|Year : 2018 | Volume
| Issue : 2 | Page : 81-83
Mobile phone use in the elderly: Boon or bane?
Alka A Subramanyam1, Shipra Singh2, Nitin B Raut3
1 Department of Psychiatry, Dr. BYL Nair Hospital and TNMC, Mumbai, Maharashtra, India
2 Department of Psychiatry, Dr. R. M. L. Hospital and PGIMER, New Delhi, India
3 Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
|Date of Web Publication||27-Dec-2018|
Dr. Shipra Singh
Department of Psychiatry, Dr. R. M. L. Hospital and PGIMER, Baba Kharag Singh Marg, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Subramanyam AA, Singh S, Raut NB. Mobile phone use in the elderly: Boon or bane?. J Geriatr Ment Health 2018;5:81-3
The world is witnessing a boom in technology and one of the important technologies that have revolutionized our day-to-day lives is a cellphone, especially the smartphones. Even the elderly population is gradually embracing the new technology, which probably can be attributed to its multifunctional utility, ranging from being connected to others to security, social interaction, and even reducing boredom.
Adoption of new technology has always been challenging for the elderly. However, with an increase in the graying population, the elderly are also found moving toward more digitally connected lives. According to the Ericsson Mobility Report, proportion of higher age group using smartphones and mobile data grew fastest between 2013 and 2015; number of people aged over 50 who use smartphones quadrupled. American research quotes that today, roughly half of older adults who own cellphones have some type of smartphone; which was just 23% in 2013. Smartphone ownership among seniors varies substantially by age. Around 59% of 65–69-year-old own smartphones, 49% among 70–74-year-old. This drops off considerably in the mid-70s and beyond.
In the past, mobile phone application was restricted to making or receiving calls and texting. However, modern-day phones have gone far beyond the traditional uses and provide a wide variety of applications. It may be related to self-management, such as instrumental activities of daily living, enhancing social contacts among older adults, thus, decreasing loneliness, and expanding access to information. Recently, it has been a method to communicate with health professionals, which also enhances autonomy and self-care. However, earlier mentioned activities still are the most common ones among the elderly.,
A focused group discussion with elderly mobile phone users studied its benefits. Frequently mentioned features were making calls (that can be done regardless of time and location), address book, alarm and reminders (reminding them about medical schedules and upcoming appointments, etc.,), display of date and time, panic button for emergency (to receive immediate assistance), incoming call with caller's picture, and camera (satisfaction in seeing their kin who are settled elsewhere). On the other hand, applications such as playing songs or videos, using e-mails, or global positioning system and others were rarely used.
Mobile phone usage by the elderly is governed by various factors. Conci et al. found that in the elderly, once the initial resistance of learning new technology was overcome- “enjoying the experience” of using the mobile phone motivated them to use the device. Other contributory factors were “heightened self-esteem” when they could perform certain chores by themselves such as paying bills or buying groceries or navigating around, and “feeling secure” (because of various safety measures available on the cellphone), as well as more realistic, goal-directed outcomes such as information retrieval and communication. In addition, social influence or subjective norm in the theory of reasoned action research also influenced the use of mobile phones. Other studies too have identified different possible motivators for senior mobile phone use, including social influence, safety, security, autonomy, relatedness, and usefulness.,
Although this gadget can be of great usage to the seniors, mostly these are designed keeping the younger generation in mind which is already tech-savvy and has grown up playing high-tech games and surfing the Web. For such younger users, phone function discovery and use are intuitive. On the other hand, the older population faces multiple issues while using such devices. The small device size makes holding it difficult and makes the text too small and difficult to read on the screen. Further, smaller keys and navigation controls make it hard for them to operate software interfaces, and thus might not easily appeal to them. The backlight time tends to be too short for their reflex time. The other aspect was the complexity of function operations and not being comfortable with the sensitivity to touch operations. This leads to frequent accidental dialing (also, because of failing to lock the keyboard). In addition, there are multiple keys on the interface with different functions, which is confusing and difficult to remember. In fact, the devices are often frustrating and even intimidating to many of them. There are special devices designed especially for the elder individuals, with larger screen size, fonts, and longer backlight display. Unfortunately, they lack so sorely in design that they have found few takers, and further development to has stalled.
Leaving apart the usual functions in a mobile phone, others are mostly Internet-related. van Boekel et al. studied the usage pattern of Internet and found four different clusters: the first was identified as “practical users” who mainly used Internet for practical and financial purposes such as searching for information, comparing products, and banking. The second group or the “minimizers” were older with the mean age of 73 years and spent the smallest time on Internet for basic minimal needs. The third group was called the “maximizers” who spent maximum time on Internet, and were relatively younger, mean age < 70 years, for a variety of activities ranging from online orders to net banking. The final group or the “social users,” mainly used the Internet for social and leisure-related activities (gaming and social network sites). The second group (minimizers) was found to have lower psychological well-being, instrumental activities of daily living, and experienced poorer overall health as compared to that of the practical users and maximizers.
Mobile phone usage has some advantages but has its own detriments as well. For example, the use of fast Internet-based apps easily available on phone at home and mediating number of needs (e.g., shopping, socializing, managing administrative and health-related procedures, and leisure activities) leads to reduced physical activity, and makes a person homebound, thus limiting his/her real social human interaction. A sedentary lifestyle has its own hazards. Literature suggests that risk of developing dementia or Alzheimer's disease is linked to various lifestyle measures. Sedentary habits predispose to cognitive decline.
Conversely, better cognitive abilities are found in the elderly who appropriately used Internet to simplify some of the everyday tasks and used technology in a balanced way. One study done indicated a significant link between the duration of Internet addiction, grey matter atrophy and changes of white matter fractional anisotropy in particular brain regions. In addition, it has been found that depressed patients are more likely to use the Internet/mobile phone to alleviate depressive symptoms and problematic usage could lead to adverse effects on daily life, thus, initiating a vicious circle. Internet use has been found to be associated with loneliness and directly or indirectly involved in suicide in older people. An indirect link in Parkinson's disease patients has been studied that dopamine agonists used in its treatment are linked with the onset of impulse-control disorders, and thereby leading to proneness to excessive gambling, compulsive spending/shopping, binge eating, compulsive buying, and compulsive computer use. The expression of this problem may be facilitated by easy availability to Internet. Such phenomenon is observed in around 30% of patients treated with dopamine agonists.
Like any other thing in the world, mobile phone has its pros and cons. A knowledgeable and insightful usage of the device would definitely help the elderly. The pattern of usage can be an early sign of impending mental health or cognitive issue. Development of targeted technology is required keeping in mind functional and physical capacity of elder individuals, for example, applications that interpret seniors' actions and assist them in device use could greatly enhance ease of use and make devices and services more useful and desirable to them.
It becomes important for the mental health professional to be well-versed with the changing trends in this regard in the elder, and hence we can translate the same into (a) taking history of mobile use in the elder (b) find if use in helping or hindering the elder (c) if there is a sign of underlying pathology mainly cognition or depression.
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