan). These findings underscore a need for a targeted approach to improve eHealth literacy and health self-management across generations.

Loneliness and Social Engagement in Older Adults Based in Lombardy during the COVID-19 Lockdown: The Long-Term Effects of a Course on Social Networking Sites Use

Older adults are less familiar with communication technology, which became essential to maintain social contacts during the COVID-19 lockdown. The present study aimed at exploring how older adults, previously trained for Social Networking Sites (SNSs) use, experienced the lockdown period. In the first two weeks of May 2020, telephone surveys were conducted with individuals aged 81-85 years and resident in Abbiategrasso (Milan), who previously participated in a study aimed at evaluating the impact of SNSs use on loneliness in old age (ClinicalTrials.gov, NCT04242628). We collected information on SNSs use, self-perceived loneliness, and social engagement with family and friends. Interviewed participants were stratified as trained (N = 60) and untrained (N = 70) for SNSs use, based on their attendance to group courses held the previous year as part of the main experimental study. The groups were comparable for sociodemographics and clinical features. Participants trained for SNSs use reported significantly higher usage of SNSs and reduced feeling of being left out. Compared to pre-lockdown levels, individuals trained for SNSs use showed a lighter reduction in social contacts. These findings support the utility of training older adults for SNSs use in order to improve their social inclusion, even in extreme conditions of self-isolation and perceived vulnerability.

The frequency of impairments in everyday activities due to the overuse of the internet, gaming, or smartphone, and its relationship to health-related quality of life in Korea

BACKGROUND

This study aimed to investigate the relationships between the frequency of impairments in daily activities due to the overuse of the Internet, gaming, or smartphones (IGS) and sociodemographic characteristics, social relationships (including family) & activities, psychosocial characteristics, health status, and health-related quality of life (HRQoL) of Korean adults.

METHODS

Secondary data from the 2017 Community Health Survey, a large-scale sample survey conducted yearly in South Korea, were analyzed for 190,066 adults over 19 years of age. Three categories were created for impairment groups due to IGS overuse: No Impairment, Mild Impairment, and Moderate-to-Severe groups. And between-group differences were examined using a one-way ANOVA for health status measured with the EQ-5D-3 L and chi-square tests for all categorical dependent variables, which included sociodemographic characteristics, social relationships & activities, and psychosocial factors. The association between frequencies of daily activity impairments due to IGS overuse and the dependent variables were examined using a multivariate logistic regression analysis and a linear regression model.

RESULTS

Approximately 21,345 (11.23%) of the 190,066 participants reported experiencing impairments in daily activities due to IGS overuse at least once in the previous year and the impairments were more severe in males than females. Participants experiencing impairments in daily activities contacted their friends a significantly higher number of times (4 times or more per month) and engaged in leisure activities more frequently (more than once per month) than those without impairments. There was also a significant positive relationship between IGS overuse and stress, depression, suicidal ideation, and suicide attempts. Among participants aged 19-64, impairments in daily activities due to IGS overuse were associated with a lower HRQoL. Conversely, for those aged 65 and over, mild and moderate-to-severe impairments due to IGS overuse were associated with a significantly higher HRQoL.

CONCLUSIONS

Increased impairments in daily activities due to IGS overuse may negatively affect mental health. However, among older adults, the frequency of such impairments was positively associated with HRQoL. This finding could be considered to apply interventions with Internet usage or ICT devices for older adults to enhance their quality of life.

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.

Aging in an Era of Fake News

Misinformation causes serious harm, from sowing doubt in modern medicine to inciting violence. Older adults are especially susceptible - they shared the most fake news during the 2016 US election. The most intuitive explanation for this pattern blames cognitive deficits. While older adults forget where they learned information, fluency remains intact and decades of accumulated knowledge helps them evaluate claims. Thus, cognitive declines cannot fully explain older adults' engagement with fake news. Late adulthood also involves social changes, including general trust, difficulty detecting lies, and less emphasis on accuracy when communicating. In addition, older adults are relative newcomers to social media, who may struggle to spot sponsored content or manipulated images. In a post-truth world, interventions should consider older adults' shifting social goals and gaps in their digital literacy.

