TY - JOUR
T1 - Changes in Everyday and Digital Health Technology Use among Seniors in Declining Health
AU - Levine, David M.
AU - Lipsitz, Stuart R.
AU - Linder, Jeffrey A.
N1 - Funding Information:
The National Health and Aging Trends Study (NHATS) is an annual, longitudinal, nationally representative survey that follows Medicare beneficiaries aged 65 years and older who were initially enrolled in 2011 through in-home, computer-assisted, personal interviews (16). NHATS employs a complex sampling design drawing from the Medicare enrollment file that oversamples non-Hispanic Blacks and those older than 90. Each year, NHATS asks the same respondents detailed demographic information, performs physical and cognitive testing, and assesses technology use. Proxy respondents—usually a family member—are used in instances where participants cannot respond due to dementia, cognitive impairment, severe illness, or speech impediment. NHATS is supervised by the Johns Hopkins University Bloomberg School of Public Health with data collection and preparation by Westat. NHATS is sponsored by the National Institute on Aging (NIA U01AG032947).
Funding Information:
Dr. Levine received funding support from an Institutional National Research Service Award (T32HP10251), the Ryoichi Sasakawa Fellowship Fund, and by the Brigham and Women’s Hospital Division of General Internal Medicine and Primary Care. The NIH had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.
Publisher Copyright:
© The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
PY - 2018/3/14
Y1 - 2018/3/14
N2 - Background U.S. seniors' digital health and everyday technology use when their health declines are unknown. Methods Longitudinal cohort using the National Health and Aging Trends Study, a nationally representative, annually administered sample of community-dwelling Medicare beneficiaries (n = 4,037). We used difference-in-differences to assess the adjusted difference (AD) in technology use from 2011 to 2014 between those with and without health declines. Health decline measures included new-onset dementia; new-onset depression; decreases in activities of daily living (ADLs), short physical performance battery (SPPB), grip strength, and self-reported health; relocation to nursing facility; increased hospitalizations; and new-onset comorbidity. Digital health included use of the Internet to research health conditions, contact clinicians, fill prescriptions, and address insurance matters. Results Between 2011 and 2014, seniors experiencing health decline used various digital health technologies at low absolute rates (range: 1%-20%). Between 2011 and 2014, use of everyday technology decreased significantly among seniors with new-onset dementia (from 73% to 51%; AD, -26%), decreased ADLs (from 76% to 67%; AD, -10%), decreased SPPB (from 88% to 86%; AD, -3%), and relocation to a nursing facility (from 49% to 22%; AD, -31%) compared to seniors without comparable decline (all p <.05). Use of digital health decreased significantly among seniors with new-onset probable dementia (from 9% to 4%; AD, -6%) and decreased SPPB (from 24% to 25%; AD, -4%; all p <.05). Conclusions The type of health decline a senior experiences predicts technology use, which may allow better targeting of digital health to specific seniors. Seniors with new dementia, relocation to a nursing home, and declining physical performance seem especially poor candidates for technology interventions.
AB - Background U.S. seniors' digital health and everyday technology use when their health declines are unknown. Methods Longitudinal cohort using the National Health and Aging Trends Study, a nationally representative, annually administered sample of community-dwelling Medicare beneficiaries (n = 4,037). We used difference-in-differences to assess the adjusted difference (AD) in technology use from 2011 to 2014 between those with and without health declines. Health decline measures included new-onset dementia; new-onset depression; decreases in activities of daily living (ADLs), short physical performance battery (SPPB), grip strength, and self-reported health; relocation to nursing facility; increased hospitalizations; and new-onset comorbidity. Digital health included use of the Internet to research health conditions, contact clinicians, fill prescriptions, and address insurance matters. Results Between 2011 and 2014, seniors experiencing health decline used various digital health technologies at low absolute rates (range: 1%-20%). Between 2011 and 2014, use of everyday technology decreased significantly among seniors with new-onset dementia (from 73% to 51%; AD, -26%), decreased ADLs (from 76% to 67%; AD, -10%), decreased SPPB (from 88% to 86%; AD, -3%), and relocation to a nursing facility (from 49% to 22%; AD, -31%) compared to seniors without comparable decline (all p <.05). Use of digital health decreased significantly among seniors with new-onset probable dementia (from 9% to 4%; AD, -6%) and decreased SPPB (from 24% to 25%; AD, -4%; all p <.05). Conclusions The type of health decline a senior experiences predicts technology use, which may allow better targeting of digital health to specific seniors. Seniors with new dementia, relocation to a nursing home, and declining physical performance seem especially poor candidates for technology interventions.
KW - Aging in place
KW - Digital health
KW - Digital health technology
KW - Health decline
KW - Seniors
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U2 - 10.1093/gerona/glx116
DO - 10.1093/gerona/glx116
M3 - Article
C2 - 28605446
AN - SCOPUS:85042170435
SN - 1079-5006
VL - 73
SP - 552
EP - 559
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 4
ER -