College of Nursing, Wenzhou Medical University, Wenzhou, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
BMC Geriatr. 2024 May 7;24(1):406. doi: 10.1186/s12877-024-05026-w.
Older people are more likely to have digital exclusion, which is associated with poor health. This study investigated the relationship between digital exclusion and cognitive impairment in older adults from 23 countries across five longitudinal surveys.
Digital exclusion is defined as self-reported non-use of the Internet. We assessed cognitive impairment on three dimensions: orientation, memory, and executive function. We used generalized estimation equations fitting binary logistic regression with exchangeable correlations to study the relationship between digital exclusion and cognitive impairment, and apply the minimum sufficiently adjusted set of causally directed acyclic graphs as the adjusted variable.
We pooled a nationally representative sample of older adults from five longitudinal studies, including the China Health and Retirement Longitudinal study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS), the Mexican Health and Ageing Study (MHAS) and the Survey of Health, Ageing and Retirement in European (SHARE).
We included 62,413 participants from five longitudinal studies. Digital exclusion varied by country, ranging from 21.69% (SHARE) in Denmark to 97.15% (CHARLS) in China. In the original model, digital exclusion was significantly associated with cognitive impairment in all five studies. In the adjusted model, these associations remained statistically significant: CHARLS (Odds ratio [OR] = 2.81, 95% confidence interval [CI] 1.84-4.28, ELSA (1.92 [1.70-2.18]), HRS(2.48[2.28-2.71), MHAS (1.92 [1.74-2.12]), and SHARE (2.60 [2.34-2.88]).
Our research shows that a significant proportion of older people suffer from digital exclusion, especially in China. Digital exclusion was positively correlated with cognitive impairment. These findings suggest that digital inclusion could be an important strategy to improve cognitive function and reduce the risk of cognitive impairment in older adults.
老年人更容易出现数字排斥现象，而数字排斥与健康状况不佳有关。本研究通过五个纵向调查，对来自 23 个国家的老年人进行了数字排斥与认知障碍之间的关系研究。
数字排斥定义为自我报告的不使用互联网。我们从三个维度评估认知障碍：定向、记忆和执行功能。我们使用广义估计方程拟合二进制逻辑回归，使用可交换相关性来研究数字排斥与认知障碍之间的关系，并应用最小充分调整的有向无环图作为调整变量。
我们汇集了来自五个纵向研究的具有全国代表性的老年人样本，包括中国健康与退休纵向研究（CHARLS）、英国老龄化纵向研究（ELSA）、健康与退休研究（HRS）、墨西哥健康与老龄化研究（MHAS）和欧洲健康、老龄化和退休调查（SHARE）。
我们纳入了来自五个纵向研究的 62413 名参与者。数字排斥因国家而异，丹麦为 21.69%（SHARE），中国为 97.15%（CHARLS）。在原始模型中，数字排斥与所有五个研究中的认知障碍显著相关。在调整模型中，这些关联仍然具有统计学意义：CHARLS（优势比 [OR] = 2.81，95%置信区间 [CI] 1.84-4.28，ELSA（1.92 [1.70-2.18]），HRS（2.48[2.28-2.71]），MHAS（1.92 [1.74-2.12]）和 SHARE（2.60 [2.34-2.88]）。
我们的研究表明，相当一部分老年人存在数字排斥现象，尤其是在中国。数字排斥与认知障碍呈正相关。这些发现表明，数字包容可能是改善老年人认知功能和降低认知障碍风险的重要策略。
