Relationship between digital exclusion and cognitive impairment in Chinese adults

Abstract

ObjectiveWe aimed to evaluate the relationship between digital exclusion, such as neither mobile payments nor WeChat use, and cognitive impairment in Chinese individuals aged 45 and older.MethodsA population-based cross-sectional study utilizing data from the fourth national survey of the China Health and Retirement Longitudinal Study (CHARLS). In the fourth wave of CHARLS, 10,325 participants aged 45 and older with complete information were included in this analysis. Self-reported mobile payments and WeChat usage constituted our exposure. Cognitive impairment was the primary outcome. Univariate and multivariate logistic regression were used to assess the relationships between cognitive impairment risk and digital exclusion.ResultsData were analyzed from 10,325 participants [mean (SD) age, 60.3 (9.1) years; 44.8% women], including 1,232 individuals with cognitive impairment and 9,093 cognitively normal individuals. The overall proportion of users who did not use either mobile payment or WeChat and those who only used WeChat were 81.3 and 6.7%, for cognitively impaired individuals 95.0 and 3.1%, and for cognitively normal individuals 79.5 and 7.2% [neither WeChat nor mobile payments vs. control unadjusted odds ratio (OR), 8.16; P < 0.001; only WeChat use vs. control unadjusted OR, 2.91; P < 0.001]. Participants who did not use either WeChat or mobile payments had an elevated risk for cognitive impairment after adjusting for a number of covariates (neither WeChat nor mobile payments vs. control adjusted OR, 3.48; P < 0.001; only WeChat use vs. control adjusted OR, 1.86; P = 0.021).ConclusionOur study reveals a positive correlation between digital exclusion and cognitive impairment in Chinese adults, providing insights for promoting active digital integration among older adults. Further longitudinal research is needed to further validate this hypothesis.

Digital exclusion and cognitive impairment in older people: findings from five longitudinal studies

“…In the subgroup analysis, the relationship between digital exclusion and cognitive impairment was not found to be more significant in any population. Previous studies have suggested that digital exclusion is more strongly associated with cognitive impairment in people over the age of 80 [ 10 ], but this study did not draw such a conclusion, possibly due to the small sample size of people > 80 years of age or confounding bias due to unmeasured covariates; therefore, follow-up studies are needed to confirm this. We also performed a subgroup analysis of digital exclusion and the three dimensions of cognitive impairment but did not find which population had a stronger relationship between digital exclusion and cognitive impairment.…”

“…Although previous studies have described the relationship between digital exclusion and cognitive impairment [ 10 ], this study was only conducted in an elderly Chinese population and does not necessarily apply to older adults globally. Our study is one of the first to examine the relationship between digital exclusion and cognitive impairment in a global sample of older adults.…”

“…Older adults with access to the Internet are more likely to obtain more information and communication resources from the network environment, for example, older people can obtain and understand the latest health management information through the Internet, purchase medicines and health products, and the Internet also provides opportunities for older people to consult health professionals in a timely manner and real-time data monitoring, thus obtaining greater cognitive benefits and improving cognitive function [ 9 ]. Digital exclusion was associated with cognitive impairment and all three dimensions of cognitive impairment, suggesting that it is a potential risk factor for overall healthy functioning in older adults [ 10 ]. Second, Internet use may impact cognitive function by affecting pallidum volume.…”

“…Lu et al [ 9 ] explored the relationship between digital exclusion and functional dependence in five cohorts, suggesting that older people excluded from the Internet are more likely to develop functional dependence, regardless of whether they live in high-income or lower-middle-income countries. In addition, Liu et al investigated the impact of digital rejection on cognitive impairment in Chinese adults and found a positive correlation between digital rejection and cognitive impairment in Chinese adults [ 10 ]. However, the study’s participants were limited to the Chinese population, the results cannot be extrapolated to other countries, and the CHARLS database includes four waves of data, but the authors only used data from the fourth wave, ignoring the first three waves.…”