Digital divide is amplifying cognitive disparities among the older population: a community-based cohort study in China

Objectives: To investigate the potential impact of the digital divide on individuals' cognitive function and its association with the development and reversion of mild cognitive impairment (MCI). Methods: This cohort study used data from Beijing Aging Brain Rejuvenation (BABRI) study applying a multistage cluster sampling design in 2008-2020. Analysis of Covariance (ANCOVA), mixed linear models, and Cox proportional hazards models were used to model the association of digital divide and multi-domain cognition. Results: Among the 10098 participants, nearly half of them (48.9%) failed to overcome the digital divide, resulting in the worse performance in processing speed (F=10.67, p<0.001). The causal model indicated that individuals' physical and mental health joint educational and occupational prestige affected the resource they achieved ultimately caused the digital divide. Moreover, longitudinal data revealed that both the elderly who successfully crossed the digital divide during the tracking process and those who had already done so prior to tracking showed significantly slower rates of decline in processing speed (B=-1.98, p<0.05; B=-2.62, p<0.01) and general cognitive function (B=3.50, p<0.001; B=3.13, p<0.01). Additionally, overcoming the digital divide also exhibited a lower risk of developing into MCI (HR=0.5;95% CI=0.34-0.74; HR=0.43;95% CI=0.29-0.62)and a greater probability of reversion from MCI to normal cognition (HR=6.00;95% CI=3.77-9.56; HR=9.22;95%CI=5.63-15.11). Conclusions: Overcoming the digital divide was significantly associated with better performance and lower aging rate of cognitive function, as well as a lower risk of developing into MCI and a higher probability of reversion from MCI into NC. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by STI2030-Major Projects (2022ZD0211600), the Natural Science Foundation of China (grant number 32171085 ), State Key Program of National Natural Science of China (grant number 82130118 ), the Fundamental Research Funds for the Central Public welfare research institution( ZZ13-YQ-073，Z0601) and Tang Scholar. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The current study was approved by the Ethics Committees of the State Key Laboratory of Cognitive Neuroscience and Learning in Beijing Normal University (ICBIR\_A\_0041\_002\_02). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Raw data of the Beijing Aging Brain Rejuvenation (BABRI) Project are available from the corresponding author on reasonable request. Restriction of raw data is to protect the privacy of participants.