Benge Jared F, Scullin Michael K
Department of Neurology, University of Texas at Austin, Austin, TX, USA.
Mulva Clinic for the Neurosciences, University of Texas at Austin, Austin, TX, USA.
Nat Hum Behav. 2025 Apr 14. doi: 10.1038/s41562-025-02159-9.
The first generation who engaged with digital technologies has reached the age where risks of dementia emerge. Has technological exposure helped or harmed cognition in digital pioneers? The digital dementia hypothesis predicts that a lifetime of technology exposure worsens cognitive abilities. An alternative hypothesis is that such exposures lead to technological reserve, wherein digital technologies promote behaviours that preserve cognition. We tested these hypotheses in a meta-analysis and systematic review of studies published in Medline, PsycInfo, CINAHL, Science Direct, Scopus, Cochrane Library, ProQuest and Web of Science. Studies were included if they were observational or cohort studies focused on general digital technology use in older adults (over age 50) and included either a cognitive or dementia diagnosis outcome. We identified 136 papers that met inclusion criteria, of which 57 were compatible with odds ratio or hazard ratio meta-analysis. These studies included 411,430 adults (baseline age M = 68.7 years; 53.5% female) from cross-sectional and longitudinal observational studies (range: 1-18 years, M = 6.2 years). Use of digital technologies was associated with reduced risk of cognitive impairment (OR = 0.42, 95% CI 0.35-0.52) and reduced time-dependent rates of cognitive decline (HR = 0.74, 95% CI 0.66-0.84). Effects remained significant when accounting for demographic, socioeconomic, health and cognitive reserve proxies. All studies were evaluated for quality on the basis of a standardized checklist; the primary outcomes replicated when limiting analyses to the highest-quality studies. Additional work is needed to test bidirectional causal interpretations, understand mechanisms that underpin technological reserve, and identify how types and timings of technology exposures influence cognitive health.
第一代接触数字技术的人已经到了痴呆症风险出现的年龄。数字技术的接触对数字先锋的认知是有帮助还是有损害？数字痴呆症假说预测，一生接触技术会使认知能力恶化。另一种假说是，这种接触会导致技术储备，即数字技术促进有助于保持认知的行为。我们在对发表于《医学索引》（Medline）、《心理学文摘数据库》（PsycInfo）、《护理学与健康领域数据库》（CINAHL）、《科学Direct》、《Scopus》、《考科蓝图书馆》（Cochrane Library）、《ProQuest》和《科学网》（Web of Science）上的研究进行的荟萃分析和系统评价中检验了这些假说。如果研究是针对老年人（50岁以上）一般数字技术使用情况的观察性研究或队列研究，并且包括认知或痴呆症诊断结果，则纳入研究。我们确定了136篇符合纳入标准的论文，其中57篇与比值比或风险比荟萃分析兼容。这些研究包括来自横断面和纵向观察性研究的411,430名成年人（基线年龄M = 68.7岁；53.5%为女性）（范围：1 - 18年，M = 6.2年）。使用数字技术与认知障碍风险降低（比值比 = 0.42，95%置信区间0.35 - 0.52）以及认知衰退的时间依赖性发生率降低（风险比 = 0.74，95%置信区间0.66 - 0.84）相关。在考虑人口统计学、社会经济、健康和认知储备指标时，效应仍然显著。所有研究均根据标准化清单进行质量评估；当将分析限于最高质量的研究时，主要结果得到了重复。需要开展更多工作来检验双向因果解释，理解技术储备背后的机制，并确定技术接触的类型和时间如何影响认知健康。
