Older adults increasingly are adopting technology at rates on par with younger, tech-savvy cohorts. Now, unfortunately, they also may be adopting similar tech-related dependency issues. 

Excessive smartphone use is rising among all age groups, including older adults, according to new research from experts who are studying “problematic” screen addictions. 

Senior living and care operators, as well as families, should be careful to monitor residents’ screen time, as they are more susceptible to issues stemming from sedentary lifestyles or poor sleep quality, experts advised. The latter is a common concern about the effect of staring at LED-lighted screens right before bedtime. 

Approximately 12% of adults aged more than 65 years check their smartphone every 30 minutes, and 22% said that it is the first thing they look at upon waking, according to a published report. In addition, as many as 68% of adults aged 65 to 74 now own a smartphone, data show.

Although that information comes from a survey of older adults in Canada, US studies have delivered similar results, with a majority of older seniors — those aged more than 70 years — now using smartphones. 

Older adults now are spending an average of 300 hours a year on social media, and 25% spend more than one hour a day on platforms, the McKnight’s Tech Daily recently reported. 

Although social media or games may be mostly for entertainment or socialization, older adults and even caregivers are becoming increasingly reliant on apps designed to manage health issues, from medication alerts to telehealth check-ins. 

One further concerning aspect of those statistics is that most people, including older adults, significantly underreport their actual smartphone usage, experts noted. 

Some recommendations the researchers on problematic screen time suggested to curb smartphone use include muting notifications, lowering the display light and even keeping the phone in another room overnight, although that may be an unrealistic suggestion for senior living residents. 

Gretha J. Boersma, PhD, from the GGZ Drenthe Mental Health Institute in Assen, Netherlands, and colleagues evaluated the presence of short sleep (no more than six hours) and long sleep (nine or more hours) as well as sleep disorders within a broad range of shift work schedules. The analysis included 37,662 working adults.

The researchers found that all sociodemographic factors examined affected the prevalence rates of short, long, and disordered sleep, consistent with previous studies. Compared with day workers, shift workers more frequently reported short sleep, most prominently night workers (26 versus 50%). Among shift workers, all sleep disorders (including insomnia, sleep-related breathing disorders and sleep-related movement disorders) as well as sleep disorder comorbidity were more common, especially among night workers. Education level had the strongest associations with disturbed sleep among night shift workers, with a twofold higher prevalence of short and disordered sleep in those with low education achievement versus academic-educated groups.

“To prevent sleep curtailment and sleep disorders, employers/occupational health practitioners should encourage good sleep health and give tools to deal with shift work as well as possible, both promoting optimal sleep during the resting period and wakefulness during working hours,” the authors write.

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When it comes to new innovations for the bedroom, tech companies aren’t dozing on the potential of the senior living and care market. 

Several dozen companies are showcasing sleep tech items, including the DeRUCCI Group’s notable new slate of products, including “smart” pillows and mattresses, at the CES 2024 conference next week in Las Vegas. 

It has been known for a long time that older adults’ sleep quality often is poor, and that it can exacerbate existing healthcare problems, or put individuals at risk for new ones. 

But a combination of new data-collection tools, such as wearable or remote monitors, have made it easier to track and improve older adults’ sleep habits. In addition, tech tools now are being embedded in beds and mattresses. 

Some of the new offerings being released by the DeRUCCI Group:  

• Smart mattresses that not only alert users about potential health issues but are connected to a room’s thermostat or lighting systems.
• An anti-snore pillow that reduces the risk of sleep apnea.
• Artificial intelligence sleep monitors and health warnings that can provide personalized breakdowns for older users.
• Inflatable air supports that can adjust for position and texture. 

Those products will be commercially available in the United States at some point in 2024, the company said. 

Although DeRUCCI’s lineup of new releases is broad, it is not the only company working on such innovations. Other companies that will showcase AI-enabled mattresses and related software at CES 2024 include Amira Health and Anssil Co. Ltd. 

One potential new sensor-laden mattress top is a collaboration between tech companies and government space agencies: the foam sensors, which can offer data on a person’s comfort and positioning, first were used on the International Space Station.

Some data exist that, no matter what, older adults naturally lose the ability to get high-quality NREM sleep. But some innovations, such as light therapy, could improve that dynamic as well. 

