Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 30, 2019
Open Peer Review Period: Apr 3, 2019 - May 14, 2019
Date Accepted: Jun 18, 2019
(closed for review but you can still tweet)
Can Digital Access Reduce Cognitive Decline: Longitudinal Evidence from Chinese Mid-aged and Elderly Population
ABSTRACT
Background:
Cognitive decline is a major risk factor for disability and death, and may serve as a precursor of dementia. Digital device can provide a platform of cognitively stimulating activities which might help to slow cognitive decline in the process of normal aging.
Objective:
This longitudinal study aimed to examine the independent protective factors of desktop and cellphone ownership against cognitive decline in mid-life and older adulthood and to examine the combined effect of desktop and cellphone ownership on the same outcome.
Methods:
Data from China Health and Retirement Longitudinal Studies cohort with 13457 community-dwelling adults aged 45 years or above in 2011-2012, followed for 4 years, with baseline measurement and two two-year follow-ups. Cognitive function was tested in baseline and two follow-up visits. A global cognition z-score was calculated based on two domains: word recall, mental intactness. The key independent variables were defined as whether one had desktops with internet connection at home and whether one had a cellphone. A additional categorical variable of three values was constructed as 0 (no desktop or cellphone), 1 (desktop or cellphone alone), and 2 (desktop and cellphone both). Mixed-effects regression was adjusted for demographic and health behavior as well as health condition risk factors.
Results:
Adjusted for demographic and health behavior as well as health condition risk factors, desktop/cellphone ownership were independently associated with decreased subsequent cognitive decline over the four-year period. Participants without desktop at home had adjusted cognitive decline of -0.16 (95% CI -0.18 to -0.15) standard deviations, while participants with desktop at home had adjusted cognitive decline of -0.10 (95% CI -0.14 to -0.07) standard deviations (difference of -0.06 standard deviations, p = .003). A similar pattern of significantly protective association of 0.06 (95% CI 0.03 to 0.10, p < .001) standard deviations between cellphone ownership and cognitive function was observed over the four-year period. Additionally, a larger longitudinal protective association on cognitive decline was observed among those with multiple digital devices, although the 95% CIs for the coefficients overlapped with those with single digital device alone.
Conclusions:
Findings from this study underscored the importance of digital devices as platforms for cognitively stimulating activities to delay the cognitive decline. Future studies focusing on use of digital devices are warranted to investigate their longitudinal protective factors against cognitive decline at mid- and later life. Clinical Trial: Digital Access
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