You can teach an old dog new tricks: a qualitative analysis of how residents of senior living communities may use the web to overcome spatial and social barriers

The Purpose of Internet Use and Face-To-Face Communication With Friends and Acquaintances Among Older Adults: A JAGES Longitudinal Study

Internet use influences social interactions in society. However, there is no consensus on whether and what kind of Internet use increases face-to-face communication (FFC). This study investigated the mode of Internet use that increases FFC among older adults after three years. Participants were 8734 adults aged 65 or older who responded to the Japan Gerontological Evaluation Study (JAGES) surveys in 2016 and 2019. The exposures were the purposes of Internet use in 2016. The outcome was the frequency of FFC with friends or acquaintances in 2019. The confounders included 13 demographic, socioeconomic, and psychological variables. We performed modified Poisson regression analyses and found that Internet use for communication in 2016 increased FFC in 2019, especially for low-frequency FFC in 2016. Internet-based non-FFC may help promote FFC and prevent social isolation among older adults who are less likely to interact with others.

You've Got E-Mail: A Pilot Study Examining the Feasibility and Impact of a Group-Based Technology-Training Intervention Among Older Adults Living in Residential Care

Older adults living in residential care often experience challenges in sustaining meaningful social relationships, which can result in compromised health and well-being. Online social networking has the potential to mitigate this problem, but few studies have investigated its implementation and its effectiveness in maintaining or enhancing well-being. This pilot study used a cluster-randomized pre-post design to examine the feasibility of implementing a 12-week group-based technology-training intervention for older adults (n = 48) living in residential care by exploring how cognitive health, mental health, and confidence in technology were impacted. Analysis of variance revealed significant increases in life satisfaction, positive attitudes toward computer use, and self-perceived competence among participants who received the intervention, but increased depressive symptoms for the control group. These findings suggest that, despite challenges in implementing the intervention in residential care, group-based technology training may enhance confidence among older adults while maintaining or enhancing mental health.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

Internet access, support, usage divides, and depressive symptoms among older adults in China: A nationally representative cross-sectional study

OBJECTIVE

This study examines the associations between multiple sub-dimensions of the digital divide, including Internet access, support, usage divides, and depressive symptoms among older adults as well as the potential moderating effects of rural/urban status on these associations in China.

METHODS

Data were obtained from the 2018 China Longitudinal Aging Social Survey, which provided a nationally representative sample of 11,418 participants aged 60 years and older. Multivariate linear regression models were used to analyze the associations between digital divide and depressive symptoms. The moderating role of rural/urban status was tested based on the interaction terms.

RESULTS

After controlling for the covariates, access to Internet devices, support for Internet use from family, and using the Internet for communication, entertainment, or as instruments, were found to be significantly associated with a lower level of depressive symptoms (P < 0.05), and compared with no access to the Internet, accessing and using the Internet was significantly related to decreased depressive risks (P < 0.001), whereas access to the Internet with non-use was not statistically significant. Additionally, the associations between multidimensional aspects of the digital divide and depressive symptoms were moderated by rural/urban status, with these associations being significantly stronger among rural older adults (P < 0.05).

CONCLUSIONS

This study highlights the importance of assessing the associations between digital divide and depressive symptoms from the multidimensional perspectives of access, support, and usage. Policy interventions targeting various aspects of the digital divide should be implemented to ensure active Internet engagement among older adults, especially those living in rural areas.

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.

The Effects of Online Social Interactions on Life Satisfaction of Older Chinese Adults: New Insights Based on a Longitudinal Approach

Population aging and digitalization have become universal phenomena. Over the past two decades, digital inclusion has started to play a crucial role in supporting successful aging. Based on a nationally representative sample of around 5200 older adults in China over the period of 2014-2018, we explore the effects of online social interactions (OSIs) on the life satisfaction of older adults. We find that OSIs can improve the levels of life satisfaction of older Chinese adults. Estimates from fixed effect and cross-lagged structural equation models further suggest that OSIs work by increasing physical activities, healthy time allocation, interpersonal trust, and informal social engagement and reducing loneliness. We also find that OSIs narrow the social inequality in life satisfaction across groups from rural-urban areas and groups with different social statuses. Moreover, a comparison among different online engagements shows that not all online activities positively affect older adults' life satisfaction. Different online activities have varying effects. Our results highlight that public digital interventions focusing on social functions can benefit the lives of older adults.

Studies on the Digital Inclusion Among Older Adults and the Quality of Life—A Nanjing Example in China

Digital inclusion can bridge the digital divide and reduce the social exclusion of older adults, yet it is understudied in China. This research examined factors influencing the digital inclusion of older adults in China and the relationship between digital inclusion and quality of life. Data collected from 312 older people (M = 69.6 years old) in Nanjing were included in a multinomial logit model to tackle these questions. Their attitudes toward technology were the most significant factor predicting their digital inclusion. Other factors included party affiliation, living situation, personal average monthly income, occupation, and capacity for instrumental activities of daily living (IADLs). This study shows digital inclusion has a direct impact on quality of life. It also serves as an intermediate variable that affects older people's attitudes toward technology and their IADL capacities. Most importantly, digital inclusion promotes social integration of older adults and improves the quality of their lives. Hence, it should not be ignored. Older people's attitudes toward technology are one of the keys to promoting their digital inclusion.

The role of assistive technology in addressing social isolation, loneliness and health inequities among older adults during the COVID-19 pandemic

PURPOSE

Assistive technology (AT) is an effective tool to promote social connectedness among older adults affected by the COVID-19 pandemic; however, its role in reducing loneliness and health inequities is not well understood. The goal of this scoping review was to construct a model for how technologies may be deployed to mitigate the impact of the COVID-19 pandemic on social isolation, loneliness and health inequities for older adults.

