智能手机对老龄大脑的影响：老年人屏幕时间与认知健康深度对话

Jeyan Jeganathan: Thanksgiving's on the horizon, which means a lot of families will be getting together and sitting down for a big meal. It also means you might find yourself saying, "Put the phone down. We're eating." But not to your kids, to your parents. That's right. Teenagers aren't the only ones glued to their devices. In 2022, nearly 3/4 of Canadians aged 75 and older were using the internet. That's up from 62% just 2 years earlier. Now, being online can mean all kinds of things. Catching up with family, reading the news, playing games, or scrolling on social media. But as more older adults spend time on their devices, there are questions worth asking, like what effect is all that screen time having on them? And when does a tool that offers connection become a bad habit? We meet a mother and daughter who have made technology an important part of their lives, and we'll look at what science has to say about how screen time can affect the brain, for better and for worse. I'm Jeyan Jeganathan. Welcome to the rundown. For some older adults, a smartphone is much more than a way to pass the time. Take Mara Lewis. She's postretirement and dealing with low mobility, and her smartphone has become an important part of her daily life. And her daughter, Rosie, wants to make sure she's getting the most out of it. Mara Lewis, great to have you in our studio. Rosie Lewis, great to have you on the line. How are you doing?

Mara Lewis: Good.

Jeyan Jeganathan: And Rosie?

Rosie Lewis: I'm very good, thank you.

Jeyan Jeganathan: Mara, I want to understand a little bit about your relationship with your phone. What do you use your phone for?

Mara Lewis: Well, number one, it's a love relationship. Not even a love-hate relationship. It's all love. And I use it now for everything. I use it for the time, the weather, fact-check, information, chat. GPT now gets to the heart of the phone number before I can look it up. And my phone is—I do Zoom calls on my phone. I do my reports on my phone. If I have to send a file, I do it on my phone.

Jeyan Jeganathan: It's very clear on your phone. There's lots of tools that are useful. But what I didn't hear from you is social media apps. Do you use any social media apps?

Mara Lewis: A lot of them.

Jeyan Jeganathan: Lot of them.

Mara Lewis: A lot of them.

Jeyan Jeganathan: Walk me through them.

Mara Lewis: So I probably start with Facebook. I take a quick look to see if there's any headlines going on that I might need to know because I belong to a couple of groups that sort of give you the immediate news. And I also use Marketplace on Facebook a lot. I go to Instagram to see what's up just with general. And then I go to TikTok, which is my favorite animal right now. And I think that's where I stop. I don't use dating apps or anything.

Jeyan Jeganathan: Help me understand here. I am guilty of this. I get on the couch. I got maybe 10, 15 minutes before I got to do something, right? And I'm scrolling, right? And then lo and behold, two hours has passed. Is that a common thing for you? Is Rosie giving you a reminder: "Hey, mom, let's get back to reality here"?

Mara Lewis: Not too much for me. For me, I have a really rigid relationship with time. So if I know that I have to meet you at 8:00 and I know that at 7:00 I've got that hour, I do my check on my phone, my email, my this, then I watch that clock. And I don't care what time it is, whatever I'm doing at that exact minute, it gets turned off and away I go.

Jeyan Jeganathan: Now, Mara, you mentioned that sometimes you find yourself on your phone in the middle of the night. Help me understand a little bit about sort of that a bit of a trap, I guess.

Mara Lewis: Yes and no. I have a routine. So my routine is always the same. I check to see if my daughter's okay. First thing I do, right? Then I go to my email and then I go sometimes just to the weather. I don't know why. And then I'll move on to Facebook to see what middle of the night catastrophe's gone on if there's any. And then I'll move to TikTok to entertain me. And TikTok is where I lose time, right? So if it's like 1:15 and I'm thinking, "Okay, let's see. I'll give this a good hour," I sometimes look up and it's close to 2:00 and I don't know where that 45 minutes went. That happens to me. But I do note when time goes by, and again, I wait for my eyes to get heavy, but I don't lose the entire night just to scrolling.

Jeyan Jeganathan: Rosie, you've got a little smirk on your face because you've heard these stories before and I'm sure that you've had to tell your mom enough's enough here, but help me understand, have you seen your mom's relationship with her phone change since she's retired?