Yue Leng, PhD, from the University of California in San Francisco, and colleagues examined the association between sleep duration and quality among adults in their mid-30s to late 40s and midlife cognition assessed 11 years later. Sleep duration and quality were assessed objectively and subjectively in 2003 to 2005; midlife cognition was evaluated during 2015 to 2016.

Data were included for 526 participants (58% women; 44% Black), with a mean age of 40.1 ± 3.6 years at baseline. Overall, 45.6% of the participants reported poor sleep, defined as a Pittsburgh Sleep Quality Index global score >5. The researchers found that those in the highest versus the lowest tertile of the sleep fragmentation index had significantly increased odds of poor cognitive performance on the Digit Symbol Substitution Test, fluency and Montreal Cognitive Assessment test (odds ratios, 2.97, 2.42 and 2.29, respectively) after adjustment for demographics, education, smoking, body mass index, depression, physical activity, hypertension and diabetes.

No difference was seen in the association between sleep fragmentation and cognitive performance by race or sex. No association was seen for objective sleep duration or subjective sleep quality with cognition in midlife.

“Our findings indicate that the quality rather than the quantity of sleep matters most for cognitive health in midlife and that the measures of sleep should go beyond self-report,” the authors write.

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Sally Jensen, PhD, from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues characterized sleep disturbance, depression, fatigue, and patient-reported medication adherence among US adults with OAB. The analysis included 159 participants.

The researchers found that scores for sleep disturbance, fatigue and depression were consistent with those of the general US population. There were no correlations of moderate or greater magnitude observed between the severity of lower urinary tract symptoms and sleep disturbance, fatigue or depression. For participants receiving antidepressants, almost all outcomes (e.g., urinary symptoms, anxiety and depression) were significantly worse than for participants not receiving antidepressants. Poorer adherence to OAB medications was also seen among patients taking antidepressants.

“Findings from the present study characterize the experience of sleep disturbance and depression in the context of the quality of life in a sample of individuals with OAB and highlight the importance of assessing depression and sleep in the clinic setting,” the authors write. “Important differences were observed in this study between genders and by age in this cohort of patients with OAB and should be considered by clinicians during their assessments.”

Several authors disclosed ties to industry.

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Older adults can prepare to browse their smartphones late at night guilt-free.

The next wave of blue light technology could avoid the pitfalls of current devices, which are known to wreak havoc on sleep cycles. Designs in development have been able to shift the light away from the wavelengths that are most disruptive, new research shows.

LED lighting, in our phone computer screens, can disrupt sleep quality at any age, but older adults in general are more susceptible to poor sleep quality and cascade effects, such as heart and kidney disease, according to the National Council on Aging.

Within senior living and care settings, administrators should stay abreast of when such new devices are available to residents or when overhead lighting systems can be retrofitted.

Human susceptibility to blue light stimulation dates back to our ocean-dwelling ancestors, whose eyes developed in water, which filters out much light except for blue wavelengths.

Older adults’ sleep and melatonin cycles are most commonly disrupted by LED television screens and overhead lighting, the NCOA noted. In addition, many blue light filters marketed to seniors may not be very effective, the McKnight’s Tech Daily has reported.

Because of issues with the latter, many senior living and care communities are working to install “smart” lighting systems that are designed to help re-establish natural circadian rhythms. 

Lighting systems need to balance assisting older adults with getting proper sleep, as well as making sure they don’t injure themselves in the middle of the night when getting up and using the restroom, experts have told the McKnight’s Tech Daily.

Better LED lighting systems were able to reduce older adult falling incidents by 43%, according to a Harvard study from last year.

Participants exposed to the new blue-light prototypes in lamps had a nighttime melatonin increase of 12%, the researchers said. Melatonin release is critical to falling asleep and maintaining circadian rhythms. 

Although those special lighting environments were unique to the research study, the scientists hoped that those findings could mean that such lighting will be implemented in the next generation of tech devices and overhead lighting systems.

Karuna Datta, PhD, from the Armed Forces Medical College in Pune, India, and colleagues examined the effect of yoga nidra practice on cognition and sleep. Analysis included 41 participants who kept a sleep diary.