METHODS

PubMed, SCOPUS and PsychINFO were searched from 2010 to 2020 for the following keywords: "social isolation," "loneliness," "social support," "resilience," "technology," "pandemic" and "health inequit*." Articles selected for full analysis attempted to understand how technology alleviates social isolation and/or loneliness among older adults.

RESULTS

Eighteen articles met the criteria for selection and data extraction. Six were review-type studies, seven were observational, three were randomized control trials, one opinion piece and one case study. ATs have been shown to reduce loneliness and social isolation, strengthen social support, and promote resilience among older adults. AT reduces loneliness both directly and indirectly, by affecting social isolation. There is insufficient evidence to determine technology's relationship to health inequities experienced by older adults.

CONCLUSIONS

The model we have proposed should help advance research on the relationship between ATs and health inequities among older adults that may be aggravated by the COVID-19 pandemic. We hypothesize that AT interventions for social support and functional competence should be sequenced to reduce health disparities.Implications for rehabilitationThe social distancing and quarantine measures as a result of the COVID-19 pandemic can be linked to adverse health outcomes among older adult populations.Technology is an effective tool to promote social connectedness among older adults affected by the pandemic.Assistive technology (AT) interventions for social support and functional competence should be sequenced in order to have best effects on reducing health disparities.

Social Capital Mediates the Association between the ICT Usage and Well-Being of Older People in Japan: Implication for a New Design Paradigm

As the population ages, the question of how to prevent isolation among older people and increase their well-being becomes a social issue. It has often been argued that Information and Communication Technology (ICT) usage can be a solution to these challenges, but empirical studies have not shown consistent results. Moreover, there are even fewer studies targeting older people in Japan, which is the most aging country in the world. Therefore, using the psychological comprehensive data of Japanese people aged 60 and over recorded in World Values Survey Wave 7, we conducted a study to clarify the relationship between the ICT usage, social capital, and well-being of older people to make a meaningful contribution to policymakers and the scientific community. As a result of the analysis, it was shown that ICT usage indirectly enhances well-being by increasing social capital. This indicates that for older people, ICT usage does not have a large effect on enhancing well-being, but becomes sufficiently large only through the improvement of social capital. The pros and cons of such modern communication means should be utilized as a reference when considering the development of future communication means and a human coach—a person who supports the use of communication means by older people. In other words, to think about the spread of communication means to community-dwelling older people in the future, it is always necessary to think about technology usage emphasizing the relationship between older people and society.

A Population Study on COVID-19 Information Sharing: Sociodemographic Differences and Associations with Family Communication Quality and Well-Being in Hong Kong

Family support through the sharing of information helps to shape and regulate the health and behaviours of family members, but little is known about how families are sharing COVID-19-related information, or about its associations with family communication quality and well-being. We examined the associations of COVID-19 information sharing methods with sociodemographic characteristics, the perceived benefits of information communication and technology (ICT) methods, and family communication quality and well-being in Hong Kong. Of 4852 respondents (53.2% female, 41.1% aged over 55 years), the most common sharing method was instant messaging (82.3%), followed by face-to-face communication (65.7%), phone (25.5%) and social media (15.8%). Female sex (adjusted prevalence ratio (aPR) 1.09), older age (aPRs 1.14-1.22) and higher household income (aPR 1.06) (all p ≤ 0.04) were associated with instant messaging use, while post-secondary education was associated with face-to-face (aPR 1.10), video call (aPR 1.79), and email (aPR 2.76) communications (all p ≤ 0.03). Each ICT sharing method used was associated with a higher likelihood of both reported benefits (aPRs 1.26 and 1.52), better family communication quality and family well-being (adjusted βs 0.43 and 0.30) (all p ≤ 0.001). We have first shown that COVID-19 information sharing in families using both traditional methods and ICTs, and using more types of methods, was associated with perceived benefits and better family communication quality and well-being amidst the pandemic. Sociodemographic differences in COVID-19 information sharing using ICTs were observed. Digital training may help enhance social connections and promote family well-being.

The effect of "Elder Care by Elderly People Program" on life satisfaction and quality of life among institutionalized senior citizens

INTRODUCTION

Improving participation in life meaningful roles is one of the most important predictors of quality of life (QOL) and life satisfaction (LS) in later life. The purpose of this study was to investigate the effect of Elder Care by Elderly People (ECP) on LS and QOL among institutionalized senior citizens.

MATERIAL AND METHOD

This was an interventional study involving a targeted sample of 36 older adults in Ghods nursing home in Tehran in 2018. WHOQOL-OLD 24-item and LS 40-item questionnaires were used to measure LS and Olathe repeated-measures ANOVA and descriptive was employed to obtain the objectives.

RESULTS

The participants were 36 older adults in Ghods nursing home. The mean age of older adults was 67.27 (standard deviation [SD] = 7.6), of whom about 77.8% were male. The mean score of QOL increased from 74.38 (SD = 13.09) pre intervention to 83.72 (SD = 11.43) 2 months post intervention, with most significant change of 9.3 QOL points between pre intervention and 2 months post intervention alone (P < 0.01). Similarly, LS increased from 114.19 (SD = 26.93) pre intervention to 133.94 (SD = 20.49) 2 months post intervention, with most significant change of 19.7 LS points between pre intervention and 2 months post intervention alone (P < 0.001).

CONCLUSIONS

The results of this study showing the evidence of the positive impact of the ECP Programmed for the elderly, therefore, it is suggested that the programmer is evaluated in future studies.

Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren

BACKGROUND

Caring for grandchildren is regarded as one of the principle roles of middle- and old-aged adults, especially among rural Chinese grandparents. This study aims to examine the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren, based on the gender differences in grandparental role engagement and the theories of role strain and role enhancement.