Rosie Lewis: Mom has definitely become more dependent on her phone, but I wouldn't say that it's dependent in a negative way. I think that she uses it to structure her life in a very meaningful way. So since we've transitioned to iPhones and iPhones have become more and more practical and productive, my mom has actually leaned into that to learn how to use the tools. So not a time goes by whenever I'm with her that she's not looking at her calendar on her phone to make sure that a particular appointment is going on or that she's scheduled something or she has a shopping list. So absolutely, I've seen that side of the phone relationship grow and develop, and I've also seen her lean to the phone in order to use tools to help herself stimulate her brain. So my mom is the best Candy Crusher I know. She's at nearly level 18,000.

Jeyan Jeganathan: Oh, wow.

Rosie Lewis: You know, it's very cool. And ultimately it is a strategy game. And so she uses other ones as well, including particular word games, especially the New York Times puzzles like Wordle, the mini Connections, things like that. So she's using the games to, A, both relax and then also, B, stimulate her brain and make sure that in her retirement where she's not thinking during work in a work way anymore, there's still new challenges coming up every day.

Mara Lewis: What I want to say about that is that my daughter has heavily influenced my choices of games because she said, "Mom, I don't want you to lose your recall." So suddenly the New York Times shows up and all the words, "Mom, I want you to do the crossword every day. Mom, I want you to." And she's really helped me be mindful of not getting lost in just games and scrolling.

Jeyan Jeganathan: Rosie, why was that important to kind of feed your mom apps and games that you thought were appropriate or perhaps redirecting her?

Rosie Lewis: I think that my mom is one of the smartest people I know and she's very sharp and she's very fast and it's been harder and harder for her to find things that stimulate her in the way that she needs. And I've also looked into studies on dementia and Alzheimer's. And I've come to see that the brain, just like any other muscle in your body, is a use it or lose it. So the more that you're using the brain, the more that you're developing new neural pathways and neural links, you are increasing the range of what you are possible of as well as retaining what you've already built up to date.

Jeyan Jeganathan: Mara, help me understand how many hours do you think you spend on your phone throughout a day?

Mara Lewis: Oh, there's no thinking involved. The phone tells you.

Jeyan Jeganathan: That's true.

Mara Lewis: And it's between 9 and 10 hours a day. I'm not watching TV much anymore. If I watch it, I'll use the phone.

Jeyan Jeganathan: Were you surprised by that number, though?

Mara Lewis: Yes, I was. I was thinking 3, 4 hours, maybe more. 10 hours? What happened? Right. And I know I sleep like 6 or 7 hours. So I guess I don't use it a few hours of the day.

Jeyan Jeganathan: I have to ask, are there, you know, your friends that you're talking to, are there similar conversations about how dependent you are using your phone? Obviously, you've got some tools. You've got your daughter looking out for you as well, giving you all of these apps to help.

Mara Lewis: Number one, my daughter is my IT department. And right now in Italy, she's my remote IT department. She always will be. I am the most savvy on the phone than any of my friends. Some of them don't know how to use your GPS. Some of them don't know how to use the files. Some of them don't know how to use the camera. Some of them don't know. So, we message each other in a simple way, but that's about it.

Jeyan Jeganathan: I imagine the roles have kind of changed in terms of being a daughter and then kind of having to put on a parental hat a little bit. And I'm hoping you can help me understand here. Do you think there are enough resources out there to help older adults and seniors, or their adult children rather, navigate healthy ways to use their phones and sort of manage their screen time?

Rosie Lewis: Ultimately, I don't think so. And I can give you the reasons why. So I understand that right now this conversation mainly centers on children and teen use of phone and like overuse of phone. So a lot of resources have been developed to help parents of younger children start to tackle this issue and teach proper boundaries for screen time. However, the complicated part to this issue is that older adults have full agency. They're responsible for their own decisions. And so often they are either left to their own to figure out what they need best and if they don't have their children helping them or you have a lot of children like me who are starting to get a little bit older themselves and who have aging parents who want what's best for them and will help them as much as possible. But it's sometimes hard for older adults to relate to someone who's in their late 20s or 30s.

So if we were to increase the resources for older adults, which I absolutely think that we should, I think the best way to go about doing that is to have older adults teaching other older adults how to do things. And it helps relate. It helps when an older adult is able to explain something in their own words and at their own speed to someone who's a contemporary. And so the messaging can actually be more effective than just another 30-year-old saying, "Hey, you should do that thing because it's good for you." And it's definitely a niche in the market that hasn't really been tapped yet.