The researchers found that yoga nidra practice improved reaction times for all cognition tasks. Compared to baseline, at follow-up, there were significant improvements seen in sleep efficiency (+3.62%), wake after sleep onset (−20 minutes), and delta during deep sleep (+4.19 μV²). Accuracy increased in visual object learning task, abstract matching and fractal-2-back test, while emotion recognition task accuracy increased for happy, fear and anger. Yoga nidra practice was associated with reduced emotion recognition task accuracy for neutral stimuli.

“This study opens up an opportunity for the use of an easy-to-do practice of yoga nidra for population health using standardized supervised model,” the authors write. “An increased awareness of sleep problems and their management amongst primary health care physicians is vital. Yoga nidra practice using formulated guidelines might ensure wellbeing of the society as it emerges from the effects of pandemic.”

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Stephanie R. Yiallourou, PhD, from the Turner Institute for Brain and Mental Health in Monash University in Melbourne, Australia, and colleagues examined the relationship between sleep regularity and incident dementia using data from 88,094 UK Biobank participants. During seven days of accelerometry, the average sleep regularity index (SRI) was calculated as the probability of being in the same state at any two time points 24 hours apart.

During a median follow-up of 7.2 years, the researchers identified 480 cases of incident dementia. A nonlinear association was seen between the SRI and risk for dementia with hazard ratios following a U-shaped pattern after adjustments for demographic, clinical and genetic confounders (APOE ε4). Relative to the median SRI, hazard ratios were 1.53 (95% confidence interval, 1.24 to 1.89) and 1.16 (95% confidence interval, 0.89 to 1.50) for participants with SRI at the 5th and 95th percentiles, respectively. Gray matter and hippocampal volume tended to be lowest at the extremes of SRI in a subset of participants with brain magnetic resonance imaging (15,263 participants).

“The current results identify sleep regularity as a potential novel dementia risk factor,” the authors write. “Future studies are required because, even in individuals with normal sleep durations, improvement of sleep timing schedules may represent a potential target for the primary prevention of dementia.”

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Joanna M. Blodgett, PhD, from University College London, and colleagues investigated associations of five-part movement compositions with adiposity and cardiometabolic biomarkers. The analysis included data from six studies (15,253 participants; five countries) as part of the Prospective Physical Activity, Sitting and Sleep consortium.

The researchers found that a greater moderate-to-vigorous physical activity (MVPA) proportion and smaller sedentary behavior (SB) proportion were associated with better outcomes. For all outcomes, reallocating time from SB, standing, light-intensity physical activity (LIPA) or sleep into MVPA resulted in better scores. Replacing 30 minutes of SB, sleep, standing or LIPA with MVPA was associated with −0.63, −0.43, −0.40 and −0.15 kg/m² lower body mass index, respectively. There was a benefit to greater relative standing time. But sleep had a detrimental association when replacing LIPA/MVPA and positive association when replacing SB. For improved cardiometabolic health, the minimal displacement of any behavior into MVPA ranged from 3.8 (hemoglobin A1c) to 12.7 (triglycerides) minutes/day.

“The most beneficial change we observed was replacing sitting with moderate to vigorous activity — which could be a run, a brisk walk or stair climbing — basically any activity that raises your heart rate and makes you breathe faster, even for a minute or two,” Blodgett said in a statement.

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Yiqi Lin, MD, from Fujian Medical University in Fuzhou, China, and colleagues conducted a cohort study to examine whether there is an association between sleep duration and all-cause mortality among participants with OSA. Data were included for 2,574 individuals with OSA defined by apnea-hypopnea index (AHI) ≥15.

A total of 688 all-cause deaths were observed among the participants. The researchers found that the groups sleeping six to less than seven hours, five to less than six hours, and less than five hours had significantly higher risks of all-cause mortality, independent of AHI, compared with the group sleeping at least seven hours (hazard ratios, 1.53, 1.40, and 1.64, respectively). The finding was mainly consistent in sensitivity analyses performed among participants with available data of positive airway pressure treatment during follow-up.

“Further research would be needed to shed light on its underlying mechanism and possible health benefits of extending sleep length among people with OSA with short sleep duration by sleep education or other sleep intervention,” the authors write.

One author disclosed ties to Eisai China Inc.

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