The associations between digital exclusion and physical or cognitive function in middle-aged and older adults: a systematic review and meta-analysis
ABSTRACT
Background:
Digital exclusion posed a significant challenge especially in middle-aged and older adults that affected their health outcomes. However, the evidence regarding to the effects of digital exclusion or Internet non-use on physical or cognitive function outcomes was controversial, and no systematic review had been performed to synthesize the pool effects.
Objective:
This study aimed to explore the relationship between digital exclusion or Internet non-use and physical or cognitive function in middle-aged and older adults.
Methods:
We conducted a systematic review and meta-analysis of cohort and cross-sectional studies including Chinese or English publications retrieved from PubMed, Embase, Web of Science, PsycINFO, Scopus, CNKI, and Wanfang databases up to August 31, 2024. The risk of bias was evaluated using the Newcastle - Ottawa Quality Assessment Scale (NOS). The pooled effect size was calculated based on odds ratio (OR), hazard ratio (HR), risk ratio (RR), and 95% Confidence Intervals (CIs). The present study was registered on PROSPERO (CRD42024585459).
Results:
Seventeen studies met the inclusion criteria, including 12 cohort studies and 5 cross-sectional studies, which had moderate to low risk of bias. The pooled analysis indicated that digital exclusion had prospective associations with decreased BADL (IRR=1.35, 95%CI=1.12-1.64, I2=94.7%, P<.0001) and IADL (IRR=1.46, 95%CI=1.13-1.89, I2=96.2%, P<.0001), incident disability (RR=1.25, 95%CI=1.09-1.43, I2=23.8%, P=0.2681), non-cross-sectional association with ADL (OR=1.23, 95%CI=0.41-3.73, I2=91.0%, P=.0009). There were prospective associations between digital exclusion and cognitive impairment (RR=1.44, 95%CI=1.33-1.56, I2=43.0%, P=.1184), dementia (HR=1.78, 95%CI=1.43-2.22, I2=0.0%, P=.6476), decreased MMSE scores (OR=1.96, 95%CI=1.39-2.75, I2=0.0%, P=.7320), as well as cross-sectional association with MMSE scores (OR=2.90, 95%CI=2.07-4.07, I2=0.0%, P=.3885).
Conclusions:
Our findings indicated the negative effects of digital exclusion on physical and cognitive functions. The results should be interpreted cautiously due to the presence of heterogeneity and publication bias.
Citation
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