METHODS

A total of 4833 rural citizens with one or more grandchildren were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Grandchild care was measured by continuous variable (duration) and categorical variable (no care, low intensity, moderate intensity, high intensity). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). We used coarsened exact matching (CEM) to balance the covariates of caregivers and non-caregivers. Following CEM, 1975 non-caregivers and 2212 caregivers were identified (N = 4187). Multilevel linear regression was employed to examine the gender differences in depressive symptoms. We also tested for the moderating role of gender on the association between grandchild care and depressive symptoms.

RESULTS

Grandmothers were more likely to provide grandchild care (54.42% vs 51.43%) at high intensity (61.46% vs 51.01%), with longer duration (39.24 h vs 33.15 h) than that given by grandfathers. Grandmothers suffered more from depressive symptoms than grandfathers, and such gap increased when grandparents were involved in high-intensity care. Grandmothers providing grandchild care, particularly at moderate intensity, were associated with fewer depressive symptoms (Coef. = - 0.087, 95%CI: - 0.163, - 0.010; Coef. = - 0.291, 95%CI: - 0.435, - 0.147), compared with non-caregivers. Grandmothers giving moderate intensity of grandchild care were also associated with fewer depressive symptoms (Coef. = - 0.171, 95% CI: - 0.313, - 0.029), compared with those with low-intensity care. However, such associations were not significant among grandfathers.

CONCLUSIONS

Our findings highlight the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. Grandparents should be encouraged to engage in grandchild care, but at moderate intensity. The health status of middle- and old-aged adults, particularly females, should be monitored closely. Humanistic care, preventive care and curative treatment strategies focusing on such populations should be developed and refined.

The Impact of an Internet Use Promotion Programme on Communication, Internet Use, and the Extent of Social Networks among Low-Income Older Adults

We examined whether an internet use promotion intervention influences low-income older adults’ communication modes, internet use, and social networks using existing data collected for an intervention. Participants living in public senior housing facilities in the United States (n = 77) completed surveys before and after a 12-week computer and internet training. The six-item Lubben Social Network Scale (LSNS-6) was used to measure the extent of older adults’ social networks. The primary mode of communication shifted from more traditional means to internet-based communications (p < .0005 in a Fisher’s exact test). The frequency of internet use significantly increased (p < .00005 in a one-sided Sign test). Overall, the LSNS-6 score increased by 4.1 points (p < .00005 in a Welch’s t-test). The LSNS-6 score increase was significantly larger among African Americans than Whites, controlling for gender (p < .05 in negative binomial regression). Moderate (p < .005) and frequent internet users (p < .05) had higher LSNS-6 scores than rare internet users at posttest when gender and race were controlled for in linear regression. Comparatively more improvement in the extent of social networks among African Americans suggests greater benefits of such interventions for population groups of disadvantaged backgrounds. Larger social networks among moderate and frequent internet users than rare users suggest positive impacts of internet communications on social networks.

Technology Recommendations to Support Person-Centered Care in Long-Term Care Homes during the COVID-19 Pandemic and Beyond

The COVID-19 pandemic has exposed persistent inequities in the long-term care sector and brought strict social/physical distancing distancing and public health quarantine guidelines that inadvertently put long-term care residents at risk for social isolation and loneliness. Virtual communication and technologies have come to the forefront as the primary mode for residents to maintain connections with their loved ones and the outside world; yet, many long-term care homes do not have the technological capabilities to support modern day technologies. There is an urgent need to replace antiquated technological infrastructures to enable person-centered care and prevent potentially irreversible cognitive and psychological declines by ensuring residents are able to maintain important relationships with their family and friends. To this end, we provide five technological recommendations to support the ethos of person-centered care in residential long-term care homes during the pandemic and  in a post-COVID-19 pandemic world.

Does the Internet Use Improve the Mental Health of Chinese Older Adults?

Purpose: The Internet has become an important part of daily life. However, older adults in China remain digital refugees amid the rapid development of digital information technology. This study attempts to scientifically answer how Internet use affects the subjective welfare of older adults.

Method: Using data from the 2014 and 2016 China Longitudinal Aging Social Survey (CLASS), a combination of ordinary least squares, ordered logit regression models, and propensity score matching (PSM) models were used to analyze the effects of Internet use on the mental health of Chinese older adults.

Results: Our findings suggest that Internet use affects the mental health of older adults and increases the incidence of their depressive symptoms. These findings are robust to changing the key indicators, research method, and sample. Further heterogeneity analysis reveals that the negative effects on mental health are more evident for specific groups of older adults, such as those who are women, younger and middle-aged, high-income, non-rural Hukou, less educated, and living with others.

Conclusions: Cultivating the ability of older adults to use the Internet and maintain a rational attitude while doing so can prevent its negative impact on their life satisfaction. Moreover, it can improve their attitudes toward using the technology and reduce their anxiety.

Digital ageing in Europe: a comparative analysis of Italian, Finnish and Swedish national policies on eHealth

Ageing Europeans are today healthier than previous generations and often manage to live independently up to a high age. The proportion of people 80 years of age and older has increased significantly, and with high age the risk of multi-illness and dementia increases. Strong urbanisation processes have changed the demographic structure in rural areas, and young women and men have migrated towards the urban areas to study and work, while older persons have remained behind. This demographic challenge of increasing numbers of persons older than 80 years with care needs living in remote rural areas has become a major European social problem. In tackling this dilemma, many European countries have high expectations for eHealth, digitalisation and welfare technology. In this comparative study of policy debates in Italy, Finland and Sweden, we analyse how – between 2009 and 2019 – the issues of eHealth have been articulated in national and regional policies of the three countries with deep differences in terms of digitalisation and health systems, but with similar ageing populations. We identify in the documents three core topics – the role of technology, the rural issue and responsibility for care. These topics are treated in the documents with differences and similarities between the three countries. Beyond the differences and similarities, the documents reveal both a certain techno-enthusiasm about the role of eHealth in the life of the older adults as well as a limited understanding of the complexity (relationally as well as spatially) of the digital landscape of caring for older adults.

