Patterns of Technology Use Among Older Adults With and Without Disabilities
Open accessAbstract
PURPOSE OF THE STUDY: The purpose of this study was to describe prevalence of technology use among adults ages 65 and older, particularly for those with disability and activity-limiting symptoms and impairments. DESIGN AND METHODS: Data from the 2011 National Health and Aging Trends Study, a nationally representative sample of community-dwelling Medicare beneficiaries (N = 7,609), were analyzed. Analysis consisted of technology use (use of e-mail/text messages and the internet) by sociodemographic and health characteristics and prevalence ratios for technology usage by disability status. RESULTS: Forty percent of older adults used e-mail or text messaging and 42.7% used the internet. Higher prevalence of technology use was associated with younger age, male sex, white race, higher education level, and being married (all p values <.001). After adjustment for sociodemographic and health characteristics, technology use decreased significantly with greater limitations in physical capacity and greater disability. Vision impairment and memory limitations were also associated with lower likelihood of technology use. IMPLICATIONS: Technology usage in U.S. older adults varied significantly by sociodemographic and health status. Prevalence of technology use differed by the type of disability and activity-limiting impairments. The internet, e-mail, and text messaging might be viable mediums for health promotion and communication, particularly for younger cohorts of older adults and those with certain types of impairment and less severe disability.
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Older adults, people with cognitive problems or disabilities are less likely to use technologies.
“research shows that older adults, people with cognitive problems or disabilities are less likely to use technologies,87”
From Development, evaluation and implementation of a digital behavioural health treatment for chronic pain: study protocol of the multiphase DAHLIA project (2022) · cites this paper as [87]
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“Older adults may encounter challenges that are not common to younger age groups, such as financial and physiological limitations, inhibiting access to innovations in technology [13].”
BackgroundUrban/Rural Digital Divide Exists in Older Adults: Does It Vary by Racial/Ethnic Groups?
Choi, E. Y., Kanthawala, S., Kim, Y. S., & Lee, H. Y. (2022) · Journal of Applied Gerontology · doi:10.1177/07334648211073605 · Cited by 55 · see citing works
Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review
Vandersman, P., Newton-John, T. R. O., & Phillips, J. L. (2017) · Pain Medicine · doi:10.1093/pm/pnx090 · Cited by 52 · see citing works
Internet use in old age predicts smaller cognitive decline only in men
Ihle, A., Bavelier, D., Maurer, J., Oris, M., & Kliegel, M. (2020) · Scientific Reports · doi:10.1038/s41598-020-65846-9 · Cited by 54 · see citing works
Money, A., Atwal, A., Young, K. L., Day, Y., Wilson, L., & Money, K. G. (2015) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-015-0190-2 · Cited by 53 · see citing works
Okonji, P. E., & Ogwezzy, D. C. (2017) · Assistive Technology · doi:10.1080/10400435.2017.1421594 · Cited by 53 · see citing works
Wang, J., Du, Y. N., Coleman, D. C., Peck, M., Myneni, S., Kang, H., & Gong, Y. (2019) · JMIR Aging · doi:10.2196/13864 · Cited by 49 · see citing works
Tomczyk, Ł., Mróz, A., Potyrała, K., & Wnęk-Gozdek, J. (2020) · Gerontology & Geriatrics Education · doi:10.1080/02701960.2020.1824913 · Cited by 48 · see citing works
“However, according to Gell et al. (2015), older adults on average are less technology literate than younger adults; this can add to feelings of marginalization.”
BackgroundMassively Multiplayer Online Role-Playing Games (MMORPGs) and Socio-Emotional Wellbeing
Zhang, F., & Kaufman, D. M. (2017) · Computers in Human Behavior · doi:10.1016/j.chb.2017.04.008 · Cited by 48 · see citing works
Drazich, B. F., Li, Q., Perrin, N., Szanton, S. L., Lee, J. W., Huang, C.-M., Carlson, M. C., Samuel, L. J., Regier, N. G., Rebok, G. W., et al. (2022) · Aging & Mental Health · doi:10.1080/13607863.2022.2046695 · Cited by 49 · see citing works
“Considering that past literature suggests that technology use varies by age and financial strain (Gell et al., 2015; Vargo et al., 2021), we stratified the technology change analyses by these demographics, treated as dichotomous variables.”
