Blog | Thursday, December 14, 2017

Online communication for early diagnosis

The Internet and social media have transformed society. I remember when I was in high school, the concept of being able to retrieve any information you needed or communicate with the world via the click of a button would have seemed the stuff of science fiction. Future generations will be stunned when they hear stories of people trawling through libraries or debating questions for hours over dinner tables. They will also be shocked at how in the old days, information could easily be restricted or controlled.

It's a completely different world we live in now. News can be spread globally in an instant, authoritarian regimes and governments find it increasingly difficult to control the information flow, and any unpleasant events can be videoed and shared with millions in the few seconds it takes to upload to YouTube. Social media may have its detractors, but all of these things are fantastic for humanity. And as far as individual communication is concerned, we can stay in touch with friends and relatives across the world, share photos, and generally have a feeling of connectivity that no prior generation could have imagined (waiting weeks for that pen and paper letter to arrive is something that so many of us still remember).

As with anything else in life, too much of anything is bad, but it would be difficult for anyone to dispute the overwhelming benefits of the online revolution to mankind.

There is however one aspect of social media and online communication, which is also a major health care issue, that absolutely nobody is yet talking about. Use of these methods of communicating are soaring among the older population. It's no longer just something for millennials and the tech-savvy generation (and that's a good thing). Statistics suggest that around two-thirds of seniors are now online, a number that's steadily going up with smartphone use.

This is at the same time as the prevalence of another scourge of old age, dementia, is also increasing. Currently more than 5 million Americans are living with Alzheimer's disease, the sixth leading cause of death in the country. By 2050 as the population ages, this could be closer to 15 million. In addition to the personal and social devastation caused by the illness, it also costs hundreds of billions of dollars every year to the economy. Treatments and, hopefully, cures may be on the horizon, but dementia looks set to remain a problem across the world for some time—and not just confined to America.

I'm not aware of any serious body of thought that has addressed the issue of online activity combined with dementia, so let me do it right here. Because as older people using social media inevitably unfortunately start getting the illness, we will very likely see some of the first clinical signs in their online activity and other technological communication including text messages. This could manifest as follows:
• Their messages and posts will start becoming more erratic or inappropriate, not in tune with prior online behavior
• Large scale spelling or grammatical errors will occur that did not previously exist
• Unusual and out of character interactions with other people online

These manifestations are of vital importance for the following reasons:
1. We can utilize these online communication signs for early diagnosis and better detection, mainly noticed at first by family and friends. Physicians and all other health care professionals need to be aware of this and ready to address and respond to concerns
2. We can educate people in at-risk age groups about this upcoming problem and how to prepare
3. From a legal perspective, this is a minefield. Consider the following hypothetical question: can someone with early dementia be held fully responsible for the content of their online postings and interactions?

We as a society have not even come close to acknowledging this upcoming technological dementia ticking time bomb, and are totally unprepared for what's about to start happening. The speed of the online revolution has caught us on the back foot. Am I really the only person who has thought of this? Physicians, technologists, health care and even legal experts need to begin the discussion and start talking about it now—as we are sleepwalking into a major issue.

Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site here.