J Korean Med Sci.  2024 Jan;39(1):e7. 10.3346/jkms.2024.39.e7.

Digital Health Technology Use Among Older Adults: Exploring the Impact of Frailty on Utilization, Purpose, and Satisfaction in Korea

• Lee H
• Choi JY
• Kim Sw
• Ko KP
• Park YS
• Kim KJ
• Shin J
• Kim CO
• Ko MJ
• Kang SJ
• Kim Ki

• KMID: 2550794
• DOI: http://doi.org/10.3346/jkms.2024.39.e7

Abstract

Background
The importance of digital technology is increasing among older adults. In this study, the digital health technology utilization status, purpose, and satisfaction of older adults were investigated according to frailty.
Methods
A face-to-face survey was conducted among adults aged 65 years or older. Frailty was defined using the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight scale.
Results
A total of 505 participants completed the survey, with 153 (30.3%) identified as pre-frail or frail and 352 (69.7%) as healthy. All respondents used smartphones; 440 (87.1%) were application users, and 290 (57.4%) were healthcare application users. Wearable devices were used by only 36 patients (7.1%). Pre-frail or frail respondents used social media more frequently than healthy respondents (19.4% vs. 7.4%, P < 0.001). Among the respondents, 319 (63.2%) were not able to install or delete the application themselves, and 277 (54.9%) stated that the application was recommended by their children (or partner). Pre-frail and frail respondents used more healthcare applications to obtain health information (P = 0.002) and were less satisfied with wearable devices (P = 0.02).
Conclusion
The usage rate of digital devices, including mobile phones among older adults in Korea is high, whereas that of wearable devices is low. There was a notable difference in the services used by pre-frail and frail respondents compared to healthy respondents. Therefore, when developing digital devices for pre-frail and frail older adults, it is crucial to incorporate customized services that meet their unique needs, particularly those services that they frequently use.

Keyword

Frail; Digital Health Technology; Older Adult; Internet Use; Application

Reference

1. Sharma A, Harrington RA, McClellan MB, Turakhia MP, Eapen ZJ, Steinhubl S, et al. Using digital health technology to better generate evidence and deliver evidence-based care. J Am Coll Cardiol. 2018; 71(23):2680–2690. PMID: 29880129.

2. Food and Drug Administration. What is digital health? Updated 2020. Accessed January 2, 2023. https://www.fda.gov/medical-devices/digital-health-center-excellence/what-digital-health .

3. Litchfield I, Shukla D, Greenfield S. Impact of COVID-19 on the digital divide: a rapid review. BMJ Open. 2021; 11(10):e053440.

4. Mace RA, Mattos MK, Vranceanu AM. Older adults can use technology: why healthcare professionals must overcome ageism in digital health. Transl Behav Med. 2022; 12(12):1102–1105. PMID: 36073770.

5. LaMonica HM, Roberts AE, Davenport TA, Hickie IB. Evaluation of the usability and acceptability of the InnoWell Platform as rated by older adults: survey study. JMIR Aging. 2021; 4(2):e25928. PMID: 33881410.

6. LaMonica HM, Davenport TA, Roberts AE, Hickie IB. Understanding technology preferences and requirements for health information technologies designed to improve and maintain the mental health and well-being of older adults: participatory design study. JMIR Aging. 2021; 4(1):e21461. PMID: 33404509.

7. Choi EY, Kim Y, Chipalo E, Lee HY. Does perceived ageism widen the digital divide? and does it vary by gender? Gerontologist. 2020; 60(7):1213–1223. PMID: 32539099.

8. Lam K, Lu AD, Shi Y, Covinsky KE. Assessing telemedicine unreadiness among older adults in the united states during the COVID-19 pandemic. JAMA Intern Med. 2020; 180(10):1389–1391. PMID: 32744593.

9. Yu H, Fan L, Gilliland AJ. Disparities and resilience: analyzing online health information provision, behaviors and needs of LBGTQ + elders during COVID-19. BMC Public Health. 2022; 22(1):2338. PMID: 36514032.

10. Phang JK, Kwan YH, Yoon S, Goh H, Yee WQ, Tan CS, et al. Digital intergenerational program to reduce loneliness and social isolation among older adults: realist review. JMIR Aging. 2023; 6:e39848. PMID: 36598801.

