Abstract
Introduction: The objective was to investigate the role of the digital divide in the association between diabetes and cognitive function among adults aged 50 and above. Methods: This study used pooled prospective data from four cohort studies across 31 countries: the Health and Retirement Study (HRS), English Longitudinal Study of Ageing (ELSA), Survey of Health, Ageing and Retirement in Europe (SHARE), and China Health and Retirement Longitudinal Study (CHARLS) from 2010 to 2018. A total of 107,188 participants aged 50 years old and above were involved. The mixed-effects linear regression models were used to analyze the data. To illustrate the cognitive function scores for diabetes and digital divide status, we used margin plots. Results: The presence of diabetes was found to be associated with a notable reduction in the global cognitive function score (unadjusted β = −0.27, 95% CI: −0.28, −0.25). Even after accounting for various covariates, this association remained statistically significant. Additionally, when adjusting for both covariates and digital divide, the coefficient slightly decreased. The presence of the digital divide was found to have a significant association with the decline in cognitive function scores related to diabetes. Specifically, the digital divide was shown to be statistically significant in its correlation with the decrease in global cognitive function scores for both individuals with and without diabetes (p = 0.015). Similar trends were observed in the scores for memory, numeracy, and orientation. Conclusion: These findings underscore the importance of addressing the digital divide to promote healthy aging. Developing digital interventions targeting diabetes-related cognitive impairments and fostering digital inclusion among older adults with diabetes hold significant value in preventing cognitive impairments associated with diabetes.
