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

Johanna Austin, Kristy Hollingshead, Jeffrey Kaye, Johanna Austin, Kristy Hollingshead, Jeffrey Kaye

Abstract

Background: Alzheimer 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.

Objective: The 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.

Methods: Computer 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.

Results: Over 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.

Conclusions: These 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.

Keywords: Internet; cognition; executive function; geriatrics.

Conflict of interest statement

Conflicts of Interest: None declared.

©Johanna Austin, Kristy Hollingshead, Jeffrey Kaye. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.09.2017.

Figures

Figure 1
Figure 1
A social network diagram of participant searches over the past year. Search terms are connected to each other if they appeared in the same search, and stronger connections indicate they appeared more frequently together. Each term is sized by the degree of the node, which represents the number of unique terms that are connected to that term. Terms are colored by community, where terms that are frequently searched for together are grouped into the same community.
Figure 2
Figure 2
Scatter plots of the relationships between cognitive function and (a) average number of unique terms per search, (b) the average number of letters per word, and (c) the average term obscurity. The observed regression line for each relationship is also plotted as a dashed line.

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