Changes in Everyday and Digital Health Technology Use Among Seniors in Declining Health

U.S. seniors' digital health and everyday technology use when their health declines are unknown.

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.

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).

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.