What Types of Difficulties do Seniors Encounter When Using the Internet to Make Health Care Decisions?

Author(s):  
Thomas Kuhn ◽  
Sara J. Czaja ◽  
Sankaran N. Nair ◽  
Joseph Sharit ◽  
Tamer El-Attar ◽  
...  

The Internet is an important source of information for health-related topics and services. Currently, however, an age-related digital divide exists, especially for lower SES minority elderly. This study examined the ability of a sample of 40 community dwelling adults aged 50–85 yrs. to use the Internet to make choices related to Medicare services. Performance data included response time, accuracy, and search behavior (based on videotape recordings) and ratings of usability. Overall the data indicate that although most of the of participants were able to find the needed information many of them made errors, used inefficient search strategies, and encountered search problems. Furthermore, most of the sample indicated problems with usability and that they were frustrated interacting with the website. These findings are discussed in terms of recommendations for training and website design. The paper will also discuss how screen capture data can be used in the development of design guidelines.

2007 ◽  
Author(s):  
Thomas Kuhn ◽  
Sara J. Czaja ◽  
Sankaran N. Nair ◽  
Joseph Sharit ◽  
Tamer El-Attar ◽  
...  

Author(s):  
Amy Hasselkus

The need for improved communication about health-related topics is evident in statistics about the health literacy of adults living in the United States. The negative impact of poor health communication is huge, resulting in poor health outcomes, health disparities, and high health care costs. The importance of good health communication is relevant to all patient populations, including those from culturally and linguistically diverse backgrounds. Efforts are underway at all levels, from individual professionals to the federal government, to improve the information patients receive so that they can make appropriate health care decisions. This article describes these efforts and discusses how speech-language pathologists and audiologists may be impacted.


2020 ◽  
Author(s):  
Victoria Kordovski ◽  
Savanna M. Tierney ◽  
Samina Rahman ◽  
Luis D. Medina ◽  
Michelle A. Babicz ◽  
...  

Objective: Searching the Internet for health-related information is a complex and dynamic goal-oriented process that places demands on executive functions, which are higher-order cognitive abilities that are known to deteriorate with older age. This study aimed to examine the effects of older age on electronic health (eHealth) search behavior, and to determine whether executive functions played a mediating role in that regard. Method: Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom diagnosis (Symptom Search), a neurocognitive battery, and a series of questionnaires. Results: Multiple regression models with relevant covariates revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Nevertheless, executive functions mediated the relationship between older age and eHealth Fact Search and Symptom Search accuracy. Conclusions: Older adults can experience difficulty searching the Internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of Internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 783-783
Author(s):  
Jennifer Schrack ◽  
Fangyu Liu ◽  
Amal Wanigatunga ◽  
Yang An ◽  
Christos Davatzikos ◽  
...  

Abstract Walking efficiency (WE) predicts mobility decline and is linked with higher fatigability. Fatigability is associated with cognitive decline and reduced brain volumes (BV), but the link between WE and BV is undefined. We examined associations between WE and BV in 860 participants of the BLSA (mean age 66.4(14.4) years, 54.5% women). WE was assessed during 2.5-minutes of usual-paced walking using indirect calorimetry and standardized per meter (ml/kg/m). BV measures were derived using MRI scans and an automated multi-atlas region-of-interest approach. In linear mixed models adjusted for demographics, education, BMI, intracranial volume, and cognitive status, lower baseline WE was associated with lower total, white, and gray matter, primarily in the frontal and temporal lobes (all p<0.05). Longitudinally, declining WE was associated with increasing ventricular and decreasing hippocampal volumes over follow-up (all p<0.01). Findings suggest rising age-related inefficiencies may reflect underlying brain atrophy and serve as a novel indicator for future interventions.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 451-452
Author(s):  
Mary Caroline Yuk ◽  
Rebecca Allen ◽  
Marcia Hay-McCutcheon ◽  
Dana Carroll ◽  
Anne Halli-Tierney

