The association between internet non-use and multidimensional frailty in older adults: a three-wave cross-sectional study from 2004 to 2021

This study examined the association between frailty and internet (non-)use, using representative data - collected between 2004 and 2021 - of community dwelling people aged 60 and older living in Flanders, Belgium (N = 43,048). Multidimensional frailty was measured by the Comprehensive Frailty Assessment Instrument (CFAI), which is a reliable and valid instrument to assess physical, psychological, social and environmental dimensions of frailty. Internet use was dichotomised into users and non-users. Multivariable regression analyses revealed that the physical domain is the most strongly related frailty factor to internet (non-)use, and this has been a constant trend since 2004. Those in the high physical frailty group have the highest probabilities of being non-user and are up to 8.0% more likely to be non-user than those in the 'no-low' physical frailty group. Future research should investigate how human-technology interaction can be improved and make internet technologies more manageable for physical frail older adults. However, average marginal effects indicate that sociodemographic variables are more strongly related to internet (non-)use than frailty domains. This result shows that internet non-use in older people is multifactorial in origin and not only attributed to their frailty status.