BackgroundMethodTelerehabilitation for people with low vision
Bittner, A. K., Wykstra, S. L., Yoshinaga, P. D., & Li, T. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011019.pub2 · Cited by 47 · see citing works
Poli, A., Kelfve, S., Klompstra, L. V., Strömberg, A., Jaarsma, T., & Motel-Klingebiel, A. (2020) · Journal of Medical Internet Research · doi:10.2196/17884 · Cited by 46 · see citing works
Kim, J., Lee, H. Y., Won, C. R., Barr, T., & Merighi, J. R. (2020) · Nursing Outlook · doi:10.1016/j.outlook.2020.05.001 · Cited by 48 · see citing works
“Research examining older adults’ use of technology using the same data from the 2011 NHATS (Elliot et al., 2014; Gell et al., 2015) did not apply this inclusion criterion, which explains the higher ICT use level in this study.”
InfluentialSocial support is associated with technology use in old age
Kamin, S. T., Beyer, A., & Lang, F. R. (2019) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-019-01529-z · Cited by 45 · see citing works
The effects of aging on the use of handheld augmented reality in a route planning task
Peleg-Adler, R., Lanir, J., & Korman, M. (2017) · Computers in Human Behavior · doi:10.1016/j.chb.2017.12.003 · Cited by 44 · see citing works
Nelson, L. A., Spieker, A. J., Greevy, R. A., LeStourgeon, L. M., Wallston, K. A., & Mayberry, L. S. (2020) · JMIR mhealth and uhealth · doi:10.2196/17534 · Cited by 44 · see citing works
New Perspectives on User Participation in Technology Design Processes: An Interdisciplinary Approach
Grates, M. G., Heming, A.-C., Vukoman, M., Schabsky, P., & Sorgalla, J. (2019) · The Gerontologist · doi:10.1093/geront/gny112 · Cited by 37 · see citing works
Kämpfen, F., & Maurer, J. (2018) · Research Policy · doi:10.1016/j.respol.2018.03.017 · Cited by 42 · see citing works
Older Adults’ Social Interactions in Massively Multiplayer Online Role-Playing Games (MMORPGs)
Zhang, F., & Kaufman, D. M. (2015) · Games and Culture · doi:10.1177/1555412015601757 · Cited by 41 · see citing works
E-therapy and social work practice: Benefits, barriers, and training
Cwikel, J., & Friedmann, E. (2019) · International Social Work · doi:10.1177/0020872819847747 · Cited by 45 · see citing works
“Furthermore, older adults with physical limitations were less likely to make use of IT interventions than those without limitations (Gell et al., 2013).”
BackgroundGell, N., Hoffman, E. V., & Patel, K. V. (2021) · JMIR Aging · doi:10.2196/27645 · Cited by 41 · see citing works
“The technology use assessment adapted questions from the National Health and Aging Trends Study [32] and the Pew Research Center [33].”
MethodSelf-citationMasterson‐Algar, P., Cheshire‐Allen, M., Hyde, M., Keating, N. C., & Windle, G. (2021) · Dementia · doi:10.1177/14713012211053971 · Cited by 39 · see citing works
Associations Between Everyday ICT Usage and (Self-)Ageism: A Systematic Literature Review
Köttl, H., Allen, L., Mannheim, I., & Ayalon, L. (2022) · The Gerontologist · doi:10.1093/geront/gnac075 · Cited by 42 · see citing works
Connectivity in Later Life: The Declining Age Divide in Mobile Cell Phone Ownership
Gilleard, C. J., Jones, I. R., & HIGGS, P. F. D. (2015) · Sociological Research Online · doi:10.5153/sro.3552 · Cited by 40 · see citing works
Teater, B. A., & Chonody, J. M. (2020) · Social Work in Health Care · doi:10.1080/00981389.2020.1731049 · Cited by 40 · see citing works
From Online to Offline and Vice Versa: Change in Internet Use in Later Life Across Europe
König, R., & Seifert, A. (2020) · Frontiers in Sociology · doi:10.3389/fsoc.2020.00004 · Cited by 40 · see citing works
“For example, vision impairment and memory limitations can be a crucial barrier for the use of many technologies (Gell et al., 2015).”
