Older age and online health information search behaviors: The mediating influence of executive functions

ABSTRACT

Introduction

Searching the internet for health-related information is a complex and dynamic goal-oriented process that ostensibly places demands on executive functions, which are higher-order cognitive abilities that can deteriorate with older age. This study examined the effects of older age on electronic health (eHealth) search behavior and the potential mediating influence of executive functions.

Method

Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom determination (Symptom Search), a neurocognitive battery, and a series of self-report questionnaires.

Results

Multiple regression models controlling for potentially confounding psychiatric symptoms, health conditions, literacy, and demographic variables revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Executive functions mediated the relationship between age and Fact and Symptom Search accuracy, independent of basic processing speed and attention. Parallel mediation models showed that episodic memory was not an independent mediator of age and search accuracy for either eHealth task once speed/attention and executive functions were included.

Conclusions

Older adults can experience difficulty searching the internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction.

KEYWORDS:

• electronic health literacy
• ecological validity
• verbal fluency
• abstraction
• set-shifting

Acknowledgments

The authors are grateful to Kishon Joseph and Nathalie Ulrich for their help with test administration and scoring. We also thank the study participants for their time and effort.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by start-up funds to the corresponding author from the University of Houston and was conducted as part of the Ph.D. requirements for the lead author.