Internet Use, Life Satisfaction, and Subjective Well-Being Among the Elderly: Evidence From 2017 China General Social Survey

Purpose: The research objectives of this study are to test the scientific propositions of whether Internet use promotes life satisfaction among the elderly, whether there is variability in the effect of Internet use on the well-being of the elderly, and through what channels Internet use affects the elderly's life satisfaction. Method: Using data from the 2017 Chinese General Social Survey (CGSS), this paper employed linear regression, ordered logit model, and the propensity score matching (PSM) approach to investigate the association of Internet use with life satisfaction among the elderly in China. Results: The results show that Internet use was significantly and negatively associated with the life satisfaction of the Chinese elderly. Further analysis on group heterogeneity demonstrates that the negative association was more prominent among the participants who were males, at a lower age, had lower income and education, non-agricultural registered, and relatively healthy. Finally, the mediating effect indicates that Internet use may affect life satisfaction among the elderly through the channel of reducing their perceptions of social justice. Conclusions: In order to avoid the negative effects of using the Internet, the following policy suggestions are put forward: Improve the elderly's attitudes toward Internet use; pay attention to the sense of fairness of the elderly to improve life satisfaction; guide the elderly to reduce the time of using the Internet.

Understanding older adults’ use of social technology and the factors influencing use

Having access and skills to use social technology, i.e. social internet use, social media and social applications, are considered as being vital to online social connection. Whilst evidence exists around facilitators and barriers to general technology use, evidence is limited with regards to the motivators, skills and tangible offline benefits older technology users experience with social technology. Therefore, this study used a qualitative, exploratory method to understand older adults’ experiences of using social technology to connect with others. Semi-structured interviews were conducted with 20 older adults (65+ years) across England, Scotland and Wales. Despite having access to social technology for social connection, and using this technology regularly, multiple barriers impacted motivators and skills for use, namely perceived self-efficacy and fear, the culture of online communication, absence of social capital and physical functioning. Some of these barriers of social technology use are reminiscent of barriers of wider technology use and emphasise the importance of addressing these barriers for digital exclusion, as well as social connection. However, some of these barriers were specific to social technology use and should be considered when providing guidance or interventions to increase older adults’ online social connection. Social connection was a clear tangible outcome to social technology use, and individuals discussed the benefits of using social technology, particularly visual communication tools, for online connection.

Assistive Technologies in Dementia Care: An Updated Analysis of the Literature

Objectives: Technology can assist and support both people with dementia (PWD) and caregivers. Recently, technology has begun to embed remote components. Timely with respect to the pandemic, the present work reviews the most recent literature on technology in dementia contexts together with the newest studies about technological support published until October 2020. The final aim is to provide a synthesis of the timeliest evidence upon which clinical and non-clinical decision-makers can rely to make choices about technology in the case of further pandemic waves.

Methods: A review of reviews was performed alongside a review of the studies run during the first pandemic wave. PsycInfo, CINAHL, and PubMed-online were the databases inspected for relevant papers published from January 2010.

Results: The search identified 420 articles, 30 of which were reviews and nine of which were new studies meeting the inclusion criteria. Studies were first sorted according to the target population, then summarized thematically in a narrative synthesis. The studies targeting technologies for PWD were categorized as follows: monitoring and security purposes, sustaining daily life, and therapeutic interventions. Each category showed potential benefits. Differently, the interventions for caregivers were classified as informative, psycho-education programs, psychosocial-supportive, therapeutic, and cognitive/physical training. Benefits to mental health, skills learning, and social aspects emerged.

Conclusions: The evidence shows that technology is well-accepted and can support PWD and caregivers to bypass physical and environmental problems both during regular times and during future pandemic waves. Nevertheless, the lack of a common methodological background is revealed by this analysis. Further and more standardized research is necessary to improve the implementation of technologies in everyday life while respecting the necessary personalization.

The Effect of Information and Communication Technology and Social Networking Site Use on Older People's Well-Being in Relation to Loneliness: Review of Experimental Studies

BACKGROUND

In the last decades, the relationship between social networking sites (SNSs) and older people's loneliness is gaining specific relevance. Studies in this field are often based on qualitative methods to study in-depth self-perceived issues, including loneliness and well-being, or quantitative surveys to report the links between information and communication technologies (ICTs) and older people's well-being or loneliness. However, these nonexperimental methods are unable to deeply analyze the causal relationship. Moreover, the research on older people's SNS use is still scant, especially regarding its impact on health and well-being. In recent years, the existing review studies have separately focused their attention on loneliness and social isolation of older people or on the use of ICTs and SNSs in elderly populations without addressing the relationship between the former and the latter. This thorough qualitative review provides an analysis of research performed using an experimental or quasi-experimental design that investigates the causal effect of ICT and SNS use on elderly people's well-being related to loneliness.

OBJECTIVE

The aims of this review are to contrast and compare research designs (sampling and recruitment, evaluation tools, interventions) and the findings of these studies and highlight their limitations.

METHODS

Using an approach that integrates the methodological framework for scoping studies and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, we identified 11 articles that met our inclusion criteria. A thematic and content analysis was performed based on the ex post categorization of the data on the selected studies, and the data were summarized in tables.

RESULTS

The analysis of the selected articles showed that: (1) ICT use is positively but weakly related to the different measures of older people's well-being and loneliness, (2) overall, the studies under review lack a sound experimental design, (3) the main limitations of these studies lie in the lack of rigor in the sampling method and in the recruitment strategy.

CONCLUSIONS

The analysis of the reviewed studies confirms the existence of a beneficial effect of ICT use on the well-being of older people in terms of reduced loneliness. However, the causal relationship is often found to be weak. This review highlights the need to study these issues further with adequate methodological rigor.