Jeyan Jeganathan: These are reminding me of the conversations I have with my mom. With that being said, Mara, help me understand, is there a message out there for older adults right now who might be listening or watching this and saying, you know what, I may have not necessarily an addiction, but I'm developing a bad habit here with my phone. And as someone who's navigated and has the support of their daughter, is there a message to them?

Mara Lewis: Yeah. Not to get lost in your phone. It's important to live life still. There's a lot of good life out there and your phone could lead you to some great places, but it's really best to—you have to put it down occasionally in the daylight hours, right?

Jeyan Jeganathan: Mara, Rosie, I want to thank you so much for joining us on the rundown. I appreciate it. Thank you so much for your insights as well.

Mara Lewis: Oh, thank you. I love being here. TVO has always been a big part of my life.

Jeyan Jeganathan: That's awesome.

Mara Lewis: Thank you.

Rosie Lewis: Thank you so much for this opportunity. It's been a pleasure to chat with you.

Jeyan Jeganathan: So for Mara, a smartphone is a big way to stay connected and engaged. And she's certainly not alone. According to advocacy group AARP, formerly known as the American Association of Retired Persons, 9 in 10 people over 50 now own a smartphone. But here's what we want to understand: How much screen time is too much for older adults? What kind of impact can it have on the brain? And are there habits we should be watching out for?

Great to have you on the program, Nicole Dalmer, Dr. Howard Chertkow, and Cara Brisson-Boivin. Thank you so much. Really looking forward to our conversation here. Nicole, I want to start with you. Nicole, you're an associate professor with the department of health, aging, and society at McMaster University. Help paint the picture for me. What are we seeing in terms of screen and smartphone use in senior and older adult populations?

Nicole Dalmer: Definitely. Thanks, Jeyan. You know for a long time we saw older adults certainly as I guess lagging behind in terms of technology adoption, but in the recent decade, especially with the advent of COVID, that certainly spurred older adults to start adopting technology at quite a rapid rate. And so we're now seeing the trends where older adults' adoption and engagement with everyday technology are almost meeting other age groups as well. And we also need to remember that current older adult populations have been working with technologies for a long time in their everyday life and also in their paid work. And so they're an increasingly tech-savvy group, which sometimes counters some of the ageist tropes we have about older adults as kind of technophobic, for example.

Jeyan Jeganathan: Dr. Chertkow, as a cognitive neurologist, help me understand, is there a difference between healthy and unhealthy screen time?

Dr. Howard Chertkow: Well, that's right. Like any technology, use of screens and smartphones for older people can have a positive outcome or a negative outcome because let's look at what we're trying to do. We're trying to maintain brain health as people get older. And at Baycrest in Toronto, we have a dementia prevention center, the Kimmel Center, where we teach people four big things:

Physical stimulation and exercise. If you're watching a screen, you may not be doing exercise. Cognitive stimulation, challenging your brain. So that depends what you're doing with this screen. It can be a negative or it can be a positive if you're doing challenging things. Social stimulation. For some older people, the screen is how they're connecting with the world, seeing their children, their grandchildren. For others, it's a way to have them stay in their apartments and never see people. So that can have a very negative social impact. And finally, sleep. Sleep is very important. People who are waking up in the middle of the night looking at a blue screen for more than 30 minutes, you're ruining your sleep pattern. You're affecting your sleep. You're not going to get back to sleep. So it can have a negative effect on sleep.

So it's the content. It's not just the technology itself. It's how people are using the technology.

Jeyan Jeganathan: Dr. Chertkow, can you give us a few more examples? I'm curious. When we talk about unhealthy screen time, I am thinking of social media apps. I am thinking of the doom scroll. Can you give me a few more examples? We talk about late at night the blue light here, but is there any other kind of patterns when we talk about bad uses of screen time?

Dr. Howard Chertkow: Of course. So looking at YouTube and social media, these are not going to stimulate your brain cognitively. But there are people who do online games. They're playing chess. They're doing courses online. Their intellectual stimulation can come from the screen and that can be a very effective way to keep challenging your brain as you get older.

But obviously searching YouTube, I mean it's addictive. You could spend hours just having YouTube throw things at you. You come away you think what did I see? You certainly didn't learn anything. So I think people have to choose wisely.

And the social element: Again, if the screen is keeping a person from getting out of their house, getting out of the apartment, seeing their friends and family, then it's going to be having a negative effect. If it's on the other hand the only way they can reach out because of physical limitation, they can't get out of their apartment, it can prevent loneliness. My story I always hear from patients when they come and see me, they say, "I haven't seen you in a year." And I say, "Well, wait a minute, we had a screen time together four months ago." They say that doesn't count. So socially looking at someone on the screen is not the same as being there face-to-face touching them. So we have to encourage people get out of their apartments, out of their houses, meet people, interact face to face.

