Screen time is up for grandma and grandpa

Folks over 65 are putting in a lot of screen time. In 2019, the Pew Research Center found that people 60 years and older spend more than half their daily leisure time https://www.pewresearch.org/short-reads/2019/06/18/americans-60-and-older-are-spending-more-time-in-front-of-their-screens-than-a-decade-ago/ in front of screens, mostly watching TV or videos. Since the pandemic, that screen time has increased. Is addiction on the rise? And what’s the best use of screen time for any of us? We’re parsing out all the questions with Ipsit Vahia https://www.mcleanhospital.org/profile/ipsit-vahia, the Chief of Geriatric Psychiatry at McLean Hospital. Interested in more stories about how technology is changing daily life? Email us your question at [email protected] mailto:[email protected]. Listen to every episode of Short Wave sponsor-free and support our work at NPR by signing up for Short Wave+ at plus.npr.org/shortwave http://plus.npr.org/shortwave. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

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• 0:00Speaker 00

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• 0:18Emily Kwong?

  You're listening to Short Wave from NPR.

• 0:24Emily Kwong?

  Some people get bummed out about their birthdays and say stuff like, oh, I'm getting so old. But I actually have loved getting older. The sense of perspective, of time passing, and older people are just cool. Ipsad Bahia agrees.

• 0:39Speaker 02

  I think older people have the coolest stories. And I could spend the rest of our time together just telling you cool stories I've heard over the years from my patients and the people I work with.

• 0:48Emily Kwong?

  Ipsad is from a family of psychiatrists, and all four of his grandparents lived well into their 80s and 90s.

• 0:55Speaker 02

  So all four of my grandparents were at my medical school graduation, which was just

• 0:58Emily Kwong?

  Amazing.

• 0:59Speaker 02

  unusual and really special.

• 1:01Emily Kwong?

  And the specialty he chose was geriatric psychiatry because he wanted to care for the mental and emotional health of older people, people his grandparents' age.

• 1:10Speaker 02

  I started to see them lose a step as they got older. But I also saw what they retained and the ways in which they just seemed to get funnier and sharper. And they just seemed to have like wisdom and perspectives to give.

• 1:24Emily Kwong?

  Now, as the chief of geriatric psychiatry at McLean Hospital, Ipsad has had a front row seat to one of the biggest transformations in life after 65, the explosion in screen time.

• 1:37Speaker 02

  The sentinel event, I think, for all tech in all of our lives, was the arrival of the smartphone that was 2007.

• 1:44Emily Kwong?

  Flash forward to today, and the screen habits of older people parallel the appetite of Gen Z. In 2019, the Pugh Research Center found that people 60 years and older spend more than half of their daily leisure time in front of screens, mostly watching TV or videos. And since the pandemic, screen time has only increased.

• 2:06Emily Kwong?

  So this got us wondering on Shorewave, is this a problem? Should we be worried? And Ipsa says it kind of depends on the technology and on the person.

• 2:14Speaker 02

  Some of it comes down to what could they be doing if they were not on that screen, which is to say, is the screen keeping them away from better things? Or is it giving them something to do when the option is isolation and apathy?

• 2:28Emily Kwong?

  Today on the show, what does science have to say about your auntie's affinity for Candy Crush? And what is the best use of screen time, really, for all of us? I'm Emily Kwong, and you're listening to Shorewave, the science podcast from NPR.

• 2:51Speaker 00

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• 4:11Emily Kwong?

  Okay, I want to focus just to start on what we know about smartphones. What does data show about smartphone use among this age group?

• 4:21Speaker 02

  So smartphone use is rising very rapidly. I think at this point, smartphone ownership data among older adults are comparable to most other age groups. But I think the pattern of how they use their smartphones, I think, varies considerably in that, you know, older adults aren't quite as engaged with things like social media and visual social media at the same rates as younger adults. They use them for more practical purposes. A lot of it is just following the news or getting information. But in my personal and family circles, the WhatsApp addiction and overuse of WhatsApp

• 5:06Speaker 02

  is the one I hear about most often. Inherent in that particular app is that, you know, you're part of a group or you're communicating with people. So there is a pro-connection aspect to it.