BackgroundLee, H. Y., Kanthawala, S., Choi, E. Y., & Kim, Y. S. (2021) · Gerontechnology · doi:10.4017/gt.2021.20.2.32-472.12 · Cited by 45 · see citing works
“Those with lower socioeconomic status and poor health have been reported to be at greater risk of being excluded from technology use (Gell et al., 2015; Silver, 2014).”
BackgroundBetter educated children, better Internet-connected elderly parents
Lei, L., Yu, D., & Zhou, Y. (2023) · Research Policy · doi:10.1016/j.respol.2023.104743 · Cited by 39 · see citing works
Mueller‐Schotte, S., Zuithoff, N. P. A., van der Schouw, Y. T., Schuurmans, M. J., & Bleijenberg, N. (2018) · The Journals of Gerontology Series A · doi:10.1093/gerona/gly155 · Cited by 39 · see citing works
“Reasons for no significant difference between SL groups could be related to coping mechanisms through cognitive resources (35,36) or use of technology (33); however, the latter may be limited to the younger old.”
BackgroundAranha, M., James, K., Deasy, C., & Heavin, C. (2021) · Gerontechnology · doi:10.4017/gt.2021.20.2.424.06 · Cited by 38 · see citing works
“…(EHR) systems (World Health Organization, 2011; Fox and Connolly, 2018). mHealth provides a wide variety of services such as the reporting of health information, monitoring of clinical signs, patient observation, and educational support for individuals and their caregivers (Gell et al., 2013).”
BackgroundMariano, J., Marques, S., Ramos, M. R., & de Vries, H. (2021) · Psychology and Aging · doi:10.1037/pag0000643 · Cited by 41 · see citing works
“Gell et al. (2015) found that those with better physical functioning were more likely to use the internet for online activities related to communication, health, shopping, and banking.”
eHealth in Care Coordination for Older Adults Living at Home: Scoping Review
Fjellså, H. M. H., Husebø, A. M. L., & Storm, M. (2022) · Journal of Medical Internet Research · doi:10.2196/39584 · Cited by 39 · see citing works
“In addition to being older and less educated, impaired cognitive and numeracy ability, limited internet experience, and physical and visual impairment can limit the use of eHealth [66,67].”
Ge, M., Carlson, M. C., Bandeen‐Roche, K., Chu, N. M., Tian, J., Kasper, J. D., & Xue, Q. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16769 · Cited by 38 · see citing works
“A three-level variable (doing neither, one, or both) was created.(26) Anxiety symptoms were assessed using the Generalized Anxiety Disorder-2 module.”
MethodVorrink, S., Antonietti, A., Kort, H. S. M., Troosters, T., Zanen, P., & Lammers, J. J. (2016) · Assistive Technology · doi:10.1080/10400435.2016.1219885 · Cited by 38 · see citing works
“Previous studies showed a decreased use of the Internet and smartphones with greater physical impairment (Gell et al., 2015; Mohadisdudis & Ali, 2014).”
Technology use and its association with health and depressive symptoms in older cancer survivors
Lee, H. Y., Kim, J., & Sharratt, M. (2017) · Quality of Life Research · doi:10.1007/s11136-017-1734-y · Cited by 41 · see citing works
Morueta, R. T., Martín, A. R., Arregui, E. Á., Sobrino, M. Á. O., & Aguaded, I. (2021) · Ageing and Society · doi:10.1017/s0144686x21001173 · Cited by 42 · see citing works
“However, the study by Gell et al .”
