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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.
Ipsit Bahia agrees.
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.
Ipsit is from a family of psychiatrists, and all four of his grandparents lived well into their 80s and 90s.
So all four of my grandparents were at my medical school graduation, which was just unusual and really special.
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.
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.
Now, as the chief of geriatric psychiatry at McLean Hospital, Ipsit has had a front row seat to one of the biggest transformations in life after 65 the explosion in screen time.
The sentinel event, I think, for all tech in all of our lives was the arrival of the smartphone.
That was 2007.
Flash forward to today, and the screen habits of older people parallel the appetite of Gen Z.
In 2019, the Pew 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.
So this got us wondering on ShoreWave, is this a problem?
Should we be worried?
And Ipsit says it kind of depends on the technology and on the person.
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?
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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Okay, Ipsit, I want to focus just to start on what we know about smartphones.
What does data show about smartphone use among this age group?
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 experience, 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.
Right.
WhatsApp is the ultimate staying in touch device.
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.
Yeah.
In preparing for this conversation, you also sent me an interesting study looking at empirical evidence from China.
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?
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.
That is so fascinating to me because it suggests that it's the social factors that drive people into the arms of technology.
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?
Yeah.
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 are that in older adults it's the isolation and alienation that comes first and the smartphone overuse comes later.
But the thing that's so hard about tech is it's hard to leave like we've all been caught doom scrolling.
Yes, so are you seeing older folks having just as a hard time putting their phone down as we younger people are?
Oh, i think we're starting to see that and um, 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 people.
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, 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.
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?
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.
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.
It hooks you by creating a sharp excitement or giving you a quick laugh, or just making you gasp at something shocking.
Like when a kid eats too much candy and they're just like...
And then they crash.
It's a sugar rush, yeah.
And then you want more.
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.
Absolutely.
What are other examples of technology at its best?
So I'll give you two examples.
And they're both interesting.
Just so obvious, you might not even think about them.
But Uber or Lyft, the rideshare 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.
I have on multiple occasions.
The treatment is teaching someone to use Lyft or Uber or a ride share service 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.
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.
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.
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.
But 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 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.
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?
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.
Many things are not really curable anymore.
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?
Yeah.
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.
Every shortwave listener over 65 just went, yeah, I was 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.
Thank you so much.
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 Shortwave from NPR.
See you next time.
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