Emily Kwong (2:25)

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 Shortwave, the science podcast from NPR.

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Emily Kwong (3:57)

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

Dr. Ipsit Vahia (4:06)

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 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 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.

Emily Kwong (5:06)

Right. WhatsApp is the ultimate staying in touch device.

Dr. Ipsit Vahia (5:10)

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, it makes it so that you rarely miss a birthday. It makes it so that you rarely miss an anniversary.

Emily Kwong (5:27)

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

Dr. Ipsit Vahia (5:34)

Yeah.

Emily Kwong (5:34)

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?

Dr. Ipsit Vahia (5:45)

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.

Emily Kwong (6:12)

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

Dr. Ipsit Vahia (6:20)

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. But in older adults, it's the isolation and alienation that comes first and the smartphone overuse comes later.

Emily Kwong (7:06)

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

Dr. Ipsit Vahia (7:12)

Yes.

Emily Kwong (7:13)

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

Dr. Ipsit Vahia (7:21)

I think we're starting to see that. And I think that is where the skies 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 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 prone to clickbait. I think many of them, they trust what they see. 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.

Emily Kwong (8:25)

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.

Dr. Ipsit Vahia (8:47)

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.

Sponsor/Advertisement Voice (8:56)

Yeah.

Dr. Ipsit Vahia (8:57)

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 just making you gasp at something shocking.

Emily Kwong (9:24)

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

Dr. Ipsit Vahia (9:29)

It's a sugar rush.

Sponsor/Advertisement Voice (9:29)

Yeah.

Dr. Ipsit Vahia (9:30)

And then you want more, and then you want more.

Emily Kwong (9:31)

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.

Dr. Ipsit Vahia (9:44)

Absolutely.

Emily Kwong (9:45)

What are other examples of technology at its best?

Dr. Ipsit Vahia (9:48)

So I'll give you two examples. And they're both just so obvious, you might not even think about them. But Uber or Lyft, the ride share services, many older adults can't or won't drive because their eyesight is failing or their response time goes down. 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. Yeah, I have on multiple occasions. The treatment is teaching someone to use Lyft or Uber or a rideshare service and 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. 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 undertapped and underutilized technology.

Emily Kwong (10:50)

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.

Dr. Ipsit Vahia (11:00)

Yeah, all of the above. So my favorite story around VR has to do with a very specific patient. She was one of my patients and we were doing psychotherapy and about 10 or 12 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. Then that's where I used VR, where we were able to get her to stand in front of her childhood home. Wow. So we had her retrace her childhood walk for from home to school, and then we had her stand outside where her father's business used to be. And something about this was transformative. She became tearful minutes after.

Emily Kwong (11:54)

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

Dr. Ipsit Vahia (12:09)

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

Emily Kwong (13:23)

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.

Dr. Ipsit Vahia (13:38)

Thank you so much.

Emily Kwong (13:42)

If you like 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 Keeley 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.

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