Kordovski Victoria M, Tierney Savanna M, Rahman Samina, Medina Luis D, Babicz Michelle A, Yoshida Hanako, Holcomb Erin M, Cushman Clint, Woods Steven Paul
Department of Psychology, University of Houston, Houston, TX, USA.
Houston Neuropsychology Associates, Houston, TX, USA.
J Clin Exp Neuropsychol. 2021 Sep;43(7):689-703. doi: 10.1080/13803395.2021.1990866. Epub 2021 Nov 3.
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.
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.
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.
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.
在互联网上搜索健康相关信息是一个复杂且动态的目标导向过程，表面上对执行功能提出了要求，执行功能是随着年龄增长可能会衰退的高阶认知能力。本研究考察了年龄对电子健康（eHealth）搜索行为的影响以及执行功能的潜在中介作用。
50名年轻成年人（≤35岁）和41名年长成年人（≥50岁）完成了涉及事实查找（事实搜索）和症状判定（症状搜索）的自然主义eHealth搜索任务、一套神经认知测试以及一系列自我报告问卷。
控制了潜在混杂的精神症状、健康状况、读写能力和人口统计学变量的多元回归模型显示，在eHealth事实搜索任务中，年长成年人比年轻成年人速度更慢且准确性更低，但在eHealth症状搜索任务中并非如此。执行功能介导了年龄与事实搜索和症状搜索准确性之间的关系，独立于基本处理速度和注意力。平行中介模型表明，一旦纳入速度/注意力和执行功能，情景记忆对于任何一项eHealth任务都不是年龄与搜索准确性的独立中介因素。
年长成年人在互联网上搜索某些健康相关信息时可能会遇到困难，这至少部分归因于执行功能障碍。未来需要开展研究，以确定针对年长成年人的互联网搜索组织和策略方面的培训的益处，以及这些发现是否适用于有执行功能障碍的临床人群。
