Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 3, 2024
Date Accepted: Oct 28, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Digital divide is amplifying cognitive disparities among the older population: a community-based cohort study in China
ABSTRACT
Background:
The digital divide (DD) has emerged as a significant social issue to describe the inequality experienced by those who are unable to access the internet, especially the aging population. The potential impact of DD on their cognitive development is still unclear.
Objective:
To investigate the potential impact of the digital divide on individuals’ cognitive function and its association with the development and reversion of mild cognitive impairment (MCI).
Methods:
This cohort study used data from Beijing Aging Brain Rejuvenation (BABRI) study applying a multistage cluster sampling design in 2008-2020. Analysis of Covariance (ANCOVA), mixed linear models, and Cox proportional hazards models were used to model the association of digital divide and multi-domain cognition.
Results:
Among the 10098 participants, nearly half of them (48.9%) failed to overcome the digital divide, resulting in the worse performance in processing speed (F=10.67, p<0.001). The causal model indicated that individuals’ physical and mental health joint educational and occupational prestige affected the resource they achieved ultimately caused the digital divide. Moreover, longitudinal data revealed that both the elderly who successfully crossed the digital divide during the tracking process and those who had already done so prior to tracking showed significantly slower rates of decline in processing speed (B=-1.98, p<0.05; B=-2.62, p<0.01) and general cognitive function (B=3.50, p<0.001; B=3.13, p<0.01). Additionally, overcoming the digital divide also exhibited a lower risk of developing into MCI (HR, 0.5; 95% CI, 0.34-0.74; HR, 0.43; 95% CI, 0.29-0.62) and a greater probability of reversion from MCI to normal cognition (HR, 6.00; 95% CI, 3.77-9.56; HR, 9.22; 95% CI, 5.63-15.11).
Conclusions:
Overcoming the digital divide was significantly associated with better performance and lower aging rate of cognitive function, as well as a lower risk of developing into MCI and a higher probability of reversion from MCI into NC.
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