Older Adults' Information and Communication Technology Use and Cognitive Function: An Investigation of the Underlying Mechanisms

Background. Dementia or severe cognitive impairment poses a significant threat to older adults’ successful aging. Older adults with dementia or severe cognitive impairment tend to have more difficulties in daily living activities and instrumental activities, more falls, more hospital stays, and higher mortality rates. In 2020, an estimated 6.07 million older adults were living with Alzheimer’s dementia in the United States, a number estimated to double in 2050 if there are no effective treatments. Previous studies indicate that information and communication technology (ICT) use has the potential to reserve and promote older adults’ cognitive function. However, the mechanisms regarding the associations are still unclear. Thus, this study aims to (1) assess the associations between ICT use and cognitive function, (2) investigate the potential mechanisms through four mediators, including loneliness, self-efficacy, depression, and physical activity, and (3) examine whether the mechanisms differ by age and gender.

Methods. The 2012 and 2016 biennial survey of Health and Retirement Study (HRS) and the 2013 Internet Survey from HRS were used for this study. A total of 1,509 participants aged 65 or older were included in the study sample (ICT user=760, non-user=749). ICT use was measured by three variables separately: ICT access/use, use frequency, and use breadth. Loneliness, self-efficacy, depression, and physical activity were four paralleled mediators. Multiple linear regressions were used to examine the associations between ICT use and cognitive function. Sequential path analyses were conducted to test proposed mediation models. Multi-group analyses were applied to assess age and gender group differences.

Results. All three indicators of ICT use were positively associated with cognitive function. The cognitive benefits of ICT use were mainly through a direct effect both among total participants and among participants in each age or gender subgroup. ICT use also affected cognitive function among all participants through two indirect paths: increased self-efficacy and decreased depression. The by-age multi-group analyses showed that in the older group, an indirect path through increased self-efficacy was significant and positive; in the younger group, an indirect path through reduced depression was significant and positive. The direct effects were not significantly different between the two age groups. The by-gender multi-group analyses revealed no indirect paths for men or women, whereas the direct effect of ICT use for women was significantly larger than the effect for men.

Discussion. Findings in this study highlight the direct positive effects of ICT use on cognitive function among older adults. The indirect effects are small, mainly through increased self-efficacy and reduced depression. Future ICT-based cognitive interventions should focus more on the direct stimulative effect of ICT. The age and gender group differences indicate that future interventions should be more tailored to participants’ age and gender. Accordingly, federal- and state-level efforts are needed to reduce financial, Internet service, and knowledge barriers and promote older adults’ ICT use.