Internet Searches and Their Relationship to Cognitive Function in Older Adults: Cross-Sectional Analysis

Abstract

BackgroundAlzheimer disease (AD) is a very challenging experience for all those affected. Unfortunately, detection of Alzheimer disease in its early stages when clinical treatments may be most effective is challenging, as the clinical evaluations are time-consuming and costly. Recent studies have demonstrated a close relationship between cognitive function and everyday behavior, an avenue of research that holds great promise for the early detection of cognitive decline. One area of behavior that changes with cognitive decline is language use. Multiple groups have demonstrated a close relationship between cognitive function and vocabulary size, verbal fluency, and semantic ability, using conventional in-person cognitive testing. An alternative to this approach which is inherently ecologically valid may be to take advantage of automated computer monitoring software to continually capture and analyze language use while on the computer.ObjectiveThe aim of this study was to understand the relationship between Internet searches as a measure of language and cognitive function in older adults. We hypothesize that individuals with poorer cognitive function will search using fewer unique terms, employ shorter words, and use less obscure words in their searches.MethodsComputer monitoring software (WorkTime, Nestersoft Inc) was used to continuously track the terms people entered while conducting searches in Google, Yahoo, Bing, and Ask.com. For all searches, punctuation, accents, and non-ASCII characters were removed, and the resulting search terms were spell-checked before any analysis. Cognitive function was evaluated as a z-normalized summary score capturing five unique cognitive domains. Linear regression was used to determine the relationship between cognitive function and Internet searches by controlling for variables such as age, sex, and education.ResultsOver a 6-month monitoring period, 42 participants (mean age 81 years [SD 10.5], 83% [35/42] female) conducted 2915 searches using these top search engines. Participants averaged 3.08 words per search (SD 1.6) and 5.77 letters per word (SD 2.2). Individuals with higher cognitive function used more unique terms per search (beta=.39, P=.002) and employed less common terms in their searches (beta=1.39, P=.02). Cognitive function was not significantly associated with the length of the words used in the searches.ConclusionsThese results suggest that early decline in cognitive function may be detected from the terms people search for when they use the Internet. By continuously tracking basic aspects of Internet search terms, it may be possible to detect cognitive decline earlier than currently possible, thereby enabling proactive treatment and intervention.

The Effectiveness of a Web-Based Health Education Tool, WESIHAT 2.0, among Older Adults: A Randomized Controlled Trial

“…Methodological limitations or even fear of using the computer by older adults may be possible contributing factors to the insignificant findings. The use of the computer by Table 6 Effect of intervention on total score of WHODAS, social support and depressive symptoms [presented as mean ± SD] older individuals requires complex motor functioning for typing, selecting, moving the cursor, language processing to understand, and focusing [56]. Therefore, with sufficient practice, older people may gain benefits by using a computer.…”

The neuropsychological aspects of performance-based Internet navigation skills: A brief review of an emerging literature

“…Tasks Table 1 shows the effect sizes estimates of the associations between INS and neurocognitive domains from the 17 studies included in this review. All five studies that looked at the association between INS and a global index of cognition found significant, typically large associations whether they used a within-group correlational approach (e.g., Austin et al, 2017;Goverover et al, 2016) or a between-group design (Haesner et al, 2015;Woods et al, 2016;. As shown in Table 1, there were 14 studies that reported at least one domainspecific analysis linking neuropsychological functions to INS tasks, 13 of which reported at least one significant domain-level relationship (92.9%).…”

“…Overall, there were nine articles that examined the relationship between neuropsychological functions and internet information-seeking behavior using performance-based INS metrics (Agree et al, 2015;Austin et al, 2017;Chevalier et al, 2015;Czaja et al, 2010;Dommes et al, 2011;Sharit et al, 2008;2015;Laberge & Scialfa, 2005;Pak & Price, 2008). Nearly half (44%) of the studies included health-related topics in the search paradigms (e.g., Sharit et al, 2008;2015), such as vaccinations, Multiple Sclerosis (MS), obesity, and exercise.…”

Extended, continuous measures of functional status in community dwelling persons with Alzheimer’s and related dementia: Infrastructure, performance, tradeoffs, preliminary data, and promise

“…Care needs for persons with dementia will thus significantly differ depending upon disease stage. For example, in persons with preclinical signs of neurodegenerative diseases, assessment of day-to-day behaviors strongly associated with cognition, such as language, may provide an early indication of AD or a similar process (Austin et al, 2017 in press). Most of these individuals will have preserved functional status, and may not derive benefit from detailed assessment of daily activity and lifespace.…”