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Updated: Jul 7, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Digital exclusion, functional limitations transitions, and life expectancy: a multinational longitudinal study.

Qian Liu^1,2, Fan Yang^1,2

¹School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China.

SSM - Population Health

|July 6, 2026

Summary

Digital exclusion significantly worsens functional limitations and reduces life expectancy globally. These impacts are most pronounced in younger adults, highlighting the need for digital inclusion in aging policies.

Keywords:

Digital exclusion Functional limitations Healthy aging Life expectancy Multi-state Markov model

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Last Updated: Jul 7, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Area of Science:

Gerontology
Public Health
Sociology

Background:

Digital exclusion, defined as lack of access to or skills for using digital technologies, is a growing concern for aging populations.
Understanding its impact on health and longevity is crucial for developing effective public health interventions.

Purpose of the Study:

To examine the associations between digital exclusion and transitions in functional limitations among older adults.
To quantify the impact of digital exclusion on life expectancy across diverse international settings.

Main Methods:

Analysis of 124,332 adults aged ≥50 years from five harmonized longitudinal aging cohorts across 23 countries.
Utilized continuous-time multi-state Markov models to assess transition patterns between functional states (independence, mild, severe limitations).
Calculated life expectancy, including functional life expectancy, using numerical integration of model parameters.

Main Results:

Digital exclusion was significantly associated with adverse transitions to mild and severe functional limitations.
Recovery from severe limitations was impaired in several countries, including England, the United States, and Europe.
Digital exclusion reduced functional life expectancy by 3.72 to 14.27 years and total life expectancy, with the largest reductions observed at younger ages.

Conclusions:

Digital exclusion is linked to increased functional limitations and decreased life expectancy in older adults.
The impact of digital exclusion varies by country and is most significant among younger age groups.
Integrating digital inclusion strategies into healthy aging policies is essential, alongside maintaining accessible non-digital healthcare options.