Jeyan Jeganathan: Cara, since MediaSmarts provides resources on digital and media literacy, help me with some recommendations. What if someone who is stuck in a cycle of unhealthy screen time, what should they be doing?

Cara Brisson-Boivin: Yeah, we definitely have lots of resources to help people. I think the most important thing is to build realistic goals. As we've been hearing, you know, screen time in and of itself is a really poor marker of sort of health, well-being, and harm. So what we need to do is get at the root of why people are using screens and in what ways.

And I think one of the most healthy and helpful inroads to have a conversation with someone who you might be worried is engaged in excessive screen use is to ask them, you know, what they're doing on their screen to get at the heart of the sort of quality of experience that they're looking for to help them understand if that app or that tool is doing the thing that they want it to do for them. Whether that's social interaction, whether that's learning, whether that's physical activity.

Other things that can help is ensure that you're working with someone to set those reasonable goals. One of the most beneficial ways that we can mitigate excessive screen use is to hold each other accountable. And often when it comes to older adults who could be living in isolation, that's increasingly hard to do. So whether it's a neighbor, a friend, extended relative to be able to set those reasonable goals and to hold each other accountable, the likelihood of those outcomes being successful are going to be much higher.

Jeyan Jeganathan: Dr. Chertkow, help me understand how the brain works here a little bit when it comes to excessive screen use. What are we seeing with the brain? I think a lot of people, a lot of older adults who have parents have some concerns when they think of dementia or Alzheimer's or depression in general, but what are we actually seeing when it comes to the brain and excessive screen use?

Dr. Howard Chertkow: Sure. Well, it's football season, so I think of your brain as like the quarterback of your team, and you've got an onslaught of the other team: bad things, bad proteins, oxidative stress, changes in energy, metabolism, assaulting your brain cells. Then you've got things protecting your brain, what we call cognitive reserve, brain resilience.

So a person has to think: What can I do to prevent the onslaught of bad things? For example, avoiding head injuries, wearing helmets when you're bicycling, avoiding toxins like alcohol and sleeping pills. Those decrease the bad things. And what can you do to increase your cognitive reserve? Learning another language, cognitive stimulation, exercise. The most important thing seems to be exercise; it gives you chemicals in the neurons which preserve their function.

So of all the bad things from a screen, the worst is if it prevents you from getting your exercise. And then there's your genetics: what you inherit from your parents that makes your brain more or less resilient to the onslaught of these changes of aging that many of them we cannot prevent.

Jeyan Jeganathan: Nicole, there is a balancing act that needs to happen here when we talk about screen use, but also, you know, as Cara had mentioned, battling loneliness and the need for connection. How do we do that?

Nicole Dalmer: I think it's a bit of a tricky line, I suppose, to walk. What's so interesting is that socially we're really painting technology as the solution for so many of the quote-unquote problems of aging. Throw an app at something, maybe put a sensor in the home to make sure Mom and Dad are moving around or have gotten up okay in the morning, and then we're somehow faulting them for spending too much time with technology when we're giving gifts of technology.

And also it seems like the only way to be able to participate in society now is to really be online. We have fewer bank tellers, for example. There's fewer cashiers that we're able to interact with. So many government forms, for example, are only accessible online. And so I think sometimes we need to step back and look at a bit of a broader picture to really question: Why are we spending so much time online? Not only older adults, but across the life course. And I think it's because we're being directed and funneled, I suppose, in a way there. And so I think it takes a bit of a broader concerted effort to be able to walk that balance, especially when it's not necessarily an individual fault for spending time online. It needs to be a bit more of a socially, politically, economically constructed solution together.

Jeyan Jeganathan: Cara, your organization has developed tons of resources, not only for children or parents trying to teach their children about healthy screen time and smartphone use, but I am curious, are you finding that adult children actually need those resources for their parents now?

Cara Brisson-Boivin: Yeah, I think we're seeing a definite increased need in conversations about screen use with older adults in particular. You know, as we've been talking about, this is a generation of older adults that are very comfortable with technology use, but it doesn't mean that they don't need to continue to develop those skills. Digital literacy and the skills to use technology critically and confidently—that's a lifelong skill set.