From Online to Offline and Vice Versa: Change in Internet Use in Later Life Across Europe

The internet can be a valuable source of social participation in modern society. Although increasing numbers of older adults are using the internet, numerous older adults also cease using the internet and become "offliners." The question of which factors in usage change (i.e., switching from onliner to offliner, and vice versa) are most influential remains unclear. This study investigates changes in internet use among the older European population using two waves of representative panel data for 13 countries from the Survey of Health, Aging and Retirement in Europe (SHARE). The analyses were based on 34,149 respondents aged 50 years and older. In general, the results indicate a positive trend by a slight (2%) increase in usage, from 51% in 2013 to 53% in 2015. However, the results also show that a total of 6% had not recently used the internet, although they had done so in the past. Our multilevel results suggest that both the onset of and cessation of internet usage are primarily driven by changes in socioeconomic resources (income and occupation), health resources (subjective health and grip strength), living situation (via relocation), and social factors (partnership and distance to children) as well as contextual factors such as country-specific wealth and social indexes and internet infrastructure. The study underlines the importance of investigating the influencing factors for commencing internet usage and of determining which factors lead to its increase.

Technology Adaptivity Mediates the Effect of Technology Biography on Internet Use Variability

Background and Objectives

Increasing numbers of older adults use the internet, but relatively little is known about the range and determinants of different online activities among older internet users. This study explores the interplay between technology-related biographical experiences and subjective technology adaptivity to explain the variability of internet use. Older adults who report having had more biographical experiences with technologies were expected to use a greater range of online activities. In addition, subjective technology adaptivity was expected to serve as a mediator of this relationship.

Research Design and Methods

The analyses are based on a sample of 707 community-dwelling older participants of the University of the Third Age between 60 and 95 years of age (mean age = 72.49 years; 48% female) who use the internet. The measures include self-reports of online activities, technology-related biographical experiences, subjective technology adaptivity, and personal characteristics (age, gender, education, income, living-together status, and subjective health). Correlations and a path model with mediator effects were used to explore the research hypothesis.

Results

The bivariate effects on the variability of internet use showed that study subjects participated in a greater range of online activities when they lived together with other people and were male, younger, and had higher levels of subjective technology adaptivity, technology-related biographical experiences, and educational level. The direct effects on the mediator show higher levels of subjective technology adaptivity for people who reported greater technology-related biographical experiences and for those who reported higher levels of subjective health.

Discussion and Implications

The results show that the positive association between people's past experiences with and stances toward technology in their own lifetimes and their range of diverse internet activities is mediated by subjective technology adaptivity. The findings also help to illustrate which biographical factors and which current individual factors explain differences in actual online behavior.

Use of Information and Communication Technology (ICT) Devices Among the Oldest-Old: Loneliness, Anomie, and Autonomy

Background and Objectives

A good person–environment-fit has positive effects on well-being in old age. As digital technologies are an integral part of older adults’ environments, we predicted that the use of information and communication technologies (ICT) is associated with subjective well-being among the oldest-old. Specifically, we compared different user groups of ICT devices (nonusers, users of nonweb-connected ICT, users of web-connected ICT) and analyzed the relations among ICT use and three domains of subjective well-being (loneliness, anomie, autonomy).

Research Design and Methods

We performed a quantitative data analysis using data from the first representative state-wide survey study in North-Rhine Westphalia, Germany on quality of life and well-being of the oldest-old (n = 1,698; age range: 80–103; 9% long-term care). Multiple regression analyses were applied.

Results

The findings revealed that 25.9% of all individuals aged 80 years and older reported using web-connected ICT, in contrast to 38.5% who do not use ICT at all. Individuals who used web-connected ICT reported lower levels of loneliness and anomie, and higher levels of autonomy. These differences remain significant when controlling for indicators of social inclusion and individual characteristics.

Discussion and Implications

This study investigated an underexplored group in terms of ICT use, shedding light on the relationship between ICT use and subjective well-being. The oldest-old generally use ICT in their everyday life but an age-related digital divide still exists. To avoid negative consequences of nonuse digital infrastructures and technology training for older adults need to be established.

Does internet use affect levels of depression among older adults in China? A propensity score matching approach

BACKGROUND

Emerging research on the use of new technology suggests that internet use is generally associated with high levels of efficiency among older adults in the following areas: quality of life, mood, positive psychological well-being, and the individual and societal costs of caring for them. However, there is little empirical evidence specifically concerning the causal effects of older adults' internet use on their depression level. There is a need for more replication studies to help confirm that the emerging evidence on the impact of internet use is accurate and applicable to different populations and in different situations.

