JMIR Publications

ABSTRACT

Background:

Cognition disorders not only lead to adverse health consequences but also contribute to a range of socioeconomic challenges and diminished capacity for preforming routine daily activities. In the context of the digital era, this study aimed to explore the potential correlation between digital exclusion and subsequent risk of cognitive decline in developing countries.

Objective:

This study aims to evaluate the association between digital exclusion and cognitive function among elderly populations in developing countries.

Methods:

This study utilized data from two large, representative national datasets: the China Health and Retirement Longitudinal Study (CHARLS) and the Mexican Health & Aging Study (MHAS). Digital exclusion was defined as self-reported absence from the internet. Cognitive assessments were conducted in five domains: orientation, immediate verbal recall, delayed verbal recall, serial 7s, and figure recall.

Results:

A total of 24065 participants in CHARLS and MHAS were included. After adjusting for confounding variables, individuals with digital exclusion were more likely to display worse cognitive performance compared with others in both CHARLS (OR 2.04; 95% CI, 1.42 to 2.99; P<.001) and MHAS (OR 1.40; 95% CI, 1.26 to 1.55; P<.001). Gender and age did not significantly modify the relationship between digital exclusion and worse cognition (P of intervention>.05). The fully adjusted mean changes in global cognitive scores between the two groups were 0.98 (95% CI, 0.70 to 1.28; P<.001) in CHARLS and 0.50 (95% CI, 0.40 to 0.59; P<.001) in MHAS cohort.

Conclusions:

There is a substantial proportion of older adults who are excluded from the internet, especially those in China. Our findings indicated that older individuals with digital exclusion were associated with an increased risk of poor cognitive performance in developing countries. Interventions for promoting internet access could potentially mitigate this risk.