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.

Size matters: locality of residence and media use in later life

Various factors determine the use of media in later life. Nevertheless, spatial inequalities among older media users have been accorded little attention in academic research. This study aimed to explore differences in variety (number) and intensity (duration) of both traditional and new media use among older adults residing in various types of localities. Data were obtained from the second wave of the ACT (Ageing + Communication + Technology) cross-national survey, comprising 7,927 internet users aged 60 and over from seven countries. The statistical analyses used in the study were chi-square and analysis of variance tests, and linear regression as a multivariate technique. The results indicated that spatial differences concern variety of media use to a greater extent than its intensity, especially with regard to use of traditional media via new devices. Overall, residents of large cities exhibited greater variety and intensity of media use than did their counterparts from smaller localities, especially rural ones. These findings supported the social stratification hypothesis – according to which individuals from more-privileged social backgrounds have better media literacy, use media to a greater extent and benefit from its use more than people from disadvantaged groups. The findings should be considered by practitioners and policy makers.

Wearable Activity Monitor Use Is Associated With the Aerobic Physical Activity Guidelines and Walking Among Older Adults

PURPOSE

To examine wearable activity monitor (WAM) use and its association with meeting the 2008 aerobic Physical Activity Guidelines (PAG) and walking among older adults.

DESIGN

Cross-sectional.

SETTING

FallStyles 2015 national consumer panel survey.

SAMPLE

1,317 U.S. adults aged ≥ 60 years.

MEASURES

Self-reported WAM use, meeting aerobic PAG, and walking. Covariates included age, sex, race/ethnicity, education level, marital status, annual household income, and geographic region of the country.

ANALYSIS

Chi-square tests to examine associations between WAM use and respondent demographic characteristics. Logistic regressions to explore associations between WAM use and meeting aerobic PAG and walking adjusted for demographics (e.g., education, income).

RESULTS

Among older adults, 8.0% were current WAM users and 11.3% were past WAM users. Current WAM use was most prevalent among those aged 65-74 (16.6%), females (9.4%), college graduates (13.8%), and those with incomes $75,000-$99,999 (14.8%). Current WAM users were more likely than never WAM users to report meeting aerobic PAG (OR: 3.98; 95% CI: 2.07, 7.66) and walking (OR: 3.90; 95% CI: 1.57, 9.69). Past and never WAM use were not associated with meeting aerobic PAG or walking.

CONCLUSION

We found current WAM use is associated with meeting the aerobic PAG and walking among older adults. Further longitudinal research is needed to understand whether WAM could promote increased PA among older adults.

Impact of the AGE-ON Tablet Training Program on Social Isolation, Loneliness, and Attitudes Toward Technology in Older Adults: Single-Group Pre-Post Study

Background

The internet and technology can help older adults connect with family and friends. However, many older adults face obstacles to internet and technology use, such as lack of knowledge or self-efficacy.

Objective

The purpose of this study was to explore the impact of the AGE-ON tablet training program on social isolation, loneliness, and quality of life.

Methods

Adults aged >60 years took part in a series of 6 weekly workshops covering the basic features of a tablet. Before and after the program, social isolation, loneliness, social support, and quality of life were assessed. In addition, data on current tablet use and attitudes toward technology use were collected. Satisfaction with the program was also assessed at the end of the study using 6 Likert scale questions.

Results

The participants (N=32; mean age 76.3, SD 8.6 years) were predominantly female (n=20, 63%) and retired (n=30, 94%). The participants reported that they were highly satisfied with the program. After completing the program, no differences in social isolation, loneliness, social support, or quality of life were found. Frequency of tablet use increased and the attitudes of the participants toward technology improved.

Conclusions

The AGE-ON program resulted in increased tablet use frequency and may improve comfort and attitudes toward tablet use among older adults. This program may assist older adults in overcoming obstacles to internet and technology use to better connect with family and friends; however, further work targeting older adults who are socially isolated or at risk of social isolation is needed to more fully understand whether tablet training programs are beneficial in this population.

Trial Registration

ClinicalTrials.gov NCT03472729; https://clinicaltrials.gov/ct2/show/NCT03472729

The first-level digital divide shifts from inequalities in physical access to inequalities in material access

For a long time, a common opinion among policy-makers was that the digital divide problem would be solved when a country's Internet connection rate reaches saturation. However, scholars of the second-level digital divide have concluded that the divides in Internet skills and type of use continue to expand even after physical access is universal. This study-based on an online survey among a representative sample of the Dutch population-indicates that the first-level digital divide remains a problem in one of the richest and most technologically advanced countries in the world. By extending basic physical access combined with material access, the study finds that a diversity in access to devices and peripherals, device-related opportunities, and the ongoing expenses required to maintain the hardware, software, and subscriptions affect existing inequalities related to Internet skills, uses, and outcomes.

Examining Cross-Age Experiences in a Distance-Based Intergenerational Music Project: Comfort and Expectations in Collaborating With Opposite Generation Through "Virtual" Exchanges

