Effects of Digital Device Ownership on Cognitive Decline in a Middle-Aged and Elderly Population: Longitudinal Observational Study

Abstract

Background Cognitive decline is a major risk factor for disability and death and may serve as a precursor of dementia. Digital devices can provide a platform of cognitively stimulating activities which might help to slow cognitive decline during 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 was obtained from a China Health and Retirement Longitudinal Studies (CHARLS) cohort made up of 13,457 community-dwelling adults aged 45 years or above in 2011-2012. They were followed for 4 years, with baseline measurements taken as well as 2 two-year follow-up visits. Cognitive function was tested during the baseline test and follow-up visits. A global cognition z-score was calculated based on two domains: word recall and mental intactness. The key independent variables were defined as: whether one had desktops with internet connection at home and whether one had a cellphone. An 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 and cellphone ownership were independently associated with subsequent decreased cognitive decline over the four-year period. Participants without a desktop at home had an adjusted cognitive decline of –0.16 standard deviations (95% CI –0.18 to –0.15), while participants with a desktop at home had an adjusted cognitive decline of –0.10 standard deviations (95% CI –0.14 to –0.07; difference of –0.06 standard deviations; P=.003). A similar pattern of significantly protective association of 0.06 standard deviations (95% CI 0.03-0.10; P<.001) 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 both of the digital devices, although the 95% CIs for the coefficients overlapped with those with a single digital device alone. Conclusions Findings from this study underscored the importance of digital devices as platforms for cognitively stimulating activities to delay 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.

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“… 36 38 For learning activities, studies showed that internet use provided important platforms for cognitively stimulating activities to delay cognitive decline. 24 Learning activities may generate a cognitive reserve buffer that promotes resilience to prevent or delay the development of cognitive impairment. 39 Our results underscored the importance of attending different types of social engagement for delaying the process of cognitive impairment.…”

“…In the CHARLS Survey, cognitive function was measured through a global cognitive function score based on two aspects of cognitive functions: episodic memory and mental intactness. 24 25 For episodic memory, each participant was asked to repeat as many as possible 10 Chinese nouns just read to him/her (immediate word recall), and then to recall the same 10-word list 5 min later (delayed recall). Answers to these questions were aggregated into a single episodic memory score ranging from 0 to 20.…”

“… 26 In addition, previous study had confirmed that the global cognitive function score demonstrated satisfactory validity and reliability among Chinese middle aged and older adults. 24 25 According to the previous studies, respondent who scored from 0 to 6 were classified as a person with dementia, and 7 to 11 were classified as CIND. 27 28 In the present study, a score of 11 or less was used as a cut point for having cognitive impairment.…”

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