11. Flynn A, Healy D, Barry M, Brennan A, Redfern S, Houghton C, et al. Key stakeholders’ experiences and perceptions of virtual reality for older adults living with dementia: systematic review and thematic synthesis. JMIR Serious Games. 2022; 10(4):e37228. PMID: 36563042.

12. Lee DR, Lo JC, Ramalingam N, Gordon NP. Understanding the uptake of digital technologies for health-related purposes in frail older adults. J Am Geriatr Soc. 2021; 69(1):269–272. PMID: 33011975.

13. Kato Y, Sakamoto R, Hori A, Momosaki R. Innovation in digital health interventions for frailty and sarcopenia. J Clin Med. 2023; 12(6):2341. PMID: 36983340.

14. Linn N, Goetzinger C, Regnaux JP, Schmitz S, Dessenne C, Fagherazzi G, et al. Digital health interventions among people living with frailty: a scoping review. J Am Med Dir Assoc. 2021; 22(9):1802–1812.e21. PMID: 34000266.

15. Ministry of Science and ICT. 2020 the Report on the Digital Device. Sejong, Korea: Ministry of Science and ICT;2020.

16. Jung HW, Yoo HJ, Park SY, Kim SW, Choi JY, Yoon SJ, et al. The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly. Korean J Intern Med. 2016; 31(3):594–600. PMID: 26701231.

17. Ministry of Science and ICT. 2021 the Report on the Digital Device. Sejong, Korea: Ministry of Science and ICT;2021.

18. Hänninen R, Taipale S, Luostari R. Exploring heterogeneous ICT use among older adults: the warm experts’ perspective. New Media Soc. 2021; 23(6):1584–1601.

19. Choi NG, Dinitto DM. Internet use among older adults: association with health needs, psychological capital, and social capital. J Med Internet Res. 2013; 15(5):e97. PMID: 23681083.

20. Choi M. Factors associated with eHealth use among community dwelling older adults. Int J Nurs Pract. 2022; 28(6):e13092. PMID: 35977421.

21. Poli A, Kelfve S, Klompstra L, Strömberg A, Jaarsma T, Motel-Klingebiel A. Prediction of (non)participation of older people in digital health research: exergame intervention study. J Med Internet Res. 2020; 22(6):e17884. PMID: 32501275.

22. Faverio M. Share of those 65 and older who are tech users has grown in the past decade. Updated 2022. Accessed April 2, 2023. https://www.pewresearch.org/short-reads/2022/01/13/share-of-those-65-and-older-who-are-tech-users-has-grown-in-the-past-decade/ .

23. Vorrink SNW, Antonietti AMGEF, Kort HSM, Troosters T, Zanen P, Lammers JJ. Technology use by older adults in the Netherlands and its associations with demographics and health outcomes. Assist Technol. 2017; 29(4):188–196. PMID: 27548101.

24. Clarke MA, Fruhling AL, Sitorius M, Windle TA, Bernard TL, Windle JR. Impact of age on patients’ communication and technology preferences in the era of meaningful use: mixed methods study. J Med Internet Res. 2020; 22(6):e13470. PMID: 32478658.

25. Zheng WY, Van Dort B, Marcilly R, Day R, Burke R, Shakib S, et al. A tool for evaluating medication alerting systems: development and initial assessment. JMIR Med Inform. 2021; 9(7):e24022. PMID: 34269680.

26. Schlomann A, Seifert A, Zank S, Woopen C, Rietz C. Use of Information and Communication Technology (ICT) devices among the oldest-old: loneliness, anomie, and autonomy. Innov Aging. 2020; 4(2):igz050. PMID: 31911953.

27. Alexandrakis D. Factors related to computer and internet use during the third age: results from an empirical research in Greece. Gerontechnology (Valkenswaard). 2019; 18(1):47–58.

28. Schlomann A, Seifert A, Zank S, Rietz C. Assistive technology and mobile ICT usage among oldest-old cohorts: comparison of the oldest-old in private homes and in long-term care facilities. Res Aging. 2020; 42(5-6):163–173. PMID: 32167019.