Association between digital exclusion and cognitive function among older adults: The serial mediating role of social...

Cognitive function is a critical concern in older adults, and digital exclusion may accelerate its decline. However, the underlying mechanisms remain unclear. This study examined the serial mediating roles of social participation and depressive symptoms in the association between digital exclusion and cognitive function.

7806 participants aged ≥ 60 years from the China Health and Retirement Longitudinal Study were included in the study. Cognitive function was assessed using the Mini-Mental State Examination, while digital exclusion was operationalized through internet access and usage. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, while social participation was characterized by engagement in nine activities. Serial mediation analyses were conducted using the SPSS PROCESS macro, controlling for significant covariates.

After adjustment for covariates, digital exclusion was significantly associated with poor cognitive function. The indirect effect was significant (B = -0.964, 95% Confidence Interval [CI]: -1.175, -0.755), accounting for 77.68% of the total effect, whereas the direct effect was not statistically significant. Social participation was the main mediator (B = -0.869, 95% CI: -1.075, -0.755), followed by depressive symptoms (B = -0.061, 95% CI: -0.109, -0.019). A significant serial mediating effect of social participation and depressive symptoms was also observed (B = -0.034, 95% CI: -0.057, -0.016).

Social participation and depressive symptoms act as significant serial mediators between digital exclusion and cognitive function in older adults. The findings underscore the relevance of psychosocial well-being in the relationship between digital exclusion and cognitive health in later life.