Bridging the technological divide: Stigmas and challenges with technology in clinical studies of older adults.

Abstract

The COVID-19 pandemic has increased adoption of remote assessments in clinical research. However, longstanding stereotypes persist regarding older adults’ technology familiarity and their willingness to participate in technology-enabled remote studies. We examined the validity of these stereotypes using a novel technology familiarity assessment (n = 342) and with a critical evaluation of participation factors from an intensive smartphone study of cognition in older adults (n = 445). The technology assessment revealed that older age was strongly associated with less technology familiarity, less frequent engagement with technology, and higher difficulty ratings. Despite this, the majority (86.5%) of older adults elected to participate in the smartphone study and showed exceptional adherence (85.7%). Furthermore, among those enrolled, neither technology familiarity, knowledge, perceived difficulty, nor gender, race, or education were associated with adherence. These results suggest that while older adults remain significantly less familiar with technology than younger generations, with thoughtful study planning that emphasizes participant support and user-centered design, they are willing and capable participants in technology-enabled studies. And once enrolled, they are remarkably adherent.

Unsupervised high-frequency smartphone-based cognitive assessments are reliable, valid, and feasible in older adults at risk for Alzheimer disease.

“…demand characteristics, "white coat" testing effects), bolster sample size and diversity, and make participation more accessible and inclusive for individuals who may otherwise be unable to come into the laboratory or clinic. Indeed, interest in smartphone studies is growing and several studies have demonstrated the feasibility and validity of smartphone-based assessments for use in older adults and individuals with preclinical AD (Güsten et al, 2021;Hassenstab et al, 2020;Lancaster et al, 2020;Mackin et al, 2018;Öhman et al, 2021;Papp et al, 2021;Nicosia et al, 2021;Wilks et al, 2021), as semi-structured interviews with the participant and an informant (i.e., family member or friend).…”

“…Feasibility and Tolerability Measures. Technology familiarity was assessed with a novel measure described in Nicosia et al (2021). Briefly, the assessment combined objective measurements of technology knowledge (technology-related icon recognition) and self-reported ratings of (1) the frequency with which they perform certain smartphone tasks; and (2) how difficult it would be for them to perform various technology-related tasks.…”

“…Briefly, the assessment combined objective measurements of technology knowledge (technology-related icon recognition) and self-reported ratings of (1) the frequency with which they perform certain smartphone tasks; and (2) how difficult it would be for them to perform various technology-related tasks. For the purposes of this study, we report participants' technology icon recognition, average frequency of smartphone task performance, and average difficulty performing technology-related tasks (for more details see Nicosia et al, 2021).…”