There has been an increase in the number of music-based intergenerational programs conducted by music therapists as part of wellness and intergenerational music therapy programs. Research has shown that intergenerational music therapy programs have improved cross-age attitudes, interactions, and older adults' psychosocial well-being. Anecdotal evidence indicates that one of the challenges for creating music-based intergenerational programs is finding agencies that serve younger and older generations within close proximity to one another. We sought to remedy this problem with the integration of "virtual" technology. The purpose of this study was to examine changes in cross-age comfort, expectations after experiencing "virtual" exchanges, and preconceived notions of older and younger persons enrolled in a distance-based intergenerational project. A secondary purpose was to determine what intergenerational project factors were most enjoyable for older and younger participants. Eighteen older adults (61 through 79 years old) from an intact music-therapy choir along and 14 younger children from an intact community choir (9 through 14 years old) served as participants for the current study. All participants experienced the 4-week distance-based intergenerational program that consisted of: (a) two group "virtual" exchanges, (b) two reflective journals related to the "virtual" exchanges, (c) an in-person half-day music-therapy intergenerational workshop, and (d) a joint performance. Cross-age comfort, preconceived notions, expectations, and preference factors were examined through pre-test and post-test measurements. Results indicated an increase in older adults' comfort level collaborating with children after participation in the intergenerational music project. The majority of younger (64%) and older (69%) participants indicated that their preconceived notions about the other generation were different and positive from what they initially thought prior to the project. Both generations indicated an improvement in cross-age attitudes and interactions due to the collaboration process ("virtual" exchange, workshop, and joint-performance) and the cross-age interactions during the project. These findings suggest that music therapists can foster cross-age interactions and relationships between generations that are not within close proximity of one another by using a combination of "virtual" and "live" interactions as an intervention for enhancing the overall quality of life among older adults.

Combatting social isolation and increasing social participation of older adults through the use of technology: A systematic review of existing evidence

OBJECTIVES

There are growing concerns that social isolation presents risks to older people's health and well-being. Thus, the objective of the review was to explore how technology is currently being utilised to combat social isolation and increase social participation, hence improving social outcomes for older people.

METHODS

A systematic review of the literature was conducted across the social science and human-computer interaction databases.

RESULTS

A total of 36 papers met the inclusion criteria and were analysed using a four-step process. Findings were threefold, suggesting that: (i) technologies principally utilised social network services and touch-screen technologies; (ii) social outcomes are often ill-defined or not defined at all; and (iii) methodologies used to evaluate interventions were often limited and small-scale.

CONCLUSION

Results suggest a need for studies that examine new and innovative forms of technology, evaluated with rigorous methodologies, and drawing on clear definitions about how these technologies address social isolation/participation.

Meanings and experiences associated with computer use of older immigrant adults of lower socioeconomic status: Les sens et les expériences associés à l'utilisation des ordinateurs chez les immigrants âgés ayant un faible statut socioéconomique

BACKGROUND

Immigrant older adults are a substantial demographic composing 12% to 30% of older adults in the United States and Canada, yet no research has addressed the meanings associated with computer use for low-socioeconomic-status and immigrant older adults.

PURPOSE

The study explored the meanings, occupational engagement, and experiences associated with computer use.

METHOD

A mixed-methods approach, qualitative participatory action research (photovoice) and survey (Computer Proficiency Questionnaire), was used. Data collection consisted of narratives, focus groups, and Likert scale responses for nine participants.

FINDINGS

The participants expressed the meanings they associated with computer use as freedom, personal growth, and engagement. Computers promote occupational engagement in social participation, education, and leisure.

IMPLICATIONS

The findings of personal growth may inform occupational therapy interventions using computers to enable adjustment to changes related to aging and wellness. Social participation and education were motivators for computer use, which may inform computer engagement strategies for this population.

Discontinued Information and Communication Technology Usage among Older Adults in Continuing Care Retirement Communities in the United States

BACKGROUND

Older adults are increasingly using information and communication technologies (ICTs). Recent studies show beneficial effects of using ICTs for older adults, particularly in terms of reducing loneliness and depression. However, little is known about the factors that may prevent discontinued ICT use in populations that may be at greater risk, such as those in continuing care retirement communities (CCRCs).

OBJECTIVES

The purpose of this study is to examine a range of factors that may influence discontinued (1) ICT use, (2) searching for health information, and (3) searching for general information over time among CCRC residents.

METHODS

We use longitudinal data from a randomized controlled trial conducted with residents of 19 CCRCs. We use flexible parametric models to estimate the hazard ratio or hazard rate over 5 waves of data to determine what factors significantly predict discontinued (1) ICT use, (2) health information searching, and (3) general information searching.

RESULTS

The analysis reveals that independent living residents who took part in an 8-week ICT training intervention were less likely to stop using ICTs. Age and the number of instrumental activities of daily living (IADL) impairments significantly predicted an increased likelihood of stopping ICT use. When examining specific ICT-related activities, the analysis reveals that independent living residents who took part in the ICT training intervention were less likely to stop searching for health information and general information online. In addition, age and the number of IADL impairments were associated with increased likelihood of discontinued health information searches and discontinued general information searches.

CONCLUSION

ICT training interventions may motivate residents of CCRCs to stay connected by increasing the ICT skill level and promoting confidence, thus decreasing the probability that they will discontinue using ICTs and searching for general information. However, the effects of ICT training on motivating continued ICT usage may be more pronounced among independent living residents. Limitations in the number of IADL impairments is a key factor leading to discontinued use of ICTs among CCRC residents, suggesting that designers of ICTs should be cognizant of the cognitive and physical limitations among this group.

The Physical-Digital Divide: Exploring the Social Gap Between Digital Natives and Physical Natives

Older adults are the most digitally divided demographic group. The present study explores how older adults perceive the physical use of information and communication technologies (ICTs), particularly across generations and contexts. Data for the present study come from nine focus groups. Seniors acknowledge that ICTs help them connect with geographically distant social ties, but that they lead to feelings of disconnection with geographically close social ties. We label this phenomenon the "physical-digital divide," which exists when a group feels ostracized or offended when those around them engage with ICTs while they themselves are not or cannot engage with ICTs. Younger generations are often referred to as "digital natives" and older generations as "digital immigrants." A more apt label for older adults may be "physical natives," as their preferred method of communication involves physical face-to-face interactions and traditional codes of etiquette. Suggestions are made for reducing the physical-digital divide.