METHOD

Using national data from the China Family Panel Study in 2016, this study helps to fill the above mentioned research gap. This study followed a two-step analytical strategy to empirically examine the association between internet use and reported depression in older adults. In the first step, we estimated a binary logistic regression model with internet use as the dependent variable and 8 demographic and socioeconomic factors as the confounding variables. In the second step, we performed a propensity score analysis to control for potential bias using the confounding variables confirmed in the first step.

RESULTS

The results show that older adults who reported internet use have lower depression levels than did those who did not use the internet, with adjustments made for gender, age, urban or rural residence, pension status, educational background, physical health, life satisfaction, and intelligence level.

CONCLUSION

These findings suggest that it is critical to advocate for technology-based policies and programs that promote older adults' internet use to improve their social well-being, which can also serve as a policy strategy to help alleviate older adults' depression.

"Who Doesn't Think about Technology When Designing Urban Environments for Older People?" A Case Study Approach to a Proposed Extension of the WHO's Age-Friendly Cities Model

The World Health Organization (WHO) strives to assist and inspire cities to become more "age-friendly", and the fundamentals are included in the Global Age-Friendly Cities Guide. An age-friendly city enables residents to grow older actively within their families, neighbourhoods and civil society, and offers extensive opportunities for the participation of older people in the community. Over the decades, technology has become essential for contemporary and future societies, and even more imperative as the decades move on, given we are nearly in our third decade of the twenty-first century. Yet, technology is not explicitly considered in the 8-domain model by the WHO, which describes an age-friendly city. This paper discusses the gaps in the WHO's age-friendly cities model in the field of technology and provides insights and recommendations for expansion of the model for application in the context of countries with a high human development index that wish to be fully age-friendly. This work is distinctive because of the proposed new age-friendly framework, and the work presented in this paper contributes to the fields of gerontology, geography urban and development, computer science, and gerontechnology.

A Framework for Choosing Technology Interventions to Promote Successful Longevity: Prevent, Rehabilitate, Augment, Substitute (PRAS)

Successful longevity is achieved when individuals can continue to plan, pursue, and reach their goals across the life-span. However, normative age-related impairments can make goal attainment more difficult, unless there are interventions to mitigate such changes. Behavioral interventions that use technology are increasing in frequency. I outline a hierarchy of approaches to mitigating impairments. The first strategy to promote successful longevity is prevention of normative age-related decline. When impairments develop, they can be addressed by rehabilitation, augmentation, and substitution approaches.

Older Adults' Perceptions of ICT: Main Findings from the Technology In Later Life (TILL) Study

Technology is entwined in 21st Century society, and within the lives of people across all ages. The Technology In Later Life (TILL) study is the first piece of work contributing to the impact, behavior, and perception of technology use, by adults aged ≥70 years, residing in rural and suburban areas. TILL is an international, multi-centred, multi-methods study investigating and conceptualizing how various technologies impact the lives of older adults; residing in urban and rural locations in the United Kingdom (UK) and Canada. This in-depth study recruited 37 participants via a multi-methods approach. Analysis of the findings ascertained two overarching themes: facilitators of technology use (i.e., sharing of information and feeling secure), and detractors of technology (i.e., feelings of apprehension of use). Proposed recommendations include promotion of technology from a strengths-based perspective focusing on positive opportunities technology to improve health and wellbeing, creating a peer support network to assist with learning of new technology, and the need to examine further how intergenerational relationships may be enhanced through the use of technology. The distinction of these themes narrates to the originality of this initial study and milieu of recruited participants, intersecting across the fields of gerontology, geography, social sciences, and gerontechnology.

Digital Pathways to Positive Health Perceptions: Does Age Moderate the Relationship Between Medical Satisfaction and Positive Health Perceptions Among Middle-Aged and Older Internet Users?

Objectives

We explored the influence of e-trust, e-health literacy, e-health information seeking, and e-health information consumerism on medical satisfaction and positive health perceptions.

Methods

Our sample consisted of 499 randomly selected panel members aged 40–93. We employed hierarchical ordinary least squares (OLS) regression analyses and structural equation modeling (SEM). We examined the moderating role of age on the relationship between medical satisfaction and positive health perceptions.

