Dr. Sara J. Czaja

Traditionally older adults have been hesitant in adopting technology, however, more and more are embracing the digital age. According to the Pew Research Center, roughly two-thirds of those ages 65 and older go online and a record number of them now own smartphones. “There’s a misconception that older adults are technophobic — that they’re unwilling to learn new skills and are uninterested in new technology. Over the years, we’ve collected quite a bit of data to dispel those myths,” says Sara J. Czaja, PhD, a world renowned expert on technology and aging. Dr. Czaja joined the Division of Geriatrics and Palliative Medicine at NewYork-Presbyterian/Weill Cornell Medical Center in 2018 as the inaugural Director of the Center on Aging and Behavioral Research.

Continuing the pioneering work she began at the University of Miami Miller School of Medicine where she directed the Center on Aging, Dr. Czaja and her team are developing innovative strategies to help keep older adults engaged, productive, and independent, and at the same time, providing helpful information and strategies for their caregivers.

The Center on Aging and Behavioral Research takes a multidisciplinary approach to the study of aging, pooling the resources of experts in engineering, behavioral sciences, psychology, neurology, psychiatry, computing sciences, and public health sciences. Their research is focusing on both challenges and opportunities for older adults and their families utilizing team science and implementation science. “We are seeking to integrate technology into research and intervention programs, with a commitment to serving diverse populations,” says Dr. Czaja.

Creating Useful Technology Systems

A major emphasis of the Center is to make sure that technology systems are not only useful for older adults, but that they can also be used. “I have a background in human factors engineering, where we look at how systems can be improved and used by the older adult population,” says Dr. Czaja. To that end, the Weill Cornell Medicine program has collaborations with the University of Miami, University of Illinois Urbana-Champaign, Florida State University, and Georgia Institute ofTechnology in CREATE — Center for Research and Education for Aging and Technology Enhancement — a program that has been funded by the National Institute on Aging since 1999.

“One does not stop learning or growing intellectually, cognitively, and emotionally at their 65th birthday. We need to find ways to maximize the contributions of this population, while ensuring their quality of life and independence.”

— Dr. Sara J. Czaja

“CREATE’s focus is on aging and technology systems from two perspectives,” explains Dr. Czaja. “The first is to ensure that older adults can realize the potential benefits of technology in terms of enhancing their independence and quality of life, and the second is making sure that technology systems are designed to accommodate the needs, preferences, and abilities of older people.”

“For example, we completed a study where we found that a specially designed software system that we developed, called PRISM [Personal Reminder Information and Social Management System], was very helpful in terms of alleviating loneliness and enhancing social support among older people who lived alone and were at risk for social isolation,” continues Dr. Czaja.

The researchers included seniors in the development of PRISM’s software, instructions, and training materials. The system offered streamlined access to email, a calendar, games, and links to community resources, and also incorporated features that included readable fonts and a “buddy tab” that enable users to stay in touch with those that share similar interests.

Dr. Czaja and her colleagues at three sites studied 300 adults, ranging in age from 65 to 98. Half used PRISM for one year; the rest received a paper notebook with content similar to that contained in the online system. Their study, which appeared in the January 2019 issue of Gerontologist, showed that the PRISM group reported significantly less loneliness and an increase in perceived social support and wellbeing than the control group. “Participants learned how to use email, were able to communicate with their grandchildren, navigate the Internet, and share photos,” says Dr. Czaja, who also has an administrative supplement with the NIH to look at the value of PRISM for individuals with mild cognitive impairment.

PRISM home page. Source: Gerontologist. 2019 Jan 9.

The Center on Aging and Behavioral Research at Weill Cornell is also looking at programs and services for family caregivers, particularly caregivers of patients with dementia. “We also use technology in those studies as a way to bring programs and services to family caregivers,” says Dr. Czaja.

The Center has an ongoing grant to provide a behavioral psychosocial intervention for both the caregiver and the patient with early-onset Alzheimer’s disease. “It is delivered in the homes of the patients and the caregivers using laptop technology, which we provide,” says Dr. Czaja. “The intervention includes components for the caregiver and the care recipient and also things that they do together. We use videoconferencing to conduct support groups, enabling people to interact with other caregivers from their own homes. We also conduct skill building sessions using videoconferencing. It alleviates the need for them to come to us and for us having to go to them.”

In other efforts, Dr. Czaja and her Weill Cornell Medicine colleagues are studying patient portals of electronic medical records, telemedicine devices, and other digital healthcare services so seniors have fewer obstacles to access.

Recently, they published the third edition of Designing for Older Adults, winner of the 2019 Richard M. Kalish Innovative Publication Book Award presented by the Gerontological Society of America. The new edition provides easily accessible and usable guidelines for practitioners in the design community for older adults. It includes an updated overview of the demographic characteristics of older adult populations and the scientific knowledge base of the aging process relevant to design.

In NIH investigations with the University of Pittsburgh, the researchers are examining factors, such as numeracy, literacy, cognition, and demographics, which predispose older adults to be vulnerable to financial exploitation.

“We have another interesting project for which we are also actively recruiting that will focus on an exercise and social support intervention for sedentary older adults,” says Dr. Czaja. “We provide the program to people after they’re trained in groups. They form a team and conduct the exercises at home via a tablet.”

Looking Ahead

Among her goals, Dr. Czaja hopes to expand their studies in social isolation. “Another aim is to form strong community partnerships because we want to understand what the community needs are and to draw participants from diverse populations into our research,” she says. “We’ve put together a community advisory board to make sure we continue to maintain a strong foothold in the community.”

In addition to her research, Dr. Czaja is a strong proponent of educating medical students and mentoring junior faculty. “We need to train a cadre of new people so that they gain research expertise, grow into independent research scientists, and are able to continue this important work,” she adds.