Embedded Online Questionnaire Measures Are Sensitive to Identifying Mild Cognitive Impairment
Seelye, A. M., Mattek, N., Howieson, D. B., Austin, D., Wild, K. V., Dodge, H. H., & Kaye, J. A. (2015) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000100 · Cited by 37 · see citing works
Kurz, A., Bakker, C., Böhm, M., Diehl‐Schmid, J., Dubois, B., Ferreira, C. B., Gage, H., Graff, C., Hergueta, T., Jansen, S., et al. (2016) · International Psychogeriatrics · doi:10.1017/s1041610216001186 · Cited by 37 · see citing works
“The increasing use of computers and internet by older adults (Gell et al., 2015) opens novel opportunities for delivering information, counseling, and support to informal caregivers, particularly when traditional formats such as faceto-face meetings or support groups are difficult to organize or are hindered by geogra…”
BackgroundAdams, L. M., Gell, N., Hoffman, E. V., Gibbons, L. E., Phelan, E. A., Sturgeon, J. A., Turk, D. C., & Patel, K. V. (2021) · Journal of Aging and Health · doi:10.1177/0898264321991314 · Cited by 37 · see citing works
“%) years use the internet, rates of use in this group are lower than younger people ’ s, and the degree to which the internet is used for social engagement versus general tasks (e.g., news) is unclear (Gell et al., 2015; Pew Research Center, 2019).”
Self-citationUnderstanding Digital Dementia and Cognitive Impact in the Current Era of the Internet: A Review
Ali, Z., Janarthanan, J., & Mohan, P. (2024) · Cureus · doi:10.7759/cureus.70029 · Cited by 59 · see citing works
“Further study is required to determine how different types of impairments utilize technology differently and whether performance expectations influence a person's decision to use technology [23,24].”
BackgroundA Conceptual framework for Adaptive User Interfaces for older adults
Machado, E., Singh, D., Cruciani, F., Chen, L., Hanke, S., Salvago, F., Kropf, J., & Holzinger, A. (2018) · IEEE International Conference on Pervasive Computing and Communications Workshops (PerCom Workshops) · doi:10.1109/percomw.2018.8480407 · Cited by 36 · see citing works
“risk of social exclusion, access to health care and wellbeing [13].”
BackgroundCritical Factors Influencing the Intention to Adopt m-Government Services by the Elderly
Talukder, M. S., Chiong, R., Corbitt, B., & Bao, Y. (2020) · Journal of Global Information Management · doi:10.4018/jgim.2020100105 · Cited by 36 · see citing works
Internet Adoption in Older Adults: Findings from the Health and Retirement Study
Macdonald, B., & Hülür, G. (2020) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2019.0736 · Cited by 36 · see citing works
“1,3,10,11,48,49 Based on Cohen’s criteria, 50 all effect sizes (pseudo R 2 ) in our study can be considered small, although the effects were significant at p 0.001 and discernible in raw data (Fig.”
InfluentialSubjective Technology Adaptivity Predicts Technology Use in Old Age
Kamin, S. T., Lang, F. R., & Beyer, A. (2017) · Gerontology · doi:10.1159/000471802 · Cited by 35 · see citing works
- Authors
- Gell, N. M., Rosenberg, D. E., Demiris, G., LaCroix, A. Z., & Patel, K. V.
- Affiliations
- Kaiser Permanente Washington Health Research Institute (US)
- University of Washington (US)
- Corresponding author
- Gell, Nancy M.
- Venue
- The Gerontologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-12-30
- Volume
- 55
- Issue
- 3
- Pages
- 412-421
- ISSN
- 0016-9013 (ISSN-L)
- 1758-5341
- PMC
- PMC4542705
- OpenAlex
- W2114661329
- Cited by
- 450
- References
- 35
- Citations by year
- 2026: 34 · 2025: 51 · 2024: 55 · 2023: 35 · 2022: 44 · 2021: 45 · 2020: 45 · 2019: 28 · 2018: 36 · 2017: 31 · 2016: 18 · 2015: 21 · 2014: 6
- FWCI
- 40.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Gerontologist (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Johns Hopkins University
- National Health and Aging Trends Study (U01AG32947)
- National Institute on Aging (T32AG027677, NIA U01AG32947, U01AG032947)
- Topics
- Social Sciences › Demography › Technology Use by Older Adults
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Keywords
- technology use, older adults, disability, internet use, email, text messaging, visual impairment, memory constraints, physical capacity, sociodemographic differences, health communication, health promotion
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Aging, Attitude to Computers, Female, Persons with Disabilities, Health Promotion, Humans, Male, Technology, Prevalence, Internet, Electronic Mail, White People, Text Messaging
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