Results

A significant interaction was found between age and medical satisfaction in predicting positive health perceptions in the OLS regression models. Medical satisfaction has a stronger association with self-care, health-related quality of life, and health status in the older adult sample as compared with the middle-aged sample. SEM analyses revealed that e-health information seeking has an indirect effect on both medical satisfaction and positive health perceptions through its significant direct effect on e-health information consumerism. Both e-trust and e-health consumerism were significant predictors. The e-health literacy and e-trust measures were significant predictors of the positive health perception index in the OLS regression models.

Discussion

The results contribute to our understanding of the potential benefits information technologies have for the health and well-being of computer-connected aging adults.

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

OBJECTIVES

Information and communicative technology (ICT) use is a potential vehicle for improving the psychological well-being (PWB) of older people. We examined the roles of age, frailty, and social connectedness in the relationship between ICT use and PWB.

METHOD

Telephone interviews were conducted in mid-2016 with 1201 participants aged 50 and above (55.7% female) residing in Hong Kong, China. The participants reported PWB, ICT use (frequency of using the Internet and smart devices), frailty status, contact with family, friends, and neighbors, self-rated health, subjective financial sufficiency, education level, and employment status.

RESULTS

We found that the association between ICT and PWB was moderated by age: ICT was associated with PWB only among old-olds (75+), but not in other age groups. This moderation was mediated by contact with family, but not with friends or neighbors. The moderation was further qualified by frailty status: the ICT-by-age moderation was found only among frail, but not pre-frail or robust older adults.

CONCLUSION

The findings suggest that ICT use can potentially enhance the PWB of older adults aged 75+ through facilitating their contact with family members. These benefits might be particularly salient for those who were frail. Improving ICT access and literacy among older adults may be promising.

Utilizing Internet-based recruitment and data collection to access different age groups of former family caregivers

As Internet accessibility grows among adults in the United States, researchers' utilization of Internet-based surveys and recruitment strategies has increased, but there is a paucity of knowledge about their use in different age groups of former dementia caregivers. The purpose of this secondary analysis is to describe 1) the use of Internet-based recruitment in obtaining a sample inclusive of young and middle aged (age 18-64), young-old (age 65-74), and older-old (age 75 and older) former dementia caregivers and 2) the feasibility of collecting data using an online survey in young and middle aged, young-old, and older-old former dementia caregivers. Utilizing convenience sampling, a four-step recruitment strategy encompassing a combination of Internet-based and non-Internet-based recruitment strategies was employed. Participants (N = 171) completed an online survey. Older-old, young-old, and young and middle-aged participants comprised 9%, 30%, and 61% of the sample respectively. All age cohorts provided minimal missing data using an online survey, but older-old participants required 15 additional minutes to complete the survey than young-old participants. Both cohorts of older adults were directed to the survey less frequently through online referral sources than young and middle-aged participants, and no older-old participants were referred via Facebook. All three age cohorts consisted of mostly white women. Internet-based surveys and recruitment were feasible among the age groups but may present challenges for the older-old and minorities. Further research on Internet-based data collection and recruitment is indicated in minority and older-old caregivers, focusing on trust, educational and financial disparities, and technological proficiency as potential barriers.

Social Relations and Technology: Continuity, Context, and Change

Social relations, although basic to human nature, health and well-being, have become increasingly complicated as a result of changing population demography and technology. In this essay, we provide a historical overview of social relations, especially as they affect older people. We briefly review the evolution of theory and measurement surrounding social relations as well as early empirical evidence. We consider how social relations have changed over time as well as continuity and change regarding basic characteristics of social relations. Of special interest is the emerging influence of technology on how people maintain contact, especially the changing ways people can use technology to increase, decrease, maintain, or avoid social relations. We consider both negative and positive aspects of these new technologies and their influence on health and well-being. Finally, we conclude that new and emerging technologies hold great promise for the future by overcoming traditional barriers to maintaining social contact, support exchange, and information acquisition. Nevertheless, we caution that these new technologies can have the dehumanizing effect of distance thus creating the potential for insensitivity and increased negativity. In sum, we are cautiously optimistic about the promise of technology to expand, but not replace, traditional forms of social contact.