Reducing the Digital Divide

America’s older adult population is increasing at a dramatic rate due to better health care, technology, and improved living conditions. However, as individuals 65 years and older begin to live longer and experience multiple life changes, there is a larger incidence of social isolation leading to loneliness, depression, and a general decline in health. This mixed-method study aimed to explore whether information and communication technologies, specifically iPads, improved the lives of older adults. Our findings suggest that the use of technology increased knowledge, elicited closer family ties, and led to a greater overall connection to society.

Smart homes and home health monitoring technologies for older adults: A systematic review

BACKGROUND

Around the world, populations are aging and there is a growing concern about ways that older adults can maintain their health and well-being while living in their homes.

OBJECTIVES

The aim of this paper was to conduct a systematic literature review to determine: (1) the levels of technology readiness among older adults and, (2) evidence for smart homes and home-based health-monitoring technologies that support aging in place for older adults who have complex needs.

RESULTS

We identified and analyzed 48 of 1863 relevant papers. Our analyses found that: (1) technology-readiness level for smart homes and home health monitoring technologies is low; (2) the highest level of evidence is 1b (i.e., one randomized controlled trial with a PEDro score ≥6); smart homes and home health monitoring technologies are used to monitor activities of daily living, cognitive decline and mental health, and heart conditions in older adults with complex needs; (3) there is no evidence that smart homes and home health monitoring technologies help address disability prediction and health-related quality of life, or fall prevention; and (4) there is conflicting evidence that smart homes and home health monitoring technologies help address chronic obstructive pulmonary disease.

CONCLUSIONS

The level of technology readiness for smart homes and home health monitoring technologies is still low. The highest level of evidence found was in a study that supported home health technologies for use in monitoring activities of daily living, cognitive decline, mental health, and heart conditions in older adults with complex needs.

The Effect of Information Communication Technology Interventions on Reducing Social Isolation in the Elderly: A Systematic Review

Background

The aging of the population is an inexorable change that challenges governments and societies in every developed country. Based on clinical and empirical data, social isolation is found to be prevalent among elderly people, and it has negative consequences on the elderly’s psychological and physical health. Targeting social isolation has become a focus area for policy and practice. Evidence indicates that contemporary information and communication technologies (ICT) have the potential to prevent or reduce the social isolation of elderly people via various mechanisms.

Objective

This systematic review explored the effects of ICT interventions on reducing social isolation of the elderly.

Methods

Relevant electronic databases (PsycINFO, PubMed, MEDLINE, EBSCO, SSCI, Communication Studies: a SAGE Full-Text Collection, Communication & Mass Media Complete, Association for Computing Machinery (ACM) Digital Library, and IEEE Xplore) were systematically searched using a unified strategy to identify quantitative and qualitative studies on the effectiveness of ICT-mediated social isolation interventions for elderly people published in English between 2002 and 2015. Narrative synthesis was performed to interpret the results of the identified studies, and their quality was also appraised.

Results

Twenty-five publications were included in the review. Four of them were evaluated as rigorous research. Most studies measured the effectiveness of ICT by measuring specific dimensions rather than social isolation in general. ICT use was consistently found to affect social support, social connectedness, and social isolation in general positively. The results for loneliness were inconclusive. Even though most were positive, some studies found a nonsignificant or negative impact. More importantly, the positive effect of ICT use on social connectedness and social support seemed to be short-term and did not last for more than six months after the intervention. The results for self-esteem and control over one’s life were consistent but generally nonsignificant. ICT was found to alleviate the elderly’s social isolation through four mechanisms: connecting to the outside world, gaining social support, engaging in activities of interests, and boosting self-confidence.

Conclusions

More well-designed studies that contain a minimum risk of research bias are needed to draw conclusions on the effectiveness of ICT interventions for elderly people in reducing their perceived social isolation as a multidimensional concept. The results of this review suggest that ICT could be an effective tool to tackle social isolation among the elderly. However, it is not suitable for every senior alike. Future research should identify who among elderly people can most benefit from ICT use in reducing social isolation. Research on other types of ICT (eg, mobile phone–based instant messaging apps) should be conducted to promote understanding and practice of ICT-based social-isolation interventions for elderly people.

Social Support and "Playing Around": An Examination of How Older Adults Acquire Digital Literacy With Tablet Computers

This study examines how older adults learn to use tablet computers. Learning to use new technologies can help older adults to be included in today's digital society. However, learning to use new technologies is not always easy, especially for older adults. This study focuses on how older adults learn to use a specific technology, tablet computers, and the role that social support plays in this process. Data for this project are from 21 in-depth interviews with individuals who own tablet computers. We examine how older adults engage with tablet devices and increase their digital literacy. The findings suggest that, for older adults to start to use tablets, social support plays an important role. In addition, a key way that many participants report gaining expertise with the technology is through "playing around" with the tablets. Suggestions for how to help older adults learn to use new technologies are detailed.

Environment as 'Brain Training': A review of geographical and physical environmental influences on cognitive ageing

Global ageing demographics coupled with increased urbanisation pose major challenges to the provision of optimal living environments for older persons, particularly in relation to cognitive health. Although animal studies emphasize the benefits of enriched environments for cognition, and brain training interventions have shown that maintaining or improving cognitive vitality in older age is possible, our knowledge of the characteristics of our physical environment which are protective for cognitive ageing is lacking. The present review analyses different environmental characteristics (e.g. urban vs. rural settings, presence of green) in relation to cognitive performance in ageing. Studies of direct and indirect associations between physical environment and cognitive performance are reviewed in order to describe the evidence that our living contexts constitute a measurable factor in determining cognitive ageing.

Getting Grandma Online: Are Tablets the Answer for Increasing Digital Inclusion for Older Adults in the U.S.?