• 5:21Emily Kwong?

  Right. WhatsApp is the ultimate staying in touch device.

• 5:25Speaker 02

  It really is because you can do everything. You can text, you can call, you can video chat. And then for a lot of them with, you know, the basic age-related cognitive challenges, it's just, it makes it so that you rarely miss a birthday. It makes it so that you rarely miss an anniversary.

• 5:42Emily Kwong?

  Yeah. In preparing for this conversation, you also sent me an interesting study looking at empirical evidence from China.

• 5:49Speaker 02

  Yeah.

• 5:49Emily Kwong?

  It's titled, "Understanding Older Adult Smartphone Addiction in the Digital Age", and it looked at a survey of 371 subjects. What'd you make of that paper?

• 6:00Speaker 02

  So what they found was that... Smartphone addiction was the consequence of other factors that they had looked at in their study. They found that if people's cognition was failing, and specifically if they had conflicts within their family, that seemed to lead to a sense of alienation. And that sense of alienation in turn led to what they defined as smartphone addiction.

• 6:27Emily Kwong?

  That is so fascinating to me because it suggests that it's the social factors that drive people into the arms of technology.

• 6:35Speaker 02

  Correct. So I think what I found really interesting about this is there's this debate, right? What comes first? Does the isolation come first? Or does the smartphone overuse come first? And I think this sort of, it gives us an early indication that smartphone addiction is the result of isolation and alienation, not the cause of it. And that's really interesting because I think in that sense, it tells us that smartphone overuse among older adults is a little bit different than younger adults. That in older adults, it's the isolation and alienation that comes first, and the smartphone overuse comes later.

• 7:20Emily Kwong?

  But the thing that's so hard about tech is it's hard to leave. Like, we've all been caught doom scrolling.

• 7:27Speaker 02

  Yes.

• 7:28Emily Kwong?

  So are you seeing older folks having just as hard time putting their phone down as we younger people are?

• 7:35Speaker 02

  I think we're starting to see that. And I think that is where the, you know, the sky start to darken a little bit on this topic because people are spending more time on their phones. And we know that this content is designed to engage.

• 7:55Speaker 02

  In some of the more informal conversations I've had with collaborators and people in the community we work with, they really worry about two things. A misinformation, that this is making older adults really

• 8:07Emily Kwong?

  Ah, yeah.

• 8:08Speaker 02

  prone to clickbait. I think many of them, they trust what they see.

• 8:14Emily Kwong?

  Sure.

• 8:14Speaker 02

  And clickbait leads to, you know, at best, spending a lot of time on things that don't really add meaning. We call it empty calories screen time, where it's hooking you, but you're not getting much value out of it. But the second more troublesome one is that they are prone to scams and they're prone to being targeted for fraud, identity theft, and other things.

• 8:40Emily Kwong?

  Right. And I mean, how does this square with other, with what we know about how the brain just gets hooked on things, period, regardless of age? Like, what happens when we pick up our phones that makes it sometimes so hard to put down? Or you pick it up mindlessly, where you didn't even intend to pick it up? You're just like, it's almost automatic? Like, what is our brain doing in that moment?

• 9:02Speaker 02

  That's a great question. And if you had to sum it up in one word, that word would be dopamine. Dopamine is the reward neurochemical.

• 9:10Emily Kwong?

  Yeah.

• 9:12Speaker 02

  It's what regulates pleasure and gratification and excitement, also apprehension. And a lot of the content, particularly on social media, is designed to give you that quick dopamine hit. It hooks you by creating a sharp excitement, or giving you a quick laugh, or making you gasp at something shocking.

• 9:39Emily Kwong?

  Yeah. Like, when a kid eats, like, too much candy and they're just like, brrrr, and then they crash.

• 9:44Speaker 02

  It's a sugar rush, yeah. And then you want more.

• 9:45Emily Kwong?

  And then you want more. What I'm hearing is, there's a real risk for overuse when it comes to screens. But I also hear you saying there are benefits to technology, including technology use among the elderly. You spoke about social connection on WhatsApp.