Abstract Age related hearing loss, or presbycusis, is a global condition that is increasing in its prevalence. Despite being one of the most common chronic conditions among the older population, there is much more to understand about its association with other aspects of physical and emotional health and well-being. Current research is suggesting that hearing loss is more prevalent in those with cognitive impairment compared to those without cognitive impairment. This study analyzed the incidence of hearing loss and its linkage to mild cognitive impairment in a community-dwelling geriatric population. With the increasing prevalence of this condition in both rural and urban communities of Alabama, it becomes a more pressing matter to understand comorbidities and risk factors for future decline in functioning. This study was conducted in an interdisciplinary geriatrics primary care outpatient clinic in a Family, Internal, and Rural Medicine department affiliated with a university medical center in the Deep South. Ninety-one participants completed the Montreal Cognitive Assessment (MoCA) and a hearing screening. Hearing screenings were conducted in quiet rooms in the medical center using Phonak hearing screening cards. Detection of 500, 1000, 2000, and 4000 Hz tones was assessed. Pearson correlation analyses demonstrated an association between hearing loss mild cognitive impairment. Poorer hearing was significantly associated with lower scores on the MoCA. Conducting behavioral health screenings like this in other primary geriatrics clinics and community settings could improve care and identification of patient needs by integrating important data regarding comorbidities and independent living.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 233-233
Author(s):  
Xiaocao Sun ◽  
Minhui Liu ◽  
Christina E Miyawaki ◽  
Yuxiao Li ◽  
Tianxue Hou ◽  
...  

Abstract Personality is associated with predictors of homebound status like frailty, incident falls, and depression. It has been rarely investigated whether personality predicts homebound status among older adults. Using the combining cross-sectional data of the Year 2013 and Year 2014 data from the National Health and Aging Trends Study (NHATS), this study examined the association between personality traits and homebound status in a sample of community-dwelling older adults aged 65 years and older (N=2,788). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and help of outdoor mobility. Personality traits, including conscientiousness, agreeableness, openness, extraversion, and neuroticism were assessed using the 10-item Midlife Development Inventory on a rating scale from 1 (not at all) to 4 (a lot). Each personality trait was included as a predictor in an ordinal logistic regression model to examine its association with homebound status after adjusting demographic and health-related covariates. The sample was on average 79±7.53 years old, non-Hispanic White (72.0%), female (58.6%), living alone (35.4%) or with spouse/partner only (37.4%). Seventy-four percent, 18%, and 8% of participants were non-homebound, semi-homebound, and homebound, respectively. Homebound participants tended to be less-educated older females. The average scores of conscientiousness, agreeableness, openness, extraversion, and neuroticism were 3.19±0.75, 3.57±0.56, 2.81±0.83, 3.13±0.75, and 2.22±0.86, respectively. Among these five personality traits, high conscientiousness (OR=1.34, p<0.001) and extraversion (OR=1.16, p=.03) were associated with a reduced likelihood of being homebound. These findings provided a basis for potential personality assessment to identify and protect individuals with high homebound risk.


2020 ◽  
pp. 1-22
Author(s):  
Joachim Gerich ◽  
Robert Moosbrugger ◽  
Christoph Heigl

Abstract Inefficient health service utilisation puts pressure on health systems and may cause such negative individual consequences as over-medicalisation or exacerbation of health problems. While previous research has considered the key relevance of health literacy (HL) for efficient use of health services, the results of that research have been somewhat inconclusive. Possible reasons for diverging results of prior research may be grounded in different measurement concepts of HL and the disregarding of age-specific effects. This paper analyses the association between individuals’ HL typology based on a two-dimensional concept and indicators of health service utilisation measured by registered data covering the number of doctor visits and medication costs. Our results confirm a significant interaction effect between age and HL typology. The age-related increase in health service utilisation is strongest for individuals with the combination of high subjective HL but low health-related knowledge, while the smallest increase is for individuals with the constellation of high subjective HL combined with high health-related knowledge. Individuals with specific constellations of HL (that is, individuals with high subjective HL but low health-related knowledge) are associated with reduced service utilisation in younger ages but higher service utilisation in later stages of life, compared to other groups. These results are likely to be attributed to a higher external health-related locus of control and more traditional paternalistic role expectations in such groups.


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