Using information and communication technologies (ICTs) can improve older adults' quality of life. ICT use is associated with decreased feelings of loneliness and depression, along with increased feelings of independence and personal growth. However, limited access and low technological self-efficacy are key reasons why some groups, especially older adults, are excluded from being fully engaged in the digital world. In this study, we focus on older adults' technological self-efficacy, which is related to their actual use of technology and the second level digital divide. Specifically, we examine: 1) how older adults decide to use a new technology, tablet computers; 2) how they conquer the barrier of technological self-efficacy through using tablets; and 3) the impacts of using this new technology in their lives. Twenty-one in-depth interviews were conducted with older adults residing in independent living communities in a medium-sized city in the Deep South region of the United States. Observational and enactive learning played important roles for older adults in using tablets. Seeing others use tablets, getting recommendations from family members, or having tablets given to them were the primary reasons they started to use tablet computers. The ease of use feature of tablets helped solve the problem of lacking technological self-efficacy. Using tablets helped increase a sense of connectedness. Tablet computers may be one way to increase digital inclusion among older adults.

A home-based individualized information communication technology training program for older adults: a demonstration of effectiveness and value

PURPOSE

To demonstrate the effectiveness and value of a home-based information communication technology (ICT) training program for older adults.

METHODS

Thirteen older adults were provided in-home ICT training by graduate occupational therapy students using an iPad. The breadth and frequency of ICT use, perspectives on technology, and perceived independence were recorded at baseline, during the 3-month training and at follow-up, along with an end-of-study questionnaire. Non-parametric Friedman analysis was conducted to verify trends in the outcome measures. The qualitative data were examined by content analysis.

RESULTS

Participants' breadth of ICT activities showed a significant trend across 6 months. Leisure accounted for the significant increase, while health management and social connections activities increased modestly. A positive trend in participants' perspectives on technology was evident along with a marginal increase in perceived independence. Participants' perspectives were thematically categorized as technology experiences, interactions with coach, training approach, and specific activities. As reflection of the training program's value, 12 of the 13 participants took ownership of the iPad at the end of the study.

CONCLUSION

Building capacity of older adults to utilize the multifaceted potential of ICT is critical in addressing declines in health, impending disabilities, and social isolation. Implications for Rehabilitation A one-on-one home-based individualized information communication technology (ICT) training program for older adults could result in a progressive increase in the breadth of online activities carried out by them. Specifically, the increase in their usage of ICT could be expected in leisure-based online activities. Individualized training programs designed based on needs, priorities, and learning style of older adults could have a positive impact on their technological perspectives and intrinsic motivation to adopt ICT.

The impact of activity interventions on the well-being of older adults in continuing care communities

As the U.S. population ages, interventions are needed to ensure quality of life continues as boomers enter assisted and independent living communities (AICs). These transitions can significantly affect quality of life. Activity and continuity theories maintain that participation in discretionary/informal activities is crucial for psychosocial health and well-being (aspects of quality of life). This study evaluates the impacts of participation in discretionary activities on life satisfaction, social isolation, and loneliness, using data from a longitudinal study of older adults in AICs. Older adults who participated in 8 weeks of discretionary activities reported greater life satisfaction and lower levels of social isolation compared with non-participants. Forming alliances and group identities is the key for building new relationships and maintaining relationships in the community. Determining the impact participation in activities has on residents is vital to being able to help develop a more comprehensive understanding of how quality of life can be maintained in AICs.

Attitudes Towards and Limitations to ICT Use in Assisted and Independent Living Communities: Findings from a Specially-Designed Technological Intervention

While much literature has been devoted to theoretical explanations of the learning processes of older adults and to the methods of teaching best utilized in older populations, less has focused on the education of older adults who reside in assisted and independent living communities (AICs), especially with regards to information and communication technology (ICT) education. The purpose of this study is to determine whether participants' attitudes and views towards computers and the Internet are affected as a result of participating in an eight-week training program designed to enhance computer and Internet use among older adults in such communities. Specifically, we examine if ICT education specially designed for AIC residents results in more positive attitudes towards ICTs and a perceived decrease in factors that may limit or prevent computer and Internet use. We discuss the implications of these results for enhancing the quality of life for older adults in AICs and make recommendations for those seeking to decrease digital inequality among older adults in these communities through their own ICT classes.

Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis

Background

Older adults are at increased risk of experiencing loneliness and depression, particularly as they move into different types of care communities. Information and communication technology (ICT) usage may help older adults to maintain contact with social ties. However, prior research is not consistent about whether ICT use increases or decreases isolation and loneliness among older adults.

Objective

The purpose of this study was to examine how Internet use affects perceived social isolation and loneliness of older adults in assisted and independent living communities. We also examined the perceptions of how Internet use affects communication and social interaction.

Methods

One wave of data from an ongoing study of ICT usage among older adults in assisted and independent living communities in Alabama was used. Regression analysis was used to determine the relationship between frequency of going online and isolation and loneliness (n=205) and perceptions of the effects of Internet use on communication and social interaction (n=60).

Results

After controlling for the number of friends and family, physical/emotional social limitations, age, and study arm, a 1-point increase in the frequency of going online was associated with a 0.147-point decrease in loneliness scores (P=.005). Going online was not associated with perceived social isolation (P=.14). Among the measures of perception of the social effects of the Internet, each 1-point increase in the frequency of going online was associated with an increase in agreement that using the Internet had: (1) made it easier to reach people (b=0.508, P<.001), (2) contributed to the ability to stay in touch (b=0.516, P<.001), (3) made it easier to meet new people (b=0.297, P=.01, (4) increased the quantity of communication with others (b=0.306, P=.01), (5) made the respondent feel less isolated (b=0.491, P<.001), (6) helped the respondent feel more connected to friends and family (b=0.392, P=.001), and (7) increased the quality of communication with others (b=0.289, P=.01).

Conclusions

Using the Internet may be beneficial for decreasing loneliness and increasing social contact among older adults in assisted and independent living communities.