The Critical Moderating Role of Cognitive Function in Digital Inclusion: Data Analysis Study on Depression Risk Among...

Digital inclusion has become increasingly important in promoting healthy aging, yet its association with mental health among older adults appears complex and heterogeneous. The role of cognitive function as a moderator and the underlying mechanisms remain understudied.

This study aims to examine cognitive function's moderating role in the relationship between digital inclusion and depression risk among older adults, and to investigate multiple pathways of association.

Using data from the 2020 wave of the China Health and Retirement Longitudinal Study, we analyzed 18,673 adults aged 60 years and above (mean age 68.4 y, SD 6.5; 50.8% male participants [n=9486], 49.2% female participants [n=9187]). We constructed interaction effect models to test the moderation hypothesis and employed path analysis with bootstrapped 95% confidence intervals (2000 iterations) to investigate multiple pathways through which digital inclusion is associated with depression.

Cognitive function significantly moderated the digital inclusion-depression relationship (β=-.002, P=.03). The association was not statistically significant at low cognitive function (β=-.137, P=.33) but strongly protective at high cognitive function (β=-.517, P<.001), revealing a "cognitive threshold effect." Path analysis identified 3 significant pathways: direct effects (66.7% of total effect), cognitive enhancement (8.3%), and social participation (8%). Importantly, higher digital inclusion was not found to be associated with increased depression risk at any cognitive function level.

Our findings suggest that older adults require adequate cognitive resources to derive mental health benefits from digital participation, though no harmful effects were observed at lower cognitive levels. This asymmetric pattern has important implications for designing cognitive-informed digital inclusion programs that integrate digital skills training with cognitive enhancement strategies for promoting mental health in aging populations.