• 9:59Speaker 02

  Absolutely.

• 10:00Emily Kwong?

  What are other examples of technology at its best?

• 10:02Speaker 02

  So, I'll give you two examples, and they're both, they're both just so obvious you might not even think about them, but Uber or Lyft.

• 10:11Emily Kwong?

  Yeah.

• 10:12Speaker 02

  The rideshare services. Many older adults

• 10:16Speaker 02

  Can't or won't drive because you know their eyesight is failing or their response time goes down there. By their own admission, they don't feel safe driving their own car. This means that they're often limited in being able to go out.

• 10:31Emily Kwong?

  Yeah.

• 10:31Speaker 02

  I have on multiple occasions, the the the treatment is teaching someone to use Lyft or Uber or a Rideshare service and and you know, setting it up with their credit card and showing them that if you click these things in this order, a car will mysteriously appear at your door and take you to wherever you need to go.

• 10:50Emily Kwong?

  Mm hmm.

• 10:51Speaker 02

  And now they're not dependent on people to take them to meet a friend or to go buy groceries or go watch a film or whatever. But virtual reality, I feel, is an under tapped and under utilized technology.

• 11:05Emily Kwong?

  Yes, virtual reality. I'm glad you brought this up. This is like, you know, those headsets, you put them on and suddenly you're like standing in a castle, you're holding a sword, you can slay a dragon in the VR world.

• 11:15Speaker 02

  All of the above. So my favorite story around VR has to do with with a very specific patient. She was one of my patients and we were doing psychotherapy. And about ten or twelve sessions in, it was just this moment in the process of psychotherapy where we really needed to talk about her childhood. And she was just consciously or subconsciously, it was hard for her to do it where she was happy to talk about her childhood and that's where I used VR where we were able to get her to stand in front of her childhood home.

• 11:52Emily Kwong?

  Wow.

• 11:52Speaker 02

  So we had her retrace her childhood walk from home to school. And then we we had her stand outside where her father's business used to be. And something about this was transformative. She became tearful minutes after.

• 12:08Emily Kwong?

  Mm hmm. How does a patient like that inform your sort of philosophy towards geriatric care? What what does it say to you about what elderly people need from people around them?

• 12:24Speaker 02

  I think the art of chariature psychiatry is actually on an individual by individual basis, figuring out exactly what the person needs.

• 12:36Emily Kwong?

  Hmm.

• 12:36Speaker 02

  You know, as physicians, we're sort of prone to think about curing diseases. In late life, it doesn't work like that. It's, it's, you know, many things are not really curable. Yes, sometimes the thing that this person needs is medications or psychotherapy to alleviate depression or anxiety. But at other times, it's listening, it's connecting.

• 12:59Emily Kwong?

  Yeah.

• 13:00Speaker 02

  And there is this implicit fear of aging. And yet, we have spent centuries perfecting medicine, perfecting all these things with the idea that we live longer. So getting old is the whole point. So if we're then going to fear it and think of aging as a problem or a challenge, then we've got it backwards, haven't we?

• 13:20Emily Kwong?

  Yeah.

• 13:21Speaker 02

  The second thing is, I would want everyone to stop thinking of this monolithic entity of the elderly. The truth is, someone in their early 60s is nothing like someone in their late 80s. And we tend to think of everyone above 65 as like this one block. They are not.

• 13:38Emily Kwong?

  Every Short Wave listener over 65 just went, yeah, listening to this. Well, Dr. Ipsit Vahia, thank you so much for talking to me. This was a wonderful conversation, and I wish you luck with all your work.

• 13:53Speaker 02

  Thank you so much.

• 13:57Emily Kwong?

  If you liked this episode, follow us so you never miss another one. And if you're looking for more, you may like our episode on guilty pleasures and the one about how to keep your brain young with mental exercises. This episode was produced by Rachel Carlson and edited by our showrunner Rebecca Ramirez. Tyler Jones checked the facts. Jimmy Keely was the audio engineer. Beth Donovan is our vice president of podcasting. I'm Emily Kwong. Thank you for listening to this episode of Short Wave from NPR. See you next time.

• 14:41Speaker 03

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