And with the onset of changes in technology, new technology like AI and how that impacts things like the information ecosystem and where we access services like Nicole was saying, but also where we get our information. Those are massive changes that require a lot of supports and how we support older adults. While it's interesting the vulnerabilities of older adults are in some ways similar to younger adults, how we support older adults is different. So it does require a different approach. We don't want to infantilize older adults. We want to counter a lot of those ageist stereotypes about older adults and technology use. And we don't want to shame and blame either. We want to find inroads where we can have open communication and make sure that people feel supported. And that's particularly challenging for a demographic of the population that in many ways can feel isolated. So I think there is a lot of work to do to ensure that we are finding ways to reach older adults in community.

Jeyan Jeganathan: Nicole, do you think we're prepared at this moment to deal with older adults and seniors using their devices to excessive limits? I see you smiling. I think I know the answer here.

Nicole Dalmer: I find the notion of dealing with really a little bit amusing. I think so because to be honest, I don't think it's any different than any other age group. We're all grappling with tech overuse. I spend too much time on my phone at night when I know I should leave it outside the bedroom. So I think it's already happening.

And so it's a matter of maybe, as Cara so beautifully was kind of saying, it's really of meeting them where they're at, recognizing that some of the younger cohorts of older adults are just as tech-savvy as kind of any other age group because they've had to work with technology and they've seen the evolution of so many different technological tools.

Nicole Dalmer: I guess I would say the importance then is not painting older adults as this homogeneous group, and recognizing that there's a lot of diversity in a 40-year kind of age group population as well. And so developing maybe different tools or techniques to reach them requires a bit of finessing and recognition of that diversity.

Jeyan Jeganathan: Dr. Chertkow, help me understand, could we be doing more as a society here? Are there enough resources available right now?

Dr. Howard Chertkow: Well, I think our society overall is on one side doing more for older people, on the other side just trying to fit them in with the younger people. For example, try going to a store and finding a smartphone geared for older individuals with arthritis in their fingers. You won't find them. Try to find apps which are geared for older people. Very difficult to find.

At Baycrest, we're trying to develop technology for the elderly, but generally the social imperative seems to be fit in, squeeze in older people with the younger. But older people have specific needs physically and emotionally. And the most important need that I think we're not meeting with technology is that one of the big factors in how you age is—I mentioned loneliness, exercise, social involvement—but a sense of meaning in your life. People who say they don't have a purpose in life are much more likely to go on and develop dementia.

So what are we doing as a society to help integrate people after they retire and help them establish a purpose in life? This is an individual thing, but it's also a social thing. Outlets for older people to meaningfully contribute to help society are very limited. So my advice to patients is always see what's going to give you a sense of meaning in life, a connection. And is going on your tablet or your smartphone giving you a sense of sharing and community and a meaning in your life, or is it just wasting your time? Ultimately, these are going to be what determine whether you're benefiting or not.

Jeyan Jeganathan: Cara, I'm going to get you to follow up on that. What could we be doing more?

Cara Brisson-Boivin: Well, I think there's lots of different programming that we need to be offering. I love the suggestions of developing apps with the needs of older adults in mind. I think that's critically important. I also think we need to bolster the educational component here.

So different programs that target older adults in a variety of different needs, including the ways in which older adults are targeted for things like fraud and scams. There's a huge need for that. And for the most part, you sort of offloaded that work onto the sort of front lines of bank tellers and other sort of cybersecurity experts who are not necessarily aware of or trained to support older adults, nor are they trained in sort of providing educational support. It's important and we need that and we're grateful for the work to sort of intercept that, but there's this whole other sort of avenue of educational support that needs to happen.

And I think that there's a lot of important critical community work happening in senior centers and community centers to make sure that older adults feel confident to be able to do things like bank safely, connect with their families in ways that are meaningful, make sure that they're making some of those choices we've been talking about today about their technology use that feels like it's going to be impactful and positive in their lives. And being able to make those choices requires that you have the skills and the critical competencies to use technology in a way to have that positive impact in your life.

Jeyan Jeganathan: Cara, Nicole, Dr. Chertkow, I want to thank you so much for your insights on this conversation. I'm sure this will be a conversation we will revisit. Thank you so much.

Dr. Howard Chertkow: Thank you.

Jeyan Jeganathan: Have you ever talked to an older friend or relative about screen time or healthy internet habits? And if you are an older adult, how much do you use a phone, tablet, or computer? And what do you use it for? Let us know in the comments or send us an email to rundowntvo.org. Until then, I will see you tomorrow.